a specific contagion, which, however, is incapable of acting, except in a certain impure state of the atmosphere,an epidemic constitution of the air, as it was termed by Sydenham. Dr. Hosack, of New York, is an advocate for this doctrine, which was formerly inculcated by medical writers with respect to the Plague, and has recently been brought forward by Dr. Calvert, in an essay on that disease inserted in the sixth volume of the Medico-Chirurgical Transactions.

There yet remains to be mentioned another set, who, though they believe the yellow fever to be truly local and endemic in its origin, think it probable that in its course, by the crowding together of the sick, with the neglect of cleanliness and of ventilation, a virus may be produced which shall be capable of communicating a similar disease to all who come within the sphere of its influence. But this opinion is rather repugnant to the little knowledge which we possess of the laws of contagion in general.

It is high time, however, for us now to attend to the author of the work, which has given occasion to these few general remarks. We learn that he arrived in Jamaica in the year 1800, and remained there in an official capacity for the space of eight years, during which he had ample opportunities of observing the diseases which prevailed in that island, and of investigating their nature and effects by dissection he himself experienced an attack of fever soon after his arrival, and a second in the autumn of 1807. In 1809, he accompanied the army to Walcheren, and was a witness of the lamentable mortality which befel that wretched and ill-fated expedition. In the summer of 1810, he joined the British forces in Cadiz, where an alarming fever made its appearance early in October, similar in all respects to that of the West Indies. His zeal for anatomical inquiry meeting with some check from Sir James Fellows, the head of the medical department, he was provoked into the use of indecorous language towards that officer; a court-martial ensued, and dismissal from the service was the result: he has, however, lately been restored to his rank.

This short statement will be sufficient to show that Mr. Doughty comes before the public with some claim to respect on the score of experience; and though he has little title to the praise of authorship, we must admit that he has added something to the store of observations on a very interesting subject. The volume is divided into three parts, containing "general observations on Yellow Fever, its causes and treatment;" with a detail of the state of health among the

troops in Jamaica: "memoirs of the fever in Cadiz in 1810, illustrated by cases and dissections :" and lastly a "recapitulation. In the extracts which we shall now make, some evidence will be afforded of the nature of the fever, and a specimen of the author's opinions, as well as his manner of delivering them at the same time exhibited to the reader. In the month of May, 1805, the eighty-fifth regiment (of which Mr. D. was then surgeon) marched in perfect health to occupy the barracks in Spanish Town. In June an alarm was produced in Jamaica by information that a powerful French fleet had arrived at Martinique, with troops on board. "It was this fleet the immortal Nelson pursued to the West Indies, and finally conquered off Trafalgar."

"It being fully supposed their object was an attack on Jamaica; every precaution was adopted by General Nugent to guard against the same. Martial law was declared; the militia called forth, and formed into brigades with the troops of the line. The 55th regiment was ordered from its several stations on the north side of thé island to Spanish Town, a distance of more than one hundred and twenty miles, which it had to march. Although the men were often drenched with rain during their route, they joined us in a very healthy state, and continued with us in brigade near two months. For one month and upwards, after their arrival, they continued free from sickness. Their several stations on the north side were, for the most part, considered healthy. The old Maroon Town, situ. ated high in the mountains, is even a more healthy post than that of Stoney Hill;-(about six miles from Kingston)"this was their head-quarters. The regiment had been separated from the date of its arrival in Jamaica, and at the time of its junction again, in Spanish Town, three years had elapsed. From so long a residence in the colony, it might be supposed the men were so far seasoned to the climate, as to be unsusceptible, in a great degree, to that cause which generates Yellow Fever. To the men of the 85th regiment this consideration might stronger apply, as they had been near four years in the island. But what was the result?"

"About the middle of August several cases of fever, of the most violent type, were admitted into hospital, both of the 85th and 55th regiments, and which continued to increase so rapidly as soon to fill it. A large building, which had been formerly a theatre, was filled up to receive cases, and this also soon became crowded.

"The number admitted, and aggravated state of the disease, created an early mortality. So great and alarming was the fever, and so inadequate were the accommodations to the number attacked, in both regiments, that the 55th was ordered to Up-Park Camp. Their change of situation produced no change in the nature of the disease, or any diminution in the number of admissions: the hos

pital at the camp was soon filled, and the mortality was uncommonly great. Our situation was not less deplorable; the admissions amounted daily to seven or eight, for more than a month after the commencement of the sickness."

"The great mortality which took place this season in Spanish Town, induced us to try every remedy but bleeding, which was only performed in one case" (and unsuccessfully because, in the author's opinion, too little blood was taken) "from the bias there was against it, and because I was not entirely at my own controul."

"The Apostle's Battery, a post situated amongst rocks on the bay of Port Royal, being elevated and open greatly to the seabreeze, has always been considered a very healthy station. To this post we sent our convalescents, with a proportion of non-commissioned officers and privates, to do the duty of the place, and assist them in hospital. These men, however, having imbibed in Spanish Town the seeds of the disease, were attacked with the same violent form of fever as their comrades at head quarters; and the mortality was equally great in the like number of cases. Of those who died, the symptom of black vomit was prevalent in five cases out of

seven.

