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Deen prember of nation of

plague

we here discases at of the

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medical department in Egypt, and has treated thousands o cases, says, that removed from malaria or miasm, he has never known the plague to be communicated by contact. He has twice inoculated himself with the pus and blood of those affected with plague, but without producing the disease.

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This fully agrees with the evidence that was given before a select committee of the House of Commons, on the con. tagion of plague in 1819. It appears from the Custom-house Returns, that none of the expurgators of goods in Great Britain, at the quarantine establishments, have ever taken the plague. What then are we to regard as the cause of pestilence, and whence is it to be sought? Undoubtedly in the miasm of pestiferous soils; or of crowded, ill-ventilated, and filthy localities. When plague has at any time become epidemic, these are the spots in which it has first planted itseif, and in which it has committed the greatest devastation. Notwithstanding the obviousness of this fact, it is a remarkable circumstance in connection with the history of plague, that no people in the world have been willing to acknowledge their own country to be the first or indigenous seat of pestilence. The doctrine that it is imported and not indigenous, is as prevalent in Turkey as it is in Egypt. The Egyptian Levantines insist that it has never been an Egyptian endemic, but has been imported by travellers or goods; while the Turks contend that it is from Egypt. In the eloquent language of Dr. Hancock, Egypt disowns it; Ethiopia has no such progeny; Syria is too genial for its production; and Constantinople harbours it through neglect or sufferance. As to the north, how could the temperate climate of Britain generate a principle so terribly destructive?' Facts however are too numerous and weighty to allow us a moment's hesitation on this point. Wherever civilization has advanced, there plague has receded, till it is now only to be found lurking among the swamps of Egypt or revelling in the filth of Constantinople. It is the spring, we have seen, that is so fatal to the Egyptians, about which time south winds prevail, loaded with putrid emanations from animal and vegetable substances in the lakes formed by the retiring waters of the Nile. In June, the wind is in the north, passing over the Mediterranean, and this is the most healthy and salubrious season. In Constantinople, the month of August is most fatal, and this is the season of the year when decomposition goes on with greatest rapidity. The exemption of the city of Oxford, in the plague of 1665, is a strong proof of the correctness of these opinions. The following words from Quincy are much to the purpose: Dr. Plott observes, the reasons why Oxford is now much more healthful than formerly, to be, the enlargement of the city, whereby the inhabitants, who are not proportionately increased, are not so close crowded together; and the care of the magistrates in keeping the streets For clear from filth. "formerly," he says, they used

or lazarettos, which, by some means or other, for we learn not how, communicated the disease to a woman living in the Rue de l'Escale. This person being received into the Hôtel Dieu, two of the nurses who assisted at her reception, and the matron who changed the linen, were taken ill the next day, and died after a few hours. In a short time it destroyed physicians, surgeons, apothecaries, confessors, and all the other officers and servants, with the whole of the poor in the hospital, including above 300 foundlings. The priests and monks who attended the infected, suffered in the same manner as the medical assistants: and lastly, of 230 galley-slaves, employed in going into the infected houses and burying the dead, 220 perished in the space of ten or twelve days. Many of these facts however may be not inaptly termed false facts; and some, of undoubted existence, that are brought forward as examples of contagion, may be explained on another hypothesis. It is admitted by all that animal effluvia, from a number of persons crowded into a small space, and surrounded by their own filth, acquire a high degree of virulence, even without the morbid action of a febrile affection. If then, to the circumstances above noticed, are superadded corrupt food and the influence of a sickly season, is it surprising that miasmata endowed with a most pestilential contagious power should be generated? But this rapid transit of plague from one individual to another is only what we know to take place in other epidemic diseases. To illustrate this position by a familiar and wellknown disease-epidemic catarrh, or influenza: what is more common than for all the members of a family living together, the clerks in the same office, and the artisans of the same workshop, to be successively or almost simultaneously attacked? Yet nobody attributes the circumstance to contagion: certainly, if one had a motive for so doing, nothing would be easier than to accumulate examples without number in support of this position. Whatever share then contagion may have in the propagation of the plague, it is quite certain that its power has been greatly overrated. According to the most staunch supporters of this doctrine, a particular state of the air is essential to its action; and they all admit that whenever the plague has been excited out of its proper season, it has not spread. Without being understood to advocate the contagious origin of plague, we fully agree with Dr. Bancroft that it is fortunate for mankind that the communication of the contagion of the plague depends upon the co-operation of so many favourable circumstances, and particularly upon that of a suitable temperature, and of certain aptitudes and susceptibilities in the human subject; for without such requisites, or such obstacles to its propagation, the earth might have long since become desolate.' Those who contend for the non-contagiousness of plague, and therefore for the abolition of the quarantine laws, maintain that these laws, however strictly enforced, have not succeeded in shutting out the plague from pestilential districts; and that countries not possess ing indigenous sources of pestilence are not visited with this disease, although unprotected by quarantine establishments. They likewise adduce numerous instances of persons in constant communication with plague patients, and even wearing their clothes, escaping the disease. Odessa has one of the best organised quarantine establishments in the world; yet not long ago the plague broke out in it, entered the town, destroyed a number of inhabitants, and ceased at a particular season. In 1835 the harem of the pasha of Egypt consisted of about 300 persons; but not withstanding the severest cordon, the plague entered, and seven died within. The cordon was composed of 500 men, who were in constant contact with the town, where the disease was raging violently; of these only three died, so that the proportion of those who perished within to those without was nearly as 4 to 1. The plague of 1665, which ravaged most parts of this kingdom, never visited Oxford, although the terms were kept there, and the court and both houses of parliament were held there; a close correspondence too was maintained between this city and the metropolis, where it was raging. The Persians, although their country is every year surrounded by the plague, seldom suffer anything by it themselves. The Turks and Moors,' says Bruce, immediately after St. John's day, expose in the market-places the clothes of the many thousands that have died of the plague during its late continuance; and though these consist of furs, cotton, silk, and woollen cloths, which are stuffs the most retentive of the infection, no accident happens to those who wear them.' Clot Bey, who is at the head of the P. C., No. 1105.

