IMAGE EVALUATION TEST TARGET (MT-S) y. 1.0 I.I 1^ ■96 1^ l^i^ m 1.2.2 y£ i2.0 •" ... i lit us K III 1.25 |||U 1.6 ^ 6" ► y] 7 O 7 /A Photogra{diic Sdences Corporation 23 WEST MAIN STREET WEBSTER, N.Y. 14580 (716) 872-4503 ^ ■«v^ U6 c^ it. m I n The population of Upper Canada has of late years been considerably augmented ; and there still is, from other remote countries, an annual influx of strangers. Since the earlier settlers came thither, the indigenous inha- bitants have been observed to undergo a gra- dual diminution ; and of those numerous na- tions who once peopled the present cultivated tracts of the country, not many are at present « to be found. The rude physiognomy of nature is now softening by degrees to the labours of in- dustry. Villages are seen rising in different parts of the province, and their enclosures, running backwards into the woods, give to the neighbourhood which they surround, a considerable degree of order and regularity. A prospect so pleasing to contemplate, in contrast with a scene of solitude and de- solation, naturally leads the mind to anti- cipate the future grandeur of this majestic country, when an increase of population shall cover its surface, and when those bounties, which nature at present scatters so profusely OP UPPER CANADA. 15 around, shall not pass unseen nor unen- joyed. The principal towns in Upper Canada are built along the shores of Lake Ontario, and on the banks of those navigable rivers which are best suited to the advantages of com- merce. The length of this lake from east to west is 180 miles: its breadth is much varied on account of the numerous indentations on its shores. Settlements adapted to commer- cial intercourse prove often unhealthy to tlieir inhabitants. Placed as they generally are on the banks of oozy streams and stagnating rivers; in certain seasons of the year, they contribute materially to the production of sickness. ' • > « - York, the seat of government, and capi- tal of the province, is built on a level plain, along the northern bank of an extensive bay, which communicates on its west side with the lake. This bay is long and narrow, and fed by many streams from the contiguous «oil, which in summer supply its waste of evapo- ration. It is navigable to vessels of consider- 1 1 16 MEDICAL TOPOGRAPIIY able burden ; and its shores in many parts are overgrown with rushes. Those winds which at times agitate the surface of the lake, seU dom or never disturb its stagnant waters. The site which the town occupies appears to have been once a deep meadow, interspersed with pools of water. Some spots of ground which border upon the town are as yet in a state of nature. Even those fields which have been cultivated, are not sufficiently in- tersected with drains to carry off the col- lections of water, which, in the rainy season of the year, often inundate the soil. The inhabitants of the town do not exceed six hundred, a number extremely small when contrasted with the whole population of the province*. The town on its west side is de- fended by a fort, which is erected on a dry and level spot of ground. Here was esta- blished thQ general hospital, in rear of the army, to which the sick and wounded were * The number of the inhabitants of the province^ with the late increase by immigration, may be estimated at 105,000. V OP UPPER CANADA. 17 conducted as necessity or contingency re- quired. In sickly seasons the inhabitants of York are liable to be attacked by intermittent fever. Kingston, which is the second town in the province, is larger than York, and con- tains a much greater number of inhabitants. It is placed on a gentle slope at the nortli- eastern extremity of the lake, near the source of the river St. I-iawrence. The situation of this town is certainly more healthy than that of York, but its inhabitants are by no means exempted from sickness. On its western side, the shores of the lake are indented with deep creeks and retiring bays, whose banks in summer put forth a rank and luxu- riant vegetation. At this place the ships of war were equipped for the service of the lake. The town is beset with pkquetthigy and a regiment with other detachments generally composed the garrison, to defend the works in case of an assault from the enemy. . On tlie southern and western boundary c •'I I II 18 MBDICAL TOPOORAPirV of the hike stand Fort George and Fort Niagara, separated IVoin each other by the river Niagara, wliich riows in a north-east- erly direction from Lake Erie to Lake On- tario, dividing this part of the country from the United States. These forts being erect- ed on elevated situations, command an exten- sive prospect of the neighbouring grounds, which arc almost divested of their forest. Fort Messissaugo, which is of recent con- struction, is built at a little distance from Fort George, and on the same side of the river, its position being also dry and elevated. Lake Erie is thirty-two miles disttint from Lake Ontario. Chippawa, and the Falls of Niagara, arc placed in the middle distance between these two lakes, and on the northern bank of the river. The inter- vening country is rich and fertile, and in many parts verging to a high state of cul- tivation. The district of Chippawa is flat and marshy, and abounds in summer with nox- ious effluvia. At this place the river Chip- l OP UPPER CANADA. 19 pavva, wliich runs thron^j^h a level and woody pui't of the country, appears dead and mo- tionless in its channel, on account of the river Niagara crossing its moutli, so as to itnpt'de the exit of its water. For miles above the confluence of these two rivers, the Chippawa overflows and recedes from its banks at very irregular intervals, owing to the greater or less quantity of water brought from Lake Erie by the river Niagara, which accordingly offers to its passage a smaller or more formidable obstruction. Neither the heavy torrents of rain, which are ob- served to fall in this district of the province, nor the vast quantity of water produced by the melting of the snow and ice, seem to have any influence on the flowing and re- cession of these two streams. This pheno- menon may be referred to the operations of another cause ; and it probably depends on the return of those inconstant winds, which impress and propel the waters of Lake Erie to their eastern confines, where, pent up be- tween two nearly approximating shores, they c2 If hi ijli i'l i 20 MEDICAL TOPOGRAPHY are forced in accumulated quantity th rough the deep declining bed of the river Niagara* Accordingly, the village of Chippawa is placed in an unhealthy situation, and, though a militaiy position both in time of war and of peace, it ought never to be garrisoned by troops except in cases of the most urgent ne- cessity. Fort Erie is erected on the north-eastern boundary of Lake Erie, near the egress of the river Niagara. This part of the country is but imperfectly cleared of wood, and little seems to have been done with regard to cultivatiori. The district is unhealthy and thinly inhabited. The tract of land which stretches from Chippawa to Fort Erie, is in many parts deep and marshy, and divided by narrow creeks, the swelling and recession of whose waters are also dependent on the increased or diminished size of the river Niagara. It is, therefore, not to be wonder- ed at, that settlers in this line of territory are at times indisposed by sickness. The Niagara frontier, extending along OP UPPER CANADA. 21 m the northern bank of the river Niagara, as far as the village of Chippawa, exhibits a more improved state of cultivation than any other part of the province. The scene is diversified by valleys and mountains, and by streams of water which in summer are refreshing to tlie sight. The woods are cleared ; the fields are enclosed ; the frontier is well peopled. But this beautiful part of the province was laid desolate by the enemy. The numerous wooden villages which were seen rising in succession along its border, no more charm the ear with the noise of their population. Those s])ots of ground upon which they stood, are now pointed out by the destruction of their fences, and the re- sidue of a few ashes. The western shores of Lake Ontario are narrow and confined, and sinuated by long bays, which run deviously into the woods. On the northern side there is a gradual ascent of the land from the shore, till the eye is arrested at a distance by rudely projecting hills, overshadowed with c3 i '-ifif'-- ""'• lillii M iiii n ii^iaa;M - * J iit M i i :ii 'I 22 MEDICAL TOPOGBAPHY forests. Here, the mountains of Burlington^ a military position of considerable strength, may be seen towering amid the clouds, and overlooking the neighbouring wilderness. These mountains, which are almost inacces- sible to an approaching enemy, were reserv- ed as a suitable place of retreat from the Niagara frontier in the event of a discom- fiture. During the war they vvere constantly defended by a regiment. Their summits abound with morass, and in autumn are almost perpetually obscured by thick clouds. The western limits of the lake are but par- tially settled, and withal very unhealthy. In the southern and eastern boundaries of the province, Cornwall and Fort Wel- Ihigton are the only military positions de- serving of attention. They are placed at a considerable distance from each other, on the northern bank of the river St. Lawrence, and command the farther shore and the na- vigation of the stream. Each is able to ac- commodate a battalion of 1000 men. The neighbouring fields are partly stripped of I OF UPPER CANADA. 23 tlieir woods, and partly in a state of iiature, and are, like many other situations, soften- ing by degrees to the operations of husbandry. Fort Amberstburgh and Fort St. Joseph may be considered as posts vakiable to com- mercial undertakings; the one being situ- ated between Lake Erie and Lake Huron, and the other being erected on a small island in the western part of the latter lake. Besides these military positions, of which I have given only a summary description, there are yet others of an inferior importance, which are placed in the interior of the coun- try, and far removed beyond the limits of colonial intercourse. The remoteness of their situations, and the dangers and fatigues to which men are exposed when conducted thither, might seem interesting to be known : but such an account would be foreign to the original import of this communication. IL The soil of Upper Canada is extremely fertile, and yields plentifidly to the efforts c4 I ' ;■* it ^■' ,1, 1' 24 MEDICAL TOPOGRAPHY of husbandry. It is composed of decayed vegetable matter, and varies in depth in dif- ferent situations. Whfen it is dug up, a. stratum of cold clay is found below it. The soil is often shallow on the declivities of mountains; but in plains or valleys, which extend along the banks of rivers, it is found to measure from three to five feet in thickness. Those districts which are at present cultivat- ed, afford a willing and an abundant pro- duce ; but the hand of industry, from those difficulties which always attend the settle- ment of a new colony, has as yet made very trivial and partial improvements. The culti- vated spots of ground, indeed, when com- pared with the waste lands by which they are bounded, seem to resemble those little islands which, in the extended lakes of the country, are seen widely scattered over the surface of the water. The clhnate of the province forms none of its least peculiarities. It is much diver- sified from a variety of causes in different parts of the cultivated districts ; these are. OF UPPER CANADA. 