Page:Transactions of the Provincial Medical and Surgical Association, volume 2.djvu/215



Fever has, in all ages and countries, manifested such close relations with local peculiarities of air and soil, that to omit the consideration of it in reference to the subject of our remarks, would be altogether unjustifiable. It is unnecessary to repeat our former statement, that regular periodic fevers are unknown as indigenous productions. Continued fever is common enough, but nine-tenths of the cases are of a simple character, terminating, for the most part, within seven days, and uncomplicated with anything more serious than slight catarrhal or rheumatic disorder. Those cases which are longer in their duration, and assume a more serious aspect, have inflammatory complications, which render the terms cephalic, bronchitic, gastro-enteric, appropriate adjuncts. But typhus gravior is rare, much more so than might be expected by those who consider such circumstances, as accumulation of filth, ill-ventilation, had diet, putrid effluvia, to be capable of generating this form of fever. Even the fever that does occur in this locality, indicates but a very slight relation with such causes as have been just enumerated. It has often been observed to be infrequent, or altogether absent, in the most crowded and dirty parts of the city, at times when it was prevailing considerably in institutions and dwellings where cleanliness and free air are most carefully attended to. Of the various local circumstances with which it has been connected, the most frequent has appeared to be a moist argillaceous soil, such as is found in certain parts of the parishes of St. Paul and St. Augustine. In the post-mortem examinations of febrile cases, ulceration of the mucous membrane