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The North-East, or windward shores of the West India islands are more level or declivous than the leeward or S.W. sides-they are consequently more marshy and unhealthy. Exposed to the northerly winds of spring, their inhabitants are annually, at that season, afflicted with pulmonic and hepatic inflammations. The dry season, in the West Indies, is from the beginning of December till the end of April; and is usually pleasant and healthy. The approach of the rainy season, in the two last months of summer, is awful, and always indicated by thick fogs hanging about the summits of the higher mountains, followed by dark, watery clouds, rolling from the North-East in terrific volumes, and darting bright electric corruscations from their edges. Tremendous torrents of water are suddenly precipitated from these clouds, and, rolling down the bottom of ravines and beds of rivers, carry every thing before them, discolouring the sea for several miles in every direction. The wet season, in the West as in the East, is checkered by many successive days of insupportable closeness and sultriness. The months of March and September are particularly stormy in all the islands, and the tract from 11° South to 19° North, is too often visited by those tremendous hurricanes which carry terror and devastation in their train by land and sea.
The medium height of the thermometer at one P. M. in the shade is 83° varying from 74 to 12.
The second chapter of Part I. is on the tendency of tropical climates to the production of disease. Dr. Chisholm remarks that, if we abstract the miasmala of marshes and the abrupt vicissitudes of temperature, the first giving rise to endemic fevers, and the second to local inflammations, the mortality is very little more, in ordinary years, than in England. This position presumes, and indeed Dr. Chisholm directly expresses it, that solar heat, except under particular circumstances, “has never been a cause of disease." But in the subsequent page our ingenious author acknowledges that the same solar beat powerfully predisposes the European constitution to be acted on by other causes of disease, and we would ask in what does this predisposition consist? Is not evidently a deterioration of the constitution—in other words, a morbid condition, or, in fact, a disease of the animal frame * Every man, indeed, who has accurately remarked
* Our author states that the action of solar heat alone does directly produce what has been termed coup de soleil ; (carus ab insolatione) and if so, we ask if it be not probable that a long-continued application of the same agent, though in a degree too small to produce coup de soleil, may yet produce other changes of a morbid nature in the system, corresponding with this milder degree of the solar agency?
his own feelings, or consulted the feelings of others, under high atmospheric temperature between the tropics or any where else, must be convinced that such feelings are incompatible with long and regular health. We ask all those who have sojourned between the tropics whether there is not something of a wearing, wasting, and exhausting nature in high atmospheric temperature, which not only predisposes to the action of other morbific causes, but actually conducts to premature old age and decay, should the individual be fortunate enough to escape the more obvious and unequivocal diseases of tropical climates induced by other agents than high temperature. With this qualification we agree with our author that, speaking generally, atmospheric heat only lays the predisposition, while terrestrial exhalations and vicissitudes of temperature call into action the principal diseases of tropical climates.
There is another draw-back on Dr. Chisholm's comparative salubrity of the West Indies-namely, bis omission of those.' “ malignant pestilential fevers," which, from time to time, have ravaged the said islands, and which be attributes to imported contagion, but which many others attribute to the climate itself. If these be included in the effects of climate, then the comparative salubrity of inter-tropical and northern countries drawn by Dr. Chisholm will not hold good. We will not, however, dip into this long litigated question, but proceed to the third chapter, which takes up the subject of Hygiene.
Dr. Chisholm's observations correspond with those of the best observers, that those men are most subject to the higher grades of the remittent as well as the pestilential fevers of the Western hemisphere, who are unhabituated to the Torrid Zone, and who possess plethoric habits, sanguineous temperaments, and rigid fibres. The grand principle of our author's Hygiene will be gathered from the following short extract.
“ I have said that solar heat, although seldom a direct, should always be deemed an indirect morbid cause, in as much as it powerfully predisposes the system of the native of a cold or temperate climate to be acted on by the direct endemic or imported causes of disease, he may be exposed to on his arrival in the tropical. It follows, therefore, that the lessening the action of heat on the system of such a person, constitutes the principle on which assimilation depends; and in its consequence gives a ready solution to all the phenomena of seasoning.” 10.
This is the very principle laid down by Dr. James Johnson also, in bis work on tropical climates. " The two fundamental rules of tropical bygiene, says Dr. J. are tempeVol. III. No. 9.
rance and coolness the latter indeed includes the former, and simple as it may appear, it is the grand principle of inter-tropical hygiene. From heat spring all those effects which originally predispose to the operation of other morbific causes.
And bow can we obviate these effects of heat, but by calling in the aid of its antagonist, cold.?" It is always satisfactory to see two authors, both independent and original in their observations, agree on material points, whether of pathology, therapeutics, or hygiene.
Our author very properly remarks, that tranquillity of mind and body, for some time after arriving in a tropical climate, is a necessary condition to give effect to a plan of preparation founded on the above principle-hence the difficulty of effecting this object among troops employed immediately after their arrival, on actual service :--- during which, the excessive heat and fatigue in the day, and the cold and humid evaporation in the night, to which they are alternately exposed, together with the large quantity of animal food which enters into their diet, give a manifold increased aptitude to suffer by endemic or imported causes of disease.” 'Our author thinks, and with great probability, that could the exigencies of the state permit the indulgence of a few month's ease and tranquillity, with a cooling, refreshing diet, to troops on their arrival from Europe, in some island, as for instance, Barbadoes, not particularly subject to irregular temperature, a great deal might be done to prevent the danger in assimilating their systems to the climate. We copy the following prophylactic measure from our able author. The plan has been ridiculed by some writers, whose lucubrations, however, arc fast sinking into oblivion, if, indeed, they are now remembered at all.
