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DUKE 
 
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 LIBRARY 
 
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Digitized by the Internet Archive 
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 http://www.archive.org/details/accountofepidemiOOlDayJ 
 

 I 
 
AN 
 
 ACCOUNT 
 
 OF THE 
 
 EPIDEMIC FEVE 
 
 WHICH PREVAILED IN THE 
 
 CITY OF NEW-YORK, 
 
 DURING PART OF THE 
 
 SUMMER AND FALL OF 
 
 1 7 9 5- 
 
 COP Y RIGHT SECURED. 
 
I 
 
AN 
 
 ACCOUNT 
 
 OF THE 
 
 EPIDEMIC FEVE 
 
 WHICH PREVAILED IN THE 
 
 CITY OF NEW-YORK, 
 
 DURING PART OF THE 
 
 SUMMER AND FALL OF 
 1 7 95- 
 
 By RICHARD BAYLEY. 
 
 NEW-YORK: 
 
 Printed and fold by T. and J. SWORDS, Printers to theFasulty of 
 Phjfic of Columbia College, No. 99 Pearl-ftjeet. 
 
 — 1796.— 
 
i 
 
PREFACE. 
 
 1 HE following fketch of the 
 probable caufes of the late epide- 
 mic, as they appeared to the 
 writer, with the treatment which 
 proved moft fuccefsful in his own 
 practice, as well as in that of fome 
 of his friends, is refpeftfully of- 
 fered to the perufal of his fellow 
 citizens, as well as to the practi- 
 tioners 
 
 
( iv ) 
 
 tioners of medicine; from whom 
 he expefts the cxercife of that 
 candour, of which the beft judges 
 are commonly the moll liberal, 
 and which he is confcious it very 
 much requires. 
 
 R. B. 
 
 New -York, May 30, 1796, 
 
 AN 
 
AN 
 
 ACCOUNT, &c. 
 
 X HE epidemic fever which made its ap- 
 pearance in this city, at the latter end of 
 the month of July laft year, and which 
 occafioned a degree of mortality among the 
 people never experienced in lb fhort a fpace 
 before, afforded matter of much ferious 
 
 converfation; and gave rife to a great di- 
 es o 
 
 verfity of opinion. An idea was entertained 
 by fome, and this idea was, by others, in- 
 duftriouily propagated abroad, that the dil- 
 eafe was imported from the Weft-Indies, 
 and that it was contagious: while, on the 
 other hand, manv contended that a con- 
 currence of local circumitances, which de- 
 rived an uncommon activity Trom a pecu- 
 liar confiituiion of the air, were alone fuf- 
 ficient to account for its production. 
 
 It 
 
C 6 ) 
 
 It is the main object of the writer of this 
 pamphlet to lay before the public a few 
 facts on this important fubject; and in do- 
 ing this, he is conlcious that the chief merit 
 of thefe will confifr. in the diligence with 
 which thev were collected, and the fidelity 
 with Which thev are detailed. lie mall 
 piKpofely avoid attacking any particular 
 doctrines in medicine, relatively to the na- 
 ture of the fever in queftion ; and the fame 
 temper will incline him to pals, without 
 animadveriion, the practice of thofe who 
 have flood defervedly high in their profcf- 
 fion. He will therefore hold himfelf re- 
 fponfible only for a faithful narrative. — It 
 has, indeed, been thrown together under 
 circumftances verv unfavourable to regular 
 compofition ; but as it fprung from no vain 
 conceit of ability to render that clear, which 
 long been involved in obfeurity, he 
 thinks he may rely on the purity of his 
 motive for publifhing it, as a fhield againit 
 the {< of criticiim. The motive, as 
 
 it 
 
( 7 ) 
 
 it firft fuggefted itfelf to his mind, was 
 none other, than a deli re to point out the 
 real caufes, as they appeared to him, of the 
 late epidemic, and thereby, in fome degree, 
 to moderate individual apprehenfiori, and 
 quiet popular alarm. 
 
 At the firft. appearance of the difeafe, the 
 following reports were diligently circu- 
 lated, and very generally credited, viz. that 
 Dr. Treat, then health officer of the port 
 of New- York, had viiited the brig Zephyr, 
 juft arrived from Port-au-Prince ; that he 
 found the crew iickly ; that feveral men 
 had died on the paflage ; that a boy had 
 died the morning of her arrival ; that Dr. 
 Treat had incautioufly opened the deiid 
 body; that it was very generally tinged 
 with a vellow colour ; and that it was ex- 
 tremely ofFenfive to the fmell. 
 
 ' How correfpondent thefe reports were 
 with truth, will hereafter appear, from a 
 {tatement of facts, fubftantiated by the tef- 
 timony of indubitable authority 
 
 A few 
 
( 8 ) 
 
 A few days after Dr. Treat vilited the 
 brig Zephyr, about the 20th of July, he 
 was feized with fever. The manner of the 
 attack, the nature and feverity of the fub- 
 fequcnt iymptoms, attended with a yellow 
 countenance, and a iimilar tinge of the fkin 
 generally, were fuppofed to conftitute the 
 difeafe the yellow fevef. 
 
 About the fame time that Dr. Treat be- 
 came indifpofed, a fever, refembling that 
 of which he died, made its appearance on 
 board the fhip William, faid to be then 
 lying at Fitch's wharf, nearly oppofite 
 Dover-ftreet. Shortly after, Auguft nt, 
 the family of Mr. Jenkins, living in Water- 
 ftreet, near Dover-ftreet, was attacked with 
 fever, which was fuppofed to have been 
 communicated from the fhip William. 
 
 At firft it feemed rather extraordinary, 
 that the (hip William, which had failed 
 directly from Liverpool to this place, and 
 whofe men had been healthy during the 
 paflage, fhould have contained matter of 
 
 a con- 
 
( 9 ) 
 
 a contagious nature, which only operated 
 upon the crew in producing fever feveral 
 weeks after her arrival. 
 
 This difficulty, however, was foon made 
 to vaniih,and the explanation became eafy, 
 when it was alledged that the brig Zephyr, 
 on board of which no one was fuppoled to 
 doubt that the yellow fever exifted, had 
 hauled along-iide the fliip William, and 
 thus communicated the difeafe to the 
 Jailors. 
 
 This account, plaufible in appearance, 
 obtained almoft univerfal credit, and 
 though hi^hlv erroneous, as will hereafter 
 be proved, was in a hafty and unauthoriz- 
 ed way conveyed to Philadelphia, and, no 
 doubt, afforded a considerable ground upon 
 which the regulations that took olace in 
 that city, relative to this* were founded. 
 
 At this period the public mind laboured 
 
 under great apprehenfions. A new difeaie 
 
 was fuppofed to have made its appearance. 
 
 Several deaths had already happened, the 
 
 B nature 
 
( 10 ) 
 
 nature 01 which, judging from the adven- 
 titious circumfhmcc of colour, had an af- 
 peel extremely formidable. The progrefs, 
 alio, of the complaint, was luppofed to be 
 
 iuch, that to thofe who took things for 
 granted, there remained but little doubt 
 that the city would foon be overfpread with 
 
 contagion : and it cannot be fufficiently 
 regretted, that the fuppofed contagious na- 
 ture of the difeafe was too much urged by 
 thofe who ought to have been more re- 
 fcrved in their opinion : for as yet no cir- 
 cumftances had really occurred to counten- 
 ance or juftify the violent and exaggerated 
 accounts which were circulated upon this 
 fubjecl. 
 
 In this ftate of affairs the torrent of opi- 
 nion became irrcfiftible. Fear and diimay 
 pervaded every mind ; and thole of the in- 
 habitants who were rnofr. alarmed, as well 
 as many of thofe who had no particular 
 motive for remaining in the city, fought 
 refuge in the country. 
 
 In 
 
( " ) 
 
 In all {ituations in which our fafety be- 
 comes a matter of confiderable doubt, it is 
 natural for us, after the panic, with which 
 at firft we are apt to be leized, has a little 
 fubfided, to enquire what the chances arc 
 that we efcape the danger. Accordingly, 
 thofe who remained in the city, and were 
 at the trouble of inveftigating the iubjee~t, 
 found, that many examples had offered, 
 where the lick had been attended with im- 
 punity : neither phyficians, nor friends, nor 
 attendants had imbibed anv infection : and 
 the circumftances attending the very few 
 inftances which were fuppofed to favour 
 the idea of contagion, were fo extremely 
 obfcure and doubtful, that nothing could 
 be collected from them, of a nature at all 
 fatisfactory. In confirmation of this, we 
 have the declaration of the Medical Socie- 
 ty, in anfwer to a letter from Governor lay, 
 dated 24th of September, 1795: — " The 
 vt collective opinion of this Society, as the 
 *' refult of attentive obfervation, is, that 
 
 " the 
 
( >* ; 
 
 H the fever is not fpecifically contagious; 
 " and we are confirmed in this opinion 
 '' from the following powerful confident- 
 " tions, that neither relatives, nurfes, nor 
 " phyiicians have, fave in one or t\\ o 
 " doubtful cafes, been infected by attend- 
 *' ing on thofe who have either recovered 
 ki or died of the difeafe." 
 
 Much was daily urged from th,efe facts ; 
 and finally, the terror with which the fup- 
 pofed contagious nature of the difeafe had 
 filled people's minds, was in a great mea- 
 sure done away : and the confidence which 
 took place, between the patient and phyfi- 
 cian, as a confequence of this conviction, 
 was, I have no doubt, in many in fiances, 
 a mean which greatly contributed to the 
 recovery of the fick. 
 
 Thus it would appear, from what has 
 already been faid, that a difference of opi- 
 nion had exifr.ed,as well among the citizens 
 as the phyficians, with refpect to the real 
 origin and character of the late epidemic. 
 
 The 
 
( '3 ) 
 
 'The object I have in view is to reconcile 
 thofe opinions, as far as that can be effected, 
 \>y bringing into one view all the facts I 
 have been able to collect: upon the iubject. 
 Thefe fhall form the principal data upon 
 which any future reafoning may be found- 
 ed ; and if the fentiments I may advance 
 are found to differ* from the opinion of 
 Others, I hope that a liberal and candid 
 communication may tend to our mutual in- 
 formation, and that the public may be bene- 
 fited by our attempts to arrive at truth. 
 
 We (hall, therefore, in the next place, 
 proceed to examine the validity of the 
 Opinion, that the brig Zephyr introduced a 
 contagious fever into this citv. And the 
 followins; letters from MefTrs. Armftrong 
 and Barnwell, and Miller and Hoope, arc, 
 in my mind, very explicit. 
 
 * New* 
 
C '4 ) 
 
 * New-Vorki zothOtf. 1795. 
 1 Sir, 
 4 The brig Zephyr, Capt. Frederick Bird, 
 ■ arrived from Port-au-Prince on or about 
 
 * the 19th of July lall, loaded with lugar 
 
 * and coffee. The cargo came to our ad- 
 4 drefs. She hauled firft to the Old-flip, 
 
 * where her cargo was unloaded. The 
 4 veflel leaked much on her paflage from 
 4 Port-au-Prince, which damaged twenty-. 
 4 two hogfheads of coffee in the ground 
 
 4 tier : in confequence of which the veffel 
 4 was ordered into the ftream, where the 
 4 damaged coffee was thrown into the wa- 
 4 ter, under the inflection of the Wardens 
 4 of the Port. One boy died on board the 
 4 day of her arrival, who had been fick all 
 4 the paffage. The captain, mate, and 
 4 one fcaman, were taken fick at Port-au- 
 4 Prince, and continued fo during the paf- 
 4 (age; but were perfectly reftored to health 
 « foon after their arrival. Dr. Treat vifited 
 
 4 the 
 
( '5 ) 
 
 * the vefTel on her arrival. The day was 
 6 extremely hot, and he ufed uncommon 
 ' exertions in the middle of it, to find the 
 1 commanding officer on Governor's Ifland, 
 ' to obtain permiffion to inter the boy there. 
 
 * He complained on his return, that the 
 1 day and exercife had almoft overcome 
 ' him. 
 
 ' The vefTel, after fhe was unloaded, put 
 4 up for freight for Baltimore, and took 
 ' on board her cargo for thence at the Cof- 
 ' fee-houfe flip. She was never near the 
 
 * fhip William, which laid at, or near 
 1 Fitch's wharf. During the delivery of 
 ■ the inward cargo we were on board every 
 ' day, as were alfo the Wardens of the 
 ' Port; and we have not learned that am 
 ' perfon has been taken ill in confequence. 
 
 ' We underftand that the captain pro- 
 1 ceeded to Baltimore in the vefTel, and 
 
 * the mate to Bofton. However, as they 
 ' were more immediately under the direc- 
 « tion of Meffrs. Miller and Hoope, to 
 
 \ whom 
 
( w ; 
 
 ' whom the veflel was configned, \vc refer 
 ; to them for particulars in that refpecl. 
 4 We were informed by Capt. Bird that it 
 4 was fickly at Port-au-Prince when he 
 4 was there in June and July, which is ge- 
 4 nerally the cafe at that feafon, but that 
 ; it was fcarccly known among the French 
 4 inhabitants, and fell chiefly on the Bri- 
 
 * tifh and Americans. He alio told us that 
 4 the place was growing more healthy when 
 
 * he left it. 
 
 4 We are, Sir, Sec. &c. 
 
 4 Armstrong & Barnwell.' 
 
 4 Xevu-Tork, OS?, zotb, 1795. 
 < Sir, 
 4 The brig Zephyr, of Bofton, Capt. 
 ' Bird, came addreffed to our houie from 
 4 Port-au-Prince; her cargo, confifting of 
 A fugar, coffee, and hides, was addrefled to 
 * Meflrs. Armflrong and Barnwell. The 
 4 bris; hauled to the eaft fide of the Old- 
 4 flip, and there difcharged her cargo, ex- 
 
 ' cepf. 
 
( '7 ) 
 
 8 cept a quantity of damaged coffee, which 
 * was thrown into the Earl-river. The 
 ' brig was then hauled to the end of Jones's 
 4 wharf, below the Coffee-houfe, and took 
 ' in her cargo for Baltimore. 
 
 ■ Capt. Bird and all his crew were iick 
 ' leaving Port-au-Prince, and one of them 
 4 died the day or day after the brig arrived. 
 
 ' The captain was in good health when 
 6 he failed for Baltimore, and we believe 
 1 the crew recovered foon after their ar- 
 ' rival in this city. 
 
 1 Miller 3? Hoope** 
 
 The foregoing letters afford an unequi- 
 vocal teftimony of the condition of the 
 crew of the brig Zephyr, on her arrival in 
 this port. They afford, alio, a complete 
 refutation of the aflertion, that the Zephyr 
 communicated a contagious fever to the 
 ihip William, the two veffels having never 
 been near one another : and, in fhort, they 
 mew, that, excepting the death of the boy, 
 C the 
 
( »« ) 
 
 flic teports circulated concerning the Z< 
 phyi", at the tirit appearance of the fever, 
 
 I indeed beKeved by many during it. 
 Continuance, were altogether without 
 foundation. 
 
 When it was difcovercd that the hrig 
 Zephyr had not been nearer the (hip Wil- 
 liam than half a mile, lb wedded were in- 
 dividuals to the idea of imported contagion, 
 that they fixed on the brig xAclive, which 
 had jufr. arrived from Martinique, as the 
 contagious vefTcl. But the following letters 
 from Me firs. Lawrence and Van Zandt 
 will be found to contain facls as little fa- 
 vourable to the opinion, that contagion had 
 been communicated from the Active, as 
 has been proved with refpect to the brig 
 Zephyr. 
 
 < Sir, 
 1 It affords us lincere pleafure to furnifh 
 ' you with fuch facls as came within our 
 4 knowledge, concerning the brig Active, 
 
 1 fuppofed 
 
( '9 ) 
 
 ' fiippoied to have been one of thole veiTels 
 ' which introduced a contagious dileafe in- 
 
 * to this city. The laid brig lailed from 
 1 this port on the 9th of April laft, bound 
 ' to the Weft-Indies, navigated by Capt 
 
 * Mathew Rogers,, a mate, and five hands. 
 6 After touching at feveral iflands for a 
 ' market, flie finally arrived at Martinique, 
 
 * where the captain difpofed of her cargo, 
 ' and received in payment thirtv-iix hog- 
 ' fheads of molaffes, and the reiidue in bills 
 ' of exchange on this city. He alio re- 
 ' ceived on board, on freight, and coniigned 
 
 ' to MelTrs. Concklin and Lovd, merchants 
 
 j 7 
 
 1 here, one hundred and thirty-four bale.^ 
 4 of caftia, commonly called wild honev. 
 
 * This and the molalTes conftituted the 
 i whole of her return cargo. The (aid 
 k brig failed from Martinique on the 30th 
 4 of June, bound for this port, and arrived 
 k here the 2 2d of Julv. Seventeen davs 
 1 previous to her arrival, fhe loft one man 
 ' by ficknefs, and from information receiv- 
 
 4 ed 
 
( ie ) 
 
 * ed from the captain, he died with a fever, 
 
 * the nature of which he could not afcer- 
 1 tain, but fuppofed it was brought on by 
 1 the ule of liquor, of which the deceafed 
 4 would, previous to his ficknefs, drink 
 ' large quantities. After his body was 
 4 committed to the waves, the captain, for 
 fc three fucceffive days, had the birth, bed- 
 6 ding, and every thing belonging to the 
 
 * deceafed, carefully cleaned, under his 
 ' own infpection. The refidue of her crew 
 ' enjoyed a full ftate of health during the 
 
 * voyage, and were all perfectly well on 
 ' her arrival in this port. Her cargo w 
 
 * landed at Fitch's wharf, partly by her 
 ' crew and partly by labourers : nor do we 
 
 * know an inftance of any one of them 
 ' being fick after their difchar&e from the 
 
 * veflfel. She remained at Fitch's wharf 
 ' about three weeks ; at which time we 
 
 * difpofed of her to Mr. Orange Webb, 
 ' merchant of this city, who immediately 
 
 * loaded her and lent her to fea. 
 
 >Thc 
 
( *' ) 
 
 ' The above is a true and perfect account 
 ' of the brig Active. If you can draw any 
 • information from it that will aid you in 
 ■ your laudable undertaking, we mall enjoy 
 i the pleaiing reflection of having, in a 
 ' fmall degree, ferved the caufe of huma- 
 ' nity. 
 
 f We remain, &"C. 
 
 fc Lawrence &? Van Zandt.' 
 
 We are indebted to Mr. Strong for the 
 following: : — 
 
 o 
 
 1 Sir, 
 *. In purfuance of your requeft, I yeftei - 
 
 * day faw Capt. Rogers, late matter of the 
 " brig Active, who tells me he hauled along 
 k fide of Fitch's wharf on Friday the 24th 
 r of July laft, and that he began to break 
 
 * bulk the next day, being Saturday the 
 f 25th. 
 
 1 He further anures me, that a number 
 f of his acquaintance were on board the 
 f brig every day, and that he has fince feen 
 
 4 fevcral 
 
( -- ) 
 
 * feveral o{ them, none of whom have been 
 w Uk< D with the late dilbrder. 
 
 1 1 was repeatedly on board, and in the 
 1 cabin : once in particular, before ihe 
 " hauled along fide the wharf, I was in the 
 ' hold of the brig, and examined the cargo ; 
 
 * but as I was not taken with the diforder 
 ' until the 5th of September following, 
 ' (although I lived near Peck-flip, where 
 
 • the difeafe firft began to rage) I am confi- 
 
 • dent I never took it on board Captain 
 ' Rogers' brig. 
 
 ' I am, Sir, &c. 
 
 • Benjamin Strong,' 
 
 The preceding letters leave little doubt 
 with refpeet to the healthful ft ate of the 
 brig Active. It appears that ihe arrived in 
 port on the 2 2d of July: on the 23d ihe 
 laid on the outfide of a veflel at the end of 
 Fitch's wharf: on the 24th ihe hauled into 
 the (lip ; and on the 25th of July ihe broke 
 
 bulk. 
 
 Hitherto 
 
( *3 ) 
 
 Hitherto it has been fuppofed, that the 
 (hip William alfo laid at Fitch's wharf; 
 but the truth is, that this veffel did not, at 
 any period this feafon, lie at that wharf. 
 Her iituation, at firft, was at the wharf of 
 Lawrence and Kipp, about fifty yards weft- 
 ward of Fitch's ; and on the 24th of July 
 (he removed to Rutgers' wharf, diftant 
 about half a mile from her firft ftation. 
 
 Upon a comparifon of thefe ftatements 
 it will appear, ift, that the veffels above 
 named were never nearer one another than 
 fifty yards ; and, 2dly, that the day before 
 the Active began to unload, the William 
 was removed to the diftance of half a mile. 
 Thus it is (hewn how little foundation 
 there was for a report of a fever being com- 
 municated from the brig Active to the (hip 
 William. 
 
 The next fubjecl of fufpicion was a par- 
 cel of cotton, which had been imported in 
 the brig Caroline, and which was depofited 
 in the ftore of Lawrence and Mott, at the 
 
 foot 
 
( M ) 
 
 foot of Dover- ftreet. It \va; reported that 
 B man had thru ft his arm into a bag of da- 
 maged cotton, and that, when he withdrew 
 it, the arm, from the virulence of the con- 
 tagion, was of a livid colour. Howevci 
 extravagant this declaration may feem, 
 there were not wanting thofc who lub- 
 fcribed to its credit. In lhort, io infatuated 
 were fbme of the inhabitants with the be- 
 lief of imported contagion, that they fuf- 
 pecled every veflel, which had arrived from 
 the Weft-Indies previous to the late epide- 
 mic, to have brought contagion in her. 
 
 With regard to the fufpecled cotton, the 
 following certificates will give the necef- 
 fary information : — 
 
 " I, John Church, mafter of the brig 
 " Caroline, of New- York, do certify, that 
 " the fiftv-one bales of cotton, fhipped on 
 " board the laid brig Caroline, about the 
 fc4 20th of June, 1795, was purchafed by 
 <L me in the neighbourhood of Lance and 
 wt Veau, and was never on board any veflel 
 
 " but 
 
 
( *5 ) 
 
 M but the faid Caroline, until landed from 
 " on board her in New- York, about the 
 '• 22d of July, i 795." 
 
 " We, the fubicnbers, do certify, that 
 " we were on board the brig Caroline, 
 " which laid at Lawrence's wharf, foot 
 " of Dover-flreet, divers times on the 21ft 
 " and 2 2d of July laft — that we faw a 
 " number of bales of cotton wool on board 
 " the faid brig — that we examined the 
 " cotton by picking it open, and running 
 " our hands into the facks, for the purpole 
 " of afcertaining its quality — that George 
 " Towniend did purchafe one bale on the 
 " 2 2d of July, and retailed it out of his 
 " ftore — that Selah Strong was not taken 
 " with the diforder : Benjamin Strong was 
 " taken lick on the 5th, and George Town- 
 " fend on the 2 1 ft of September following. 
 
 " Benjamin Strong, 
 
 " Selah Strong, 
 
 " Geo. & Benj. Townsend. 
 •• Ncw-Tork, 16th Dec. 1795." 
 
 D I have 
 
( =6 ) 
 
 I have thus advanced iiich document-, 
 upon the fubjecl of imported contagion, as, 
 from a careful enquiry, I have been able 
 to collect. From this inveiti^ation the 
 public is in pofleflion of filch information, 
 as may be made the bafis of a tolerably ac- 
 curate judgment ; and I have little hehta- 
 tion in believing, that the conclufion na- 
 turally refulting from the premifes, will be 
 extremely unfavourable, if not abfolutelv 
 againft. the opinion which feme have fo 
 warmly embraced, that the caufe of th< 
 late epidemic was imported contagion. 
 