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to kill all manner of cattle within the walls, and suffer their dung and offals to lie in the streets. Moreover about those times, the Isis and Cherwell, through the carelessness of the townsmen, being filled with mud, and the commonshores by such means stopped, did cause the ascent of malignant vapours whenever there happened to be a flood. But since that, by the care and at the charge of Richard Fox, bishop of Winchester, in the year 1517, those rivers were cleansed, and more trenches cut for the water's free passage, the town has continued in a very healthful condition, and in a particular manner so free from pestilential diseases, that the sickness in 1665, which raged in most parts of the kingdom, never visited any person there, although the terms were there kept, and the court and both houses of parliament did there reside." Now what was done in Oxford, as early as 1517, to remedy its unhealthiness, has since been done in all the principal cities of this country and on the Continent. Accordingly we find that the plague has not visited us since 1665. Holland, which has no system of quarantine, has experienced an exemption corresponding to that of our own country. Paris has not been attacked since 1668, and a century has elapsed since the plague of Marzeille.

Treatment of Plague.-The preventive treatment of plague will be gathered from what we have said respecting the causes of this disease, and the most effectual barriers that can be opposed to its future introduction into Europe, are, to adopt again the language of Dr. Hancock, the barrier of cleanliness in our towns and villages against filth and crowded habitations; the barrier of Christian charity VOL. XVIII.-D

towards our poor against famine and distress; the barrier of peace against the desolating evils of war; and the barrier of industry against the vice of sloth.' With regard to remedial measures, it appears little can be done towards arresting the progress of plague after it has once declared itself in an individual. Our efforts therefore are limited to removing the patient from those sources of miasm which gave origin to his disease, and in placing him in those conditions which are most favourable for his recovery. Free exposure to fresh air, supporting the strength, and regulating the secretions, are the only means which promise much chance of success. When this plan is adopted, we have the authority of our latest writers on this subject for declaring that the mortality of the disease may be considerably diminished. Thirty per cent. only, of those attacked, die under this mode of treatment; while in the lazaretto at Alexandria, 90 per cent. died in 1833, and 77 in 1836. With respect to the management of buboes and carbuncles, they must be treated in the way which is found efficacious in their removal when uncomplicated with plague, and if by these means we are unable to effect their dispersion, suppuration may be promoted by the employment of emollient cataplasms or any other mild stimulant.

In the following chronological table of some of the principal plagues upon record, we have purposely omitted the mention of many which, although described under that name, are obviously a different disease; even among those we have selected, the vagueness with which the symptoms of some are described, leave us in doubt whether the disease was the same as that which at present goes under the name of plague :

D.C.

1491. The plague of Egypt. Exodus, xii.

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in the Wilderness. Numbers, xi.

of Egina. Ovid's Metam., lib. vii. 523.
in the Grecian camp at the siege of
Troy. Homer's Iliad, book i.
among the Philistines. 1 Sum., v. and vi.
in Canaan. 2 Sam., xxiv.

of Rome. Plutarch's Life of Romulus.
Livy, iii. 6; Dion. Halicar., lib. x.
Livy, iii. 32.

1250.

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Livy, iv. 21, 25.

of Athens. Thucydides, ii. 48, &c.

of Carthage. Justin, xix. 2; Diod,

Sic., xiii., xiv.

of Rome. Livy, vii. 1; Short On Air.
Livy, x. 31, &c.; Orosius,

iii. 21.

213. In the Cathaginian and Roman armies before
Syracuse. Livy, xxv. 26.
182-177. Rome and all Italy.
126. Numidia and Carthage.