25 the peculiarities of soil and local circum- stances, the difference of latitude, and the remote ascent of the plains and moun- tains from the level of the ocean. The cli- mate of a country is best exemplified in the revolutions of its seasons : I shall therefore give a description of each season, in its re- gular order of succession. The spring is often wet and cloudy, and attended with easterly winds. The shores of the lakes being now loosened by the resolv- ing influence of the season, have their deeps covered with shoals of ice, broken into pieces by the violence of the winds. The vast quantity carried down by the different rivers of the country, is truly astonishing. Their deep and rapid currents are often filled for the space of ten days ; nor is that period, when the winter has been more severe than usual, adequate for its passage. Those beds of undissolved ice and snow, which remain for a long time in the northern regions of the province, have a powerful effect in re- tarding the progress of vegetation. In April M m ki n i« ff i ill a 26 MEDICAL TOPOGRAPHY the spring comes forth in all its beauty. Extensive pools of water, formed by the melting- of the snow and ice, deluge the plains in every direction ; and remain for a considerable space of time, till the rays of the sun have sufficient power to complete their evaporation. The heat soon becomes oppressive. The day and night evince re- markable extremes of lieat and cold, the temperature of the one being elevated by the rays of a powerful sun, and that of the other greatly depressed by the vast quantities of snow and ice which are gradually passing into solution. The medium heat of the summer, along the southern boundaries of the province, is nearly the same as that of a tropical country. The cultivated spots of land, enclosed by lofty forests, and in many parts by extended mountains, are now exposed to the direct influence of a burning sun, while those breezes are thus intercepted in their course which might otherwise mitigau* the fervours of the season. The great evaporation which 2 OF UPPER CANADA. 27 is daily going on, has a surprising effect on the general aspect of nature. The soil be- comes drier and more compact, and a beau- tiful vegetation clothes those plains which were lately sheeted over with water. But when the day is sultry, and the earth is much heated by the sun, an offensive odour is at times evolved from the surface of the ground. In no country does nature, indeed, appear to be more lavish of existence. The woods abound with musquitoes : the earth swarms with innumerable tribes of insects ; and the loose vegetable mould, when ex- posed to view, exhibits many forms of or- ganized life, not only passing into being, but undergoing a putrescent revolution. The sun, thus operating on a humid soil, and completing the decomposition of so great a mass of organized matter, tends to the pro- duction of those diseases by which men, whose constitutions have not been assimilat- ed to the climate, are always liable to suffer. It is truly remarkable, that the insalubrity of the air, in all warm countries, should be 28 MKDICAL TOPOGRAPHY accompanied with an unusual fertility of the soil; or, in other words, that those causes which promote the rapid growth of vegeta- tion, should generate in man the seeds of sickness. The drought of an ardent summer has little effect in checking the progress of vegetation ; for the daily evaporation from the earth is succeeded every night by heavy dews, which cherish and refresh the face of the countrv. Hence, in cultivated situa- tions, the fruits of the earth are produced in abundance, and are early hastened to ma- turity and perfection. When the winds blow from the south, or equinoctial regions, they are generally accompanied with a sultry state of the air, and, sometimes, with thun- der and lightning, succeeded by heavy showers of rain. When they proceed from the east, the air is often thick and hazy. In summer they seldom blow from the north. When they come from the north-western boundaries of the province, they are always cool and invigorating to the constitution. Autumn is more pleasant than any other 11- lorn zy. •th. OP UPPER CANADA. 21) her season. The heat of the sun becomes gra- dually more temperate. August, however, is at times more sultry than any of the sum- mer months; and the more elevated the temperature of the day, the more reduced is the subsequent coldness of the night. The evenings now feel chilly, and the dews fall in great abundance, so as to wet the clothes of those who travel under night. Marshes, solely from the depositions of dew, become more and more filled with water. In places where no rain has fallen, pools of water are often to be found. The decline of this season is always attended with heavy fogs, which give to every evening and morning a con- siderable degree of opacity. This mistiness of the air must be referred to the sudden condensation of those vapours which had been exhaled by the sun. So rapid is the formation of the fog, that in the evening, when the sun has withdrawn his beams, it appears to be instantly precipitated from the atmosphere ; and every hill, mountain, and valley, is enveloped in a general cloud. ! n i 1 1 I'l? f ! " .iill ^li ■ t a i ! 30 MEUICAL TOPOGRAPHY During the day, the sky resumes its usua! transparency. When the equinox arrives with attending winds, this state of the wea- ther shortly disappears. Afterwards, the rainy season sets in, and the country is de- luged with rain till the beginning of De- cember. The heavy showers which fall from the clouds during this period, are almost in- credible. The ditches are filled with water, and the low grounds are inundated by nume- rous streams which come from the mountains. Military operations at this time arc attended with many difficulties, not only from the in- clemency of the weather, but from the ge- neral wetness of the so>l. Winter commences at uncertain periods in different parts of the province, owing to the variations of latitude and situation, and to the contrary states of agricultural improvement. In the eastern parts of the country, the snow falls often in the beginning of December ; but in the more southern dis- tricts, it is much later than that period. In the northern and western boundaries of the OP UPPER CAN yt\. 31 province, there is almost a j, Tpetuji wliit*"'^ the eartli being frozen to a great dei ' .j throughout every season of the year. Ther^, nature scarcely revives at the return of spring. The decrepit appearance of the forest evinces the sterility of the climate. The waste grounds, intersected with rivers, and par- tially covered with lakes and marshes, are almost perpetually swept by cold icy winds. In many parts of the country, when the winds blow from the north or north-west, they are extremely cold and piercing, and always bring with them a severe frost, llie trees of the forest bear marks of the prevail- ing influence of these winds. In many si- tuations their branches incline towards the east, and their trunks are covered with a stronger coating of bark on their northern, than on their southern surface. When the winds veer much from these directions, the snow and ice often undergo a partial resolu- tion. The quantity of snow which falls in the northern, is much greater than in the southern regions of the province. Its depth iT l\ (I irii 32 MEDICAL TOPOGRAPHY on the surface of the earth, wlien not driftetl by the winds, is therefore influenced by the degrees of latitude. When the surface of the snow has been congealed by the frost, it proves very serviceable for the passage of sleighs *, by which means a communication is kept up between distant parts of the country. While the frost continues, the air is always pure and salubrious, and the sky is remarkably serene. It often happens, that the winter passes away without much frost ; 1i)ut when this is the case, the moist state of the atmosphere renders the season extremely unpleasant. Accordingly, the medium tem- perature of the air varies considerably in ditferent winters. The thermometer often indicates as great a reduction of heat as is met with in any country. The winters of Upper Canada are now less severe than at a former period, and also of much shorter duration. It has been ob- served, that the severity of the cold has de- * Sledges. OP UPPER CANADA. S3 i creased in pro[)()rtion as tlu; soil lias been cleared of its wood ; but as the cultivated grounds are very inconsiderable, when coui- pured with the waste lands of the province, we arc not thence to suppose, that this anieli- ration of the flimate is dependant soUly on the progressive state of agricultural iiuprovc- Uient. A variety of causes no doubt exist in the economy of nature, which tend to promote this important purpose. As associ- ated with these causes, the visible revolutions which are taking place in the interior of the province, are not to be overlooked. vSome of the small lakes have lost so great a por- tion of their water*, that they appear to be slowly passing into a state of desiccation. Others are gradually filling up with the vast quantities of soil and gravel, which are ear- ned down from elevated situations by their numerous rivers. Extensive marshes are now found in those places which were for- merly occupied by lakes. These marshes again are undergoing transformation. From the accumulated mass of their decayed pro- i:i% V. 31 MEDICAL TOPOGRAPHY ductions, a new soil, already covered with trees, is emerging from the surface of the water. Even the rivers and great lakes are supjjoscd by some to be in a state of pro- gr(;ssivc dinnnution. Of these, however, it is diflicidt to judge, on account of the pe- riodical movement of their waters. Should these physical revolutions have no share in effecting an alteration in the climate, they are yet of material importance in a geolo- gical point of view. The naturalist may trace the incipient configuration of a soil, which in time, under the hand of cultiva- tion, may extend the territorial resources of an agricultural people. III. Tiie services of the army in Upper Canada were arduous and severe. So great was the scarcitv of men, both at the com- mencement, and during the continuance of the war, that no sooner had a regiment ar- rived at Quebec, than it was immediately ordered to proceed on its march to the Upper Province. The route was long and tediouSj OF UPPER CANADA. 35 the latig'iies .£>Tcat ; and many difficulties were to be overcome. This line of march, from the point of debarkation to the Nia- gara fi'ontier, where hostilities were carried on, includes a distance of nearty 550 miles. The road is cut through the woods, and runs along- the banks of the river St. Law- rence, and the northern side of Lake On- tario, varj^ing in its course with the undida-« tions of the shore. It is often interrupted by- deep bays, and also by numerous tributary streams which discharge their water into the river St. Lawrence. In many places where the ground is low and marshy, large trees are cut down, and laid crosswise, to facilitate the passage. When a march was under- taken in spring, or in autumn, the miry state of the roads presented many obstruc- tions. Nor were the oppressive heats of summer, superadded to the fatigues of long and forced marches, less dispiriting to the soldier. When the passage was render- ed tedious from the wetness of roads, the d2 -fl ii ^ ti m Vn S6 MEDICAL TOPOGRAPHY t Ni troops were generally conveyed to the Upper Province in hatteaux *, from which they were often obliged to disembark when they had to encounter the rapids of the river. The hauling and poleing of these vessels against the stream, was attended with much l^jjour. The clothes of the men employed on this duty were almost constantly wet. During night their accommodations were wretched. They slept cold and comfortless in the barns and out-houses of the settlers, which are widely scattered along the banks of the river. Some- times, when overtaken by night, a fire was kindled in the woods, around which they stretched themselves till morning. But winter, with its attending storms, of- fered greater impediments to a march than any other season. Vehicles to forward the baggage could not always be procui'cd. For successive days the march was at times ob- structed by the falling of snow; and the drifted state of tliis in the woods rendered it hazard- i Small flat bottomed boats. OP UBPER CANADA. 