 We muft now take the liberty of recur- 
 ring to a further confideration of circum 
 ftances relative to the brig Zephyr. 
 
 From the ilatements contained in tht 
 letters already inferted, regarding this vei- 
 fel, fevcral facts of considerable importance 
 are made to appear, viz. that no perfon 
 died on board the Zephyr, during the whole 
 of her voyage, except the boy already men- 
 tioned • <-b.it all thole of the crew who had 
 
 been 
 
( «> ) 
 
 been taken fick at Port-au-Prince, and had 
 become convalefcent, foon got well after 
 her arrival in this harbour ; and that nei- 
 ther the wardens of the port, the confignees, 
 nor any other perfon who had been trail- 
 iiently on board the Zephyr, except Doctor 
 Treat, fufFered any bad confequences from 
 their vifits. — The queftion then occurs, 
 Did Doctor Treat take the difeafe, of 
 which he died, from the Zephyr ? 
 
 It was a circumftance well known, that 
 the health of Doctor Treat was generally 
 impaired. His rtomach was in a ftate of 
 conftant diforder ; and this, independent of 
 other effects, was, at particular periods, ac- 
 companied with iiich extreme dejection of 
 fpirits, that he did not, as he had often af- 
 fured me, expect to live from one dav to 
 another. The Doctor had been complain- 
 ing more than common for feveral dav^ 
 before he vifited the Zephyr. He embarked 
 jri a fmall open boat at mid-day, with a 
 black hat on his head, and without an um- 
 
 bivlla, 
 
( -3 ) 
 
 brella, which he had always- been accuf- 
 tomed to ufe, to defend him from the fun's 
 The day was calm, extremely hot, 
 and the veffd at leaf!: one mile and a half 
 from the place of his departure. It is alio 
 ilated, that he was much fatigued, upon 
 Governor's Hland, in fearching for the 
 commanding- officer. 
 
 Thus, then, it would appear as matter 
 of fact, firft, that Doctor Treat was indif- 
 pofed at the time he virited the Zephyr: 
 iecondly, that in performing that dutv he 
 was expofed, for feveral hours, to the ex- 
 treme heat of the fun; and, thirdly, that 
 he encountered confiderable bodily fatigue. 
 If thefe circumitances are well confidered, 
 and that peculiar ftate of the weather, 
 which predilpofes to fever, is taken into 
 the eiHmate, is it unreafonable to fuppofe 
 that the fever with which Doctor Treat 
 was attacked, might have originated from 
 the operation of fuch a combination of 
 caufes r Every candid phvfician will give 
 
 a ne~ 
 
( *9 ) 
 
 a negative anfwer to the queftion. But 
 we lhall not be very folicitous to prove, that 
 Doctor Treat did not contract his difeafe in 
 this manner — We grant that he might 
 have received infection from the Zeph\ r ; 
 but does it neceffarilv follow, that it mould 
 have cauled a contagious fever \ A conli- 
 deration of the confequences, in a variety 
 of parallel caies, will contribute much to 
 the formation of an opinion upon this iub- 
 je6t. — The following is confidered illultra- 
 tive of this point. 
 
 At the termination of the late war be- 
 tween the United States and Great-Britain, 
 Colonel William Smith, of this citv, was 
 appointed, bv General Washington, to re- 
 ft de in New -York, with the confent of Sir 
 Guv Carlton, for the purpofe of luperin- 
 tending the evacuation of the country, and 
 to fee that it was performed agreeably to 
 the treaty. In the exercife of this duty, 
 he had frequent occaiion to go between the 
 decks, and into the holds of vefTels. In 
 
 the 
 
( 3o ) 
 
 • conrie of there viiits, he was lei zed 
 v.'ilh (what is commonlv denominated a 
 fhip-fever) a bilious remitting fever. After 
 a few days, the fever happily intermitted, 
 and Colonel Smith foon recovered a toler- 
 able mare of ftren^th. 
 
 It wa^ thought proper to caution him 
 againir. the danger he would incur by re- 
 peating his viiits on board fhip. He an- 
 swered, that the duty was indiipeniible. 
 The confequence was, he contracted a fe- 
 cond fever. The firfr. of the attack was 
 attended with a iei\{Q of coldnefs, which 
 was foon Succeeded by violent pain in the 
 head. His countenance was flufhed, and 
 his eyes were very red. The third day his 
 neck and breafr. took on a yellow appear- 
 ance; and in forty-eight hours, the whole 
 of his body became as yellow as an orange. 
 From the accefiion of his fever to its ter- 
 mination, his heat was fo conlidcrable, that 
 on feeling his pulfe, or grafping his wrifr, 
 the fenfation communicated was fimilarto 
 
 the 
 
( P 
 
 § 
 
 the fling of nettles, or very fine needles 
 pricking the hand. 
 
 Colonel Smith lodged at Mr. Depeyfter's 
 in Pearl-ftreet, and notwithftanding the 
 unremitting attention he received from the 
 family, the diieafe was not communicated 
 to one of his attendants.* 
 
 I have twice, in the purfuit of my avo- 
 cations, imbibed infectious fevers — once 
 on fhip-board ; and again on viliting a 
 prifon. I was handled very feverely in 
 both inftances, and deprived of my fenfes 
 feveral days during each confinement. My 
 attendants were numerous, and vigilant ; 
 
 yet 
 
 * ' Sometimes only one man in a ship may be seized 
 with the petechial, or with the yellow fever, while all the 
 rest continue unaffected: of this the Magnamine afforded 
 an instance,' &c. &c. &c. 
 
 * Another person was sent from the Raven sloop, in the 
 yellow fever, of which he also died ; and yet no other per- 
 son on board of those two ships were, either before or af- 
 terwards, taken ill of such fevers.' 
 
 ' I have frequently visited patients in fevers similar to 
 the above mentioned, in families, where an infection was 
 not in the least suspected.' 
 
 Lind on Scamon, ji. 213. 
 
( J2 ) 
 
 • r no one iurTered from contact with my 
 . or from breathing the air of my 
 chamber* 
 
 . mrable to the (ame conclufions 
 
 with the above inftances, and tending: to 
 llluftrate the doctrine we arc endeavouring 
 to cfhiblilh, we lhall here introduce the 
 hiftory of a fever which raged among the 
 men of Monf. De la Motte's fleet, in i y c; y. 
 
 A fleet, under the command of Monf. 
 De la Mottc, (ailed from Brefr. on the third 
 day of May, i 757, for Lou ifburg, in Nova- 
 Scotia. A number of failors (about two 
 hundred) who had been confined in Roch- 
 fort hofpital, with putrid fever, and had 
 become convalefccnt, were embarked on 
 board the Glorieux and Due de Burgogne, 
 fhips of war. Thefe (hips had been two 
 
 ars in a irate of equipment, and moft of 
 that time at lea ; thc\ , therefore, could not 
 be fuppofed to have been very clean. The 
 other mips of the fleet had lain fome time- 
 in the harbour of Breft, and were not in a 
 
 very 
 
( 33 ) 
 
 very healthy condition. On board the 
 different veflels were alfo difhibuted four 
 hundred Tailors, who had juft returned from 
 confinement in the Englifh prifons. The 
 mips' companies became fickly on their 
 paffage, particularly thofe of the Glorieux 
 and Burgogne; and on the 20th of June 
 they arrived at Louifburg. The wind was 
 fair during the paffage, blowing moftly 
 from the fouth-eaft ; and the weather was 
 fb favourable and temperate, that it was 
 found unneceffary to ihut the port-holes 
 or clofe the hatch- ways. 
 
 As loon as the fleet arrived atLouifburs;, 
 the different mips had their tents pitched 
 on more, for the accommodation of the 
 lick ; and they were accordingly difem- 
 barked immediately. The tents were 
 pitched too near one another, and hence 
 the lick did not receive all the advantages 
 which they might have derived from their 
 fituation. 
 
 E The 
 
( 34 ) 
 
 The particular ftate of the Tick during 
 the months of July and Auguft, their 
 number, or the mortality which prevailed, 
 >t mentioned. But it is obferved, that 
 the number of the fiek was greatly aug- 
 mented during the latter part of September. 
 This aroie from t\\ o cauies ; firft, from the 
 iiit\ thev were under of collecting all 
 their ftrength from the different veffels, to 
 finifh works, in order to defend the cit\ : 
 iecondly , from a fevere gale of wind, which 
 happened on the 25th of September, and 
 threatened deftruclion to the whole fleet. 
 Several mips were in particular danger, to 
 1a\ e which, the united exertions of officers 
 and tailors were required; and in perform- 
 ing this duty, the men were unavoidably 
 expoied to exeeffive labour and extreme bad 
 athcr. After this, the fick became more 
 numerous; and by the 30th of October, 
 the dav on which the fleet left Louiiburg 
 for Brett, the lick amounted to fourteen 
 hundred. Of this number, four hundred 
 
 of 
 
( 35 ) 
 
 of the worft cafes were left atLouifburg, ia 
 bad lodg-insrs, and under the management 
 of few, and thofe unikilful attendants. 
 
 The fleet had not been at fea more than 
 fix davs, before mofr. of thole who were fick 
 at the time of failing, with many others, 
 died. The paflage was attended with very 
 boifterous weather ; and the fea ran fo high, 
 that the ports were obliged to be kept Ihut. 
 Under circumftances fo uncomfortable, the 
 malady fpread with great rapidity, and on 
 the arrival of the fleet at Breil, which hap- 
 pened on the 2 2d of November, the num- 
 ber of the fick amounted to four thoufand. 
 
 Fifteen davs before the return of De la 
 Motte's fleet, the two (hips of war, Bizarre 
 and Celebre, arrived in Breft harbour from 
 Canada. The crews of thefe ihips were 
 affected with a complaint fimilar to the one 
 which prevailed on board the Louifburg 
 fleet ; and they had already fent one thou- 
 land men to the hoipitals at Breft. The 
 hoipitals, therefore, were foUhd crouded; 
 
 and 
 
( 3* ) 
 
 and tor the accommodation of the Tick 
 newly arrived, temporary hospitals were 
 erecled. Into thcfe the Tick were hurried 
 from the fhips, in cold and w et V* eathcr, 
 and thrown together in heaps (entaffe peM 
 mele). Under thefc circumftances, little 
 benefit was obtained from the means cm- 
 ployecl for their relief. 
 • The diicafe raged, with unrelenting 
 violence, from the 2 2d of November to tin 
 laft of February. It becran to diminish in 
 the month of March, and ceafed entirely 
 in April. But it was remarked, that this 
 cruel difeafe did not ceafe until it had de- 
 ftroyed fo many men, that thofe who re- 
 mained had, in confequence, an opportu- 
 nity of enjoving all the advantages of 
 breathing a pure air, of cleanlinefs, and 
 good attendance. 
 
 The number that died in the hofpitals at 
 Breft, at this period, was not lefs than ten 
 thoufand, befides a confiderable number in 
 the city. 
 
 Of 
 
( 37 ) 
 
 Of the four hundred men left at Lou it- 
 burg, who appeared to be in a condition 
 from which a recovery could not be ex- 
 peeled, badly accommodated, and worfe 
 attended, three hundred and eighty were 
 cured. 
 
 The foregoing is an epitomized narra- 
 tive of a vovasre from Bred: to Louiibur^, 
 in which is related the prevalence and 
 mortality of a fever, which the author of 
 the account denominates putrid, ma- 
 lignant, contagious, and PESTILEN- 
 TIAL. 
 
 A confederation of the circumftances at- 
 tending this expedition, and the flate of a 
 confiderable part of the men employed on 
 the occahon, will readily, T apprehend, 
 explain the fatality attending it, without 
 recurring to the fuppohtion of the difeafe 
 being, in its nature, effentiaUy contagious 
 or pejlilentia!. 
 
 It will have been perceived before this, 
 that we have been fomewhat folicitous to 
 
 eirnbhih 
 
( 3» ) 
 
 eftablifh a diftincrion between difeafc 
 which arc infectious, and thole which arc 
 contagious. By contagion we understand 
 
 fon /• and fpei'ifjc, pofleffing 
 
 properties ejjcntially different from an\ 
 thin«4 die. Thus the contagion of the 
 fmall-pox,the meafles, &c* Thofc difeaies 
 do not require the concurrence of certain 
 caufes to render them contagious ; they are 
 fb under all circumftances. But other dif- 
 
 I es ma \ , ( >r may not be i?ifeclious, according 
 to the conditional ftate in which thev are 
 placed. Thus a fever mall continue days, 
 or even weeks, without giving rife to the 
 leaii fufpicion that it has, in any inftance, 
 been the caufc of fever in any perfon, who 
 may have been, either a frequent viiitor, 
 Or confhmt attendant : whilfl a fever, ac- 
 companied with the fame ivmptoms and 
 appearances, and not more violent in de- 
 cree, (hall be communicated from one to 
 
 >ther, and extend to incalculable lengths, 
 J o long as the circumitances cxifr. which 
 
 favour 
 
( 39 ) 
 
 favour its propagation. Agreeably to this 
 difmition, may be explained the flow, or 
 rapid progrefs of the fever of the Louiiburg 
 fleet, at different periods. 
 
 To illultrate this more fully, we (hall 
 take a review of the circumftances attend- 
 ing that fleet, from the time of its failing 
 from Breft harbour, to its return to that 
 port, and the after difpolal of the men. 
 
 The convalefcents from Rochfort hof- 
 pital received on board the fleet, had been 
 weakened by a previous difeafe ; the na- 
 ture of which we prefume not to have 
 been contagious, becaufe no mention is 
 made of it. They were ordered into mips 
 which had been the greatefl: part of two 
 years at fea, and in a condition, it is dated, 
 not very favourable to the re-eilablilhment 
 of health. The conlcquence was, that 
 mod of thefe unfortunate men had a 
 return of fever, and this fever became in- 
 fectious. The fever, it is laid, was com- 
 municated to fome of the (hips' company 
 
 during 
 
( 4o ) 
 
 during the paflagc tpLouiiburg. We ha\ E 
 
 no doubt of the fact. But we by no means 
 
 mit this as a proof of the contagious 
 
 nature of the diieafe. It is \cr\ common 
 for fevers to become infe&ious, when a 
 number of lick are crowded together in 
 confined apartments; and on (hip-board 
 they are particularly liable to become fo, 
 from the impoflibility of ventilation in 
 lome instances, and the neglecl of it in 
 others. Here, too, it often happens, thai, 
 for want of room, the well are compelled 
 to lie with, or near the lick, and to breathe 
 an air rendered extremely noxious from 
 the abflraclion of that part which is efTen- 
 tial to animal vigour, and from a combi- 
 nation of the different effluvia arifing from 
 the lick, the dying, and perhaps the dead. 
 Hence a caulc appears why (hip-fevers are 
 often communicated with io much facility, 
 and are a caufe of ih great a mortality. 
 
 But in the ca(e now more immediately 
 under confideration, the extenfion of the 
 
( 41 ) 
 
 fever, bevond thole who came on board in 
 a debilitated ltate, did n : place in 
 
 manv inifances : and the realbn is evident : 
 — The weather, during the [ 
 Breif. to Louitburr. fc mild, that the 
 
 port-holes (the windows of a ihip they 
 mis;ht be called) and hatch- were 
 
 permitted to be generally open, by which 
 means a circulation of air was kept upbe- 
 
 caufes of u 
 tion were, in a great mealure, carried c 
 The tine weather, alio, allowing the 
 to be chiefly on deck, was 
 why the crews were not more licklv. 
 
 The narrative does not mention 
 ltate, nor the number of the lick during 
 the months f ] and Auguft. I: 
 i; On a perdit quelqu'un." 
 
 It this fever had been contas -, ou^ht 
 it not to have fpread more generallv during 
 the iummer months : •• I 
 peu." I p relume thai 
 among lb manv ^ld have be. 
 
 F s^ene rally 
 
( 4= ) 
 
 illy experienced, that a particular 
 
 account of it would have been kept, ami 
 reported in the general ltatenu-nt. 
 
 To promote the object of the expedition, 
 it was thought neceffarv, fome time in Sep- 
 tember, to collect all the men of the fleet, 
 
 ' throw up works, in order to defend the 
 town. The exertions that were made on 
 this occafion sreatlv augmented the num- 
 
 O JO 
 
 ber of the lick; and this efFecl: was attri- 
 buted to the contagious nature of the dii- 
 eafe. But I apprehend the caule to have 
 been over-fatigue, and of that fort to which 
 the men had not been accuftomed : to 
 which we may add, expofure to inclement 
 weather, and a fcarcitv of provilions, and 
 thofe of a bad quality. 
 
 On the 25th of September, a fevere gale 
 of wind happened. This neceflarily occa- 
 fioned a great degree of expofure, and much 
 fatigue. From thefe caules the lick be- 
 came more numerous; and the number 
 increafed till the period of their departure 
 
 from 
 
( 43 ) 
 
 from Louiiburg, which was on the 30th of 
 October, when fourteen hundred were 
 upon the lift. Of thele it was thought 
 that four hundred of the moft defperate 
 and hopelefs cafes mould remain at Louii- 
 burg. 
 
 The fleet had not been at fea more than 
 fix days before mod: of thofe who were ill 
 at the time of failing, with many others, 
 were dead ; and by the time that the fleet 
 arrived at Breft, which was on the 2 2d of 
 November, four thouiand failors were con- 
 fined with fever. 
 
 If we confider the circumftances of the 
 paflage, viz. the ftate of the men taken on 
 board the fleet ; the condition of them af- 
 terwards, owing to boifterous weather, 
 which rendered clofe confinement neceffa- 
 ry, and a proper ventilation impracticable, 
 we need not be iurpriied that the fever 
 ihould have prevailed io generally, nor that 
 the mortality mould have been (6 confider- 
 ablc. The air between decks, in a ftagnant 
 
 irate. 
 
( 44 ) 
 
 irate, and in which k> many fick were 
 crouded together, could not fail of be- 
 coming infectious : and the heat, as well 
 as the moifture, which muft neceflarily 
 exiit in fuch fituations, would give a parti- 
 cular activity and virulence to the infec- 
 tion. And in this way we may account 
 for the propagation and fatal tendency of 
 the difeafe, without fuppofing it to have 
 had any thing in its nature fpecihcally 
 contagious. 
 
 After the arrival of the fleet at Breft, the 
 men were placed under circumftances as 
 little favourable to their recovery, as they 
 were before their debarkation. They were 
 fent to hofpitals, too lmall to contain them, 
 fave in a ftate extremely crouded ; and 
 there were not attendants in tufficient 
 number to take proper care of the fick, and 
 to preferve clcanlincfs. 
 
 In this fituation, fo confined was the air, 
 and fo impregnated with the foul vapours, 
 arifing from the fick, that, on entering the 
 
 hofpital, 
 
( 45 ) 
 
 hofpital, it is obferved, a perlbn found him- 
 felf iurroimded by an air fo extremely- 
 warm, and poffeffing a cadaverous odour, 
 fo difagreeable to breathe, that one who had 
 not been accuttomed to it, could not remain 
 expofed to its operation but for a few mi- 
 nutes, without feeling a pain in the head. 
 
 When, from the great numbers who 
 died, the hofpital became fo thinned, and 
 the fick fo few, that they received all the 
 advantages of pure air, good attendance, 
 a due obfervance of cleanlinefs, proper me- 
 dicines, &c. the progrefs of the difeafe was 
 foon arretted, and in a fhort time it finally 
 difappeared. 
 
 Now, when the preceding hiftory is well 
 confidered, together with the concluiions 
 drawn from the facts therein ttated, it will 
 appear, that the fever of De la Motte's fleet 
 ought to be arranged under the head of m- 
 feftious difeafes, and not that of a conta- 
 
 gious one. 
 
 But 
 
( 46 ) 
 
 But if it mould iVill be urged, that there 
 i in the cafe, and at the lame 
 time we admit, (which faffs compel us to 
 grant) that a free air, and other circumftan- 
 ces, will flop the progrefs of a contagioiib 
 diieafe, nav,deitrov its contagious propertv, 
 the concciiion is all we wiih to obtain, in 
 order to eftablifh our doctrine of the nature 
 of infectious fevers. 
 
 As a corroborating fact to our opinion, 
 it will be proper to remark the altonifhing 
 recovery of three hundred and eighty, 
 out of the four hundred word cafes, that 
 were left at Louifuurcr. The hiftorv of 
 
 o 
 
 contagious difordcrs no where, I believe, 
 furnifhes any thing like a parallel example 
 of lb large a proportion of lick getting well. ' 
 
 We 
 
 * ' When a malignant fever, in the late war, was brought 
 from England into the hospital at Mali. m, the house being 
 insufficient for the reception of so great a number of pa- 
 tients, tents were erected in the fields for many of the men. 
 c poor men were thought to be hardly accommodate d : 
 but it was observed, that most of those who lay in tents 
 recovered; when the mortality in the house was so great, 
 i ime wards, not one in three escaped,' &:c. &c. 
 
 hind ok Sran;on. 
 
( 47 ) 
 
 We find upon record, numberlefs ex- 
 amples of people having received infection 
 of the mod ferious nature, from going out 
 of the healthy air of the common atmof- 
 phere, into confined places ; fuch as dun- 
 geons, crouded prifons, or between the 
 decks of vefTels, where fevers have pre- 
 vailed. But there is not an inftance within 
 my recollection or obfervation, where a 
 perfon, having imbibed fuch infection, and 
 where cleanlinefs, keeping the room well 
 aired, and other proper attentions have ' 
 been obferved, has communicated the dif- 
 eaie, either to occafional viiitors, nurfes, 
 friends, or relatives : and the particulars 
 of Doctor Treat's cafe will furnifh another 
 analoomis fact. 
 
 He went on board the Zephyr, and, as 
 his duty required, defcended into the hold, 
 or between decks, to afcertain the ftate of 
 the vefTel, as it regarded infection. In 
 doing this, we will iuppofe that he expofed 
 himfelf to foul and ftagnant air, rendered 
 
 particularly 
 
( 4» ) 
 
 particularly noxious by the exhalations 
 which pulled off before and immediately 
 after the boy's death. 
 
 A dav or two afterwards he began to 
 complain. Where he reiided, there was a 
 family about him. His filter, particularly 
 during his illncfs, was a conftant attendant 
 at his bcd-llde. His numerous friends were 
 prefling around him to his lafr. moments. 
 Several of them affifted in the execution 
 of the means prefcribed for his relief, when 
 they had direct contact with his body, and 
 were more immediately expofed to what- 
 ever arofe from it : — Yet the fever was in 
 no inftance communicated to a fecond per- 
 fon. 
 
 If, then, the Doctor's difeafe had been 
 fpecijically contagious, ought we not to have 
 expected an unequivocal manifestation of 
 it, in fome of thole who were placed under 
 circumftances fo favourable for receiving 
 contagion r 
 
 Many 
 
( 49 ) 
 
 Many people were confirmed in the 
 opinion, that the fever was contagious, 
 from the vague reports of examples having 
 occurred, where perfons were infected with 
 fever in the country, in conicquence of 
 having had a communication with thofe 
 who had carried the difeafe from the city. 
 Now, I believe, there are not any well au- 
 thenticated cafes of this fort : and if a few 
 folitary inftances are offered in fupport of 
 the contagious nature of the difeafe, which, 
 however, are very obfcure, they prove very 
 little when compared with the uniform 
 confinement of the diforder to thofe who 
 were immediately expofed to the firir. 
 caufes which produced the complaint. 
 
