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ART. I.-Remarks on the connection, pathological and etiological, sup-
posed to exist between Pneumonia and Periodic Fever.-Fifth
Essay. By R. LA ROCHE, M.D., Philadelphia.

THE two diseases do not differ less essentially in regard to the force
with which they affect the several races. It can scarcely be necessary
to remark, that in all countries subject to malarial fevers generally-
whether it be the true and genuine yellow fever, or the ordinary autumnal
or periodic fever, the black race is to a greater or less extent exempt from
the disease. So far as regards the former fever, the immunity enjoyed
by negroes born and raised, or acclimated, in countries where the dis-
ease is endemic-the West India Islands and the coast of Mexico, and
Southern America--and especially by the natives of Africa-has been
noticed and recorded by almost every writer. This immunity they pos-
sess in much greater perfection than the whites born, bred or acclimated
in the same localities; and they owe, therefore, a large share of it to the
peculiarity of their organization. Few among them take the fever; and
those that do so have it generally, though not universally, in a milder
form.* If, like the whites, they occasionally lose this protection by a pro-
longed residence in cold climates, and take the disease on their return
within the tropics, the occurence is less frequently noticed among them,

*Custin in Duncan's Com., 5 p. 149, (Am. ed.); Moseley, 146; Lempriere, 2 p.
29; Bancroft, 57, 194-6; Jackson, fevers of Jamaica, 250; Hunter, 20, 308;
Pugnet, 346-7; Sevarési, 256-8; Frost, Med. Repos., 12 p. 223; Rufz, Med.
Examiner, 3 p. 129; ib. Chervin's Rep. 30; Ferguson's Med. Ch. R., 8 p. 121;
ib. Med Ch. Rev., Jan. 1840, p. 300; ib. Recol. 142, H. McLean, 187; Hum-
boldt, 772; Hume, 237-8; Chisholm, 1 pp. 142, 225; Bourgeois, Maladies de St.
Domingue in Voy. interessants, &c., 417; J. Clarke, p. 3; Caillot, 14; Manson,
5; Bally, 269, 303-5; Arnold, 34; Dickinson, 12, 48; Evans, 276; McWilliam's
Niger Exped.. ib. Fev. of Boa Vista; Doughty, 50; Warren, 14; Wright, 7p.8;
Henderson, 7; Bryson, 54; Pinkard, 2 p. 484; Copland, 3 p. 151; Leblond, 18,
245; McCabe's Rep. on dis. of warm climates, p. 43; Diction. de Med., 19 p. 151.
37

VOL. VIII.—NO. V.

and the attack is of a milder character;* and if blacks removing there from northern climates suffer from the disease, sometimes even in its most aggravated forms, the effect is far less frequently observed among them than among the whites.

In our Southern States the blacks have always exhibited the same superiority, in regard to immunity over the whites-subject, however, to the same modifications—not only in those parts where the protection afforded to the latter by acclimatization, is very general, if not entire,‡ but in those places, as Natchez, Washington, (Miss.,) Norfolk, &c., where that protection is comparatively limited.§. In our Middle States the blacks have usually-though not always-escaped entirely, and among the few affected, the disease has almost invariably proved of a mild and tractable character. For proof of this, I confidently appeal to the records of the epidemics by which this city has been visited; || while, if we cross the Atlantic, and inquire how matters stand in that respect in the cities of Spain and in Leghorn, we shall find that there also the blacks have almost universally escaped.

Nor is it less a fact placed beyond dispute, that blacks are much less liable than whites to other forms of miasmal fevers, and that when attacked, they have the disease in a milder form. This comparative unsusceptibility, was noticed in the West Indies from the period of the earliest introduction there of negroes. It did not escape the attention of Herrera, (lib. 3 and 10) and other of the early historians, whose observations on the subject have been confirmed by every subsequent writer, on the climate and diseases, not only of those Islands, but also of every other portion of tropical regions. "The negro," says Dr. Ferguson, "may also be said to be fever proof, and the marshy savannahs, which lie low and scattered and unventilated, prove to him the most healthful abode.

* Jackson Dis. of Jamaica, 250; H. McLean, 187; Lempriére, 2, p. 29; Bancroft, 176; Savarési; Loc. Cit.; Gillkrest, 2, p, 279.

+ Frost, Op. Cit 224, note; Ferguson Bell's J., 3, p. 14.

Ramsay's Hist. S. C., 2, p. 85; Simons, 14; ib. Address, 12; Daniel, 65; Thomas, 77; Chalmers, 1, p. 39; Seagrave Med. and Phil. Reg., 3, .p 420; Fever of N. O., in 1839, in Rev. Med., for 1840, p. 325; Ticknor, N.A. J., 3, p. 218; Dickson, 345; Lewis, N. O. J., 1, p. 416; Bartlett, 345.

§ Cartwright Rec., 9; Seldon and Whitehead, Med. Repos., 4, p. 335; Merrill Chapman's J., 9, p. 246; Archer Recorder, 5, p. 61; Monette Am. J., 1, p. 245; Hogg Western J., 1, p. 413-416; Valentin, 90.

Caldwell Memoirs, 210; Cathull, 6; Currie, 13-14; Wood, 1, p. 307; Deveze, 108-9; Folwell, 57; Carey, 85.

Berthe, 167; Caisergue, 191-200; Burnett, 242; Rept. of the Med. Acad. of Barcelona, 23; Pariset, fever of Barcelona, 542.

From peculiarity of idiocyncrasy, he appears to be proof against endemic fevers. To him marsh miasmata, which so infallibly destroy our white soldiers, are in fact no poison. The warm, moist, low and leeward situations, where these pernicious exhalations are generated, prove to him congenial in every respect. He delights in them, for he there finds life and health, as much as his feelings are abhorrent to the currents of wind that sweep the mountain tops, where alone the whites find security against tropical diseases; but the black, when placed there, is almost infallibly struck with the bowel and heart complaints which prove so fatal to him."

The comparative average prevalence of fever among the European and black troops of the British army in the West Indian and African cominands, and the like mortality from the same disease, afford a striking illustration of the difference of susceptibility in question. Thus, we find, that during a period of 20 years, from 1817 to 1836, inclusive, the result was as follows:

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The following table will show the comparative ratio of mortality,

from the disease, per 1000 of mean strength, in the various West India Islands, and other commands:

Ferguson's Recollections, Black troops in the W. I., p. 207, 209. See also McCabe, loc. cit., p. 43.

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In all those localities we find the average number of fever cases among white troops far exceeding that among the blacks, while the mildness of the disease among these is evinced by the smallness of the mortality they suffered, compared to that among their Caucasian comrades. In speaking of the sickness of the British troops in the Sierra Leone command, Major Tullock says: "Fatal as the fevers of this colony have proved to the whole troops, the blacks have been but little affected by them; indeed the attacks have been fewer, aud the deaths have not materially exceeded the proportion among an equal number of white troops in the United Kingdom or other temperate climates. Though fevers are much more frequent and fatal among the whites than in the West Indies, the reverse is the case with the blacks.* By an another writer, Dr. Bryson, p. 22, we are told, that the natives of Fernando Po are a healthy athletic race of people, yet this island is more detrimental to health than any spot in the known world-even the Africans from the Continent are always sickly here. Of thirty white mechanics who arrived in November, 1827, all had the fever in a very short time-the number that died cannot be ascertained. A few were invalided and five only remained in June, 1828, (22, 69, 70.)† The

* Dis. and Mort. of the Br. Army, (Western Africa) p. 16.
See also Daniell's Topography of the Coast of Guinea. p. 134.

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