154 CHANNEL ISLANDS :
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the patrimony of the cottager. Hence I am informed,
by unquestionable authority, that hundreds of the
smaller farmers (the labouring class) live, for months
together, upon a diet consisting of a dark brown bread,
cider largely diluted with water, and a soup made of
kale or cabbage, lubricated with a morsel of the fat of
bacon,—the leaner parts being reserved for holidays.
Such a diet is obviously insufficient for the support of
the body under field labours, often continued almost
unremittingly for 14, 16, 18, or even 20 hours. It
is not therefore surprising, that they should be found
resorting to the use of ardent spirits, in order, as they
express it, “ to give them heart;” and especially,
since the low price of alcohol, under all its forms,
offers in Jersey an almost irresistible temptation to
tl?^ poor cotter to “ steep his labours in forgetfulness.”
I have already said, that rheumatic fever is of less
frequent occurrence in these parts than the chronic or
sub-acute form: and I am assured by other medical
gentlemen of long experience, that they do not
remember one instance of metastasis of rheumatism to
to the heart.
Hepatic or bilious diseases come next to be considered;
being next in the frequency of their occurrence
here as compared with England. However
extraordinary the announcement may at first appear,
the views which I shall open upon this subject, tend
to associate these affections closely with those that
have just occupied our consideration; for it will be
seen that the hepatic derangement to which, under this
head, I make particular reference, owes its origin, in
all probability, to the same causes that give birth to
the sub-acute form of rheumatism; and is actually
accompanied by many of its symptoms : and that
there is even strong ground for believing it to be,
in fact, if nol a metastasis of rhuematism, at least
an extension of that disease to the liver. , Liver
disease presents itself under two distinct forms. The
first is the chronic or sub-acute form; or, more frequently
still, symptoms of structural disorganization
of the liver consequent on that state. This is common
among the subordinate classes of natives, among
whom, beyond doubt, partial induration of the liver
is very general. Hence the prevalence of hydropic
disease under all its forms.
But it is to the second kind of hepatic affection that
I am solicitous more particularly to direct the attention
of the faculty. This kind shews itself mainly under
the form of functional derangement of this viscus, and
of those organs in its propinquity, that co-operate
towards its function. It is thus characterized. A
person, after some brief and obscure minifestations
usual in the commencement of pyrexial disease, is
attacked by sickness and vomiting. A dull pain is
referred to the right shoulder, the epigastrium, and the
right hypochondrium. This is increased by pressure
on those regions. The tongue is white and furred at
the sides. The pulse is nearly natural; the urine is
reddish, and deposits largely on standing. The eyes
are lively but yellow; the countenance is sallow, and
the bowels at first open, but afterwards costive. The
vomiting comes on irregularly:—occasionally three or
four times a day, at other times twenty: and, after a
day or two, bile is discernible in the egesta. The
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