or less required-that purgatives are more useful, or tolerated worse, &c., some years than others, at the same period

or season.

Inexplicable as may be the causes of the general constitution of the atmosphere of particular seasons producing these results, the correctness and truth of the remark will be admitted as unquestionable. While the diseases of Memphis and the surrounding country have each year exhibited some modification in their general character from this cause, a general but obvious change has been going on, probably since the first settlement of the country, and certainly for the last eight years. In the early settlement of the country and town, when but a small proportion of the lands was reduced to cultivation, and the timber was chiefly left standing upon the fields-when the town was like an encampment in the woods, closely surrounded by a heavy forest and thick undergrowth, the atmosphere was so loaded with humidity and miasm, that a state of atony and relaxation of the system was the universal condition of the permanent population who had been long exposed to it.

This condition of the system rendered it peculiarly liable to intermittent and remittent fevers, attended with congestion and great functional derangement of all the secretions, and in the fall and winter seasons especially, to violent and suddenly fatal attacks of congestion of the brain and lungs. Protracted cases of an inflammatory character of disease, were unknown except in recent settlers, arriving with the tone and elasticity of the system common in older, more elevated and improved countries, with a purer, dryer and more bracing atmosphere.

With the growth of the town and the improvement of the country-the clearing up and tramping the lands, rendering them firmer and dryer, the atmosphere has gradually been becoming less humid and filled with miasm, and more elastic and bracing; and the consequence is, that disease has gradually become less congestive and functional, and more inflammatory, complicated, and protracted in its character.

This change has been gradually and obviously manifesting itself every year, but in no year previously have the diseases of the winter, spring, summer, and autumn presented so decidedly an inflammatory character, and required so much depletion by venesection, and so rigid an antiphlogistic treatment as the present.

The statement of these general facts we have deemed proper, before the report of the cases of erysipelatous fever that occurred here, and the treatment that was instituted, because the depletion and antiphlogistic remedies mainly used and relied upon, were not only justified, but required by the medical constitution of the atmosphere of the season and this locality, modifying and rendering inflammatory a disease which in its general character is a pyrexia of excessive action, but deficient in the power and tone of the system.

CASE I.-RW, aged about 30, a carpenter, of steady habits and pretty good constitution, was attacked April 21st with slight hoarseness attended with pain in swallowing.

24th. Hoarseness and pain in deglutition very much increased; the epiglottis so enlarged and œdematous as to project up visibly. In deglutition there was not only great pain but part of the fluids passed into the trachea producing strangling and great distress. The pulse, tongue, fauces, skin, and general condition of the skin normal. No medicine had been taken but a purgative. Treatment-ordered a mercurial cathartic; rubefacient to the throat, and a stimulating gargle of infusion of red pepper, salt and vinegar.

25th. Fever developed; pulse about 90; œdema of the epiglottis increased; swallowing more painful and distressing; venesection 3xxv.; tartarized antimony grs. viij. in solution to be taken through the night so as to produce repeated nausea, vomiting and purging; rubefacients and gargle continued.

26th.—7 A.M. Deglutition less painful and better. The tartar emetic has produced repeated vomiting and purging.

Remedies continued; the antimonial to be given in febrifuge doses.

5 P.M. Fever increased; venesection 3xx.; cal. grs.xv.; stimulating foot-bath; gargle continued.

27th.—8 A.M. Deglutition much less painful and better. The oedematous condition of the epiglottis much relieved. Inflammation more diffused over the mouth, fauces and throat.

6 P.M. Considerable fever, but less swelling of the epiglottis; swallowing pretty good; ipecac. and cal. gr.ij. each to be given every two hours.

28th. The local disease of the epiglottis so relieved as not seriously to effect deglutition, which is still however attended with pain extending to all the muscles concerned in swallowing

The fever continued about a week longer, attended with pain in the pectoral and dorsal muscles, and occasionally paroxysms of spasmodic action in these muscles, so violent and painful as to require two more general bleedings, and repeated local bleedings with cups, followed by blisters, to relieve them. Auxiliary to the depletion, alteratives, diaphoretic anodynes, &c., were persevered in, until slight ptyalism was produced. The disease was gradually subdued and the patient recovered.

