LIBRARY OF CONGRESS. §\ ' # fo She: ,n42-. UNITED STATES OF AMERICA. Entered according to Act of Congress, in the year 1879, by J. J, Hayes, M.D., in the Office of the Librarian of Congress, at Washington. All rights reserved. m it; m A Treatise on its cause, nature, prevention and cure; a synopsis of the pamphlet published and copy- righted in 1858 on the same subject and by the same author: and embraced in an appeal to four of the most learned Physicians of the City of New Orleans, for pe- rusal and consideration ; and for their decision on its merits; on its truth. THE FEVER, AS AN EPIDEMIC CHECKED IN A FEW DAYS: AS A COM- PLAINT CURED IN A FEW HOURS. ■BY- J. J. HAYES, M.D NEW ORLEANS: T. H Thomason, Printer, 26 and 28 Bank Place. 1879. m- A Treatise on its cause, nature, prevention and cure; a synopsis of the pamphlet published and copy- righted in 1858 on the same subject and by the same author: and embraced in an appeal to four of the most learned Physicians of the City of New Orleans, for pe- rusal and consideration ; and for their decision on its merits; on its truth. THE FEVER, AS AN EPIDEMIC CHECKED IN A FEW DAYS: AS A COM- PLAINT CORED IN A FEW HODRS. —BY— j. j/hayes, m.d. It A NEW ORLEANS: T. H. Thomason, Printer, 26 and 28 Bauk Tlaee. 1879. CAUSES OF YELLOW FEVER. 1st Cause. — Caloric is the remote, specific, determining, primitive cause of yellow fever. 2d Cause. — Reduced density and increased elasticity of the atmospheric air, the effect of caloric, is the second or intermediate cause of yellow fever. . 3d Cause. — The effete material remaining in the system, mixing with the chyle and fermenting, the effect of the second cause, is the proximate, internal, inti- mate cause of yellow fever. NATURE OF YELLOW FEVER. Heat of fermentation, yellowness, want of locomotive power, rejection of % dark fluid of a charcoal and metallic hue, constitute the nature of yellow fever, PREVENTION OF YELLOW FEVER. Making the atmospheric air preponderate, in the lungs, over the effete material and the chyle. CURE OF THE YELLOW FEVER. Making the atmospheric air preponderate, in the lungs, over the effete material and the chyle. YELLOW FEVER. Drs. LAB A TUT, KENNEDY and LEWIS: Gentlemen — In behalf of suffering humanity, in behalf of the Medical S jiences, virtue and truth, you are appealed to to take iuto due consideration that scourge, yellow fever, which every now and again Jkgr^ate'l th^ t^Lof New Orleans and State of Louisiana. <£x^--o<^cX-^ Being a question of the Medical Sciences, namely: anatomy, organic and inor- ganic chemistry, physiology and pathology, to you exclusively belong its study and consideration, and not to the outside secular worlds all of whom are utter strangers to the Sciences named and who, notwithstanding, taking advantage of the apathy ol medical men, are ever swaying to and fro, floundering in all kinds of ridiculous and mechanical notions and expressions uttered in the public press, in a vain effort to furnish a solution, which is far beyond their reach and sphere; aud who, instead of looking for it in the human body where the disease origi- nates, is seated and can be seen and found; who, instead of looking for it in the Sciences mentioned, are ever trying to hunt it up in other lands, in distant coun- tries where the inhabitants themselves have never found it, can't say whence it comes — whither it goes; who are looking for it in ships, gutters, sewers, streets, offal matter and swamps, as if these were not the same the world over; looking for it in all kinds of vague mechanical expressions, viz: germs, wee animals — spores ; looking in every place except the right one ; in every notion except in those derived from the Medical Sciences, which alone unmask it, disclose, reveal it, reducing it to a thing of nothing — scattering it to the winds. Gentlemen, you are appealed to in the heart-rending accents of wives, bereft of husbands, of the tears and wailings of innocent children, bereft of parents, abandoned to desolation and consigned to a cruel, stormy, ruthless world with- out protection or provision, you are thus appealed to to wrest this question from the vague, crude, uncouth expressions and futile researches of the secular world, and transfer it to the Scientific, luminous one to which you belong and which can and wiAl disclose the nature and prevention of this phantom complaint; and arrest for all time its horrors and ghastly exactions. Gentlemen, a few phrases would be sufficient to state to you the. nature, cause and seat of the complaint; but, as the public are alive to the solution of the question, I will state it to suit both, as I am equally anxious that they should understand it. A complaint is defined in Pathology to be, a lesion of tissue, of the tissues of an organ, causing a disturbance in its function; a lesion or alteration in any of the fluids of the body ; a change of relation, a disturbance of relations between the fluids and solids aud gases, which jointly execute the same purpose or func- tion; or a morbid, abnormal condition of said fluids. Pathology teaches three kinds of causes, viz: proximate, remote, occasional and predisposing causes. The lesion, disturbance of relations or abnormal conditions constitute the proximate, intimate or immediate cause. The agent causing the latter is the remote, the -specific, determining cause. Then, what is the proximate cause of yellow fever? The effete material of the human body remaining in the body, not eliminated from the body, is the proximate cause; the intimate, immediate cause of yellow fever; the cause of the conditions which ensue — which conditions constitute yellow fever — yellow fever in its essence. What is its remote cause? The want of an adequate amount of air in the lungs, causing a