A vast proportion of the most virulent diseases to which the human race is subject in almost all parts of the world, but more especially in tropical regions, is produced by the action of effluvia arising from decomposing dead animal and vegetable matter on the surface of the earth, and incorporated with the soil. These effluvia are the immediate instrument by which thousands of our fellow men are annually deprived of existence, the career of the young and the robust is abruptly stopped, never again to be renewed. Malignant fever is the disease, by which death is occasioned from these effluvia; and this fever assumes forms, characters, and titles, various and manifold. It ravages in almost every country within the tropics, and in many situations it annually commits the most dreadful havoc—cutting down so rapidly that the ordinary forms of burial cannot be observed. Whole communities suffer, the inhabitants of a particular tract of country are sometimes almost extirpated, and to visit some countries is almost to incur death from pestilence, so near to certain is attack, and its destructive character is so uniform.

The average duration of life in many countries is extremely low, chiefly on account of the wasteful career of that scourge, under its various characters and designations; and it is not saying too much that there the number of deaths is four times as great as occurs in our own happy country.

In those regions in which malignant fever prevails so much, almost every inhabitant at one period of his life, sooner or later, is afflicted with it. If he survive he is more fortunate than thousands of those who lived beside him; but his health is often deteriorated, he is often deprived of that vigour and elasticity both of mind and body, which spring from a sound constitution, and he not unfrequently lingers under the sufferings of chronic disease till his life is gradually though slowly exhausted; unless, indeed, as often happens, it is suddenly terminated by a fresh attack of the active pestilence.

“Almost every territory in which it (malignant fever) has committed its ravages has given it a new name. It is as gorgeously arrayed with titles as the mightiest monarch of the East. From the depredations it has committed in the West Indies, and on the American coast, it has been called the St Domingo, Barbadoes, Jamaica, and American fever; and from its fatal visitations on the Guinea Coast, and its adjoining islands, the Bulam fever. In British India it is distinguished by the name of Jungle fever, and still farther to the east by that of Mal de Siam. Nearer home, in the lowlands of Hungary, and along the south of Spain, it is called the Hungarian or the Andalusian pestilence. From its rapid attack on ships’ crews, that are fresh to its influence, the French denominate it Fievre Matelotte, (fever of sailors) as the Spanish and Portuguese call it vomito Prieto or black vomit, from the slaty or purplish and granular suburra (grounds) thrown up from the stomach in the last stage of the disease; while, as its ordinary source is moist lands, it has frequently been named Paludal Fever.”^[6]

This fever is severe with new settlers in these countries. Persons visiting places in which it is endemic, during its severity almost necessarily suffer, but sometimes they escape with a slight attack, in which case they are said to have had a “seasoning fever.” The pestilential vapours may be carried to a great distance, by winds and currents. Instances have already been given where districts are immediately rendered unhealthy upon the visitation of a wind which has passed over an unhealthy swamp at a distance. Many instances are also well known where ships, riding at the distance of a league from an unhealthy coast, have had their crews affected with the distemper, on the vapours being sent among them by the wind coming off that direction. The British navy is, alas, too familiar with instances of ships being visited by that pestilence when lying off the coast of Africa, where, too, no direct communication had been maintained. The most appalling mortality occurs in these cases; it is not unusual during the short period a ship remains on that station for the whole officers and crew to be swept away in one general tide of death, and it not unfrequently happens that, after the short space of three years, the ordinary time of service, that when a ship returns to England, she has not a hand on board she carried out—but is manned with a crew that has succeeded one which had, in its turn, taken the place of that which danced in joy, and looked all gallantry, only a few short months before, when with hearty huzzas they left their native land, and committed themselves to their bark and to the buoyant billows. At the time of the expedition to Walcheren a disastrous state of health prevailed among the soldiery in Holland, in consequence of vitiated air and other forcible adjuvants;—the pestilential vapours which arose from the soil were borne by the winds to the ships riding at a distance, and there fever failed not to manifest itself with its usual severity.

The actual amount of mortality produced by pestilential effluvia from the soil has never been accurately calculated in those countries where they are most severe. No bills of mortality or registers of deaths are kept, as in this country, in connection at least with the natives. But enough is known to shew that the amount is prodigious.

Tables are kept of the deaths occurring among the soldiers belonging to this country, serving on foreign stations, and they amply shew that the mortality is frightfully greater in those countries infested with these effluvia, and with the diseases which these effluvia are wont to excite, than at home—and as they are the chief agency of an unwholesome character, known to prevail in these regions, it is not unfair to attribute to them, in a general manner at least, a very great proportion of the excessive mortality.

