disposing of some of their superfluous stock. From the moment they entered the house, Mary seemed to eye them with a kind of melancholy attention. She made signs to her father to insist upon their remaining all night, and seemed very urgent that they should occupy her bed. They, however, paid no attention to the “dumb wean's" whims, but set out on their journey homewards. They had no sooner left the house than Mary burst into tears. She made a hole in the ashes on the hearth similar to a grave, and intimated, by her cries and gestures, that the hour of these two men was at hand. About a mile from the house of Mary's father, they had to cross a river, and, as she had foretold, the passage-boat was overset by a sheet of floating ice, and they were both drowned. The actions of the dumb girl had such an effect upon her father and his friends, that they, fearing some accident was to befall their acquaintances, left the house and followed them with the intention of prevailing upon them to return back; but, though they made every possible haste, they only reached the banks of the river to witness the last struggles of the unfortunate sufferers, and to assist in searching for their lifeless bodies. Such is the tale we have often been told by one who was a witness to the whole circumstances, and who, as long as Mary was in life, was a firm believer in her supernatural powers.

which is often inseparable from them, but also on account of positive bad effects which may arise either from spreading unnecessary alarm through the country, or from misconceptions of statements or misapplication of instruction by the half informed.

Popular medical instruction should be confined to what may be called preventive medicine, or a knowledge of the means of preventing disease, and checking it at its first approach, and to the correction of vulgar errors. For a Magazine occasional communications of this kind are well fitted, when there is reason to dread the introduction of a contagion, or during the prevalence of an epidemic, or when a hurtful practice is generally adopted. But to write a monthly or quarterly report of the diseases prevalent in Edinburgh, or any other large city, would be a task indeed, utterly useless, or worse than useless. The state of health in Edinburgh varies with the season, with the abundance or scantiness of the means of subsistence, with the introduction of a contagion, and some other general circumstances. But still that diversity is not such as to furnish matter for a series of popular reports for a succession of years. They would soon become uniformly uninteresting, or at least a mere repetition of what was formerly written, or would be filled with irrelevant and inappropriate discussions. I am aware, that, in opposition to this opinion, the admirable reports of Dr Willan upon the diseases of London may be quoted, which were inserted in the

FEVER IN EDINBURGH.

MR EDITOR,

I SHOULD Very willingly comply with your request to contribute a periodical report upon the diseases prevalent in Edinburgh, if I considered myself competent to the discharge of such a task, and if I could satisfy myself that such a report would be either useful or fit for a Magazine, which is intended for general readers. I am very far from thinking that the profession should be wrapt up in mystery, or that all access to some acquaintance with its principles should be denied to the general reader. But much discretion must be used in introducing medical discussions into a popular work, not only on account of the indelicacy

cess, that every Magazine now must have its medical report. But every physician is not a Dr Willan, and, accordingly, the effusions of many of his followers or imitators, are romances, dreams, or any thing but a true report of the diseases of the city which they profess to describe. To this censure there are certainly some honourable exceptions, but they are written for the profession, not for the public. The fact is, Dr Willan wrote for the profession, and his reports, collected into one volume, have become a valuable addition to the library of the physician. But even Dr Willan did not write a report of the diseases of London, but only of his own practice in the General Dispensary and in private, and this is all that any reporter

can write from his own knowledge; so that a very different view of the diseases of the same place and period may be given, as the reporter is a person of great experience, and sees nothing unusual in the present times, is in practice in high or low life, or is an active practitioner attached to an Hospital or Dispensary, or writes from books more than from patients.

After such a preamble, it may seem inconsistent to send you a professional communication; but at present I wish to correct some vulgar errors, and to disseminate, through the medium of your Magazine, some precepts of preventive medicine.

A considerably greater degree of alarm has been spread among the higher classes of society, concerning the prevalence and danger of a fever in Edinburgh, than I think is necessary or well-founded; and, on the other hand, the lower classes are, as usual, too indifferent about the means of preventing it. The subject suggests a few questions, which I shall endeavour

lent at present than in past years;-the greater attention paid to the state of the sick poor, both by the Dispensaries rivalling each other in doing good, and the increased exertions of theactive and humane Society for relieving the destitute sick. The consequence is, that almost every case of fever is brought to light, and is made a subject of conversation and remark in the circles of our active philanthropists. Next, the sick are no sooner discovered than, very properly, they are furnished with recommendations for admission into the Royal Infirmary, and advised, and often reluctantly induced to go to that useful asylum, which, we are happy to be informed, has, up to this time,* received every fever patient who has come to the waiting room, although, from the extraordinary exertions in sending in patients, it would not be wonderful if their accommodation and funds should have proved insufficient. From this cause, therefore, it is possible to account for the greater number of fever patients which have been received into the Royal Infirmary du ring the last twelve months, without any actual increase of the frequency of fever in Edinburgh. It is well known to practitioners, that this city is never altogether free from continued fever; that it is always lurking in the

Since

This was actually the case when this report was drawn up. But on the 25th of October the female wards were quite filled, and it was necessary to refuse the admission of a girl labouring under fever. that time, however, fever patients have been almost daily admitted and none refused. Several wards, besides the usual fever wards, have been appropriated to fever cases, and every exertion made to meet the pressure. It must also be remarked, that it has frequently been very difficult or impossible to dismiss the convalescents when they became no longer proper objects for an infirmary, especially the Irish and other strangers, from the total indigence of many of them, and their inability to work, so as to gain the means of even a scanty subsistence. In some instan. ces, also, patients were detained a few days longer in the hospital, in consequence of the Society for relieving the destitute sick being engaged in cleaning and purifying their houses.

