YELLOW FEVER. The prevalence of this epidemic in the Southwestern States, in 1867, demands some notice. The disease, like cholera, has marked and peculiar symptoms from its outset. Commencing with a feeling of chilliness, a quick fever supervenes, accompanied by pains in the head, back, and limbs. The pain in the head is frontal, and often exceedingly severe, attended with confusion of thought and violent delirium. The stomach is early affected, and vomiting ensues almost immediately. The matter vomited consists of the contents of the stomach, of bile, and thin colored fluids. The patient complains of a burning sensation in the stomach, the face is flushed and swollen, the eyes red, suffused, muddy, and sensitive to light. The breathing is sometimes hurried and irregular, sometimes slow and embarrassed. The skin is commonly hot, dry, and harsh. The yellowness, from which the disease derives its name, first tinges the eye, then spreads to the forehead, neck, and breast, and last to the extremities. The color varies from an orange to a bronze, and sometimes, in the last stage, approaches a dark mahogany. The tongue is at first generally moist and white, then red. The pulse leaps to 100, and is full and bounding. The patient is very restless, constantly changing his position, while the expression is gloomy and anxious, or sometimes fierce and threatening. These are the first stages of the disease, the average duration of which is from 36 to 48 hours. The second stage is succeeded by an abatement of all the unpleasant symptoms. The skin becomes moister and cooler, the pain in the head and limbs is relieved, the stomach is irritable, the pulse calmer, the expression of the countenance more natural. The yellowness of the skin, however, becomes more marked and deeper in tint. The stage of remission generally lasts from 12 to 18 hours, though it may be prolonged to 24 or 36. The third stage is characterized by prostration; the pulse becomes more feeble and the skin darker; the tongue may remain large and moist, or become dry and brown, or smooth, red, fissured and bleeding. The irritability of the stomach returns or is increased. The vomiting is often incessant. At first it may consist of a colorless, acrid liquor; soon, in bad cases, it begins to contain flakes of a dark color, increasing until the matters vomited look like a mixture of soot, or coffee-grounds and water; that is the black vomit. The quantity thrown up is often very great, and it comes up with little effort. Sometimes diarrhoea now supervenes, the stools resembling the matter ejected from the stomach. With the appearance of these symptoms the patient becomes more and more Y prostrated; the skin is cold and clammy, the pulse very feeble, frequent, or intermittent; the breathing irregular and labored; the tongue is black and tremulous; there is low, muttering delirium, and death closes the scene. Pathological anatomy has not hitherto added much to our knowledge of yellow fever. The most constant alteration is found in the conditions of the blood. This is usually dark colored and fluid, seeming sometimes to have entirely lost its coagulability. The surface of the body is usually more or less yellow after death, even in cases which did not present any trace of that color during life. The liver presents a full yellow or fawn color, and is more or less fatty; and the stomach is more or less reddened and its mucous membrane generally softened. The causes of the disease are much the same as those of cholera. Filth, decayed vegetable and animal matter, marsh miasm, the excessive use of tropical fruits, and excesses in eating and drinking are the principal causes. The disease is epidemic during the hot season, a succession of heavy frosts checking and usually ending it for the season. Opinions in regard to its contagiousness are divided, a small majority of professional men favoring the idea of contagion, or at least of communicability from the fomites of the disease. Some persons are not subject to it, and others who having had it are exempt, but lose their protection by a residence in a cold climate for a single season. During the summer and autumn of 1867, it raged with great virulence in the West Indies, proving unusually fatal in St. Thomas, Santa Cruz, Cuba, and Hayti; some cases occurred in the Florida ports, more in Mobile, while in New Orleans it was more severe than it had been since 1853, the deaths from it in August being 255, in September, 1,637, and in October (the first week), 431, and for some time it continued at the rate of from 50 to 60 deaths daily. In Galveston it was still more severe, taking all classes and producing a frightful mortality. Throughout the coast portion of Texas it raged with great virulence. It made its way up the Mississippi and visited Natchez, Vicksburg, Helena, and Memphis, all previously desolated by cholera earlier in the season. The cities of the Atlantic coast were exempt from the scourge, except a few cases on board one of the ships of the navy at Philadelphia, which had just come from Florida, and the cases at Quarantine, New York. Of these last there were 390 cases of yellow fever which had occurred in port, on the passage, and in quarantine, and of these 112 were fatal. The epidemic was peculiar in the much greater frequency of profound congestion than is usual. The most effectual treatment has proved to be the use of very hot baths, profuse sweating, and careful nursing. If the action of the secernent vessels of the skin and a steady and uniform circulation of the blood throughout the system can be maintained, by whatever method it is accomplished, the patient will be saved. The evil to be most carefully guarded against, in apparent convalescence, is the morbid craving for food. If allowed at that stage of the disease it is followed almost inevitably by speedy death. In persons of weak and enfeebled coDstitutions yellow fever is more sure to prove fatal than in those of robust habit, the disease incubating for some time in the system, before decided symptoms make their appearance. Yet the statistics of the epidemics of it in New Orleans indicate that there-and the same is true in tropical countries-women, children under five years of age, and the colored races, are less subject to it than white male adults. INDEX OF CONTENTS. ABDUL-AZIZ-KHAN.-Sultan of Turkey, 727. See Turkey. Abyssinia.-Area and population, 1; army, 1; forts, 1; council and aldermen of Mobile and appointment of |