Of a very similar attack of this disease, we have been informed, Dr. Russell, of Huntsville, Ala., died some months since.

CASE II.-Mr. R, aged about 45, living in the same house, was attacked May 7th with phlegmonos erysipelas of the fore arm and arm. The limb swelled very much, attended with fever, furred tongue, and deranged biliary secretions. Suppuration occurred, extending between the muscles from near the wrist to the elbow. This case was treated chiefly by my partner, Dr. Frayser, (who assisted in the treatment of most of the cases), with mercurial purgatives and febrifuges, of either antimonials or ipecac. and cal. When suppuration took place, free incisions were made to discharge

the matter, followed by bandaging and the cold dash. He recovered in three or four weeks.

CASE III.-Mrs. R, while dressing her husband's arm had a slight sore on her thumb, on the side of the nail. At that point inflammation commenced May 20th, and the thumb exhibited the appearance of a superficial whitlow.

23d. Thumb less swelled, but a red line extends from it along the course of the absorbents to the axilla. Complains of lassitude and aching in her limbs, with slight fever, and frequent but feeble pulse. Ordered cal. grs.xv.

24th.-7 A.M. Still walking about, but increase of fever and lassitude. Ordered febrifuge doses of cal. and ipecac., to be repeated every two hours.

25th.-6 P.M. Severe pain, tenderness and heat in the abdomen, (which had commenced the evening before), attended with rigors, dry tongue, thirst, frequent tense pulse, and cold extremities. Venesection 3 vj.; cal. grs.xv., morph. gr. d, stimulating foot-bath, hot fomentations to the abdomen, to be applied frequently over a blistering plaster.

26th.-7 A.M. Pain less severe; pulse 130; extremities cold; tongue dry; very restless. 3 iss. oil, emollient poultice to the abdomen, and sinapisms to the extremities.

5 P.M. All the symptoms worse. Great restlessness; prostration; internal heat; very frequent pulse, and extremities cold.

27th. Died in the night. Post-mortem examination objected to.

CASES IV. and V.-Were daughters of II. and III., aged about 12 and 14 years. They were attacked, one the 22d, the other the 24th of May. In both cases the attack commenced with slight chilliness, sore throat, and a remittent form of fever, and about the third or fourth day of the disease, an erysipelatous eruption occurred in both cases, on the side of the face, extending to and around the ear, and down the neck. Treatment:-One was bled, and both were treated with ipecac. and cal. in broken doses, to produce vomiting and purging, followed by mercurial cathartics, worked off

with oil, and also febrifuge doses of antimonials or ipecac. Nitrate of silver applied freely to the eruption, which arrested its progress. They both recovered.

These were the first cases, and they all occurred in the same house. Shortly before they got sick, the house was plastered, and they lived and lodged in it during the time, moving from one room to another while the plastering was going on.

CASE VI. ER, a girl, 14 years old, a visitor of case I., who had been removed near her place of residence, to his brothers, was attacked with sore throat and the erysipelatous eruption very much as cases IV. and V. were. She died about the 18th day of her disease, evidently from effusion in the brain. Having seen her near the close of her disease only, in consultation, the previous treatment cannot be particularly given.

CASE VII-JW, brother of case I., to whose house he had been removed, was attacked about the 10th of May. Having called on the 12th to see case I., who was then convalescent, I saw him, and as he was in the care of another physician, only made a slight examination of his case, which exhibited all the characteristic symptoms of the others-frequent pulse, sore throat, and the erysipelatous eruption on the cheek and neck. Further than seeing a blistering plaster over the eruption, the treatment was not ascertained. Two days afterwards he died of effusion in the brain, as his friends reported there had been delirium some thirty-six hours previous to his death.

CASE VIII. On the 27th of May I was confined with this disease. For near a week previously I had felt languor and lassitude, with increased sensibility to cold, attended with wandering, gnawing pains, a dull headache and a very unpleasant metallic taste.

27th.-8 P. M. Headache; slight continued chilliness; pulse 110, and soreness of the throat. Treatment:-Hot

foot-bath, warm drinks, followed by a cathartic.

28th.-5 P.M. Though the perspiration the night before