+ The same may be said of almost every large town. In proof of this, we refer to the Report of the Fever Hospital in Dub

narrow closes and lodging houses of the poor; and that, from time to time, it has always increased to a lamentable degree of frequency. But formerly a very small proportion of the unhappy sufferers by it thought of going to the hospital, and there was no organized society for sending them in. For more than twenty years I have known continued fever always to exist, and often to a very great degree, in Portsburgh. I have examined the district, by the desire of the gentle men connected with the House of Industry, with a view to get some of the dunghills removed, and found fever in almost every house. Upon one occasion, I remember visiting a close where almost every individual was ill, and in one house I found seven children affected, the father having gone to the hospital, where he died, and the mother only able to be out of bed, with the precursory symptoms upon her, and not a neighbour able to lend assistance; and yet, upon these occasions, the public in general heard nothing of the prevalence of fever. The knowledge of the misery it occasioned was confined to the attending practitioners and a few active philanthropists. In spring 1816, every one of the children in the West Kirk poorhouse, about 160, was attacked with fever, of whom two died, and between 30 or 40 of the aged poor, of whom more than a third died, yet its existence was scarcely known, except to the managers and officers of the charity. In the autumn of 1816, every child in the City Charity Work-house, 200 in number, was affected with fe

ver, none of whom died, and about fifty other individuals belonging to that institution, of whom about one in twelve died. But, during this present season, not one person in either of these extensive asylums for the poor has been affected; nor, so far as I have been able to learn, has fever occurred in any other of the public institutions in which numbers of individuals are collected together for the education of the young, or for the relief of the aged. Therefore, from the mere increased number of admissions to the hospital, I would not positively conclude that there was an increased pre

valence of fever.

Another reason why the public believe that fever is more prevalent is, that it has caused several deaths in the higher classes of society. This mortality is, I believe, extraordinary, and, so far as I can learn, during the present year, a larger proportion of deaths than usual has taken place among the rich, not only in Edinburgh, but all over the kingdom, and every death in this rank of society is known, and excites general lamentation and fear. But occasionally fever has been prevalent to a considerable degree, especially among the students of medicine. The present Professor of the Practice of Physic in the University mentions, in his lectures, an epidemic of this kind, which was the reason why the clinical lectures were transferred from the hospital to the University; and when I was student it prevailed epidemically among us for two successive years, in one of which upwards of thirty students and three clinical clerks, of whom I was one, were seized within a short time. In one year eleven medical stu

admitted were in

parable in extent has occurred among the students this year. I do not, however, mean to deny that fever has been, and still is, rather more prevalent than usual. I only wish to state my reasons for thinking that it is generally believed to be much more prevalent than it really is.

Is the continued fever at present in Edinburgh more malignant or severe than usual? To this question I am happy to be able to answer decidedly No. On the contrary, it may be rather denominated slight. The reports of its unusual malignity have arisen partly from the circumstance already alluded to, that several persons of the.

higher classes of society, and some of these under circumstances of extraordinary interest and regret, have fallen a sacrifice to it, and partly from a misconception of the meaning of the denomination Typhus, as applied to it by some medical men. In consequence of the theoretical opinions of Dr Cullen and Dr Brown, the idea of malignity, to a greater or less degree, was attached by them to the term Typhus, and typhoid was used to designate that state of fever in which the powers of reaction, or of vitality, were deficient, as characterized by the presence of certain symptoms, and with them typhus and typhoid were always associated with danger. But typhus is now used by many physicians, and I think more correctly, as a proper name to designate a particular kind of continued fever, (the common continued fever of this country, capable of being communicated by contagion,) without any reference to its degree of mildness or severity, so that they speak of a slight or severe typhus; and, according to this understanding of the term, I would say that Edinburgh is never altogether free from typhus; and that the typhus of this year has been, among the lower classes, milder than usual, although it is seldom very severe in Edinburgh.