The following extract, from an official return, will shew the greater mortality among the military when serving in the British Colonies than when stationed at home—

Official return of the mortality among officers and soldiers in the several British Colonies, chiefly for the seven years from 1820 to 1826, shewing the annual deaths out of ten thousand men.

Such is the fearful mortality which occurs among our soldiers stationed in some of our colonies, where effluvia of a pestilential character exhale from the ground. In Ceylon, where terrestrial effluvia are known to prevail, the number of deaths of our soldiers is more than nine times that which occurs among those who are stationed in Great Britain.

The immediate cause of that frightful mortality is the malignant fever, the chief agent in whose production, again, is the pestilential atmosphere, rendered such by terrestrial effluvia, and not by the presence of specific contagious poisons, as defined at page 105, assisted, perhaps, by other hurtful influences, such as, the intemperate habits which new comers in those colonies frequently adopt, the great heat of the climates, operating with particular force upon those accustomed to the more temperate climate of England.

This pestilential fever, the product of effluvia from the soil, commits such mortality among our gallant soldiery, as throws into insignificance the carnage attendant on active warfare, as renders that, even in the field of battle, comparatively of little moment.

Men in action may fall fast around; whole lines, nay columns of living humanity, its boldest samples, in one brief moment may be hewn down; still, as such carnage can last but a few hours of the day only, or, if protracted, a few days at most, the work of death is inconsiderable, compared with that effected by pestilential effluvia in many situations, operating both night and day, from day to day, and from year to year, unceasingly.

The inhabitants of countries infested with malaria, or vitiated air, when they have been spared the more acute forms of disease, or have recovered from them, are generally the victims of a miserable state of health, compared with which many conceive that death itself would be preferable.

The body loses its vigour and aptitude for exertion, becomes weak, disabled, sluggish, and impotent; the appetite fails: the limbs refuse to carry their burden aptly so called, and they become swollen and dropsical. The mind becomes lethargic and unfit for exertion, and the unhappy sufferer, who is insensible to whatever gratifies his more highly favoured fellow-men, becomes often weary of existence, a burden to himself, and an object of pity to others, who are accustomed to regard the activity, the cheerfulness, and graceful lineaments of health.

Thousands are so afflicted; and the number of those who thus have their existence embittered,—who are deprived of the manifold enjoyments which our condition can afford, and whose lives are prematurely terminated,—is even greater than that of those who die of the more violent and more speedily mortal distempers which are induced by vitiated air.

“A glance at the inhabitants of malarious countries or districts, must convince even the most superficial observer, that the range of disorders produced by the poison of malaria is very extensive. The jaundiced complexion, the tumid belly, the stunted growth, the stupid countenance, the shortened life, attest that habitual exposure to malaria, saps the energy of every bodily and mental function, and drags its victim to an early grave. A moment’s reflection must shew us, that ague and fever, two of the most prominent features of the malarious influence, are as a drop of water in the ocean, when compared with the other less obtrusive, but more dangerous, maladies that silently but effectually disorganize the vital structures of the human fabric, under the operation of this deleterious and invisible poison.”^[7]

Such is the general state of health of the inhabitants of many parts of the world; but it is chiefly in some parts of “fair Italy,” whose celebrated blue skies invite, whose luxuriant vegetation delights, whose gay and extensive prospects ravish, and whose classic associations charm the ecstatic spectator,—where humanity acquires that degenerate character, and that hideous aspect, which it assumes as if on purpose to mark the contrast between the gay revelry of vegetation, and the revolting degeneracy of mortality.

The resident in Italy can scarcely escape entirely the action of malaria; if he survive or escape the more immediate and more violent effects, those just described are, in the course of time, almost sure to manifest themselves.

Many of our countrymen make their residence in Italy, invited by its sky, its sun, its fertility, its ancient monuments, and stirring associations, and they not unfrequently prolong their stay so much as to imbibe the seeds of general bad health, which, though it may not develope itself at the time, will manifest itself at some future day. The malaria of Italy, like that of some other countries, sometimes acts slowly, and does not produce its effects, until the sufferer is again resident in his native country. Assailed with general decay, he is at a loss to know its cause, happening, too, at a time, when he had expected that his general health would have been more than ever established by his residence in a warmer climate, and under a clearer sky. It is a remarkable feature in the general bad health thus produced, that it is marked with periodical alternations of activity and repose, or with aggravations and remissions.

CRETINISM.

Cretinism, by which is meant a degenerate state of body, and an imbecile state of mind, which occurs for the most part in the valleys of Switzerland, and among the hollows of the Alps and the Pyrenees, and that is in a great measure the product of vitiated air, emanating from the swampy valleys and basins, which contain animal and vegetable materials, powerfully acted upon by the direct and reflected rays of a burning sun.

