MALARIAL FEVER. Wfl need
require
to
hardly remark that there are few subjects which be approached with greater caution than those con-
nected with malarial fever ;
nor is it our intention to advance, theory on the matter: our object is simply to ento lay before our readers, as we mentioned in our last
any novel deavour
the ideas expressed by the majority of medical officers practising in Bengal, who have lately favored us with their views regarding the circumstances of this form of fever. The question has often been asked by contributors to this journal, as to what malaria is; and because we are unable to give a definite answer to this question, or to describe the characteristics of the "bad air" which engenders ague, the existence of
issue,
such
a
tiling
as
malaria is apt to be discredited.
It seems to
of our inability to handle or see us, however, that the fact the morbific agent which wo call malaria, is hardly sufficient of its non-existence; the air wo breathe is invisible,
proof
nevertheless it is
being
a
real, material substance
unable to
see
;
nor
it hinder us from
does the fact
endeavouring to work out the laws which govern the atmosphere, or its action on our bodies and their surroundings ; in the same way we the circumstances of malaria in its may, with advantage, study action on the human being, /although We fail at present to see We fully admit that it or handle this mysterious influence. i3 beyond our comprehension how bad air" produces a tram of morbid phenomena in man, the sum total of which we designate ague ; nor can we understand why an overdose of hydrocyanic acid will kill a human being ; we nevertheless accept the fact, because we know from experience that such of
our
"
THE INDIAN MEDICAL GAZETTE.
188 is the case.
in the present state of our is,?have we evidence to
question, therefore,
The
which we have to consider
knowledge
breathing
the effect that persons localities become,
as
a
the
atmosphere of certain a specific form of
rule, stricken with
we acquainted with any definite meteorological other circumstances, which will induce agnr in the
Are
disease,
changes, human subject, other than conditions arising from decaying vegetable matter, in combination -with a certain temperature, or
state
of soil, and moisture ?
We all know that if the air
we
breathe contains
definite
a
out of
a ninety-nine percentage hundred, persons breathing such an atmosphere are sent off into a deep sleep; we must bear in mind, however, that there are exceptions to this rule, and that a very small dose of chloroform in place of sending some people to sleep will kill them ; nor can we possibly explain the reason why this should be the case. But it may be argued, if it were demonstrated, that the inhalation of bad air," like chloroform, induced a specific effect on
chloroform, that
of
in
cases
"
those who breathe it, such for instance that there would be nnd that every
one
an
end of all
as
an
speculation
attack of ague, on
the
would then admit the existence of
subject, a
mala-
poison. There is great difficulty, however, in collecting and conveying air to operate with from a fever-stri6ken district, such as that of Burdwan, to Calcutta, cr any other healthy place ; and supposing we had bagged our air in sufficient quantity, we rial
find it
should
no
easy matter to surround
a
person with it,
under circumstances similar to those in which he would have
breathed the air, had he been residing in Burdwan. So that we cannot demonstrate the existence of malaria by means of
though we are unable to by no means an uncommon circumstance for residents of the former city to travel to the latter, with consequences of which the following is an example :?Baboo Doorga Bass Chatterjee, residing in Rajah Kaleekrishna's Street, left Calcutta with his mother, a brother,
a
crucial experiment of this kind
bring
air from Burdwan to
;
but
Calcutta,
it is
sisters, a niece, and five servants on the 3rd of November 1872, for his country, house in the vicinity of Burdwan. Four
two
day8
after
arriving there, three of the party fever, others fell ill in the same
intermittent quence on
they
all left the
the 10th of the month.
observation,
place
at
once,
At the time
were
seized with
way, and in
returning they came
conse-
to Calcutta under
the whole of the eleven persons were then
our
affected,
severely, with intermittent fever, and two of them seriously ill. It is difficult to understand that the meteorological conditions under which this family lived in Calcutta and in Burdwan differed very materially, and there can be no possible doubt that their mode of living was precisely similar in both places. So that it is really very hard to concceive why all the members of this family should have been attacked with a definite form of disease on reaching Burdwan, unless there was something in the water, food, or atmosphere they consumed there which induced the disease. And if this be a plain common-sense view of the matter, then wc may safely conclude that the same morbific influence, which affected these people, has also smitten the majority of the inhabit, less
more
or
were
very
ants
of the Burdwan district with
of disease.
