No.7.] LONDON, SATURDAY, MAY 21, 1825.

LECTURESON THE

PRINCIPLES AND PRACTICE

OF PHYSIC,

BY DR. ARMSTRONG.

y/tMth’e 0/’ Anatomy, Webb Street.

Those of our readers who have

seen the articles in the " LYestntin z

ster Review," on the" PLAGUE andSANATARY LAWS," will not be a littlesurprised to find that the followingadmirable Lecture, which embraces the

facts and opinions contained in thosearticles was delivered by Dr. ARM-

STRONG four years since, and they willbe still more surprised at the want of candour evinced by the writer of the

essays in question in not acknowledg-ing the source from which he derivedhis information, when we further

state, that he was then, and has sub-

sequently been, in the habit of at.

tending Dr. ARMSTRONG’S discourses.

LECTURE 26.

0)! the origin of Typhus Fe’l’er, in whichits Contagious or Non-coratagiotcs na-ture is considered.

IN my last Lecture, that on Erysi-pelas, I tinisiipd the consideration ofthe varieties of Common Fever, thatfever which, under all its modifica-tions, arises from the operation ofcommon causes, namely, common de-

pressants, common irritants, commonstimulants, or common interrnptants;and I have proved, I trust, by a re-ference to symptoms, to dissections,and to the effects of remedies, thatthis fever is legitimately divisibleinto three great leading varieties,namely, common congestive, commonsimple, and common inflammatoryfever. One or two slight deviationshave been made from that arrange.ment, as far as the remote occasionsare concerned ; and hence, in speak-ing of inflarnmation of the air pas.sages, I showed that it sometimesarose from a common cause, such as

cold, and sometimes from a peculiarcause, such as an epidemic constitu-tion of atmosphere. In like manner,it was explained how the purulentform of opiithalmia sometimes pro-ceeded from the intensity of a com-mon cause, and sometimes from theapplication of a peculiar virus ; andlastly, it was particularly illustrated,that erysipelas, under itsphlegmonoid,erythrematic, or specific varieties, de-pended upon common or peculiarcauses, and that, in the two last men.tioned varieties, the affection of theskin was only a small part of the dis-order, the pia mater and arachnoid,and more especially the mucous mem-brane of the bronchia and of the in-testines being always affected, and.occasionally even the tunics of someinternal arteries and veins. Havingproceeded so far, I have now to enterupon the investigation of those agentsin nature which have not the proper-ties of common causes, but which aremarked by special ones; yet believe-that I shall here also be able to show,by facts and fair deductions, thatthese peculiar causes, namely, thepoison called malaria, human conta-ions, and certain epidemic conditionsof atmosphere, likewise produce threeforms of fever—the congestive, simple,and inflammatory-in reference to.

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their internal pathology, blended,however, with some peculiar effectsproceeding from the peculiarity of theremote cause or occasion ; such ef.fects being the most conspicuous inthe external pathology, such as therash of measles, the eruption of smallpox, or the efflorescence of scarlet.fever. This doctrine, I repeat, shallbe confirmed by an appeal to symp-toms, dissections, and the effects ofremedies.

With respect to the peculiar causeswhich produce fever, there are somewhich may be termed infections andothers contagions, for remember tiiatI make a distinction between infec-tion and contagion ; infection is a

local taint, or contamination of air,which arises from a combination of

agents or circumstances external tothe human body ; whereas, as far ashuman inquiry has yet legitimatelyextended, contagion originates, notwithout, but within the body, an ap-parently subtile secretion from theblood itself, the mode of the primarygeneration of which is yet one of thearcana of nature. Besides, there ap-pears to be another difference betweencontagion and infection, namely, thatcontagion is unquestionably cotiimu-nicable from person to person, this

eommunicability being the true test ofa contagion ; whereas, though it hasbeen presumed, that febrile disorder i,commencing from an infection, as bye-fore defined, propagates itself by con-tagion, by the new formation or asi-milation of some subtile and specialpower or poison—though this, I say,lias been presumed, yet it has not, tomy mind at least, been indisputablyproved to be the case; and to me itappears a problem still requiring asatisfactory solution. That fever aris-ing from infection propagates itself bycontagion is the prevailing dogma oftime-established schools and colleges,but there it amounts only to a preju-dice ; an opinion taken up and main-tained without due examination ; anopinion which, like most others de-scended from such authorities, re-

quires to he tried and tested by onrown individual and dispassionate in--v4estigalions, for the time has at lengthcome when the human mind maintainsthe sacredness of independent in-

quiry.

In this lecture I shall confine my-self to the consideration chiefly of oneinfection, namely, that which is vaguelycalled Malaria, or Marsh Mitism, andwhich originates from certain condi-tions of the earth and air. It is anexhalation which, evading our senses,is only, in the present state of ourknowledge, distinguishable by its ef.fects. What are these effects ? Theseare, first, the production of an inter-mittent form of fever; secondly, of aremittent form of fever ; and thirdly,of a continued form of fever; eachhaving, as will be shown in my nexttectnre, a peculiar combination ofsymptoms by which they differ fromcommon fever, although their internalpathology is similar to fevers proceed-ing from common canses, that is to

say, it is congestive, it is simple, orit is inflammatory fever, under the

general operation of this peculiaragent : the intermittent, remittent,and continued forms of fever, each

having certain peculiar combinationsofsymptoms as the regular effects of ma.laria, or marsh efliovia. The intermit-tent form of fever is simple, the remit-tent inflammatory, and the continuedstill more highly inflammatory, as willbe clearly demonstrated in my next.Though the intermittent, remittent,and continued forms of fever, frommalaria, pass and repass into eachother, yet it is to the continued formthat the designation of typhus hasbeen attached, under the suppositionthat it proceeds from human conta-gions, and that it is not related to theintermittent and remittent forms.

