Observations on the causes and cure of remitting or bilious fevers. To which is annexed, an abstract of the opinions and practice of different authors; and an appendix, exhibiting facts and reflections relative to the synochus icteroides, or yellow fever.
Currie, William, 1754-1828.
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OF THE CAUSES OF BILIOUS FEVERS.

FROM the numerous observations which have been made in different quarters of the world, there can be no doubt, that the cause of the fevers under consideration, is a miasma or exhalation, which issues from a marshy or putrid soil, or from putrefying vegetable and animal substances. The similarity in the season, situation, and soil, in the different countries and districts in which these kind of fevers prevail, and es|pecially the time of the year in which they are most epidemic and dangerous, concur in proving that how|ever symptoms may vary in different situations and constitutions, they arise from one common cause, and that cause is miasma.

This miasma is supposed to partake of the nature of the putrid source from whence it is derived, but what|ever its nature may be, it exists in the atmosphere over the soil or putrefying substances, from whence it arises in various quantities, and perhaps degrees of strength, according to the climate, season, temperature of the air, and quantity of putrid matter. Hence in tempe|rate climates in the hot season, it is in less quantity or in less strength, than in hotter climates with a similar soil. In hot climates also, the heat and impurity of the air, favours its operation, by inducing debility and pre|ternatural irritability in the animal system. In tempe|rate climates the difference between the temperature of Page  18 the air of the days and nights, render the body more especially liable to be affected by febrile miasmata.

Why these miasmata when diffused abroad in the at|mosphere of marshy districts, do not produce fever in all the inhabitants within the sphere of its influence, or why some are affected by it much later than others, can only be explained by supposing that it can only operate on relaxed, infirm, or debilitated constitutions, and that some debilitating cause must conspire with it, before it can produce any morbid effect in vigorous and robust constitutions. This appears to be confirm|ed by its effects on the emigrants from Ireland, which generally arrive in this country the beginning of Au|gust. Very few are affected with either the remitting or intermitting fever the first season, though numbers are with the dysentery, whereas very few of those that take up their residence in the suburbs of Philadelphia, escape it the second or third season after their arrival: but many are affected the first season of their arrival with infflammatory fever, especially if the season be dry and hot,—if wet and cool, the dysentery. This is also the case with persons who come to reside in the city, from the western and hilly parts of Pennsylvania.

Mud and stagnant water in every climate, possess the materials which give origin to the cause of this species of disease; but a combination of other circumstances is requisite to give it activity. Among the principal of the circumstances which give activity to this cause, may be reckoned the influence of a powerful sun. Hence some situations, which in the winter season are distinguished for no particular disease, are observed in the hot months to be most remarkably unhealthful.

There are few men whose observations are so circum|scribed, as not to know, that it is in the neighbourhood of swamps, mill-dams, and near the shores of fresh water rivers, that intermittents and remittents chiefly prevail; yet it deserves likewise to be remarked, that though a fever of one of these forms is most prevalent in such situations, no champaign or level country is en|tirely exempt from them, especially when wet sum|mers are succeeded by dry and sultry autumns.

Page  19Fresh cleared land in level countries, is rendered much more unhealthful for some time, than when co|vered with wood. The reason is obvious; the wood not only stops the progress of noxious vapours carried from a distance, but it also covers and protects the ground from the immediate action of the sun; in doing which it more than counterbalances the less free circu|lation of the air, or the greater dampness of the ground. Hence no opinion is more erroneous, than that the clearing a country of its woods, renders it healthful. Unless the grounds be drained and cultivated as well as cleared, the effect is likely to be the reverse.