37 •d- oiis to prosecute the journey. The faces of tlie men were often frost-bitten, when much exposed to the north wind. Sometimes, in- deed, the tear was no sooner secreted from tlie eye, than it congealed into an icicle upon the eyelashes, so as to restrain their motion. Many of the wooden bridges which conducted across the streams had been burnt down by tlie enemy. The ice not being of sufficient thickness to support the men and baggage, delay was thus rendered unavoidable. But more dejecting than all, such obstructions as these were sometimes accompanied with pri- vation. When the rations of the men were expended, the settlers could afford but little from their winter's stock of provisions. Tims want, in addition to the inclemency of winter, and tlie numerous impediments of a long march, increased the burden of general cala- mity. The night, too, proved more uncom- fortable than the day. Though the men were stretched before the fire, the intenseness of the cold was severelv felt. The toils of the day were not always followed by the refection D 3 I i-T p. lib m h I } 38 MEDICAL TOPOGRAPHY of sleep. Its return seemed to be prevented by a certain degree of cold, and a deficiency of covering. The silence of the night was disturbed by the bowlings of savage wolv^es, that prowled around the cottages. Nor was the ear less impressed by the loud winds in the forest, and the incessant noise of an im- petuous river. The road at timi's emerging from the woods, ran for r. considerable dis- tance along the edge of the river. Huge sheets of ice were then seen piled to an amaz- ing height along the rocky maiiiin of the stream. The accunudated mass, obtruding from the shore, appeared to alier the direction of the current. Rivulets descendiim- fi'om au- rupt precipices, seemed from afar, frozen to the eye. The grandeur of the scene was heightened by a variety of all those sublime objects whicli can engage the mind amid the general wildness of nature. Infants at their mothers' breasts supported with impunity the severity of winter. When the shores of the lakes were suf- ficiently frozen, so as to support the men and OF UPPKU CANADA. 39 l)agg"ige, the (lay's march was completed with facility, liesides, it could be shoftened or prolonged according- to circumstances, when a choice oi* accommodation could frequently be obtained ; j^et the early com[>letion of a route, attended with so many unavoidable olistruc- tions, was always to be wished. Though other difficulties were to be surmounted in the field, tlieir anticipation had as yet no power to sully the fondness of expectation. In the prosecution of active operations, the services of the men were truly important. Physical obstructions were more difficult to be overcome than those opposed to them by the designs of the enemy. The centre of a wide forest was sometimes the theatre, where bravery was to be shown, or victory to be won. The inequalities of the ground, tlie deep and extended marshes, and, above all, the thickness of the Vv^ood, rendered it impos- sible to keep the men in a solid body when advancing- into action. The mode of warfare, too, was new to the greater part of the British troops. By being separated into small parties, I) 4 J- t ■ ■ % '■- 40 MEDICAL TOPOGRAPHY h?. I ■ \i^ an advancing column had its effective force considerably impaired. Its power, thus weak- ened by the subdivisions it had made, could not be concentrated again, to decide the fate of the day by the point of the bayonet. The artiller;, also had much to contend with. Their guns, locked, from their excessive weight, in the ground, could not always be brought into action. At the commencement of the war, the country was naked and defenceless to the in- roads of the enemy. Forts and batteries were erected, and breastworks were thrown up. In the construction of these, the troops were employed ; consequently their duty, both in defensive and offensive operations, was at- tended with many hardships. Those actions which were fought in winter, were generally partial ; but those in summer were more se- rious and bloody. Incomplete forts, block- houses, and temporary huts, formed the chief covering for the troops. Both in winter and summer the army was kept on the alert by the contiguity of the enemy. Numerous sentries or UPPER CANADA. 41 surrounded every fortress by night. By means of advanced picquets, a long chain of com- munication was maintained in the woods ; and every position which the troops occupied way guarded in a similar manner. Thus the dis- charge of an important duty never failed to give a stimulus to the mind of the soldier: his energy was increased when he had difTi- cnltics to encounter; his courage was renewed and strengthened when he had dangers to oppose; and his patience and perseverance were never overcome under all the fatigues of his long retroceding and counter marches. IV. We have now given a short view of the general aspect of the country, and of the principal settlements, and different military positions, as far as they vire worthy of our at- tention. We have also considered the nature of the soil and of the climate, and the arduous services which the troops had to execute. From what has been said, some idea mav al- ready be formed of the nature of those dis- eases which obtained in the army. 42 MEDICAL TOPOGRAPHY I 't: In every remote rei»ion, there are many objects to eiiga;:;e the attention of a medical observer. The face of nature is new and in- teresting. The vegetalde kingdom displays around him a number of her productions, whose history he had known only by descrip"* tion. Amid tlie general variety presented to view, he feels an inward ])leasure in recognising some of those plants, which are also tlie oiF- spring of his own native soil. His mind is no less interested with tlie peculiarities of the climate, than with the dilFerent forms of those diseases which are prevalent in the country. In those changes which are every where conspicuous on tlie surface of the eartii, the sun is to be regarded as an important agent. His heat and light promote vegetation. Be- sideSj the remains of all vegetable and animal substances, draw, not only their putridity, but their infectious power, from the action of his beams. There is often in the revolution of each season, a wide field laid open to medical pur- suits. In unhealthy situations, a minute re- 2 OF UPPER CANADA. 43 gard should be paid to every local ciicuin- staiice. The alterations of atmosplieric tem- perature should always be examined, and tlie small 01" copious depositions of dew, with the deficient or superabundant falls of rain, ought to be taken into consideration. Those winds, too, ever varyinc^, not only in their direction, but in force, frequency, and in the period of theii' duration, should not escape ol)servation ; for in all countries they have been found con- nected with the different states of health and of sickness : and though those causes which tend to the partial or general production of disease, lie Jiid from our perception, yet amid all the doubt and uncertainty which accom- pany our investigations, we are still able to trace an evident analogy between each season of the vear and its attendins" diseases. In this point of view I shall treat of those diseases, which, as far as my observations extend, were most prevalent in the army during its exposure on service to all the vicissitudes of the dif- ferent seasons. Commencing with the dis- eases which made their appearance in springs, i have had repeated attacks of puLMi-niJuia, E !■ i!« 50 MEfftcAL TOPOGRAPHY are for the most part affected with a trouble- some cough. The exhalant vessels of their lungs seem relaxed. The glands of the trachea and bronchic'c discharge an unusual quantity of mucus. The investing membrane of the air-cells is much irritated in cold weather by the action of the air. Attacks of inflamma- tion are induced, adhesions between the pleu- rae become more extensive, the vital functions of the lungs are more and more injured, the cough becomes frequent and urgent, and the patient at last feels breathless upon his accus- tomed exertions. When he inspires freely he may now be sensible of a tightness in his breast. Even in a state of repose, the breath- ing is partially hurried, the pulse is quickened, the cheeks arc occasionally flushed, and there is also a burning sensation in the soles of the feet and palms of the hands. The capacity ot the chest seems diminished, the head bends forward, the shoulders become pointed, and the patient gradually assumes the phthisical aspect. Few medical officers have served in the OF UPPER CANADA, 51 army, for any length of time, who have not witnessed, in the same constitution, the re- peated attacks of pneumonia and its con- sumptive termination. It is a remarkable fact, that in the early stage of inflammation, death has never di- rectly followed the abstraction of a large quantity of blood from the human body. The consideration of this circumstance, when it ia deemed expedient to have recourse to blood- letting, ought to inspire confidence in the inLnd of the young practitioner. When the powers of the system have not yet suffered from the constitutional excitement of inflam- niation, much good may be done by the sea- sonable employment of the lancet. Dr. Hallei has recorded a number of cases in which hse- njorrhages have occurred to an alarming ex- tent. He reports one person to have lost twelve pounds of blood by vomiting in one night. He mentions another who discharged, ill the same space of time, twenty-two pounds of blood from the lungs. Nor in tliese Uvo instances were the evacuations of E 2 52 MEDICAL TOPOGRAPHY il.»i ^% Mil I ■# blood succeeded by death*. SiiicCj tlieii, iin- ture has spontaneously poured out more than three fourths of the ciroulatin*,^ mass from the livin<^ system, what reason have we to dread li fatal termination from the extensive employ- ment of artificial blood-letting ? Late and untimely bleedings have lessened the reputation of the lancet. When pneumo- nia has run on for a number of days, without blood-letting being employed to retard its pro- gress, that quantity of blood, requisite to be taken in order to accomplish resolution, at an after-period of the disease may be so g^eat as to endanger the essential principles of life. Under such circumstances, the lancet has been resorted to both by the bold and the timid practitioner. The attempts of the one have been unsuccessful in checking effusion and suppuration ; those of the other, though they may have prevented these consequences of the disease, have sometimes led to the fatal supervention of typhoid debility. He who, ^ l^leraenta Physiologiai, vol. iv. page 15. OF UPPER CANADA. 53 on so trying occasions, has been gnided by his re dcat'i, the skin assumed a yellow ap- pearance. In a number of instances, it ter- Hiinated in an obstinate intermittent fever. This fever, like the bilious remittent of the F 3 Pi U ''■'\ I ; 70 MEDICAL TOrvGRAPIIY West Indies, often resolved itself fdvciraMy on the third day after its attack. A few spo- radic cases occurred which had a striking re- semblance to that fever. They differed, how- ever, from it in not being accompanied with the black vomit, and in being less prone to terminate fatally. How evident soever the simiUtude mav be which exists between these ft' two fevers, it would certainly tend to much tedious and fruitless disputation, should I at- tempt to prove their identity. They are, without doubt, the offspring of the same causes, and are found co-existent only in the elevated ranges of atmospheric temperature. The features and symptoms of remittent fever have been observed to differ much in their general expression and in their degree of seve- rity. Accordingly, this fever has derived its present numerous appellations from tlie va- riety of character which it has assumed in different countries. But in whatever region it presents itself, as modified either by the peculiarities of constitution, or by the quan- tity and concentrated state of the poison, as it OF UPPER CANADA. 