Typhus Fever.

Now it happens that we have nocorrect definition of typhus, nay, notthe semblance of a definition, for it isan insnit to common sense to admitCULLEN’s definition to be such, which,including none of the essentials of

typhus fever, is so loosely worded asto be applicable to the last stage ofany fever where the brain has beenmuch affected in the first. Indeedmost of Cullen’s definitions, as theyare called, are merely nominal, notreal definitions, since they are ab-stract words, by which a number ofsymptoms arestrung together, withoutany reference to the pathological con-

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ditions upon which those symptomsdepend. This is particularly the casein regard to what Cullen denominat-ed febres, concerning the true natureof which he seemed to know little or linothing; and yet this is the author Iwho is held as a guide in most of ourschools and systematic works ! Yonare aware that Cnllen has certainartificial distinctions, which he callsclasses, orders, genera, and species.A definition of a class, nosologically,is the most general description whichcan be given of affections which havesymptoms in common; and a defini-tion of an order is the next most gene-ral description, while that of thegenera and species becomes more andmore particular. Now Cullen’s defi-nition ofpyrexia is this, " After shiver-ing succeed, a quick pulse, increasedheat, with interrnption and disorderof several functions ; diminution ofstrength, particularly that of the

joints." That this definition is verygeneral must be admitted, indeed no-thing can be more indefinite ; besides,it is really inaccurate as to matter offact. Ctillen here assumes, that shiver-ing is always an essential part of fe-ver ; but I showed, on a former occa-sion, that fever sometimes arises fromthe direct application of a stimulant,without any cold fit or shivering atall; neither does the hot stage inva-riably follow the cold one, as this de-finition implies, for the cold stagesometimes remains and constitutes

genuine congestive fever. But to goto his order febrcs, which he definesthus ..... Pyrexia, preceded by languor,lassitude, and other signs of debility,without any primary local disease."—This definition, you will perceive, is

only a repetition of the former, withthe addition of a particular clause,namety, the words, " no primary lo-cal disease," by which he distinguishesit from the class. Pyrexia is made,by Cullen, a part of the definition offebes, and the definition of pyrexiadescribes the functions as being muchdistarbed, yet we are told, even infebres, that there is no primary localdisease. He assumes this, but it isa metaphorical and medical absurdity,for no disorder of the functions canpossibly take place without havingbeen preceded by some change in theorgans connected with such functions,

and that change is, as I before at-

tempted to prove, either a state otdisorder or disease. Ctillen, like manyof the older authors, did not, it mustbe confessed, discover the existenceof that disorder, and therefore theterm idiopathic fever was an admira-ble shelter of expression, one nicelyfitted to conceal an ignorance respect-ing those alterations which take placewithin the body.

If we pass on to CULLEN’S conti-

nued fever, he describes it after thisfashion : " Fever, without intermis-sion, not arising from marsh miasma,but continuing with remissions andexacerbations, although not very re-markable, two paroxysms in eachday." Here is an assumption that acontinued fever never arises frommalaria, or marsh miasm ; but thetruth is, as will by and bye appear,that this cause, operating in almostall parts of the inhabited world, doesvery frequently indeed produce con-tinned fever, that usually termed ty-phus. If we pass on to his snbdivi-

sions of continued fever, we find hissynocha, his synochus, and his typhus.As to his definition of synocha, whatis it pray? He says, the heat is muchincreased, the pulse freqnent, strong,and hard, the urine red, the ftine-tions of the sensorium little disturbed.Now only recollect that synocha is

arranged under the order febres,where, according to Cullen, there isno primary local disease." But didany m.)n ever see a fever, attendedwith such symptoms, which was not

preceded by some primary tocat dis-order ? Most confidently, I answer,never. Synochus, we are informed,by the same authority, is a fever com-pounded of synocha and typhus; a

synocha in the beginning, and a ty-phns towards the end. Indeed ! Is adisorder really one thing at the com-

mencement, and another at the close?Do small pox, measles, scarlet fever,pass into each other ? Is there anyknown affection which so changes itscharacter, nay, its constitution ? This

’. is surely a nosological subtility, notsanctioned by what is yet known in, the changes of explored nature. Buti let ns- hear what CuM.EN says abouttyphus. It is, agreeably to his creed,a contagious fever, in which the heat, is but little increased; the pulse

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weak, small, and in general quick;urine little changed ; the animal func-tions much disturbed ; prostration ofstrength. But did any man ever wit-ness such a concourse of symptomsunpreceded by primary local disor-der ? The answer is, assuredly never.Moreover, this enumeration of symp-toms is no more applicable to typhusfever than to any other fever, wherethe powers of life are giving way,and where the brain is oppressed. Intruth, it contains no correct allusions

ito genuine typhus fever, the cliarac-ters of which I shall endeavonr todescribe, when I shall hae premised,in this Lecture, some remarks on theremote occasions, and its contagiousor non-contagions nature.