From the mountains there pour many streams into the valleys or troughs beneath, and, as the water is seldom completely carried off, it there forms an excellent or very favourable nidus for the putrefaction of animal and vegetable remains.

It is said, by those who have attentively observed the miserable population in these regions, that they form the most humiliating picture of humanity. The body presents the most loathsome condition, and the mind is removed only a step from idiocy itself.

The unwholesome tendency of these terrestrial vapours is materially increased by the almost incredible filth in which the inhabitants keep their persons, clothes, houses, and streets, the effluvia of which alone are almost intolerable and most offensive.

The general degeneracy of the body is frequently accompanied with a large swelling at the front of the neck, which gets the name of “Goitre,” and which is known in England under the appellation of “Derbyshire Neck.”

Cretinism has prevailed in Switzerland for many centuries, and has been likewise noticed among the mountains of China.

Cretinism is thus ably described by Dr James Johnson: “The stature is seldom more than from four to five feet, often much less;—the head is deformed in shape, and too large in proportion to the body;—the skin is yellow, cadaverous, or of a mahogany colour, wrinkled, sometimes of an unearthly pallor, with unsightly eruptions;—the flesh is soft and flabby;—the tongue is large, and often hanging out of the mouth;—the eyes red, prominent, watery, and frequently squinting;—the countenance void of all expression, except that of idiotism or lasciviousness;—the nose flat;—the mouth large, gaping, slavering;—the lower jaw elongated;—the belly pendulous;—the limbs crooked, short, and so distorted as to present anything but a waddling progression;—the external senses often imperfect, and the Cretin deaf and dumb;—the tout en semble of this hideous abortion of nature presenting the traits of premature old age. The Cretins are voracious, and addicted to low propensities. To eat and sleep form their chief pleasures. Hence we see them, between meals, basking in nonchalance on the sunny sides of the houses, insensible to every stimulus that agitates their more intelligent fellow-creatures.”

Before closing this sketch of the effects of malaria in Italy, a table of the annual decrement of life is submitted, which will shew the fearful mortality of that country over that of England, the disproportion against the former country being owing, in a very great degree, to the contamination of the atmosphere, caused by the effluvia which arise from the soil.

In Rome, 1 out of every 25 persons dies annually, or a 25th part of the whole population.

In Naples, 1 out of every 28 persons dies annually, or a 28th part of the whole population.

In England, 1 out of every 60 persons dies annually, or a 60th part of the whole population.

Thus, in England, the mean term of life is more than double what it is in Rome or Naples; and thus, while it takes 60 years to extinguish a generation in England, the brief period of 25 years completes the same work at Rome.

INTERMITTENT FEVER, OR AGUE.

Intermittent fever, more familiarly known as ague, is also a common product of air which is vitiated with effluvia arising from the soil.

That disease was much more prevalent some years ago in England than it is at present, where it is almost confined to Lincolnshire, and some of the low grounds and meadows of Kent and Essex, through which the Thames flows.

It is unnecessary to mention the symptoms of ague, as they are familiarly known. Convalescents are very liable to relapses, and many of those who have recovered from the more violent symptoms, are frequently affected, throughout the whole term of life, with very troublesome complaints, which arise from what is vulgarly known as ague cake, which is an enlargement of the spleen, an organ which lies near the stomach.

Ague is very prevalent in the West Indies, America, Holland, and other countries which are much covered with wood, are ill drained, and liable to be periodically inundated. This disease displays none of the virulence of the malignant remittent fever already noticed, yet affects vast numbers in its peculiar localities, and not unfrequently leads to mortal results.

The whole population of those fens and swamps in which ague is endemic, is generally affected at some period of existence, scarcely one person escaping.

The effluvia which produce that disease are sometimes carried to a considerable distance, and there induce their peculiar distemper; and instances are well known, where effluvia have been conveyed to high grounds, where they have attacked the inhabitants, while those in the immediate neighbourhood of the source of these vapours, have escaped for the time.

Ague is a much milder disease than the remittent fever, which springs from the same general source, viz. terrestrial effluvia, and which prevails in the East and West Indies, and on the coast of Africa.

When and where intermittent fever only is produced, it would appear that the effluvia from the soil are less virulent and concentrated, and perhaps their activity is modified or tempered by a proportionately great quantity of watery vapour combined with them in the atmosphere, by the climate of the country, and by the constitution of the people.

In this country, even so lately as half a century ago, ague or intermittent fever prevailed to a considerable extent, but is now almost unknown.

In East Lothian many of the old inhabitants remember ague as being a common disease in that county. At present it is there unknown.