71 is received into the system ; we may observe in all its forms a corresponding resemblance, and an almost constant tendency to sangui- neous congestion in the most important vis- cera of the body. The treatment of this fever on its first at- tack, consisted chiefly in depletion. When the pulse was hard, the lancet was used freely. The abstracted blood at times exhibited marks of inflammation. When there was great de- termination to the head, much benefit was obtained by the opening of the temporal ar- tery. In those men in whom the irritability of the stomach was not great, emetics proved very useful. Calomel and jalap were the principal purgatives which were administered. When dehrium or coma supervened, blisters were applied to the head, and calomel, com- bined with James's powder, was given in such quantities as might affect the mouth. As a means of promoting salivation, mercu- rial ointment was also nibbed in over the re- gion of the liver. When the heat of the skin was much higher than natural, the cold affu- F 4 'hi u i J I I 72 MEDICAL TOPOGRAPHY Kion WHS sometimes effectual in producing; a remission of the fever. Ou the appearance of a remission the bark was administered. My friend Mr. (iriffith, of tiie Royals^ who served with liis regiment in Upj)er Ca- nada during the period of hostility, has fa- voured me with a letter on the sul)ject of tliis disease, part of which I shall now take the liberty of transcribing. " No doubt can be entertained," he says, " tliat the remittent fever of Upper Canada is produced by the putrid effluvia with which the shores of the lakes and the low wet grounds of the country in many parts abound. When the fever pre- vailed in my regiment, the services of tiie men were very laborious ; for they were em- ployed in strengthening their position, and in throwing up breast-works. Every night par- ties were sent out on the advance to recon- noitre in the woods. In this manner, exposed at one time to the heat of the sun, and at another to the cold dews of the night, it was not to be expected that tlic men could remain long free from sickness, liesides, their huts 4 OF UPPKR CANADA. 73 were built of ;^reen wood, covered with live turf, and pervious to every sliower tlmt hap- pened to full. Taking- all these thiiij^s into consideration, we shall not be at a loss to account for the appearance of this fever. Thr remittent fever of Canada was certainly less violent in its form, and more irrcu^ular in its symptoms, than the yellow fever of the West Indies. In a number of eases of the former I ventured to give emetics ; but in tlu; latter, you well know, we always reckoned their use ex- tremely hazardous. I bled freely in Canada, but not so plentifully as within the tropics. In the remittent of Canada, the ablution of the body with cold water often brought on a remission, after which the bark was given with advantage. Calomel, however, was the principal remedy; for, when the mouth became affected with that medicine, the patient had, for the most part, a speedy recovery, and was not so liable as others who were treated in a difterent manner, to be attacked with inter- mittent fever. It is difficult to assign any reason, why those causes which produced in 74 MKDICAL TOPOCiUAPHV I'. I ! i some men a tertiun or quotidian intermittent, should have produced in others who were placed under siuiilar circumstances, the well- known symptoms of a bilious remitting fever." Of dysentery I have but little to commu- nicate. The acute form of this disease, which in other countries has often proved distressing to an armv, was not much to be dreaded in Uj)per Canada. In those cases which came under my care the symptoms of inflammation were not very urgent. The remittent and in- termittent types of fever were attendant upon the complaint. The tenesmus, though not severe, was sometimes long continued. The faeces were mixed with nmcus, and at times with blood. Gentle bleedings, a few purga- tives, and attention to diet, generally over- came the complaint. It terminated in the chronic form, in tliose men whose viscera were enlarged, or in those who were debili- tated from frequent attacks of intermittent fever. Dysentery seemed so blended with that disease, that, in a number of instances, it alternated with the paroxysms of the fever. OF UPPER CANADA. 75 Chronic dysentery is supposed by some to hv connected with a vitiiited state of the hiliaiv secretion. The opinion is certainly well found- ed ; for the liver has been observed diseased in a number of patients, who have fallen vic- tims to this form of the complaint. Although it may seem reasonable to refer the deranged action of the bowels to the morbid operations of that organ ; yet chronic dysentery appears to me to be connected M'itli other glandular secretions. Mercurial friction, when it is pushed so far as to affect the mouth, almost always suspends the dysenteric symptoms. In this case, would it not be improper to at- tribute the salutary influence of the mercury to the supposed improved secretion of the bile in the liver? When ptyalism has ceased, do not the bowels again resume their diseased action ? But, further ; — the motion of a ship has long been supposed by some to coun- teract the inordinate action of the intestines. Hence a voyage has frequently been pre- scribed to men labouring under protracted dysenteries. Those cases of the disease which 76 MEDICAL TOPOGRAPHY 1^;" arc animally imported from tropical coimtrics, arc always benefited by the sea breezes, and, in a number of instances, undergo a sponta- neous cure during' the passage. From the increased dis('har<»:e of urine, which alwavs ac- companies the gradual amelioration of tlie symptoms of tlie disease on board ship, I have been led to conclude, that not only the per- spirable matter from the skin, but the dis- eased secretion from the intestines, is capable of being tran-lited to the urinary organs, by which means the disordered bowels have at last re-establislicd their healthful operations. The close of autumn, when the armv was in the field, for the most part brought M'ith it an increase of sickness. Remittent fever now ceased to show itself. As the season advanced, intermittent fever became more and more rooted iu those men wlio had suftvred from its previous attacks. The cold nights, and foggy state of the air, seemed to incorporate the disease with the constitution. During the autumn of 1814, its consecpiences were severely felt amongst the troops, when er^- OF UrPER CANADA. 57 gaged in tlie siege of Fort Erie. At that pe- riod there was a daily inerease of siek, and the effective force in the fiehl ^vas at kxst re- (hiced to one half of its original nunihcr. The huts and block-honscs conbtnicted before the fort, for the shelter and defence of the men, were then ])crmeable to the heavy rains of the season. No time was allowed to con- valescents to repair the M'aste of disease. When discharged from liospital, they were instantly marched off to participate in the hardships of an urgent service. On their v/ay thither, some might be seen falling down and relapsing into fever. The pressure of duty was always so great, that the CKcitiuJis of every individual, however feeble, wew of ma- terial importance in the protection of the country. When a regiment was put in -^ . tion, the debihtated state of tlje men i-.il not escape notice. Numbers, unable to i>io- ceed, straggled, or lingered in the reai. It was not the love of plunder that o^jcaslo* d the delay of the soldier, but the feeble po .3 of an exhausted constitution. Tlie deep 1 1 78 MEDICAL TOPOGRAPHY If i r?- ,:M and unequal grounds, over which he was called to niarcl), the weight of his accoutre- ments, which ho was scarcely able to sup- port, rendered the journey tedious and in- surmountable. In this pitiable condition, it is much to be lamented, that he should so often resort to inebriation, as a temporary retreat from his numerous sufferings. The only account of the intermittent fever of Upper Canada, with which I am acquainted, is that afforded us by Mr. M'Causland, who was surgeon to my regiment during the former American war. From his communication, it appears that he had been quartered, for a number of years, with his battalion in Fort Niagara. He mentions that tartar emetic, given in the form of pill, was more efficacious than the Peruvian bark in the cure of the in- termittent fever. " I am confident," he re- marks, " that I speak considerably within bounds when I say, that, from the year 1 775 to 1781, this remedy alone has removed three hundred agues'*." Future experience, * See Medical Commentaries, vol.viii. p.2'1'2. itl It OF UPPER CANADA. 79 however, has not confirmed this assertion. He likewise takes notice of the insuffi- ciency of zinc as a remedy in the disease. From the tabular statements which he has given, as well as from the general purport of his paper, I may with certainty affirm, that intermittent fever had prevailed to a less ex- tent in the regiment, during its former, than during its recent services in Upper Canada. " It is a well-known fact," observes Dr. Rush, " that intermittent and bilious fevers have in- creased in Pensylvania, in proportion as the country has been cleared of wood. It is equally certain, that these fevers have less- ened, or disappeared, in proportion as the country has been cultivated." In the account of the wounded, I shall advert to the efficacy of those different medicines which were em- ployed in the cure of the autumnal intermit- tent fever. Rheumatism and pneumonia made their appearance at the beginning of winter ; but were less frequent than in spring, and re- sisted in a less obstinate manner, the usual !■ f I ;r ^ p 80 MEDICAL TOPOGRAPHY mode of treatment. When the frost com- mencetl, an immediate check was often given to intermittent fevers of long standing. Du- ring winter tlie hospitals were occupied by a few cases of general debility, of obstructed viscera, and of protracted diarrheas. These affections were all consequent to former dis- eases. Ophthalmia, though met with at times in every season of the year, was most preva- lent during winter. It sometimes owed its origin to contagion; but, for the most part, to the severity of the north winds, and to the bright reflection of the sun's rays from the surface of the snow. Ophtlialmic patients suffered much on a route, from their unavoid- able exposure to cold. The division of the temporal artt 'v, on the invasion of the dis- ease, almost always gave an inunediate check to the progress of inflammation. In those men whose eyes had been much weakened by the disease, relapses were of frequent occurrence. In ophthalmia as well as in pneumonia, it was sometimes requisite to OF rPPEU CANADA. 