Malaria: an Essay on the Production and Propagation of this Poison, and on the Nature and Localities of the Places by which it is produced: with an Enumeration of the Diseases caused by it, and of the Means of preventing or diminishing them, both at Home and in the Naval and Military Service. By JOHN MACCULLOCH, M.D. F.R.S. &c. Physician in Ordinary to his Royal Highness Prince Leopold. Octavo, pp. 480. Longman & Co. 1827.

THE subject of this Essay has undergone investigation, under various names, ever since the days of Hippocrates-perhaps from a much earlier period. Marsh miasmata-paludal effluvia -morbific emanations-epidemic constitutions--vegeto-animal exhalations--malaria, and other appellations, have been conferred on an invisible, intangible, undefinable-and hitherto unascertainable something, which has been only appreciated by its effects, but which is totally unknown in its essence. By a few visionaries, its existence has been denied, because its substance could not be demonstrated; but all men of sober sense and unbiassed observation have acknowledged, not only the existence, but the terrific power, of this invisible agent. The medical practitioners of our fleets and armies, from the melancholy and extensive experience which they have had of its influence in the production of diseases, where its operations have been on a large scale, bear ample testimony, in their writings, to the VOL. VIII. No. 15.

2

tremendous effects of this scourge of the human race; but, we believe that no man has ventured to extend its influence to so wide a circle, or multiply its sources to such an indefinite extent, as Dr. Macculloch. For this he will be deemed a visionary by many-perhaps by most medical men, who give themseves little trouble in such an investigation. In this Journal, he will find a stanch supporter, though not an idolater. We are in the habit of thinking for ourselves--and we believe we have had a field for observation somewhat wider than Dr. Macculloch has had. We shall freely criticise and freely commend --but always under the guidance of what we conceive to be public justice and public utility.

Dr. Macculloch will secretly acknowledge that he has ardently aimed at being impressive, and even eloquent. In the former object he has often succeeded--in the latter, seldom. With learning, science, and ample command of words, our author has been singularly unhappy in the construction of his sentences--a majority of which terminate as if something were wrong or defective, obliging the reader to reperuse them. Dr. M. will find that an elegant or eloquent sentence must never cost the reader a thought as to its meaning and import. We make this observation, because we think that the want of brevity and perspicacity will greatly circumscribe the range of utility to which this work might otherwise extend. We shall now proceed to notice the chapters in the order of their occurrence in the book before us.

CHAP. I.-Introductory.

Dr. M. observes, that the existence of malaria has long been familiar to physicians, and even the vulgar, as the cause of intermittent fevers; but this is of little use, if the one class and the other are ignorant that, to this same malaria are owing the common fevers of summer and autumn, as well as a host of other and unsuspected diseases, as dysentery, cholera, neuralgia in various forms, nervous and dyspeptic affections-and, finally, what may be termed bad health. Dr. M. concludes, that one half, at least, of human mortality is owing to this cause. It does not, however, bear equally hard on all countries--nor at all times in the same country. In England, for instance, the death of a king by marsh fever would now excite some sensation" yet thus died Cromwell, one among hundreds; the death, indeed, not without note, but its cause not esteemed out of the ordinary course of mortality." In England, observes our author, "that which has been diminished, has

not been extirpated." The fens of Lincoln are not the rivals of Walcheren-nor is Romney equally pestiferous as the Pontine Marshes. Still, as travellers, as merchants, as voyagers, and as soldiers, we are interested in the salubrity or insalubrity of all parts of the world, as well as of our own Islands. Dr. M. thinks we may take the average of life among ourselves at 50-in Holland, at 25-in some districts of France, at 22, 20, 18-so little is the chance of life.

"Let us turn to Italy: the fairest portions of this fair land are a prey to this invisible enemy, its fragrant breezes are poison, the dews of its summer evenings are death. The banks of its refreshing streams, its rich and flowery meadows, the borders of its glassy lakes, the luxuriant plains of its overflowing agriculture, the valley where its aromatic shrubs regale the eye and perfume the air, these are the chosen seats of this plague, the throne of Malaria. Death here walks hand in hand with the sources of life, sparing none: the labourer reaps his harvest but to die, or he wanders amid the luxuriance of vegetation and wealth, the ghost of man, a sufferer from his cradle to his impending grave; aged even in childhood, and laying down in misery that life which was but one disease. is even driven from some of the richest portions of this fertile yet unhappy country; and the traveller contemplates at a distance deserts, but deserts of vegetable wealth, which man dares not approach,--or he dies." 7.

He

The above is a fair specimen of the better kinds of Dr. Macculloch's style and manner-we shall have occasion to point out some less favourable specimens as we proceed.

The walls of Imperial Rome cannot keep out this enemy of human life. It enters with the Roman into his chambers, and stalks through his streets-nay, "the hour is impending when the Eternal City will cease to be-when it shall submit to that fate, which has been the fate of proud Nineveh, and Babylon, the queen of nations."