In respect to this disease particularly, the health of the population of England has greatly improved, and it is well ascertained that the gratifying fact is chiefly owing to the country having been cleared of its superabundant wood, which prevented the land being readily dried, and which interfered with the due action of the winds, and to the speedy removal of water from the surface of the earth by draining, which is now so universally adopted. By draining, the water which formerly formed a receptacle for the decomposition of animal and vegetable remains, is now carried off, and with it the opportunity it afforded for the extrication of unwholesome vapours.

The operation of vitiated air in the production of disease is often very much assisted by the presence of other prejudicial influences.

It has been frequently remarked that one stroke of misfortune seldom comes alone, and that observation holds with striking force in reference to the causes of disease. One cause of disease produces another, which in its turn generates another, and so on, till the tendencies to, and the excitants of, pestilence, are so strong and so numerous, that whole communities are affected, one after another.

It not unfrequently happens that the predisposing source of some of the most severe visitations of the most virulent distempers, is the want of food, which generally depends on the exorbitant prices of provisions, raised either by the arbitrary regulations of rulers, or by comparative scarcity.

The total or almost total want of food is calculated to bring about, very shortly, a mortal result, from exhaustion or from sinking of the powers of the system.

When food is not withheld altogether, but is only given in sparing quantity, in an amount insufficient for the maintenance of the body in vigour, a condition of the system is induced, in which the functions are imperfectly performed, in which the blood and the various humours become universally prone to morbid change, and in which there arises a great tendency to disease of a low or asthenic character.

If, under such privation, vitiated air be present, whether arising from men in health, but uncleanly or crowded in close apartments; from the clothes, or excretions of the sick; or from terrestrial effluvia; it will give form to disease, will act as a spark amid fuel, and will shortly convert any predisposition to sickness that may exist into reality itself.

In those suffering under scarcity of food, there is generally experienced great depression of mind, which is hurtful in itself and injurious by preventing sufficient exertions for the maintenance of cleanliness: there is an inability to procure requisites for the purpose, and when, perchance, they are obtained, there is too often too much apathy or supineness to admit of their being used.

That miserable individual who is famishing, who is so unfortunate as to hear his helpless children call for bread, which he, alas, cannot give, who himself is exhausted and sinking with want, is seldom found to be very solicitous about cleanliness.

A mother so situated will, in her misery, amid her actual sufferings, and with the dark yet immediate prospect of further hardships, forget the necessity or disregard its call; of removing impurities from her hut, of retaining the persons and clothes of her family clean—and of washing the furniture, the walls and floor of her pestilence-haunted cabin.

In such a situation, cleanliness is neglected and impurities of all kinds accumulate which emit effluvia, to add to the number of the causes of gradual death impending over a family thus situated.

Let a case be supposed in which disease makes its appearance in obedience to the summons of so many forces, and let the malady be of a low or putrid character, and the patient dangerously ill. This family is unable from depression of mind, and from that exhaustion attendant upon actual want, to give him the requisite attention and assistance, and neither the means of cure are administered, nor is a suitable diet afforded. Effluvia arise, and no means being adopted to remove them, they become highly concentrated, and prove the immediate exciting cause of disease among all around who may be prepared by the operation of other favouring influences for that consummation. The occurrence of typhus fever among the labouring classes of this country, which is observed every winter, but more especially on those occasions when provisions, the necessaries of life, are high in price, when employment is with difficulty obtained, and when the wages are low, sufficiently attests the fact that scanty food is a powerful cause of disease, and one of a widely extended range of action. It is invariably in those years when there is least correspondence between the severity or inclemency of the season, the price of provisions and the means of the labourer that typhus fever commits most havoc. I have had occasion to note the prevalence of an unusual amount of disease, and amongst other forms, that of fever, in winters following partial failures of the crops, and the most satisfactory evidence has been afforded that a large proportion of the sickness was the consequence of high prices, and consequent scanty and insufficient food.

Such great prevalence of disease can be readily accounted for, when it is known that the ordinary amount of the wage of the day labourer does not exceed nine or ten shillings per week. I have heard labourers of the most sober and frugal habits affirm, that if their whole wage were spent in the purchase of oat meal for porridge, and of bread, that there would not be more of those provisions than would barely satisfy their children and themselves.

A scanty and unwholesome diet induces a bad and acrimonious state of the fluids, and leads to many diseases, and among others, to scurvy, which was long a frightful pestilence among our sailors.

Where there exists that tendency to scrophula, which is common in this climate, the relaxing influence of a poor and scanty diet is particularly hurtful, and proves the exciting cause of that hideous disease in all its frightful forms. Scrophula is much connected with a sluggish state of certain organs called glands. These organs are found in all parts of the body, and in health vary in size from that of a pin’s head to that of a bean, but in scrophulous subjects they are found much larger, the smaller being often more than the size of a pea, and the larger being equal to a hen’s egg.