a prcciselv similar form We may take another instance to demonstrate our
meaning, by supposing a case which, in the aggregate, is hardly likely to occur, but which,in individual instances, must have fre-
[Jttly 1,
1873.
the notice of the medical
practitioners imagine that towards the end of the holidays in October or early in November, some twenty young Englishmen, having nothing better to do, determined, ten of them, to spend the day on the Calcutta cricket field, and tbu remainder go out sliooting to the south of the salt water lakes ; they may all be equally well fed, clothed, and undergo about the suine amount of exposure to the sun and physical exertion; anci although the two parties are within twelve miles' distance of one another, we do not hesitate to say, that at least half the number of those who went, out shooting would be attacked with fever shortly afttfr their day's sport,
quently of this
been
brought
place.
Let
to
us
playing at cricket day's amusement. Or
whereas those who had remained in Calcutta wouid liavo been all the better for their
take another case, which came to our notice a few days ago?A robust healthy man, who had resided many years in India, and never had an attack of ague, was travelling towards the end
of the rains from one
factory
to another in Xirlioot.
He
had to pass at night for a few miles along the road, which borders the district to the north, separating it from the Nepal
terai, and although he was warmly clad and the doors of his palkie were closed, he was attacked with ague within twelve hours of his having gone along this bit of road, and from that day to the present has been subject to frequent attacks of malarial fever. be
quoted, experience
Innumerable instances of this kind
and their occurrence must bo
a
migh
matter of familiar
to most of the readers of this journal; and, further probable that, whatever it may be that engenders ague, this something can be carried from one place to another by means of the wind, and through the medium of water,?
it seems
subject to which we shall return to in our next number. We strongly, however, recommend those interested in the matter to refer to Dr. Aitkin's work, "The Soience and Practice of Medicine" (6th edition, page 356) on the nature of malaria, and malarious fevers. a
would
require
to
hardly remark that there are few subjects which be approached with greater caution than those con-
nected with malarial fever ;
nor is it our intention to advance, theory on the matter: our object is simply to ento lay before our readers, as we mentioned in our last
any novel deavour
the ideas expressed by the majority of medical officers practising in Bengal, who have lately favored us with their views regarding the circumstances of this form of fever. The question has often been asked by contributors to this journal, as to what malaria is; and because we are unable to give a definite answer to this question, or to describe the characteristics of the "bad air" which engenders ague, the existence of
issue,
such
a
tiling
as
malaria is apt to be discredited.
It seems to
of our inability to handle or see us, however, that the fact the morbific agent which wo call malaria, is hardly sufficient of its non-existence; the air wo breathe is invisible,
proof
nevertheless it is
being
a
real, material substance
unable to
see
;
nor
it hinder us from
does the fact
endeavouring to work out the laws which govern the atmosphere, or its action on our bodies and their surroundings ; in the same way we the circumstances of malaria in its may, with advantage, study action on the human being, /although We fail at present to see We fully admit that it or handle this mysterious influence. i3 beyond our comprehension how bad air" produces a tram of morbid phenomena in man, the sum total of which we designate ague ; nor can we understand why an overdose of hydrocyanic acid will kill a human being ; we nevertheless accept the fact, because we know from experience that such of
our
"
THE INDIAN MEDICAL GAZETTE.
188 is the case.
in the present state of our is,?have we evidence to
question, therefore,
The
which we have to consider
knowledge
breathing
the effect that persons localities become,
as
a
the
atmosphere of certain a specific form of
rule, stricken with
we acquainted with any definite meteorological other circumstances, which will induce agnr in the
Are
disease,
changes, human subject, other than conditions arising from decaying vegetable matter, in combination -with a certain temperature, or
state
of soil, and moisture ?
