Mr. URBAN,

Oct. 1. F the various inftitutions which, during this age of benevolence, have been eftablished for the ***** relief of fuffering indigence, none appears to have a ftronger claim to the gratitude of pofterity than thofe formed to deftroy the virulence of contagion, or to counteract its progrefs. The Small Pox, once the fcourge and terror of Europe, was in a great meafure defeated by the introduction of inoculation; and fince the important difcovery of the Cow Pock, it has ceafed to excite apprehenfion. The Plague, formerly fo frequent, is now known only in thofe parts of Europe which are enervated by floth, and buried in. ignorance; and we are taught, by the fuccefs which has crowned every well-concerted attempt to arret the progrefs of contagion, how eafily it is deftroyed.

This fubject has within thefe few years excited attention; but its importance entitles it to a more particular confideration. By prudence we are enabled to guard against the ordinary accidents of life arifing from external violence; but, while we mix with fociety, we .are daily, ray hourly expofed to the infidious attacks of difcafe, againit which our fenfes are unable to warn us, and whole effects, when fully produced, human art is unable to combat. The melancholy accounts of the ravages produced, for fome years paft, by the Yellow Fever in the Weft Indies and America, have spread terror to our thores, and excited the active interference of Government. us change the name; and for Yellow Fever fubfiitute Typhus, or

Let

1802.

low contagious Fever: the found imparts lefs terror, but its effects are not lefs dreadful. At this moment febrile contagion, the bang of the human race, exifts in every populous town in England; it is a frequent vifitor in crowded manufactories, and delights to inhabit the fordid dwellings of the poor, and thofe afylums for wretchednes which the hand of Benevolence has raifed. The workhoufes of parifhes, the laft refource of laborious induftry, are too often avoided from the apprehention of its ef 'fects; and this is perhaps one rea fon why fo many objects daily expofe themfelves to a precarious fupport from charity, rather than enter thefe fufpicious edifices.

Until of late, the nature of Contagion was little underflood: it was fcarcely noticed until after the time of Sydenham, and confequently no precautions were taken to guard against its effects. It is to the indefatigable exertions of a HOWARD, that we are indebted for our moft valuable information; obtained by expofing himself to dangers which would have appalled a lefs intrepid breaft. Inftead of erecting a Pillar, let us raife to his memory a Monument more durable than brafs, by employing for the public fecurity the materials which he has bequeathed to us after fo dear a purchafe. This plan has been pursued by Dr. Clark, fenior Physician to the Infirmary and Difpenfary of Newcatile, who has lately published a work, intituled, "A Collection of Papers, intended to promote an Inftitution for the Cure and Prevention of infectious Fevers in Newcattle and other populous Towns." Thefe papers were written in confequence of a propofal, made by

Dr.

Dr. Clark to the Governors of the Infirmary, to appropriate to the reception of Fever patients a fmall and diftinct part of the new building lately added to the old InfirIt was propofed that thefe Fever Wards fhould receive not only the Fevers which may accidentally appear in the Infirmary, but likewife thofe which occur in the crowded habitations of the

mary.

poor. To form fome idea of thefe wretched fituations, the hot beds of contagion, the Collection itfelf thould be confulted, (p. 5) The plan intended to be purfued was, to remove as foon as poffible from their foul habitations the firft perfons of any poor families who fhould fall fick; and after being admitted into the receiving-room, ftripped of their dirty clothes, their bodies well wafhed, and fupplied with clean linen and an hofpital drefs, to place them in comfortable beds and in well-ventilated rooms. By purfuing thefe means, and purifying infectet habitations, Fevers may be checked on their first appearance; the fource of contagion is deftroyed; the other members of the family and their vifitors are preferved in health; and the patients, when convalefcent, are fent home with their clothes completely purified. The advantages of clean linen, pure air, and of a well-ventilated apartment, are well known.

The learned Profeffor of Medicine in the University of Edinburgh, whilft prefling the eftablishment of Fever Wards, ufes the following forcible expreflions:

"The degree of ventilation neceffary to prevent the danger of contagion from much febrile effluvia, may eafily be obtained in a proper Fever Ward; and of fuch confequence is it to the patient, that here we reckon it more than half the cure; and I would much

rather undertake the cure of patients in fever with the help of pure cool air, and no med cines, than with all the medicines in the Difpenfatory without the help of pure cool air. I have often

obferved, that, on bringing fever patients from their own foul, tainted, ill-aired houfes into the clinical wards (the Fever Wards in the Royal Infirmary at Edinburgh), which are always kept hours, even before they got any me as pure and cool as poffible, in a few dicines, their fymptoms were much relieved; and Dr. Hamilton affures me, that he has often obferved the fame in the fever wards." P. 59.