Glands are congeries of vessels in which fluids of various kinds are elaborated, and it is partly from these fluids or those from which they are formed, stagnating in their vessels, owing to want of vital action, that the swelling arises, which is always found in scrofulous subjects.

That sluggish disposition of these parts is generally connected with a languid and lax state of the general system, which is liable to be greatly increased by whatever diminishes the vigour of the body. Few circumstances are better calculated to produce that effect than insufficient food, and hence it is that those diseases whose foundation is a scrophulous taint, are so much promoted in times of scarcity, and among individuals accustomed to a liberal diet when accidentally placed on scanty fare.

Instances are known where persons have become affected with weak eyes, with tenderness, watering and disposition to ulceration in these organs, immediately upon being put on spare and poor diet, and where a liberal supply of nutritious food has proved an almost immediate cure. That affection of the eyes was a form of scrophula, and fortunate it was for them that the form in which that disease manifested itself was not more dangerous. They had much reason to be thankful that the injury was capable of cure, and was not irremediable, as it has been in many instances, where the first intimation of the bad consequences of a scanty and insufficient diet has been decided and incurable consumption of the lungs.

When the glands which assume the scrofulous action are those of the lungs, and when they become the seat of the formation of matter, pulmonary consumption is said to be produced, a disease which annually carries off a great proportion of the adult population of this country.

Consumption of the lungs, or pulmonary consumption, is a common affection among those who subsist on scanty and insufficient food, and is frequently observed with dogs and other animals whose sustenance is small and precarious. Scrophula manifests itself in other forms, not less severe and extremely loathsome—in running sores on the neck and other parts, in swellings of the joints, and in various wasting diseases of the bones and their coverings.

In the various forms which this disease assumes, the blood and the different humours of the body become unhealthy and often acrimonious. The milk of nurses who are tainted with that habit is unwholesome, and when they are made to subsist on scanty and insufficient diet, it becomes poor, less nutritious, and positively injurious—and instead of being bland and white, it often appears watery and yellowish, and is irritating and acrimonious.

Food of an unwholesome or vitiated quality is also injurious, and has on many occasions proved to be the cause of much disease. Plants as well as animals are subject to disease, and food when obtained from such sources is highly unwholesome and detrimental to health.

The flesh of animals which have laboured under disease, has, on many occasions, done much harm, and is liable to be much more injurious than flesh which is merely putrid from being too long kept. Flesh merely putrid much more seldom proves hurtful, as, long before it can be very pernicious, it becomes so offensive that it cannot be consumed. Moreover, food which has acquired a slight taint, is more easily digested, its fibres become less tense, less hard, and more easily divided and dissolved in the stomach.

But the most important injuries of the kind have arisen from the use of diseased grain. On the Continent the rye sometimes becomes diseased, and the grain throws out a fungus somewhat like the spur of a cock. Rye thus deteriorated, when used for food, has produced disease of a very serious character. Persons who partake of it suffer great pain of stomach, fiery heat in the extremities, and very violent convulsions. This spurred rye produces mortification of the extremities, of a very remarkable nature.

The late celebrated surgeon, Mr Pott, thus describes these affections. “At the extremity of one or more of the small toes, in more or less time, it passes on to the foot or ankle, and sometimes to a part of the leg, and in spite of all the aid of physic and surgery, most commonly destroys the patient. It is very unlike to the mortification from inflammation, or to that from external cold. In its severer attacks, however, the constitution seems to be generally contaminated, the mind and body become equally debilitated, there is great irritability and a tendency to convulsive action.”

Rye thus diseased produces another distemper, which partakes of the nature of typhus fever and that of plague: it is called by the French “Mal des ardens,” and is generally considered one of the worst forms of the pest. That disease is marked by the most virulent character, and has, on many occasions, committed the most fearful ravages. It commences with a sensation of burning, prostration of strength, delirium, and vehement headach; a bad form of erysipelas attacks the skin, ending in suppuration, matter forms in the armpits and groins, and these symptoms almost invariably terminate in death. There is good reason to believe that the fungus or cock-spur is the product of disease in the plant. It is about the size of a cock-spur, is coffee-coloured, and may be readily detected when the farmer is disposed to use his eyes.

In this country, wheat which has been blighted or infected with the parasitic plant called mildew; has sometimes produced very bad effects, not unlike the severe burning at stomach, and the mortification which supervene on the use of spurred rye on the Continent. Not long ago, several families living in England were nearly destroyed by their using some diseased grain, which a farmer, knowing it to be bad, had sold at a reduced price. Other plants are sometimes known to be attacked with disease, and in that state are ascertained to inflict much mischief. The potato is more particularly injurious when its quality is bad.

Plants, like animals, may be affected with disease, and may be most unwholesome, without exhibiting any very marked signs of their morbid condition.

DRINK.

