Volume 1

The modern practice of physic : exhibiting the symptoms, causes, prognostics, morbid appearances, and treatment of the diseases of all climates / by Robert Thomas.

  • Robert Thomas
Date:
1853
Catalogue details

Licence: Public Domain Mark

Credit: The modern practice of physic : exhibiting the symptoms, causes, prognostics, morbid appearances, and treatment of the diseases of all climates / by Robert Thomas. Source: Wellcome Collection.

    27/792 (page 11)
    Paroxysmal fevers attack the feeble and dispirited, the ill fed and ill clothed, rather than those who are more favourably circumstanced; but they belong rather to the open country than to towns, and when they visit these last it is in the wide and open streets, the abodes of wealth and luxury that they make their attacks, while they spare the closely crowded but filthy dwellings of the poor. As regards Rome, Dr. Macculloch has remarked that malaria must there be imported, not generated *; while he says in another place, that its progress through that city appeai-s to be determinate if slow, so as gradually to drive the inhabitants before it, as far at least as these are opulent and able to quit their unhealthy habita- tions, since not only does poverty check the migration of the lower classes, but their crowded streets are far less affected by this poison than the dwellings of the rich.f The Judaicum (he adds farther on), which might be expected to suffer as well as the streets around it, is always, as I am informed,—generally, may at least be believed, — free from the diseases in question ; and what the confinement and filth of that place is, needs not to be stated to those who know Rome even by reading. ^ Of continued fever (the typhus or synochus of authors), the generally received though not the universally admitted cause is a contagion, or morbid poison, transmitted from the sick to the healthy, in uninterrupted succession, but incapable of reproduction from any other source. Its prevalence and severity are favoured by a temperate or cold climate, whence its fatality is greatest in northern latitudes, while it is rare or unknown within the tropics; winter, too, and spring, rather than summer and autumn, are the seasons of its greatest predominance. Although its course is liable to be prolonged by various incidental but very frequent inflam- matory complications, its natural duration may be considered as definite for the same epidemic, however different in those of different years. In respect of its cause, as we have just stated, it presents a close analogy with the eruptive rather than with paroxysmal fevers; like them, too, it has been observed often to present a characteristic rash, although this is neither so constant in its appearance, so uniform in its character, or regular in its progress, as those of the exanthemata. In typhus, as in eruptive fevers, a first attack affords some protection against a future one; but no habituation to the poison defends those who have long watched or tended the sick from themselves becoming victims; there is no evidence of any thing like the acclimation which modifies the liability to remittent or intermittent fevers. To have lived for a time unscathed in the atmosphere of typhus, affords no certainty to the physician or to the nurse of an ultimate escape. Typhus again, unlike paroxysmal fever, has so distinctly for its favourite abode the crowded, ill ventilated, and ill drained dwel- lings of the poor, surrounded as they often are by stinking mud and every variety of filth, that some have found an explanation of * An Essay on Malaria, p. 2JH. f Ibid. p. 253. | Ibid. p. L>!>1>.