81 t^arrv blood-letting to a great length. The disease has always been more or less prevalent in my regiment sine»; its services in Egypt, notwithstanding every precaution has been taken to prevent its propagation. Tlie external j)arts of the body were liable to be affected by the frost. The nose, checks, and ears, suffered more severely than any other part. A person whose face is frost- ])itten has a very uncommon appearance. The lips are deprived of their red colour, the nose and cheeks become pale, and seem more pointed than natural. Every feature except the eye, loses its expression of life. In this state the individual is not conscious of the injury he has sustained, till apprised of it by his friends ; nor even then is he inclined to place an implicit confidence in their asser- tion. The dead part, when pressed by his fingers, communicates to them a peculiar sensation, similar to that which is imparted by other dead portions of matter, not con- nected with fabric of the bod v. Men who were in a state of intoxication, perished in a o • :■>§ 82 MEDICAL TOPOGRAPHY ¥ few instances from the severity of the win- ter's cold. In such, these local effects of the fi'ost were the first steps to exanimation. The powers of muscular motion were next impaired ; a state of sleepiness was induced ; the senses became annihilated. The vital energy of the system, thus overcome, resisted every means of resuscitation. Friction with snow, or ice-cold water, was tlie most effectual remedy for restoring life to a frozen part. The circulation in those parts which had been injured by frost, was after- wards rendered weak and languid, and liable to be interrupted in future, even by a slight exposure to cold. Parts whose vitality had b(;en much injured, were prone to be attacked with indolent ulc^ tions, the cure of which, even under stimulating ap{)lications, was di(- ficiilt to be accomplished. V. The active; services of the troop's were continued for a period of nearly three years. Tiie cumj)aign of 1811, wliich preceded the ratification of peace in the following spring, OF UPPER CANADA. 83 was rendered important by the successful achievements of the army. Being stationed at York in charge of the general hospit.il during the greater part of that year's campaign, a favourable opportunity was afforded me of witnessing the state of tlie sick and w unded who were sent thither from the army. That part of the province, I may observe, which stretches from Fort George to Fort Erie was tlie principal field of active operation. After the several actions which were fought in that tract of the country, the wounded were im- mediatclv conducted to the rear as far as Fort George, from whence they were shipped on board small vessels, conveyed across the western extremity of Lake Ontario, to be landed at York, and admitted into hospital. On the evening of the second or third day after an action, they generally reached their place of dijs^hiation. After the battle of Chip- pawa, which took place on the 5th of July, a considerable nund)er of wounded were dis- embarked at York, and admitted into hos- pital. Sufficient accommodation being af- G 2 11' ir 84 MEDICAL TOl'OGRAl'ilV ;; J forded tlieiii, the routine of medical duty luid not as yet met with any obstruction. The battle of Lnndey's Lane, wliich was fought on the 17th of the same month, being more sanguinary than that of Chippawa, filled the general hospital at York, and its adjacent buildings, with its nuuierous wounded. After the latter period, the duty of the medical de- partment, not only at York, but along the Niagara frontier, became serious and labo- rious. The skirmishes and casual engage- ments which occurred during the remainder of the campaign, kept the hospitals more or less filled with wounded till the beginning of winter, when the enemy, evacuating Fort Erie, passed over the river Niagara to the peaceful possession of his own territoiy. Our troops, tliough opposed to a force much greater in number, generally juajntaiued their ground ; and in almost every ren- counter had tlie scale of victory on their side '^. * The number of regular troops in the Upper Pro- vince did not exceed SjOO. The American force nas ahvays more than double that number. OF UPPER CANADA. 85 The task, however, is not mine, either to applaud the well-con(Uicted enterprises of ati army, or to censure those precipitated mea- sures, which, in their fatal conserpiences, often ol)scure the brightest prospects of suc- cess. The general hospital at York, though a commodious building*, was deficient in size for the accommodation of the sick and wounded. Its apartments being originally intended for family use, were too small for the wards of an hospital, and did not admit of a free ventilation. Neither were the ad- joining houses of the hospital, which were fitted up for temporary accommodation, any way suitable for the reception of the wounded. Wlien, in the course of the summer, the wounded became so numerous as not to be contained within the general hospital and its outhouses, the church, a large and well-ven- rikitcd !)uilding, was dismantled of its seats, and, for the time being, converted into an hospital. Having made these preliminary remarks, I shall now proceed to give an ac- G 3 86 MEDICAL TOPOGRAPHY count of the state of the wounded, wliich is to be ujiderst(K>d ,•• referring solely to the campai»rn of 1814, l»y far the most iiMportant epoch of the war in Uppc r Canachi. Many of the vvonnded were dehihtated from severe service, and Lad also snll'ered from the endemic diseases of the country. Their constitutions were not, therefore, in a State well arlapted to make reparation for the loss of substance, occasicued by serious in- juries. Neither were they in a favourable conditit)n to undergo those formidable opera- tions which are too often the last resort of surgical interference. The sultry season of the year, and the contined apartments of an ill-ventilated hospital, militated much against the recovery of the wounded. These unto- ward circuniGtances did not fail to excite many painful apprehensions in the minds of those who felt anxious for the welfare of the soldier. The constitutional fever attendant on se- vere injuries, was evidently modified by the influence of climate. It partook of a remit- Hi if OF UPPER CANADA. 87 tent character, its period of attack depend- ing^ on the early or late appearance of local inflanunation. In a few instances, the re- Hiissioiis of tlic fever conld be traced ; but, for the most part, they covdd not be distin- guished. Exacerbations often caine on with- out any previous abatement of fever. Such, indeed, constituted the highest grade of the Kyniptomatic fever. Sometimes the exacer- bations were evidently connected with an ir- ritable state of the constitution. At other limes they seemed i-eferable to the extent and violence of the inflammation, occupying the peculiar structure of that part which had undergone the solution of its continuity. A high state of constitutional fever, deriving its existence from the presence of inflamma- tion, is not to be regarded in a secondary point of view. It is universally allowed to have much influence on the pain, heat, and swelling of an injured part. To lessen the violence of its symptoms by a general anti- phlogistic treatment ought, therefore, to be one of the principal objects of the surgeon. g4 I' s , ^*^!, ^. J^^w^ IMAGE EVALUATION TEST TARGET (MT-3) 1.0 1.1 ■ 50 1^ 1^ 2.0 lii 6" 1.8 1-25 III 1.4 i 1.6 / f 7] %. ^? I '^ 7 Photographic Sciences Corporation 23 WEST MAIN STREET WEnSTER.N.Y. 14580 (716) 872-4503 ^. ■^ ^^^ ■^ 88 MEDICAL TOPOGRAPHY I.I ; i: in While his art is employed to subdue the fe- brile excitement iu the system, he may not only check the process of inflammation, but may at times prevent the invasion of a fatal gangrene. The symptomatic fever which accompa-- nied wounds in the large joints, was often long continued and serious in its conse- quences. Such injuries, though apparently slight, sometimes put on a most alarming ap- pearance. The pain was great, the surround- ing parts became tense and tumefied. The coagulable lymph which was diffused through the cellular texture of the limb, and extendi ing far above the circular border of articular inflammation, with the deposition of osseous matter, both in the joint and in the contiguous muscles, may be considered as the effect of a high and deranged state of arteiial action. In some of the wounded, when the con- stitutional fever had ceased to operate as a source of general irritation to the system, an attack of intermittent fever prevented reco- very, This fever proved fatal to a great OP UPPER CANADA. 89 number of the wounded in hospital. In some of the wounded, before deatii, its pa- roxysms were so slight in their accession, that they could not be distinguished from those which occur in hectic fever. A colli- quative diarrhoea, alternating with intermit- tent fever, was at times the forerunner of a fatal termination. This fever undermined the powers of the constitution. Its effects on injuries, even of a trivial nature, were serious and alarming. The process of granulation was interrupted. The matter discharged from a wounded part, became copious, sanious, and bloody. Du- ring the intervals of fever, a slight livid disco- loration might be observed around the smooth or ragged edges of an injured surface. The surrounding integuments looked shrivelled, and felt flaccid to the touch. The lips of a la- cerated wound were either retracted on ac- count of their adhesions being destroyed, or they appeared flat and compressed from the absorption of internal granulation. There is perhaps no situation in which a 2 90 MEDICAL TOPOGUAI'HY ■r- ! medical practitioner can be placed, more painful to liis ieelii^gs t .. * that which adbrds him an opportunity ot vvitiicssing the eiFects of an obstinate intermittent i'ever spreading its ravages amongst tlie wounded. Cinchona, which had before been successful as a remedy in this disease, now seemed to lose its bene- ficial influence. In many of the men, the stomach had become so irritable from its frequent use, that it could not be given in that quantity which was adequate to over- come the fevei". Thus, its long-continued ad- ministration rather tended to debilitate than to support the strength of a patient. As bark, in its different forms of preparation, had ul- timately failed in the cure of the disease, it then became a desirable object to have re- course to the exhibition of other tonic medi- cines , Zinc was accordingly given in the form of pill ; but in no obstinate form of the fever did it either lessen the severity of the paroxysms, or suspend their usual period of accession. Charcoal in powder was next employed, as recommended by Dr. Calcagno of Palermo. OF UrPER CANADA. 91 To a number of patients, a scruple of this medicine was given for a dose three times a-day; but that quantity being- found inef- fectual, a table- spoonful was administered eveiy four hours, without any better success re- sulting from the prescription of so large a por- tion. It proved serviceable as a remedy only in a few cases which were not of long stand- ing. Fowler's solution of arsenic was found more effectual in the cure of this fever than any other medicine. Before it was adminis- tered, the stomach was emptied by an emetic, and the primw v'lw by a gentle aperient. Four drops of the solution were at first given three times a day, and the dose afterwards increased as it was found necessary. In the course of four or five days, many of the most obstinate cases of the disease began to yield to this preparation of the medicine. The arsenical solution, however, though in some instances given in conjunction with opium, could not be continued with safety on ac- count of the irritable state of the stomach and bowels. It was therefore not proper to 92 MEDieAL TOPOGRAPHY II. , .1 employ it indiscriminately in every case of the disease. Much caution was requisite to be observed in its administration. When given before breakfast, is was apt, in some patients, to produce uneasiness in the sto- mach, and griping in the bowels. Its spe- cific effects on the constitution were always to be watched with much circumspection. The itching of the tarsi, the tenderness of the mouth, and the salivation which sometimes came on, contra-indicated in some individuals its farther use. Convalescents from fever, to whom arsenic had been given, were more subject to relapses than those who had been cured by cinchona. It was, there- fore, requisite, during the state of recovery, to give from time to time small doses of the solution. The good effects of this treatment were very observable amongst the men in hospital. While their wounds put on a fa- vourable appearance, they were less disposed to relapse into fever. Many of the settlers in Upper Canada hf^ve nostrums for the cure of intermittent k OF UPPER CANADA. 