Remote Causes of Typhus.The remote exciting cause of typhus

is peculiar, but there are certain cir-cumstances which favour the opera-tion of this cause, and they may becalled the predisposing causes, all of

which operate in one mode, namely,by producing debility. It is in thisway, if an army be in full retreat,the minds of the men being harassed,and their bodies enervated, and if

they pass over, and especially if theyrest in, a district where the malariaprevails, typhus is almost sure tobreak out amongst them. It is on thesame principle that famine becomesthe predisposing cause of typhus, forthen people experience physical Ytantwith mental distress. The history otthis fever in Ireland has often beenconnected with scarcity, of whichmany proofs might be given. The

epidemic which occurred in and aboutLondon, in the year 1818, shows theinfluence of the same cause ; many of’the poor were then almost starving,and the summer having been anusnallyhot, they were very much predis-posed to the attacks of typhus. Fast-

ing predisposes powerfully in some;thus, if a man go out without hisbreakfast and fatigue himself by a

long walk or business, he is very lia-ble to be attacked by this disorder, if

exposed to the exciting occasion. Itis for the same teason, namely thatof depressing the mental and physicalpowers, that fear operates so deci-

dedly in predisposing to this affec-

tion. The Romans were so well awareof this, that they had no less thanthree temples in different parts ofItzily, to inspire the people with con-fidence, dedicated to the goddess Fe-bris. In modern Turkey, the doctrineof predestination prevails among thenatives, and travellers assert that theyare less liable to plague than stran-gers who do not believe in that doc-trine to the same unqualified extent.Charms were worn in ancient times,and incantations performed for the

purpose of communicating cottfidence;nay, even in the present times, peopleoften put camphor bags about theirnecks, which give the wearers con-rage, and courage is the best preven-tive of typhus. The weather also

powerfully predisposes to the infla-ence of infection, especially dampstill weather, and therefore the all-

tumn generally favours its operation.Cold is supposed by some a cause oftyphus, but it is merely a concurrentone, by weakening the body. Women,upon the whole, are more liable thanmen, but the strongest individual maybe attacked, if exposed to a concen-trated malaria, or marsh miasm. For-merly I believed, that human conta-gion was the primary and sole excit-ing cause of typhus fever; but havingbeen accidentally led into a new pathof inquiry, and having discovered, tamyself, at least, satisfactorily, that Iwas mistaken in this respect, the onlyreparation which I can make is thuspublicly to acknowledge my error, andhowever humiliating such an acknow-fedgment might be to human pride,yet I have the reward of possessingwhat I hold to be the truth at last.

It is now nearly six years ago sinceI attended an individual who had anintermittent fever or ague, distinctlymarked by the cold, hot, and sweat-ing stages, followed by a perfect in-

termission, and recurring at certainintervals. But in a few days this feverlost the intermittent type, it becameas distinctly remittent for a few days,and then this remittent cleanged itscharacter and became continued, andat last assumed the most malignantsymptoms of typhus. This case madeso deep an impression on my mind,that I could not help asking, whetherintermittent fever, remittent fever,

and the continued fever, called ty-

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phns, might not be modifications ofone and the same disorder? At allevents, I determined to investigatethe subject most minutely, and com-menced it, independently of the for-mer prejudice of my college educa-tion, as if, indeed, I had known no-

thing previously on thesitt’ject. Theresult of my inquiries is, that I be-lieve malaria to be the primary sourceof what is commonly denominated

typhus fever, that this fever has an in-termittent, remittent, and a continuedform, and that each of these forms sopass and repass into each other as toshow that they all are realiy modifi-cations of one affection, as far as

their remote exciting cause is con-

cerned. Having imagined, on colle-

giate authority, for a term of fifteenyears, that typhus originated fromhnman contagion, and having disco-vered this opinion to be erroneous,the very relation of such a circum-

stance onght to teach you how cautiousyon should he in forming your opinionson matters of importance; that youshould not, in fact, take them up uponthe mere assertions of others, bnt de-duce them from a consideration of

facts, viewed neither through a me-dium of prejudice, nor of partiality,with respect to particular persons.When I communicated this change ofmy opinion to some of my acquaint-ance, I have been much amused toobserve how it has been received.One shrubs up his sloolders, hems,and says that it is very strange; ano-ther cocks his eye into a corner, putshis hand into his pocket and smiles,sarcastically smiles ; a third shakeshis head, and swears that typhus notonly arises from, but propagates itselfby contagion ; while a fourth strokeshis chin, seems at a dead stand, andsays that it is a subject which certain-ly requires fur ther investigation. Nowif at the end of this Lecture youshould stloke yonr chins, and makea similar declaration, I shall be per-fectly content, for all that I wish is,not that you should adopt my opinion,but that you should investigate foryourselves, with all that sincerity,with all that punity of mind which itsgreat importance to society demands.But to come to the facts; What are

he facts which justify the opinionhat typhus arises from malaria? I

shall now adduce those which I havedelivered from this place for someyears past, and which, I believe, whentaken together, you will deem per-fectly conclusive as to the primarysource from which typhus proceeds:

1. Typhus often arises simnltaneous-ly, in single cases, in places remotefrom each other. This circumstance

frequently occurs both in and aboutLondon, and I ask, how is it to be ex-plained on the doctrine of contagion,no direct or indirect intercourse hav-

ing existed, by persons or things inthese situations?