 We have already admitted that the air 
 of a room in which a perfon is lying with 
 a bilious remitting fever, may become in- 
 fectious, if ventilation is not performed, 
 if all excrementitious matter is not fpeedily 
 removed, and if the bedding and clothing 
 of the patient are not in due time changed. 
 G And 
 
( s= ) 
 
 And if the fever has arifen in thecounG 
 
 in the manner the reports above dated e\- 
 prefs, I prefume infection has been the 
 caufe, and not contagion ; tor all that has 
 hitherto been alledged is, that one or two 
 initances have happened, where people 
 have taken the difeafe, from the many of 
 thofe who have fickened in the country 
 after leaving the city ; not that the difeafe 
 has fpread through a neighbourhood or a 
 village. 
 
 1 prefume it is fufflcientlv proved by this 
 time, that the late epidemic fever was not 
 brought here from abroad ; and, alio, that 
 there exifts in nature, and that there ought 
 to be made, a diftinclion between 'mfeElioui 
 and contagious diforders. Much more might 
 be faid upon theic fubjecls, and a variety 
 of teftimony added ; but, without fatigu- 
 ing; the reader, bv entering into a farther 
 difcumon of thefe queltions, I fhall proceed 
 to enquire into thofe caufes which may, 
 
 w ith 
 
( 5' ) 
 
 \ ith great probability, be coniidered as 
 productive of the late epidemic. 
 
 During the months of January and Feb- 
 ruary, 1795, the weather was unufually 
 variable ; the lowelt degree to which the 
 thermometer fell was five degrees of Fa- 
 renheit's fcale, and it rofe as high as forty- 
 fix deo-rees. 
 
 o 
 
 The weather of the fuccceding fpring, 
 during the months of March and April, 
 was alio very variable, and was attended 
 with a greater degree of cold and wet than 
 common. This was remarkably evidenced 
 by their effecls upon vegetation. Trees 
 put forth their buds, and bloflomed later, 
 than is ulual in ordinary feafons. 
 
 As the feafon advanced, the weather 
 became warmer ; but the moifture of the 
 air was in no decree diminiihed. This 
 ilate of the atmofphere continued during 
 the fummer months. The acceflion of 
 heat was flow, but by the latter end of 
 July it became exceffive, and continued fo 
 
 crenerally 
 
( s* ) 
 
 generally during Augufr. and the firft part 
 of September. The etiecls of this hot and 
 moiit air was remarkable in the production 
 of mould. 
 
 It was a very common complaint, that 
 hardly am thing could be kept without be- 
 coming mouldy. Books, which had re- 
 mained for years in libraries and other 
 j 
 
 places, became covered with this fub- 
 itance. Shoes and boots, thrown afide only 
 a day or two, contracted an abundance of 
 mould; and the wooden floors, and pa- 
 pered walls of family rooms which were 
 clofed a few days only, and even in fome 
 inftances where the rooms were daily ex- 
 pofed to a free accefs of air, which before 
 had always remained perfectly dry, now 
 generated a great quantity of mould. 
 
 The prevailing conftitution of the air 
 produced remarkable effects upon cab- 
 bages. It was obferved, that this vegeta- 
 ble grew with uncommon rapidity to its 
 uiual fize, and with the appearance of 
 
 great 
 
( 53 ) 
 
 great health and vigour; it would then 
 fuddenly aflume an unhealthy afpecl, 
 which, on examination, was found to de- 
 pend upon ibme dileafe at the juncture of 
 the head with the trunk ; and this, on 
 many occafions, proceeded fo far as to 
 caufe a complete leparation, and the head 
 would fall to the ground. It was alio a 
 common obiervation, that the cabbages 
 which were brought to market, were found 
 damaged about the center : and, further, 
 that fome fpecies of cabbages would not 
 form into a head as ufual. 
 
 The effects of a peculiar feafon were 
 (hewn alio upon different kinds of fruit. 
 It was remarked that cherries did not come 
 to that perfection in which we commonly 
 have them, and that they very foon mewed 
 a difpofition to decay, Early in the feafon 
 the apple-trees were very generally ex- 
 tremely productive, and promifed a large 
 fupply of their fruit in the autumn ; but 
 the expectations of the hufbandman on this 
 
 head 
 
- 
 
 ( 54 ) 
 
 head were greatly disappointed : the ap- 
 ples began to tall at lealt. a month before 
 the ufual time, and in a yery imperfeel 
 
 Rate; and thole which came to maturity 
 could not be kept fo long as it is common 
 for them to be preferred. 
 
 In a letter from John Kemp, Efq; pro- 
 feffor of natural and experimental philolo- 
 phy, &c. &c. in Columbia college, dated 
 April i 2th, 1796, it is Hated, " that in his 
 objervationg upon the irate of the atmof- 
 phere during the lafl fummcr, the mercury 
 in the thermometer was, on an average, 
 three degrees cf Farenheit's lcale higher 
 than it has been, at the fame feafon, during: 
 the ten preceding years ; that the moifture, 
 as indicated by the bell: hygrometers, was 
 much greater than ufual ; that the quantity 
 of" active electricity was 1o Imall, as to be 
 frequently imperceptible bv very fenfible 
 electrometers, connected with an exploring 
 rod ; that the quantity of rain was much 
 greater than ufual, and thunder ftorms Ids 
 
 frecuent ; 
 
( 55 ) 
 
 frequent ; and that, for the moft part, the 
 wind was between fouth-eaft and north- 
 eaft." 
 
 The firft being eftablifhed, that the ftale 
 of the air, during the winter of 1 794 — 5, 
 and particularly during the fucceeding 
 fpring and lummer, has differed very ma- 
 terially from its ufual temperature and 
 difpoiition, can there be any good reafon 
 afligned why the difeafes to which our cli- 
 mate is liable in a greater or lefs degree, 
 every feafon, mould not receive a particu- 
 lar cbaracler, or be varioufly modified by 
 a peculiarity of weather ? The influence 
 of climate upon the human constitution 
 has been remarked in all ages ; and not a 
 year paffes that we do not hear of particu- 
 lar difeafes, being attended with fome un- 
 common appearances, arifing from pecu- 
 liarity of feafon. 
 
 At a meeting of the Medical Society of 
 the State of New-York, held on the fecond 
 Tuefday in July, it was remarked by one 
 
 of 
 
( 56 ) 
 
 of the members, that he had feen feveral 
 caics of angina tracheal^ which were 
 attended with anomalous fvmptoms, and 
 alio a few cafes of dyfenterv in adults, 
 which proved obttinate : and as thefc dii- 
 caics were not unfual at that feafon of the 
 r, he concluded that they would become 
 epidemic, or be found the forerunner of 
 one. He was led to this opinion from the 
 hiitory of epidemics ; difeafes of that kind 
 being almoft always anticipated by fome 
 particular previous diibrder : and he fur- 
 ther remarked, that there was fomething 
 in the ftate of the air which predifpofed to 
 complaints. 
 
 At the fame time it was obferved by ano- 
 ther member, that he had alio feen feveral 
 cafes of angina tracheal is, and he found 
 the difeafe attended with leis danger of fuf- 
 focation than ufual. Bleeding ferved ra- 
 ti icr as a check to the fymptoms than to af- 
 ford that manifcir. advantage which is its 
 effect on common occafions. The dif: ale 
 
 yielded 
 
( 57 ) 
 
 yielded to emetics, warm bathing, moderate 
 bleeding, and liberal bowels. 
 
 It was further remarked, that febrile 
 complaints had occurred more frequently 
 than ufual at that feafon, and efpecially 
 among children ; and that in the ufe of an- 
 timonials, the evacuations were extremely 
 bilious in their appearance. From what 
 had been obferved, therefore, there would 
 remain little doubt that there was fomc 
 circumftance in the feafon, which predif- 
 pofcd to complaint, and on many occafions 
 attended with a fuperabundance of bile. 
 
 Several members of the fociety had met 
 with inftances of cholera, and alio with 
 obftinate conftipation of the bowels. It 
 was alfo noticed, that the diarrhoea and 
 dyfentery, to which children are fo liable 
 here in the fummer feafon, and which is 
 iome times a caufe of great mortality among 
 them, were very rare difeafes. 
 
 The Medical Society came to a refblu- 
 
 tion to be particular in noticing the difeafes 
 
 H which 
 
( 53 ) 
 
 which might take place in the interval be- 
 tween the then prefent meeting and their 
 next monthly meeting. But the report of 
 a contagious yellow fever, which began to 
 prevail in the city about the 25th of July, 
 was a caufe of fo much hurry and hafty 
 declaration of opinions, that a companion 
 of notes, and a friendly ditcuiiion of a 
 queilion of fo much importance, at the 
 time appointed, was entirely fuperfeded. 
 But, however widely individuals differed 
 in' fentiment on this intercfling occafion, 
 it is but juftice to mention, that no exer- 
 tions were wanting, on either fide of the 
 •queftion, to leiTen the calamity with which 
 our city was threatened. 
 
 If we carefully peril fe the hiftory of 
 uifeafes, wc ihall find, that thofe which 
 have proved mod: fatal to the human race, 
 have proceeded, either directly or indi- 
 rectly, from fome acknowledged peculiari- 
 : u of the ftate of the air. 
 
 Of 
 
( 59 ) 
 
 Of this truth, every author, who has 
 written on epidemic difeafes, bears abun- 
 dant teftimony : and notwithstanding that 
 fome countries are more expofed to changes 
 than others, few have been found altoge- 
 ther exempted. Nor can it be expecled 5 
 from the nature of things, that the people 
 of North- America, who inhabit a climate 
 which may be laid to participate of all the 
 climates in the world, mould not, in their 
 turn, experience the operation of fimilar 
 caufes. 
 
 In order the better to underftand why 
 the fever arofe in a particular part of the 
 city, and was more prevalent, as well as 
 malignant, in that part, it will be neceflary 
 to take a general view of the Situation of 
 New-York, and the difpofition of the 
 ground. 
 
 New-York is fituated in north latitude 
 forty degrees and an half, longitude feven- 
 ty-four degrees weft from the meridian of 
 London. It is built on a fouth-weft point 
 
 of 
 
( 60 ) 
 
 of land, the higheft elevation of which, 
 above the level of high water mark, is 
 near forty feet, and which is continued, 
 through the city, near a mile length wa\ 5. 
 From this elevation in the original ftate of 
 the ground, there was a pretty bold defcent 
 continued, in oppolm . to the water's 
 
 edge. But it has been the policy of the 
 corporation of this city, at different times, 
 to make new ground, as it is called, or to 
 fell to others the privilege of doing lo; 
 which has confiderablv increafed the di- 
 menfions of the citv, both on the eaft fide, 
 and on the north. 
 
 The new made ground is nearly a level, 
 or the defcent is fo gradual, that it is drained 
 with difficulty ; and we may add, that the 
 level of the new made ground is but very 
 little above the mark of high water. In- 
 deed, it is fometimes entirely overflowed 
 by the fpring tides ; and from the loofe na- 
 ture of the ground, the water frequently 
 finds its way into the cellars of the houfes 
 
 in 
 
( 6. ) 
 
 in Front and Water flreets, and ibmetimes 
 even into thofe of Pearl-fixeet. 
 
 The new made ground from Whitehall 
 to Catharine-ftreet, along the Eaft-rivef, 
 is, on an average, four hundred feet in 
 breadth, creating, if one may fo fpeak, fifty 
 acres of ground, all of which is built upon. 
 The ground made on the weft fide of the 
 
 o 
 
 city is about ten acres. The confequences 
 of this mode of extending the city are, no 
 doubt, extremely injurious to the health of 
 the inhabitants ; and it is much to be re- 
 gretted, that meafures are not taken to 
 prevent an increafe of the evil : for we 
 mall prefently fee, that the late epidemic 
 was rendered particularly malignant and 
 fatal, from caufes arifing in this plan of 
 inlarging the city. To render this appa- 
 rent, we muil: take a more particular far- 
 vey of that part of the city where the epi- 
 demic firil made its appearance. 
 
 We mall begin at the river on the eafl: 
 fide of Peck-flip : from thence to Water- 
 
 ftreet 
 
( 62 ) 
 
 Itreet the ground is nearly a level : proceed 
 up the flip, and after leaving Water-ftreet 
 a few paces, the ground afcends until you 
 arrive at Pearl (late Queen) ftreet: from 
 this to Dover-ftreet the ground is riling, 
 but gradually deicends again as vou proceed 
 along Cherry-ftreet as far as Roofevelt- 
 ftreet : from this to the New-flip it is 
 nearly a level. The ground at the top of 
 Dover-ftreet may be conlidered as the 
 higheft fpot in the range between Peck and 
 the New -flip, bv the way pf Pearl and 
 Cherry ftreets, and extending eaft and weft, 
 maintains a general height, which may 
 be computed at fifteen, twelve, ten, &rc. 
 feet above the level of Water-ftreet. 
 
 The houfeson the high grounds are prin- 
 cipally three ftories high, and built of brick, 
 I <i tween which and thofe lowly fituated on 
 the north fide of Water-ftreet, there is a 
 fpace of ground conftituting the different 
 yards of the above houfes, meafuring about 
 one hundred feet, 
 
 Water- 
 
( 63 ) 
 
 Water-ftreet, extending from Peck to 
 New-flip, in many places has been railed 
 two feet, or more, above the ordinary level 
 of the ground on the north fide of the ftreet, 
 From thofe grounds to the river there are 
 no drains to convey off the water, &c. 
 which renders an accumulation of filth, 
 in the rear of the houles upon thofe 
 lots, almoft a neceffary confequence. 
 Water will frequently become Stagnant, 
 and this containing animal and vegetable 
 matters, expofed to a hot fun, mud prove a 
 fruitful fource of noxious vapours. Under 
 thefe circumftances, it is natural to expect 
 that thofe who are expofed to the influence 
 of fuch foul air, mould feel its effects, efpe- 
 cially in a ftate of predifpoiition, arifing 
 from a peculiar constitution of the air. 
 
 The grounds on the fouth of Cherry- 
 Street are fo arranged, that they are more 
 immediately expofed to the fun ; for they 
 may be considered as on the fouth fide of a 
 considerable hill ; and no one is ignorant 
 
 of 
 
( 6 4 ) 
 
 of the powerful effects which the {un pro- 
 duces on a furface of this expolure. 
 
 In a very correct map of this city, by 
 
 Benjamin Taylor, it will appear, that a 
 
 line drawn from Whitehall to the bottom 
 
 of Dover-ftreet, will run in the direction 
 
 of north-call:; and from the bottom of 
 
 Dover-ftreet to Coi le's-hook, the courfe is 
 
 nearly eaft. An attention to this fact, alio, 
 
 is of confequcncc, if it produces the effect 
 
 upon the tides it is (aid to do, viz. that of 
 
 creating different eddies, which furnifh a 
 
 vail: quantity of floating, periihable matter, 
 
 to the flips in the vicinity of the ground 
 
 which we have been defcribing-. 
 
 From this arrano-ement of the mores 
 along the Eaft-river, the falutary effects of 
 thofe winds which blow during the hot 
 months, from the different points of the 
 compafs, between iouth-weft and north- 
 eaft, and which io often afford refremment 
 to the inhabitants of the elevated lituations, 
 and at the well: end of the town, are little 
 
 oj 
 
( <>S ) 
 
 or not at all experienced by thofe who re- 
 fide at the eaft end : for the air is lb chang- 
 ed in its temperature and qualities, before 
 it arrives there, by palling over a large part 
 of the city, that it loies that vivifying 
 principle fo effential to health. 
 
 From all thefe circumflances it is plainly 
 difcoverable, that the fouth-eaft part of the 
 city is placed under circumftances not very 
 conducive to the health of its inhabitants ; 
 efpecially as a great number of them are 
 of the poorer kind, and in many places 
 very much crouded together in {mall con- 
 fined apartments. To flrengthen this opi- 
 nion, I will give an extract of a letter from 
 a gentleman of great candour and refpecl- 
 ability in the neighbourhood of Dover- 
 itreet : — " Although the docks in the vici- 
 " nity of the ftore which I occupy may be 
 " lets oftenfive than in many other parts 
 " of the city, yet many of them are in a 
 " very exceptionable fituation. The pond- 
 " ing of water, by running a bulk-head 
 I kk acrof; 
 
( 66 ) 
 
 ** acrofs an unfinished dock, and leaving 
 44 the vacancv, for feveral years, to be 
 44 filled with every fpecies of filth and pe- 
 44 rifhable matter, is an objcd worthy the 
 44 attention of the police. The fituation 
 44 of the grounds between Water and 
 44 Cherry ftreets is rendered very noxious, 
 M by Water-ftreet being raifed above a 
 44 certain level, and thus preventing thofe 
 44 grounds from beino; drained. The effect 
 44 of fuch a nuifance on the health of the 
 " inhabitants of a crouded part of the city 
 44 cannot be imaginary." 
 
 It is not to be underftood, that the lati- 
 tude of a place is always to determine its 
 temperature ; nor is it uniform in giving a 
 Similar character to the difeafes moft pre- 
 valent under a fimilar parallel. Local cir- 
 cumftances will have a much more power- 
 ful operation,, and, in general, are found 
 to produce the characteristic distinctions 
 which exift between the prevalent difeafes 
 
 of 
 
( 6; ) 
 
 of countries upon or near the fame line of 
 latitude. 
 
 The country bordering upon the fea- 
 coaft, from the Province of Main to the 
 Neverfmk, or Highlands of Shrewfbury, is 
 rough and irregular, and almoft every 
 where covered with hardy oaks and hick- 
 ories ; and the foil is generally as irregular 
 as the face of the country. Moft of the 
 different capitals, on the coaft, are fituated 
 upon eminences, or high ground, and fo 
 near the fea, that the rapid currents which 
 wafh their harbours, may be confidered 
 almoft as pure as the fea itfelf ; and this is 
 particularly the cafe with the harbour of 
 New- York. 
 
 The nearnefs of New-York to the lea, 
 the ready accefs which the tides have to its 
 harbour, and the elevation and boldnefs of 
 the mores, muft doubtlefs be a great fecu- 
 rity to the health of the inhabitants. I 
 believe it may be faid, with great truth, 
 that few cities enjoy fo many natural ad- 
 vantages, 
 
( 68 ) 
 
 vantages, arifing from iituation, as New- 
 York ; and I make no doubt, that a vigilant 
 and determined police would render it as 
 healthy a city as any under the fun. 
 
 The country, on the fea-coaft, for many 
 hundred miles to the well: and fouth of the 
 Highlands of Neverfink, is low, with very 
 few elevations, and thofe not confiderable. 
 The principal cities are moftlv lituated at 
 adiftance from the fea, and on the margin 
 of fome river, the navigable waters of 
 which are a mixture of frefh and felt 
 water ; and the frefhets which take place 
 in thofe rivers, at particular feafons of the 
 year, often overflow their banks, and have, 
 no doubt, a confiderable agency in produc- 
 ing the epidemic difeafes which fo often 
 prevail in thofe climates, of which Doclor 
 Jackfon has given a very particular and 
 interefting defcription. " We learn from 
 " experience (fays the Doclor) that fe- 
 " vers are little known in rough and hilly 
 " countries, where waters flow with a rapid 
 
 44 cpurfe: 
 
( 69 ) 
 
 *f courie : while we alio know, that they 
 " are common in low and champaign 
 M countries, where water Magnates, or has 
 *< only a lluggifh motion. Independent of 
 " which, thole lituations which are in the 
 " neighbourhood of large iwamps, or near 
 " the oozy banks of large rivers, have 
 " always been obferved to be particularly 
 *' liable to luchdiieaies." 
 
 Winterbotham, on the climate of North- 
 Carolina, remarks, that " in the flat coun- 
 try, near the fea-coaft,the inhabitants, dur- 
 ing the fummer and autumn, are fubjecl to 
 intermitting fevers, which often prove fa- 
 tal, as bilious or nervous fymptoms prevail. 
 Thefe fevers arefeldom immediately dan- 
 gerous to the natives who are temperate, or 
 to lfrangers who are prudent. They, how- 
 ever, if iuffered to continue any length of 
 time, bring on other diforders, which 
 greatly impair the natural vigour of the 
 mind, debilitate the conftitution, and ter- 
 minate in death. The countenances of the 
 
 inhabitants, 
 
( 7° ) 
 
 inhabitants, during thefe feafons, have ge- 
 nerally a pale yellowim cart, occafioned by 
 the prevalence of bilious fvmptoms. They 
 have very little of the bloom and frefhnefs 
 of the people in the northern ftates." 
 
 The plague, which often rages in Egypt, 
 appears, upon good authority, to be occa- 
 fioned by iimilar cauies. " En Egypte ou' 
 " la pefte eft trois, ou quatre mois l'annee, 
 " a, caufe des difbordmens duNil. Leur 
 " mauvais effet, fe fait furtout fentir, 
 " quand un vent chaud& humide, foutfle, 
 " ou bein quand el eft mele avec des 
 " vapeurs corrompues." The effect of 
 low iituations, attended with moifture, in 
 producing fever, is well illuftrated in the 
 following detail : — " In the year 1 748, 
 upon the breaking up of the Britiih camp 
 in Flanders, the cavalry were cantoned 
 upon the unhealthy ground., about Bois le 
 Due, and were foon after attacked with a 
 
 oral ficknefs, occafioned by a late inun- 
 dation of that part of the country. Doctor 
 
 I lorne, 
 
( 7i ) 
 
 Home, then furgeon to Cope's dragoons, 
 obferves (Differtat. Medica. Inaug. de Fe- 
 bre Remittente) that the troops fuffered in 
 proportion to their proximity to the 
 marines ; and that, universally, the nearer 
 to Bois le Due, the more violent was the 
 diftemper ; the number of fick, by very 
 accurate obfervations, being found exacllv 
 to correipond with the dampnefs of their 
 fituations and of the air. 
 
 To put the matter beyond all doubt, this 
 ingenious gentleman provided himfelf with 
 a good hydro/cope, by which he carefully 
 meafured, every day, the degree of moif- 
 ture and drynefs of the air. 
 
 Upon comparing his tables with the rc- 
 gifter he kept of the fick, he found that the 
 progrefs of the difeaie kept an exacl: pace 
 with the humiditv of the air. 
 
 On the 29th of June they left the camp, 
 and from that day to the 1 2th of July, the 
 air being dry, not one foldier was affected 
 with an ailment. 
 
 On 
 
On the evening of the 20th, the hygro- 
 meter indicated a great degree of moifture 
 in the air ; and that vcTy night the epidemic 
 ficknefs (viz. the remittent fever) began 
 among the troops, three dragoons of Cope's 
 regiment being ieized with it. 
 
 During eight days afterwards the air 
 continued extremely moift, and the num- 
 ber of the Tick was proportionably increafed. 
 The ten following days being dryer, the 
 number of the infected vidbly diminimed : 
 but two very moift davs fuccecding, the 
 patients were again greatly increafed. 
 
 In a word, the fame quality of the air 
 which differently affected the inftrument, 
 did alfo, every day, in like manner, affeel: 
 the health of the men. 
 
 Sir John Pringle, on the difeafes of the 
 army, has alfo the following oblervations. 
 Speaking of the difeafes of the low and 
 marfhy parts of the Netherlands, which are 
 derably to the northward of our filia- 
 tion; " It is to be remarked, (fays he) 
 
 that 
 
( n ) 
 
 that the ficknefs never begins till the heats 
 have continued fo long as to give time for 
 putrefaction, and evaporation of the water ; 
 the commencement, therefore, of the epi- 
 demics, may be dated from fome time in 
 July, or the beginning of Auguft, under 
 the canicular heats ; their fenlible decline 
 about the falling of the leaf; and end when 
 the froft begins." 
 