93 fever. These are for the most part composed of bitter vegetable infusions and ardent spi- rits, to which are added Cayenne pepper, nutmeg, and other aromatic stimulants. They are exhibited in small quantities, and at short intervals, before the cold fit is ex- pected. Their operation, as far as I have observed, is always of a violent kind. They are productive of much sickness at stomach, heat of skin, and ultimately throw the patient into a profuse perspiration, which often continues for the space of thirty-six hours. In this manner he becomes exempted, for a few days, from a return of his ague. The debility, however, which follows the operation of such mixtures, is often serious in its consequences. The constitution of tlie patient now appears to be more immediately under the influence of those causes which at first occasioned the fever. He again relapses into his complaint, which is not only more aggravated in its paroxysms, but more deeply rooted in the system. Such medicines no doubt have been found useful, when taken : jj \% 14 114 MEDICAL TOPOGRAPHY early in the disease, but, in cases of long continuance, they have certainly hastened the period of dissolution. During the warm months of summer and autumn, swarms of flies are often found in those situations where putrefaction is going on. To such insects, an hospital, crowded with wounded, always becomes a desirable place of retreat. They come forth in im- mense multitudes, either impelled by hunger, or by the instinctive impulse of their nature to propagate their species amongst those pu- trid substances upon which they live. That state of the air which favours the decompo- sition of animal matter, seems, in a wonder- ful manner, to promote their rapid genera- tion. When the earth had been refreshed by warm showers of rain, and again heated by the sun ; when the winds were still, and the day or night felt close and oppressive, the succulent maggot appeared more imme- diately to be called into being. At such a period I have found numbers of them in the extremity of a stump, within the short space I OF UPFKR CANADA. 95 of twenty-four hours after the perforfimncp of amputation. The lly, in this state of it'i existence, proved a source of nuich misery to the wounded*. When maggots were found in a wound, the matter discharged became fetid and otfensive. As they were employed entirely in feeding, they often de- stroyed a considerable portion of the mus- cular substance of the part in wliich they had been brought forth 'j-. In cases of am- putation, when they extended their course far into the muscular substance and cellular texture of the hmb, they were the cause, not only of much local irri<^ation, but of much constitutional fever. They consumed parts which were necessary to form a new bond of union. As a means of destroying them, spi- rits diluted with water, vere injected into those situations which they occupied. Ve- * See Edinburgh Medical and Surgical Journal, No. LI. Art. V. Case of wounded Bladder, by J. Douglas. f The musca vomitoria (^flesh-fly) is said to lay 20,000 eggs. Tlie larvae of three of these flies will consume tlie carcass of a horse as soon as a lion. For a classification of larvae, by Bergman, see Insecto-Theology, page 339. 96 MEDICAL TOPOCUAl'HY I I: \i getabie and mineral acids were also found useful in their extermination. But, as they often lay concealed from the eye, in the deep sinuosities which they had formed, injections were not always successful in completing their destruction. From such places it was found necessary to effect their extraction with a probe. The ablution of a stump, or of a wound, with vinegar and cold water, was an excellent means of preventing their recur- rence. Those men who underwent the operation of amputation immediately after action, had usually a fortunate recovery. Though con- ducted in waggons to a considerable distance in the rear, and crowded with other wounded on board ship, no fatal consequences super- vened to the fatigues of their passage. But those men, on the contrary, whose limbs were amputated at York, at an after period, were placed under more inauspicious cir- cumstances. Some of them had been sub- jected to much pain during the tedious gra- dations of their journey. Many of them at OP UPPER CANADA. 07 at tlie inomunt oi' iiuipulutioii were (.Icbilitiitecl, either from the copious (]isehar<;e of matter from their wounds, or from the previous ex- istence of a high state of constitutional fever. The appearance of hectic fever, with its noc- turnal sweats and colliquative diarrhoea, ren- dered some men unfit to support amputation. Hsemorrhages which threatened life, and which art could no longer restrain, some- times called for the immediate removal of an injured member. In many unfortunate in- stances, an accession of intermittent fever superseded the necessity of having recourse to amputation. All these untoward circum- stances tended to convince the surgeon how dangerous it was in a number of cases to postpone amputation, even for a short time after the infliction of a severe injury. They taught him, that in a country, where the wounded are liable to be attacked by those diseases which are endemic to the soil, and to suffer from the impure air of a crowded hospital, there are certain kinds of injuries ^vhich it would be improper to trust to the s 9a MKDICAL TOPOGRAPHY '\ '4 fortuitous efl'orts of nature, and that, should he allow the first seasonable period of am])U- tatluii to pjiss away, he would ultimately witness with painful accusation, the fatal consequences of his ill-timed humanity. The heat of summer was injurious to the WcU-doinf,^ of amputation. By quickening the constitutional fever into a high degree of action, it prevented, in some measure, the process of adhesion. The boundaries of local inflammation were extended. The suppu- rating surface of a stump became large, the matter plentiful, and ill-conditioned. It was therefore requisite to remove the superficial dressings in the evening of the second, or on the morning of the third day, after anijmta- tion had been performed. This being done, the patient felt relievetl from the pressure caused by the bandages, and by the bloody ichor which had been effused in the extre- mity of the stump. On such occasions the cold lotion which was sometimes applied to the seat of inflammation, was effectual in reducing the limb to an equable temperature. OF UPPKR f'ANADA. 91) 'II riioiiifli many uiilorcstTn events may take place in the treatnient of ainimtations, and wliieli indeed may thwart tlie desiq^ns of the surgeon, notwithstandiiiij^ his most eaiilious circumspection ; yet it must hv j^eneniliy ac- knowledged that a moderate and uniform state of atmospheric temperature is most conchicive to the recovery of sucli oi)erations. Mr. Griffiths, who had charge of tlie wounded at Fort Wellington, after the action {it Og- densburgh, in the spring of 1813, makes the following remark with regard to amputa- tion : " The piercing cold of winter was un- favourable to the recovery of those men upon whom I performed amputation. Every me- dical comfort, appropriate ten* the state of the wounded, was afforded me ; but the hos- pital accommodation was certainly unfriendly to their general welfare. I found much dif- ficulty in keeping np a uiu'form tcinperatnre in the apartments of the sick. Tlie want of a thermometer was an unfortunate occur- rence. The stoves by whicli the rooms were heated, were not supplied so regularly with H 2 i y • !^ n\ ^iit loo MEDICAL TOPOORAPHV fuel during the day or night as I could have wished. To the extremes of heat and cold I therefore attributed the protracted recovery of many of my patients ; and were I agaio to be placed under similar circumstances, I think I should regulate matters with more advantage to the wounded, and with more satisfaction to myself." In cases of amputation, the divided muscles of a limb are sometimes prone to an unusual degree of retraction. A long and tedious transportation, immediately after the performance of the operation, the o ; urrence of secondary hsomorrhagc for which the dressings have been removed in order to se- cure the bleeding vessel, the presence of intermittent fever, and the careless applica- tion of the bandages at the subsequent dress- ings, may all have a tendency to produce it. Maggots, too, when allowed to remain in a stump, seem to operate as an immediate exciting cause to this involuntary action. Nor can it be denied that the presence of a number of ligatures in the living soft parts. Ill OP UPPER CANADA. 101 which have iiicludecl both nerves and blood- vessels at the moment of their application, so as to become a source of local irritation, may also have some share in the production of muscular retraction. It is well known that the irritability of the muscular fibre, which, in fact, constitutes retraction, may act so far independent of the nerves as not to be connected with the consciousness of feel- ing, and that, even in the dead body, it may exist for a considerable time, till at last the organization begins to be dissolved. But it must likewise be confessed, that its inordi- nate state of action is, to a certain extent, influenced by nervous excitement ; for it ap- pears to be increased by the stimulus of in- flammation in the extremity of a divided nerve, and accordingly resembles that state of local inflammation which, in its turn, is considerably aggravated by a high grade of symptomatic fever. By a proper and timely attention to the l)andaging of a hmb, the retraction of the muscles may often be prevented. The soft h3 ''i A^.\\ 102 MEDICAL TOPOGRAPHY iS?!l i! ■■ $ ti^/f parts Should be gently extended, while the circular roller is applied with a moderate de- gree of tightness, so as not to impede the circulation in the extreme vessels of the stump. When the pressure of the bandage is too great, secondary hocmorrhage may take place, shortly after the performance of the operation. Attention should be paid at each future dressing, that no matter may lodge in those parts where union has not yet been completed. In the after-treatment of those cases of amputation, in which too small a portion of muscular substance had at first been reserved to cover the extremity of bone, other unfortunate consequences are to be dreaded from the injudicious application of the circular roller. Haemorrhage, inflam- mation, and a feeling of tension in tlie limb, which might, at a former period, have been the result of an inordinate degree of pressure, will not now be occasioned ; but, in their place may be produced the gradual con- sumption of the muscles by interstitial ab- sorption. The bone may likewise protrude ■ I'l'f .li I OF UPPER CANADA. 