A.D.

lib. v.

1625. London and various parts of Europe. Short.
1635 and 1636. London, Nimeguen, and several other
places in Europe. Diemerbroeck, Tractatus de Peste
1655 and 1656. Most of Europe. Naples suffered very
severely, three-fourths of its inhabitants having
perished. Univ. Hist., vol. xxviii., 318.
1563-65. London and most parts of England and Hol-
land. Sydenham; City Remembrancer; Hodge's
Loimologia.

1702-11. North of Europe. Described, especially as it
appeared in Danzig, by Dr. Gottwald; and Univ.
Hist., vol. xxxv.

1720. Of Marseille. Chicoyneau's Traité de la Peste;
Bertrand's Relation Hist. de la Peste de Marseille.
1743. Aleppo. Its Natural History, by Dr. Alex. Russell.
1751. Constantinople. Chenier's Marocco, vol. ii., 275.
1760-62. Aleppo, Jerusalem, and Damascus. A Treatise
of the Plugue, &c., by Dr. Patrick Russell.
1770 and 1771. Constantinople, Poland, and Russia.
Described, especially as it appeared in Moscow, by
Mertens; and Ann. Regist., 1772, p. 155.
1783-85. Egypt, Dalmatia, Constantinople, &c. Volney's
Travels, vol. i, 192; Courant, October 28, 1783, and
October 27, 1785.

1799. In the French army in Egypt. Sotira, Mémoire
sur la Peste observée en Egypte pendant le Sejour de
l'Armée d'Orient dans cette Contrée; Baron Larrey,
Description d'Egypte, &c.

For further accounts of the plague, as it has appeared more recently, see Tully's Hist. of the Plague in the Islands of Malta, Gozo, Corfu, Cephalonia, &c., 1821; also Dr. Bowring's Observations on the Oriental Plague and on Quarantine, &c., 1838.

PESTILENTIAL, EPIDEMIC, OR ASIATIC CHOLERA is a disease not less fatal than that described in the preceding article; and in its endemic origin, its occasional epidemic eruptions, its selection of victims, and the localities which it ravages, it bears a striking resemblance to plague. Its essential character is however perfectly distinct, as will be seen by the following account of the symptoms of cholera. The disease has two well-marked stages: the cold or choleric, called also the stage of collapse; and the hot or febrile stage, or that in which reaction takes place. The first is generally preceded by certain premonitory symptoms, among the most prominent of which is diarrhoea, accompanied usually with languor and some degree of nausea; the deJections are fæcal and bilious, and often very copious. The commencement of the purging may precede the accession of the febrile stage for several days, or only a few hours may elapse. It is important not to think lightly of this disorder during the prevalence of epidemic cholera, for many Livy, xli. 21. Livy, Epit., 60; Orosius, taken, and appropriate treatment adopted for removing it, a life might have been preserved if timely warning had been before the accession of the symptoms about to be described. Symptoms of the Cold Stage.-The time of its invasion is, in the majority of instances, from two to four o'clock in the morning. The patient is attacked with uneasiness of the stomach, to which speedily succeed vomiting and purging of a watery, colourless, and inodorous fluid, similar to barley water, or more frequently to rice-water: sometimes it is like milk, and occasionally yellowish; but the conjeestools,' as they are termed, which consist of albuminous flakes floating in serum, or discharges of pure serum, are of the most frequent occurrence. These discharges are attended with severe cramps in the extremities, especially in the calves of the legs, and are succeeded by exhaustion, giddiness, and sinking of the pulse; the pulse is small, weak, and accelerated; and after a certain interval, becomes imperceptible. The skin is cold from the commencement; and as the disease advances, it becomes gradually colder, and is covered either with a profuse sweat or a clammy moisture. The features are shrunk and anxious: there is restlessness and agitation, with great thirst, heartburn, and hurried respiration. Notwithstanding the coldness of the body externally, the patient complains of heat, and throws off his bed-clothes. As the cold increases, the skin freseem drawn into and fixed at the bottom of their sockets; the tongue is cold, but moist; the voice is feeble, hollow, hoarse, and interrupted; but the mental functions remain undisturbed to the last. At this advanced period the collapse is complete, the respiration very slow, and the patient, who suffers little or no pain, presents the appearance of a

68. Rome. Tacitus, Annals, xv. 47; xvi. 13; Orosius, lib. vii.; Univers. Hist., vol. xiv., 139. 167 and few following years. Rome and a large part of the known world. Am. Marcellinus, lib. xxiii.; Echard's Rom. Hist., vol. ii., 315, &c. 187. Rome and Italy. Herodian, lib. i. 252-270. Rome and a large portion of the globe. Zonaras, lib. xii.; Gibbon, vol. i., 10. 407. Most of Europe, Asia, and Africa. Nicephorus, xiii. 6 and 36; Magdeburg, cent. v. 13. 542-590. A plague raging, with intermissions, in most parts of the world. Niceph., xvii. 18; Eccles. Hist., lib. iv., 29. 1345-1350. Europe, and most parts of the world. Boccaccio, Decameron, Prima Giornata;' Muratori, iii. 588, &c.; Villari; Short On Air, vol. i., 165; Univ. Hist.,

vol. xxxii.