 Speaking of the garrifon of Ghent, he 
 obferves, — " The battalion of the guards 
 was a remarkable inftance of the difference 
 of quarters : two of its companies were fta- 
 tioned on St. Peter's hill; the remaining 
 eight in the lower part of the town, in 
 rooms fo very damp, that the men could 
 hardly keep their fhoes and belts from 
 moulding. In the month of July, the fick 
 of this one battalion amounted to about 
 one hundred and forty ; of which number 
 only two men belonged to the companies 
 on the hill, and all the reft to thofe in the 
 lower town. But in the middle of Auguft, 
 K upoi; 
 
( 74 J 
 
 upon changing the ban. , the lid: 
 
 .ill' abated," 
 
 ( lu any thing (hew more iatisfacionlv, 
 
 than this limit description of Sir JohnPrin- 
 
 gle, the unfailing influence of Situation > in 
 
 determining: the extent of diieafes under 
 
 . ul;ir ennititutions of the atmofphcrc : 
 And might not any one tuppofe, that Doc- 
 tor Home's hydroicopical observations were 
 made in New -York, during the prevalence 
 of the late epidemic ? For my part, I can- 
 not refrain from comparing Broadway, and 
 the higher fituations of New-York, to St. 
 Peter's hill ; and the upper end of Water- 
 ftreet, to the lower part of the city of 
 Ghent. 
 
 It is a facl, then, well eftablifhed, that 
 while an epidemic has raged among the 
 inhabitants of flat and low fituations, thole 
 who have liv d DO high grounds, in the 
 
 hbourhood, have not, in the Smalleir. 
 
 felt its influence : but they need 
 
 onl) 1 to the low ground, and they 
 
 will 
 
( 7$ ) 
 
 will there ficken in common with the in- 
 habitants. 
 
 If the preceding circumftances are con- 
 sidered, they afford a fufficient explanation 
 why the effecls of the late epidemic were fo 
 partially felt by the inhabitants of this city. 
 
 It will be proper to remark here, that 
 the epidemic of lafr. year is not a new dil- 
 cafe. It is eftablimed upon refpeclable 
 authority, that a diforder, in every refpeel 
 iimilar to the one which made its appear- 
 ance in this citv in Tulv laft, and in one 
 inftance attended with the f)mptom of 
 black Vomiting, occurred in Water-ftreet, 
 in the neighbourhood of Dover-flreet, four 
 or five years ago, and more or lefs every 
 year lince; and was particularly confined 
 to that part of the cit\ I but being unaided 
 by a particular ftate of the air, and under 
 the influence, perhaps, of exciting caufes 
 of a lefs active nature, it was neither fo ge- 
 nerally felt, nor fo fatal in its operation. 
 
 Agreeably to this opinion is the declara- 
 tion 
 
( 76 ) 
 
 tion contained in a letter we before have 
 had occafion to quote ; the author of which 
 obierves, — 4i I am convinced that the dif- 
 H order has originated from local caufes, 
 M becaufe it has appeared in this quarter 
 " of the city, at the fame feafon, for feveral 
 " years paft." 
 
 Nor has this difeafe been confined to 
 New-York. It is a facl beyond contro- 
 yerfy, that during the warmer parts of the 
 year 1795, a fever, in all effential circum- 
 ilances refembling the epidemic of this 
 place, appeared in many places in this ftate 
 and in the ftate of Connecticut. The fame 
 caufes, we fhould naturally expect:, would 
 produce fimilar effects. Accordingly, we 
 have it upon the evidence of feveral very 
 refpectable charadters, that a peculiar con- 
 ftitution of the air, the fenfible qualities 
 of which were excejjive heat and moijiure, 
 was generally prevalent. This ftate of the 
 atmofphere, operating with the exhalations 
 arifing from the decompofition of dead 
 
 animal 
 
( 11 ) 
 
 animal and vegetable matters, in low and 
 damp (ituations, were a frequent caufe of 
 bilious remitting fever. 
 
 In confirmation of this truth, we are 
 fortunate in being enabled to prefent our 
 readers with the following interefting 
 communication from Doctor Williams. 
 
 * Philadelphia, i gth Dec. i 795. 
 c Sir, 
 * As near as I can recollect, there are at 
 f Whitehall, formerly called Skeenfbo- 
 *, rough, about two hundred and eighty fa- 
 c milies ; out of which, and tranfient per- 
 f fons, there died, from the hrfl of July to 
 
 * the lafl of October, about twenty of a 
 ; bilious fever. 
 
 1 In the town of Hampton, which lies 
 I fouth-eaft, and adjoining Whitehall, 
 1 containing about one hundred families, 
 r five died of bilious fever. In Weflfield 
 J and Greenfield about twenty-four died. 
 
 • two thirds of a bilious fever. 
 
 1 That 
 
( ;8 ) 
 
 ' That part of the town of Whitehall 
 ' where the deaths in general happened, 
 4 is by the fide of Wood-Creek, where 
 4 there are low marfhy grounds and dead 
 4 waters. New comers to this place are 
 
 * commonly attacked with bilious or inter- 
 ' mittent fevers. But the laft year, by 
 ' reafon of continued hot and drv weather 
 
 * fucceeding an uncommon Wet fpring, 
 ' fome of the old fettle rs were lrkewile 
 ' attacked with thefe complaint3. 
 
 * It was obferved that the lownefs of the 
 
 * waters had expofed, more than common, 
 ' dead vegetable matter to the action of 
 4 the fun ; and thus the exhalations did not 
 ; confift of watery vapours only, but of a 
 4 putrid effluvia, arifmg from the decom- 
 4 pofition of dead vegetable matter, and 
 4 innumerable infects, which arc always 
 4 found in iuch fituations. 
 
 * About the year 1788, at the town of 
 
 * Hebern, fouth and adjoining Grenvillc. 
 - a mill was erected on a dead creek. The 
 
 4 waters 
 
( 79 ) 
 
 * waters in confequence fpread over the 
 4 flat grounds for near three miles in length. 
 
 * This caufed, in the hot feafons, a fourth 
 ' of the inhabitants adjoining this water, 
 
 * to be attacked with bilious fever. 
 
 * About fix years fince, in the town of 
 c Argyle, an obftruclion of water was 
 ' caufed as above, io that three hundred 
 ! acres of land were overflowed. This oc- 
 
 * caiioned, the firfr. year, flight bilious and 
 ? intermitting fevers. The fecond year, 
 6 when part of the land before covered with 
 6 water became dry, and was expofed to the 
 ' fun, the complaints became putrid in their 
 - tendency, and numbers died. The ob- 
 ' ftruclion, the following winter, was re- 
 8 moved, and the place again became heal- 
 i thy, and lb remains. 
 
 ' It is to be remarked, that the laffc fum- 
 '- mer produced more ficknefs than was ever 
 1 known in that country, except in the 
 
 * year 1788; when, at the latter part of 
 i July, there happened a great flood, which 
 
( Bo ) 
 
 '■ was followed by a great drought. The" 
 1 heat of lalt fummer was acknowledged 
 4 by all to have been much greater than in 
 ' former fcafons. The water of Saratoga 
 4 lake, in Saratoga county, was very low, 
 1 and the colour exceeding green. 
 
 ' From Lanfingburgh, northerly, along 
 
 * the banks of the river Hudfon, the in- 
 6 habitants were generally attacked with 
 ■ bilious fever; moft of which, without 
 c timely care, became putrid. At Schoch- 
 4 ticook, a town about a mile to the eaft of 
 4 Hudfon river, and upon the banks of Ho- 
 ' fack river, heretofore healthy, the inha- 
 6 bitants were generally attacked with bi- 
 6 lious fever, and fome died. 
 
 * Although I have attended numbers, 
 ' and frequently remained days and nights 
 6 with the fick, I never felt any bad effects 
 ' from it. But I have obferved, that, if the 
 6 nuries came from iituations not fo much 
 
 * expofed to bilious complaints, it was not 
 '• uncommon for them to be taken fick. 
 
 1 I am, &rc. &c^ 
 The 
 
( 8i ) 
 
 The exiitence of a bilious remittent 
 Fever, refembling the late epidemic of this 
 place, at a diltance from the city, is further 
 confirmed by the teftimony of a gentleman, 
 of high eftimation, and exteniive practice 
 in his profeflion, in the city of Hartford, 
 in the ftate of Connecticut, who writes, 
 in a letter to Doctor Wright Poft, dated 
 January 12th, 1796, as follows: — 
 
 ' This epidemic (the dyfenterv) was by 
 ■ no means a partial one ; it fpread over the 
 ' whole city, and continued until about 
 ' the beginning of October, when it gave 
 1 way to the introduction of the bilious re- 
 4 mittent, which has, as yet, fcarcely left 
 ' us, though for a month or fix weeks paft, 
 ' the cafes have been few and trifling;- 
 1 This, although not (6 prevalent as the 
 1 dyfentery, fpread over particular parts of 
 ' the town, and many of the cafes were 
 ' obftinate and lensthv. 
 
 4 The weather, especially in Auguft and 
 
 • September, while the dyfentery prevailed, 
 
 L ' was 
 
( fc ) 
 
 4 was very lingular, foch as is without a 
 1 limihr inftance in the recollection of the 
 4 oldeft: perfons ; I mean particularly as it 
 1 lcfpceled the deluging rains, which fell lb 
 4 frequently in the courfe of thefe two 
 6 months. Every two or three days, a 
 ' fall of rain, which generally laded about 
 
 * fix hours, would deluge the whole coun- 
 
 * try ; infomuch that mod of the vegeta- 
 
 * bles, plants, grafs, &c. in the vallies, 
 ■ where vegetation was much the moft 
 4 rapid, were killed and lwcpt away, or rc- 
 1 mained among ftagnant waters. In many 
 4 places the air became highly orTeniive, 
 ' and wholly unfit for refpiration. Thefe 
 ' heavy rains were fucceeded, almoft 
 4 without an exception, by uncommonly 
 
 * hot funs; hence the whole atmolphere 
 4 was impregnated with exhalations, from 
 
 * putrid vegetables, and more efpecially in 
 4 the neighbourhood of rivers and vallies. 
 
 4 The effect of local fituation was par- 
 4 ticularly obfrrvable in this place; I mean 
 
 4 as 
 
( 8 3 ) 
 
 * as it refpeels the bilious remittent. 
 4 Between our front ftreet and the river, a 
 
 * distance of about forty rods, the ground 
 
 * is much lower than on each fide. This 
 ' extends about half a mile in length, with 
 c feveral interruptions, by fheets being 
 4 built acrofs it. It was about this place, 
 i and on the banks of a little river which 
 \ runs through a part of the town, that this 
 1 difeafe was moftly confined; and this I 
 [find ivas generally the cafe in the mofi 
 ' fickly parts of the fiat e, 
 
 1 I will relate to you the fituation of one 
 1 family, which was the mofr. remarkable 
 ' of the whole. Some time in the month 
 4 of September, I was called to vifit a young 
 ! man, about eighteen years old, in a fami- 
 ' ly in the fkirts of this town. He was 
 1 violently attacked with moft of the cha- 
 4 racleriftic fymptoms of the yellow fever, 
 \ as deicribed by Rufh. The next day a 
 \ fecond was taken in the fame manner; 
 \ and on the morning of the third day, 
 
 * three 
 
( 84 ) 
 
 * three more were taken lick. This led 
 1 me to iiifpecl fome particular caufe. I 
 
 * fearched for it in vain at that time. The 
 ' next morning, on palling through the 
 ' kitchen, I fmelt fomething that was very 
 ' offeniive, which none of the family had 
 6 noticed. On opening the cellar-door, I 
 4 found that it proceeded from the cellar. 
 
 * Two perfons went down to examine, 
 ' and found in one corner of a imall tight 
 
 * room, a quantity of June cabbages, on 
 ' which the fun had fhone about three 
 « hours in the day. They had rotted, and 
 6 funk down into a lump of putrefaclion. 
 ' They run a flick under them, and lifted 
 
 * them up, and there immediately iflued 
 
 * fuch an intolerable irench, as obliged 
 
 * them inftantly to leave the cellar. A 
 
 * vomiting was brought on at once, which 
 ' lafted them near!) an hour. Notwith- 
 
 * ftandin<r that the doors and windows of 
 ' the cellar were thrown open, it was two 
 ' days before they could clear it out. No 
 
 ' other 
 
( »S ) 
 
 * other perlbn in the family was taken 
 4 afterwards, and thofe who were already 
 ' feized, all recovered. 
 
 ' Here was the fame difcafe, excited by 
 i the fame caufe which produces it elfe- 
 
 * where, and that caufe detected. Why 
 w may we not fuppofe, that if this circum- 
 4 itance had taken place in a thickly inha- 
 ' bited neighbourhood, prepared by predif- 
 1 pofition, and aided by all thofe caufes 
 i which generally exift. during the hot fea- 
 1 fon, in populous places, that it would 
 6 have fpread with the fame rapidity it 
 
 * did in New-York or in Philadelphia ? I 
 { confefs the conjecture appears to me a 
 4 rational one, and ought, at leaft, to ex- 
 fc cite our attention.' 
 
 We cannot forbear to remark on the 
 facls contained in the above letters, how 
 analogous the circumftances were, under 
 which the bilious fever arofe in different 
 parts of the country : and by comparing 
 thefe facls, more efpecially as they relate 
 
 to 
 
( S6 ) 
 
 "ie citv of Hartford, with what hap- 
 d in this place, we ice a very (Irons 
 analogy indeed. Now, were it neceflary 
 to inlarge any further upon the iubjeft of 
 imported contagion, we might, with great 
 propriety, adduce the exigence and preva- 
 lence of a fever at Hartford, and efpecial- 
 k in the family fo particularly mentioned, 
 the fame as our late epidemic, which no 
 one ever entertained a fufpicion to have 
 arifen from any caufes than thofe perfect- 
 ly local. 
 
 It would be difficult to afcertain with. 
 accuracy, what proportion the different 
 defcriptions of people bear to one another, 
 who were attacked with the late epidemic 
 (c\er. It mav be taken for granted, how- 
 ever, upon the teftimony of thole whofe 
 opportunities bed enabled them to judge, 
 that the number that were taken fick, 
 living on the new made ground, particu- 
 larly at the fouth fide of the city, and in 
 other low places, compared with thoie 
 
 refidine 
 
( 8 7 ) 
 
 refidine in more elevated durations, may 
 be computed as twenty to one; and if we 
 were to make a calculation of the number 
 of inhabitants who died, compared with 
 viiitors, or tranfient perfons, we might fay 
 five of the latter to one of the former. 
 
 This difproportion may be accounted 
 for: firftlv; viiitors, efpeciallv thole from 
 the northward, where the air is generally 
 purer, are more fufceptible of an epidemic 
 influence than the inhabitants, who are 
 accuftomed to the circumftances of their 
 duration : for there cannot remain a doubt, 
 that the human conftitution acquires, by 
 habit, the power of refilling, to a certain 
 degree, the effects of thofe caufes which 
 have a tendency to produce difeafe. 
 
 We find this fact particularly noticed by 
 moft writers on the bilious or yellow fever, 
 which fo commonly makes its appearance 
 on board the (hipping in the different har- 
 bours in the Weft-Indies. It is defcribed 
 as moft fatal to thofe lately from the north- 
 ern 
 
( 83 ) 
 
 ern latitudes. So, in New-York, the firfl 
 appearance of the fever was on board the 
 fhip William, from Liverpool, the 2sth 
 of July, four of whole crew died. On the 
 26th of July the fever appeared in the (hip 
 Connecticut, from Liverpool : fhe alio loll 
 four of her men. Thele velTels, it mud: be 
 remarked, laid at the wharfs in front of 
 that part of Water-flreet, where the dif- 
 eale firfl appeared among the inhabitants. 
 Their men, without doubt, were frequently 
 on fhore, and having lately arrived, were 
 more fufceptible of the caules producing the 
 fever, than the refidents of that lituation, 
 who had become gradually habituated to 
 its action. 
 
 The men of many other veiTels from 
 the northward, which were itationed at 
 different wharfs in the eafl river, felt more 
 or lefs the effects of the epidemic influ- 
 ence : whereas the crews of thofe vel- 
 fels which arrived during the furomer 
 months from the Weft-Indies, and other 
 
 warm 
 
( »9 ) 
 
 Warm latitudes, all remained well ; and 
 iuch individuals among; them as had been 
 rick on their pafTage, recovered very foon 
 after their arrival in this harbour. 
 
 Secondly ; of the vilitors who were feiz- 
 ed with the epidemic fever, a great propor- 
 tion were emigrants from England, Ireland 
 and Scotland ; and they were more expofed 
 to its effects from the very crouded and 
 confined fi tuations in which they were 
 unavoidably placed. 
 
 The miferable condition of that clafs 
 of unfortunate people, is well mown in 
 a candid and very interefting communica- 
 tion from the Rev. Mr. O'Brien, paflor to 
 the Catholic congregation in this city, from 
 which the following is an extract : — 
 
 ■ As loon as the above caufes had pro- 
 ' duced their malignant effects in the part of 
 ' the city which was previouily difpofed to 
 ( receive them, I was conftantly employed, 
 4 infomuch that I might with fome truth 
 ' lav, that I lived in the centre of thedifeafe; 
 M . ' and 
 
( 9° ) 
 
 and for nearly two months, never laid iri 
 bed one whole night. I found in molt pla- 
 ces, a total want of ever) nccellary of life. 
 Numbers of poor fufFerers, confined in 
 fubterraneous apartments, which admit- 
 ted no light, but from their hatch-doors ; 
 io that when (hut down at night, it might 
 literally be faid of them that they were 
 buried alive. In the progrefs of vifiting 
 thc fick, I was much difnifted at the abo- 
 minable, uncleanly ftate of their mifera- 
 ble habitations, and a total want of ne- 
 ceflaries : for in mod places, they had 
 not even a ftool to fit on, nor a bed to lie 
 upon. On inquiry, I found the much 
 greater part of them to be emigrants of 
 that very fummer; infomuch that out 
 of four hundred and fixty-two of my con- 
 gregation, who funk under the ditorder, 
 nineteen twentieths were totally un- 
 known to me.' 
 
 To this deplorable condition of the poor 
 emigrants who arrived in this city during 
 
 the 
 
( 9' ) 
 
 the prevalence of the epidemic fever, is 
 to be afcribed, humanly fpeaking, the ex- 
 tent of its mortality. It is a circumftance, 
 moreover, well known to many, that 
 numbers of them were obliged to remain 
 on board fhip for fome time after their ar- 
 rival in this port, as well from their want 
 of means to procure comfortable lodgings, 
 as from the very crouded ftate of the city ; 
 and at laft they exchanged their confined 
 holds for thofe fubterraneous apartments 
 which have juft been fo emphatically de- 
 fcribed by Mr. O'Brien. This may account 
 for the fact, that out of nearly eight hun- 
 dred perfons who died, not more than one 
 hundred and fifty were citizens of New- 
 York ; and of this number but a fmall pro- 
 portion until the difeafe had prevailed a 
 confiderable time, perhaps one half during 
 the laft. four weeks. 
 
 If the above ftatement be true, what a 
 leiTon does it convey, as well to the peo- 
 ple as to the magiftracy ! Ought it not 
 
 to 
 
( m ) 
 
 to infpire the citizens with a proper degree 
 of confidence, and Simulate thofe who 
 have the regulation of our city police to 
 adopt fuch meaiures as are within their 
 authority, in order to obviate, as far a~. 
 pofTible, the fatal effects of another vifita- 
 tion ? 
 
 I fhall now difmifs this part of the 
 fubje6l, in order to lay before my readers 
 the fymptoms which ferved to characler- 
 ize the fever in queftion, as far as they 
 came under my obfervation. 
 
 The firit and the mod: conftant of thefe, 
 as well as the moft fevere, was a pain ordi- 
 narily fixed in the fore part of the head ; 
 and this was ufually attended with a dif- 
 fuicd rednefs of the eyes, and a pain in 
 the back. Thefe fymptoms have been 
 known to exift, in a moderate degree, feve- 
 ral davs previous to the attack of fever. 
 
 A fenfe of eoldnefs did not always take 
 place at the beginning of the fever; and 
 
 much 
 
( 93 ) 
 
 much lefs frequently was any thing like 
 rigors experienced. The lofs of ftrength, 
 alio, in the beginning, was very variable. 
 Many did not complain of any particular 
 weaknefs; whilir. others felt fo great a 
 degree of proftration, as to be unable to 
 fupport themfelves. 
 
 The patients fomctimes complained of 
 a general forenefs of the muicles, and 
 particularly thole of the thighs and legs ; 
 and in fome this affecf ion continued a trou- 
 blefome iymptom. 
 
 It did not frequently happen that the 
 ftomach was much affected at the com- 
 mencement of the difeafe ; yet inftances 
 occurred where the fever was ufhered in 
 with great ficknefs, frequent retchings to 
 vomit, opprerlion and pain about the prae> 
 cordia, with exceflive anxiety and reflleiT- 
 nefs. 
 
 The tongue often at firfl appeared na- 
 tural, but it mod commonlv looked white. 
 After the fever had continued fome days, 
 
 the 
 
( 94 ) 
 
 the n : collected upon its furface, at- 
 fumed a brown colour, but continued moiit, 
 At length it became dark,fometimes black, 
 dry, and rough. 
 
 The pulfe was generally frequent at the 
 beginning of the fever, but varied, as to 
 fulnefs and Strength, according to the ha- 
 bit and conftitution of the patient. ]t 
 Sometimes happened, after the fever had 
 made confiderable progrefs, that the pulfe 
 remitted, and was commonly a iymptom 
 of great danger. A rare pulfe, alio, was 
 in fome inftances met with. In a bov 
 who had had the fever fix or feven da\>, 
 and in whom the number of pulfations 
 in a minute had been, for the moil part, 
 about one hundred and twenty, the fre- 
 quency was fuddenlv diminished, and did 
 not exceed fifty-five Strokes in a minute. 
 In this State thev continued, with very 
 little variation, for two days, while the pa- 
 ; appeared to be getting well. The 
 pulfe then Suddenly became as frequent 
 
 as 
 
( 95 ) 
 
 as before, and two davs after the acceffion, 
 he died. It happened alio in the inftance 
 of a gentleman, whofe attack was very- 
 violent ; whofe pulfe was frequent, full, 
 and ftrong, and who had been freely and 
 repeatedly bled ; that after eight days, the 
 number of pulfations we're reduced be- 
 low the ufual ftandard, and lccmed to 
 be attended with a o-eneral change for the 
 better. Thefe appearances, however, 
 were fallacious : a recurrence of violent 
 fymptoms foon put a fatal termination to 
 the difeafe. The fame circumftance we 
 find taken notice of by Doclor Hunter 
 and others. 
 
 Yellownefs of the fkin was by no means 
 a conftant concomitant of the difeafe. 
 Sometimes it appeared partially about the 
 face and neck ; at other times a little tino-e 
 of the eyes was the only yellownefs to be 
 obferved. In fome inftances it made its 
 appearance about the third day, but more 
 commonly not until the fifth, fixth, or fe- 
 
 venth 
 
96 ) 
 
 venth dav. When it came on early, it 
 was generally attended with violent lVmp- 
 tonis, and denoted danger: and yet pa- 
 tients recovered, whole ikin was univer- 
 ially as yellow as faffron. 
 
 The temperature of the Ikin varied very 
 coniiderablv. Ih ibme cafes it was hot 
 and dry, and communicated a very difa- 
 greeable fenfation to the touch. In others 
 it wab moid: and cool from the firft. attack, 
 and continued fo during the difeafe. 
 