2. It often attacks many persons atthe sriite time, and in the same place.An instance of this occurred sometimeago, in which several children wereattacked in one day, in a school whereno fever had previously prevailed.How is that to be explained on thedoctrine of contagion?

3. Where many persons are attackedin the same place or district, if youtrace the history of the cases minutelybackwards, you will generally findthat some appeared under an inter-

mittent, some under a remittent, andothers under a continued form, a factfor which the doctrine of contagioncannot account.

4. These forms, namely the inter-mittent, remittent, and continued,pass and repass into each other in

many cases, the intermittent becom-

ing remittent, and the remittent be-coming continued ; while, on the otherhand, the continued sometimes be-comes remittent, and the remittentsometimes intermittent; and does thedoctrine of contagion at all explainthis conversion ? It certainiy does

not, whereas the doctrine of malaria.does, since it produces an intermit-tent, a remittent, and continued fever.convertible into each other, a pecu-liarity which is not observable, so faras I know, from any other remote oc-casion whatever.

5. Typhus prevail most remarkablyin particular places. The common

opinion is, that it prevails only incrowded situations, but this is a greatmistake, as can be easily proved byan advertence to facts, which are ex-hibited within the metropolis, andwithout its boundaries in the mostopen di-.tricts of the country. A househad been shut np for some time, when

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be vitiated, as it is sometimes, bywhich persons wili wish to eat char-.coal and clay, then we say that such

’’

a being has a bad taste. There is a

power of configuration; is it submit-ted to laws ? Can a person having thispower say, I shall find ugly thingsbeautiful ? We want to know whe-ther the activity of the internal pow-ers is going on right or wrong, and itis this sort of decision of the internalpowers acting perfectly that we calljudgment. In the arts this power issometimes -called judgment, andsometimes taste. The greatest acti-vity of a power does not always indi-cate the best judgment. We com-

pare here the operations of the mindwith those of the body, and we findthat it is not every one who has thebest appetite that has the best diges-tion ; not every one who has a fine earthat has a perfect action in the ear;nor has every one who has a goodtaste a delicate taste. Some who arefond of music are not capable of

judging correctly of its merits ; somewho are fond of colours are not capa-ble of judging of them ; hence we mayhave as many judgn:ents as there arepowers. There is ro fundamentalpower of judgment, but it is the at.tribute of the powers I have alreadyspoken of!What we call a philosophical judg-

ment in the reflective powers, whatis that ? The judgment of each poweris confined to itself, as colour, me-lody, configuration, &c. ; but as we

have spoken of certain reflective

powers which act differently fromothers, we perceive these powerssometimes to be active, and whenthey are active, then the result is thatwhich is called a philosophical judg-ment : but it is not of itself a funda-mental power, it is merely the perfectstate of action of the individual now-ers. One may have a perfect actionin comparison, but not in causality.

Is there a power of association ?Association takes place we know, butis there a power of association ? It issupposed, in general, that one powerexcites another. I may see a colour,and it may remind me of a person Isaw with clothes of that colour, of athing of that colour. Is there a powerof association? There is a combina-tion of the individual powers, but

those are wrong who speak of an in-dividual power of association. Thuswe are able to rectify by phrenologythe abuses of’ philosophy, and what-ever has been said by philosophers ofthe mind, can only be explained by areference to the individual powersthemselves, and then we have seenhow diversified are the modes of ac-tion, which have been mistaken forprimitive powers. We have takenquite a new step to-day, particularlyas regards the modes of action of thedifferent powers.

Now I wish to touch on another

point, after having examined the pow-ers themselves, their natural lan-

gnage, and their modes of activity,and this is certainly a very importantpart of the subject, to study the modesof the activity of the powers; I cometo the mutual influence of the poivers;no power acts alone, all the ponersact in a combined way, and in thiscombined operation there are various

subjects to be considered. First, Howthe powers ought to act. It seems to

me, that the powers are given, accord-ing to certain riiles, as theyougtitto to

act; therefore letns first look at menas they ought to be, and then as theyare ; but v-e always wish to see man-kind act as they ought to do. Themutual influence of the powers opensa wide field of study, all immensefund of phrenological inquiry is openhere, to examine the mutual inflnenceof the powers, and this is necessary if

you wish to speak of actions. Youmost, I repeat, first discover the dif-ference between the fundamental pow-ers, next their different degrees ot ac-tivity, and, lastly, their mutual in.fluence. The mutual influence of the

powers produces a greater decree ofactivity in the powers individually,and therefore produces an infinitenumber of modifications of actions.A power being combined with two,three, or four other powers, ivill pro-duce quite a peculiar action, very dif.feren from what it would do, snppos.ing it to act alone. The result of thecombined opeiatioii of the powerswill be considered in a future Lecture.I wish now only to call your attentionto one point, that of the powers whichact according to determinate rules;some take the lead and others remain

behind, and the question for conkide-

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ration is, which ought to take the

lead, and which ought not ? Frequent-ly I am told by a person,

" You do

not like to speak of my organs, becausethey are bad;" but I say,

" No, I donot, I cannot speak of good organs orbad organs ;" the organs in themselvescannot be good or bad, since these areonly relative terms. Is water bad or

