James Johnson.

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THE LIBRARY

OF

THE UNIVERSITY
OF CALIFORNIA

PRESENTED BY

PROF. CHARLES A. KOFOID AND
MRS. PRUDENCE W. KOFOID







University of California Berkeley




, A <y

L j -









7 .



THE

.^

INFLUENCED?

iicemvy of ;.- .






TROPICAL CLIMATES



ON



23u<roj)c#u Constitutions :

BING A

TREATISE ON THE PRINCIPAL DISEASES INCIDENTAL TO
EUROPEANS IN THE

EAST AND WEST INDIES, MEDITERRANEAN,
AND COAST OF AFRICA.



BY JAMES JOHNSON, Xtt.B,

OF THE ROYAL COLLEGE OF PHYSICIANS, LONDON.



FROM THE THIRD LONDON EDITION,

GREATLY ENLARGED.



NEW- YORK :

W. E. Dean, Printer, JVb. 3 Wall-Street.

PUBLISHED BY EVERT DUYCKINCK, GEORGE LONG, COLLINS & CO.

COLLINS & HANNAY, O. A. ROORBACK, AND

JOHN GREGG, PHILADELPHIA.

* 1826.

[Pnce Three Dollars,}



I * * f 1~r f



<r 7



TO



HEADS OF NAVAL AND MILITARY MEDICINE,

DR. JOHN WEIR,



AND



SIR JAMES Me. GREGOR, M. D., &c.



AND TO

HIS MEDICAL BRETHREN

IN FLEETS, ARMIES, AND COLONIES,

THIS

THIRD EDITION

IS RESPECTFULLY INSCRIBED,

BY THEIR SINCERE FRIENB,

The Author.



*







PREFACE

TO THE THIRD LONDON EDITION.



THE First Edition of the following Work was published in
1813, chiefly at the Author's own risk and expense, for he could
find no Bookseller to undertake it. The Second, consisting, as
the First, of 1000 copies, was published in 1818, and has been
more than six months out of print. In the present Edition the
Author has endeavoured to render the work more extensively
useful than ever, by placing before the reader a series of Analy-
tical Reviews of the best modern Works, embracing the Diseases
of Tropical and other sultry Climates. Whoever has seen the
diversified maladies produced by climate, season, constitution,
and co-existing circumstances, will easily appreciate the utility
of thus concentrating the experience, observations, and sentiments
of many individuals, as multiplied resources in exigencies for ever
varying.

The Author has the satisfaction of knowing that the former
Editions of this Work have proved serviceable, not only to his
junior Professional Brethren, serving in sultry climates ; but also
to a very considerable proportion of Naval, Military, and Civil
Officers sojourning between the Tropics. In the Eastern Hem-
isphere a Work of this description was imperiously called for.
where many of the Company's Officers, as Dr. Balfour has justly
remarked " being constantly employed durhrg the first years of
" their service, in the most unhealthy corners of country, remote
" from medical assistance, their success, reputation, health, and
" lives, and the lives of all around them, depend often on the
" medical skill which they may have acquired."*

To the last and present editions of this Work, a new feature
has been added the consideration of Climates bordering on the
Tropics, the diseases of which, at particular periods, resemble
those of equatorial regions. The Author is convinced that this is
an essential requisite in every Work on diseases of the Torrid Zone.
These diseases acknowledge no cancer or Capricorn boundaries.
The same class sallies occasionally from La Plata to the Scheldt
sweeping the Banks of the Ganges, the Euphrates, the Nile,
the Tiber, the Guadalquiver, the Chesapeake, the Mississippi,
the Oronoco, and every sinuosity of the great Western Archipe-
He then who studies the influence of Tropical Climates on

* Preface to Treatise on Sol-Lunar Influence, p. xiii.



VI PREFACE.

