The Milroy Lectures : On epidemic influences; on the epidemiological aspects of yellow fever; on the epidemiological aspects of cholera / by Robert Lawson.

Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: The Milroy Lectures : On epidemic influences; on the epidemiological aspects of yellow fever; on the epidemiological aspects of cholera / by Robert Lawson. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    Bermuda rose to 14‘3 per 1,000 from 3‘0 in 1820, and in Canada it was 2‘8 per 1,000, having been O'G only in 1820, and yellow fever showed itself at Baltimore, and Norfolk Virginia. In 1821, the second year of the wave in the Mediterranean, there was a severe epidemic of yellow fever at Barcelona, while it continued at other points, and fever among the troo]3S in the Ionian Islands caused a mortality of 24'7 per 1,000. In like manner in 1822 yellow fever was seen at New York, and in Nova Scotia the millesimal rate of deaths from fever among the troops was 1*9, there having been no death from this cause in 1821. The next wave to be noticed can be followed from the Cape to this country. The millesimal ratio of deaths from fever among the troops at Cape Town in 1822 was 2’2, there having been no death from it the previous year; the returns for the frontier, which were rendered in 1822 for the first time, showed a ratio of 4’8, which fell the following year to 1’7. At Mauritius, there was no death from fever among the troops in 1822. I have no infor- mation as to the prevalence of fever under this wave south of the equator in 1823, but there was a severe outbreak of yellow fever at Ascension in 1823, under the second year of the preceding one, when that disease was epidemic at Sierra Leone under its first year. In 1824, the wave would pass the isoclinal 0°, and in Ceylon, the deaths among the troops from fever were 104‘9 per 1,000. The first Burmese war commenced this year, and the troops in the field there suffered very severely from fever and dysentery, and that form of fever called dengue appeared. The Ashantee war in the vicinity of Cape Coast Castle, which is in the same zone as the Burmese territory, took place in 1824, and here, also, there was excessive mortality from fever and dysentery among those exposed in the field. In 1825, the wave reached the isoclinal 30° north, the fever continued among the troops in the Burmese territory, and dengue spread along the valley of the Ganges, from Calcutta. This year, a considerable force of white tliough following immediately on that of the previous year, was evidently due to llie extension of the succeeding wave under which the severe outbreak in Jamaica luid occurred the previous year. This following up of the outbreaks under one wave by tliose of the following one is not infrequent in epidemics, masking their true relations, and prolonging the apparent duration of the epidemic to two, three, or four years. Under such circumstances when the more powerful wave is followed by a feebler one the disease culminates in the first pei’iod, and diminishes gradually over the second, and on the other hand when the wvaker o!ie precedes the stronger the disease seems to rise gradually, attaining its highest point in the third or fourth year.