good, or is fire bad or good ? You can

only answer this question by makingapplication of either one thing or the jother, and then the application maybe good or bad. Now comes the greatquestion about arrangement.Reflect a little oa this, whether a

man comes into the world with cer-taiu regulations,-;n his powers ? thequestion is very difficult. I wish toknow whether we can change the lawsof nutrition, or of circulation, or ofrespiration? I am always inclined todefend the rights of the Creator, andthe laws of Nature. Can you changethe laws of digestion?There are laws to be submitted to,

but they are not sufficiently attendedto; and I wish to know whether thereis any arrangement here, whetherthere is any internal law given to re-gulate the fundamental powers.The next time, I shall consider all

tbe objections which have been enter-ed against phrenology, as leading tomaterialism, fatalism, and the de-struction of all moral and physicalliberty.

LECTURE XV.

LADIES AND GENTLEMEN,By degrees you will perceive, that

the study of phrenology is very ex-tensive ; so extensive indeed, that itembraces the whole range of humanknowledge. You have seen, that afterhaving studied certain manifestationsof the mind, and after having observed the correspondence between theirdevelopment, that some applica-tion of the knowledge thus derivedhasbeen made to the arts- You haveseen how opposed phrenology is tothe speculative philosophy of theschools, and how deceptive their opi-nions are, which have regarded themodifications of the mental powers aspowers themselves ; whereas they arebut the modes of action of the fun-

damental’ powers. I come to-day toa new sort of consideration.Many who at first opposed phreno-

logy have, from an examination of itsdoctrines, become converts to it andthe greatest number of those who atpresent show an opposition to it, arenot correctly informed of its nature orof its objects. I would say to thosewho suppose phrenology to have adangerous tendency, Phrenology, is ittrue or is it false ? If it be not found-ed in truth, no danger can attendit, because it cannot stand long ; andyou know, that in natural philosophymany truths were, when first promul-gated, considered dangerous, and wereattempted ta be suppressed ; the dis-coveries of Copernicus were for a longtime so treated. Whatever is founded

in nature, remains ; hence we beginby observing in phrenology the fun-damental powers, and if the brain benecessary for the manifestations of themind now, that will remain eternallytrue. I would say to all those who cryagainst phrenology and maintain thatit is dangerous, Yes, I admit it, Iknow no modern doctrine so danger-ons as phrenology; but to whom is itdangerous ? Do vou think that anvtruth whatever is dangerous to man-kind at large? Impossible! for thatwould be to accuse the Creator, whois the author of truth. But to whomis it dangerous ? It is dangerous tomere speculative philosophers, for’they must either prove that phreno-logy is unfounded in nature, or theymust give up their self esteem andfalse systems, and acknowledge thatthey are ignorant of the human mind.It must modffy the opinions hithertoprevalent in society, and this will

prove dangerous to mere theorists,who, ignorant of the powers of thehuman mind, yet exclaim against thedangers of phrenology. But phreno-logy has been considered dangerousin another point of view, namely, ina moral. It has been urged as an ob-jection to phrenology, that it leads tomuterialisna, to fatuasm, and so on.It is very easy to cry, but do thosewho cry understand the thing theycry against; this is only done by thosewho have taken a superficial view ofthe phrenological system.

Hitherto it has been customary toconsider the whole brain as necessary

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of regular cloacte to drain and receivethe filth of the city. In the reign of IAugustus curators were appointed tocleanse the streets and keep the cIoa-cae in good condition. The ancientRomans, tempted by their fine cli-mate, lived much in the open air.

Besides, as the government conciliat-ed the people as long as any tracesof liberty remained, the public build-ings were magnificent, and much fre-quented by them ; and unless greatcare had been taken as to cleanlinessof the earth’s surface in particular,typhus must have been very prevalentthere. What a contrast between an-cient and modern Rome! What a

contrast between ancient and modernLondon ! The one has been enslaved,and the other free for ages. Rome isnow not only infected by the malariaof the earth, but that worse malaria ofthe mind, which makes her the veryslave of those barbarians whom inher better days she despised; whileLondon nurses within her bosom thepure spit it of independence, which,leading from one improvement to an- Iother, has already made her the envy ofthe world, and which will still be pro-ductive of many blessings to presentand succeeding times. One distin-guished political writer has suggested,that in every government there oughtto be a minister of health. Be this asit may, I am sure that London admitsof considerable improvement, in re-ference to the prevention of malaria,and consequently to the prevention oftyphus fever.

It is a singular circumstance, thatwhen I first settled in London, thecurrent opinion among the professionwas, that typhus fever originatedsolely in human contagion, and it isremarkable that it should have beenreserved for me to discover that mis-take in this metropolis. But the dis-covery, from what I before mention.ed, was quite accidental, and I takeno credit to myself for having made it,though, when I reflect upon it, it givesme great pleasure, because whateverprejudice may exist in the profession,the discovery will make its way, thetruth will triumph, and prove useful tomankind. Malaria, then,I hold to be theprimary source of typhus fever. ThatI consider as a settled question. Butthis question involves another, namely,

does typhus fever, thus originating,ever become contagious? Does it everacquire the property of communicat.ing itself from one person to another,like small-pox, measles, or scarletfever? This, I repeat, is another ques-tion, and one that requires an unpre-judiced examination.