European Constitutions, by parallels of latitude, will do so inef-
ficiently. It is like studying the physiology of the stomach or
liver, without regarding the functions of the surrounding viscera.
An appeal may be made to the parallel between the Valley of
Egypt and the Coast of Coromandel, for the truth of this remark.
It will there be seen that the climate and diseases of the one
elucidate those of the other, and that this comparison has solved
a problem in Etiology which has hitherto proved a stumbling
block to Physicians namely, the question of an indigenous poison
existing in India, and occasioning the prevalence of Hepatitis
there.

During the last few years, the Author has had extensive com-
munication, personal and epistolary, with a very great number of
his professional Brethren, on their return from various Climates of
the Globe, and he can conscientiously aver that their reports have
not given the slightest encouragement to change any of the senti-
ments or opinions broached in the former Editions of the Work.
This is a source of great gratification to him and on this fact he
may reasonably ground a hope of the permanent utility of the
publication to those for whom it is designed.

To the present Edition there is an addition of at least 250 pages
of important matter, as will be readily seen on a comparison
with the Second Edition. A few articles have been omitted, and
others curtailed, in order that the new matter might not swell
the Work beyond a single volume. And here the Author is injus-
tice beyond to acknowledge the able and valuable assistance
which he has received from Dr. Dickson and Mr. Sheppard, in
the arrangement and composition of an important division of the
Work.

The Author does not consider it necessary to make any further
prefatory remarks, as the Work must rest on its own merits,
whatever they may be, in its way through the World. He is
very conscious, at the same time, that numerous imperfections
and deficiencies may be readily detected in it by those who find
it easier to judge than act and whose trade is to point out the
failings of others, without correcting their own. To the Cri-
ticisms of this class Author is perfectly callous while to the judg-
ment and opinions of the good and the wise, he acknowledges
himself to be tremblingly sensible. On the liberality and indul-
gence of these he confides convinced that the well-intentioned
effort to be useful to his junior Brethren will be rewarded with
the approbation of all tbose in whose esteem it is desirable to
stand.



ANALYTICAL TABLE OF CONTENTS.



Page

Preliminary remarks on the Human Constitution . ' 10

Degeneracy of the Portuguese in India . . ib.

African children brought to Europe . . ib.

Fool-hardy Europeans in India . . . . .11

PART I.

Primary Effects of Hot Climates on European Constitutions . 13

1. Transitions from Cold to Hot Climates, effects of on the skin . . ib,
Refrigerating Process of Perspiration exemplified

Bad Effects of Stimulation

2. Sympathies between the Skin and internal organs

3. Considerations on the Physiology of the Liver

Effects of a High Temperature on Biliary Secretion . 19

Sympathy between the Skin and Liver . ib.
Vitiation of the Biliary Secretion

4. Lichen Tropicus, or Prickly Heat

PART II Specific Diseases.

EASTERN HEMISPHERE.

. I. Fever in General .... 24

Human Effluvium, or Contagion , '.' ' 25

Contagious Fever in Sir John Moore's Army . . . ib.

Laws of Contagion . / " . . . , . ' .26

Marsh Miasma . .27

Ratio Symptomatum in Fever V' -'' <. *: ,. . 28

Remedies in Fever Venesection '. . *' 34

Purgatives . . . . 35

Cold and Tepid Affusion . . 37

Mercury . . . . ib.

Emetics and Diaphoretics ... 38

Tonics and Stimulants . . .39

II. Endemic Fever of Bengal, or Marsh Remittent ... 41

Medical Topography of the Course of the Ganges . . ib.

Dr. Clarke's Description of the Bengal Fever . .45

Dr. Lind's Remarks on this Fever . ib.

