to the different forms under which the disease appears in such or such a season, the mortality does not exceed twelve or fifteen per cent. - We have derived this number from the lists of the hospital of the Consulado under the direction of M. Comoto. It no doubt appears very small when we compare it with the ravages recently made by the yellow fever in Spain"; but when we oppose these circum

* We may judge of the mean mortality observed in Spain in the epidemics of 1800, 1801, and 1804, from the following table founded on statements which I owe to the obliging kindness of M. Dumeril.

Mean

Years. Towns. | Patients. | Deaths. mortality.

- Cadiz 48,520 9,977 | 20 percent.
1800 {
|Xerez 30,000 12,000 | 40

1801 Seville 4,100 660 | 60

Alicante 9,000 2,472 27 1804 {{. 5,000 || 2,000 | 40

M. Arejula informs us, that, in every 100 patients, there died in 1800 at Seville 19; in 1804 at Alicant 26; at Malaga in 1803 nearly 40, and more than 60 in 1804. He affirms that the physicians in Spain may boast of having cured three fifths of the patients who vomited black matter (De la Febre, p. 148. 433–444). This assertion of a celebrated practician would indicate, in the case of a great exacerbation of the disease, a mortality of 40 per cent.

stances to one another, we must not forget that the disease does not rage every year, and does not affect every individual with the same violence. To obtain accurate results as to the proportion between the deaths and the patients, we must distinguish the different degrees of eracerbation of the vomito, in its progressive developement. According to Russel, even the plague appears sometimes at Aleppo under such benign atmospherical influences, that many of the infected individuals are not confined to bed during the whole course of the epidemic. In the environs of Vera Cruz, the vomito is only felt in the country at the distance of ten leagues from the coast. In proportion as we- advance towards the West, the ground rapidly rises, and as the temperature of the air is affected by this elevation, New Spain cannot throw any light on the important question, whether the yellow fever is ever developed in places at a distance from the sea. M. Volney" relates that an epidemical disease, bearing a great resemblance in many respects to the yellow fever, prevailed to the east of the Alleghany mountains in the marshy grounds which surround fort Miami, near lake Erie; and M. Ellicott made similar observations respecting the banks of the Ohio; but

we must not forget that remittent bilious fevers sometimes assume the adynamical character of the yellow fever. In Spain as well as in the United States, the epidemic has always followed the sea coast, and the course of the great rivers. It has been called in question whether it ever really prevailed at Cordova; but it appears certain that it exercised its ravages at Carlota, five leagues to the south of Cordova, a very healthy town situated on a high hill, and open to the most salubrious winds. * The system of Brown did not excite greater enthusiasm at Edinburgh, Milan, and Vienna, than it has excited in Mexico. Those persons of intelligence who were enabled to observe with impartiality the good and the evil produced by the stimulant system, are in general of opinion that, upon the whole, American medicine has gained by this revolution. The abuse of bleeding, purgatives, and all the debilitating remedies was very great indeed in the Spanish and French Colonies; and this abuse not only increased the mortality among people in bad health, but was detrimental to newly arrived Europeans, who were bled

* Berthe, p. 16. Carlota is twenty-six leagues in a straight line from the sea.

while in the enjoyment of the best health, and to whom this prophylactical treatment became a predisposing cause of disease. * Is it to be wondered at, that notwithstanding its imperfections and its deceitful simplicity, the method of Brown was productive of good in a country where an adynamical fever was treated as an inflammatory fever; where they dreaded to administer quinquina, opium, and ether; where, in the greatest prostration of strength, they were patiently waiting for a crisis, prescribing all the time nitre, water of marshmallows, and infusions of scoparia dulcis 2 The reading of the works which have appeared on the Brownonian system induced the Spanish physicians to reason on the causes and forms of diseases. Ideas along ago announced by Sydenham, the school of Leyden, by Stoll and by Frank, have found admission into America; and they now attribute to the system of Brown a reform due to the commencement of a spirit of observation, and the general progress of intelligence. Although the vomito is announced by a sthenical diathesis, the bleedings so warmly recommended by Rush, and frequently employed by the Mexican physicians in the great

epidemic of 1762, are looked upon as dangerous at Vera Cruz. Under the tropics the passage from the synoque to the typhus, and from an inflammatory state to a state of languor, is so rapid, that the loss of blood, which is falsely said to be in dissolution, accelerates the general prostration of the strength. In the first period of the vomito, minoratives, baths, ice water, the use of sherbets, and other debilitating remedies are preferred. When, to use the language of the school of Edinburgh, the indirect debility is felt, they employ the most energetic excitants, beginning with strong doses, and gradually diminishing the power of the stimulants. Mr. Comoto was very successful in giving more than a hundred drops of sulphuric ether, and from sixty to seventy drops of tincture of opium per hour. This mode of treatment is a singular contrast to that which is used by the lower people, and which consists in not raising the vital strength by stimulants, but merely in employing lukewarm and mucilaginous drinks, infusions of tamarind, and fomentations on the epigastric region, to calm the irritation of the abdominal system. The experiments which were carried on at Vera Cruz till 1804, as to the use of quinquina in the yellow fever, were not at