Many men believe that typhus iscontagious, because they have beentold so at school or col!ege; preciselyon the same principle that childrentake the assertions of their fathers andmothers as truths upon all subjects.A friend of mine was sitting in hisdrawing-room, and two of his childrenwere playing about him, and theysoon got into an argument, when oneof them attempted to settle the mat-ter, by saying that papa said it wasso, and that, therefore, it must be so;the other little fellow said, but I know,that if papa said so, he was mistaken,for I saw it myself. His father lookedup and exclaimed, what, you little

dog, did you say that 1 was mistaken?Yes, replied he boldly, if you said so,papa, you weM mistaken. Well, re-joined the father, yon are a fine fel.low. there is a sliillinl, for vou. and besure always to maintain the truth.Now as our fathers and forefathersof physic have often been mistaken,we should not take their assertions as

necessary truths, and since they livedin a less enlightened age than the pre-sent, we should put them to the testof the most minute investigation.The question, whether typhus fever

is contagious or is not contagious, cannot be decided by any reference toblack-lettered books, but by a refe-rence to facts, and facts alone, con-templated with the most perfect im-partiality. You know, that I once

believed typhus fever to be conta.

gious, but 1 feel it my duty now todeclare, that I have lived to doubt thecorrectness of that opinion, and shallnot decide till I have made the mostextended and complete inquiry. ButI can say, from a review of a greatmany cases, that if ever typhus provecontagious, the circumstance of its

being so must be rare, and that thepublic alarm upon the subject is notsanctioned by what occurs in London,for I must repeat again and again theincontrovertible fact, that this affec-tion exists in certain patches or parts

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of the metropolis, almost in everyparish, and yet it never spreadsthroughout society. It must be recol-lected also, that most of the poor remainin their houses till the very last stageof typhus, and consequently, if thisdisorder were so contagious as is ge-nerally believed, it would spread inall directions. If small pox, measles,and scarlet fever, thus exi,ted inalmost every district, and if they werethus allowed to advance to the last

stage without removal into some hos-pital, there can be no doubt hut eachof these affections would be diffused,as it were, all over London. Now

why is not this the case in regard totyphus fever? Why, if it be so con- Itagious, is it limited to particular i

places, beyond which it does not pass?Why, I repeat, does it observe thislaw, so different from that by whichsmall pox, measles, and scarlet feverare regulated ? Let the advocates forttnqaatified contagion answer these

questions. ’

Again, I have known a great manyinstances in vehich patients labouringunder typhus were removed into a

fresh atmosphere, and yet in no casedid the disorder propagate itself toany other individual. Now how doesthis happen, if typims be contagions?Had the cases been those of smallpox, measles, or scarlet fever, theywould have been communicated to

many pei-sois, provided those personshad not been before the subjects ofsuch affections. Why does this diffe-rence exist between typhus fever, smallpox, measles, and scarlet fever? Doesit not show that they are, generallyspeaking at least, essentially differentas to the capability of their being-communicated ? Besides, I have known nwives kiss their husbands again andagain, when the tongue and teeth ofthe latter were crusted with the sordes sof typhns fever,-I have kuown fathersand mothers do the same thing totheir childen similarly situated,—Ihave known mothers suckle their chil-dren while they were subjects of ty-phus,—I have kncwn persons in healthsleep in the same bed, with those sickof typhus,—and yet, in none of thesecases, has the disorder been comm-nicated. Now I ask yon, once more,how such things could, by possibility,happen if typhus were that contagion!

/

affection which schools and colleges,and which those secondary and shal-low intellects, who borrow their no-tions wholly from such authorities,would have ns implicitly to believe ?Perhaps we may be enabled to throwsome light upon this obscure subject upon the difference between iufer-tion and contagion, by referring tosome facts observable in certain casesof erysipelas, and of fever followingpuncture in the dissection of bodies un-dergoing the putrefactive process.

I have repeatedly observed, that ifthe wards of an hospital he crowdedwith bad cases, when the air is so

stagnant without as to prevent theremoval of the foul air within from thefresh air without; I have repeatedlyobserved, I say, that erysipelas arisesunder such a combination of circum-stances, and alone under such a com-bination, in the place already speci-fied. In one person the remote oc-casion shall appear to be the punctureof a leech; in another, cold appliedto the cheek; in a third, it shall arisefrom food offending the stomach, andin a fourth, it shall arise spontaneously,without there being such apparentlyconcurring cause. In the progress ofsuch cases. a continued fever arises.which so exactly resembles the conti-nued typhus from malaria, that puttingout of consideration the external ery-sipelas, it would be difficult, perhapsimpossible, to distinguish it from conti ntied typhus ofmarsh miasm. ThoughI have carefully watched the iise andprogress of this form of erysipelas,which you know I call the erythrema-tic, by may of distinction, yet I havenever known one instance of it inwhich it appeared to propagate itselffrom person to person. It occurs with-in a local taint or contamination ofair, and persons removed from thatair do not communicate the affection.On reflection, it appeared to me highlyprobabic, that this local taint or conta-mination-ofair was the product of theodour of the stools, urine, breath, andperspiration. Assuming this to be thecase, when I was physician to the Fe-ver Hospital, induced the committeeto establish convalescent wards; andas they enabled me, while I was there,to keep the receiving wards much lesscrowded, this expedient, togetherwith free ventilation, nearly proved a

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preventive of the erysipelas, for I

only had two slight cases afterwardsduring the whole of the time which Iremained in that office. With respectto the low fever which sometimes fol-lows puncture in dissecting, it also

puts on so exactly the character ofcontinued typhus from malaria, that,losing sight of the original puncture,the beamed absorbents np the arm,and the tender glands in the axilla, intwelve cases which I have witnessed,I could not have distinctly drawn theline of demarcation. Yet in none ofthesp. examples has the disorder pro-pagated itself, though I have noticedtheir progress very narrowly, and

though most of them occurred amongmy pupils in confined situations.