It appears, that in the yard of the old Infirmary, a fmall room called a Fever Houfe was originally erected, to receive Fevers which accidentally occurred in the Hofpital; but though this Fever room is detached from the chief building, yet it is in the common yard, and its entrance only forty-two feet diftant from the back door of the Infirmary; the fame kitchen is common to both houses, and the nurfes have free communication with every part of the Infirmary. In the intended new Fever Houfe, which is annexed to the new Infirmary, fuch precautions are taken as enfure to it every advantage of a detached building. It is placed at the Weft end of the new building, and is cut off from the other parts of the Infirmary by a thick brick wall. It has its own entrance, which is four hundred and fixty-eight feet diftant from the common entrance into the Infirmary. It has, moreover, a room for receiving and wathing patients, a kitchen, wafhhoufe, baths, &c. &c. The yard is inclosed by a high wall.

This plan of establishing Fever Wards has been oppofed under the pretence of its being a dangerous innovation. It is not, however, a novel plan; it has ftood for thefe laft twenty years the teft of experience in the Infirmary at Chetter, in that of Edinburgh, Manchester, Liverpool, and many other places. wonderful good effects in London It has lately been followed with under the auspices of the "Society for bettering the Condition of the Poor;" and we fincerely hope that

ferving the health of the poor. It is recommended that the different parishes fhould reimburse the governors of the Infirmary for the expence of each patient; which, ac cording to the calculations of Dr. Ferriar," has varied in different years (in the Manchefter Fever Wards) from 11. 18. 3d. to 1l. 10s. 3d. exclufive of wine and medicines, which are fupplied by the Infirmary; and about two guineas per head including wine and medicines, and the whole expence of the establishment."

Dr. Clark has not contented himfelf with giving the refult of his own experience for upwards of 30 years upon the fubject of Contagion, which appears to have been a favourite ftudy. He has given us likewife upon this fubject the obfervations of a great number of the most eminent and moft experienced phyficians in the kingdom, all of whom corroborate, in the moft unequivocal terms, the opinions of Dr. Clark and Dr. Ramfay respecting the fafety, propriety, and general utility, of Fever wards.

The guardians or governors of public charities will receive much fatisfaction from the perufal of this collection. They will perceive many important defects pointed out in the conftruction of the old holpitals and infirmaries, with the means of remedying them. They will alfo obtain much valuable information from the "Inquiry into the State of various Infirmaries" (p. 207), made with a view to the improvement of the Infirmary at Newcafile. To overfeers of the poor, who wish to difcharge their duty confcientiously by watching over the health of paupers placed under their infpection, and to the benevolent inhabitant of the country as well as of the town who is interested in the prefervation of his own health and that of his poor neighbours, this publication offers a more extenfive collection of practical facts, divefted of medical terms,

than has ever been laid before the publick in fo fmall a compass.

In returning thanks to Dr. Clark for his unwearied attention to the fubject, it is not poffible to pass unnoticed his candour in inferting the objections of the three gentlemen who opposed the inftitution.

The addreffes, however, of the opponents, though containing nothing but bald affertions, falling in with popular prejudices, feems to have alarmed the governors of the charity to fuch a degree, that they have given one decision against opening the Fever Houfe annexed to the Infirmary; and by this decifion continue the very evils which their humanity would have prevented, had it not received an improper bias. But, if the question should be ever re-agitated, there can be no doubt, when popular prejudice has fubfided, that this plan will be thought of all others beft calculated to preferve the objects of an Infirmary from the risk of contagion, of eradicating it in the habitations of the poor, and fecuring all other ranks of fociety from its baneful influence; that the enlightened governors of the Infirmary in this populous and commercial part of the Ifland will establish Fever wards; and that a Board of Health will be formed, to carry proper regulations of prevention into execution in the habitations of difcafed indigence; an example which cannot fail to be followed in a litthe time in every populous town throughout the kingdom. Yours, &c.

Mr. URBAN,

IN

MEDICUS.

Oct. 8. N thefe eventful and alarming times, every real Chriftian feems to be particularly called upon to make publick any conjecture that tends to confirm the truth of Revelation, and to ftrengthen our truft in that merciful Being, who alone" ruleth the raging of the fea and the madnefs of the people." With this conviction upon my mind, I am

ausious