 Although the fever frequcntlv ran high, 
 it was feldom attended with much thirft ; 
 except in fome few cafes, where it was 
 difficult to fatisfy the demands of the fick 
 for drink. 
 
 When the pain in the head was very 
 confiderable, the eyes were comrhonly a 
 good deal inflamed, fulfil fed with tears, and 
 verv impatient of light: and it now and 
 then happened, that the patients com- 
 plained of a fenfation, as if the eves were 
 endeavouring to efbape from the lockets. 
 
 The 
 
( 97 ) 
 
 The refpi ration was feldom much af- 
 fected at the beginning. On ibme occa- 
 sions, however, it was difficult, attended 
 with a fenfe of fulnefs in the chefr, which 
 was fometimes a caufe of great anxiety, 
 and frequent deep fighing. Doctor Hunter 
 obferves, that " there is no difficulty in 
 " diftinguifhing thofe fymptoms from la- 
 " borious refpiration, that depends upon a 
 " local affection of the lungs. In the lat- 
 l* ter the difficulty of breathing is uniform ; 
 " whereas, in the former, both the expira- 
 " tions and infpirations will, for two or 
 " three times, be natural and eafy, and 
 " immediately* after become laborious and 
 " unequal, and fo on, alternately.'* 
 
 The urine, in general, underwent very 
 little chanoe. It was fometimes a little 
 incrcafed in quantity, and at other times ra- 
 ther diminifhed. But in thole cafes where 
 the lkin became yellow, the urine put on 
 that dark brown appearance which is com- 
 N mon 
 
( 93 ) 
 
 mon in diftufions of bile. In fome in- 
 frances of black vomiting, and in two or 
 three cafes, previous to the occurrence of 
 that iymptom, the urine became exceed- 
 ingly turbid, and dcpolitcd a dark coloured 
 matter. 
 
 Thefe were the ordinary train of fvmp- 
 toms, which attended the fever, we have 
 endeavoured to defcribe; and though in 
 particular cafes, no doubt, fome deviations 
 might be noticed, yet it is believed there 
 were none which could be thought to af- 
 feci eflentially the character of the difeafe. 
 
 In the treatment of the late epidemic 
 fever, my nrft care was to have the pa- 
 tient placed in a room as large, and well- 
 ventilated as poffible. The advantages 
 arifing from an attention to this part of 
 practice, rnufr. appear obvious to all who 
 reflect, that while a caufe which may have 
 produced a difeate continues to act, or 
 while circumftances exift, which tend 
 very much to aggravate the fymptoms, the 
 
 efficacy 
 
( 99 ) 
 
 efficacy of our remedies is rendered, if not 
 of no avail, at leaft extremely doubtful. 
 
 When the patient was placed in a fitua* 
 tion as eligible as could be procured, the 
 leading object was to evacuate the ftomach 
 and bowels. If this important point could 
 be effected at the hrit attack, it was often 
 found to cut fhort the courfe of the difeafe : 
 and when it did not do this, it for the moft 
 part rendered the iiibfequent fymptoms fo 
 moderate, that they more readily yielded 
 to the means of art. 
 
 In general it was not thought of much 
 confequence, what purgative medicine 
 was ufed, except in inftances where the 
 ftomach lhewed iigns of particular difor- 
 der. A folution of falts and manna, in 
 fuch dofes as circumftances feemed to in- 
 dicate, was very commonly prefcribed. 
 In moll: cafes it fat eafy upon the fto- 
 mach ; and even when the firft dofes were 
 rejected, by perfevering in its ufe, it final- 
 ly palled downwards, and, upon the whole, 
 
 was 
 
( 1°3 ) 
 
 was found to operate with more certainty 
 and erTecl, than any other medicine. 
 
 The bowels being emptied, with falts 
 and manna, it was thought expedient to 
 continue the evacuation in a moderate 
 degree ; and for this purpofe, a folution of 
 manna and cream of tartar was employed, 
 fo as to produce its effecl three or four 
 times a day. This was a favourite medi- 
 cine. It was found not difasreeable to 
 take, and generally remained upon th<- 
 ftomach, without producing any fickncls 
 or other uneafinefs. When the difeafe 
 was extended beyond the fixth or feventh 
 day, and purgatives were indicated, there 
 was -a manifefr. advantage derived from 
 equal parts of rhubarb and magnefia, in 
 mint-water, over any other medicine, 
 given in fmall and repeated dofes ; or a 
 ftrong watery infufion of rhubarb, with 
 the addition of a little manna, and fp. 
 lavend. comp. to render it agreeable to the 
 tafle. Thefe medicines anfwered the pur- 
 pofe 
 
pofe of gentle aperients, whilft they in-, 
 duced no debility by their operation. 
 
 If jalap and calomel were prelcribed at 
 the beginning of the complaint, it was 
 ieldom thought neceffary to repeat them. 
 To preferve the bowels foluble, a folution 
 of manna and cream of tartar was found 
 better to anlwer the intention. 
 
 When a diibrdered ftomach did not ap- 
 pear among the primary affections, but, on 
 attempting the ufe of purgatives, they were 
 thrown up again, a few grains of ipecacu- 
 anha, with a free ufe of camomile tea, has 
 fometimes emptied the ftomach to advan- 
 tage. After allowing the ftomach to red: 
 a few hours, purgatives could then be 
 employed with the ufual fuccefs. 
 
 A difordered ftomach, with frequent 
 retchings and efforts to vomit, was now 
 and then met with at the be^innins; of the 
 fever, and fometimes, with other matters 
 thrown up, there was an appearance of 
 bile. Glyfters, frequently repeated, very 
 
 common iy 
 
( I02 ) 
 
 commonly moderated this fvmptom. CK - 
 cafionally an infufion of camomile, or, 
 where the patient preferred it, warm wa- 
 ter, was ufed to cleanle the ftomach ; and 
 as foon as there was a probability that the 
 ftomach would retain it, recourfe was had 
 to the purgative Ablution. 
 
 When a {enfe of weight and oppreflion 
 at the ftomach, a tendernefs or forenefs 
 of the praecordia upon prelTure, a vomiting 
 of a bilious matter, of a dark poracious 
 appearance, extreme reftleftnefs, a dejec- 
 tion of fpirits, were met with among the 
 primary fvmptoms, the cafe wore an a- 
 larming afpecl, and called for the utmoft 
 flail and exertions of the phyfician. To 
 allay the vomiting, frequent glyftcrs, and 
 the application of a blifter to the region 
 of the ftomach, were found moft effectu- 
 al ; and to thefe was added the occafional 
 ufe of eftervefcinor draughts. If this me- 
 thod did not fuccccd, the feet and legs were 
 wrapt in large flannel cloths, wrung very 
 
 dry 
 
( I0 3 ) 
 
 dry out of hot water. This expedient, by 
 relaxing the veffels on the furface, and in- 
 ducing perfpiration, ibmetimes relieved the 
 diftreffing iymptoms juft enumerated. 
 
 When the vomiting; could not be fub- 
 dued, the patient at length threw up 
 a dark coloured matter, refembling the 
 grounds of coffee, and fometimes little 
 dark coloured flakes were found mixed 
 with it. To this arYeclion of the ftomach, 
 lucceeded coldnefs of the extremities, with 
 a livid appearance of the hands and fect^ 
 intermitting pulle, exceffive anxiety, op- 
 nrefiion about the region of the ftomach, 
 and hiccough, with difficult and laborious 
 reipiration. Theie fymptoms continuing 
 in a high degree, commonly indicated the 
 near approach of death, which was feldom 
 protracted to more than two or three days. 
 I am happy to add, however, that there 
 were not wanting inftances of the recovery 
 of pcrfons who had laboured under black 
 vomiting, accompanied with all the diftref- 
 
 fine 
 
( '<H ) 
 
 fmg iymptoms peculiar to this ftage of the 
 difeafe. 
 
 It likewife happened during; the pro- 
 grefs of the foregoing iymptoms but at no 
 certain period, that a haemorrhage took 
 place from the nofe, mouth, or gums, and 
 lometimes from all three lourcea at once. 
 In one inftance, a friend of mine inform- 
 ed me, that the blood trickled from the in- 
 ternal parts of the ears. But in the courfe 
 of my vifiting the fick, I feldom met with 
 considerable haemorrhages, that the ap- 
 plication of ice to the bleeding veifels, or 
 to the neighbouring parts, did not moft 
 certainly check the discharge. 
 
 The fevere train of fymptoms above 
 enumerated, according to my obfervation, 
 generally occurred in what might be called 
 the fecond ftage of the difeafe, and fome- 
 times after a free ufc had been made of 
 the lancet. 
 
 At the firft of my attendance upon the 
 epidemic fever, I was impreffed with an 
 
 idea 
 
( "05 ) 
 
 idea that an early recourfe to the bark was 
 efTentially necefTary to the fuccefsful treat- 
 ment of it. Under the influence of this 
 opinion, after the contents ot the ftomaeh 
 and bowels were carried off, I directed the 
 bark to be ufed, either in powder, decoction, 
 or the cold infuiion, as circumftances ap- 
 peared to indicate. In every inftance it was 
 found to difagree with the firit pafTages. In 
 lome it occanoned a fulnefsand ilraightnefs 
 about the praecordia : in others it offended 
 the inteftines, producing a fulnefs and fore- 
 nefs in the abdomen : whilft in others it. 
 excited the fyftem, increafed the head-ach, 
 and brought on an accefiion of fever. Nor 
 did I ever lee the bark do good, until an 
 entire folution of the dlfeafe took place. That 
 it might not have been beneficial, I fhall 
 not ailert. If, however, an opportunity 
 of a limilar kind unfortunately occurs, I 
 fhall pretcribe it, under particular circum- 
 llanccs, in a manner very different from 
 that in which I have before uied it. 
 
 O The 
 
( io6 ) 
 
 The bad effects of the bark, which fo 
 invariably followed the uie of it, under 
 m\ direction, were commonly removed 
 In the ofe of purgatives. Whilft the pa- 
 tient was taking laxative medicines, I 
 made it a common practice to give freely 
 of ip. minderer. and evidently with good 
 cffecls. 
 
 If the heat and fever were confiderable, 
 and the ftomach retentive, imall doles of 
 antimonials, particularly James's powder, 
 ibmetimes joined with camphor, were 
 found uieful. The fp. minderer. alio, was 
 a ufeful medicine in this ftate of the 
 difeaie. 
 
 The diaphorefis which it commonly in- 
 duced afforded great relief, and general- 
 ly brought on a remiflion, if not an in- 
 termiffion of the fever. When a free 
 perl pi ration took place on the fecond or 
 third day, it was confidered as a favoura- 
 ble event, and denoted a happy termina- 
 tion of the difeafc. But fweatingj did not 
 
 o 
 
 always 
 
( io 7 ) 
 
 always prove ferviceable. Inftances hap- 
 pened, where this evacuation was pro- 
 fufe from the firft attack, without ieeming 
 to benefit the patient in any degree. 
 When it came on thus early, the tempera- 
 ture of the fkin generally, and particularly 
 of the extreme parts, was lo altered as to 
 communicate a confiderable fenfe of cold 
 to the touch. 
 
 With reipecl to calomel, which many 
 have piefcribed with that freedom and 
 conftancy, as if it poffeiTed ibme fpecific 
 qualities, I can fay little from my own ex- 
 perience. I never could induce my mind 
 to believe that it poffeffed any advantages 
 over many other purgatives ; and from the 
 account given of its effects by lbme of 
 my friends, I am dilpoled to favour a be- 
 lief that its operation, as a purgative, was 
 very limited. It produced frequent ftools, 
 but the quantity difcharged was very fmall ; 
 and during the ufe of it, the patient fre- 
 quently complained of a fenfe of fulnefs 
 
 and 
 
( io8 ) 
 
 tion in different regions of the 
 
 abd ere commonly 
 
 the more copio cua- 
 
 tions procured by either of the purgative 
 
 lutions before mentioned. That calomel 
 has nothing fpecitic in its nature, fdems 
 piv. evinced by thol in 
 
 which it has been taken as a preventive. 
 Inftances of this fort were not unfrequent 
 during the prevalence of the late epidemic 
 in this city. But the fever was known to 
 attack perfbns under the influence of this 
 medicine; while others, who did not take 
 mercury, and were living precifely under 
 the fame cirCumftancesj have efcaped the 
 difeafe. 
 
 Three perfons out of four, of the fame 
 , had taken mercury for fome time, 
 with a view to guard themfelves agajnft 
 the but they were, notwithftandi, 
 
 feized with the epidemic. In one, a fali- 
 vation had been produced, and in this 
 fituation, he was attacked with fever. 
 
 As 
 
( io 9 ) 
 
 As foon as the fever came on, from a 
 conviction that the mercury had not been 
 of any fervice to him, he omitted the rife 
 of it, and with the aililtance of mild pur- 
 gatives, loon got well. The fourth per- 
 fon, who had not taken any calomel, and 
 who nurfed the other three, cfcaped the 
 difeafe. 
 
 A number of other inilances might be 
 mentioned, in which calomel had been 
 taken as a preventive, where the perfons, 
 notwithstanding, took the difeafe. 
 
 In the management of the late epidemic, 
 the cold bath was frequently reforted to. 
 As a general application, I can fay no- 
 thing of it from my own observation. I 
 have been, indeed, in the habit of wafhing 
 the hands, arms, face, neck, and breaft, 
 with cold vinegar and water, in cafes of 
 fever, and always found it a very grateful 
 refreshment to the patient. I according- 
 ly employed it freely, and as exteniively 
 as conveniences would allow. But 1 know 
 
 that 
 
( M° ) 
 
 that the general bath was alio employ 
 fur the Late fever, with great advantage, 
 but Under what particular circumftan 
 I cannot fpeak with prcciiion. Doctor 
 Charlton, of this city, a phylician of much 
 experience, who had in many infhmces 
 
 itneded its good effects, favoured me 
 with the following communication : " I 
 " experienced the happieft effecls from 
 M cold bathing, in a variety of cafes. I ufed 
 " river-water, and had the patient placed 
 M in a large tub, and a couple of pails-full 
 M thrown over him. It happened in one 
 " inftance only, that the patient did not feel 
 " lb much refrefhment, as to be impatient 
 " for a repetition of it. In this cafe the 
 " patient grew chilly after uiing the bath, 
 " which I thought a fufheient reafbn for 
 ". difcontinuing it. In every other infbmce 
 wt I found no method fo effectual for reliev- 
 %t ing the extreme diftrefs of the head and 
 •• ftomach, fo generally attendant on that 
 
 liieafe." 
 
 We 
 
( "" ) 
 
 We find a fimilar practice recorded by- 
 Mr. Bruce, who lavs, that the inhabitants 
 of Mafuah are fubjecl: to violent fevers, 
 which " generally terminate the third 
 " day in death. If the patient furvives till 
 " the fifth day, he very often recovered by 
 " drinking water only, and throwing a 
 " quantity of cold water upon him, even 
 " in his bed, where he is permitted to lie, 
 " without attempting to make him drv, or 
 " change his bed, till another deluge adds 
 " to the firft." 
 
 In the ufe of cordial medicines, or 
 drinks of that nature, much circumfpec- 
 tion was neceffarv. In the firft. frames of 
 thedifeafe, they were altogether inadmif- 
 iible. They were prefcribed in fome in- 
 ftances, after conliderable remifiions had 
 taken place, but manifeftly to the injur}- 
 of the fick. Even after complete inter- 
 mifiions had formed, they fometimes pro- 
 duced a ftate of excitement, which ren- 
 dered the patient's fituation much lefs 
 
 comfortable. 
 
( ki2 ) 
 
 comfortable. Thcfe obfervations appl) 
 particularly to thofe caic.-, where the rc- 
 mifi • ' '. place at an early period, or 
 
 where thcdiiealcdid not runout bevondthe 
 fifth, fixth or feventh day. When the fe\ ei 
 was of longer continuance, the debilitv it 
 induced made the ule of cordials not only 
 allowable, but particularly neceflary. 
 
 Porter, more or lefs diluted, was found 
 to agree better with the fick than anv other 
 drink of the cordial kind: but its falutan 
 effects appeared very much to depend upon 
 a liberal ftate of the bowels. When given 
 conjointly with fome mild purgative, it in- 
 creafed the ftrength, and very often fuper- 
 feded the ufe of any other tonic. 
 
 In the latter ftages of the complaint an 
 infuiion of fnake-root was alio made ufe i 
 with advantage. On mam occafions it 
 compoil-d the ftomach, iupported the 
 ftrength of the patient, without exciting 
 him, and feemed productive of very happy 
 
 Much 
 
( ll 3 ) 
 
 Much has been faid and written re- 
 specting the uie of the lancet, and the ef- 
 fecls of bleeding in this difeafe. On this 
 part of practice I ihall advance nothing, 
 but what is the reiult of experience and ob- 
 fervation. In general, the indications of 
 cure were not fuppofed to include this 
 operation ; it was, therefore, but feldom 
 had recourie to. In ibme of thofe cafes^ 
 in which the lancet was uled, the good 
 effects of bleeding were obvious, more es- 
 pecially in relieving the diitreflmg pain 
 in the head ; whereas in other instances, 
 and, where the Symptoms ieemed to ren- 
 der it peculiarly proper, it did not afford 
 the relief that was expected from it ; but, 
 on the contrary, although the quantity of 
 blood drawn was copious, and the bleeding 
 frequently repeated, the patient funk un- 
 der the difeafe. 
 
 If I were to fay in what cafes bleeding 
 
 would probably be ufeful, it would be where 
 
 the fever ieizes upon healthy, robuft con- 
 
 P ffitutions, 
 
( M4 ) 
 
 ltitutions, where the pain in the head v. 
 extremely violent, and where the eyes, (to 
 ufe a frequent expreflion of the lick) Teem- 
 ed ready to leap from their lockets, and 
 efpecially if fuch a fuhject had jujl arrived 
 from the purer and cooler air of the country. 
 In a perfon of this description, the attack y 
 and all the fubfequent fymptoms, are com- 
 monly violent indeed ; to moderate, there- 
 fore, the exceflive action of the fyftem, 
 bleeding would probably be necefTary and 
 ufeful. Under circumftances like thefe, 
 I have accordingly bled, and to good pur- 
 pofe ; but I have, previoufly to blood-let- 
 ting, directed my patient to drink freely 
 of warm water ; by which means I have 
 obferved, that not only the action of the 
 vafcular fyftem was much abated, but al- 
 io that the whole body more readily yield- 
 ed to a copious perlpiration. But if a 
 perfon is attacked with this fever, whofe 
 body has been previoufly debilitated, per- 
 haps by a fedentarv manner of living, and 
 
 from 
 
{ "5 ) 
 
 from having refided fane time in the epidemic 
 confiitution of the air, it could hardly be 
 fuppofed that the fame remedies would be 
 required as in the former inftance. 
 
 An attention to the above diftindtion of 
 caufes, as far as refpecls the remedy of 
 bleeding particularly, may be of greater 
 importance in the treatment of this difor- 
 der, than has been commonly imagined. 
 
 Opium was rarely admifiible in this fe- 
 ver, and never in the firir. ftage of it. But 
 after the contents of the ftomach and bow- 
 els were freely evacuated, and the excef- 
 five action of the ivftem moderated, the 
 ufe of it was juftiried in many inftances 
 of fuccefsful practice. Indeed, particular 
 cafes occurred, in which great irritation, 
 reftlefTnefs, and want of fleep, could by no 
 other means be fo well alleviated. When 
 given under fuch circumftances, it was 
 commonly conjoined with fome fudorific, 
 and moft frequently with fp. mind. When, 
 alio, in the advanced ftagre of the difeale, 
 
 the 
 
n6 ) 
 
 the vomiting became exceffive, opiurr. 
 adminiftered with the heft effects. 
 
 Bliiter> were occaiionally employed; 
 
 they were found moft ufeful in removing 
 local affections. If the head-ach continu- 
 ed ieverc, after free evacuations, a blifter, 
 applied between the fhoulders, often re- 
 moved the pain. When the ficknefs at the 
 flomach was great, attended with oppref- 
 iion and pain, a blifrer to the pnecordia 
 has often proved of advantage. Doclor 
 Blanc found nothing io luccet>ful in remo- 
 ving irritability of the ftomach, as a blif- 
 ter applied externally to the part. When 
 there has been a general forenefs and ful- 
 nefs of the abdomen, which has not fub- 
 iided after a free ufe of purgatives, the 
 application of a blifter has produced the 
 happieft effe&S. A friend of mine had 
 a young clergyman under bis care, whole 
 kfe, from its continuance, had become 
 verv formidable. He was covered with 
 r^etechix; his ftomach svas eafily 
 
 cited : 
 
( "7 ) 
 
 cited ; his {tools were generally of a dark 
 
 O J 
 
 colour, and fometimes black. The bark 
 had been tried, but it did not agree with 
 him. Upon examining the abdomen, 
 it was found utiiverfally tender to the 
 touch, but not painful. A large blifter 
 was applied to the affected part, the ope- 
 ration of which put an immediate check 
 to the progreis of the difeafe. His drink 
 was porter, to which water was occafion- 
 ally added ; and with the affiftance of an 
 eafy diet, fuch as iago, gruel, &c. his re- 
 covery was foon completed. 
 
 The drinks which leemed the moll: 
 grateful to the fick, and were confidered 
 as the mod proper during the fever, were 
 lemonade, water with toait in it, water 
 alone, mobiles and water, balm-tea, &c. 
 
 The diet commonly recommended was 
 iago, tapioca, panado, and occafionally 
 weak broths. The latter, however, fre- 
 quently produced uneafineis at the fto- 
 mach, which made it aeceffary to deiifr. 
 
 from 
 
( "3 ) 
 
 from their \\fe. A gruel made with 
 dian-mcal, or oat-meal, appeared, upon 
 the whole, to agree better with the lick 
 than any other food; and, in many in- 
 stances, it conftituted the whole diet and 
 drink of the patient. 
 
 The uie of animal food was uniform- 
 ly attended with bad effects ; the fmalleft 
 quantity, taken in the intermiffion, has 
 haitened the acceiiion of fever, and in- 
 creafed its violence. Even after the dif- 
 cafe had entirely fubiided, and debility 
 only remained, a too early recurrence to 
 animal food has brought on a renewal of 
 fever. 
 
 I fhall only add, that through the whole 
 courfe of the diieale, the ftricteft attention 
 was paid to cleanlinefs, efpecially to the 
 immediate removal of all excrcmentitious 
 matter. The patient's linen, bed-cloaths, 
 and often the bed itfelf, were frequently 
 changed, and the refrefhment it always af- 
 forded was a fufficient proof of its utility. 
 
 The 
 
( "9 ) 
 
 The foregoing exhibits an unvarnifhed 
 view of the hiftory of the late epidemic, 
 as far as it came under my notice ; and 
 of the practice, as far as it feemed ra- 
 tional, and was fuccefsful under my ma- 
 nagement : and I have purpofely avoided, 
 as much as poffible, all theoretical or 
 controverfial grounds. 
 
 Indeed, I have been anxious about no- 
 thing fo much as to fix upon the mind, the 
 great and obvious distinction betwixt con- 
 tagious difeafes, and thole which, under 
 very peculiar circumitances, may aflume 
 much of that character. 
 
