The middle aged, the strong and robust, are in general soonest affected, and suffer most severely: children and old persons are less violently attacked; yet in the latter it is most often fatal: a humoral asthma, or a catarrhus suffbeativus, is a frequent consequence. Children at the breast generally escape, nor did any seem to suffer within the first year; but no period of advanced age, nor any previous disease, appeared to secure any person. All beyond early infancy were indiscriminately attacked. It has very rarely happened that any person who had perfectly recovered was again attacked; but he has appeared equally liable to the influence of a future epidemic.

The causes undoubtedly existed in the atmosphere. Of a dozen persons in perfect health, in the same room, ten have been often attacked within a very short period. Those confined to bed, insulated from every infected person, have equally suffered. In one hospital, containing one hundred and seventy persons, more than one hundred were attacked within twenty-four hours, and few of the remainder escaped. The infection passed the Atlantic, with little or no remission of its severity, and attacked Americans who had not had the slightest intercourse with Europeans.

Is not contagion then also a cause? It evidently is, though in many instances only an exciting cause; yet the concurrence of the disorder with contagion, apparently received by the most familiar intercourse, has often appeared so striking, that its influence must be admitted. It is indeed difficult to say, when every one is equally exposed to a general cause why any given person should be exempted, whether contagious influence concurs or not. The man most subject to contagion may have been affected, as well as those at a distance from any fomes. The negative cannot be proved; but the very existence of the question seems to show that there were many apparent instances of its influence, though it was often perhaps, as we have said, an exciting cause only. Other exciting causes were cold, fatigue, and depressing passions.

The predisposing causes were previous debility of every kind, in the young and robust. In the aged, infirm health seemed by no means a predisposing cause. The previous state of the air, either with respect to heat, cold, elasticity, or damp, seemed to have little power. Influenzas have recurred at every different season, in every state of the barometer, thermometer, and hygrometer. If we were to fix on any state of the atmosphere in which it has most frequently appeared, we should say it was when supersaturated with moisture. The distinctions between common and epidemic catarrhs, are the universality of the attack and the violence of the symptoms. Yet in these there are various degrees; and we have seen influenzas where not one in twenty have been affected, and where the appearances scarcely differ from common colds. The load in the head, and particularly over the eyes, with the great debility, more strikingly distinguish this disease, and it bears the same relation to the common catarrh that the putrid pneumonia does to the inflammatory species. Physicians have differed respecting the propriety of bleeding. It may, in the young and strong, be indicated; but it is by no means a general remedy, and should scarcely in any instance be employed. Even in these, however apparent peripneumonic symptoms may seem to indicate it, the practice is followed by considerable, often a long protracted, debility. It is with regret we are obliged to add, that the mania for bleeding is far from being extinguished, and we daily witness its mischief in the putrid forms of diseases, which were usually inflammatory: real inflammatory complaints are now very rare.

Vomiting is a remedy better adapted to the disease; but even this discharge, if violent, greatly debilitates the patient, and it is not easy to set limits to the operation of an emetic. In nauseating doses, combined with opiates, both the ipecacuanha and tartarised antimony are highly useful; but to these we must return.

When the pains in the side, usually indicating bleeding, are violent, a blister is the appropriate remedy; and it is always necessary to keep the bowels free, though the action of violent purgatives greatly debilitates.

In short, in this and every putrid complaint it is necessary to keep up the vis vitae, and gently determine to the skin. Diapnoe, a term applied by Chenot, to distinguish this easy perspiration from more violent sweat, will relieve without inducing debility, and this will be best kept up by warm cordial liquids' The use of wine, at first in moderation, and afterwards more freely, is very beneficial; and by thus cautiously supporting the strength, nature will often effect the cure.

The wine should be given with warm water, and the determination to the surface secured by diluting liquors, and a moderately warm room. If this is not easily effected, emetics in nauseating doses, with opium, may be given with success. The neutrals, particularly the ammoniacal ones, will assist this operation; and vinegar whey, with white wine, is also an excellent diaphoretic. Nitre is often injurious by its cooling sedative power, and from its irritating cough. If any particular medicine, not peculiarly suited to these indications, is necessary, we think it is the camphor. It is eminently useful in putrid peripneumony, and we think it has been so in the epidemic catarrh.

Bark has been recommended, and often, it is said, given with advantage. We have had its necessity in frequent contemplation during epidemic catarrhs, but never yet found it necessary. In general, it may be asserted that this disease is never fatal. In its consequences it may be so; and the cutting a corn may induce gangrene, but the operation is not on that account dangerous.

The debility that follows is very considerable, and continues often for many months. A cordial diet, free air, and exercise on horseback, are its best remedies. The author of this article, who suffers always severely from influenza, experienced this debility in a great degree; and though the cough remaining was considerable, he used with the happiest effects the cold bath. The bath was at some distance, and at first both in going and returning he was obliged to rest three times: on the second attempt he rested twice, and on the third once only. On the fourth no rest was required, so rapid was the recovery.

See Hoffman's Med. Rat. Syst. Opuscula Med. Doc-toris Baker, Dr. Fordyce's Elements, part. ii. Brooks's Practice of Physic. Schneider de Catarrhis. Cullen's First Lines, vol. ii. p. 83. edit. 4. Wallis's Sydenham. Catarrhus intestinorum. On considering the affections of the mucous membrane from inflammation, our attention was necessarily attracted by this disease, which, however, has not yet found a place in the medical systems. It appeared, on reflection, singular, that, though the oesophagus, at least its upper part, was occasionally affected by catarrh, there was no instance of this disease being continued to the stomach. It however occurs to observation in the intestines; and diarrhoea, from cold, is no uncommon disease. It may be discovered by its occurring in consequence of exposure to cold and damp, by its coming on with fever, with slight colic pains, acrid motions without relief, excoriation of the lower part of the rectum, and the absence of either bilious evacuations or symptoms of indigestion. The cure is sufficiently obvious. But a question here arises; is dysentery nothing more? We must recur to this subject; and what we have here mentioned will not, we trust, be forgotten. The facts just recorded are, however, faithful pictures from nature, without any reference to the connection just mentioned. Catarrhus vesicae. This disease is noticed by Hoffman, Lieutand, and Cullen, but by few other authors. It is confounded with dysuria, with calculus, and with abscess of the urinary organs. We have twice seen it as a true catarrhal affection, from cold; and twice only. It consists in a painful discharge of urine, sometimes with fever, but more frequently without its attendance; and of the urine nearly half the bulk is composed of a light, flocculent matter. It appears, though very rarely, as we have said, from cold, but more often from any cause which occasions acrimony of urine, or a difficulty of discharging it; in fact, from any cause which excites inflammation or irritation on the neck of the bladder, or occasions an unusually strong action of this hollow muscle. Its cause will require only an investigation of the previous symptoms, but these will not always assist in determining whether the discharge be not purulent. To the experienced eye pus is soon known by its filamentous appearance. while the mucus of the bladder is more light and uniform. The smell, however, will immediately discover it.

The cure will be regulated by the cause. Mucilaginous diluting drinks, with gentle laxatives, are always proper; and if the pain is violent, opiates may be joined. We seldom want any further aid: but it is sometimes necessary to inject the opiates united with a starch clyster; and we have already observed, that camphor exerts a peculiar sedative effect on the bladder. A mild diet, rest, and a warm room, will greatly expedite the cure of every catarrh.

Catarrhus bellinsulanus. See Cynanche parotid,AEa.

Catarrhus suffocativus. See Suffocatio stridula.