Dr. Clarke's Mode of Treatment, ineffectual ... 46

The Author's Bad Success . . .47

Depletive and Mercurial Treatment . 48

Dr. Balfour'a Plan of Treatment . .52

Treatment by the Natives ...... 54

Etiology of the Bengal Fever ... .55

Marsh Miasmata profusely extricated . 56

Mr. NeUTs Remarks on Miasmal Fevers . .60

Insalubrity of Diamond Harbour . '. . ; . 61

Modus Operandi of Miasmata .62

Predisposing Causes of Fever . . 64

Scheldt Expedition, Remarks on . . 65

Mental Despondency and Intemperance . . 67

SoUunar Influence . . . .69

Difference between East and West India Fevers 70

The Question of Contagion . . . . ' 72

Intermittent Forms of the Fever . - . . . .' 73

III. Analytical Review of a Medical Report on the Epidemic Fever of Coimba-

TW /r t0re .' drawn U P bv Drs - Ainsley, Smith, and Christie . . 76

IV. Mr. Gibson's Observations on the Guzerat Fever, with General Remarks

on the Action of Mercury in the Diseases of India 82
V. Dr. A. Nicoll on the Fevers of Seringapatam

VI. Bilious Fever . . - ,\ gjj

Exemplification of this Fever in the Centurion . . .92

EX vk P in 1800 n f ^ Bataviaa Endemic * a Squadron blockading Bata-'

Cases of the Batavian Fever . U3

General Observations on the Batavian Endemic 122

VI II. Disorders of the Hepatic System J26

Climates of Madras, Bengal, and West Indies compared . 127-



Till CONTENTS.

Page

Ratio Symptomatutn of Hepatic Diseases

Symptoms of Indian Hepatitis . . 138

Treatment of Indian Hepatitis . . 142

Sympathetic Connection between the Mental and Hepatic Functions considered 152

IX. Dysentery . . . . . . 155

Ratio Symptomatum ..... 157

Treatment i ..... 164

Analysis of Mr. Bampfield's Treatise on Tropical Dysentery
Analytical Review of Dr BallingaFs Observations on Indian Dysentery 181

1 Colonitis, a form of Dysentery . . . . ib.

X. Cholera Morbus, Mort de Chien, and Spasmodic Cholera of India . 189

Analytical Review of the Bombay Medical Board's Report on the Epidemic
Cholera of India ..... 197

Review of the Bengal Reports on Cholera . . 205

Review of Sir G. Blane's Paper on Cholera ... ib.

XI. Beriberi . . . .211

XII. Dracunculus, or Guinea Worm ... . . 213

XIII. Elephantiasis . . . . .215

XIV. Mr. Johnson's Observations on Indigenous Customs in India . 217

MEDITERRANEAN.

SECT. I. General Observations on the Climate of the Mediterranean . . 223

Dr. Sinclair on Mediterranean Phthisis . . . 225

II. Analytical Reviews of Dr. Burnett's Work on the Bilious Remittent Fever

of the Mediterranean ... . 227

HI. Review of Dr. Boyd's TJhesis on the Fever of Minorca . . 236

IV. Drs. Irvine and Boyle on the Climate and Fevers of Sicily . . . 241

V. Observations on the Climate and Diseases of Egypt . . 247

VI. Loimologia; or Observations on Plague . . .251

COAST OF AFRICA.

An Account of the Climate and Medical Topography of the West Coast

of Africa . . . . . .261

St. Mary, on the River Gambia . . ... 262

Bulam, in the Rio Grande ..... 264

Sierra Leone . ... 266

Grain Coas . . . . . . 270

Ivory Coast . ib.

Gold Coast - . . . .271

Apollonia . ib.

Dix'Cove . . "... . . . 272

St. George del Mina ...'.,, . . . 273

Cape Coast Castle . ib.

Accrah Country .... 274

Slave Coast ... . . . .276

Fevers and Dysenteries . . < . . 277, 278

WESTERN HEMISPHERE.

SECT. I. Analytical Review of Dr. Bancroft's First Essay on Yellow Fever . 279
II. Review of Dr. Bancroft's Sequel to the above . . . 280

III. Dr. Dickson's Topographical Observations on the Causes and Prevention

of the Tropical Endemic . . . . 328

IV. Observations on the Locale of Yellow Fever, by Dr. Fergusson ; with Ob-

servations on the Mariegalante Fever, by Drs. Dickson and Mortimer 346

V. Account of the Causus, or Yellow Fever of the West Indies, by Dr. Me.

Arthur ...... 356

VI. On the Inflammatory Endemic of New comers to the West Indies, from

Temperate Climates, by Nodes Dickinson, Esq. . . .365

VII. Tetanus ...... 369

VIII. On the Dysentery of New Orleans, by Archibald Robertson, M. D. . 375

PART III.