disturbance of proportion between the effete material of the body and the air in the lungs, may also be considered an element of the proximate or immediate cause. What, then, is the remote, specific or determining cause ? Caloric is; a want of an ad- equate supply of air in the lungs, caused by caloric or high atmospheric temper- ature, is; a rarefaction, expansion of the atmosphere, caused by caloric, is; an increased elasticity of the constituents of the air, impeding the chemical union of the effete material with the oxygen of the air, caused by caloric, is. Hence, caloric, or high atmospheric temperature, is the remote, determining, specific cause of yellow fever, by causing a disturbance of proportion between the effete material of the body and the quantity of air in the lungs; by causing an expan- sion, a rarefaction of the atmosphere, and thereby reducing its normal quantity and creating a disturbance of proportion between the effete material and the sup- ply of air in the lungs; by impeding the chemical union in the lungs which eliminates the effete material by increasing the elasticity of the air; augmenting the repellent tendency of its molecules. Therefore, the effete jnaterial of the system remaining in the system; the de- fective supply ofvatmdspheric air in the lungs; the disturbance of relative pro- portions between the effete material and the atmospheric air in the lungs, consti* tute the proximate cause of yellow fever. Caloric or heat, rarefying, expanding the atmospheric air, thereby reducing the normal quantity introduced into the lungs and required by the system; and thereby increasing the inherent repellent property of the molecules of gases, namely: their elasticity — thereby rendering the chemical union of respiration still more difficult; in addition, the chemical fact that at an abnormal high at- mospheric temperature, no union of gases is possible, I repeat caloric, by such expansion and diminution of air in consequence; by such increase of elasticity, and by such increase still rendering all chemical union of gases impossible, con- stitute the remote cause. The remote cause is also called the determining spe- cific cause. The effete material of the body not eliminated constitutes the prox- imate cause. Caloric, or high atmospheric temperature, diminishing the air for elimination, constitutes the remote specific cause. Please see the Articles on Circulation and Besphation, in any work on Physi- ology; also see Liebig's Organic Chemistry on the same functions. Which is the effete material of the system ? It is that portion of the human body which has been used to produce some action of the body, or of the mind. For every act, exertion of the body, for every exertion of the mind, namely: every feeling, thought or sentiment, a portion of the human body ceases to live; in the same manner, for every ray of light obtained a corresponding portion of oil or gas has to be consumed. The portion thus used is dead, and never sub- serves in the fame body the same purpose again. The portion thus used, dead or consumed, is the effete material, and has to be removed or eliminated as soon as dead. This removal is incessant, and is effected by atmospheric air in the lungs and by the skin. For that purpose forty cubic inches of air, weighing about 12 grains, are introduced twenty times per minute — 400 cubic inches, 240 grains, must be introduced per minule: and 400 cubic inches, weighing somewhat more, are eliminated. The air introduced is pure; the air expired or rejecied is impure air, to which thy effete material is reduced by a process of combustion in the lungs. The pure air meeting the effete matter in the lungs consumes it and reduces it, by a chemical combustion, to carbonic acid and water. The effete material before reacbiug the lungs has become bile, carbonic acid and water. Those with urea constitute the dead body, or the portion of the body used for the bodily or mental uses already mentioned. Unless removed as soon as dead, the person dies; dies within five minutes— expiration removes it; inspiration introduces the air which consumes it and a fresh supply for the sys- tem. Inspiration furnishes the agent for its removal and a fresh suppy for vital purposes, as stated. Inspired air is oxygen and nitrogen; expired air is carbonic acid and water. They both constitute respiration, which is executed twenty times per minute. Suspended for three or four minutes, the individual is dead. Its object is to remove the dead material and to furnish oxygen to the system. It is the oxygen of the air that removes the dead master; it is the oxygen of the air that produces all bodily and mental purposes. The air inhaled must intro- duce the oxygen necessary for elimination and for the execution of the bodily and mental purposes, viz: locomotion and sensibility. The nitrogen of the air subserves no purpose. It only tempers, dilutes the oxygen which otherwise is too active. Nutrition is effected by the food we use; it is to restore, to repair the loss sustained by use; to take the place of the dead material eliminated. The food we take is intended to repair the loss and to maintain life. It consists of veg' tables and meat; the vegetables are composed of oxygen, hydrogen, and Carbon ; the meat is composed of oxygen, hydrogen, carbon and nitrogen. The whole vegetable world, trees, shrubbery, fruit trees, flower tre^s, cereals, etc., are oae and all composed of oxygen, hydrogen and carbon. The whole animal kingdom, from the elephant to the mosquito, is composed of oxygeD, hydrogen, carbon and nitrogen. Nitrogen added to the constituents of the vegetable king- dom const tutes the animal kingdom. Therefore, the food we take consists of oxygen, hydrogen, carbon and nitrogen. The three first