Dr. FENNER:

ARTICLE III.

ON THE DENGUE OF WOODVILLE, MISS.

By A. C. HOLT, M.D. (In a letter to the Editor.)

Dear sir:-I have just received your note, in which you request me to give you all the information I can relative to the epidemic which prevailed in Woodville last fall. I comply at once, and cheerfully, with the request.

The first cases of the fever, named variously, Dengue, Breakbone, etc., occurred here about the first of September last. The cases gradually increased in number till the first of October, at which time there were very few in the village, white or black, who were not either in bed, or just recovering from it. The whole number of cases has been estimated to be between six and seven hundred. All ages seemed alike liable, the very young as well as old; I saw an infant of two weeks with a wellmarked attack. There were no deaths. The duration of the attack was generally from four to six days; in many, the fever subsided on the second and third days - but in all these, relapses oecurred upon their leaving bed earlier than the sixth or seventh day.

The precursors of an attack were those usually attendant upon ordinary influenza, patients often expressing themselves as feeling like they were taking cold;' then a distinct chill, followed by a high grade of febrile excitement, accompanied with

* From this short but interesting communication, from a highly respectable practitioner, it would seem that the dengue was better marked by eruption in Woodville than it was in New Orleans. This is the village in the interior of the country that was so severely scourged by yellow fever in 1844. The dengue appears to have behaved pretty much like the yellow fever, being confined to the precincts of the village, and not spreading among the neighboring plantations, although many persons contracted it by going into town, and then returning to the country. Although Dr. Kilpatrick contended that the yellow fever of that year was imported from Galveston or New Orleans in the person of a Methodist preacher, Dr. Stone, the other historian of that epidemic, thought differently; and the idea of contagion had but very few adherents. In the case of dengue, contagion is not even mentioned by Dr. Hoit. He seems to have been forcibly struck with the affinity between dengue and yellow fever. As stated in our report on the fevers of this city, we cannot sex why there might not occur an epidemic of extraordinary mild yellow fever, as well as of scarlatina, or any other fever.-ED.

agonizing pain in the head, eyeballs, back and extremities, and oftentimes a stricture across the chest. The eyes, in a majority of cases, presented a streaked appearance, (yellow and red ;) the tongue broad and moist, but heavily coated; thirst slight, and except in the advanced stages, often altogether absent, and the bowels generally evinced a tendency to constipation. During the first days of the attack, the restlessness was a most distressing feature of the disease; and throughout, the mind, whether the patient were asleep or awake, seemed in a dreaming condition, -confused thoughts and painful visions being constantly present. An eruption, similar to that of measles, made its appearance in many instances, while in a few cases the eruption was that of nettle-rash. The fever had no tendency to remissionone paroxysm, with no return, except from too great haste on the part of the patient to leave the sick room.

The debility following an attack was excessive; and I could not see much difference in this respect, whether the attack was mild or severe. It is proper here to state the interesting, and, to those who have once suffered with this disease, the very agreeable fact, that in the fall of 1848, there occurred in Woodville some fifteen or twenty cases of dengue, and that but one of these was attacked last fall. These were more exposed, too, than any other citizens of the village, from the fact that they were the only individuals who escaped in their respective families, and consequently suffered greatly from loss of rest and fatigue in nursing.

All who visited Woodville from the surrounding country, during the prevalence of the disease, were taken sick, soon after their return home. The county, during the summer and fall, was generally very healthy, notwithstanding there had been a greater amount of rain than usua! during the summer, with oppressive heat, followed by a remarkably dry fall.

The treatment pursued in the epidemic was very simple; from ten to twenty grains of blue mass, or calomel, followed in six or eight hours by a dose of castor oil, was all the medicine used in a majority of cases. Hot mustard foot-baths, and hot teas were freely used, and cups to the head and back. In many cases it was necessary to repeat the castor oil, on the third or fourth day, after the failure of enemata.

In a few of the first cases I administered quinine freely, but abandoned it with the impression that it was a waste to give it. As soon as the fever subsided, porter was ordered, and in nearly every case produced the most happy results, by composing the wandering and confusion of intellect, so distressing to the patient, and restoring the strength more rapidly than any other agent.