103 from the end of the stump ; and the surgeon, iittributing- these unfortunate oceurrenees to an unusual retraction of the muscles, is daily led to stretch the soft parts more and more downwards, and to circulate the bandage round the limb with a greater degree of tightness, by which means he increases an evil which he intended to counteract. To effect that degree of pressure by the applica- tion of a roller, so as to facilitate, but not to prevent, the union of vital parts, ought, therefore, to be a grand object of a surgeon. Hospital gangrene made its appearance only in two instances. The subjects of its attack were debilitated in constitution, and had passed the middle period of life. In one patient, it supervened to amputation below the knee, and ultimately proved fatal. In the other patient. It invatled the gastrocnemii nuiscles, which had been severely lacerated by a canister shot, immediately above the tendo Achillis ; and to preserve life, ampu- tation above the knee was carried into effect. The man survived the operation, and had H 4 104 MEDICAL TOPOGRAPHY a tedious recovery. This disease was not marked by any uncommon degree of ra- pidity, nor was it so malignant in its nature as to infect the sores of the other wounded in hospital. It was neither accompanied by fever, nor bv local inflammation. A fetid ichor was discharged from those parts over which it spread. At first tlie granulations were interspersed with ash-coloured spots, which afterwards assumed a black appear- ance, but did not enter into a state of su- perficial incrustation. In the patient who died, the consumptive progress of the disease was accompanied with a black putrid ex- udation, not unlike to dissolved blood. The internal administration of tonic medicines, with the external use of antiseptic applica- tions, appeared to have no influence in check- ing its slow but fatal progress. No cases of tetanus came under my no- tice ; nor did I ever hear of the occurrence of this disease amongst the wounded in Up- per Canada. The wounded who were admitted into the OP UPPER CANADA. 105 church hospital, had all the advantages of a free ventilation. This building became ex- tremely serviceable to the recovery of those men whose injuries were of a serious kind. From the pure air which the sick and wounded enjoyed in it, their progress to a state of convalescence wfis often rapid. Men whose wounds put on an unpromising as- pect in the general hospital, were at times transferred to this establishment. Intermit- tent fever, however, with all its fatality, pre- vailed in the latter, as well as in the former building. VI. The provincial militia were generally healthy, when employed on active duty, and were more exempted from sickness than the British troops. Their services, though se- vere, were not always long continued. Some corps being embodied during the war, were constantly employed, either in the field, or in garrison duty ; others being called out only on particular emergencies, often enjoyed through winter the tranquiUity of their homes. lOG MEDICAL TOPOGRAPHY I'' 1 , V I''. ?'l Tlie inhabitants of the province usually enjoy a good state of health. Some of theui are robust and athletic, and well calculated to support the fatigues of war and the la- bours of husbandry. In childhood, however, they are subject to ague ; and it is even com- mon in sickly seasons, to observe infants at their mothers' breasts trembling in a fit of the disease. As they grow up to manhood, their constitutions become naturalized to the climate ; and except when they reside in unhealthy situations, they seldom relapse into fever. Emigrants who rear their huts in low wet grounds, often suffer much in their families from sickness, during the first few years of their settlement. In Canada, as in other countries, there are elevated si- tuations to be found, in which the air is pure and salubrious, whose inhabitants, nei- ther in youth nor in age, have ever been indisposed by those diseases which at times predominate in the surrounding districts. Many of the old settlers, though living in places which are productive of disease, and OP UPPER CANADA. 107 who, after their arrival in the country, had been annually seized with obstinate agues, may now be seen, even at an advanced pe- riod of life, actively employed with their numerous offspring in the cultivation of their farms. ■I! VI. It is not my intention to descend into minute particulars concerning the In- dians of Upper Canada. I shall neither de- signate each nation by its appropriate appel- lation, nor delineate those peculiarities of character by which the individuals of one nation may be distinguished from those of another. To observe a number of different Indian tribes, headed by their respective chiefs, and assembled together from the most remote parts of the province, to co-operate with a regular army in the defence of their territo- ries, is certainly a new and entertaining sight. The Indians of Upper Canada bear a striking resemblance to those who inhabit the other parts of North America, nay even to iill ,' I ill t I 108 MEDICAL TOPOGRAPHY those who are scattered over the great south- ern division of the new continent. Should we exclude the Esquimaux people from the account, and a few other individuals wlio are found in the central parts of the conti- nent, so great is the similitude tliat exists amongst the numerous tribes, that, though differing remarkably from each other in lan- guage, we are induced to conclude, that they are all sprung from the same common stock. The individuals of each nation vary but little in stature and the symmetry of their bodies. Their limbs are muscular and well made. In a state of progression, how- ever, tlieir toes are inclined inwards, and their knees bent a little outwards. Their skin, which is extremely thick, is of a brown or copper colour, and has a shining appear- ance, from the vegetable juices and greasy pigments with which they stain and besmear their bodies. Their faces are for the most part round; sometimes, however, they are found approaching to an oval shape. Their frontal bones have little or no projection, 2 OP UPPER CANADA. 109 and the facial line is perhaps more inclined, but straighter, than that of any other savage nation. The cheek-hones are elevated, but their angles are rather rounded than pointed. Their eyes are small, of a dark colour, and are able to distinguish objects at a great distance. The internal cant hi, which are turned a little upwards, give to the face an expression of obliquity. Their chins are sel- dom or never covered with a beard. The hair of their head is black, lank, and has a glossy look, as if kept in a state of constant mois- ture. Their noses are often flat, their lips are thick, their teeth white and regularly disposed. Their pulse seldom exceeds 62 strokes in a minute; and corresponding to this slowness of the circulation, there is a want of vivacity in their countenance, the usual expression of which is sullen and me- lancholic. Upon an attentive examination of the face, the individuals of a particular tribe may be distinguished by an accurate observer. There is, therefore, a peculiar 11 19 hi u l^ 1^ 110 MKDICAL TOPOGRAPHY association of feature assignable to a tribe, by wbicb its - ".mbcrs may be pointed out. There is rca ~n to believe, that the heat of the sun is not the only cause to which the diversity of colour in our species may be at- tributed; for, when we cast our eyes over the wide regions of the old continent, and observe the variety of complexion among men, not only in different, but in the same parallels of latitude, we may with certainty conclude that this great operating cause must be assisted by others of an inferior and less powerful nature. But, further ; — were the rays of the sun adequate to produce so won- derful an effect, we should expect to find among the nations of the new continent, as we travelled from the temperate to the equatorial regions, a gradual assimilation of complexion, deepening as it were in propor- tion to the ascending ranges of atmospheric temperature. But what reasonings can be deduced from the association of a number of other circumstances, which we know to exist, but which we cannot well point out, and OF UPPER CANADA. Ill which, in conjiinction with tlic sun, wc sup- pose sufficient to modify the diversity of co- lour among different nations ? Even taking into account tiie geographical position of a country, the elevation of its peopled districts above the level of the ocean, the soil and productions, with those habits of life which may have long characterized its inhabitants as a separate or individual people, how are we to reconcile the colour of the A^egro with the milky whiteness of those people termed Albinos, whose conn)lexions, almost from the moment of birth, remain alike unchanged amid the sultriness of the climate? This branch of physiological science, how inte- resting soever it may be as connected with the history of human beings, is as yet in- volved in much doubt and obscurity. The many difficulties, indeed, which we have to surmount in attempting its elucidation, are almost sufficient to discourage the pursuit of our inquiries. Each Indian nation preserves in its own territory a savage state of independent li- 112 MEDICAL TOPOGRAPHY Jk I ihi bcity. Civilization has as yet made little progress amongst the greater number of the nations. Their intellectual powers may there- tbre be regarded as in a state of infancy. Because their stock of ideas has not been in- creased by education, their curiosity ap- pears inactive. Hence, objects, in them- selves interesting, are regarded with an un- accountable air of indifference. From their reasoning faculties not being exercised, they are unaccustomed to reflection. Improvident of futurity, they consider indolence and li- berty as the chief enjoyments of their being. In their colloquial intercourse, tlieir words are few, and the same word is often applied to a number of different objects. Their lan- guage, however, is bold and figurative, and their speech is accompanied with a variety of gesticulations, evidently introduced to fa- cilitate the expression of their ideas. The principal occupations of the Indians are war, hunting, and fishing. Few indivi- duals of any of the tribes obtain their sup- port by cultivating the soil. Hence, an In- OF tiPPRn CANAr-A. 113 diaii is not often to be seen in the cnltivatcd parts of I fie province, vrhieh always [)mve inhospitable to tlie pnrsnits of the chase. hy l(/»sal\in^ the settlements of his new neighbonrs, and i*etirin«^ into iiis remote and trackless deserts, he is thus snpplied with a inore easy means of subsistence. In time of war, eacii nation is headed by its own chief, who may be said to |)ossess only a nominal authority. He issues no or- ders ; he enforces obedience from none of his subjects. Power, therefore, is usurped by no individual of a tribe. While every person claims an equal share of property, ambition has no room to operate. With a sentiment of equality in his breast, and conscious of his own importance, every warrior goes forth to battle to obtain victory and glory. Hia associates in arms he regards as his brothers, or as his friends ; and in the prosecution of every warlike enterprise, he considers his own exertions as subservient to the welfare of the community in which he lives. Proud of his Independence, he spurns at the idea of sub- 114 MEDICAL TOPOGRAPHY ■>y 1 » 1 1 i'< tf Ijv ^ ■'; r t h ,9 ■f ' i I' mission^ and considers himself as inferior to none in arms, or in courage. The manners of the Indians are solemn and reserved, and destitute of that gaiety which is observed amongst a civilized people. Their songs and dances, which are often symbolical of their transactions in life, ex- cite sensations of horror and melancholy in the breast of a spectator. In doing, or in suffering, an Indian cannot be charged with those weaknesses which are incidental to hu- manity. An indulgence in love he regards as the height of effeminacy. Under priva- tion, or bodily torment, he is patient and composed. Though- his desh'e for food be great, he will not complain of hunger. As he has no fixed period for repast, he satisfies his appetite only when urged by the gentle or imperious calls of nature. When led into captivity by his enemies, his courage never forsakes him ; and, even in the moment of trial, he upbraids their want of ingenuity in inflicting torture. In time of war he is active and vigilant ; and if in pursuit of his OF UPPER CANADA. 