combined make the vegetables we eat; the fourth united with these makes the flesh we eat. In their primitive state they exist as gases. Oxygen combined with hydrogen makes water; oxygen, hydrogen and carbon make the vegetable world; the same with nitrogen make the animal kingdom. The vegetable food introduced is the same. With nitrogen the food enters the human system as cooked vegetables and meat. In the body it is macerated, liquified, and becomes chyle. It is tben conveyed to the right side of the heart in chyliferous canals, and mixing there with the venous blood, the heart projects it with the blood into the lungs, where it under- goes the combustion by which the bile is eliminated. It is then conveyed to the left heart and arteries, where the meat material becomes fibrin, albumen and protean and the vegetable food becomes oleagenous, fatty or saccharine matter. When used for purposes of human or animal life, it is again restored, returned to its primitive condition, viz: oxygen, hydrogen and carbon for the vegetable part and oxygen, hydrogen, carborf and nitrogen for the animal part; When thus restored or returned, they become the effete material and assume the following shapes or conditions: the effete oxygen and hydrogen combine forming water; the effete oxygen, hydrogen and carbon combine forming bile; the effete hydro- gen and nitrogen combine forming urea. The effete material, consisting of the same constituents as the food, assume in the body, before or after elimination, the forms of water, bile, carbonic acid and urea. The water, bile and carbonic acid are eliminated by the lungs and skin; the urea is eliminated by the kidneys. These elementary component parts enter the system in the form of albumen, fibrin, protean, and carbonaceous matter. When dead and reduced again to the inorganic state, they assume the shape of water, carbonic acid, bile and urea, When again rejected and restored to the dead world, they return to their natural, original elements and again become oxygen, hydrogen, carbon and nitrogen. They don't rest long in a dead condition, for on sight they are absorbed by veg- etables and become vegetables, and these devoured by animals again become animals, and so continue 'their perpetual revolutions. Such is the effete material. In their primitive state they are gases: oxgen, hydrogen, carbon and nitrogen. The first and second unite and form water — the water of the world; the first, second and third unite and form the vegetable kingdom; now, again, uniting with the fourth they form the animal kingdom. The effete matter is formed in every part, every organ of the body; it is formed when that part or organ officiates, as the organs act eternally. Every part acts occasionally, but frequently it is being produced, always, ever, eternally. The human system, the animal system, is ever officiating, therefore ever, eternally generating effete matter. In other words, the human body is always, ever, eter- nally dying. The living matter ever passing to dead matter by combustion. This combustion is effected by the oxygen of the air combining with the human tissue. The union is a chemical union, generating heat, carbonic acid and water; all combustions happen in the same manner, the result is always tho same, viz: heat, light, carbonic acid and water. In organic combustions there is no light — that is the only difference. As the organs of the body and parts of the body officiate by a combustion, the body is kept always, ever, perpetually warm, heab-d; the degree of heat being 98 ° F. The functions of the body, in addition to the combustion of bile in the lungs, maintain always, ever, the temperature of the normal system, viz: 98° F. As the body is eternally dying by combustion, I see no reason why, when dead, it should not be restored to its primitive ele- ments by a combustion. The living part has scarcely become effete, or dead, when it passes into little canals destined for that use, namely: the veins — they convey it to the right heart; the chyliferous canals convey the liquified food, now called chyle mixed with the bile, also to the right heart, which now contracts and projects all three into the lungs, where they are parted; the bile is burnt and reduced to carbonic acid and water and expelled from the body by expiration. Expiration at thesame time expels the carbonic acid and water of decay, which take place in all parts of the body when the functions are being executed, and which flow in the veins at the same time to the lungs. Therefore, as already stated, the dead material is expelled by expiration, while inspiration imports atmospheric air to effect this purpose ; also a fresh supply to execute the functions in the organs and different parts of the body. When the atmospheric air fails to import enough of oxygen to effect this double purpose, viz: to eliminate the dead material and to animate the remainder, death must ensue. At the time the effete material is being eliminated in the form of bile, water of decay and carbonic acid, the surplus oxygen unites with the hon of the glo- bules, now become protoxide and convert it into deutoxide. The iron globules convey to the lungs the carbonic acid of decay from all parts of the body where functions of mind or body have been executed; in the lungs they part with it. For such execution they parted with the surplus oxygen as deutoxade and theii reduced to protoxide they, on sight, combine with the said carbonic acid. Having reached the lungs and again meeting oxygen, they abandon the car- bonic acid by reason of a superior affinity, and unite with oxygen, tgain be- coming deutoxide. In the veins it is a carbonate of iron; in the arteries it is a deutoxide of iron. Bile being burnt in the lungs and reduced to carbonic