You ask me to state, whether I noted any similitude between this and the epidemic which prevailed here in 1844?

The greatest difference perceptible to me, was in the results, the epidemic yellow fever of 1844 being very fatal, while in this last, as I have before remarked, no deaths occurred.

From my limited observation, I am led to conclude yellow fever and dengue to be children of the same parent, with probably some difference in their nurture.

You ask, 'Do you believe you had any new and specific epidemic? or was your fever only one of the protean forms of endemic malarious fever?

I hardly know how to answer this question with satisfaction to myself, without extending this letter further than my crude cogitations on this subject would justify. I will say briefly, that while perchance all fevers in our climate may be traced to some general cause, I see no good reason why some particular aids to that great cause may not, at certain times, result in the duction of a fever specific in its character; and such, in my opinion, is the case in yellow fever, dengue, and perhaps also with the endemic typhoid fever, which occasionally visits us.

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I have not a little faith in the cause of fever, as set forth by a certain learned professor, who replied, when interrogated on the subject, that 'all fevers were produced by a concatenation of circumstances.'

Wishing you all the success your laudable undertaking merits,

I am, very respectfully,

A. C. HOLT.

REPORTS FROM ARKANSAS.

ARTICLE I.

ON THE MEDICAL TOPOGRAPHY AND DISEASES OF FORT GIBSON, ARKANSAS. Compiled, with permission, from records in the office of the Surgeon-General,

By RICHARD H. COOLIDGE, Assistant Surgeon U.S.A.

FORT GIBSON is situated on the east bank of the Neosho or Grand river, in the Cherokee Nation, west of Arkansas, latitude 35° 48′ 10′′ north; longitude 95° 3′ 15′′ west, and about 425 miles north of the Gulf of Mexico, measuring from a point near the mouth of the Sabine river.'

The fort stands upon a plain 550 feet above the level of the sea, and about twenty feet above ordinary low-water mark in the Neosho. This plain extends back from the river about 350 yards, where it terminates in a ridge, the commencement of a high rolling prairie, which spreads in an easterly direction to the Menard mountain, distant about three and a half miles. On the north it is terminated immediately at the fort, by the high prairie above alluded to, which here attains an elevation of over 100 feet, and reaches to the bank of the river. On the south and south-east, this plain is continuous with the 'river bottom,' of which it is in fact a portion, which extends south to the confluence of the Neosho with the Arkansas river, two and a half miles, and thence south-east for five miles, following the Arkansas to the Bayou Menard, a small stream at the base of the Menard mountain. This bottom land has a river margin of about eight miles, and an average breadth of three miles, the whole of which, except in the immediate vicinity of the fort, is covered with a dense growth of forest trees and cane, and has within its borders several lakes and lagoons. The whole, not excepting the site of the fort, is subject to overflow, and during the intense heat of summer the lagoons are mostly dried up.

To the south-west lies a similar 'bottom,' triangular in shape, bounded on the east by the Neosho, on the south by the Arkansas, and on the west by the Verdegris, a river which empties into

the Arkansas, one-half mile above the mouth of the Neosho. The width of this 'bottom,' measuring from the Neosho to the Verdegris, varies from a half to three miles, while its average extent in a line north from the Arkansas is about two miles.

The climate of Fort Gibson is variable; the summers are intensely hot, and the winters, though sometimes mild and pleasant, are occasionally severe, the rivers being frozen so that loaded wagons cross in safety.

The following table exhibits the results of the thermometrical observations at this post for two periods, one of eleven years, during which three observations were taken daily, and one of four years, when four daily observations were made. The results for the first period are obtained from a table calculated by Assistant-Surgeon Van Buren, and published by authority of the Surgeon-General in 1844; those for the second period are now published for the first time. It will be observed that the results obtained for the two first periods are nearly similar, except in the 'extreme range' and in the maximum' and 'minimum' temperatures.

TABLE OF MEAN TEMPERATURES,

FROM OBSERVATIONS MADE BY OFFICERS OF THE MEDICAL STAFF,

61.07 12.50 61.26 79 .17,61.53 36.26 Jan'ry 81.60 July.. 103 3 100

61.20 43.29 61.61 78.12 62.06 41.75 Dec'er 80.54 July..95.50 10 85.50