Drink is as essential as food itself, to the maintenance of the health of man. Thirst is no less urgent than hunger itself, and it often happens that it must be satisfied when the calls of the appetite for food are unheard. Drink of a wholesome quality is highly salubrious, and conduces much to maintain the blood, and the various humours in a healthy condition. Water is the only beverage with which Providence has directly supplied his creatures, and is, under ordinary circumstances, the liquid of all others the best adapted to their use.

Pure water is refreshing, cooling, and dilutes the blood, which, without some diluent, would become too thick to move readily along its containing vessels, to perform aright its manifold duties, and to accomplish its numerous purposes in the animal economy. Water taken into the stomach goes to supply that very considerable part of the mass of blood which is constantly earned off in the shape of sensible and insensible perspiration, and of other secretions, and to correct the tendency in that vital fluid, to become irritating and acrimonious from the formation and accumulation of various salts.

In order that the deleterious action of some liquids may be the more readily understood, we will inquire how drink, which is taken into the stomach, is there disposed of.

One of the chief objects which is obtained from the use of drink, is the dilution and mollifying of the blood; and in order that this important purpose may be effected, it is necessary that they be brought in contact and mixed with each other.

Water, or any watery beverage, being received into the stomach, many thousand vessels open their mouths upon the walls of that organ, and imbibe the contained liquid, in virtue of a vital action which they possess. The liquid is soon sucked up, and is carried by the veins and the absorbent vessels into the general circulation, there to be mixed and incorporated with the mass of blood. It has been popularly thought, that there exists a direct communication between the stomach and the kidneys, by which the contents of the former are conveyed to the latter organs; and that supposition probably arose from the fact, that the kidneys have an immediate increase of duty after copious drinking; and that fluids having a peculiar and strong odour have been detected, discharged, very soon after their reception into the stomach.

However, there is no direct communication between these organs, and all liquids which are taken into the stomach must be passed through the general circulation before they can reach the kidneys; and thus it is worthy to be observed, that liquids which are possessed of deleterious properties, have an ample field for their operation.

It is rare that any bad effects follow the use of moderately cold water in a state of purity, and any instances in which injury has followed, may, with perfect propriety, be regarded as depending on accidental circumstances.

It sometimes happens, that water free of impurities, cannot be obtained, and that, what is highly impure is taken into the stomach. Many nations are occasionally subject to the privation of pure water, and are compelled to have recourse to the tainted waters of sluggish rivers, of almost stagnant rivulets, and putrefying lakes; and the consequence is, that their health suffers, and that the invasion of disease is much promoted.

The inhabitants of Switzerland, and of several other countries, are supplied on some occasions, with no other water than that which is obtained from snow, and the prevalence of goitre among the Swiss, has been attributed by some physicians to that circumstance.

But man is not satisfied with this excellent beverage—water—which is ever at hand, and to be obtained without a price.

While yet little advanced in the knowledge of the arts, man discovered that the various juices with which the various fruits of the earth abound, afforded, during fermentation, a liquor which possessed properties such as strongly recommended it to his use. These juices, after fermentation, prove exhilarating and intoxicating, and all the nations of the world have their respective wines or intoxicating beverages. This liquor, which is the product of fermentation, gives to these juices their peculiar character. It is called spirits of wine, is colourless, and is lighter than water.

The liquors in which that active agent resides, when taken in small quantities, quicken the circulation of the blood, render more acute the perceptions, and augment the heat of the body. When these liquors are taken more copiously, the circulation becomes violently affected, the face flushes, and the blood is sent to the head, with too great velocity, and in too great abundance.

At first the mind is stimulated, but there gradually ensue sleep, stupor, and privation of sense and motion, which may continue even unto death. Several cases, in which death took place in this way from drinking to excess, are detailed in Mr Watson’s excellent work on homicide. But when the quantity which is taken is insufficient to produce the last-mentioned effects, but is often repeated, it frequently happens that disease, more or less acute, attacks some of the more important organs of the body, as the stomach, liver, kidneys, brain, heart, and the general nervous system.

The diseases which follow the long continued excessive use of liquors, containing spirits of wine, vary in their nature, but, on the whole, they prove highly dangerous, interfere with the performance of some of the most important functions, and often lead directly to a mortal result.

Where death is not the immediate consequence of the diseased condition of these organs, symptoms arise which make the course of life run bitterly along, the general system breaks up, the miserable victim presents in vivid colours, the signs of premature decay, the accession of acute and mortal sickness is greatly favoured, and the intellectual faculties are impaired.

Many melancholy instances are known of soldiers at the sacking of conquered towns, who, indulging in wine and other spirituous liquors to great excess, have died in vast numbers, both immediately, and more slowly, through the operation of disease, which had been induced by too deep potations, by too long protracted carousing, and by that exposure to those influences favourable to the developement of disease, to which excess never fails to lead.

