fevers, continued to prevail throughout the greater part of the month of October; but as the season advanced, diseases of an inflammatory nature appeared, and owing to the sudden and frequent changes of weather, and the great quantity of rain with which both city and country have been deluged, they have been more than usually prevalent during the last two months. Accordingly, catarrh, pleurisy, peripneumony, and rheumatism make up the greater part of the catalogue of our diseases during the period mentioned.

But in the weekly obituary, we continue to observe consumption at the head of the list. Notwithstanding the boasted ptisans of lichen islandicus, alcornoque, and other remedies industriously recommended as specifics in consumption, this disease in most cases still obstinately resists the best efforts of our art.

We have also had occasion during the last three months to record many cases of apoplexy and palsy. For the most part they occurred in advanced life; but in some few instances these diseases also attacked persons between thirty and forty years of age. In the latter cases they were manifestly induced by general plethora of the sanguiferous system, the effect of free living and want of exercise. Bloodletting, purging, blisters, and abstinence have been the remedies most successfully employed. We cannot however but remark, that we have witnessed much injury from the very copious and repeated bleedings that are prescribed by many of our practitioners, in these diseases: even in the most athletic habits, such sudden evacuations and consequent prostration of the powers of life, cannot be justified either by reasoning or practice. The timid conduct of others, who object altogether to evacuations

by the lancet in those diseases when they occur at an advanced period of life, is equally to be reprobated. Although the system may be debilitated by age, it should be recollected that the secretions are also impaired from the diminished exercise at that period of life, and that an accumulation takes place in the larger vessels especially in the venous system. Where this plethora manifests itself in the brain by producing a general disinclination to motion and propensity to sleep, inability to articulate distinctly, or a sense of numbness in the extremities, which symptoms not unfrequently precede a fit of apoplexy or palsy, the lancet should be employed, followed with moderate evacuations by the bowels. But in such cases we have had reason to observe that they are too frequently neglected.

Convulsions, according to our public records, have also been attended with more than usual mortality during the last three months. In our private practice we have had occasion to witness many cases of this disease; but in those cases the convulsions readily yielded to the use of laudanum and the warm bath, administered during the paroxysm. These were succeeded by the use of such other remedies as the probable nature of the cause producing the disease appeared to point out: viz. the free division of the gums when inflamed and distended by teething; the evacuation of the stomach and bowels when the irritation appeared to originate in the intestinal canal; and in cases of worms, by the use of elixir proprietatis, occasionally administered as a laxative, followed by a course of chalybeates.

To Correspondents. Communications have been received from Col. Williams, Dr. H. U. Onderdonk, Dr. Arnell, Mr. Spafford, Dr. W. Currie, Mons. Magendie, and Dr. Delile but are necessarily postponed

Erratum. In Dr. Hosack's paper on Cnicus Arvensis, in second number, page 212, line 7, for Professor Willdenow, read Persoon.

THE

AMERICAN

MEDICAL AND PHILOSOPHICAL

REGISTER.

APRIL, 1811.

ORIGINAL COMMUNICATIONS.

I.

AN ESSAY on the Nature and Cause of the MALIGNANT PLEURISY, which proved so remarkably fatal to the inhabitants of Huntington, and some other places on Long Island, in the winter of the year 1749. Drawn up at the request of a weekly society of gentlemen in NewYork, and addressed to them at one of their meetings, January, 1749. By the late Dr. JOHN BARD.*

GENTLEMEN,

OF all the objects of physical knowledge, there are none more amazing, or that afford a more useful speculation, than the history of epidemical diseases; a right

*

Believing a copy of this essay of Dr. J. Bard to be in the possession of some of his friends, we, in a former number of the Register, expressed a wish to obtain the manuscript of it for publication. Through the polite attention of Dr. David Craig, a pupil of the author, and now a practitioner of medicine in Rahway, New-Jersey, we lately received an entire copy of the essay; besides two other original letters on philosophical subjects, by Dr. J. Bard and Lieutenant Governor Cadwallader Colden. EDITORS.

knowledge of these is of the utmost importance to the improvement of the medical art, and, consequently, to the benefit of mankind.

By epidemical diseases are meant general or spreading disorders, attacking great numbers within the circle of its appearance, at or near the same time, proceeding from a contagious affection of the air, and sometimes propagated by contagion received from one by another person unaffected; of this kind is the disorder now prevailing on Long-Island, the subject of our present examination.

That we may proceed on this inquiry in a regular and intelligible manner, I shall beg leave to premise a few maxims relating to the nature of epidemical diseases in general, first discovered, or at least received in Europe by the incomparable Sydenham, and since established by the authority of the learned and industrious Boerhaave, and clearly evident to every diligent observer engaged in the practice.

:

First, then, the remote causes of these disorders are entirely inscrutable by us, and the attempting to account for all their phenomena from the sensible qualities of the air, or particular systems of philosophy, is altogether vain and fruitless their sensible appearances, however, are reducible to fixed and certain laws, considered either with regard to the relation they bear to one another, the regular rise, progress, height and declension of a whole epidemical constitution, of one particular season, a year or years; or the rise, progress, height and declension of the symptoms which make up the history of any particular disease; their tendency at the vernal or autumnal equinoxes,

(at which seasons they are generally most prevalent,) and many other particulars which experience and observation have established as unquestionable maxims.

These inquiries, formed upon a just knowledge of the animal economy and the history of diseases, the assistance of Dr. Harvey's discovery of the circulation of the blood, unknown to the ancients, together with other improvements which had at that time been made in physical learning, engaged the indefatigable application of this great and sagacious man, particularly for the last fifteen years of his life; in which time he compiled a most accurate and complete history of the acute and epidemical diseases, which prevailed in his time and country, and has communicated his observations to the world with the utmost faithfulness and candour.

The epidemical fevers which prevailed in the city of London, during his observation and practice, he distinguishes into what he calls stationary and intercurrent, the intercurrents he again divides into essential and symptomatical. By a stationary fever he means a regular, simple, stated epidemical fever, arising not from any of the sensible qualities of the air, or an error in the non-naturals, (he having observed that years perfectly agreeing as to the manifest temperature of the air, have nevertheless produced very different tribes of diseases, and vice versa,)*

* The variety of symptoms observable in epidemical distempers are so obscure, that physicians have not been able to deduce them from any abuse of the non-naturals, and yet there are many circumstances which make it highly probable that their causes reside in the air, but depend more upon the inexplicable variety of exhalations contained therein, which by their mixture with the fluids of the hu