1562 and 1663. London and most of the principal cities of Europe. Short, vol. i.; Thuanus. 1575 and 1576. Italy and most parts of Europe. Thuanus, lib. lxii.; Short, vol. i.; Mercurialis On the Plague of Venice. 1580 and 1581. Grand Cairo and different parts of France.quently becomes blue; the eyes, which are dull and suffused,

Thuanus.

1600 and 1603. London and various parts of Europe. Maitland's Hist. of London; Mignot, Hist. of the Turkish Empire, p. 256.

1611 and 1613. Constantinople, France. Riverius, lib. xvii.; Short, vol. i.; Mignot.

y

5

person who has been dead for some time. The urine is usually suppressed throughout the whole of this stage; but the dejections, becoming thinner and thinner, continue to the last. Some patients, although blue, cold, and pulseless, have sufficient strength to go about many however die of exhaustion before all these symptoms have declared themselves. In the majority of cases the spasmodic symptoms are first observed, and afterwards the collapse: the former are characterised by pain, evacuations, and moans; the second, by the suppression of voice, urine, and heat. If however the patient get over the cold stage, that of reaction commences. The coldness and blueness gradually disappear; the pulse returns, increasing in force and frequency; to the pale or blue cheek succeeds the flush; the eye brightens; the tongue, which was of a dirty white, becomes cleaner and dry; vomitings are less frequent, but diarrhoea continues; and there is some tenderness of the abdomen, with thirst, great disgust of food, and intense headache. The urine however is secreted; and if all goes on well, at the end of two or three days the features assume their usual expression; the stools are less frequent and more natural; the strength and appetite begin to return; the pulse resumes its ordinary character; and the patient is convalescent. Several varieties occur in the duration and intensity of cholera, and complications are sometimes produced of a character not less fatal than the disease itself. We are informed by M. Dalmas, that soldiers attacked in full march will retire from the ranks, lay down their arms by the road-side, and expire in two hours. During the prevalence of the last epidemic in India, several instances were heard of at Houbley and other places in that country, of natives being struck with the disease while walking in the open air; they fell down, retched a little, complained of vertigo, deafness, and blindness, and expired in a few minutes. This rapidly fatal form of cholera has not been observed in this country. The most severe cases that we have met with generally lasted five or six hours; but the average duration of the fatal cases, when they did not terminate in consecutive fever, was from twelve to fourteen hours. When reaction was established, and fever supervened, the duration of fatal cases was from four to ten days. As a general rule to guide us in forming a prognosis, it may be stated that the more complete is the collapse, the greater is the danger; and if the patient survive it, the more violent and malignant is the subsequent fever. The cases in which spasms and vomiting are most violent are by no means the most dangerous. Morbid Anatomy of Cholera.-Dissection presents us with nothing satisfactory by which we can judge of the nature of the disease. There is general venous congestion of all the important organs in the body; but it is rare that any traces of inflammation are discovered. The gall-bladder is mostly distended with bile, and its ducts are constricted. In the stomach and intestines is found either a transparent or a turbid serous fluid, mixed with a white opake substance in the form of flakes, and similar in all respects to the matters ejected during life. The mucous membrane lining the intestinal canal is most frequently of a pale white colour, and somewhat more soft and pulpy than in its natural condition; but occasionally some degree of vascularity is observed. The urinary bladder is empty and contracted. With respect to the blood, it is found to be more viscid, and darker coloured than natural, which arises from a deficiency of its saline and watery components, and a relative increase of its solid constituents. In 1000 parts of serum, Dr. O'Shaugnessy found 133 of albumen, whereas healthy serum contains only 78 parts. On comparing the blood with the matter found in the intestines, it is manifest that the latter contains all the ingredients of the blood, except the red globules; and that the aqueous and saline parts pass out of the circulation more rapidly than the albumi

nous.