Sicily, Sardinia, Greece, are grand seats of this destructive production, "while, in tropical regions, it is to fall by thousands and tens of thousands, the summer harvest of Death walking hand in hand with that of the vegetable world." England herself is far less exempt from malaria than she is supposed to be. Speaking of our participation, as soldiers, in the malaria of other countries, Dr. Macculloch rises into the sublime, or even the terrific.

"It is disease, not the field of action, which digs the grave of armies; it is Malaria by which the burning spirit, fitted for better things, is quenched, and in the coward's bed of death. This is the

Destroying Angel, the real pestilence which walks at noon day; and to which all the other causes of mortality arc but as feeble auxiliaries in the work of destruction." 9.

Most of his readers will agree with our author, that "it is not the field of action which digs the grave of armies." The idea of a field digging a grave is more incongruous than that of a grave digging a field. If Dr. M. had substituted the sword for the field of action, the metaphor would have been highly poetical, and without any thing to shock the ear. We think these little incidental criticisms are fairly called forth, when we see a constant attempt at eloquence, and sublimity of ideas.

Dr. M. alludes to a characteristic feature in the moral character of those who inhabit malarious countries--namely, their firm belief in the healthiness of their native air and soil. Walcheren is instanced as an example. We can positively state that the inhabitants of Walcheren did not "repel with indig nation the charge of unhealthiness which was brought against their beloved birth-place," by our troops on the late fatal expedition. We were there from the beginning till the end of the expedition, and can vouch for the fact, that the inhabitants considered the Autumn of 1809 as a very sickly season among themselves, and remarked that this was the case at intervals of various duration.

Dr. M offers nothing new, when he undertakes to prove that the existence of a marsh is by no means essentially necessary for the production of febrific miasmata. Every naval and military surgeon knows, and many of them have demonstrated in their writings, that malaria will often arise from ground parched with heat-from the summits of mountains-the rocky bottoms of ravines--and the densest forests. We need not refer to the writings of Lind, Jackson, Blane, Burnett, Johnson, Dickson, Fergusson, Musgrave, and hundreds of others, for proofs of this

assertion.

CHAP. II.-Nature of the Evidences respecting the Production of Malaria.

In this chapter, our author is conscious that he is " compelled to resort to proofs of some delicacy, and to appeals to an experience, for which, be it received as it may, he must be very often himself responsible." We are disposed to grant him every degree of liberal indulgence on these delicate points. We agree with him that it is a fundamental fallacy in this case, to limit the power of producing malaria to those soils or situations only, where intermittent or remittent fevers are found to prevail. Such mistake, we grant, is very common in the minds of "imperfectly educated practitioners," of which, however, the number is rapidly diminishing.

This fallacy set aside, the real conclusion (observes our au, ther) to be drawn is-" that, whatever remitting fevers, or fevers of whatever nature, that are not contagious, as well as dysenteries, are produced, the proof of Summer malaria is as complete as if the same soils had, in Spring, produced ague." With some modifications, we can have little difficulty in subscribing to this doctrine; for we have invariably maintained that all endemic, as well as epidemic fevers, were owing to something emitted from the earth--rather than to things generated in the air. This last is merely the vehicle by which the miasma is suspended or wafted about, like the mineral impregnation which mingles with the water of spring or stream.

The careful observer will often perceive that there are certain determinate places, without any marshes, where fevers are almost annually prevalent; while other places in the vicinity are almost wholly or nearly exempt. In the former localities, (Dr. M. avers) some one of the various circumstrances of soil, hereafter to be pointed out as productive of malaria, will, on careful inquiry, be found.

A more delicate proof may be drawn, he thinks, from the fact, that some localities are known to be unhealthy, as compared with other neighbouring places.

"Thus it is a vulgar remark, that in certain houses or places, a family is rarely without some sickness, or, to use the strong but coarse language in which it is generally stated, that the apothecary is never out of the house.' It is almost equally familiar, that families, which had before been healthy, have become the reverse on changing houses or situations; as, in the opposite cases, that they have recovered health by change of residence. Of such facts as these, there is no observer who must not be able to recollect numerous examples." 19.

The laxity of reasoning among medical men, as to the causes of these local peculiarities, is strongly censured by Dr. Macculloch. But he should be merciful, and recollect that all men are not such acute philosophers as himself.

To anticipate, but no more than is here necessary, what must shortly be said on the subject, if a gravelly soil is healthy, it is because its easy drainage prevents the growth of that particular vegetation which is the cause of malaria; and if a clayey soil is the reverse, it is because, by lodging superficial water, it generates, however partially, those marshy or undrained spots, or wet woods, or moist meadows, which are the sources of this poison, and, consequently, of the various diseases confounded under the vague term unhealthiness." 21.

It is to be remembered, however, that gravelly soils often contain spots generative of malaria; while large tracts of clayey