 The utility of this diftinction is fo welt 
 ihewn by Doctor John Hunter, in his En- 
 quiry into the Nature and Caufes of the 
 Remittant Fever, that I cannot do better 
 than give his own obfervations upon the 
 fubject. " There is hardly any part of the 
 " hiftory of a difeafe (fays the Doctor) 
 M which it is of more confequence to 
 " afcertain with accuracy, than its being 
 
 " of 
 
\ 10 ) 
 
 or" an infectious nature or not. I'poii 
 tliis depends the propriety of the ileps 
 that fhould be taken, either to prevent 
 it, or to root it out. It is productive of 
 great miichief to confide r a difeafe as 
 infectious that really is not io ; it expofes 
 inch as labour under it to evils and in- 
 conveniences, which creatly aewavate 
 their fufFerings, and often deprive them 
 of the necefTarv affiftance : they are neg- 
 lected, if not fhunncd ; and at the time 
 they require the greatefl care and at- 
 tention, they have the leaft. I have 
 had occafion to obferve, that the remit- 
 tant fever, whether with its ufual, or 
 more uncommon fvmptoms, with the 
 yellow colour of the eye^ and (kin, or 
 without them, was never found to be 
 infectious. The ftrougeft proofs of this, 
 in mv opinion, were to be met with in 
 private families, where the ion, the bro- 
 ther, or the huiband, labouring under 
 the worit fevers, were nilrfed with un- 
 
 " remitting 
 
( i« ) 
 
 " remitting affiduity, by the mother, the 
 " lifter, or the wife, who never left the 
 " flck by day or by night, yet without be- 
 *' ing infected. That fuch near relations 
 " mould take upon them the office of a 
 " nurfe, is matter of thehigheft commen- 
 " dation in a country, the difeafes of which 
 " require to be watched with greater care 
 " and attention than can be expected from 
 " a fervant." 
 
 Why the late epidemic, in many in- 
 ftances during its deftructive progrefs in 
 this city, wore the dreadful afps£t of con- 
 tagion, may be gathered, in a good degree, 
 from the few following particulars, with- 
 in the knowledge of us all, viz. The 
 laft fummer, and a great part of the au- 
 tumn, were marked by an uncommon 
 degree of heat, combined with moifture. 
 The atmofphere, which, at that feafon, 
 is ordinarily loaded with the electric 
 fluid, feemed deftitute, for weeks together, 
 of this vivifying principle. The intenie 
 Q heats 
 
( ** ) 
 
 which we often experience in the 
 moons o£ Jul) and Auguft, are gene- 
 allayed In thunder and lightning, 
 and the refrefhing rain.,, which follow 
 towards the evening ; but in the feafon re- 
 ferred to, this precious relief from the lan- 
 guor induced by a verticle fun, was fel- 
 dom felt. 
 
 Now, when we reflecl: that a great ma- 
 jority of thofe who fell victims to the late 
 epidemic fever were not only foreigners, 
 but poor perfons, many ot whom had been 
 only a few weeks in the country, arrived 
 after a long voyage, and predifpofed 
 to fickneis by hard and {canty fare ; hud- 
 dled together, in a great many initances, 
 in the moft uncomfortable apartments, and 
 theie fituated in the moft unhealthy parte of 
 the city; frequently without the early at- 
 tention of a phyfician, deftitute of friends, 
 and often without the moil common com- 
 forts of life ; under fuch diftremng cir- 
 cumftanccs, notwithstanding the huma- 
 nity 
 
( I2 3 ) 
 
 nity of the citizens, were numbers placed ; 
 and what confequences, but thole which 
 followed, could reafbnably have been ex- 
 pected r* 
 
 * In the former part of this essay, we enumerated man) 
 circumstances which tended to shew, that the season of the 
 late epidemic more especially, was attended with ati •■■ 
 
 ?uc:i constitution of the air. Since these observations were 
 put together, I have been favoured with a letter from Mr 
 Gardiner Baker, proprietor of the Museum in this 
 city, who mentions several occurrences illustrative of 
 the same thing. He observes, " Books in my libra- 
 " ry, and those that were in daily use, were covered 
 " with mould. All the preserved animals in the Mu- 
 " seum, that were not contained in glass cases, were in- 
 " jured very much by the long continued atmos- 
 " pheric moisture, and some of them quite spoiled; parti- 
 " cularly a very finely preserved butfaloe, which had, in 
 " fhe course of twelve years, been exposed to every climate 
 " on the continent, without shewing the least disposi- 
 " tion to decay. But, in the month of August last, upon 
 " appl\ ing my hand under the belly, I found it as wet as 
 " if taken out of water, and soon after this part of the an; 
 4 * mal began to fall, piece by piece,, as large as my two 
 " hands, until the whole of the belly had fallen to the door. 
 4i Fish that had been well preserved for several weeks. 
 " had collected so much moisture from the air, that drops 
 " of water fell from them. 
 
 " I have a very excellent electrical machine, and have 
 " been in the daily habit of using it; but during the sick- 
 " ness, when the appearance of the atmosphere was the 
 " most favourable, I could not, with a'.l my art or industry, 
 
 " c 
 
I «*4 ) 
 
 " excite it, so as to answer any purpo:e in experiment, 
 ' : &c. when, in the ordinary state of the atmosphere, four 
 '• or five revolutions of the cylinder, will give as hard a 
 I bear with convenience." 
 ioregoing observations of Mr. Baker prove, in a re- 
 ible degree, that there was a prevailing property in 
 the air, viz. extreme moisture. The annexed table will ex- 
 hibit the degree of heat, which appears, upon an average, 
 ceed the usual temperature several degrees. 
 
 , . . \ical C vatiotu far 1795, made by G. Baker. 
 
 THERMOMETER. 
 
 . 
 
 ,. 
 
 
 Weather. \No. of Rains. 
 
 lary. 
 
 H 5° 
 
 8 
 
 Verv variable. 
 
 11 quan. 
 
 Febr 1 
 
 ,6 
 
 5 
 
 \ T ot very variable. 
 
 2 very little. 
 
 ch. 
 
 
 23 
 
 Not very variable. 
 
 9 small quan. 
 
 April. 
 
 74 
 
 28 50 
 
 Variable. 
 
 1 3 
 
 
 
 Si 
 
 48 {O 
 
 Not very variable. 
 
 '4 
 
 large quant. 
 
 June. 
 
 37 
 
 57 
 
 
 □ 
 
 small quan. 
 
 
 89 
 
 6? 
 
 Not variable. 
 
 9 
 
 considerab. 
 
 August. 
 
 93 5° 
 
 57 50 
 
 Not very variable. 
 
 : 1 
 
 large quant. 
 
 mber. 
 
 37 
 
 4.8 
 
 Not variable. 
 
 8 
 
 small quan. 
 
 Oct > 
 
 75 
 
 ;8 ?o 
 
 Not very variable. 
 
 Ssmall quan. 
 
 mber 
 
 67 
 
 23 
 
 ry variable. 
 
 c/considerajj. 
 
 mber. 
 
 54 
 
 37 
 
 variable. 
 
 8 small quan. 
 
 BAROMETER. 
 
 Month 
 
 
 Low. 
 
 Months. 
 
 /%/,. 
 
 low. 
 
 [anu 
 
 30 2. 
 
 29 30 
 
 July. 
 
 30 1 1 
 
 19 55 
 
 February. 
 
 P c 
 
 29 45 
 
 August. 
 
 3° 5 
 
 29 50 
 
 . h. 
 
 30 3c 
 
 29 15 
 
 September. 
 
 30 8 
 
 -9 2 5 
 
 April. 
 
 30 17 
 
 2 9 3 5 
 
 October. 
 
 30 28 
 
 28 Bo 
 
 
 50 r$ 
 
 29 65 
 
 November. 
 
 30 a 3 
 
 28 95 
 
 June. 
 
 30 40 
 
 29 60 
 
 December. 
 
 30 6 
 
 28 85 
 
 " It is very remarkable, that for near three years there has 
 u been but a very small quantity of thunder and lightning. 
 •' In the month 0/ May last it thundered and lightned three 
 " times, and there vria no more until October, when we 
 " had a verv distant thunder, and some lightning, and this 
 " was the last fo 
 
APPENDIX. 
 
 INTRODUCTION. 
 
 X HOSE who have inclination, and have not perufed 
 the writings of fome authors juflly diftinguilhed for their 
 talents in medicine, and who have written profefTedly on 
 the fever 1 in quejiion, (tor I pay no regard to the vari- 
 ous n imes by which it is known) may find in the annex- 
 e;l pages, a very circumfcribed view of their opinions 
 of right practice, as far as relpe£b> the moft efficacious 
 remedies employed againft it. Thofe who have more 
 leifure, and more curiofity, will, of courfe, confult the 
 originals from whence they are taken ; for my own 
 part, I have by no means intended, by this fele&ion, to 
 drain any part of their practice, with a view to 
 ffrengthen, or give confequence to my own opinions, or 
 to fix a mcthodus medendi, which, it will occur to eve- 
 ry intelligent practitioner, obtained under circumftances, 
 in many inftances, very diflimilar. 
 
 HILLARY. 
 
 THE hxft indication of cure, Doctor Hillary ob- 
 ferves, is " to moderate the too great and rapid motion 
 " of the fluids, and abate the heat and violence of the 
 
 " fever, 
 
( 126 ) 
 
 of the difeafc. Wherefore 
 " bleeding, in the beginning of the firft ftage of this fc- 
 " ver. ei :reateror' tity, accordingly 
 
 :1 S fymptoms and circumitances indicate, is 
 " always abfolutely neceffai te quantity to beta- 
 
 " ken away fhould always be as the age and ftrength of 
 " the patient, the degree of the plethora, and thegrea 
 " or lefs elaflic ftate of the folids. the fulnefs of bis pi 
 " and the violence of the fever and its fymptoms. For 
 ** v v hen I have been called in time, (which 
 
 ■ fcldom the cafe) I generally order 12, 14. 
 " iS, or 20 ounces of blood to be taken away on the 
 " fir ft or fecond day , but always, as the above fymp- 
 " to:ns and ruler, indicate and direct : and it the patient's 
 ,: pulfe rifes after the firft bleeding, or if the fever con- 
 ' tinues 10 he ltill high, and the pulfe full, (for it is ne- 
 <• ver high in thi.> fever) I repeat the bleeding once, in 
 
 r fecond day of the difeafe, if the above 
 mentioned fymptoms indicate it; but bleeding a 
 '• third time is feldom or never required, neither is 
 1 bli n the third day almoft ever required; and 
 
 " when it is performed on that day, it ought not to be 
 " advifed without great caution and judgment; neither 
 " fliould a vein be opened after the third day in this 
 " fever, unlefs fome very extraordinary fymptoms and 
 " circumftajices require it, which very rarely or never 
 " happen. I have always found that taking awav a 
 " moderate, but fufficient quantity of blood on the firft 
 " or fecond days, has rendered the lever more moderate, 
 " and abated the putrefcent diathefis afterwards. But 
 <■ as to the quantity of blood to be taken away in this 
 '• cafe, cither the firft or fecond time, or on the firft or 
 '- fecond days, it is impoflible to afcertain it, lince thai 
 
 " m 
 
( **7 ) 
 
 ■ muft be different, in different patients ; becaufe forna 
 " conftitutions can better bear the lofs of fifty ounces 
 " of blood than others can the lofs of eight or ten ; 
 *' therefore, the only rules that can be given are thofe 
 " laid down before." 
 
 The irritable ftate of the ftomach, Doctor Hillary 
 fays, forbids the ufe of emetics ; but to carry off the 
 contents of this organ, a liberal ufe of warm water is 
 recommended, which -greatly relieves the patient. In 
 the next place, " in order to gain a truce, and fome 
 " refpite from the anxiety, and almoft continual 
 " reaching, vomiting, and fickneis, which are not in- 
 " creafed, but fomewhat relieved by di inking the warn: 
 " water, I ufually give extract, thebaic, g. I vel. g. I fs. 
 " and order them to take nothing into their ftomachs for 
 " two hours after it, that they may retain it; and it be 
 " ing in l'o fmall a compafs, they fcarce ev; i 
 " By this method the poor diftreffed patient gets forne 
 " reft and refpite, and all the fymptoms are generally 
 " confiderably abated, the reaching and vomiting ei- 
 " ther totally ceafes, or do but feldom return ; lo that 
 " other medicines may be given and retained on the 
 " ftomach, which it would not retain before, fuch as 
 " cooling acid juleps, or other antiphlogiftic and anti- 
 •' feptic medic i i 
 
 The evacuation of the bowels is the next circum- 
 ftance to which Doclor Hillarv directs our attention. 
 Heattempts this firft by glyfters, " and after fix or eight 
 " hours reft and refpite, he orders a gentle antiphlogif- 
 " tie and antifeptic purge. 
 
 '' Or if die patient has a purging before, which 
 " fometimes, though very feldom happens, I order a 
 " gentle dofe of foaiVd rhubarb to be given, and an an- 
 tifeptic 
 
( 128 ) 
 
 " tifepric anodyne, after it has operated, to abate an j 
 
 ck the too much purging, but not to ftop it, as I 
 
 obferved it to be of fcrvice in this cafe, 
 
 " provided that i: is moderate, and not too violent : and 
 
 " I obi i it all thofe who had thi< purging, gene- 
 
 ; with it, if the patient's ftrengtl 
 " but properly fupported with fui table nourishment, 
 " and proper antiieptic medicines, which laft are al- 
 " ways abfolutely neceffary in this fever. 
 
 " And though purging in many other fevers, may be 
 " deemed bad practice, vet In this fever, as n:nure in- 
 " dicated it, I have always found it of lingular fervice, 
 " and the patient not only greatly relieved by it, but the 
 " diieaie always rendered mo: tte and manage- 
 
 " able afterwards." 
 
 Doclur Hillary not only purges in the beginning of 
 the difeafe, but, fays he, "and I moll commonly find 
 4< it neceflary to repeat this purging every fecond or 
 " third day, for two or three times, and fometimes, 
 :i the fymptoms are very bad, and have not 
 " much abated upon taking the firft and fecond purge, 
 " and the patient has not been treated in the method 
 " before defcribed, or I have not been called in till late 
 •• in the difeafe, I have found it neceflary to repeat the 
 " gentle purging . .. v day, for four or rive days fuc- 
 kt ceflively, and with the defired fuccefs too." 
 
 In the latter ftagee of the dii" rder, when, (according 
 to Doctor Hillary) it might be fuppofed that antifeptics 
 " we; a ftop to the putrescent difpo- 
 
 :: of the iiuids, and prevent gangrenes coming 
 " on," our author found the cort. peru. though a 
 medicine of the nature indicated, " fo difagrceabl.e to 
 " mo. ind the ftoinachs of the iick, in this 
 
 dif 
 
( "9 ) 
 
 M difeafe, arc fo much affected, and fo weak, and fo 
 " fubjeit to reject every thing, even die moil pleafanr. 
 " and innocent, that they can very rarely take it in any 
 " fhape, and itill much fewer can retain ic, when they 
 " have got it down." 
 
 As a fubftitute for the bark, Doctor Hillary ufed 
 an infufion of (hake- root, to which Madeira wine 
 and elixir of vitriol was added, " and with much bet- 
 " ter fuccefs than he could hope for, or dare expect." 
 If this medicine required " more warming," the quantity 
 of rad. ferpent. was increafed, or vin. croc, or confec. 
 cardiac, or fome fuch medicines were added. 
 
 Thofe fymptoms, viz. " low pulfe, coma, delirium, 
 " coldnefs of the extreme parts, tremors, convulfions, 
 " fpafms, &;c." which might be fuppofed to indicate 
 viheatories, " have not only not been relieved by iheir 
 " application, but have been increafed thereby, and the 
 " haemorrhage which ufually attends this fever has been 
 " haftened oil, or if come on before, it has been in- 
 " creafed by their application.." 
 
 HUME, 
 
 " The firft patient I was called to, was one An- 
 
 " drews, a plethoric, mufcular man, about twenty-five 
 
 " years of age: he had not complained three hours 
 
 " when 1 law him, about ten in the forenoon ; yet the 
 
 " oppreflion on the praxordia, and the bilious vomit- 
 
 S had already feized him. His pulfe was full and 
 
 " ftrong, and I took lixteen ounces of blood from his 
 
 i immediately) and ordered a laxative clyfter to 
 
 R " be 
 
( *3° ) 
 
 " be injected as foon as it could be got ready, and en- 
 " joined him to drink plentifully of barley water, acidu- 
 " lated with thejuice of the lime. I called upon him at 
 " noon, and was much difappointcd to find the ardent 
 " fymproms, and the oppreflion on his breaft both in^- 
 "creafed: his vomitings were almoft continual, and 
 " he complained much of diftrefs on breathing, and of 
 " the burning of his eyes. The reafons for bleeding 
 " him ftill continuing, I took fourteen ounces of blood 
 " from the fame oririce, and ordered him, the fame 
 " evening, a fcruple of ipecacuanha at fix o'clock, and 
 M at ten applied, a large blifter between his ihoulders, 
 *' in hopes of relieving his cheft." 
 
 " He continued to vomit, with but fhort intermif- 
 " fions, from the time he took the emetic, aldiough he 
 " difcharged a great deal of bile by ftool. He had a 
 " very refrlefs night, and continued through the fe- 
 " cond day, vomiting, and labouring under the oppref- 
 ** fion of his breaft, till about twelve at night, when 
 " he died; about forty hours from the time of his be- 
 M ing fir ft fcized. 
 
 " At this time the practice in Barbadoes was, to uk 
 • ; large and repeated bleeding, vomiting, and bliftering, 
 " as recommended by Doctor Town, which method ], 
 " as a ftranger, thought myielf obliged to follow. 
 
 M Before Andrews died, feveral others were taken 
 " ill, and, except the fecond bleeding, which was omic- 
 M ted, they were treated the fame way, with no better 
 '< fuccefs." 
 
 Do£lor Hume next relates the morbid appearances 
 exhibited upon opening the bodies of the two firfr. men 
 who died. There were an inlarged liver, and " evi- 
 u dent marks of inflammation on the lower extremity 
 
 " of 
 
( is 1 D 
 
 ?' of the ftomach, and likcwife on the fuperior part of 
 " the duodenum. 
 
 " No marks of mortification were found on the in- 
 " ternal or external furface of the ftomachs of either of 
 " thefe men ; but I opened two not long after, who 
 " died in a more advanced ftate of the difeafe, and found 
 " one of them, who had vomited the black matter, in a 
 " flate of mortification every where, and fome coagu- 
 " lated blood in it; the internal coats of the other were 
 f* covered with livid fpots of different fizes, and, exter- 
 " nally, towards the bottom, there were large black 
 " fpots of the fize of a crown piece." 
 
 " Having obferved, with much regret, the bad fuc- 
 " cefs I had from bleeding and vomiting, and that the 
 11 firft man who died evidently funk after the firft 
 " bleeding, I bled the reft but once ; and when the pa- 
 " ticnts were not plethoric, I have frequently omitted 
 " the operation altogether, as I fometimes did when T 
 *' had not feen them within twenty- four hours of be- 
 u ing taken ill." 
 
 " I have feen fome fubjects opened, ort whofc fto- 
 " machs no marks of inflammation could be difcover- 
 " ed, yet even thefe had excefTive vomitings." 
 
 " The (late in which I found the ftomachs of the 
 " two firft men who died, deterred me from giving any 
 " more vomits ; and I have ever found that bowel fodeli- 
 " cate and irritable, that I have never lince ventured to 
 " give any emetic whatever. There feems, however, 
 " a necefTiry to evacuate the bile by the ftomach, by the 
 " inteftines, and by the fkin, when there is a tendency 
 " to fweat." 
 
 " After bleeding, I ufed to order a clyfter of &c. and 
 " for common drink, I ordered a plcafant fherbett made 
 V of frefti, ripe limes, &c." 
 
 " I found 
 
J 5 : ) 
 
 c: T found this n r <i only a p'ei-fant drink forth* I 
 " but looked upon it as the moil powerful antifeptic, 
 tl and antiemetic 1 could give ihcm. It is true that 
 " on I was thrown up as faft as water, 
 
 i) , but fuch ;. ution 
 
 re in drinking ir h<-k fits- 
 
 " lefs ievere ; and, after thefirft th; • draughts, 
 
 " every fucceeding one remained longer on the ftomach 
 
 ■ . inter- 
 
 the tits of. voi • e to be fo 
 
 ied, that 1 could atti e mild 
 
 " purgative medicine. 1 commonly ordered two ounces 
 
 manna, and one of cream of tartar, difl 
 " in three pinis of lemonade. Of this I gave them 
 " a tew fpoonfuls, or a tea-cup full, at fuch dif- 
 *' tanccs of time, as J thought their ftomachs could 
 u bear." 
 
 " Manna and cream of tartar was continued occa- 
 " fionallv, through the whole courfe of the difcafc, on- 
 " ly it was fometimes changed for tinclure of rhubarb, 
 " drawn in weak cinnamon- water, to render it more 
 " grateful to the ftomach. When thefe tailed of pro- 
 " during frequent bilious ftools, glyfters were inj< 
 *' but the heat, frequency, and acrimony of thefe bi- 
 
 rived mc of this rcfoun 
 " the extremity of the rcdium. many times, became fo 
 " tender as not to be able to bear :he introduction of 
 " the fmallcft and fmoorheft pipe." 
 
 " When I ol tdency to fweating, ] al- 
 
 " ways discontinued the laxative medi ! gave 
 
 " fix drachms, or an ounce of the lp. mind, and re- 
 " pcatcd the dofe in five or fix hours, if theiweat con- 
 " tinued fo long, encouraging the fick to drink a weak 
 
 " infufiou 
 
( *33 ) 
 
 fC infufion of fage, acidulated, if they defircd to have 
 » it fo." 
 
 Doctor Hume recommends the application of blif- 
 ters to the thighs, to relieve the fevcre vomitings. 
 ** When," fays he, " the lick complained much of the 
 " bliftcrs of their thighs, the vomiting ufually began 
 " to abate, and to ceafe entirely, as the irritation and 
 " inflarrijAation increaf- 
 
 " This fever, like fome others, often ends in fcabby 
 " eruptions about the mouth and nofe, and fometimes 
 " 1 have feen fmall biles, from the fize of a common 
 " pea to that of a horfe-bean, break out on the brcaft, 
 " iides, moulders, or hips, and prove critical." 
 
 " There is one critical appearance, which I do not 
 " remember to have lien taken notice of by any wri- 
 " ter on the bilious fever, and which, I believe, has 
 " been obferved bv few practitioners, (it fometimes 
 " happens in the third Mage, and fometimes in the 
 " courfe of it) which is, one or more drifters of fmall 
 '•' florid eruptions on or near the pit of the ftomach, 
 " not larger than mealies, and from three or four to 
 ■" feven or eight in a duffer." 
 
 " In whatever ftate of the difeafe the lick are re- 
 " lieved. whether by fweats, bilious ftools, biles, i 
 " tions, or by bliftcrs, and it is evident from the cefla- 
 " tion of the vomiting, from the load at the brcaft be- 
 " ing removed, and from the refpiration becoming ca- 
 li lit!', that the fever is giving way, we fhould attempt 
 ive the bark : fooner would be to no purpofc, for 
 " it would hurt the patient, by oiafpcrating the fymp- 
 
 To tiic infuhons of bark, ufed by, Doctor Hume, 
 i'r.ak. g added. 
 
 Speaking 
 
( 134 ) 
 
 Spea opiates, Do&oi Home fays, " it doc: 
 
 " not Ici.in probable ihar thcv can be of anv ufe in this 
 afe, if ii is considered, that the principal inten- 
 tion of the offending bile, 
 '" by ..ad to attempt confining it by opi- 
 
 " ates, is to counteract that in 
 
 DOCTOR JACKSON 
 
 OX THE FEVERS OF JAMAICA, &TC. 
 