“Some thousands of soldiers covered the great square and the adjoining streets (of Moscow), but they lay extended and stiff in front of the magazines of brandy which they had broken open, and from which they had drawn death, expecting to derive from them life.”^[8]

The habit of indulging to excess in spirituous liquors, when it does not directly induce pestilence, assuredly lays those who are its victims, particularly open to its invasion, and is, therefore, entitled to be regarded as a very important agent in the great tragedy of life which is enacting.

Few of the primary causes of pestilence among large bodies of men are so powerful or so extended in the range of their action, as extreme and long continued cold, want of sufficient clothing and shelter, and depression of the mind.

Coincident with many of the epidemics which are wont to prevail in this country, these circumstances are almost, without exception, found to be present; and if they are not admitted to be considered as the sole and exclusive causes of the prevalent disease, it is proved that they are co-agents or adjuvants of the very first importance.

Much of the continued fever which infests the poorer classes of our countrymen, and almost all the pleurisies, colds, and consequent consumptions, which prevail more or less among the various ranks every winter, are in a very great degree dependent on the extreme cold of the season which suddenly sets in, and against which the dress of the inhabitants of these islands is insufficient to provide. The labouring classes suffer much, more particularly from the action of cold and the inclemency of the weather. They are generally very scantily clothed, nay, they are sometimes scarcely covered, and the consequence is, that the cold makes a strong and lasting impression, the circulation on the surface is suddenly impeded, the perspiration is checked, and the whole fabric involuntarily shivers. Now these are the very first symptoms of fever, and unless the constitution is possessed of stamina to remove those symptoms without loss of time, and to establish the circulation in its vigour again upon the surface of the body, that disease, or some other, will undoubtedly be established.

When a body thus affected with cold is placed in a warm situation, there supervenes an excitement or reaction, which is marked by increased force of the circulation, and with redness and heat of the skin, a condition which is often experienced by persons who go immediately to the fire when newly arrived from a journey in the cold. When that reaction ceases, and is followed by a sense of coldness and by shivering, which again is succeeded by reaction, fever, in its proper sense, is established, and will assume a character of violence, lowness, or malignity, according to circumstances.

The clothes, the house, and the diet of the working man, are insufficient to protect him against the action of the cold, and to resist its operation when once it has fastened upon him; and thus it is, that to comparative want and to many privations, there is so often conjoined so much disease.

But it is in vain to expect any other result as long as our most deserving labouring population is worked in an inordinate degree,—so long as they labour beyond what their limited energies will, with impunity, permit—so long as they are often unable to obtain a diet sufficient for the maintenance, even of an idle person, and so long as their very breasts, from very want of clothing, are literally open and exposed to the fiercest blast that blows, and to the most searching and chilling rain that falls from Heaven.

Observe the industrious labourer at his work; behold his powers are taxed to the utmost, his energies, his capabilities, are put upon the stretch, and the entire fabric, God’s most complicated and most delicate creation, is actually labouring and heaving with protracted exertion. His blood distils the dew of labour, and his clothes, such as they are, are moistened with perspiration bursting from a thousand pores.

It frequently happens, that the labour of the poor man being over, sorely fatigued, too exhausted even to enjoy the consciousness that his hour of rest has arrived, with a heavy and unwieldy gait and hanging head, he seeks his comfortless abode, his scanty board, his dreary, dark, scarcely furnished apartment, with its faint and glimmering embers.

He swallows his spare repast and falls asleep at his fireside, but having no change of clothes, and those which he has on being wet with perspiration or with rain, are allowed to dry upon him. In the mean time the heat of the fire proves sufficient to create a steam on the side next it, and the house of course being open to the wind, currents of air, chillingly cold, pervade the apartment, and strike upon that side of the poor inmate which is most remote from the fire, and thus he of a thousand misfortunes and privations is actually steamed on one side, and perished with cold on the other. Persons placed in such a situation can scarcely, for any length of time, escape disease, and it is consonant with my knowledge to say, that the condition of a great proportion of the labouring classes is not one tittle better. Fever and many other diseases will continue to assail our labouring population as long as their food is insufficient, as long as they are barely covered during the inclement season, and as long as their habitations scarcely own a roof or a door, as long as the wind and rain enter at a thousand crevices; and while the cheerful and salubrious light of heaven is denied admittance by the old hats, bunches of straw, and rubbish which so frequently, in the absence of glass, fill up the space originally intended for a window. Yes, so long as every energy is exerted, and every moment that can be cheated from rest, to obtain that wherewith a supply of the necessaries of life may be procured, and when every other consideration sinks and gives way to the more pressing wants of nature, will disease prevail.