History and Statistics of Cholera.-The last outbreak of pestilential cholera, which commenced in India and traversed successively nearly every country in the world, was perhaps the most diffused and best observed of any similar visitation: the observations we shall have to make will therefore chiefly relate to this epidemic. It originated in the district of Nuddeah and in some other parts of the delta of the Ganges, about the end of May or the beginning of June, 1817. During that year it did not extend beyond the territory of Lower Bengal; but in 1818 and the early part of 1819 it diffused itself throughout the extreme length and breadth of the Indian peninsula, yet leaving untouched many

districts placed between its lines of movement. Its progress along the lines selected was wonderfully uniform, being, for some successive months, at the rate of about one degree in a month. As early as 1818, it extended itself beyond the boundaries of Hindustan into the Burmese empire and other parts of Eastern Asia, and making gradual progress through these countries, reached China in 1820, and in the following year visited the numerous and populous islands of the Indian Archipelago. The Isle of France suffered its invasion in 1819, and some cases occurred in the same year at one point in Bourbon. In 1821 it extended along the shores of the Persian Gulf, and, during this and the following year, spread through parts of Arabia, Persia, and Syria, and closely threatened Europe. It appeared in the Russian territories in 1823, at Tefflis, Orenburg, and Astrakan; but its farther northern and western progress was stopped for a time. It however re-appeared in Orenburg in 1828, and again in 1829, and in 1830 advanced through the southern provinces of the Russian empire, till it reached Moscow on the 28th of September of that year. and Petersburg the year following. Warsaw was attacked in March, 1831; Danzig in May; Berlin, in August; Hamburg and Sunderland in October; and London and Paris in 1832. At the end of 1833 it had reached Mexico and several other parts of America. We see that the course of the epidemic was principally from east to west, and it was observed that prior to its appearance in many countries, and during its continuance, easterly winds were uncommonly prevalent; but most accurate and extensive meteorological observations, made daily during the continuance of the disease, prove that neither variations of temperature, fluctuations of the barometer, change of wind, nor the prevalence nor absence of moisture, affect in the slightest degree its duration or intensity. Bowel complaints appear to have preceded the cholera in most places, and to have continued for some months after its cessation. In many localities the disease existed only for a few weeks, while in others it lingered for several months. In the first case, the mortality was invariably high; in the last, the malignancy of the disease generally diminished as its stay was prolonged. Into whatever country or town the disease advanced, its first and most deadly fury was expended upon the poorest and most miserable of the population, and upon those who inhabited crowded districts, or low humid localities bordering on a port or river. Among this class of individuals whole families were sometimes cut off by it; indeed it is a peculiar feature of epidemic cholera that its ravages are confined almost exclusively to the poor. When the disease has appeared in a family occupying a station in life above the labouring class, we have the authority of Dr. Brown for declaring that in every case it has been confined to the individual first attacked, and has not in any instance spread to the other members of the family. The mortality from this disease is very great; but it varies somewhat in different countries and at different stages of its epidemic career. During its early prevalence in India, in 1817 and 1818, we learn, from the Report to the Medical Board at Bombay,' that there is reason to believe that of 1294 cases which received no medical assistance, every individual perished; and it is added, that it is not ascertained that any person has recovered to whom medicine had not been administered. This appalling statement however is without parallel, and it is gratifying to know that where the premonitory symptoms have been combated by early and judicious treatment, the mortality has always been diminished. This is strikingly exemplified by the statistical records kept at our different military stations in various parts of the world. In all situations and under all modes of treatment, about one in two died of the cases in civil, and one in three of those in the military hospitals; a result doubtless to be attributed to the strict surveillance exercised over the troops, by which nearly one-half of the cases among them were noticed in the premonitory stage, and consequently could be treated with a greater prospect of success than those in the civil hospitals, where the great majority of the patients were far advanced in the disease before they applied for medical aid. Of the severe cases however the mortality is probably nearly the same in all, being about 60 per cent. One of the most extraordinary features of this epidemic, observes Major Tulloch, is that the proportion of deaths to the number attacked has been very nearly alike in all the military commands of which the medical records have been investigated: for instance-In the United Kingdom, the

·

The influence of age on the mortality by this disease among the troops of the line serving in Canada is exemplified in the following table:

Age.
Under 18

18 to 25

25 to 33

33 to 40

40 to 50

Ratio of Deaths at each Age, per 1000
of strength, by Epidemic Cholera.

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15.5 23.

