A practical treatise on the bilious remittent fever; its causes and effects

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PRACTICAL TREATISE

ON THE

WITH ILLUSTRATIVE TABLES AND CASES, ON THE TEMPERATURE OF THE SYSTEM IN THE FEBRILE DISEASES OF JAMAICA.

TO WHICH IS ADDED,

MEDICAL TOPOGRAPHY OF THE DIFFERENT MILITARY STATIONS IN THAT IMPORTANT COLONY.

FELLOW OP THE ROYAL COLLEGE OF PHYSICIANS, MEMBER OP THE WERNERIAN SOCIETY, EDINBURGH, &C. &C.

LONDON :

JOHN CHURCHILL, PRINCES STREET, SOHO.

ITS CAUSES AND EFFECTS.

BY W. ARNOLD, M. D.

MDCCCXL.

PRINTED

LONDON I

BY IBOTSON AND SAVOY STREET.

VALMER

TO

SIR JAMES M'GRIGOR, BART.

DIRECTOR-GENERAL OF THE ARMY MEDICAL DEPARTMENT, &C. &C. &C.

Sir,

Conscious as I am of the solicitude you have ever evinced for the health of her Majesty's land-forces in every part of the kingdom, but more particularly in the East and West Indies, I am gratified in being permitted to prefix your name to a work which has for its chief object the laudable attempt to preserve the lives of that force which achieved for England a peace of twenty-five years.

The very flattering manner in which you have been pleased to express your opinion of my endeavours, is not to me more gratifying than is the honour which I confer on myself by inscribing this volume to so respectable a name — a name associated with every benefit which has been obtained for the men&bers of that department which is placed under your guidance ; and with much sincerity I subscribe myself

Your faithful and obliged Servant,

W. ARNOLD, M.D.,

Fellow of the Royal College of Physicians, Member of the Wernerian Society, Edinb. &c. &c. &c.

Preface

The following observations comprise a period of twenty-five years, the accuracy of which may be relied upon, both as regards the medical and philosophical remarks, of the vicissitudes of the seasons, the prevailing diseases in each year, and the peculiar character of the several epidemics during the period.

A brief analysis of each year's observations will serve to explain the changes of the seasons, and how far the diseases are influenced by those changes.

Close personal observation for so many years of the various phenomena connected with the diseases of a tropical country could not fail to present to an inquiring mind a rich mine of materials ; and, in offering the result to an enlightened public, I only claim the merit of being actuated by the laudable desire to preserve the lives of my fellow-creatures in a climate which has acquired the name of being exceedingly hostile to the health of Europeans.

I commenced the task unassisted, and without reference to any author ; for I cavil not with the opinions of others.

Vi

PREFACE.

I desired only to satisfy my own mind correctly of the nature and causes of the diseases incidental to Europeans, as well as of the nature and causes of the indigenous fever, the great scourge of life of Jamaica. I was not a little perplexed, in my early career, to witness amongst practitioners such a discrepancy of opinion relative to the treatment of this formidable enemy of mankind, each party advocating doctrines diametrically opposite. One party assailed the foe with the lancet indiscriminately. The other party with more subtilty attacked the citadel with poison, and gave their favourite mercury with prodigal liberality.

Surrounded by no common order of difficulties, when men of long standing and ability marshalled such forces to the fight — unable as I was at that time to say who was right — I determined to act with caution, to make nature my guide, to watch her works in all and every way, to separate cause from effect ; and whilst reasoning thus, I sought to uplift the veil which screened the truth from my view.

I accordingly adopted the plan of keeping a diurnal registry, in which I recorded the changes in the temperature of the weather ; the peculiarities of the diseases witnessed and treated, whether assailing the European, the various castes of Creoles, or the black inhabitants ; and I sought also to inquire how far the changes in the temperature of the atmosphere had influence over the diseases, and if the changes observed in the diseases could be ascribed to such changes.

The preliminary experiments on the temperature of the system were instituted for the purpose of ascertaining the

PREFACE.

vii exact temperature of every class of residents in the island, in a state of health, and under the various circumstances which are mentioned.

The cases on temperature of the system in the febrile diseases will then follow; for I have considered this symptom to be one of the most formidable with which we have to combat in the treatment of the bilious remittent fever, no matter where we may meet it : believing, as I do, that the system when labouring under this disease must inevitably give way to the cause which produces even a few degrees of thermal exaltation beyond 105° of Fahrenheit's scale, and that all our remedies will have little effect if we find it 110° during the first or the second stages.

I may here remark, the greater number of cases given in illustration of this fact, in the course of the work, were males, for the most part patients treated in the military hospital under my charge, at different periods, for a great many years.

I must also claim the medical reader's attention to the remarks relative to the treatment of females when assailed with this disease in civil life, as being in every respect essentially different in every stage.

The concluding aphorisms will enable the reader to form a just estimate of the admonitions on this head.

The medical topography, it is hoped, will not be found the least interesting portion of the work.