Is the fever at present in Edinburgh contagious in its nature? This is a question of the greatest importance to the community, because an erroneous opinion on this point is attended with great and public evils. It may either cause unnecessary alarm, or prevent the necessary precautions for arresting its progress from being taken. To those not of the profession, or unacquainted with its controversies, it may appear strange that there should be any dispute whether any disease be contagious or not; yet it so happens that this most important fact is still unascertained with regard to the greatest number of the most important diseases; and the doubt does not arise from want of observation, but from the difficulty, perhaps the impossibility, of analyzing the various circumstances and conditions of the propagation and generation of disease. Thus, we find plague, yellow-fever, puerperal-fever, ague, dysentery, chincough, influenza, consumption, as well as our typhus, maintained to be indubitably contagious by some phy

sicians, and as positively declared to be certainly not contagious by others, and both parties appeal for the truth of their opinions to their own personal and abundant experience. As far as my experience goes, and as far as I am able to judge from the facts I have witnessed and read of, I am inclined to think a kind of middle opinion to be the true one in regard to typhus, viz. that it sometimes proceeds from the concurrence of occasional causes of disease independent of contagion, such as fatigue, want, distress of mind, intemperance, cold, foul air, &c. and that it more frequently is propagated by contagion or effluvia generated in and emanating from a person labouring under the disease; in short, that typhus is sometimes primary, sometimes propagated. But while I thus believe typhus to be a contagious disease, for the effluvia of even primary typhus are capable of communicating the disease, I also believe that it is only contagious under certain conditions and circumstances, or that it is not what may be called a very contagious disease. I believe that it is most easily communicated in a confined and foul atmosphere, where many diseased persons are collected, and to persons previously debilitated by fatigue, want, &c. ; that it acts only at a very limited distance from the diseased person, and that it requires exposure to its influence to be continued for a certain length of time. Further, many persons, especially those who have already passed through the disease, seem to be proof against, and capable of resisting it under every circumstance. If these opinions be correct, there are sufficient grounds for taking due precaution to prevent the propagation of disease, while, on the other hand, there are no grounds for general alarm. The fever is sufficiently contagious to suggest the impropriety of unnecessary exposure to the effluvia proceeding from the bodies of the sick, but not so highly contagious as to deter us from giving them every attention and assistance which may be use ful to them, or to authorize any harsh or hurtful regulations for cutting off all communication with the diseased.

I shall conclude these observations, already perhaps too long, with requesting you to insert the following

"Instructions, drawn up under the

direction of the medical gentlemen

of the Fever Hospital in Dublin, in order to prevent Infection.

"Signs of Fever.-For one or two days the person affected cannot bear exertion, loathes food, sometimes vomits whatever is taken into the stomach; a general sense of uneasiness, rather than pain, is felt; a wish to lie down, yet a restlessness when in bed, or sometimes sleepiness.

To these succeed shivering, with a sense of coldness, while to a bystander the skin feels hot; thirst, pain of head and back, and very generally a feel of weight about the sto

mach.

*

com

"Treatment. At any time within the first three days, give a vomit of hippo, (Ipecacuan,) mixed in a teacup full of warm water, and work it off with thin oatmeal gruel. If the belly be costive, give a mon house clyster, and repeat it every day, if necessary. Let the drink be two milk whey, or thin gruel, to each quart of which add a tea-spoonful of cream of tartar. No other medicine or food should be given till signs of weakness, or a cool skin, with appetite, come on. In the former case give a little wine or weak punch; in the latter, frumenty and milk, which should be very cautiously and gradually changed to more nourishing diet during recovery, as relapses are often the consequence of over-eating at this period.

"If fixed pain be felt in the breast or any other part, a blister should be applied over it. The face and hands should be washed and kept clean with warm water and soap, and the bedclothes kept clean; the apartment should (at every stage of the fever) be kept cool, and with as few persons besides the attendants as possible. Should a great disposition to sweat appear within the first five or six days, the room should be kept cool,

An excellent drink commonly given to fever patients in Dublin, composed of equal parts of sweet and butter milk. The former is made to boil, and then poured upon the latter, when the curd of both oagulated and easily separated from the Night and grateful whey.

but still not warm. During the whole sickness the floor and clothes should be frequently sprinkled with vinegar.

"N. B. Bleeding should hardly ever be employed, (unless prescribed by a regular medical attendant.)

"To guard against Infection.-Immediately after the recovery, removal, or death of the patient, let all the doors and windows be thrown open, and remain so for several hours.

"Let the house or room be immediately cleansed; all dirty clothes, utensils, &c. should be immersed in cold water. The bed-clothes, and all clothes used by the sick person, and every one about him, should also be steeped in cold water, then wrung out and washed in warm water, with soap; and every box, chest, drawer, &c. in the house or room, should be emptied

and cleansed.

Keep yourself in open air as much as possible for a week.

"Wash your face, and hands, and feet, and comb your hair every morning at least.

"N. B.-The benefit of this advice

you will soon feel, and, persevering in your attention to it, will, under God, preserve you from all the variety of wretchedness occasioned by infec tious fevers. Attend to it then with spirit and punctuality, for be assured, that cleanliness will check disease, improve your health and strength, and increase your comfort."

A. D. J.

This is evidently a misprint. It should evidently be," the room should not be kept too cool, but still not warm," or, "the room should be kept cool, but still not cold."