36.6 70.6

deaths were 1 in 31; in Gibraltar, 1 in 3; in Nova Scotia, | party. Of fifteen medical reporters in India who had ob 1 in 3; in Canada, 1 in 3; in Honduras, 1 in 3; in the served the disease, two only thought it contagious, eight were Mauritius, 1 in 8. The Mauritius appears to be the only of a contrary opinion, and five were doubtful. The medical exception to this; so that either the epidemic was less severe officers at Gibraltar seem to have been almost unanimous in its character, or the remedies employed were more suc- in their opinion that the disease was not contagious. In the cessful. same ward with the cholera patients in the civil hospital were several persons labouring under other diseases, who, although in constant communication with and frequently in attendance on those suffering under the epidemic, were in no instance affected by it. In the military hospital too it was observed that the orderlies employed in attendance on the sick were not attacked in a greater proportion than others who were not so employed; and of thirty medical officers in constant attendance on the sick during the prevalence of the epidemic, all of whom, from the nature of their duties, were subject to great fatigue and anxiety, only one or two exhibited any symptoms of the disease, and their cases were comparatively slight. Nevertheless it is probable that under some circumstances cholera may be contagious, and this opinion derives support from the great mortality which was always observed under the operation of the quarantine laws, on the inutility of which, in this disease at least, all medical men are agreed. The predisposing causes of cholera may be gathered from its history. The poor, the old, the infirm, and the dissipated were the principal sufferers. In the north of Germany, Tuesday was always the day of the greatest mortality, owing, it was supposed, to the excesses committed on the two or three preceding days. Hence every circumstance which tends to debilitate the system generally, whether occasioned by atmospheric vicissitudes, by residence in an unhealthy locality, by unwholesome or insufficient food, by the abuse of spirituous liquors, or by debauchery, acts as a predisposing cause in the production of cholera. Treatment of Cholera.-Premising, in a prophylactic point of view, the superiority of avoiding all the predisposing causes of cholera to the absurd practice of swallowing specifics against the disease, our treatment must be regulated according to the state in which we find the patient. If the premonitory symptoms only are present, the stomach should be unloaded by an emetic, and a table-spoonful of good mustard constitutes a very efficient one. The diarrhoea may be treated by a full dose of calomel and opium, combined with some aromatic, and a blister should be applied to the abdomen. Bleeding also has been recommended at this period. of the disorder. If the patient is already in a state of collapse, the various modes of treatment which have been. adopted prove how little is to be effected when the disease has advanced to this stage. Major Tulloch informs us that the principal remedy of the American aborigines consisted in merely swallowing large quantities of charcoal mixed with. lard; yet very nearly the same proportion recovered as among the white inhabitants of the towns who had the advantage of the best medical science. In this country, blood-letting, cold affusion, hot-baths, emetics, purges, astringents, sedatives, and stimulants of the most powerful kind, have been. successively tried with very doubtful advantage. The plan however which has excited most attention is that by salines. Medical men, guided by chemical analysis, conceived the project of supplying by artificial means the serum which was found wanting in the blood. With this view lavements and potions of an alkaline solution, resembling serum in: composition, were administered; but not being able by this means to arrest the vomiting, it was recommended and put into practice by Dr. Latta of Leith to inject the same fluid into the veins. This was first done by means of one: of Reid's syringes, the temperature of the solution being kept at from 108° to 110° Fahr. Of 74 bad cases treated in this method, 22 recovered, and in one case only did any unfavourable symptoms occur, and this was from phlebitis, or inflammation of the veins. alkaline solution have been injected in the space of 52 As much as 33 lbs. of this hours, and with a successful result. Some practitioners have even exceeded in amount this quantity. The compo sition of the saline injection employed by Dr. Latta consisted of two drachms of common salt and two scrupies of carbonate of soda dissolved in sixty ounces of water; but this formula has been slightly varied in different cases. The immediate effects observed on injecting this fluid into the veins are, an increase of the temperature and perspiration, a reappearance of the pulse, if before imperceptible, small, frequent, and feeble. The collapsed appearance of or it becomes fuller, stronger, and slower, when it was before the countenance gradually vanishes; it becomes fuller and

It appears from the authority to which we are indebted for the foregoing table, that females were attacked in very nearly the same proportion as males, but that the cases proved more generally fatal. Children were in a great measure exempt, though, when attacked, they rapidly sunk under it. The greater mortality of the disease in females has also been observed in this country. Dr. Ogden informs us that of 145 fatal cases of cholera at Sunderland, 63 were males and 82 females. The information which we possess on the relative mortality of the disease in the different races of mankind is rather meagre. The native Indians of North America suffered from it in an equal degree with the white population; and the same was observed with regard to the Sepoys in our Indian army. In the Mauritius, whose population in 1831 was 90,000, of which 25,000 were whites and the rest coloured, the total number of deaths recorded in the civil and military hospitals was 1327. Of these 168 were whites, 162 coloured, and 997 blacks, principally negroes, who seemed peculiarly subject to the disease. This great susceptibility of negroes to the invasion of disease, when absent from their native land, we have had occasion to notice in the article PHTHISIS; and that time seems to have had little effect in weakening this susceptibility, appears from a comparison of the mortality among them in the present epidemic with that which took place during a similar epidemic in this island in the year 1775. At this date, more than 2000 out of 4300 slaves belonging to government were cut off by it, and of those belonging to the planters nearly as many. Causes of Cholera.-That the whole series of phenomena results from the action of a morbific poison on the body, there can be no doubt; that this morbific matter is indigenous to some countries, and apparently has its origin in certain peculiar conditions of the soil, is supposed to be true from the effects which we find to be produced upon animal bodies living in these districts. But why the miast arising from the overflow of the Nile should produce plague; that of the Ganges, cholera; that of the parts situated in the tropics, yellow fever; or our own marshes, simple intermittent-we are entirely ignorant; nor can we, in the present state of our knowledge, at all account for the epidemic spread of some of these endemic diseases. The doctrine of contagion has been had recourse to in cholera, as in many other diseases, in order to explain its diffusion, and it has been asserted by the advocates of the exclusive operation of this principle, that the disease has always been found to move in the line of human intercourse; and it must be acknowledged, observes Dr. Brown, that while so migratory an animal as man inhabits the earth, it cannot well do otherwise. But if it is meant to be asserted that its diffusion has been in proportion to the intercourse between infected and healthy districts, the assertion is by no means supported by facts. Its appearance at Madras, for instance, whither, according to this doctrine, it ought to have been conveyed almost three months earlier by trading vessels from the infected districts, was simultaneous with its appearance in parallel latitudes in the interior. It did not reach Ceylon, to which, on the contagious principle, it ought to have been conveyed much earlier by shipping from the infected points of the coast, until it had previously gained the nearest point to it on the continent, and had been long prevalent on both coasts of the peninsula. In its importation into this country like wise, supposing it to be imported, so far from following the great routes of human intercourse, it chose one of the least frequented paths. The principal evidence on this point, which was collected during the last epidemic cholera, goes to negative its contagious character; and the advocates of the contrary opinion are at present by far the more numerous