 Doctor Jackfon, after dividing the yellow fever into 
 three fpecies, and giving the fymptoms attending each 
 form, proceeds to the method of cure. 
 
 Treatment of the fir Jl /pecies. 
 
 " The fpecies of the yellow fever," fays he, " which 
 H I have now defcribed, is univerfally allowed to be a 
 " terrible difeafe; and there are few, I believe, fo 1111- 
 " candid as to boaft of general fuccefs in the manner 
 " of curing it. A road is, therefore, left open, not on- 
 " ly for improvement, but almoft for total innovation. 
 " The only author J have read on the fubject, or the 
 " practitioners with whom I am acquainted, do not 
 " feem to have extended their views beyond the C 
 " toms of the difeafe. There are fomc, who, from ob- 
 " ferving that there is pain in the head, and flufhing of 
 ** the face, recommend bleeding ; others, trom the pre- 
 " fence of naufeu, or inclination to vomit, make trial 
 " of emetics; and many, from various caufes, infift on 
 *' the indifpenfible ufc of cathartics. Mv views, 1 mull 
 ** contefs, are different from thofe of preceding authors. 
 " Bleeding was employed occafionally ; emetics were 
 
 " cautioufly 
 
( *3S J 
 
 4i caufioufly avoided ; but time appealed to be too pre- 
 '"■ cious to be fpent in attending to the effects of ca- 
 " thartics, which cannot often be known in lefs than 
 " twenty-four hours; and which at beft arc precarious 
 " and feeble. Inflead, therefore, ot attempting to cva- 
 " cuate redundant bile, or to correct it when fuppofed 
 " to be vitiated, I exerted myfelf from the firfl moment 
 * that I was called, to the patient, to change the genius 
 " and natural temper of thedifeafe , or, if \ may be al- 
 " lowed the expreffion, to take the bulinefs, as fpeedily 
 " as poflible, out of the hands of nature." 
 
 " I remark, in the firft place, that I generally began 
 " the cure of this fpecies of the yellow fever with bleed- 
 " ing. Bleeding was employed in the prefent cafe, 
 " chiefly with a view of paving the way to remedies 
 " of greater efRcacy. It was, however, found to mo- 
 w derate the violence of local pain, particularly the 
 " violence of the head-ach, and to be not altogether 
 " without effect in retarding the ufual rapid progrefs of 
 " the difeafe. It has hitherto been thought neceffary, 
 M indeed almoft indifpenfible, to empty the firft palTa- 
 " ges in this fpecies of fever; but time is fhort, and the 
 ** good which accrues from fuch evacuations, is not 
 " verv certain, and often not efTential. It was, there- 
 K fore, thought fuffieient to truft this intention, for the 
 " moft part, to laxative glyfters ; after the employment 
 " of which, (bleeding having been premifed in fuch 
 K quantity as was deemed proper) the patient was wafh- 
 " ed clean, and bathed in warm water, in as complete 
 " a manner as the circumffances of fituation would 
 " permit. It is needlcfs to mention that this was done 
 <l with a view to increafe the mobility of the fyftem, 
 " and to remove fpafmodic ftricture from the extreme 
 
 " veffeli 
 
( *3* ) 
 
 lels of the furfacc; in confequcncc of which, 
 
 iter benefit was expected from the application of 
 
 tcr, whu h w.,s daihed l'udJcnly from a 
 
 is practice 
 .e without 
 e; but I can 
 
 • to its good c: \ with 
 
 ;rom all ihc feeling s oi anxiety and dif- 
 i . generally the confequence of this mode of 
 • i*iTict)t. if employed within the full twelve ' 
 
 . k, it fcldom i all the 
 
 '• fymptoms of danger; oi total and 
 
 " plctc change in the nature and circumftances of die 
 iv was more:. lough 
 
 fame rule of practice might ftill be proper, the 
 cution required more boldnei cifion. It 
 
 olypoflibl 
 " cafj, at this period, of the neceflity or propri 
 •' bleeding, and of empl Lower inteftines, by 
 
 " means of glyfters ; but when this bulmcfs fhall 
 "have been accompli fhed, in fuch manner as Ihall 
 " hav< it, or conducive to the main 
 
 " view, it will be advifablc to lhave the head, t< 
 " the whole body in warm water, and inftantly toda/h 
 
 n a bucket on the head and fhoi 
 " I have even fomerimes, where there was an appear- 
 " ance of greater obftinacy, ventured to w rap the \\ hole 
 I iaked in fea-water, or in water in 
 " which was duTolved a lai < portion ol fait, h 
 t, or naufea and vomiting troubh 
 •' I have al I benefit from the application of a 
 
 u. Opiates, joined wiih 
 : . bad a tendency to detennine to the 
 
 " fui 
 
( *37 ) 
 
 " i-irface, were found to be ferviceable ; and wine, with 
 " a fupply of frefh and cool air, in molt cafes was high- 
 " ly neceflary. This method of proceeding will, per- 
 " haps, be thought unwarrantable, but I can fpeak con- 
 " fidently of its fafety; and I mav further add, that 
 " unlefs fome decided fteps are taken to change the 
 " nature of the difeafe, during the continuance of this 
 " ftage, our future endeavours to do good will gene- 
 " rally be in vain. 1 have hitherto promifed fuccefs in 
 " the cure of this fever, with a good deal of confi- 
 " dence; but if it mould fo happen, that we are not 
 " called to the patient till the vellownefs has fpread 
 " over die whole of the body, or till the black vomiting 
 " has begun to make its appearance, the profpedt, I 
 " mud confefs, is then very dark. The ordinary re- 
 " fources of our art are feeble ; and if good can be 
 " done at all, it can only be done by means, which, in 
 " the common opinion of practitioners, border on 
 " rafhnefs. In this latter ftage of the complaint, fo 
 " great a degree of torpor overwhelms the powers of 
 " life, that remedies do not produce their ufual efFe£h 
 " and our labour is often the fame, as if we attempted 
 " to refufcitate a corpfe. I have, however, feen in- 
 " ftances of fuch unexpected recoveries, from the mod 
 " hopelefs ftate in fevers, that I feldom totally defpair 
 " as long as life remains. I know that death mav be 
 11 prevented, even after black vomiting has appeared, 
 " with all its terrors, if a remedy can be found power- 
 " ful enough to excite the a&ion of the extreme veflels, 
 " and to recall the determination to the furface of the 
 " body. For this purpofe, I have employed alternate- 
 " ly, warm and cold bathing, with fuccefs. I have 
 " even wrapt the body, as I mentioned before, in a 
 S " blanket 
 
( i33 ) 
 
 " blanket foaked in water, in which a large portio: 
 
 (alt was diflblved, or which had been deeped in bran- 
 " ilv or rum, enjoining, a( the fame time, the liberal ufe 
 
 i wine, or even more powerful cordials. 1 ! 
 " h -.veil attested inftan • plenti- 
 
 " fill (ii.r rum and water have che< Led the vo- 
 
 . and apparently faved the lives of patients, af- 
 " ter die medical people had given them up for loft." 
 Treatment of the fec$nd fju 
 " The cure of this fpecies of the difeafe, though by 
 • no means i. if.. difficult, upon the whole, 
 
 tan that of the former. Inftead of the torpor and 
 1 infenfibility, which pi evaded in the latter periods of 
 " me proper yellow fever," ffol |ackfon con- 
 
 s the hrft defcribed fpecies as the true yellow fe- 
 ol Jamaica) " the mobility of the nervous fyfrem 
 > much increafed in the ppefent fpecies of dif- 
 11 cafe, that remedies fcldom failed of producing fenli- 
 " hie effects : and wherever remedies produce cflecls, it 
 11 is generally in our power to manage the bufinefs in 
 " fuch a manner, that fome good may arife. It may be 
 " obferved in the firft place, with regard to the cure, 
 " that bleeding, which frequently was ufetul in the fbf- 
 11 mer fpecies, was generally hurtful in the prefent; and 
 bat, inftead of retarding, it oftener accelerated the 
 " progrefs of the difeafe. Emetics wire employed, 
 rv commonly, by the practitioners of the Weft- 
 la this as in oth i fever; but I can- 
 " not help remarking, that languor and debility, fre- 
 " quentlj efs, and fometimes a continual vo- 
 . which no remedies could reflrain, were often 
 " the corrfequence of antimonial emetics of levere 
 ,i , and T have no doubt in laying, that the 
 
 " approach 
 
( J 39 ) 
 
 H approach of death was actually haftened, in feveral 
 " inftances, by this method of treatment. Laxatives 
 " were occafionally of fervice ; but the ftronger purga- 
 " fives frequently hurtful. Blifters were often ex- 
 " tremely beneficial; but it requires care and difcern- 
 " ment to apply them in the proper circumftances, fo a 
 " to reap the full advantage. Opiates were fometimes 
 " ferviceable; and bark and wine, in mod inftances, 
 f were remedies of great value; but the principal trull 
 " was placed in warm and cold bathing, which, under 
 " proper management, feldom failed of anfwering e\ ery 
 " expectation completely, or fpeedily of removing the 
 " chief fymptoms of danger. Sometimes it appeared 
 " to cut ihort the courfe of the difeafe abruptly." 
 
 In the next place, as introductory to the fymptoms 
 and method of cure, of the third fpecies of yellow fever, 
 Doctor Jackfon obferves, " I have now defcribed two 
 " fpecies of iexcr, which feern to be, in fome degree, 
 f peculiar to the natives of northern regions, foon af- 
 " ter their arrival in the Weft-Indies. In the one, a 
 " determination to the alimentary canal and biliary or- 
 " gans, with marks of putrcfcent tendency, in the ge- 
 " ncral mafs of fluids, was difcoyerable at an early 
 " period ; in the other, the brain and nervous fvfrem 
 "were more particularly and principally aiFedted ; 
 " while the fpecies of which I now attempt to give' 
 " fome account, exhibited ftrong marks of vafcular ex- 
 " citement, with a very high degree of apparent in- 
 " flammatory diatheiis. This was more irregular in 
 " its appearances, and more complicated in its nature, 
 " than the others. The marks of inflammatory diathe- 
 " lis were generally very apparent in the beginning : 
 if but they ufually gave way, or became complicated 
 
 " in 
 
( *4° ) 
 
 in rhelatttT flage*. with fymptoms of putrefcenc 
 
 us arfcclion." 
 Speaking of the cure of this fpecies, he fays, " if we; 
 proceed on the firft obvious view of the difcafc, we 
 fhall often do irreparable mifchief, by copious and 
 repeated evacuations; yet there will not Ik* lefs dan- 
 ger, on the other hand, if, regardlefs of the prefent 
 degree of excitement, we indulge freely in the ufe 
 ot ftimulants. It is nercfTary to ohferve a middle 
 courfe; and, I muft confetti, that it is fomctimes dif- 
 ficult to do any thing without doing harm. Bleed- 
 ing was fitquentlv employed in the cure ot this dif- 
 eafe, and, in mofr caies, it was an ufeful remedy, 
 though lefs perhaps from its own eftecls merely, than 
 from paving the way to other more powerful appli- 
 HS. h i^, however, capable of being eafily 
 carried to execis ; and ought not to be truftcd to 
 wholly for the removing the irritability, and high 
 degree of excitement, which prevail io generally in 
 the beginning of this difeafe. After bleeding, eme- 
 tics and cathartics are employed very freely. I have 
 always piofefTed myfelf an enemy to the practice of 
 giving emetics in the fevers of Jamaica ; yet I muft 
 confefs, that antimonials were not only fafer, but of 
 more particular fervice in this, than in any oth( I 
 cies of fever where I have feen them tried. Among 
 the great variety of forms which have been recom- 
 mended by practitioners, for the purpofe of empty- 
 ing die firit paflfages, I have not tound any one an- 
 fwer fo well, as a thin folution of the fal catharti- 
 cum, given at difFercnt intervals, with a fmall por- 
 tion of emetic tartar, and fomctimes with the addi- 
 tion of laudanum. The operation of this remedy 
 
 u v 
 
( Hi ) 
 
 K was extenfive. It might be fo managed as to pro- 
 " mote naufea, or vomiting, fweat, or moderate evacu- 
 " ations downwards ; at the fame time, it proved very 
 f< powerfully fedative. I may likewife add, that I have 
 v ' fometimes found benefit from nitre, camphor, and 
 " opium, given in pretty large dofes, and accompani- 
 " ed with plentiful dilution. But though thefe reme- 
 ** dies were often fervieeable, and contributed, in many 
 " cafes, to moderate the high degree of irritability ; 
 t* yet the chief dependence of the cure was much 
 f better trufted to cold bathing. After the furface of 
 t ( the body had become fufficiently relaxed, by the pre- 
 " vious ufe of warm bathing and fomentations, the ef- 
 M feels of cold bathing were wonderful. The excef- 
 " live irritability was moderated or removed, and the 
 t* powers of life were invigorated, in a very lingular 
 V manner, in confequence of it." 
 
 MOSELY 
 
 ON TROPICAL DISEASES. 
 
 " It is unneceffary to fill many pages with a long 
 W catalogue of prefcriptions and medicines in the treat- 
 " ment of this fever, for it iscomprifed in a few words, 
 *' and almofl as few medicines ; and requires only care 
 " and attention, that thofe moments do not flip away, 
 " that the occaiion is forever loft, when 
 
 " Bleeding, Diaphoretics, 
 
 " Purging, Blifters, and 
 
 <( Baths, Bark, 
 
 " ought to have been timely ufed, for the falvation of 
 
 " the patient's life ; and that afterwards they are not 
 
 " untimely employed for its ddlruction." 
 
 "If 
 
( M2 ) 
 
 " If rived in the Wcft-Tndiev 
 
 f* ful ntelf to anv of the caufes which may 
 
 " produce this fever, previous to the attack he has fuf- 
 icm wan. him, if he will attend to it, and 
 
 " ti:i :, in general, to cure it by anticipation, 
 
 " For, as loon as any lv >r relrlcflhefs, or laffi- 
 
 " tude, or ftretching and yawning is perceived, he has 
 " reafon to expedf. that they are the harbingers of this 
 " tragedy, and he fhould immediately he blooded, and 
 " take a dofe of falts, and dilute plentifully, and keep 
 " himfclf quiet and cooi ; and after the operation of the 
 " f.: Its, he ihould take (mall dofes of James's powdery 
 " live low, and drink barley-water. After the body 
 " is well evacuated, and cooled, it is always prudent 
 " to take the bark." 
 
 " In the firfr. ftage of the fever, when it has made a 
 " regular attack, when thefe precautions have not been 
 " ufed, or when they have failed, and the patient is no 
 " longer able to abftain from his bed, he fhould be kept 
 " in a large room, as cool as poffible, covered lightly 
 M with bcd-clodus, with a circulation of air admitted 
 '* into the room, but not directly upon or near the bed : 
 ' and this muft be obferved through the whole ot the 
 " difeafe." 
 
 " Bleeding muft then be performed, and mult I 
 •• peated every fix or eight hours, or whenever the cx- 
 
 ■ erbations come on, while the heat, tulneis 
 
 ' pulfc, and pains continue ; and, if thefe fyinptoms be 
 
 nt and obflinate, and do not abate during the 
 
 • firfr. thirty-fix or forty-eight hours of the fever, 
 
 ling fhould be executed ufque ad an'iml dc- 
 
 um." 
 
 « ] 
 
( HS ) 
 
 ** The blood taken away in the beginning is very fio~ 
 " rid, and of the arterial blood colour ; and the furface 
 4 ' never fizy, and feldom contracted." 
 
 " The intention of bleeding can be anfwered only 
 ** by performing it immediately, and in the moft exten- 
 " five manner, which the high ftate ot inflamma- 
 " tion, and the rapid progrefs ot the diieafe, demand, 
 " Taking away only hx or eight ounces of blood, 
 " becaufe the patient may faint, which is a fymptom 
 " of the difeafe, is doing nothing towards the cure. 
 " Where bleeding is improper, no blood fhould be 
 " taken; where it is proper, that quantity cannot re- 
 " lieve — and it is lofing that time which can never be 
 " regained." 
 
 " Bleeding, it is evident, muff not be performed in 
 " any other ftage of the diieafe than the firft, or in- 
 " flammatory ftage; but this has been injudicioufly 
 •* done, which has given rife to the notion, that a pu- 
 " tient will feldom bear more than two bleedings. 
 
 " Many practitioners have been deterred frpm bleed- 
 *' ing their patients from the depreffion of the pulfe, 
 " and from the faintnefs which fometimes accompanies 
 " the very firft onfet of this fever ; but here the pulfe 
 " always rifes, and the faintnefs difappears, as the heart 
 " is relieved from its oppreffion by the lofs of blood." 
 
 " Faintnefs and depreffion of the pulfe here are not 
 " to be confidered like thofe circumftances where putri- 
 M taction has commenced, or where there has been long 
 " and fatiguing illnefs: they are fymptoms here of ple- 
 ** thora, the reverfe of inanition; and bleeding is ad- 
 " vifed for fuch fyncopes by two of the greateft phyfi- 
 " cians the world has produced." 
 
 11 Nor 
 
( 1+4 ) 
 
 " Nor is fainting, during the operation, anv reafon 
 " for not repeating it. in the firft ftage of the fev< 
 " I have often cured it by bleeding only : and it has 
 *' frequently happened in the Weft-Indies, that acci- 
 " dental bleeding from the orifice, when a patient has 
 " fallen afieep, to far greater quantities than has ever 
 " been directed to be taken away, has carried oft' the 
 '■ fever entirely ; and the furprifc on discovering a pro- 
 " f ufion of blood in the bed, has been changed to joy 
 " k>r the alteration it has produced in the patient." 
 
 " The effects ot nature would be oftener tuccefsful 
 " than they are, were not her powers totally overcome 
 " in hot climates. Bleeding at the nofe, in the firft: 
 " ftage ot this fever, has fometimes removed it; and i: 
 " is as certain a folution of this fever, as it is of the 
 " caufus in Europe." 
 
 " In the early part of the difeafe fpontaneous hae- 
 " morrhage is always critical, and fhould never be fup- 
 " prefled; afterwards it is fymptomatical, and if not 
 " flopped, the patient foon finks under it." 
 
 " Eruptions about the lips and nofe, painful biles, or 
 " phlegmons about the body, which alwavs fnppuratc 
 " unkindly, or an abfeefs forming, are alfo critical, and- 
 " generally terminate the difeafe." 
 
 " Sweating, in the rirft ftage of the difeafe, is feldom 
 " critical. Whenever fweatB are critical, which may 
 " happen very early in the difeafe, if the patient has 
 i well evacuated, they are accompanied with a 
 •' ( ciTation of vomiting, and a change in the appearance 
 " of the urine: the fweating is then to be aftiduoully 
 " promoted, and if preceded by a bleeding of the nofe, 
 " it is a complete crifis." 
 
 " The 
 
( H5 ) 
 
 " The fickncfs of the ftomach, anddifagreeable tafte 
 " in the mouth, indicate the quality, and not the quantity 
 " of the offending fecretions. The vomiting is from 
 <v irritation in the ftomach, and not from plenitude; 
 " therefore vomits are never to be given, though 
 " ftrongly advifed by Towne : no, not fo much as warm 
 " water, recommended by Hillary, for fear ot exciting 
 " and ftirring up that terrible operation, which, when 
 *' once begun, no art can lometimes allay." 
 
 " When a fufficient quantity of blood has been taken 
 " away, which is never done, let the patient's habit be 
 " what it may, while the heat, reiterated exacerbations, 
 " flufhings in the face, thirft, pains in the head, and 
 " burning in the eyes remain, the ftep is to evacuate 
 " the contents of the bowels, and turn the humours 
 " downwards," 
 
 " But if large and repeated bleedings, during the two 
 " firft days, fhould not remove the thirft, pains, rluhV 
 " ings, and heat in the eyes, and the ftate of the fto~ 
 " mach fliould be fuch as to reject every thing that is 
 " taken, fo that there is no chance of procuring eva- 
 " cuation by ftool, the patient fliould have repeated 
 " purgative glyfters, and be put in a tepid bath." 
 
 " The bath Ihould be compofed of a very weak de- 
 " coction of camomile flowers, in which a little nitre 
 " may be diflblved, and a little vinegar added." 
 
 " This will often remove every fymptom at once, 
 " and diipofe the patient to a diaphorefis, which muft 
 " be promoted until a fufficient quantity of fome pur- 
 " gative medicine can be taken, fo as to make an effec- 
 '• tual operation downwards." 
 
 " There is feldom a necefTity to repeat the bath, as 
 
 M the ftridtures and tenfion generally yield to the firft 
 
 T 4< inimerfion, 
 
; immcrfion. The patient ihoulJ not remain 1 
 " the hath, nor fliouhl it be deferred till late in f 
 " cafe, for it can be of no ufe wlien the ltomach is de- 
 " ftroyed." 
 
 ift, fmootb drinks, free from any ftrrnulating 
 ihv, fuch as barley-water, always anfwer bell 
 * for common drink, and are no impediment in the way 
 " of medicine." 
 
 flyfters are to be frequently given in the beginning 
 " or the difeafe, larly where the patient is cof- 
 
 11 tivc, and to precede the ule of cathartics, and aiiilt 
 *' tlicir operation." 
 
 " The purging medicine to be ufed in the yellow fe- 
 K ver, is the tart arum, vitrio latum chryjlalifatwn y or 
 " fal polychrcftns, dilTolved in equal parts of Jlmple cin- 
 " namon and common water, or in Gmple cinnamon- 
 u water alone. It mull be given in fatal! dofi S every 
 " hour, until it operates; and the patient is to dilute 
 '■ copioufly while it operates, with very weak chicken 
 " broth. The quantity of die fait is four drachms, to 
 " fix or eight ounces of water, (as much as the water 
 <; will diffolve) and the dofe of it may be two table 
 " fpoonfuls. In defect of this medicine, foluble tar- 
 " tar, or fal catharrJcus amarus, or manna and cream 
 " of tartar, mull be ufed. But let me caution pra&i- 
 " tioners againft adding tartar emetic, i.i order to 
 '•quicken the operation of their medicines; which, 
 " however ufefui it may be in bilious difeafes, may be 
 " fatal in ; 
 
 " Purging generally completes the fuppreflion ol the 
 
 " fever, and carries off the vomiting; but it mud be 
 
 nued while the (tools remain bilious, or Icetid, 
 
 " otherwife the. fever will rife, and the vomiting return." 
 
 « In 
 
. ( H7 ) 
 
 " in cafe the fever ftill continues, the ftomach fet- 
 f* tied, and the bowels well evacuated, recourfe inuft 
 " be had to fudorihes : repeated dofes of James's pow- 
 " der, pffervefcent draughts, and plentifully diluting 
 " with barley-water, or bahn, or mint-ten, generally 
 " foon remove it." 
 
 " An intermiflion being procured, bark, in fubftance, 
 " is immediately to be given, and repeated every hour. 
 " ill drachm dofes, if the ftomach will bear it, until 
 " twelve drachms have been taken ; which is generally 
 " a fufEcient fecurity againft the progrefs of the difeafe : 
 " but it mull ftill be continued, at longer intervals, tor 
 " ninny days; interpofing mild cathartics, fuch as an 
 14 infulion of rhubarb and tamarinds, with, or without 
 f* a fmall quantity of fal polvchreft, or by keeping the 
 " body from a coftive ftate by glyfters." 
 