acid and water, therefore the whole decayed material escaping by expiration , consists of carbonic acid and water. Kespiration consists of eliminating the dead material and introducing oxygen. It is executed in the lungs. While transpiring the liquid food, chyle passes through the lungs at the same time. When executed as stated, the chyle, with'the globules, enter the left heart and arteries; the chyle enters to compose to repair where loss has taken place in the organs or parts of the body, either by lo- comotion or sensibility. No act of the body, no act of the mind could take place without loss. Tne globules importing oxygen accompany the chyle and floods the system for all future actions, for none can take place without it; absent, there can be no act of either body or mind; there can be no locomotion, no sen- sibility. Oxygen is the agent of both; without it the most robust man could neither walk, talk or think. Without oxygen, he should be still or passive as if dead ; in the absence of oxygen, should he try to walk or talk- death is the con- sequence. The human body consists of two systems only — a muscular and a nervous sys- tem. The muscular system is that of locomotion; the nervous system is that of sensibility — all the phases of feeling and mind are included in the latter, and all that can be executed is included in the former. When the system has no oxy- gen death takes place in from three to five minutes; while there is only enough to animate the involutary muscles the man may live some time by remaining ut- terly passive. Still, when there is only enough for that purpose, and that the man makes a slight effort at locomotion, he dies. The chyle repairs the body and gives nutrition and growth; oxygen gives locomotion and sensibility; loco- motion and sensibility are produced by the use of the body— the decay of the body. Locomotion and sensibility are the chasm between the vegetable and ani- mal kingdoms. Trees live and grow; animals live, grow and execute locomo- tion and sensibility; that is, they move and feel. Trees live tor ages; they don't expend themselves by locomotion and sensibility. The effete matter is the material expended in order to move and feel; locomotion and sensibility are the expenditure of the nutrition and growth furnished by the chyle. Trees receive nutriment and growth; animals receive nutriment and growth, and so far, it is vegetable life. But animals move and feel; that is, execute locomotion and sen- sibility, which constitute animal life. How do they do it? By using the material ot nutrition and growth when they move or feel the material is used; it is used by consigning it to decay or effete matter. So animal life is vegetable life in a state of decay. An animal in motion is a vegetable in a state of decay, or de- composition returning to his primitive eliments. Without oxygen the animal cannot move or feel. There can be no animal life, no locomotion, no sensibility. The globules being the carriers, the importers of oxygen, their importance cannot be overestimated. This is quite important to remember, as it explains one of the most mysterious, formidable and fatal of the symptoms of yellow fever, namely death on locomotion or making a slight effort to walk or in talking. All the otner symptoms are visible; this alone reveals it- self by the consequence, and the consequence is death. Locomotion and sensibility may be deemed the essence of the human body; the muscular system furnishes the first; the nervous system the other. The loco- motive faculty transfers us from one place to another, transports us to and from places, while sensibility embraces the power of the mind and enables us to see, examine and judge all external things. They constitute the functions of relation between us and the universe. They furnish the glow of light which enables us to appreciate the universe and examine the earth, to extend our view to the myriad planetary systems, surpassing our own in number and magnitude and equally dependant on a central sun ; enables to see and contemplate con- gregations or clusters of the same, so remote that light, which travels at the rate of 30 million miles a minute, would take two million years to reach the earth; and even there we discover that the universe only begins as here. Astronomy teaches us so. It would seem incredible that such power should emanate from apparently such trivial things; as the returning of our primitive constituents to their original state, yet our surprise will cease when we remember that two of them, oxygen and hydrogen, have made the oceans and seas and waters of the world, when two others, oxygen and nitrogen, have made the vast atmospheric ocean in which we live; when three of them, oxygen, hydrogen and carbon have made the whole vegetable kingdom, and when the four, oxygen, hydrogen, carbon and ni- trogen have made the whole animal kingdom. The above constituents, having subserved the purposes of hum an life by the production of locomotion and sensibility at which we have just taken a bird's-eye look, assume the shapes already mentioned, viz: Carbonic acid gas, water, bile and urea. Having assumed those shapes they have become the effete material, but don't tarry long in that condition. Unless eliminated immediately they poison ■the body upon which they have just conferred such marvellous power; as a light or a fire is extinguished by being confined in the smoke which escapes from it. Having assumed these shapes it flows in the veins to the lungs and there meeting oxygen in abundance and at a normal temperature, the bile is first burnt and re- duced to carbonic acid and water; the extra heat caused by the combustion converts the said water and that of decay from the whole system into vapor; next the surplus