TROPICAL HYGIENE.
Preliminary Observations ..... 388

SECT. I. Dress ..... .390

II. Food ..... .394

III. Drink ... ... 400

IV. Exercise ... .405

V. Bathing .... .409

VI. Sleep .... 412

VII. The Passions . 415



THE

INFLUENCE OF TROPICAL CLIMATES

ON

EUROPEAN CONSTITUTIONS.



I BELIEVE it is a general opinion among philosophers, that the
constitution of man is better adapted to bear those changes of tempe-
rature, &c. experienced in migrating from a northern to a tropical
region, and vice versa, than that of any other animal. They proudly
observe, that this power of accommodating itself to all climates, is a
distinctive characteristic of the human species, since no other animal
can endure transplantation with equal impunity. But I think it would
not be difficult to show, that for this boasted prerogative, man is more
indebted to the ingenuity of his mind, than to the pliability of his
body.

To me, indeed, it appears, that he and other animals start on very
unequal terms, in their emigrations. Man, by the exertion of his
mental faculties, can raise up a thousand barriers round him, to obvi-
ate the deleterious effects of climate on his constitution ; while the
poor animal, tied down by instinct to a few simple modes of life, is
quite defenceless. Nature must do all for the latter ; and, in fact,
it is evident that this indulgent mother does compensate, in some de-
gree, for the want of reason, by producing such corporeal changes, as
are necessary for the animal's subsistence under a foreign sky, in a
shorter space of time than is necessary for effecting correspondent
changes in man. One example may suffice. The tender and inno-
cent sheep, when transported from the inclemency of the north to
pant under a vertical sun on the equator, will, in a few generations,
exchange its warm fleece of woo/, for a much more convenient coat of
hair. '* Can the Ethiopian change his hue," in the same period, by
shifting his habitation from the interior of Africa to the shores of the
Baltic ? Or will it be said, that the fair complexion of Europeans, may,
in two or three generations, acquire the sable tinct of the inter-tro-
phical natives, by exchanging situations ? Assuredly not. Where
then is the superior pliancy of the human constitution ? The truth is,
that the tender frame of man is incapable of sustaining that degree
of exposure to the whole range of causes and affects incident to, or
arising from vicissitude of climate, which so speedily operates a change
in the structure, or at least, the exterior, of unprotected animals.

2



10 MIGRATION.

But it is observed, that of those animals translated from a temper-
ate to a torrid zone, " many die suddenly , others droop, and all de-
generate." This is not to be wondered at, considering the disadvan-
tages under which they labour. Man would not fare better, if plac-
ed in similar circumstances. Even as it is, the parallel in not far
from applying. Of those Europeans who arrive on the banks of the
Ganges, many fall early victims to the climate, as will be shown here-
after. That others droop, and are forced, in a very few years, to
seek their native air, is also well known. And that the successors
of all would gradually degenerate, if they remained permanently in
the country, cannot easily be disproved ; while a very striking in-
stance, corroborative of the supposition, may be here adduced.

Whoever has attentively examined the posterity of De Gama, and
Albuquerque, now scattered over the coast of Malabar, the plains of
Bengal, and the Island of Macao, once the theatres of Lusitanian
pre eminence, will be tempted to exclaim :

'Twas not the sires of such as these,
Who dared the elements and pathless seas ;
Who made proud Asian monarchs feel
How weak their gold was against Europe's steel-
But beings of another mould,
Rough, hardy, vigorous, manly, bold !



