(* In The Oriental Plague (Another Form Of Typhus Characterised By Great Disorder Of The Lymphatic System) Immediate Contact Is Less To Be Feared Than Is Generally Thought.

Larrey maintains that the tumified glands may be touched or cauterized without danger; but he thinks we ought not to risk putting on the clothes of persons attacked with the plague.

- Memoire sur les Maladies de l'Armee Francoise en Egypte page 35.) The sick, when removed to the inland country, and especially to cooler and more elevated spots, to Xalapa, for instance, do not communicate typhus to the inhabitants of those places, either because the disease is not contagious in its nature, or because the predisposing causes are not the same as in the regions of the shore. When there is a considerable lowering of the temperature, the epidemic usually ceases, even on the spot where it first appeared. It again breaks out at the approach of the hot season, and sometimes long before; though during several months there may have been no sick person in the harbour, and no ship may have entered it.

The typhus of America appears to be confined to the shore, either because persons who bring the disease disembark there, and goods supposed to be impregnated with deleterious miasms are there accumulated; or because on the sea-side gaseous emanations of a particular nature are formed. The aspect of the places subject to the ravages of typhus seems often to exclude all idea of a local or endemical origin. It has been known to prevail in the Canaries, the Bermudas, and among the small West India Islands, in dry places formerly distinguished for the great salubrity of their climate. Examples of the propagation of the yellow fever in the inland parts of the torrid zone appear very doubtful: that malady may have been confounded with remitting bilious fevers. With respect to the temperate zone, in which the contagious character of the American typhus is more decided, the disease has unquestionably spread far from the shore, even into very elevated places, exposed to cool and dry winds, as in Spain at Medina-Sidonia, at Carlotta, and in the city of Murcia. That variety of phenomena which the same epidemic exhibits, according to the difference of climate, the union of predisposing causes, its shorter or longer duration, and the degree of its exacerbation, should render us extremely circumspect in tracing the secret causes of the American typhus. M. Bailly, who, at the time of the violent epidemics in 1802 and 1803, was chief physician to the colony of St. Domingo, and who studied that disease in the island of Cuba, the United States, and Spain, is of opinion that the typhus is very often, but not always, contagious.

Since the yellow fever has made such ravages in La Guayra, exaggerated accounts have been given of the uncleanliness in that little town as well as of Vera Cruz, and of the quays or wharfs of Philadelphia. In a place where the soil is extremely dry, destitute of vegetation, and where scarcely a few drops of water fall in the course of seven or eight months, the causes that produce what are called miasms, cannot be of very frequent occurrence.

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