oxygen decomposes the carbonate of iron of the globules, impregna- ting the iron with an extra quantity of oxygen, making it a deutoxideby liberating ing the carbonic acid. Now, at this time the whole effete material brought to the lungs is become carbonic acid and vapor of water and expelled by expiration, while the globules return to the system laden with oxygen. The whole takes place within three minutes, inspiration occupying a little more time than respiration. The urea is eliminated by the kidneys. So the whole effete matter is eliminated in the foim of carbonic acid, water and urea. The effete matter rejected and the material of nutrition and the globules laden with oxygen imported, the work of respiration is over. The material of nutri- tion gives vegetable life, viz: nutrition and growth; the oxygen gives animal life, viz: locomotion and sensibility. This function must be repeated twenty times per minute. Without nutrition a man may live a few days; without oxygen, he would not live five minutes. Put a man in water or in a closed room with burn- ing charcoal, the length ef time he survives is the term he lives without oxygen. They both inflict death in the same manner. He can't survive two respirations six minutes. What else can be fatal to him by depriving him of oxygen ? Caloric: Caloric by producing an excessive rarefaction and elasticity of the atmospheric air defeats inspiration in four different ways: By sunstroke, congestion of the brain, — in these cases the respiratory muscles become paralyzed and a muscular as- phyxia is the result, impeding respiration and depriving him of oxygen. Again by the plague and yellow fever. When inspiration is defeated by an excessive rarefaction and elacity, caused and produced by high temperature, that is, by caloric, the effete matter — bile — 8 passes through the lungs, mixes with the chyle and carbonate of iron, imparting neither the material of vegetable life — nutrition and growth — or that of animal life — locomotion and sensibility. The whole turbid fluid of the effete matter mixes with chyle, and having entered the arterial system, death is instantaneous; just as in drowning or in a room where burning charcoal has exhaused the oxy- gen imported to keep the heart and involuntarv muscles in motion. This seldom happens in an open atmosphere. But look in St. Louis recently: children and adults have died this year from that cause. From that condition, in 1864, the same happened in this city. The people said the heat killed them; but they did not say how the heat killed them. It did not burn them; it did not ignite them. It killed them by excluding oxygen. When the attenuations and in- creased atmospheric elasticity so reduces respiration as only to admit enough of oxygen to keep the heart in motion, a rapid fermentation and putrifaction en- sues; the individual lives, while the heart beats loDg enough to see himself a mass of petrification ; he dies on the eve of the first day or dawn of the next. So little effete matter is eliminated and so little oxygen imported, that the heart alone receives a supply; a rapid fermentation and putrefaction ensues, which is fatal as stated. This condition is very prevalent in tropical climates and is designated the plague. Whole armies when having invaded tropical cli- mates have perished by it; they have been said to have died like rotten sheep. When respiration has been so defeated by reason of the rarefaction and elas'icity of the atmospheric air caused by caloric, that so little effete matter has been eliminated, and that only enough of oxygen is inspired to give motion to the heart and involuntary muscles; and none for the external and voluntary; a gentle fer- mentation ensues, accompanied with a gentle heat and moist skin. This is yellow fever, and has always been called so; the heat having alwavs been mistaken for a fever. The plague and yellow fever are produced by one and the same cause; the last is a minor degree of the other; an all but complete defective respiration produces the first; a very defective one produces the hist; the plague, excluding all chance of recovery; the yellow fever affording four days and four hours by re- maining without motion. When respiration is so reduced that only enough of oxygen is received to animate the heart and involuntary muscles, that constitutes yellow fever, and immediately the person is apprised of it. He may have a cold, creeping feeling, and, at the same time, a very gentle heat; he does not heed that; he deems it nothing, but should he etand up to walk, he feels weak and staggers; and wants to lie down. Committed to rest again, he feels well; he thinks he can walk; he tries it, but staggers and faints. This is the first formid- able symptom of sickness, of danger, he has experienced. Should he transgress it, and repeat an effort to walk or talk, he faints and dies. This is an infallible proof that the person during respiration received only enough of oxygen up to then, to keep the heart and iuvoluntary muscles in motion. That *or locomo- ti n there was none; that for sensibility or mental purposes there was none; that consequently the necessity to remain still, motionless as a vegetable or a tree, was imperative. Instantaneously with this, which was the third condition or or consequence of the effete matter not having been eliminated, the whole body assumes, exhibits a yellow hue. The lid of either eye elevated, the sclerotie tissue was seen to be suffused, excessively suffused with bile, intensely yellow. At this early moment of the effete matter predominating over the necessary amount of air in the lungs, in the system, the three first immediate consequences of only enough of oxygen to keep the heart and involuntary muscles in motion were