148 REPORT ON THE EPIDEMIC DISEASES OF GEORGIA. atmosphere then supposed to pervade the greater portion of the United States. The occurrence of fatal cases of cholera morbus at the same time gave credibility to this opinion. "The months of July and August seldom pass by without the occurrence of many cases of bilious dysentery, in some of which the influence of malaria is very perceptible. "Influenza, or epidemic catarrhal fever, is of frequent occurrence. It may be said to be a regular visitant of the spring and fall seasons, each visitation being characterized by some new peculiarity. In the fall of 1851 a form of the disease prevailed, marked by the following symptoms: pain in the head, back, and extremities, cold shivering sensations, deep bronchial cough, and occasional slight fever. All of these symptoms were worse in the early part of the day. The weather was dry, but had been preceded by heavy rains; previous to the rains there was a great drought. 'Neuralgic affections are quite common in this country. They appear generally to be of malarious origin, and yield to quinine, cupping, &c. In the colder seasons the disease is frequently blended with rheumatism, and appears to be developed by exposure to cold and damp weather. The facial variety is most common." I have now finished the work assigned to me, to the best of my ability, and hope that it may meet the views, and fulfil the requirements of the Association. And now, also, I make my acknowledgments, gratefully, for the assistance which I have received from those gentlemen of the profession who have given me the benefit of their knowledge. To Dr. P. M. Kollock I am indebted for most of the part belonging to the neighborhood of the sea, and through his instrumentality to Dr. Bealer, of Effingham, Dr. Dunham, of Camden, and Dr. Hopkins, of Wayne County. Dr. H. Briggs, of Troupville, Lowndes County, communicated all that I have given of Southwestern Georgia. I owe to Dr. G. F. Cooper, of Perry, Houston County, much of what I have said of the upper part of the first, and lower part of the second division. Dr. Robert C. Word is my authority for all concerning the third or limestone division. I have endeavored carefully to distinguish the parts due to each contributor, as vouching for the correctness of whatever I have written, whenever it was not from my own observation. JOHN F. POSEY. REPORT ON THE USE OF CINCHONIA IN MALARIOUS DISEASES. LOCATED in the midst of a malarious district of country, where intermittent, remittent, and bilious fevers prevail during the autumn, and often during the major part of the year, I have presented to me an extensive field for observation and experiment, with every facility for testing the curative powers of the various remedial agents which may be brought to the notice of the profession for the treatment of miasmatic diseases, I have thought that the result of my experience with cinchonia as an antiperiodic agent would not be unacceptable to the profession. Miasmatic fevers, frequently complicated with diarrhoea and dysentery, are the predominant diseases of our vicinity; they are principally confined to the laboring classes, who are more exposed to the malaria. The pure alkaloid and sulphate of cinchonia was introduced to the notice of the profession by Professor Wood, of the University of Pennsylvania. Since the year 1819 I have been prescribing it as a substitute for quinia. The alkaloid was procured from Powers & Weightman, manufacturing chemists, Philada. It was administered in the form of pill and solution during the apyrexia, the dose being graduated according to the age and sex-two, six, twelve, and twenty grains being prescribed as the case might require, which acted promptly and efficiently, arresting the chill generally after the first, and invariably after the second or third dose. The time for complete convalescence proved In each case the average attendance was from four to eight days. The tendency of the disease to return at weekly, bi-weekly, and tri-weekly periods was not so frequent as when quinia had been used; this probably was owing to its universal administration, the system becoming more or less unsusceptible to its action, it failing, in ordinary ten to twelve grain doses, unless the dose was increased, at each subsequent period of its administration, five or ten grains. Quinia, also, being high in price, the pecuniary circumstances of many would not admit of their purchasing sufficient to effect a permanent cure. The alkaloid cinchonia has proved itself in my experience to be equal, if not superior in its action on the system, to quinia in the treatment of intermittent, remittent, and typhoid fevers, and in all periodical diseases in which quinia has been heretofore thought unparalleled. Without entering upon a lengthy detail, I present a few facts as observed. It is less stimulating, milder in its action, less nauseous, and more acceptable to the stomach, than quinia; it does not produce fulness of head or headache, tinnitus aurium, and deafness. In children under twelve years of age it produced, in at least thirty cases that came under my observation, a peculiar erythematic hue of the skin, which confined itself to the face, thorax, and upper extremities, and continued from one to two hours, while the patient was under its full influence; this was observed more in the female than the male sex. The above phenomena were generally sufficient to alarm the family, who would send for me in great haste; finding the pulse slow, averaging from eighty to eighty-five, brain clear, pupils active, skin not unusually hot, no danger was apprehended and no treatment required; after noticing it in several cases, I generally informed the patient that an increased action of the capillary circulation frequently resulted from its use. It is with pleasure that I can testify and recommend to the profession the substitute of cinchonia for quinia, after a thorough and impartial trial of it for the last six years. The formulas used were as follows: R.-Cinchoniæ gr. xx; Pulv. acaciæ, Syr. simplicis, aa q. s.-M. Ft. pil. no. xx. I gave two, three, or five pills, as the case required, every two hours. In cases in which the paroxysms were early in the morn ing, I gave ten in the evening and ten in the morning. In cases in which the stomach was very irritable, morphiæ acetat. gr. to |