tract from my official report for the third quarter, 1845, briefly states my views of the nature and treatment of this disease.

'The disease called "winter fever" is in fact a pneumonia. The attendant fever appears to be continued, and not to differ from the sym-· ptomatic fever attending pneumonitis at the north, but if closely watched, slight remissions may be observed, even in the severest cases. There appears to be an "essential fever," with local inflammation. In such cases, my observation teaches me that you may bleed, cup, give mercurial cathartics, and use the tartrate of antimony freely, and still the disease will gain ground. I have closely watched several cases, and notwithstanding the employment of remedies which, in ordinary pneumonias, would have been successful, I have found the disease steadily advancing both in extent and degree. In this condition, with extensive inflammation of both lungs, I have given the sulphate of quinine in ten and twenty-grain doses, with the happy effect of removing almost entirely the attendant fever in less than twenty-four hours, and checking, or at least enabling remedies, before inefficacious, to check the progress of the disease.'

In a subsequent report, (March, 1847,) the following remarks

occur:

'I have had an excellent opportunity this quarter of treating this disease, (winter fever') in a severe form, among the Arkansas volunteers, and the success of my treatment has corroborated the views expressed in my report for December, 1845.'

The treatment adopted was moderate bleeding, cupping, and external irritants; a mercurial cathartic followed by the nitrous powder of the United States Dispensatory, frequently repeated, and quinine given in sufficient doses to check the fever, which it always did.

The disease had a typhoid tendency, which prevented large bleeding, and rendered the use of serpentaria, senega and wine necessary in the latter stages.'

'Sixteen cases were treated during this quarter, two of which were fatal; of these, one was apoplectic when first seen; the insensibility was never removed, the patient dying in sixty hours; the other was complicated with meningitis, and was under treatment only thirty-six hours.'

REPORTS FROM TEXAS.

ARTICLE 1.

ON THE CLIMATE, ETC., OF A PORTION OF TEXAS.

BY ASHBEL SMITH, Esq.

[For this interesting letter we are greatly indebted to the distinguished author, who seems ever ready to maintain the honor of his State, in whatever way he may be called on. Knowing the large number of intelligent physicians in the young and growing State of Texas, we had expected something more than a brief general communication from a retired practitioner. However, we are duly thankful for this, and hope it will serve to stimulate others who are still 'in harness,' to record their observations.-ED.]

Dr. FENNER, Editor Medical Reports:

My dear Sir:-The information I shall be able to give you on matters Hygienic and Medical, in Texas, is very meagre. I do not practice Medicine further than occasionally to attend cases, such as are forced upon every gentleman who has been once in the harness of our profession; I feel, however, as lively an interest in its practice, philosophy and improvement, as did the old tallow-chandler, who stipulated in the sale of his chandlery for permission to be present on trying days. I hope your correspondents who are in brisk practice will not leave Texas to be represented in the Southern Reports' by the medical officers eminently competent I admit-of the United States army, who are stationed on our frontier.

Texas has been generally very healthy during the last twelve months. I believe this is true of the entire State, but my information is more definite in relation to the districts west of the Trinity river. I shall advert to some exceptions to this general healthfulness, after having made one or two observations. Texas, you are aware, is a prairie country. On its north-eastern border there is a large proportion of wooded land, interspersed with prairies; as you proceed westward from the Sabine through the Gulf district to the Rio Grande, the proportion of timbered land

to prairie gradually diminishes until, at the San Antonio river, and thence to the Rio Grande, the country presents one broad prairie, with rare and narrow skirts of low trees. The common opinion is, and I think it in the main well founded, that the healthfulness of Texas increases pretty regularly as you proceed from the east to the west. Perhaps this is owing to the face of the country becoming, as you thus proceed, more and more open, and thus occasioning less obstruction to the Gulf winds, which blow with unfailing regularity during the warm season. These winds do not fail, for they are caused by the heat of the surface of the earth at the time being; they blow nearly at right angles to the Gulf coast; they are strongest at the time of greatest solar heat-from 1 to 3 P. M.; they greatly diminish the sensible heat of the atmosphere, and dissipate miasmata, or whatever are the causes of intermittents and remittents. Without insisting on the soundness of this opinion as to the cause, or rather one cause of the healthfulness of Texas, of one fact I am confident, after fourteen years' residence in Texas, and extensive acquaintance with the States of North Carolina and Tennessee, and those lying south of them, that there is no planting district bordering the Mississippi, if we except the 'coast' so called, or east of that river, that can vie in healthfulness with Texas. Climatic diseases are comparatively infrequent, of a mild character, yield promptly to curative means, with speedy restoration to full vigor of health. I remember very well in North Carolina, that after a summer or autumnal fever, the invalid commonly did not become strong and really well until the setting in of decided cold weather. I have spoken of our climatic fevers yielding promptly to curative means they are intermittents and remittents, being of the class usually enough called bilious; I have, since I commenced practice, read pretty regularly the reports of bilious fevers originating in a southern clime, treated in the New York and Philadelphia hospitals, with the careful autopsies appended to them. I hope it is not unprofessional to say that the mortality has ever appeared to me extraordinary, and that any of our old field country doctors would lose his practice, if not more successful than the reports of cases alluded to.

