In the statistical report of Sir Alexander Tulloch it is stated, that out of 1658 white troops sent out to military stations on the western coast of Africa, 1271 perished from climatic diseases; while of the 387 who remained to be sent home, 17 died on their passage; 157 were reported as incapable of further service; and 180 as qualified only for garrison service; thus leaving only 33 out of 1658 men who were fit for active service.
As we pass out of the torrid zone a remarkable change takes place in the general character of epidemics. They lose more and more of their intermittent type, and become either remittent or continued. The remittent keeps its hold over the southern part of Europe, and continually breaks out in the form of Yellow Fever. As we proceed northward out of the yellow fever zone, that disease wholly disappears, and typhus and its kindred maladies take its place; typhus commencing precisely at the point where yellow fever ends.
There is, indeed, one of the ordinary diseases of temperate climes, and only one, which appears capable of penetrating within the torrid zone, and of committing greater ravages there than in lower temperatures, and that is Small-pox. With this exception, the ordinary epidemics of temperate climates do not enter the tropics, while, on the other hand, the ordinary epidemics of the tropics every now and then decimate the temperate regions.
“In these our latitudes,” says Dr William Fergusson, “cold and fatigue, and sorrow and hunger, will generate fever anywhere; but every region, every climate, will exhibit its own form of fever. With us it is Typhus; in the warmer countries of Europe, Remittent; in the upper Mediterranean, Plague; in the Antilles and Western Africa, Yellow Fever; this last being restricted to particular localities, temperatures, and elevation. While typhus fever goes out when you enter the tropics, it is there that yellow fever commences; the pure epidemic of a hot climate that cannot be transported or communicated upon any other ground. Places, not persons, constitute the rule of its existence. Places, not persons, comprehend the whole history, the etiology of the disease. Places, not persons! Let the emphatic words be dinned into the ears of the Lords of the Treasury, of Trade and Plantations, until they acquire the force of a creed, which will save them hereafter from the absurdity of enforcing a quarantine[[12]] in England against an amount of solar heat of which its climate is insusceptible. Let them further be repeated in the Schools of Medicine until the Professors become ashamed of imbuing the minds of the young with prejudice and false belief, which, should they ever visit warmer climates, may cause them to be eminently mischievous in vexing the commerce and deeply and injuriously agitating the public mind of whatever community may have received them.”
[12]. See Cases of the Eclair, Dygden, &c., post.
Climate differs not only in different countries but in different parts of the same country. The climate of the country is different from that of the city. The climate of every city, town, and village, differs from that of every other. The temperature, the moisture, and the other meteorological conditions of different districts, nay, even of different streets in the same town, vary to such a degree as to influence materially their relative salubrity and the prevalence or absence of particular classes of disease. These local climatic conditions and their connection with prevalent diseases, have not as yet received due attention: when they shall have received it—and they will receive it—a new light will be shed on local epidemics.
I pass now to Civilization.
We have no sufficient knowledge of the state of the people and of their diseases, in any of the civilized nations of antiquity, to trace the relation between them. The authentic history of periods, comparatively near to our own time, as far as concerns the diseases of the people, goes scarcely further back than the 14th century. The first great epidemic, to which I have so often called attention, occurred in that century, and we have reliable evidence, both of the phenomena attending this plague and the condition of the people at that time. I assume this period therefore as my starting-point.
I take a civilized community to be one in which there exist—