In answer to this it will be alleged, " that they have married and
blended with the natives until all shade of distinction is obliterated."
But it is well known to those who have resided long in India, that the
two great prevailing classes of society in that country, the Hindoos
and Mahomedans, hold these descendants of the Portuguese, in the most
marked and sovereign contempt ; while the latter, still retaining a
remnant of the religion, and all the prejudice of their progenitors,
entertain an equal abhorrence to their idolatrous and infidel neigh-
bours. This being the case, we may fairly presume, that the inter-
mixture has been much less extensive than'is generally supposed ; an
inference strongly supported, if not confirmed, by the well known
fact, that, while the people in question have forfeited all pretentions
to the European complexion, their more stubborn features still evince
a descent, and establish their claim to an ancestry, of which they are
superlatively proud. Let those who deny one common origin of man-
kind, and that climate is the sole cause of complexion, explain this
phenomenon if they can.

On the other hand, if we look at inter-tropical natives approach-
ing our own latitudes, the picture is not more cheering. The African
children brought over by the Sierra Leone Company for education,
seldom survived the third year in this country. " They bear the
first winter, (says Dr. Pearson,) tolerably well, but droop during the
second, and the third generally proves fatal to them."

The object of these remarks, which, at first sight, might seem irrele-
vant, will now appear. Since it is evident that nature does not operate
more powerfully in counteracting the ill effects of climate on man,
than on other animals, it follows that we should not implicitly confide,



PLAN OF THE WORK. 1 1

as too many do, in the spontaneous efforts of the constitution, but on
the contrary, call in to its aid, those artificial means of prevention
and melioration, which reason may dictate and experience confirm.
In short, that we should, as my motto expresses it :

" Study well the clime,

Mould to its manners our obsequious frames,
And mitigate those ills we cannot shun."

That these salutary precautions are too often despised or neglect-
ed, a single quotation from a gentleman, who has resided more than
twenty years in India, and whose talent for observation is, in rny opin-
ion, unequalled, will put beyond a doubt. '* Nothing can he more
preposterous, (saysCapt Williamson*,) than the significant sneers of
gentleman on their first arrival in India ; meaning thereby to ridicule,
or to despise what they consider effeminacy or luxury. Thus se-
Teral may be seen walking about without chattahs, (i. e. umbrellas,)
during the greatest heats. They affV-et to be ashamed of requiring
aid, and endeavour to uphold, by such a display of indifference, the
great reliance, placed on strength of constitution. This unhappy in-
fatuation rarely exceeds a few dayw ; >it the end of that time, we are
too often called upon to attend the funeral of the self-deluded vic-
tim."'!

I shall be my endeavour in this essay, after tracing the causes,
and pourtraying the effects of tropical diseases, in such a manner as
must impress the most heedless European with the necessity of cir-
cumspectionon approaching the scene of danger, to furnish a code
of instructions deduced from principle and experience, that cannot
fail to prove a usefiil companion to every one who regards health as
the grand source of happiness, and the most invaluable blessing
which heaven can bestow. Many a day's anxiety and personal suf-
fering should I have escaped, had I been furnished with so friendly
a monitor !

Without any very fastidious regard to arrangement, it will still be
necessary, for the sake of perspicuity, to observe some order. I
shall therefore divide the *utject into three principal heads, viz :

1. The Primary or General Effects of a Tropical Climate on the
European Constitution.

2. The Specific or Actual Diseases.

3 Prophylaxis; or the Means of Counteracting the Influence of
Climate and Preserving Health.

* Author of " Oriental Field Sports," ' East India Vade Mecum," c-
t East India Vade Mecuin, vol- 2. page ii.



PART I.

PRIMARY OR GENERAL EFFECTS,



UNDER this head, I shall consider some of those gradual and pro-
gressive changes in the constitution, and deviations from previous
health and habits, which, though predisposing, and verging, as it
were, towards, yet fall short of actual disease.

These are consequences which all must expect, more or less, to
feel, on leaving their native soil, and, of course, in which all are di-
rectly interested. For although a few individuals may occasionally
return from even a long residence in hot climates, without having
suffered any violent illness, or much deterioration of constitution,
yet the great mass of Europeans will certainly experience the effects
developed under this head, and many others of minor consequence,
which will be taken notice of in different parts of the work.