Since I commenced practice in Texas, thirteen or fourteen

years ago, a great change has been wrought in the character of our febrile diseases. They are still, as then, intermittent or remittent in their type; but at the period mentioned, and for some five years after, every fever ran readily, or rather rushed into intense, overwhelming congestion-the congestion masking and overriding all other symptoms, being itself the symptom and the disease, if I may so speak. This intense congestion is now rarely met with; I have not seen a genuine old-fashioned case, even incidentally, for nearly three years. The increased comforts of living in Texas are too important to be forgotten in searching for causes of this modification; but as for efficient causes, I know nothing better than to take refuge in the old 'constitutional state of the air' having changed. In reference to this marked modification of febrile disease, from frequency of congestion to its nearly utter disappearance in an intense degree, I will add that saline purgatives, and especially Epsom salts, were formerly proscribed as almost fatal; but during the last year it is almost the only medicine I have used as a purgative and refrigerant in fevers, and as the sole curative agent in diarrhoeas, in the practice incidentally imposed on me on my plantation or in the neighborhood. Diarrhoeas were pretty frequent during the hot season, of a mild character; they commonly yielded at once to a teaspoonful of Epsom salts dissolved in water, with moderate care in diet and exposure. In the fevers I saw, the same remedy was very efficacious in abating the febrile excitement, and producing bilious evacuations. I seldom had occasion to resort to calomel, to 'rouse the liver.' Epsom salts, in our diseases, should be given in divided doses. In all cases after the abatement of fever, quinine is necessary to prevent its recurrence; in other forms of disease among us, the curative powers of quinine are hardly less than in fever: the consumption of it in Texas is considerable; yet so atrocious are its adulterations, that I do not believe, of all that is sold, one-eighth part is of genuine pure sulphate of quinine. I saw a German emigrant slowly dying of an intermittent of months' duration, (when two doses of good quinine would have cured him, as the result proved,) taking a villainous compound of mannite and I know not what else, with scarcely quinine enough in the mixture to 'bitter it,' as George III. said about 'horse

aloes.' Could lynch-law ever be justifiable, the adulterators of medicines would be the most meritorious candidates for its offices.

Galveston and Houston were respectively visited in 1839, 1843 and 1847, with epidemic yellow fever; both places have remained wholly exempt since the last date. I was in New York in 1848, at the time when yellow fever prevailed at the Quarantine ground near that city. I saw upwards of twenty cases in the hospital and its neighborhood; the latter were among permanent residents of the island. The disease then presented an unmistakeable identity with the same disease as I had seen it in our part of the world. I made several autopsies: black vomit in the stomach, hemorrhages elsewhere, and the milk-and-coffee liver of Louis, were prominent appearances in all. According to my observation, I should say the disease suffered as little modification by difference of climate as does the small-pox.

During the past twelve months the cholera has visited Texas, but for the most part mildly; a few cases in Galveston and Houston; a 'smart sprinkling' in one district on the Brazos; and some cases, I know not to what extent, in the westernmost sections of the State. The cases occurring in Galveston were, as intimated, few in number, and traceable directly to New Orleans, or they occurred almost exclusively in such as had direct personal intercourse with fatal cases coming from New Orleans, or with the old plunder' and clothes of such fatal cases. After very great personal observation of cholera in London, Paris, New York, Memphis, etc., I was a decided non-contagionist and indeed still am; but facts that have occurred in Galveston and also on the Brazos, seemingly well verified, are of a nature to lead me, if further extensively confirmed, to modify that opinion somewhat. I leave the matter in the hands of those who have ampler opportunities than I for a decision, after briefly stating a few facts which I consider well authenticated, respecting the cases which appeared in Galveston, and on the Brazos; but for occupying your time unprofitably, I could give you the facts much more in detail. Different cases arrived in Galveston from New Orleans, which proved fatal. In different instances, persons who waited closely on these cases, and who washed the clothes that had been worn by them, sickened and died. The disease did not spread further.