exhibited, viz: heat of fermentation, yellowness of the the body or the bile not elimonated and want of locomotion, or inability to transfer one's self from one place to another. At this moment, the want of locomotion or muscular power is the exact meas- ure of the amount of oxygen he has received from respiration, viz: just enough to keep the heart and inner muscles in motion; it is also the exact measure of the deficiency he sustained. How much then is the deficiency? Liebig says it is the quantity which an ordinary or normal atmosphere affords in four chiys and four hours. Then put him in such an atmosphere, and he is cured or well. Gen- tlemen, it is not possible that you could have attended the mauy patients you have without perceiving that four days and four hours is the duration of the complaint. The fifth is a transition day. On that day he takes some nourishment; it is a day of extra weakness. Give him the same amount of oxj'gen in one day or two days, in one hour or two hours, and he is quite well. On the contrary, let him expend in a fruitless effort the amount he had aod he dies instantly. He thereby transfers the inner supply to the external muscles, and the heart ceases and beats no more. Fourth symptom — black vomit: This symptom, like the two past ones, is visi- ble; can be detected by the senses; and invokes inquiry. It is more obscure than the preceding ones; but the nature of the preceding ones discovered, well ascertained, the difficulty of understanding the fourth becomes much reduced; for it is what might be expected; it is the sequence of the preceding ones. It is a dark fluid rejected from the digestive canal by the mouth. It consists of car- bon, charcoal or soot; it is the black material of the venons blood; it is what gives the venous blood the black color, it is the carbon of decay of the human system. The oxygen for the elimination of the effete material being deficient, the latter ferments;* the oxygen for the elimination of bile being deficient, the latter de- luges the system. The oxygen for locomotion being deficient, the patieot can- not make an effort without becoming a lii'ele.-sbody — a corpse. The oxygen still deficient, the carbon of decay no longer becomes bile; arriving at the spleen and liver by the vena cava; both are gorged, overwhelmed, with bile; they can make no more; the venous blood passes through them as it came, and the carbon oozes in flakes from the spleen, liver, into the intestinal canal, and is rejected by the duodenum, stomach and mouth — not by muscular effort or contraction, but by the elasticity of carbonic acid which accompanies it. Hence, the next se- quence is the rejection of carbon in the condition in which it is in the veins. This takes place about the third day; at this time the system not having received the oxygen as above stated, the spleen and liver, gorged with bile, no longer im- poses the usual changes on the venous blood; and the chief ingredient escapes unchanged. Gentlemen, it is unnecessary to observe to you that bile, m its constituents, is similar to oil, fat, lard, sugar or gum; all composed of carbon, oxygen aud hydro- gen, but chiefly of carbon. The carbon, now escaping in its primitive condition, indicates extreme peril up to this time, and even still it wss possible to save the patient; but now he stands on the brink of eternity — one step further, and he belongs to eternity. The effete matter not eliminated, and the fermentation continuing, sulphuretted hy- drogen is generated, and decomposes the globules, decomposing the oxide of hon, rendering it a sulphuret of iron, and never again can it become protoxide or deu- toxide ; never after can it export carbonic acid from the system ; never after can it import oxygen to the system. At this moment, the black carbonaceous fluid rejected contains iron, the iron globules of the blood, the agents of respiration, and exhibits a metallic hue. The patient now belongs to eternity, and his only hope is in the kingdom to come. — Please see pamphlet of 1859. The above are the symptoms or pathognomic conditions which the patient pre sents during life. Before considering the post mortem condition or utterances of the corpse, let us take a retrospect view of the close connection between the former. 1st Symptom — Fermentation. — The absence of oxygen in the lungs during respiration causes it. The effete matter not eliminated, the chyle mixes with it, enters the arterial system, and does and must ferment, and generates a heat and not a fever; but always called yellow fever. 2d Symptom — The Yellow Color. — The absence of oxygen in the lungs causes it. Bile, the chief ingredient of decay, not eliminated; its color attests its presence, and the want of oxygen in the lungs for its removal; its presence also attests that a fermentation must, and has ensued. 3d Symptom — Want of locomotion or muscular power. — The absence of oxy- gen in the lungs causes it. This is the inevitable coincident of the two preceding conditions and the utter evidence of the same cause; it is the irrefragable evi- dence of the want of oxygen in the lungs during respiration. 4th Symptom — Black fluid, first carbonaceous and then presenting a me- tallic hue, rejected from the mouth. — The absence of oxygen in the lungs causes it. The bile not eliminated, and at this time in vast quantities in the 10 system, the carbon must escape, as mentioned, and quite soon after the iron globules of the blood. The medical student who applies for a diploma, and who, on being shown a case of yellow fever for the first time, could not trace the above conditions to their source, should be rejected. It would be evident that he did not know anat- omy, physiology and chemistry. It would be evident that he never studied the functions of repiration and circulation. Post-mortem symptoms or conditio ds. — We will now proceed to consider and understand what the corpse has to say. The symptoms of the patient while living were visible; one only — the third— excepted. The post-mortem ones are still more visible, more conspicuous. The latter are generally deemed the most im- portant, the most reliable. 