cargoes of cotton were taken into the Lazaretto for ventilation, and many of the labourers employed in this duty have been attacked with malignant fever, and died, whilst the crews on board at quarantine have remained healthy.* If, however, it be true that the plague is not so liable to be caused in this way as the yellow fever, it exhibits a marked difference between two diseases, that have a common origin, and have simultaneously prevailed in certain seasons in the same place; as was the case in the plague of Marseilles in 1720, when thousands perished with black vomit and yellowness of the skin. The same concurrence happened during the prevalence of the yellow fever in Philadelphia in 1793, where the writer of this article treated two fatal cases of bubo, and one of carbuncle. The two diseases, in different times and places, also exhibit a protean and diversified type, that is calculated to mislead the practitioner who does not extend his views to a full consideration of the causes which may modify various epidemics. The Levantine plague, like the yellow fever of this country, has its gastric derangements, its dysenteric and hemorrhagic fluxes, as well as its walking, and cold cases with partial suspensions of the intellectual functions: both in their prevalence are limited to a short duration; and some of their recoverable cases equally assume the forms of ordinary fevers, and are cured by diaphoresis, hemorrhages, and other evacuants; but not a single fact can be produced of either disease being propagated by a subtle poison, provided a pure and cold atmosphere shall exist to dispel or correct the invisible pestilential mantle that has been spread over an ill-fated city.

It is absurd, and makes nothing for the doctrine of the contagiousness of the plague, to adduce the instances of one or two European physicians having inoculated persons who afterwards were affected with the disease, when in all these cases the persons so inoculated were exposed to an

* This fact was observed by Dr. Felix Pascalis, a Member of the Medical Society of Marseilles, and for five years a resident of that city.

infected atmosphere, and in that way liable to take the disease. To rebut the conclusions that some are disposed to draw from such facts, we can bring the testimony of twenty faculties, of twenty states, and more than twenty years experience, against the existence of human contagion in any form of our yellow fever. We have, moreover, the diversified and conclusive experiments of the late Dr. Ffirth, of South Carolina, made in Philadelphia in 1799. He exposed himself for many hours in a close room to the vapour of boiling black vomit; he also swallowed six ounces of it, and twenty pills of the inspissated material, and all without any effect--but we cannot at present proceed further in the discussion of this important and interesting subject; and we leave it, relying on the impressive and satisfactory statements of Dr. Maclean to produce conviction in the minds of the candid and disinterested. We wish him, in his country, as much success in the work of reforming this abuse quarantine and contagion laws, as our venerable predecessors have obtained in guarding us against their adoption here. If, after all that has been adduced, the British ministry still adhere to their errors, we think we may, with the author, say of them what Lord Orford said of the Monks of old, "Whenever a ray of light breaks into their cells, they are ready to cry fire! fire!”

COLLECTANEA CLINICA.

Case of Irritability of the Stomach, attended with alarming symptoms of Debility, successfully treated by the internal administration of Ice-by JAMES R. MANLEY, M. D.

JOHN HOWARD, of New-York, of a sanguine temperament, and firm constitution, aged twenty-two years, was attacked with typhus fever, under which he suffered 22 days, before any signs of convalescence were apparent; he was much emaciated, and, as might be supposed from the duration of his disease, extremely weak. While in this condition, he was permitted to indulge himself ad libitum, in eating some savoury, though indigestible, food, and was shortly afterwards afflicted with singultus. At first, no particular attention was paid to his situation; but the complaint continuing, I was requested to visit him at 9 o'clock in the evening of the 21st July. Knowing what had been his previous state, I merely inquired into the cause of his present indisposition, and how long it had continued: I was satisfied that the cause was sufficient to account for his symptoms; and believing it to be the labour of an indigestion, which would soon subside, I prescribed a moderate dose of laudanum and ether, with directions, in case it was rejected, to give the Riverian mixture in effervescence 3i every hour and a half.

I visited him on the next day, (22d.) and was informed that he had vomited the anodyne draught, and the offending material, (the soft crust of a boiled pye,) but that his hiccough had continued during the night without much intermission, although he had some sleep. He was directed to continue the effervescing mixture with the addition of some tinc: opii: and to have applied to the epigastrium hot

fomentations of spirits and vinegar. At evening, singultus more distressing; had vomited several times during the day; pulse small, frequent, and feeble; skin cool; tongue dry, but clean; desires cold drinks, which are rejected a few minutes after being swallowed; no evacuations from the bowels since the commencement of the present attack. He was directed to take the following medicine:

R. Gum: Camphor.

Mosch::

Gum: opii:

9i. gr. viij.

gr. v. M. div.-in pill.

vi.-sumat i. qq. 2d. hora.-to have a blister applied to the region of the stomach, and lemonade in small quantities for his drink.

23d. The patient is no better; the pills were rejected, and vomiting was so painful, that he begged to discontinue them; when tinc: lavend: comp:, tinc: castor:, aq: ammoniæ, and other stimulants and antispasmodics were by turns substituted for the remainder of the night; his blister had drawn well, but there was no remission of his symptoms, which began now to assume a serious character. The pulse was frequent, small, and feeble; skin cool, particularly on the extremities; pupils dilated, and I thought that I could perceive some wandering of intellect; hiccough not so frequent, but very painful and exhausting. I now determined to alter his plan of treatment, for no other reason than that the one pursued was found to be utterly useless. Blisters were directed to be applied to his arms and the calves of the legs; sinapisms to the feet; cold (iced) punch to be given him to the extent of a pint in four hours, and 30 drops of sulphuric ether, in some very cold drink, every hour. 3 o'clock-Hiccough still continues very distressing; more heat of skin, and some febrile excitement: directed to have a cathartic enema, and if it operated more than twice, to arrest the catharsis by an injection of starchwater and laudanum. Evening-The appearance of the patient generally improved; there was no necessity for the anodyne injection; directed to continue the treatment, but

to allow the blisters to remain applied, in the hope that some strangury might be induced. His hiccough still continues.

24th. The patient is much worse: pulse small, frequent, and at the wrist scarcely perceptible; extremities cold, and skin about the neck and chest moist; blisters pale; great prostration of strength, and extreme anxiety as to the event of his disease; hiccough as frequent as heretofore, but not violent. Believing that he could not survive many hours, I seated myself by the bedside, intending, as opportunity offered, to apprize him of his situation. After a few moments conversation, he perceiving the drift of my remarks, asked me, with peculiar emphasis, whether I could do any thing more for him; to which I replied, that I had done all that I had known others to do in such circumstances; but there was still one remedy which I had not tried, because the experiment was hazardous, and in place of recovering him, it might expedite his death. He was anxious to live, and begged that I would persist in remedies, however small might be the prospect of benefit from them. I accordingly proposed to give him ice in substance, which he was not only willing but desirous that I should do.

I had been of opinion, that the introduction of some dilute acid, followed by a neutral salt, which, by being decomposed in the stomach, would produce a great degree of cold, might be essentially serviceable; but I was deterred from exhibiting them, from the fear, on the one hand, that I might produce too great a degree of cold, and on the other, that the new compound might prove violently cathartic-in either of which cases, my patient would be seriously injured, perhaps destroyed; I therefore determined now to introduce into the stomach ice, in such quantities, and in pieces of such size, as should require some time for their solution, and sent immediately for the article, broke it into small parts, and threw them into warm water, in order to take off the sharp edges of the fragments. I gave half an