It is, however, by the most scrupulous attention to these incipient
deviations from health, by early arresting their growth, or at least re-
tarding, as much as possible, their progress, that we can at all ex-
pect to evade those dangerous diseases, to which they inevitably,
though often imperceptibly, tend.

Sect. 1. The transition from a climate, whose medium heat is
52 of Fahrenheit, to one where the thermometer ranges from 80
to 100 and sometimes higher, might be supposed, a priori, to occa-
sion the most serious consequences. Indeed, 4he celebrated Boer-
haave, from some experiments on animals, concluded, that the blood
would coagulate in our veins, at a temperature very little exceeding
100. More modern trials, however, have proved that the human
frame can bear, for a short time at least, more than double the above
degree of atmospherical heat, and that too without greatly increasing
the natural temperature of the body.

The benevolent Author of our existence has endowed man, as well
as other animals, with the power not only of generating heat, and
preserving their temperature, in the coldest regions of the earth ;
but has also provided an apparatus for carrying off any superabun-
dance of it that might accumulate where the temperature of the at-
mosphere approaches to or exceeds that of the body. With the for-
mer process, which is supposed to be carried on in the lungs, we have,



14 PERSPIRATION.

at present, nothing to do ; the latter is one which deserves great at-
tention, and which will meet with ample consideration in various
parts of this essay. 9

We are no sooner beneath a vertical sun, than we begin, as may
naturally he supposed, to experience the disagreeable sensation of
unaccustomed warmth ; and as the temperature of the atmosphere,
even in the shade, now advances within tenor twelve degrees to that
of the blood, and in the sun very generally exceeds it, the heat per-
petually generated in the body, cannot be so rapidly abstracted, as
hitherto, by the surrounding air, and would, of course, soon accumu-
late so as to destroy the functions of life itself, did not Nature imme-
diately open the sluices of the skin, and by a flow of perspiration, re-
duce the temperature of the body to its original standard.

Whether the superabundant animal heat combines with the perspir-
able fluid, an< thus escapes; or whether the refrigeration takes
place on the principle of evaporation, is more a matter of specula-
tion than practical importance to ascertain. We know the fact, that
perspiration is a cooling process. The modus operandi

" Let sages versed in Nature's lore explain.' '



When we contemplate this admirable provision of nature, against
what might appear to us an unforeseen event ; when we survey the
resources and expedients which she can command on all emergen-
cies her power of supplying every waste, and restraining every
aberration of the constitution, we would be almost tempted to con-
clude, that man was calculated for immortality ! But, alas !



There is a point,

" By nature fixed, whence life must downward tend,"

'Till at length, this wonderful machine, exhausted by its own ef-
forts at preservation, and deserted by its immaterial tenant, sinks,
and is resolved into its constituent elements !

Nasceotes morimur, finisque ab origine pendet.

But, to return. We must not conclude that this refrigerating pro-
cess, adopted by nature to prevent more serious mischief, is, in itself,
unproductive of anjr detriment to the constitution far otherwise.
' If, (says Dr. Currie,) the orifices do not pour out a proportionate
quantity of perspiration, disease must ensue from the direct stimulus
of heat ; and if the necessary quantity of perspiration takes place,
the system is enfeebled by the evacuation."*

Here, then, we have Scylla on one side, and Charybdis on the
other : morbid accumulation of heat if we do not perspire enough
debility if we do. How are we to direct our course through this
intricate and dangerous navigation ?

* Medical Reports, Philadelphia edition, p. 192.



PERSPIRATION. 16



Dr. CURRIE.

" Europeans who go to the West Indies are more healthy, in pro-



Online LibraryJames JohnsonThe influence of tropical climates on European constitutions : being a treatise on the principal diseases incidental to Europeans in the East and West Indies, Mediterranean, and coast of Africa → online text (page 1 of 55)