We all know that if the air
we
breathe contains
definite
a
out of
a ninety-nine percentage hundred, persons breathing such an atmosphere are sent off into a deep sleep; we must bear in mind, however, that there are exceptions to this rule, and that a very small dose of chloroform in place of sending some people to sleep will kill them ; nor can we possibly explain the reason why this should be the case. But it may be argued, if it were demonstrated, that the inhalation of bad air," like chloroform, induced a specific effect on
chloroform, that
of
in
cases
"
those who breathe it, such for instance that there would be nnd that every
one
an
end of all
as
an
speculation
attack of ague, on
the
would then admit the existence of
subject, a
mala-
poison. There is great difficulty, however, in collecting and conveying air to operate with from a fever-stri6ken district, such as that of Burdwan, to Calcutta, cr any other healthy place ; and supposing we had bagged our air in sufficient quantity, we rial
find it
should
no
easy matter to surround
a
person with it,
under circumstances similar to those in which he would have
breathed the air, had he been residing in Burdwan. So that we cannot demonstrate the existence of malaria by means of
though we are unable to by no means an uncommon circumstance for residents of the former city to travel to the latter, with consequences of which the following is an example :?Baboo Doorga Bass Chatterjee, residing in Rajah Kaleekrishna's Street, left Calcutta with his mother, a brother,
a
crucial experiment of this kind
bring
air from Burdwan to
;
but
Calcutta,
it is
sisters, a niece, and five servants on the 3rd of November 1872, for his country, house in the vicinity of Burdwan. Four
two
day8
after
arriving there, three of the party fever, others fell ill in the same
intermittent quence on
they
all left the
the 10th of the month.
observation,
place
at
once,
At the time
were
seized with
way, and in
returning they came
conse-
to Calcutta under
the whole of the eleven persons were then
our
affected,
severely, with intermittent fever, and two of them seriously ill. It is difficult to understand that the meteorological conditions under which this family lived in Calcutta and in Burdwan differed very materially, and there can be no possible doubt that their mode of living was precisely similar in both places. So that it is really very hard to concceive why all the members of this family should have been attacked with a definite form of disease on reaching Burdwan, unless there was something in the water, food, or atmosphere they consumed there which induced the disease. And if this be a plain common-sense view of the matter, then wc may safely conclude that the same morbific influence, which affected these people, has also smitten the majority of the inhabit, less
more
or
were
very
ants
of the Burdwan district with
of disease.
a prcciselv similar form We may take another instance to demonstrate our
meaning, by supposing a case which, in the aggregate, is hardly likely to occur, but which,in individual instances, must have fre-
[Jttly 1,
1873.
the notice of the medical
practitioners imagine that towards the end of the holidays in October or early in November, some twenty young Englishmen, having nothing better to do, determined, ten of them, to spend the day on the Calcutta cricket field, and tbu remainder go out sliooting to the south of the salt water lakes ; they may all be equally well fed, clothed, and undergo about the suine amount of exposure to the sun and physical exertion; anci although the two parties are within twelve miles' distance of one another, we do not hesitate to say, that at least half the number of those who went, out shooting would be attacked with fever shortly afttfr their day's sport,
quently of this
been
brought
place.
Let
to
us
playing at cricket day's amusement. Or
whereas those who had remained in Calcutta wouid liavo been all the better for their
take another case, which came to our notice a few days ago?A robust healthy man, who had resided many years in India, and never had an attack of ague, was travelling towards the end
of the rains from one
factory
to another in Xirlioot.
He
had to pass at night for a few miles along the road, which borders the district to the north, separating it from the Nepal
terai, and although he was warmly clad and the doors of his palkie were closed, he was attacked with ague within twelve hours of his having gone along this bit of road, and from that day to the present has been subject to frequent attacks of malarial fever. be
quoted, experience
Innumerable instances of this kind
and their occurrence must bo
a
migh
matter of familiar
to most of the readers of this journal; and, further probable that, whatever it may be that engenders ague, this something can be carried from one place to another by means of the wind, and through the medium of water,?
it seems
subject to which we shall return to in our next number. We strongly, however, recommend those interested in the matter to refer to Dr. Aitkin's work, "The Soience and Practice of Medicine" (6th edition, page 356) on the nature of malaria, and malarious fevers. a
would
