A CLINICAL TREATISE ON THE ENDEMIC FEVERS OF THE WEST INDIES, INTENDED AS A GUIDE FOR THE YOUNG PRACTITIONER IN BY W. J. EVANS, ESQ. M. R. C. S. "Quid verum atque decens curo et rogo, LONDON: JOHN CHURCHILL, PRINCES STREET, LEICESTER SQUARE. MDCCCXXXVII. 694. PREFACE. IT is admitted on every hand that of all the diseases which fall under the observation of the physician, none have led to greater discussions respecting their nature, nor to more opposite modes of practice, than those which constitute what is called the " Endemic" of the West Indies. Doubts and difficulties beset the path of the young practitioner in these countries, which reading, unassisted by his own researches and experience, only renders the more confused and discouraging. Fascinated, perhaps, by, the plausible reasoning and partial views of one author, he sees in the cases which present themselves to him, so many gastrites, or gastro-enterites of various types. Daily observation destroys the illusion, and his doubts return. Again, he refers to some established authority for information, and is told that these diseases are not inflammatory; that they are general and essential; depending upon a spasm of the extreme vessels; on a disturbance, interruption, or suspension of the alternate uniform action and rest of the irritable and moving parts of the body; on an affection of some part, or the whole of the nervous system; or on a disease of the blood, &c. &c. He is bewildered and confounded, and either ceases to think further upon the subject, or else endeavours to explain the "proximate cause" in the manner his observation teaches him. Such has been my case—and such is the apology I offer to the public for bringing before it the present treatise. My object is to exhibit the cases as they have occurred to me in all their varieties; to detail faithfully their symptoms; to expose the appearances that the different organs presented after death; and to explain, as far as I am able, the physiological operation of the producing causes. "Une nouvelle époque commence pour la médecine. Il ne s'agit point de reconstruire l'édifice de la science, mais d'y ajouter, et de remplacer plusieurs parties que leur vétusté fait tomber en ruines. Il est à désirer que chaque medecin jaloux de contribuer au perfectionnement de la science des maladies, s'emparant d'une portion de l'ancienne pathologie, en rapproche les observations de ses prédécesseurs, celles de ses contemporains, les résultats de sa pratique, co-ordonne le tout d'apres les lumières que fournissent les progrès les plus récens de l'anatomie et de la physiologie pathologique, et présente les faits que nous possédons sous le jour qui convient à l'état actuel des sciences médicales. Beaucoup d'essais n'atteindront pas ce but, mais aucun ne sera sans quelque avantage pour la science dans ce mouvement general vers le bien, les vaincus eux-memes ne se retireront pas sans avoir contribué au triomphe de la vérité." |