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beneath the cuticle. At first sight they look very like fleabites, but they do not disappear when they are pressed with the finger. They usually indicate an altered state of the blood, and are often symptoms of very serious diseases, as in typhus fever (some varieties of which have hence been called petechial fever), scurvy, purpura, &c. They commonly appear also in very severe cases of small-pox, measles, and scarlet fever, and are amongst the worst symptoms by which those diseases are marked.

more natural; the eyes brighten, the thirst diminishes, and PETE'CHIÆ are small spots of a dark red colour pro-
the patient expresses himself in terms of gratitude or satis-duced by the effusion of drops of blood in the skin just
faction at the wonderful change wrought in his feelings.
But this change is evanescent; the purging continues, and
the patient is shortly reduced to the same hopeless state in
which he was previous to the adoption of this treatment.
By recommencing the injections, the same beneficial results
are obtained, and, provided this treatment prove successful,
the patient does not again relapse into his former condition,
but the diarrhoea and vomiting diminish, and reaction
commences. With respect to the treatment of the febrile
stage of cholera little need be said. The same recognised
principles that are applicable to the treatment of pyrexia in
general must be our guides in treating this fever; and the
physician should never neglect to impress upon his patient
the probability of a relapse, if he should indulge too soon in
any dietetic or other irregularities.

PETAL is one of the inner divisions of the organs clothing a flower, and called floral envelopes. These are usually double, the outer being a calyx composed of sepals, and the inner a corolla composed of petals. Both these parts are leaves incompletely organised. The petal, being fugitive, and of very temporary utility, is generally the more delicate, containing no woody tissue to protect the spiral vessels. It is sometimes of extraordinary size, but is as frequently a very minute body. [COROLLA; MORPHOLOGY; FLOWER.] PETALISM. [OSTRACISM.]

PETALITE, a mineral which occurs massive. Structure perfectly lamellar in one direction. Cleavage parallel to the lateral planes, and both diagonals of a rhombic prism. Fracture uneven. Hardness 6 5. Brittle. Colour greyish, greenish, or reddish-white. Streak white. Lustre vitreous, inclining to resinous. Translucent. Specific gravity 2:42 to 2:45. When heated in acids, it undergoes partial decomposition; emits a blue phosphorescent light when gently heated. When by itself, it melts with difficulty, and only on the edges; but with borax, it fuses into a colourless glass.

It occurs at Utön in Sweden, and in North America. It consists, according to Gmelin, of-Silica, 74:17; Alumina, 1741; Lithia, 5·16; Lime, 0:32; Water, 2:17.

PETARD. [ARTILLERY.]

PETER, ST., one of the twelve Apostles, was born at Bethsaida, on the western side of the lake of Gennesareth. His name at first was Simon, which was changed by our Lord into Cephas, a Syriac word signifying a stone or rock; in Greek, petra, whence Peter. In conjunction with Andrew his brother, he followed the occupation of a fisherman. Both were hearers of John the Baptist, by whom they were taught that Jesus Christ was the Messiah. While plying their business on the sea of Galilee, the Saviour called them to be his disciples: Follow me, and I will make you fishers of men: immediately they quitted their boats and nets, and became his intimate friends and constant associates. Peter was one of the three, James and John being the others, who were favoured by our Lord with peculiar marks of his confidence.