115 enemies, he consumes but little of his time in rest or in sleep. When he cxainine«5 the bark of the trees, find the inclination of their trunks and braKi'.ies to the cast, or the man- ner in whicli their leaves are strewn upon the ground by the winds of autumn, he can find out, with great exactness, the cardinal points of the heavens. With a scanty means of subsistence he is able to travel to an incre- dible distance, and can guide his footstepis Mnth the most wonderful precision through every untrodden part of his boundless deserts. Before the Indians have attained an ad- vanced period of life, the marks of old age appear on the countenance. This is caused, not only by the severe fatigues and privations to which they are often exposed, but by the habitual indolence to which they are prone, when supplied with plenty of provisions. The Indian women, like those of many other savage nations, participate in the mis- fortunes of a cruel servitude. In their ordi- nary transactions of life, they show more vivacity than the men. Their features are I 2 m r ,. i t > lit 116 MEDICAL TOPOGRAPHY often regular and expressive. Some indivi- duals amongst them have pretensions even to a considerable share of beauty. They are seldom given in marriage before they have attained the twentieth year of their age. Their bodily strength, however, soon becomes impaired under the pressure of those toils to which they are subjected by their husbands. Hence, that exei cise which, under judicious appropriation, might invigorate the powers of the constitution, impairs, from its long continuance, the very principle of action. Their children, though healtliy, are few in number. This circumstance can be re- ferred to no other cause than to the de- o^raded state in which their mothers live, nc- companied, in many of the tribes, witli vUi extreme scarcity of provisions. In the latter months of pregnancy, the female is exempted from those arduous occupations which have a tendency to induce premature labour. When the hour of travail approaches, she retires, often unattended, to u hut, IVoni whicii. OF UPPER CANADA. 117 after tlirpc or four days' confinement, she re- turns again to her usual employment. The food of the Indians, though differ- ently prepared from that of civilized nations, is composed both of animal and vegetable matter. They appear remarkably fond of the numerous kinds of wild fruit, with which their forests in many parts abound. The roots and leaves of various plants, made into soup, form a part of their aliment. After many hours spent in eating, to which they are often disposed on account of their long fastings, they are at times observed to dry the flesh of the wild deer, by exposing it, when cut into small pieces, to the rays of the sun. To reserve it for future use, they in like manner expose it during winter to the action of the frost. The Indians, how- ever, are in general so careless of the future, that they seldom resort to such measures as these, in order to provide against the con- tingencies of hunger. The customs and man- ners of the Indians have often excited the admiration of travellers ; and have furnished I 3 t 118 MEDICAL TOPOGRAPHY r i ■ r '. r <|i' matter, both for the historian and poet. Some men, indeed, regarding the Indian simplicity of life as essential to happiness, have left the refinements of civilized society, and retiring into the woods, have assumed the manners, and adopted the cnstoms, of a particular nation. How captivating soever that simplicity may appear, either when dressed in the imposing language of history, or associated with the most beautiful images in poetry, it can have few attractions to that man, whose mind, guided by the principles of a sounder philosophy, has been led to form a different estimate of human happiness*. The Indians are strangers to a number of those diseases which are incident to man in a polished state of life. The manner in which they are treated in youth, and the nature of those hardships to which they are exposed in manhood, have certainly some share in ren- * For further particulars concerning the Indian Nations in Upper Canada, see Mackenzie's Voyages in North America, Carver's Travels, and Charlevoix's History of Upper Canada. OF UPPER CANADA. 119 (leriiij^ their bodies able to resist the causes of disease. Their children suffer little or notliing from sickness during the period of dentition. After birth they are daily im- mersed in cold water, that their bodies may be early accustomed to support the vicissitudes of heat and cold, from which they suppose a number of their diseases to originate. They are also swathed to a board for several months, upon which they sleep more frequently in the erect, than in the recumbent posture. From this mode of treatment is derived the peculiar shape of their lower extremities, which I have already mentioned. This board is employed by every female of the North American In- dians in the rearing of her offspring, and seems to have been originally intended to facilitate their removal from one place to another. For eighteen months after birth, every cliild is supported solely by its mo- ther's milk, no other food being adminis- tered till it is provided with teeth to mas- ticate a more nutritious aliment. Parents, to I 4 t I f f 120 MEDICAL TOPOGRAPHY ^uake trial of the courage and patience of their male children, have at times been known to sear their bodies with a red-hot iron, or to expose them, w^hen naked, to the flames of a slow consuming fire. Remittent and intermittent fevers are to be tiK t with amongst the Indians, The lat- ter disease is confined chiefly to the time of infancy, adnlts almost never suffering from its attacks. It is, therefore, probable that the greasy substances with which they are accustomed to anoint their skins, may tend in some measure to protect their bodies against the effluvia of the marshes. Acute innammations sometimes seize the internal parts of their frame. Such afl'ections when seated in the lungs or intestines often prove fatal to the Indians, Variola is reported by travellers to have been extremely destructive to the ahorigines of the new continent. Some individuals amongst them bear on their skins the marks of this disease. The inflammatny symp-f toms of this wasteful distemper are highly OP UPPER CANADA, 121 aggravated in the Indian constitution. The process of suppuration appears to be greatly impeded by the extreme thickness of the cutis vera, and the matter when formed, being deeply seated, is discharged with consider- able difficulty from the surface of the pus- tules. It was rumoured at one time, that the ve- nereal disease had spread extensively amongst the Indians. No cases of syphilis, however, either in its primary or secondary form, ever came under my notice. The disease made its appearance only in a few instances amongst the troops, and from this circumstance thr report seemed to originate. It is asserted by some who have lived and travelled in the in- terior parts of the country, that many of the Indian nations have a knowledge of cer- tain plants, whose efficacy they deem infal- lible in the cure of every form of syphilis. An interpreter of the Souk nation, with whom I have conversed, not only corroborates this statement^ but affirms, that he has seldom 122 MEDICAL TOPOGRAPfty known the disease prove fatal to any of the Indians. Pulmonary consumption has never been observed in any individual amongst the In- dians ; nay, it is even doubtful whether mania, apoplexy, hypochondriasis, and gout, should be classed among those diseases to which they are subject. Vensesection is resorted to by the Indians in the treatment of severe attacks of fever. Sharp pieces of flint, or wood, are the instru- ments with which they perform the operation. They are also acquainted with the use of pur- gatives, emetics, sudorifics, and blisters ; but such medicines are usually intrusted to the care of their diviners, who in serious cases of disease act the part of physicians. The mythology of the Indians is wild and inconsistent. As they believe in the existence of certain spirits upon whom they suppose their happiness or misery to depend;, it is not to be wondered at, that some in- dividuals among them should have preten- sions to a knowledge of the future, should OF UPPER CANADA. 123 employ spells and incantations, or have re- coui'se to a variety of mysterious rites, in order to impose on the credulity of their weaker brethren. Thus deluded by divina- tion, they are taught to believe that certain substances, worn on particular parts of their bodies, have the power not only of averting disease, but of protecting tliein against every evil of a destructive nature. In every rude and uninformed nation, we may alvrays ob- serve a wonderful connexion between medi- cine and superstition. A stranger who in- terferes with the concerns of a savage, is often regarded with an eye of suspicion. No means we can employ are sufficient to per- suade him to disclose the secrets of his na- tion. An insurmountable barrier is there- fore opposed to our inquiries concerning those remedies which the rude tribes of North America employ in the cure of their diseases*. * Much valuable and original information relating to the state of medicine amongst the Indians may be ob~ tained by i^eferring to Rush's Medical Inquiries, vol. i. p. 1. Hi M£DICAL TOPOGRAPH V I' u kh It was my wish that another pen than mine had consecrated its time to those sub- jects of which I have attempted to treat. More than two years have elapsed since my arrival from Canada ; but no commnidcation relating to the diseases of the army in that country, has as yet been given to the public. To atone for so great an omission, the fore- going pages are presented to the world ; — but they are offered with every feeling of appre- hension whether they may prove useful. As the contents of my paper are merely a faithful relation of all that I have witnessed when with the army in Upper Canada, on this account they may be said to resemble a picture which is intended to represent a variety of objects. If I have introduced sub- jects which are foreign to my proposed ar- langements, the fault may be excused by OF UPPER CANaD.v 12.J those who regard no picture as coij |ilel« which is destitute of its meaner objects. 'J'lu' pathological and surgical divisions, I am well aware, contain many imperfections. By de- viating in some measure from the opinions of those whose authority is respected, I may have been led incautiously into error. If such should be the case, let it be remembered, that the boundaries of human knowledge have never been extended by those who have implicitly followed the doctrines of others. If I have advanced any thing whereby tlie practical ends of medicine or of surgery can be benefited, I shall feel amply compensated that my labours have been so happily be- stowed. Even abandoning the hope that the report which I have given may prove useful in a medical point of view, pretensions of an inferior kind may be its desert. As a memo- rial of what has been done and suffered by the army, it may awaken in the minds of some who read it, an emotion of social in- terest. Should the Upper Province of Ca- nada again become a field of hostility, it 2 mi ti 12(i MEDICAL TOPOGRAPHY, ik-C. may forewarn the young medical practi- tioner of a number of those untoward events which he may be called to encounter in the discharge of his professional duty. JOHN DOUGLAS, Astistant Surgeon Sth R*gi. m J" .X f S. GosNELL, Printer, Little Queen Street, Loudon.