We allude principally here to the localities and the facts, as they are now before us; circumstances and events which seem to us of the greatest importance, as enforcing the value of the details which he has collected, and as holding out warnings to the people respecting the preservation of their healths, in addition to those which the work before us has given in describing the soils or characters of ground in England from which this destructive poison is generated. And before we proceed to the analysis of his book, we shall state what those are, or at least a few of them, while wondering that he should have overlooked them, or regretting that any fancies should have prevented him from stating what would have been of so much utility. [p101]
It is notorious that, in the last autumn, the remittent fevers in various parts of the country amounted to a species of pestilence, such as has scarcely been known in England from this cause, or we might almost indeed say, from any other disease since the days of Sydenham. Wherever ague had ever existed, or even been supposed possible, in those places was this fever found: so that in all the well-known tracts in Lincolnshire, Norfolk, Suffolk, Kent, Essex, Sussex, Hampshire, and so forth, there was scarcely a house without one or more inhabitants under fever, while the event, as might be suspected, was a considerable mortality. In the parish of Marston, in Lincolnshire, for example, it amounted to 25 in 300 inhabitants; in some other places, it reached one in sixteen, one in thirteen, one in nine. And so extensive was its range, that even Hastings did not escape; while it should be almost superfluous to say that every other town on the sea-coast was so much infested by it, that they who resorted to them for bathing, as usual, found themselves most awkwardly situated, and also suffered in considerable numbers.
To come nearer home, and to what must interest us of the metropolis more, the same fevers were extremely abundant in various parts of the outskirts of London, as also in the villages or towns which are connected with it, within a range of from six to ten miles. Not to enumerate all these, this was the case throughout the range of streets or houses which extends from Buckingham Gate to Chelsea; in which long line, it is said, that almost every house had a patient or more under this fever; though, as the author has truly observed, these were mistaken for typhus, or at least thus misnamed. Thus it was also about Vauxhall and Lambeth; and to a great extent among all that scattered mixture of town and country which follows from Whitechapel, from Bishopsgate, and so forth, and very particularly along Ratcliffe Highway, and so on, to an indefinite range along the river, not only on this side but on the opposite one, so as to include Rotherhithe, and then proceeding onward to Deptford, Greenwich, Woolwich, Plumstead, so as to carry us beyond the boundary which we proposed to notice.
And in addition to the towns or villages which we have just named, we may enumerate Lewisham, in which we knew one house in which there were nine patients under this fever, which proved mortal to one. Dulwich, especially subject to this disorder, Fulham, Ealing, and the several other villages along the Thames, as far as Chertsey; and even Richmond, [p102] where, as at Lewisham, there was one house known to us, inasmuch as being intimate friends, where ten individuals at one time were suffering under this disease.
We must not prolong this enumeration, since we might easily occupy a dozen of our pages with similar details, ranging, in fact, all over England; but we must still observe, that whatever was the pestilence last year, it promises to be much greater in the present one. This is easily judged from the manner in which the season has set in; but still more decidedly from the extraordinary prevalence of ague in the spring; since that which is intermittent fever then, will be remittent in the autumn, or rather, as the author has justly remarked, there will scarcely be a definite season of vernal intermittent, but the remittent will commence immediately, increasing in extent and severity as the summer advances, and promising to become, in the autumn, the greatest season of disease that England has known for this century.
As an example of this, it must suffice to enumerate two or three facts, while these are as satisfactory for our purpose as a thousand would be. The most general of these is, that ague is at this moment extremely abundant where it was formerly so little known as not to be noticed, and that where single cases used to occur, there are now hundreds. Thus has it prevailed at Fulham and Ealing, and in the outskirts of London, and even in the town itself; and thus does it so prevail at Greenwich, Deptford, and in the associated vicinity, that a medical friend informs us, that it comprises more than two-thirds of his entire practice, which is very extensive; whereas a few years ago he had rarely a patient in a year. Thus also in the Military Hospital at Woolwich, there were in the spring three hundred patients with this disease; while in former times, we are assured, that an ague was scarcely known once in five or six years.
These are a few of the facts within our knowledge, but not one in a thousand, which evince the necessity of the publication before us; a book which seems to have been singularly well-timed, in as far as its purpose is, by a dissection of the sources of malaria, to diminish the ravages of both these kinds of fevers. And in this view we consider it a work of very considerable utility, inasmuch as it points out all the needful circumstances, as to prevention, in great detail; while these seemed particularly called for in England, from the entire and not less singular neglect which this subject has experienced, not only from the people at large, but from the medical profession. Beyond this, all that we need say of [p103] the character of the work is, that it contains the only regular and complete attempt at the natural history of Malaria that has been executed; since the several foreign writings on this subject are partial, or imperfect, or local in their investigations; and having said thus much, we shall proceed to give a brief analysis of its form and matter. And this analysis may be truly brief, without inconvenience; since the two Essays from the pen of the author, to which we have given a place in our Journal, will supersede the necessity of making that useful and practical abstract which we should otherwise have felt ourselves bound to give.
To pass over an introductory chapter of the usual necessity, the author commences by pointing out the several disorders, in a general way, which are produced by malaria, for the purpose of proving the sources of this poison; and as we are of those who take the facts as already proved, we need not notice it further.
The third chapter details the characters of those soils or situations which are most commonly or generally admitted to produce this poison: and though it contains some facts not very universally known, we shall also pass it over as of less moment than that which follows.
This is the fourth chapter, containing the details of the circumstances producing malaria, which have been either denied or overlooked; and it is one of the most important practical chapters in the book, inasmuch as it is to the popular ignorance of these that we must attribute a large proportion of the cases of fever occurring in common life. These, therefore, we shall mark briefly; and even the briefest notice will be of use in the way of precaution, while we must refer to the book itself for those proofs of the truth of the several views, which we could not take room to give. Generally, however, we may state this leading argument of the author, because it is brief, and, to us, appears satisfactory. It is this: that as the quantity of the poison which any person can inspire is necessarily small, and as this small quantity can be produced by a small marshy spot as well as a large one, it is the same as to the production of disease, whether the marsh is a foot square or a mile, provided the exposure be complete: while also, any piece of ground where vegetables decompose under the action of water, is virtually a marsh, or must produce malaria.