"The advocates for the doctrine of contagion may ascribe the sickness at this reputed healthy post, in those who were sent free from disease, to their having received the infection from the convalescents whom they accompanied. But I consider that the same cause which created the fever first in Spanish Town, and which had not ceased to operate its influence at the time they were removed to the Apostle's Battery, occasioned the fever amongst them here. Their constitutions had been saturated with those noxious exhalations in Spanish Town, and which might be brought into action by that additional excitement, peculiar to change of situation in the West Indies. It is probable had they not removed from the focus of the disease, the morbid cause might have remained dormant in the system, and not have had sufficient power to produce febrile derangement. For although the disease was very general throughout the regiment; yet several remained exempt from any attack." (pp. 57–64.)

This last remark coincides with, and illustrates an observation made by Dr. Jackson in St. Domingo, in the year 1796; when an astonishing and unaccountable degree of sickness was observed to occur in every embarkation of troops proceeding from the Mole to other posts. To mention a single instance: the 29th light dragoons embarked, about the end of June, in perfect health; but, "during a passage of four or five days, the sick-list became formidable, and one ship alone lost thirty men."

In the summer of 1806, the 85th regiment went into barracks at Fort Augusta, which is washed in three-fourths CRIT. REV. VOL. IV. August, 1816.

Y

of its circumference by the sea. Here they remained nearly a year, with a very trifling degree of sickness; they were then removed to the barracks in Kingston, and in the autumn of 1807 again suffered severely from the fever, of which Mr. D. also at that time sustained a second dangerqus attack.

The following statement bears upon the most important of the points in dispute.

Without any apparent cause, that I could learn, fever, in the samé violent form and attended with the same fatal consequences, has prevailed, two or three successive seasons, in the garrison of Port Royal, in the month of May, when the troops in every other station of the island have been entirely exempt from it. This repeated occurrence, at so usually healthy a part of the year in other parts of Jamaica, induced the principal medical officer to recommend, and the comniander of the forces to approve, the removal of the greater part of the garrison to Up-Park Camp, for a month or six weeks, the time it generally continued. I remember their removal to the camp produced no fever sui generis" (if we must have latin, better say ejusdem generis) "with that under which they laboured, amongst the other troops in the same quarters; and which must have ensued had the disease been contagious, because they indiscriminately mixed together: and those labouring under the disease were placed in the same hospital with those confined from complaints of a total distinct nature.” (p. 70.)

The fever which afflicted Cadiz in the year 1810, commenced, as was before observed, early in October, after an excessive sultry, hot, and dry summer; it made its first appearance in the Barrio de Santa Maria, the filthiest and most crowded quarter of the town, and continued to be most fatal in this district. Our author, having charge of the surgical cases, was not called upon to undertake the treatment of this disease; but he let slip no opportunity of inspecting the bodies of those who died, the results of which occupy a large portion of the second part of this work. Like his precursors in the enquiry, he detected various and very general derangement in the internal organs of the body, most commonly inflammation of the parts within the cranium, and likewise of the stomach, with remarkable congestions in several of the other viscera. The author here reverts to a consideration of the causes from which the fever originates, and discusses the doctrine of exemption from second attacks: his ideas on this last topic we shall take the liberty of exhibiting at some length; they seem to be perfectly rational.

The same degree of cause which produces fever one year in a given number of people exposed to its action, will not have the same effect the succeeding year, with the same person so exposed, should the morbid virulence be in the same degree. No, the suscepti bility to its influence is reduced by the change which the constitution undergoes from febrile action. Nay, a given number of people, exposed to the action of the febrile cause which may produce only a slight derangement of health the first season, would not by any exposure to the same cause, the succeeding year, be any ways affected, if the degree of virulence in the cause was the same, and they had been residing during the intermediate time of health in Let them, the same quarter where the febrile miasm is generated. however, quit this focus of sickness for two years, and reside in the more healthy parts of Spain, or where Yellow Fever is never seen, then return, and take up their residence in their former dwellings in the Barrio de Santa Maria, during the prevalence of the Endemic Fever, I am well convinced they would not escape its influence. The susceptibility to its action would be regenerated, by having for the time I have supposed, inhaled an atmosphere divested of those morbific miasms which generate fever in the autumnal season of Cadiz, Gibraltar, the West Indies, and other parts. Hence the idea of seasoning.

"I shall suppose a cause prevails which I will calculate in force equal to 30o, and which creates, in the usual season, fever amongst six or more persons, of which they recover; the same cause prethese vailing in the same degree of force, would have no effect upon persons the succeeding year, they would be unsusceptible to its action; but let the morbid principle be increased in force to the 40th or 50th degree of concentration, then would they, I am convinced, be again affected with febrile action. This reasoning is not founded on the basis of visionary hypothesis, it is drawn from facts which I have explained in the former part of this work, when speaking of the effects produced in different quarters occupied by the 85th regiment in Jamaica. Hence the great consideration in Mr. Pym's publication, that the particular order of fever which he speaks of "attacks the human frame but once" is doubtful. I am aware that persons exposed to the cause, and who have laboured under the effects of the most aggravated form of Yellow Fever, are not likely to have it a second time; but those who have been exposed to a cause of the minor degree, and laboured under this fever in its milder form, will certainly run great risque in being again attacked, if exposed to the source of this disease in a more powerful degree of concentration; and more especially if there has been any regenerated susceptibility from a residence, for a given time, beyond the precincts of the generative cause." (pp. 181—4.)

In proof of the non-contagious nature of the fever at Cadiz, it is mentioned that, though an unrestricted inter