Such is the destitution among many of the labouring class, and the vast amount of disease which prevails among them, is the necessary consequence.

The following facts illustrate well the influence which scanty food, insufficient clothing, and the privations attendant upon poverty, exert in the production of disease.

During the last three months (10th February 1839), the fishermen and potters living in Prestonpans, have been in a very destitute condition, the former, partly from the very boisterous weather which has prevented their going regularly to sea, and the latter from the closure of the potteries at which they were employed. During that time, these two classes of people have been suffering much from fever, about ten of their number having died in that short period; while the people, amounting to 750, including children, connected with Prestongrange colliery, who are well employed, well paid, and well fed, though inhabiting the same locality, and the houses stretching from Prestonpans to Musselburgh Links, have been almost entirely free of that disease, fever having affected two of those families only, in the course of the same time; and while fever is still prevailing extensively among the potters and fishermen, the people connected with the colliery have been entirely free of that disease since about the 7th of last December. On these facts I am well informed, being the medical attendant of the colliery.

Let us mark the operation of the same or similar circumstances upon soldiers; the consequences of exposure to cold, to the inclemency of the weather, of the want of sufficient clothing, and of habitations, among young and robust men, employed in the most active and spirit stirring occupations, connected with the most kindling and heart-rousing anticipations, and flushed with the glory and honour of victory.

Let the case be that of Napoleon’s Grand Army in Russia, perhaps the most remarkable recorded in human history, and that, perhaps, will equal any that will yet mark the future career of man, in the total discomfiture, in the unspeakable sufferings, in the awful destruction of human life, and, in short, in the triumph of nature over humanity, which, from beginning to end, attended the disastrous retreat of that mighty congregation of France’s bravest sons.

Let the case be that of the retreat of the Grand Army from Moscow, which, alas, was one horrid series of unprecedented disasters, of wreck upon wreck, whose course was one prolonged deathbed—one white, one snow-white shroud—one extended grave, which barely spared enough to convey the fatal tidings, and which received heroes by thousands, valour and all that is ennobling in the mass, which monuments can never note,—and broken hearts and broken ties, those of husband, of father, and of comrade, for which tears have flowed, but which tears can never bind again.

“At every step he (the Emperor) saw his soldiers, stricken by cold, extenuated by hunger and fatigue, falling half dead into the hands of the Russian cavalry.

“Around these (their bivouacs) hunger and cold rivetted those wretched sufferers. It was impossible to tear them away.

“Above sixty thousand men well clothed, well fed, and completely armed, attacked eighteen thousand half naked, ill armed, famished men, encumbered by more than fifty thousand stragglers, sick and wounded. For two days the cold and misery were so intense that the old guard lost a third, and the young guard one-half of their effective men.

“It was indeed but the shade of an army, but it was the shade of a grand army. It felt itself conquered by nature alone.

“Under these circumstances, the elements appeared more hostile to us than the Russians themselves. Their climate did its part—if they had done theirs.”

In that disastrous retreat there was a most extraordinary accumulation of influences powerfully destructive of health. There was extreme cold, that of an intensely cold climate, there was an insufficiency of food and of clothing, and there was a want of proper habitations,—the wretched sufferers lying almost naked around their fires in the open air, perhaps enjoying the partial protection of a shed, a ruin, or a stable, and sometimes seeking shelter in the carcasses of horses. But there was also present another influence, highly prejudicial to health, and equal of itself to a considerable proportion of the fearful amount of disease which prevailed, and that was depression of mind.

Depression of mind conveyed a withering influence to the hearts of the bold victors of a thousand actions, and paralyzed the whole energies of the system. Here it acted on a gigantic scale, and its work of death, yes, of death itself, was not less prodigious.

The humiliation, the mortifications, and the heart-rending misfortunes of which these once victorious but now unhappy men were the prey, could not but induce a state of mind, which, of all other circumstances, must have been the most favourable to the invasion of disease. Daily experience demonstrates that disease is much favoured by the presence of circumstances, such as are referred to in the following passages.

“That grand army, which, in the course of the preceding twenty years, had marched in triumph through all the capitals of Europe, now, for the first time, reappeared, mutilated, disarmed, and fugitive in one of those (Konigsberg) which its glory had reduced to the greatest abasement. Its inhabitants hastened into the streets, as we passed along, to observe and reckon our wounds, and to estimate by the number and the extent of our misfortunes, the foundation on which they might build their hopes: we were forced to regale their eager and delightful eyes with our miseries; to submit to pass under the yoke of their delight, and, dragging our squalid and miserable forms in full review before their detested scrutiny, to march under the almost insupportable weight of calamity which the hatred of the spectators beheld even with transport.”^[9]