Ackermann’s Repository of Arts/Series 1/Volume 1/January 1809/Medical Report
MEDICAL REPORT.
For the last twelve months, London has not been visited by any epidemic disease, or universally prevailing complaint. Typhus fever, at one time so much and so justly dreaded, is now scarcely known; not because a fever-house has been established to receive cases of this nature, and thus secure the poor from exposure to the contagion: however laudable and excellent this institution may be, we know that very few patients are admitted within its walls, because there are very few affected with the complaint. We must rather attribute the cause of this happy truce from the attack of contagious fever, to the plentiful and comparatively cheap supply of food: whilst the wages of labour are high, the industrious poor are able to obtain every necessary, and many of the comforts of the affluent. This induces a desire to improve their condition, they have a greater respect for themselves, they take more pains to keep their habitations clean; and where temperance, cleanliness, and plenty are combined, we need not fear the prevalence of contagion. It would not be difficult to lay down certain rules by which typhus fevers might be engendered. In corroboration of the opinion that scarcity essentially promotes fevers of this description, we may remark, that some years ago, when provisions and particularly bread, were extremely scarce and dear in London, and the public mind was desponding, typhus fevers were both frequent and fatal.
Scarlet fever and measles (formerly we might have added, and the small-pox,) are seldom absent. In the spring of last year, measles spread throughout the metropolis and its environs; for, though it never occurs twice to the same individual, yet (children constantly coming into the world) the infection is readily continued, and probably there is also a certain state of atmosphere conducive to its propagation. In this climate, where the disposition to pulmonic affections is strong, the accession of measles must always be regarded with an eye of jealousy, and its progress watched with unremitting assiduity. Though most children go through the complaint with safety, and scarcely are subject to one unpleasant symptom, it not unfrequently happens, that from some peculiarity of constitution, want of care and proper management, they are lost, or become the victims of a lingering complaint, from which they never perfectly recover. It is not too much to say, that three fourths of those who die in measles might be saved by proper treatment in the first instance; and where this is not employed sufficiently early, some of the worst consequences may still be prevented. If this complaint sometimes baffles the skill and judgment of the most practised and experienced physicians, what must be the result of feeble, inert practice, or mistaken opinion?
From the beginning of the year till late in the spring, the wind blew almost constantly from E. & N.E. : we have uniformly observed, that when the easterly winds have prevailed for a length of time with little variation, nervous people and those subject to lowness of spirits are considerably affected; and about this time many such deplorable cases claimed our attention. The long continuance of cold is in itself depressing, and when combined with a cloudy foggy atmosphere, materially assists any moral cause in producing hypochondriasis and melancholy. These again are often dispersed by the cheering influence of a fine spring day, or the grateful warmth of a summer’s sun. The state of the weather not unfrequently arrests the arm of the intended suicide, or impels the fatal stroke: hopeless indeed is that stale which resists alike the consolation of friendship, the balm of the physician, and the joys of the opening summer.
Catarrh, or what is vulgarly termed a cold in the head, was also frequent in the beginning of the year, and as the summer and autumn proceeded, gave way to synochus, bilious and bowel complaints: none of these, however, presented any unusual appearances.
The following is an enumeration of the diseases which the writer of this article has attended from the 20th of November to the 20th of December, 1808:
Acute diseases.Scarlet fever, 6.....Scarlet fever and sore-throat, 8.....Inflammatory sore-throat, 3.....Intermittent fever, 2....Typhus fever, 1....Catarrhal fever, 10....Puerperal fever, 2....Acute rheumatism, 6....Pleurisy, 1....Peripneumony, 3....Measles, 4....Hooping-ough, 5....Small-pox, 3 ....Peritoneal inflammation, 2....Gout, 2... Acute diseases of infants, 6.
Chronic diseases.Pulmonary consumption, 3....Cough and dyspnœa, 18....Marasmus, 2....Pleurodyne, 4....Lumbago and sciatica, 3....Chronic rheumatism, 8....Asthenia, 6....Palsy, 2....Dolor faciei, 3....Cephalalgia, 4....Gastrodynia, 7....Enterodynia, 3....Dyspepsia, 3 Diarrhoea, 5....Bilious vomiting, 3....Dysentery, 4....Dropsy, 3.... Hœmorrboids, 2....Hœmatemesis, 2....Epilepsy, 1....Cutaneous diseases, 5....Menorrhagia, 3....Amenorrhosa, 4....Leucorrhosa, 2.
Of the acute diseases it appears, from the above list, that scarlet fever and sore-throat were the most prominent; they were the most frequent in November, and arc now on the decline, no new case having occurred within the last week. In two or three instances the throat was ulcerated, and the fever assumed a malignant form: they all, however, recovered, though some of them were in the moat unfavourable circumstances. Fifty years ago this disease was much more fetal than it has been of late times: so mild indeed is its present type, that some practitioners recover their patients without using bark, or wine, adopting the evacuating antiphlogistic plan, which formerly was so fatal. Unless in cases of imminent danger, all extremes are to be deprecated, "medio tutissimus ibis:" in the same case, one man would prescribe a bottle of wine and other stimuli daily; whilst another would take away a pound of blood, and administer drastic purges.
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