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LONDON:

PRINTED FOR RICHARD PHILLIPS, NO. 7, BRIDGE-STREET,
BLACK. FRIARS.

BY E. HEMSTED, GREAT NEW STREET, FETTER LANE.

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when thus seasoned were discharged. The relapses, however, were found to he as numerous among these convalescents, as among those who were at duty; and it was remarked, that the men who had recovered in Walcheren were less liable to relapses than the others who recovered at home. Perhaps this may be accounted for, by the duration of the disease inducing greater debility. In fact, the men continued in such a weak, languid state till the beginning of June 1810, that few were able to bear the least excitement of whatever kind, Avifhout causing relapses. These returns of the disease were also frequently united with pulmonic complaints, which increasing soon terminated fatally. In these critical cases all the efforts of the medical practitioner were too often of no avail, for while he endeavoured to evade Scylla, he was sure to fall on Charybdis.

The time this disease lay latent in some habits, who were not affected with it while in Holland, appears a curious fact; several being attacked with different species of intermittcnts after they had been home seven or eight months. Many officers as well as privates were thus attacked at different subsequent periods.

As an example of the extent to which this malignant en-' demic proceeded, I need only mention, that out of one battalion consisting of about seven hundred men, only 21 escaped its attack, and about an hundred of the others fell its ■victims.

* About the middle of October a great many were attacked with hydropic complaints, so that one third almost of the patients who laboured under the different forms of intermittenfs Ik came dropsical. At first hydrothorax and universal anasarca often suddenly appeared, which increased by the violence of the paroxysms of ague, frequently terminated fatally during the exacerbation. I was present at three of these afflicting scenes, even conversing with my patient a few minutes before "his exit, which was so unexpected, that I saw Cue rise out of bed and place himself on the close stool, where lie expired in a few seconds. Another robust, athletic man Was seized with a violent paroxysm of ague, when his respiration became so difficult and hurried, that he was obliged to sit up in bed to assist his breathing. His thirst was insa

"tiable. He spoke frequently, and said he should die; and with these words he leaned himself backwards and immediately expired; Being present I took hold of his hand, when I felt the pulse beat, which continued its pulsations for near

• two minutes after respiration and other vital appearances ceased.' This man had lio other external appearance of dropsy than that of a slight tumefaction about liis ancles. On cx•■••■■;•■•■' ■'• '.' . •>• '../.•.",-» ...-;;. amiuiiis

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amining the body a large quantity of water was found in the thorax, and near six ounces in the pericardium. The abdomen also contained some serous fluid.

The third case was a man who had just arrived, and who appeared so well that he was sent to the convalescent Wards where I saw him, at which time no hydropic complaint appeared. An universal anasarca attacked him so quickly that he died a few hours after. On viewing the body the skin seemed so distended on every part, that it was ready to burst, and a general exudation had commenced, especially on the scrotum and thighs.

These dropsical affections had now become so prevalent, that it was a general rule particularly to examine the patient concerning them.*

Some time afterwards Dysenteria appeared, and the sick increasing, it very soon became a frequent and fatal malady. The disease was, in general, preceded by a diarrhea. The sick labouring under the greatest debility from the length of time they had been afflicted, and from the immense quantities of bark and other medicines administered, among which purgatives held a principal station, it will not be difficult to conceive what must be the consequence. The bowels thus repeatedly harassed and irritated with these medicines, gradually lost their tone, when diarrhea was produced; and as the intermittents often did not even then subside, it was kept up by the continued exhibition of the remedies for the original complaint.

When therefore the purging was not checked by proper remedies, it soon degenerated into a dysentery, -which was peculiarly distinguished by that most harassing symptom tenesmus, accompanied with bloody mucous stools, and continued pain of the hypogastric region; for the support of which flannel rollers were constantly used, and found highly beneficial. This disease being often combined with others was seldom without fever. Many died soon after its appearance, so that some medical men concluded that no man who was attacked with it would recover. This conclusion, however, proved to be false. Several languished for many weeks, till they became so emaciated as to appear nothing more than skin and bones (to use the vulgar phrase) and at length recovered. When it appeared in this chronic state, the patient's appetite remained good till death, which generally snatched him off during his slumbers.

* Boerhaave mentions tbis disease as frequently occurriiis; in Holland, particularly among lobust people, to whom, after mucli muscular action, cold ami inactivity soon weeecd.

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