Peter was a man of an open and generous nature, strong in his attachments, ardent, and precipitate. He was prompt on every occasion to exhibit his zeal in behalf of his master, of which we have a memorable instance in his conduct towards the high-priest's servant, whose ear he cut off when the Jewish officers were about to apprehend our Lord. Yet, notwithstanding the ardour of his character and his solemu declaration to the contrary, he denied Christ when he was in circumstances of danger. After the denial, 'Jesus turned and looked upon Peter. That look entered his heart; and stung with deep compunction, he went out and wept bitterly.

On the day of Pentecost which succeeded the ascension of our Lord, the Holy Ghost descended upon the Apostles, and produced the most astonishing and extraordinary results. The gift of tongues came upon them; and they were enabled to address the inhabitants of different nations, each in his own language. On this occasion the character of St. Peter sustained a singular change; and he preached with so much effect, that three thousand were converted to the Christian faith. He now took a prominent position among the Apostles. When a miracle is performed, it is Peter who avails himself of the opportunity, and preaches to the people. When brought before the council for declaring the resurrection of their Master, it is Peter who speaks in reply to the charges against them. In the case of Ananias and Sapphira, it is Peter who detects and punishes the fraud. Being at Joppa in the course of his apostolic labours, he converted Cornelius, a Roman centurion, the first Gentile who was admitted into the Church without circumcision. This event was considered satisfactory evidence that the benefits of the Gospel were intended, not for the Jews only, but for mankind universally. Shortly after, the zeal and success with which he propagated the new religion induced Herod Agrippa to cast him into prison, from which he was miraculously delivered by an angel. The last important transaction in which we find him engaged was in the apostolic council held at Jerusalem, A.D. 49, when it was decided that Christianity required of its converts neither circumcision nor the observance of any other rite of the Jewish institute. It is supposed that he afterwards preached to the Hebrew Christians dispersed through Pontus, Galatia, Cappadocia, Asia Minor, and Bithynia; and that he visited Rome, A.D. 63, where he soon after suffered martyrdom.

PETAURUS. [MARSUPIALIA, vol. xiv., pp. 460, 461.] PETA'VIUS, DIONYSIUS PETAU, born at Orleans, in 1583, studied at Paris, and afterwards entered the order of the Jesuits. He lectured on rhetoric in the colleges of Rheims, La Flèche, and lastly at Paris, in which he was made professor of theology in 1621. He applied himself assiduously to classical and historical studies, and became a distinguished scholar and critic. In 1627 he published his great work on chronology, De Doctrinâ Temporum,' 2 vols. folio, which was republished with considerable additions by himself, as well as by Hardouin and others, in 3 vols. folio, Antwerp, 1703. The 'Doctrinâ Temporum' consists of 13 books. In the first 8 books, Petau discusses the principles of the science of chronology, antient and modern; in books 9 to 12, he examines the application of chronology to history, the various æras, &c.; and in the last or 13th book he gives chronological tables of the principal events from the creation to the reign of Justinian. After the publication of the work, Philip IV. invited Petau to Madrid to fill the chair of history, but Petau declined the offer, as well as an invitation to go to Rome by Pope Urban VIII., preferring the tranquillity of his cell in the Jesuits' college of Clermont at Paris, where he died in 1652. Just before his death he published Rationarium Temporum,' 2 vols. 8vo., 1652, which is a kind of abridgement of his great work, and forms a useful manual of universal chronology. It has gone through many editions, and has been translated into French: Abrégé Chronologique de l'Histoire universelle, sacrée et profane, 5 vols. 12mo., Paris, 1715. Perizonius published an edition of the Rationarium Temporum,' with a continuation down to 1715. At the end of the work are lists of the Roman consuls, the popes, the emperors of the Eastern and Western empires, of the various dynasties of modern Europe, as well as of the councils,and of the various heresies and schisms. Petau wrote also 'De Theologicis Dogmatibus,' 3 vols. fol., Antwerp, 1700. He edited the Breviarium of Nicephorus, in Greek and Latin, with notes, Paris, 1648; the works of Synesius, bishop of Ptolemaïs in Cyrenaica; and those of St. Epiphanius, with a Latin translation, 2 vols. folio, Paris, 1622. He also wrote a dissertation upon Photinus, 'De Photino Heretico.'

St. Peter was the author of two Epistles, both of which
make part of our canonical Scriptures. The first, whose
genuineness and authenticity have never been questioned,
is addressed to the strangers scattered throughout Pontus,
Galatia, Cappadocia, Asia, and Bithynia.' There is much
difference of opinion among the learned with respect to the
persons here denominated strangers. Some suppose they
were Jewish Christians; others, that they were in the first
instance proselytes to Judaism, and then converts to Christ-
ianity; others again, that they were Christians in general.
There are two considerations which induce us to hold that
the first is the more probable opinion. The word strangers
(Пaperionuo) properly signifies persons from another coun-
try; and therefore it is very suitably applied to those Jewish

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