1st Symptom or condition. — When dead the corpse exhibits a yellow hue — an intensely yellow lemon color; a striking, ghastly, terrific hue, as if reproaching mankind and medical science for not knowing or discovering the cause of a death so simple aud so evident. The corpse would seem to say, and his color actually does say: don't you see that I have been deluged with or drowed in bile? don't you know how to take me out cf this flood of bile, or how to take the flood out of me ? The eternal, infallible utterance of the corpse revealed the nature of the complaint and the way to cure it. Then to comply, how can either be executed ? By atmospheric air or oxygen. Put the patient in a current of air, in a stiff breeze, in a storm in a gale or hurricaue, and in a few hours, perhaps a few minutes, the bile, or effete matter, will be eliminated; the muscular faculty or power will be restored; and he will quit his bed, and walk and act and work as well as before. Is it not a matter of painful wonder, that go back a hundred years to any work on Physiology, and you will see that respiration consists of re- moving the effete matter, that is bile, from the system and introducing oxygen; yet, the application of it has never been made medically when needed, as in yel- low fever, though over a million of human beings have perished, drowned in bile, in the language of the victims, and though reprimanded and admonished by the dread, infallible utterances of one million corpses. 2d Post-mortem condition. — The second condition is quite as evident and still more marvellous. The corpse is hot; hot, oh, Heavens ! can the human mind realize anything so averse to common sense or reason, as a hot dead man ? Life extinct, a frozen cold ensues instanter. When the heart ceases to beat, the tem- perature of the body falls to zero; yet a yellow fever patient retains his heat for days after death; retains it when put in the coffin, and long after. In the human body there can be only two kinds of heat: one, the vital or or- ganic heat, the other, a chemical or inorganic heat. The first is the heat of life; the other is the heat of disease or death ; the latter is that of fermentation. The dead body, warm or hot, the corpse reveals the heat to be one of fermentation Hence the corpse says, in the most emphatic terms: I am dead; my heat is not a living heat, it is one of fermentation, which can only be furnished by animal or vegetable matter in a state of transition, such as fermentation, decomposition, or putrification. The corpse says no more ; it said enough. One word upon the concurrent testi- mony of the living and the dead ; of the patient and the corpse. The first expression of the complaint of the patient when attacked is a heat — a heat of fermentation. The last expression of the corpse confirmed it. The second expression of the com- plaint of the patient is yellowness, which attests the presence of bile, and which increases every day until deluged with it. The last dead utterance of the corpse is: "I am drowned in bile." The two intermediate symptoms, viz: want of muscular power and "black vomit,"' are the direct, immediate sequence of the concurrent testimony of the living and the dead; of the patient and the corpse. Remove the bile and loco- motion is restored; remove the bile and black vomit cannot ensue, as already fully explained and corroborated by the infallible utterances of Omnipotent Nature. The applicant for a medical diploma who could not interpret both post mortem conditions should be refused. It would be very evident that he did not know physieology, organic and inorganic chemistry. The physician in Europe who could not tell the remote and proximate cause of the complaint, on being told the living and post mortem condition, is not entitled to be considered a 11 physician. The physician in Europe who, on being told the remote cause, and could not tell the proximate cause and the living and post mortem conditions of the complaint, should not be considered a physician. TREATMENT OF THIS COMPLAINT. Has any practical illustration of the expose* just made been ever given ? I have given six hundred such illustrations or proofs. This question brings us to the treatment of the complaint. In exposing the pathology of the complaint, we saw that the yellow fever patient takes to his bed only when he experiences an inability to stand up, to walk, to think or talk; and when attacked he feels warm, rather a pleasant warmth. He does not heed it; he can't believe that an* agreeable heat can injure him, can overcome him. He walks a few paces, he staggers, feels faint, and is compelled to rest. While motionless, he feels well; he repeats his attempt to walk; he becomes faint, he staggers and faints. Should he repeat, he staggers falls and dies. While at rest he can live; should he commit himself to motion, make an eftort, he dies. "Now, elevate the lid of either eye, and the white tissue of the eye is gorged with bile; the whole system is equally so. The three conditions are simultane- ous, viz: the heat, the yellowness, and inability of motion. The bile or effete matter causes the other two. The inability of motion is the exact measure of the quantity of oxygen ihe atmosphere then prevailing gives him; it is also the exact measure of the quantity it did not give — of the quantity lacking. Ho receives enough to keep the heart and involuntary muscles