Moreover, GASPARD has shown, byexperiment, that putrid animal orvegetable matter, introduced into theblood, occasions a fever of the typhoidor typhous character.

It would appear, then, that a feverhaving a peculiar intermittent, remit-tent, and continued character, arisesfrom malaria, and malaria alone, as

far as my observation goes; but itwould also appear, that a fever ofa continued form, with a typhoidor typhous character, arises, 2dly,]From a local taint or contaminationof air from the odour of the stools,urine, breath, and perspiration ; and,3dly, from the introduction of putridmatter, as in the case of puncturefrom dissection, or of the experimentsmade by GASPARD on the lower ani-Mali. Now does it ever happen that

persons labouring under this form offever so contaminate the air by a like

miasm, or putrid product, as to affectthose who approached them in a likeiiiaiiner ? Or does it ever happen,that the clothes of persons who ap-proach such patients are so imbuedwith such a miasm, or putrid product,as to give it off again, and occasionthus a similar fever in individuals

previously healthy? These are qlles-tions which can only be answered byan observation at once the most mi-nute and extensive ; and though Ihave been so long and so laboriouslyattending to the subject, I must pause,must leave my mind open to the re-ception of future facts, and decideaccordingly. In the mean timewould say, that the thing is possible, !I,

but that I have not yet met with anywell authenticated and consideredfacts which would justify me in draiv-ing such a conclusion. Common can.

donr, however, requires me to state,that I have met with some cases, afew, indeed, out of a vast many,which at first sight gave a strong co-loui-ing to the doctrine of contagion,but which, duty considered, are ex.

plicable on that of malaria. Thus,for instance, the sister of a younglady who died of typhus, requested tosee the body the day after death, and,while standing over it, she becamefaint and sick, and had an attack oftyphus. But the lady, whom I sawin a dying state, and who soon after.wards expired, lived in a house whereI had traced the existence of mala.ria for some years; her sister, the se.cond affected, had also lived in thathouse, and is it not, therefore, pro.bable, that the sight of the body, bydebilitating her frame, was onty thepredisposing cause, and that this se-cond individual, like the first, hadbeen exposed to malaria, the predis.posing cause ?One of the porters of the Fever

Hospital was attacked by typhus, andan excellent physician told me, thatthis surely was a convincing proof ofthe contagious nature of the disorder.But I replied, that this porter hadbeen almost daily in districts wheremalaria prevailed, and it turned out,in investigating the case, that it hadthe character of a quotidian agae a

week before it put on the continuedform, thus showing, that it had arisenfrom malaria. Nurses about the hos-

pital are occasionally attacked, andespecially those who wasli the clothesof the siek.

.

, B In allusion to the influence of smells,

I may mention, that I have seen indi-viduals who, being debilitated by dis-agreeable odours of a common nature,were seized, some by intermittent,someby remittent, and others by continuedtyphus ; and in such cases we can onlysuppose, that the disagreeable odourof a common kind had been the predis-posing canse, since the symptomswhich arose were those of a peculiarcharacter, such, in a word, as arisefrom malaria or marsh miasm.

Confinement within the walls ofa hospital is a powerfully predis-

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posing cause to some, and the hos-

pital stands in one of the malaria

districts, to the influence of which itsinmates must be occasionally exposedin passing to and from the hospital. Imight assume, with as much show of

truth, that this theatre is a focus ofcontagion, and might apparently proveit, by saying that many of my pupils,far more than the proportion of theinmates of the Fever Hospital, are

attacked by typhus ; but the fact is,that many of my pupils are brokenup by hard study; and lodging in oneof the malaria districts, the Boroagh,they become predisposed, and beingexposed to its influence, they are at-tacked. But though their friends waitupon them affectionately, as nurses, Ihave never known any of them re-ceive the disorder from the sick.Upon the whole, then, though I wouldnot take upon myself to deny, in the

present stage of the inquiry, the pos-sibility of typhus being contagious,yet I have become more and moresceptical on the subject, the more mi-nutely I have inquired into facts.Many men, it is true, make confidentdeclaration-, and say that typhus hasspread from such and snch a familyas from a focus; but wherever I havehad an opportunity of investigatingthe matter on the spot referred to, ithas happened, either that the evi-dences of malaria were distinct, orthat the drains were in such an iiii-

perfect state as to produce a localtaint or contamination of air.What formerly deceived me, and

what still deceives many persons is

this, that one, two, or more indivi-duals may be attacked in the same

house. But if one case arise from

malaria, why not another and an-

other ? And where this is the case,generally speaking, we have groundsfor inferring that malaria was the pri-mary source, because, on minute exa-mination of the testimony, it will befonnd, that some cases in the com-mencement assumed an intermittentor a remittent character.The doctrine of contagion has been