 " In the fecond ftage, or mctaptojes of this fever, 
 " which I believe will feldom happen, where the 
 " preceding directions have been faithfully purfued, we 
 " mult draw a diftindt. line, or boundary, in the very 
 " beginning of it, and put a final period to bleeding. 
 " In this alarming flate, all the fkill and power of phy- 
 " he muft be fummoned up, and quickly too, to oppofe 
 " the various breaches which the difeafe is now male* 
 " ing, for the entrance of death." 
 
 " The ftrength now begins X^ fail , the pulfe is fink- 
 " ing; the fufFulion of yellownefs is perceived in the 
 " eyes, neck, and breaft ; the vomiting inceflant, and 
 " the ftomach rejects every thing that is fwallowed. 
 " A coldnefs here, not fucceeded by fweat, or bilious 
 " difcharges, is almoft a certain mortal fvmptom." 
 
 " In this ftate nothing but purging can remove the 
 " vomiting, and favc the patient's life. Here the cor- 
 
 " ruption 
 
( 148 ) 
 
 ruption of the humours begins, and the Aools are 
 acrid, corrolive, and foetid, to an extraordii 
 degree." 
 
 " The misfortune here is. that the ftomach. retain- 
 kg, without great difficulty, oppofes all our 
 pts. The tartarum vitriolatum, or ial polv- 
 chreft, is a naufeous medicine : but there is no other 
 proper medicine, of which a fmall quantity will 
 purge, which is the objection againft tamarinds, 
 cream of tartar, and manna; nor is there any other 
 that I have ever found equally cooling and attenuat- 
 ing. It mult he given; and though part of it will 
 be returned, vet fome of it will remain ; and bv re- 
 peating a very fmall quantity every hour, ftools will, 
 in time, be procured, and generally urine, plentifully. 
 If the patient have five or Ox ftools, the vomiting 
 will ceafe. He mull: dilute with weak chicken 
 broth." 
 
 " Glyfters may affift, with warm fomentations fre- 
 quently applied to the region of the praecordia, which 
 fometimes bring out a crop of acrid eruptions about 
 the pit of the ftomach, on which the vomiting gene- 
 rally ceafes ; but in cafe thefc attempts tail, the pi- 
 tient fhould be put into a tepid bath, and have a b!:f- 
 tcr applied to his back, or to the infide of his tl 
 or, what is more efFedtual, to the region of the fto- 
 mach ; and a diaphoretic treatment adopted, with 
 ^(amci % powder, in order to x lieve the internal irri- 
 tation by rcvulliop, and enable the flomach to bear 
 purgatives, which alone can carry off the offending 
 humours, and remove that perverfion, as it were, of 
 the periftaltic motion, which is the ungoverna 
 fymptom, and, by its continuance, the raoft certain- 
 ly mortal fymptom of this fever." 
 
 « As 
 
( H9 ) 
 
 " As to what is called fever, there is nothing after 
 " the firft ftage of the difeafe that deferves that name. 
 c ' Therefore, after the firft ftage, bark is always to be 
 f given, when the ftomach will bear it. The wcrft 
 " evil that generally attends the giving of bark here a 
 " little too earlv, is oppreflion and load at the ftomach , 
 " which, ifglyfters do not remove, the purgative folu- 
 " tion, or a watery infufion of rhubarb, will ; or the 
 f uniting fome purgative medicine with the bark." 
 
 " Sometimes, foon after the firft attack of the fever, 
 <; an abatement of every lymptom is obtained ; and thofe 
 <; who are not well acquainted with the pulfe, and 
 f* the extenfive evacuations this fever demands, con- 
 ** chide that a rcmiflion, or an intermiffion, or a folu- 
 " tion of the tever is decided. But when this happens 
 f before the third d.iv, a ftricl attention to the pulfc, 
 " and the excretions, will diicover the deception, and 
 " fliew, by their difagreement with thofe fymptoms 
 " which appear favourable, that they appear fo with- 
 f out a proper caufe, and cannot be lafting." 
 
 " They who unfortunately make any dependence 
 ( ' here, defift from further evacuations, and proceed to 
 " giving hark, and cordial nouriihment. Every bedy 
 " about the patient is rilled with flattering hopes of his 
 " recovery. But the evacuations have been difconti- 
 " nued too foon, and have not been fufficientto extin- 
 " guiih entirely the inflammatory difpofiticn of the dif- 
 " eafe ; which, now aggravated, breaks out and rages 
 " with redoubled violence, and hurries the patient into 
 " the fecond ftage of the difeafe, and then foon out of 
 " the world." 
 
 " A yellow fuffufion maybe either critical, orfyrnp- 
 " tomatical. Critical, as Towne fuppofes ; but it muft 
 
 " be 
 
( *53 ) 
 
 tranquil ceflation, without languor, 
 I ptoms, with warm perforation; 
 ptomarieal, as Hillary fuppofes, when a< 
 
 ng, coljiqua- 
 ilfe. 
 " Great difputeshave arifen in dais pair oftheditf 
 pplication of bliftcrs." Blif- 
 ; :rs, however, according to Doctor Mofely, "are found 
 be a 1'afe and powerful remedy. Natives, and 
 ^ in the Weft-Indies aie feldono difturb- 
 natory difeafes, and bliftcrs canfearcely 
 r be appli They give a ftimulus to mts 
 
 Is, and form a drain for the acrid fcrum 
 the blood, which ofti n ki i p up disorders frpns dc- 
 bftruction, and irritation." 
 "It . baths, and diaphoretics, do 
 
 nove the lever in its in il ftage : 
 
 mg, baths, diaphoretics, and bliftcrs, do not 
 " remove it in the fecond flage: 
 
 " ii the vomiting cannot be fuppreffed, and the bark 
 
 ■led: 
 
 " Thelaft fcagc of the difeafe appears with its dirc- 
 
 " ful vomiting; which at firfr. has generally the apJ 
 
 mce of the grounds of coffee ; then that of a flate 
 
 ind then dark, thick, and grumous. Tluin- 
 
 . faces of the body are oozing out blood into 
 
 r cavities. Every excretion is corrupted blood." 
 
 " Ihr. :■ feen people recover after the vomiting has 
 
 ' : refembled coffee grounds, when any purgative medi- 
 
 '* cine, united with a decoction of bark, could be made 
 
 houid not have thought it neceffarv to mention 
 
 n in this fever, had not Hillary 
 
 " advifed 
 
t 151 ) 
 
 * advifed it, and others rafhlv followed his advice in ' 
 " giving it, to check die vomiting in the beginning ot 
 " this diTeafe." 
 
 " In a fever fo highly inflammatory, with the flo- 
 " mach in a conftant ftate of inflammation, and the 
 " contents of the whole alimentary canal fo hot and 
 ft acrid, it mull he, what I believe it often has been, a 
 ** fatal medicine." 
 
 " In regard to regimen, during the hrft three or four 
 " days, thin, fort, cooling drink, emulfion, and chicken 
 " broth, belides the medicines, will be as much as the 
 " ftomach can fuftain, even were any thing cite necei- 
 " fary. After the crifis, or after the firft ftage of the 
 " diicafe, panado, fago, and grnel, are the moft propei 
 " articles of nom iihment, with the addition of a fpoon- 
 " tul ot Madeira wine, where the patient is weak, 
 " languid, and exhaufred. Wine chcrifhes the fto- 
 *' mach, and acts as a cordial, mixed with thefe nou- 
 " riihments ; but if it be given in any other way, it af- 
 " feels the head, and heats the patient. Wine, where 
 " it is nece'Jary, ihould be ufed in the fame manner 
 " in all fevers." 
 
 THE CURE OF THE REMITTENT FEVER. 
 By John Hunter, M. D.* 
 
 " In treating of the cure of the remittent feyer, [ 
 " fhaH give an account of the remedies, in the order in 
 " which they were adminiftered when the fever had 
 " its moft ufual appearance ; and llnll afterwards enu- 
 
 " merate 
 
 * Observations on the Diseases of the Army in Tamaica. 
 
f 15= ) 
 
 u incrate the means that were found mofi: fuccefcful 
 " in removing, or palliating particular fyrnptoms, 
 
 • No lii •! 1 quires more fpeedy affiftance ; for thr 
 " efficacy of the medicines emplow-d depends, in a 
 " great u. . n their being given early." 
 
 " It" 1 fee a patient during the firft tit. I direct an 
 " ounce of Glauber's fait, or the lame quantity of the 
 " bitter purging fait, to be diflblved in half a pint of 
 " water, to which two drops of the oil pf peppermint 
 " being added, four table fpoonfuls of the fplution arc 
 " given every half hour, till it operates, or be all taken. 
 ' As there is generally much ticknefs at the ftomach, 
 " it is given in lmall doles, left it fhould excite vomit- 
 ** ing. The eflcntial oil coveis the tafte of the fait, 
 " and renders it lefs orFeniivc to the ftomach." 
 
 " It is probably of no great confequence, what kind 
 " ot purgative medicine is given, provided it operates 
 " effectually, and without violence." 
 
 " After a few ftools having been procured, the patient 
 " generally feels himfelf much eafier, and a remiflion 
 ,; often eniues. This is to be carefully watched for, and 
 " immediate advantage is to be taken of it, for adminif- 
 " tering the Permian bark. The common dofe of this 
 " medicine is a drachm, which may be repeated every 
 " fecond hour; and as a general rule in riving it, this 
 " is perhaps die befr ; but both the quantity and inter- 
 '• val mult often be varied, according to circumllances. 
 " Where the preceding fit has been uncommonly fe- 
 " vere, and there is reafon to tcai that the fucceeding 
 " one will be ftill more violent, and where a long re- 
 " million cannot be depended upon, the dole may be in- 
 •• creafed to two drachms, which may be given every 
 ir. But few ftomachs will bear fo much, and 
 
 4i fomctimes 
 
( ^53 ) 
 
 * fometimes the bark cannot be given at all, in fub- 
 " fiance. In 1'uch a cafe recourie muft be had to a 
 " decoction, or an infufion." 
 
 " In fevere attacks of the fever, in which it is ahfo- 
 " lutely neceffary to watch for the reinifiion, in order 
 " to make the beft advantage ot it, whenever the pulfe 
 u becomes a little flower, and the heat begins to abate, 
 " a dole or two of the infufion may be given, and the 
 " powder added afterwards, as foon as the flomach 
 ♦* will bear it. This I found the moft certain way of 
 ** moderating or preventing the next paroxyfm." 
 
 ** The vehicle in which the bark is given, muft, in 
 " many cafes, be fuited to the patient's llomach. It 
 '- will fometimes (it eafy on the flomach, when mixed 
 u with coffee, with wine and water, or with wine 
 " alone, if the iemifiion be confiderable ; in feme cafes, 
 " it anfwers the fume purpofe to mix it with milk, or 
 14 with a weak infufion of camomile flowers. By 
 " thefe expedients the flomach is reconciled to the me- 
 ,: dicine, is enabled to receive a larger quantity of it, 
 <c and to retain it better." 
 
 " It will fometimes happen that the bark purges 
 " flxongly, and paffes through the body almofr. un- 
 '• changed. This is not an unfavourable fymptom, 
 " and the remedy is eafy, for three or four drops of the 
 " t'mlrt. thebaic, added to each dofe, foon put a flop 
 " to the purging." 
 
 " When the method of cure laid down above is 
 11 carefully put in praclice from the beginning, it will, 
 " in many cafes, prevent a return of the fever; in ge- 
 " neral, however, a fufficient quantity of bark cannot 
 " be given on the firfl remiflion, nor is there time for it 
 U " to 
 
( '54 ) 
 
 to pToducc its eflc&s upon the body, fo as to pre 
 .1 fecapd paroxyfin." 
 
 " The heat, reftledhefs, anxiety, and indeed all the 
 fymptoms ulually accompanying the fecond p; 
 vim, are more violent than in the rirlt, it' nothing has- 
 been d toe in the remimon to ftop the progrefs of the 
 fevei ; but it the length of the remimon, and the 
 ftatc of the ftomach have admitted of the liber. d 
 of the bark, it has a conliderable effecl upon the en- 
 fuing tit. The fymptoms run high, but the flrcngth 
 of the patient appears more equal to the ftruj 
 the paroxyfm is lharp, but it is of Ihort duration, 
 and the remilFion that follows is of the complete]': 
 kind." 
 
 " J he medicme that I have found moft confident - 
 bly to relieve the fymptoms during die paroxyfms. and 
 promote a remilhon, is James's powder. Jt is given 
 in fmall doles, feldom exceeding five grains, and is 
 repeated every three or four hours. If the ftomach 
 be in an irritable ftatc, the dofe is often not larger 
 than half the quantity juft mentioned; for, as has- 
 been obferved betorc, no fymptom of the difeafe is 
 more troublefomc or dangerous than vomiting ; in 
 the cure, therefore, care mufr. be taken to avoid 
 every thing that might induce or aggravate any 
 tendency that way. The moft falutary operation 
 of fames's powder is, either to excite a lweat, or 
 gently open the body. There is feldom occaiion 
 \e James's powder in the firfr. paroxyfm, 
 that being occupied by the purgative medicine, 
 but if the fit continues as long as forty-eight 
 hours, and the purge has been given and produced 
 
 " the 
 
 
( *55 ) 
 
 *' the full effeit, and ftill there is no remifTion, James's 
 " powder may be given in the manner jufl: mention- 
 " ed, and by exciting a fweat, or further gently open- 
 " ing the body, it promotes a remiflion of the fever." 
 
 " In fublcqucnt attacks, the fame courfe is to be 
 " followed; that is, fmall doles of James's powder are 
 " to be given during the paroxyim, and the bark in 
 " remiflions." 
 
 " It James's powder does not keep the body open, 
 " which it feldom fails to do, laxative glyfters i 
 " ufe; for it is to be obferved, that one or two ltools 
 " in the twenty-four hours, greatly relieve the lick, 
 " and promote the good effects of the bark. This 
 <f is particularly the cafe in the fevers fublcqucnt to 
 " the rains in September and Odtober, which are of 
 <' the word kind. In fuch it is frequently advanta- 
 " geous to join four or five grains of rhubarb, to each 
 " dole of the bark, in order to procure two or three 
 (t motions in a day." 
 
 " I have had occafion to mention, that no fymp- 
 " toms are more dangerous than violent retching and 
 t* vomiting, and nothing can be more pernicious than 
 " the uie of emetics in fuch ciicumfhinces. If there 
 & be ficknefs and vomiting at the beginning of the 
 " difeafe, camomile-tet, or warm water, are fufficient 
 " to cleanfe the ftomach. If the vomiting or retch- 
 "■ ing ftill continues after making ufe of them, which 
 " they will'often do, and harrafs the lick, even dur- 
 " ing a remiflion of the other fymptoms, faline 
 " draughts, in a Hate of efferrefcence, repeated every 
 " hour, or oftener, will frequently allay this diflrefftng 
 t* fymptom. The ftomach is alio relieved by operi- 
 u ing the body, which further tends greatly to check 
 
 " the 
 
( '5* ) 
 
 " the vol rut as cathartic medicines would l>,-. 
 
 "immediately thrown i p. purgative glvfters arc the 
 " only mean n be employed tor that purpofe, 
 
 " and it ry fometimes to repeat them fevcral 
 
 " times. In this way the vomiting is often quieted, and 
 " the ftomach enabled to retain the b..: 
 
 " It will fometimes, however, happen, in the worft 
 " fevers, that the • are not abated bv the efTer- 
 
 " vefcing draughts, which are themfelvcs thrown tip. 
 " In fuch cafes I have hud recourfe to opiates, and 
 " generally with fuccefs. From fifteen to tw< 
 11 drops ot the tir.Fi. thebaic, may be added to an 
 " effei ; draught, or given in a little Brill"! 
 
 " water, and repeated in two or three hours, accord- 
 u ing to the ej f the fyraptoms," 
 
 " The vomiting being overcome, the bark mi 
 u given with diligence, yet with caution at rtrlT, by bc- 
 " ginning with the infufion, or decodtion, and adding 
 " the fubftance as the ftomach will bear it." 
 
 " During the acceflion of fever there is commonly 
 u more or lefs of head-ach, which fometimes becomej 
 " extremely violent, and greatly diftreffes the patient. 
 " A blifter, applied between the moulders, feldom of 
 " ever fails either to relieve, or entirely remove thi; 
 " fvmptom." 
 
 " In the very low ftate that was raei I fome- 
 
 " times to fucceed violent pai , eljiccially in, 
 
 '* tbofe. fevers that were attended with ycllownefs of 
 "the fkin, nothing was (i as cordials; for, 
 
 " though the bark was not entirety -laid afide, \ti I 
 " quantity he ftomach would bear, in any form, ■ 
 " fo fmall that little could he expected from it. V. 
 '* and nourishment were the belt cordials." 
 
 I 
 
( iS7 ) 
 
 The nourishment which Doctor Hunter recom- 
 mends, confifts of chicken broth, panado, fago, falop, 
 thin gruels, and tea, in which bread lias been foaked. 
 " To all thefe, except the broth and tea, wine may be 
 " added, with fugar and nutmeg, or any other fpice 
 " that is more agreeable. It is of the utmoft confc- 
 " quence in giving both nourishment and wine, that it 
 u be repeated often, and that only a little be fwallowed 
 " at a time ; for the ftomach is eafily overloaded, and 
 " provoked to vomit." 
 
 " When the lick are greatly reduced, after two or 
 f* more paroxyfms of fever, wine and nourishment be- 
 " come more effential than medicine." 
 
 " Tn treating the lick, I have fuppofed the method 
 " of cure to be put in practice from the beginning of 
 •" the difeafc ; but this cannot always be the cafe, as, 
 " for various and obvious reafons, a firfr, or even a 
 " fecond paroxyim may have pafled before any thing 
 " is done towards the cure. In this fituation, if there 
 {' be a rcmiffion, and the preceding fit has been violent, 
 " and there is reafon to believe that the fucceeding one 
 i* will be more fo, it is not advifable to lofe three or 
 M four hours in riving an opening medicine, which 
 " mull: therelore be omitted, and the bark administered 
 *' directly. Jn order, however, to prevent any fenfe 
 " of fulnefs, either in the ftomach or bowels, which 
 " might arife from that medicine, and likewife to pro- 
 "' mote the operation of it upon the conilitution, Tome 
 " opening medicine is joined to it, fo as to procure 
 " three or four ftools in the twenty-four hours. With 
 " this view, tour or five grains of ihubarb may be ad- 
 to each dole of the bark." 
 
 " If 
 
( i5» ) 
 
 C4 Tr" a delirium, with a considerable degree of wild. 
 '• nefs and agitation", which fometimes prevail during 
 
 paroxyfm, continue after the ufual evacu . 
 " an opiate, given in a mod 1 repeated 
 
 " aftei three hours, will, in fome cafes, have a 
 
 " good effect in quieting it, and thereby promote a re- 
 f miffion of the fever." 
 
 Doctor Hunter, in his obfervations on the effect of 
 remedies, remarks; " Blood-letting well defervesto be 
 " considered. In fuch caies as feemed moll to require 
 <; it, for example, where the patient was young, flrong, 
 " of a full habit, and lately arrived from Europe ; where 
 " the pulfe was quick and full, the face flufhed witn 
 " great heat and head-acb, and all thefe at the i 
 •'• ning of the fever, bleeding did no good. It neither 
 " diminifhed the fyinpton time, nor procured 
 
 " a fpeedier i (.milium. J cannot fay, however, that it 
 " did that mifchief that has been imputed to it bv fome ; 
 " for, provided it were a moderate quantity, it could 
 I to produce any ill confcquenccs. But 
 u if it were copious, or repeated a fecond time, it was 
 • always hurtful, and rendered the recovery of the pa- 
 I extremely flow, if not attended with worfe con- 
 ,; fequenccs. This effedt. it had in the inflamm 
 
 ' t the lungs that fometimes happened, in wl 
 " was neceflary to bleed freely. It will not be confi- 
 ed as a recommendation of bleeding to fay, that 
 ,; there were fome cafes in which it did little or no 
 " harm, if ufed moderately ; yet fuch is the conclufion, 
 •• to which the obfervations 1 had an opportunity oi 
 11 making lead .. 
 
 IT 
 
( '59 > 
 
 IT will be recollected that I fet out with a refolutionj 
 
 from which I am unwilling to depart, to make no com- 
 ments on the doctrines, or method ot cure, of thofe au- 
 thors who have written largely and learnedly on the 
 bilious remittent fever ; but I cannot torbcur making a, 
 remark or two on the practice of administering of bark. 
 My own experience authorizes me to fay, as in page 
 105, that I never knew itfafc or ufeful, until an entire 
 folution of the difeafe took place ; or at leait when no 
 fymptoms of importance remained, except the confe- 
 rence ot fevcre fever, viz. mere debility. That the 
 bark is too indiscriminately given, and without due re- 
 gard to the condition of the fir ft paffages, cannot have 
 cfcaped the notice of the molt inattentive ; and to me 
 it appears evident, that in thofe cafes where it is given 
 in the early ftages of the difeafe, unlefs it acts as a 
 gentle purgative, it feldom fails to do mifchief, particu- 
 larly it the pain be considerable in the head, or any 
 tendon or fenfe of fulnefs remains in either of the 
 larger cavities. To throw in the bark, as the phrafc 
 is, after the firft obfeure remimons in fevers of the bi- 
 lious fort, particularly in theje northern climates, is a 
 practice, in my judgment, if not calculated to endan- 
 ger the life of the patient, at leaft fuch as to protract, 
 in many inftances, the continuance of the molt formid- 
 able fymptoms. This fact is correfpondent with the 
 obfervations and experience of feveral practitioners ot 
 medicine in this city, who Stand defervedly high in their 
 profetfion. The celebrated traveller Bruce, who was 
 alSo a phyfician, informs us, that in Mafuah, on the 
 coait of the Red Sea, a certain Species of fever prevails, 
 which, in that country, is called tie dad, and which, 
 when it terminates fatally, is generally on the third day. 
 
 In 
 
f i6o ) 
 
 I fever there is no remedy fo fovcreign as the 
 bark; but he polirively afTcrts that it does not fucceed 
 unlefs it ads as a purgative. 
 
 " The fecond or rhird dofe of the bark, (fays he) if 
 " any quantity is fwallowed, never tails to purge; and 
 " if this evacuation is copiou ient rarely dies, 
 
 " but on the contrary, his recovery is generally 
 " rapid." 
 
 He further adds, " bark, I have been told by the Spa- 
 " niards, who have been in South- America, purges al- 
 " ways when taken in their fevers. A different eli- 
 te, dilferent regimen and habit of body, or cxer- 
 " cife, may finely fo far alter the operation of a drug, 
 "■ as to make it have a different effect in Africa to 
 " what it has in Europe. Be that as it may, ftill I fay 
 " b?.rk is a purgative, when it is fuccefsful in this 
 " fever," Sec. 
 
 ERRATA. 
 Page 29, line 3, for "did not contract" read did contrail. 
 45, between the word " thought," at the end of the 
 third line, and " that," at the beginning of the fourth, 
 insert the word proper. 
 
 55, line 4, lor " first" read J aft. 
 • 56, line 6, for " unsual" read usual. 
 Page 57, line 9, for " would" read cot 
 Page 102, line n, for " poracious" rod porraciotu. 
 Page 1 1 5, line 6, for " causes" read cases. 
 Page 124, line 6, for " that there was a" read one. 
 Page 129, line 10, between tiie words " required more" 
 insert to be. 
 
 Page 130, last line but one, for " There" read These. 
 
 ;e 1 33, line 6, for " of" read on. 
 Page 144, Hue 1 1, lor " effects" read efforts. 
 
 FINIS. 
 
4 
 
"V 
 
 I 
 
 V 
 
 fc