On reaching the northern tropic of N. lat. 23°, every stranger to the torrid zone should be bled to an extent proportioned to his age and strength; and a pill of five grains of calomel, given at night, and a saline purgative the following morning. The bleeding should be repeated, if necessary, once before landing ; but the calomel and salts should be frequently resorted to; and this will be more necessary should there be a disposition to constipation. I have already observed that on approaching the tropics, a considerable tendency to congestion is perceived :-this greatly increases on a further advance, more especially hepatic congestion, which, in fact, is the most serious consequence to be apprehended on entering the tropics.Nothing more effectually obviates this, than moderate bleeding, and mercurial and saline purgatives. To assist this course, the diet should be made as cooling as possible. Perspiration being the great means employed by nature to carry off the superfluous heat, every thing which tends to restrain it should bu avoided; dilution is, therefore, in every respect, highly necessary; and it is evident,
that, with this view, water is the fluid best calculated, for whilst it promotes perspiration, it necessarily prevents determinations and congestions.” *12.
Cold bathing is recommended, and properly, we think, by Dr. C. as an essential itein of prophylaxis. After landing, it is desirable, if possible, to place the men out of the reach of marsh effluvia, and so high as to secure a temperature of from 70° to 80°. Exercise should there be frequent and regular, with gradual exposure to the sun. We recommend this part of the work to commanding officers of regiments or corps, as containing most sound, rational, and practical doctrines.
The medical management after landing, must be analogous to that during the voyage. Plethora must be diminished by occasional bleeding and purging the cutaneous surface kept clean and permeable by bathing, and by the use of flannel and oily inunctions.
The fourth chapter is on the particular seasons of the West Indies. From accurate returns and eighteen years' personal observations, it appears that the months of July, August, and September, are the most sickly-Oct. Nov. and Dec. next in degree; and Jan. Feb. and March least sickly. In the next page, by some error of the press, it is recommended to send troops before the month of October, and a little farther on, the best time of lcaving England is stated to be carly in October. It is probable that a not is omitted in one of these passages, which, of course, alters the sense of the text entirely.
The 'endemic diseases of the West Indies are either bilious or inflammatory as the seasons are hot and wet, or cool and dry. Thus in the summer and autumn we have remittunts, dysenteries, cholera, &c. and in marshy districts, at this season, obstinate intermitients almost always depending on visceral obstruction or inflammation, together with hepatic dysenteries of a very dangerous character. In the winter and spring the complaints are, of course, of an inflammatory character.
Miasmal diseases are by far the most formidable within the Torrid Zone. The yellow and sallow complexions of those who may be considered as “ascripti glebæ," manifest the nature of the air they breathe; and the short lives, of the men more especially, constitute a still more forcible testimony. Unfortunately those bays and inlets which afford most protection from the stormy elements to our shipping, are those which are most productive of dreadful miasmal diseases. The carenage or harbour of Fort Royal, in Martinique, exhibits a melancholy illustration of this truth.
A stranger, Dr. C. justly observes, who believes that the diseases of tropical climates must necessarily spring entirely from heat, will be greatly disappointed. In fact, the best writers on those climates represent a great proportion of the diseases of Europeans as proceeding from the application of cold, after the human frame has been enervated by heat.
“ 3. The third sub-division, viz. the diseases from cold and moisture within the tropics, also demand a no less assiduous attention. Exposure to this state of the atmosphere has always been found injurious to the human constitution in hot climates. In these climates, this combination has never failed to produce the effects of marsh influence, united with the inflammatory diathesis proceeding from cold alone. In fact, its product is typhoid inflammation, which is always topical, and often attended by symptoinatic fever. The form the inflammation assumes is either pleurisy, hepatitis, or rheumatism, and the type of fever is remittent generally, often intermittent. The intestinal canal is not unfrequently the seat of this inflammation, and almost always in the form of dysentery, so often experienced by armies obliged to lie on wet ground, and after exposure to rain and great fatigue." 22.
Imprudence and intemperance are prolific sources of disease within as well as without the tropice. Exposure to a very high temperature during the day, and chilling dews in the night-especially if combined with intemperance in drink, is too often followed by dangerous yellow fever, or no less fatal hepatitis, terminating, with rapidity, in gangrene of the liver. Dysentery and enteritis are also very frequently the consequence, and often end quickly in mortification of the bowels. For many excellent prophylactic remarks at the conclusion of this chapter, we must refer to the work itself. The fifth chapter also we must pass over, (embracing the prevention of disease depending on public policy,) particuJarly as it takes up the subject of contagion, on which we shall not at all enter in this article--for unfortunately the more the subject has been discussed, the greater has been the discrepancy of opinion entertained, and the more tenacious have the opposite parties become of the doctrines originally embraced. We do not therefore deem it adviseable to waste our time in hopeless disputations.
The second part of Dr. Chisholm's work is on the diseases of the West Indies, and especially those of an endemic nature. Those, he observes, might be divided into four classes as before-namely, as resulting from marsh exbalation, atmospheric vicissitudes, cold and moisture united, and lastly, intemperance, &c. but, in truth, the causes of disease are so often mingled within the tropics, that the subdivision in question is not always so distinct as to render it necessary to treat of the endemic diseases accordingly.