productive of one great practical evilin London and elsewhere. It haswithdrawn the attention of the pro-fession, of the public, and even of thegovernment, from the considerationof its primary source, namely, mala-

ria, and has led them to trnst t8 feverhospitals as means of prevention. Bntif my observations be correct, feverhospitals are of’iittle or no utility in a.preventive point of view, especiallythose which receive patients in the laststage. Indeed typhus obeys moraland physical laws to which the over-nors of such establishments do not atall advert, and how can we expectthem to be useful in a preventivepoint of view ? So certain am I in thetruth of the doctrine of malaria, anda local taint or contamination of air,that I believe, with the aid of the Le-gislatnre, I could go far to annihilatetyphus fever in the British metropolis,where many substantial improvementsmight be made in reference to thissubject.The doctrine of contagion is so in-

flnential, so pernicious in its unqua-lified application, that it ought to besifted to the very bottom. By alarmingthe healthy, it powerfully predisposesthem to the operation of malaria andother subtile agencies ; it renders theattendants often so selfish, that theysacrifice the sick by sending them tohospitals at so late a stage that thefatigue of the removal destroys allreasonable hope of recovery ; it alarmsand debilitates the sick themselves,and in that way often destroys themthrough its mental irritation and de-pression. It has endangered thewelfare of whole cities, as of Alicant,where military lines were drawnround, so that the inhabitants couldnot leave their homes, but were com-pelled to breathe the local taint orcontamination of the atmosphere there.Nav- it mav endanger the verv libertyof a country, to say nothing of icom-merce, as recently happened in Spain,where the doctrine of contagion wasmade an infamous pretence of gather-ing together that French army whichadvanced, more fatally than any con-tagion, and crushed the rising liber-ties of Spain, and restored all the*horrors of an unrestricted despotism.Yon would do well to ponder upon allthese things. You would do well to

I pause before you admit the doctrineof contagion, since it involves suchmomentous conseqnences, private as

well as public. Above all, let me ad-I vise you, as you value your own ap-- probation, the health and lives of the

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public, and the advancement of yourprofession,—above all, I repeat, letme advise you to examine into thequestion through facts, uninfluencedby any prejudice towards others, or

by any partiality to myself personally.In my next, I shall consider the

symptoms, morbid anatomy, and treat-ment of typhus, and shall, at the sametime, endeavour to show the identityof that affection and what are com-monly called yellow fever and the

plague.(Loud applause followed this long

and excellent lecture.)

LECTURES

ON

PHRENOLOGY,BY

DR. SPURZHEIM.

LECTURE 6.

LADIES AND GENTLEMEN,I have spoken hitherto of the ani-

mal propensities, and there tcmainthree to be considered.

Secretiveness.

Among the different charactersfound in society, there is one distin-

guished by the name of cunning. Itis not always that persons excel byjudgment, persons may be very cun-ning and have but little judgment.It is difficult for such persons to givedirect answers to questions, they willturn the point, if they can, by evasion,and in speaking with them you mustinsist upon the argument to inducethem to pay attention and to answer

you; they prefer to tell lies. (A laugh.)Some individuals are exceedingly fondof intriguing, and they are fond ofshift-ing; they turn with the wind. If everyou have to defend an opinion theyare ready to join you, and do as youdo, and if you alter your opinion theyalter their’s. Hence, observing thisversatile disposition in some indivi-duals, it was very natural to be atten-

tive to the organization of the brain,to see whether it corresponded withthe actions observed, and we observethat a very intriguing fellow, whoplays a double character, will oftensucceed well in the woi ld. There aresome individuals without great meritwho know how to find their waythrough life, they know how to playoff to the greatest advantage ; whilstothers never succeed, they fail in

every thing they nndertake. GALLwas attentive to the organization ofsuch cliai-acteis, and he fouud thatthey were broad above the ear, abovethe organ of destractiveness. This

(showing a cast) was an individual ofthe character I have desciibed ; if youlook at the configuration of his headyou will find that it is broad here, atthe middle, and on the side of thehead above destructiveness. This in.dividual (showing a cast) belon"edto a good family, a very respectablefamily, he spent a great deal of money,and then to get more he deceived allhis friends ; he borrowed large snmsof money of one and then of another,but no one person thought he hadborrowed of a second ; he obtaineda sum so large, and having spent itall, he could in the end, pay nobody,and thus he was discovered. Dr.GALLfound very cunning individuals alwaysvery broad here, and he called it theorgan of cunning. If you examine

cunning individuals you will find thatthey are broad here, laterally. Indi.viduals in different countries nhoarecunning you will find broad here.

However, shall there be an organ ofcunning? I will give you my opinion.In order to be cunning, we must pos-sess a certain quantity of intellect,and the feelings I have hitherto

spoken of are without intellect andblind, and I have stated that they areblind because they produce a deter-minate impulse without the exerciseof judgment. To be cunning is also

natural, but persons do not like to beconsidered cunning although natureappears to have given a propensity.What then is the fundamental powerof this organ ? If you reflect ou theactions of men and animals, you willfind that there is a peculiar instinct tohide and conceal ; an instinct whichis very necessary and important toanimals. Many escape from their