other health resorts of Southern California, to teach that they are unsuited to all cases of consumption; for we are satisfied that in certain cases they would prove most beneficial; but we have known a number of persons to resort thither without reaping the benefits that had been anticipated, and the localities mentioned undoubtedly possess that admixture of land and sea air which we have seen to be a disadvantage elsewhere; and we can not but believe that to many persons this is a disadvantage sufficient to thwart the benefits likely to accrue from the other good qualities pertaining to the climatology of the foregoing region.

In conclusion, we shall not attempt to direct physicians as to where they shall send their patients, or how they shall determine the locality suited to the particular case they may have under advisement; nor will we enter into any of the details as to the personal hygienic management of patients, which is of such great importance in this disease, preferring to leave both of these to the judgment of the intelligent physician, after he shall have carefully studied the characteristics of climate that pertain to the several health resorts in the United States, and the condition and needs of his patients. But in the name of common sense and humanity, and for the sake of science, do not send from friends and the comforts of home those unfortunates who have already passed the bounds of curability. If all such cases were kept at home, and all physicians would give the subject of climate the attention its importance deserves, the number of persons benefited at our various health resorts would be proportionally far greater, and the number called to die among strangers, far from home and friends, would be much less.

MALARIA;

ITS NATURE AND MODE OF SPREAD.

BY BENJ. H. RIGGS, M. D., SELMA, ALÀ.

I know of no subject that is of such profound interest to the physician, or that more nearly concerns him in every day practice and experience, than that of malaria-or, as it is sometimes called, "Marsh Miasm"; abounding in all lands, and to some extent in all latitudes; finding its victims in every direction; now manifesting itself in a candid form, and again intercurrent with some other disease and more or less masking its features; and again assuming the shape of another malady, and hiding itself completely behind it, and only to be routed when specially assailed. It is all-pervading; "the viewless winds bear it upon their wings; the evening and morning mists entangle it in their meshes, and the fragrant odors of the spring are treacherous with its poison." This invisible, imponderable, intangible, yet real, positive and undoubted something has invoked the attention of medical philosophers from the earliest ages of this philosophy, for its effects have been seen by every physician who has observed. We are all familiar with it by its effects upon our patients and upon ourselves. The diseases of Alabama, more particularly those of the rich farming lands of central Alabama, are at least one-half, if not a greater per centum, due directly to its influence. Concerning us all to this great degree, I have, on this occasion, accepted the duty of drawing attention to the nature of the malarial poison, by summing up the most pop

ular and generally received views held concerning it. As I take it, there need be desired no better field for the study of malaria than this section of Alabama; the harvest is white for the garner; we need workers, skilled microscopists and attentive observers. So far as I am aware, notwithstanding the exceeding prevalence of this substance in our midst, there has been no paper devoted exclusively to this branch of the subject ever reported to our Association, except the paper by Dr. Jos. A Graves, of Summerfield, Dallas county, in 1871, entitled "A Chemical Explanation of Malaria." Other States in the Union have gone into this work, and physicians in other States in the Union have achieved great reputation by their researches.

I propose merely to give to-day, in as brief form as is consistent with perspicuity, a statement of the present status of the subject of malaria among medical scientists. I do this for the double purpose of chronicling medical progress, and serving as a guide for those who may wish to study the subject further. I shall merely view it in the aspects of its modes of development and diffusion.

Malaria is an ancient designation that was originated before the days of chemical discrimination. It has about as much significance as Influenza-THE INFLUENCE. It is true, that malarious atmospheres of to-day are "bad air," but there is much bad air that is not malarious. This word has lost its etymological significance, but has to be retained along with much in our nosology that means one thing and denominates another. "Marsh Miasm," as will be shown further on, is also a bad name; for it proposes to particularize, and does so imperfectly or falsely; for malaria GROWS fatally and abundantly in lands that are apparently arid, desert wastes, as well as in the marshy districts. In different ages of the world many views have been held as to what constituted malaria. Many theories have been advanced in explanation of it; for a long time it was held to be some pestiferous gaseous emanation or combination of gases. Again, it has been thought by some to be due to electrical telluric influence, or to "an allotropic

condition of atmospheric nitrogen in an electro-negative state." But in obedience to the general tendency of the professional mind of these times, the "germ theory" has been invoked in · explanation of its phenomena; and to-day it is almost universally received and taught in colleges, text-books, and monographs, that, in the language of Niemeyer, "marsh miasm-malaria-must consist of low vegetable organisms, whose development is chiefly due to the putrefaction of vegetable substance. It is true these low organisms have not actually been observed. No one has seen 'malarial spores,' but the facts above mentioned, as well as many other causes, urge us to believe that the poison exhaled by marshes, as well as that given off by a patient with measles, is an organic living substance." (Niemeyer's Text Book of Practical Medicine, vol. ii., page 609.)

As I understand it, the above is a fair expression of the present state of the question among medical scientists. The organic germ theory of malaria had its birth-place in America; to Prof. J. K. Mitchell belongs this honor. Its most prominent advocate was Dr. J. H. Salisbury, of Cleveland, Ohio; in 1866 he published an article in the "American Journal of Medical Sciences," in which he gave to the profession the result of his researches, evincing much industry and ingenious investigation, and in which he attributed malarial diseases to the poisonous emanations from a microscopic vegetable belonging to the Palmellæ.

Dr. Lebert says: "Before proceeding farther I may be permitted an etymological observation. Nægeli has named these minute plants schizomycetes, because they propagate by fission. The fact really is that the fission is found to be simply a cross-section in the rod-like bacteria and spirilla, and I have often observed it in my ovoid panhislophyton of the silk On the contrary, the gemmation of the micrococcus, as has been observed in the microsphere of small-pox lymph, is rather a biscuit-like contraction, with subsequent separation. We are concerned here with the lowest vegetable forms, those which are recognized by their extreme

worm.

* * * *

minuteness, being, in fact, on the ultimate boundary of microscopic vision, and which are held by the best mycologists as incapable of becoming transformed into more highly organized fungi by cultivation. I include, therefore, the groups of globular, rod-like and spiral fungi (it seems to me as irrational to speak of globular bacteria as of globular rods) together under the name of protomycetes.

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Though our knowledge in this department is as yet very incomplete, still every one who is familiar with the results of the latest researches will agree with me, that a deep and intimate connection exists in a great number of cases, between the development of protomycetes in the human organism and infectious diseases. I believe also that it will probably hap pen in this case, as in the thousand-years' conflict over the theory of spontaneous generation, that the facts against the latter, and which correspond to the protomycetic theory, will win more and more victories in the domain of research, until the term generatio spontanea will be considered as synonymous with generatio incognita. Thus, possibly, may the facts of the germinal origin of infectious diseases supersede the hypothesis of their primitive origin. Still we must be cautious in bringing forward prematurely an exclusive theory in order to support a theory of uniformity.

Salisbury's statements in regard to the influence of the minute palmella-like fungus have not thus far received scientific confirmation. For this reason the existence of malarial protomycetes can thus far only be accepted as an hypothesis, and it cannot yet be decided whether the air alone is the bearer of malarial infection, or whether, more probably, as I incline to believe, some fluid-it may be dew or mist, it may be drinking water-is the agent. * * Here non-conta

*

giousness alone is settled; all beyond is conjecture." (Ziemssen's Cyclopedia of the Practice of Medicine, pages 241 and 242.)

My attention was called during the past summer to an article in the April number of the Virginia Medical Monthly, which was an analysis of an article from the January number