in motion. He re- ceives none for the voluntary muscles. Should he transfer the small amount of the former to the latter, in order to make a solitary effort, he exhausts all and the heart ceases to beat, and beats no more. Remove the bile and he is cured instanter; remove the bile and the heat and inability of motion will vanish. In other words, give him the lacking quantity of oxygen, give Tlfta the quantity needed for the voluntary muscles, the locomotive muscles, and he is cured in- stanter. How much is the lacking quantity ? This is the supreme question. This question brings us to our goal. A few words before I answer this final question. Gentlemen, look at the patient prostrate on the bed; his life hangs on a thread; he can live only by being still, motionless and foodless. He has not enough of the material ot animation, namely, oxygen, in his system to enable him to set up in his bed, or to put the drink to his mouth. At the peril of his life he is com- pelled to be motionless This shows how little oxygen he receives; that little removed or denied him, he becomes a corpse. It is so little that he may be con- sidered as having, or receiving, none at all. Should the patient be utterly deprived of oxygen, what quantity of it does he need to restore animation, to restore the normal quantity. The great German professor, Baron Liebig, computes it to be the quantity furnished by a temperate atmosphere in four days and four hours. Gentlemen, you must be aware that the exact duration of yellow fever is four days and four hours. Having remained motionless for four days and four hours, the bile is eliminated and the fermentation over. In four days and four hours, the system is impregnated with oxygen, with the quantity needed for voluntary and involuntary motion. Thus, the amount of oxygen he inhales during four days and four hours is the lacking quantity. This is the goal we aimed at; wo have reached it successfully. How much oxygen does he receive during that ,time ? Very easily known. We inhale at every inspiration forty cubic inches of air; we inhale twe.ity times per minute. Forty cubic inches of air weighs about 12 grains; one hundred inches weighs 30 grains: See Miiller's Physiology and Physics. One-fifth of the air inspired is oxygen, and weighs about 2 grains; Two grains per inspiration make forty per minute, -400 per hour, 57,600 per day, or 7 5 lbs.; making 30 lbs. 2 oz. and 40 grains for the four days and four hours. This is the lacking quantity of oxygen; of the principle itself in its purity When the patient first feels warm, looks yellow, and is unable to move, let him inspire, inhale in its purity, or from the atmosphere, the lacking quantity of oxy- gen, and the heat, yellow color, and inability of motion will vanish, and a perfect cure will be effected. Let him inhale it in one day or in two days. Let him in- hale it in one hour or two hours, and instanter he is well. Let him receive or inhale the lacking quantity and the effete matter is eliminated, and the sequences dispersed. Let him inhale the lacking quantity, and his mind and body are re- 12 stored to their integrity; to their normal condition. Put him in a storm, gale or hurricane, and in a few minutes he will have received, inhaled the lacking quan- tity; in a few minutes he will be deluged with air, and the deluge of bile will vanish like smoke and in smoke; will vanish as fast as chaff before the wind, or like oil thrown into a blaze. Practical Illustrations or Proofs. Having made my medical studies in Paris, I arrived from France in this city in 1844. The complaint called yellow fever was the only one I was not familiar with. For some time I pursued the treatment then, and to the present day in practice in this city. I soon saw that the treatment was more fatal than the complaint, and that many more would have recovered had they not been sub- jected to it; had they been left to the kind offices of nature. I then studied the symptoms, or marked conditions, the ensemble of which constituted the com- plaint, and its extreme simplicity surprised me. Sick in 1847, the epidemic of 1853 was the first I saw. When called upon, and at the patient's house, I looked first for a room which admitted a draft, a current of air, by having opposite doors or windows* I then insisted upon hav- ing the patient's bed placed in that draft. I next insisted upon having not only the opposite openings, but all the openings in the building left open, day and night. In addition, I often insisted on the patient being fanned, night and day, when the temperature ranged between 80° aDd 90° F. Bed covering. — The bed covering I reduced to one sheet during the above at- mospheric temperature, and varied it according to temperature; increasing it when the temperature declined; the object being to maintain the normal physi- ological temperature of the skin, in order not to impair or impede the evapora- tion therefromg^hich is similar to that of the lungs, viz: carbonic acid and water, and for a similar purpose. The position of the bed, the ventilation and bed covering determined upon, the next indispensable requisite was to remain still, passive, absolutely so; and as still, tranquil in mind as in body for four days and four hours. The next was, fasting for the same time. Nature made this requisite imperative; for the patients loathe food during the specified time. The next was the drink. The patients preferred water and it was the best; was the best as contaiuing no nu- triment. The treatment or cure: on giving the patients the lacking quantity of oxygen, 30 lbs., 2 oz. and 40 grains, the complaint called yellow fever was over. To remain motionless and foodless in the open air, for four days and four hours, was the infallible remedy, the infallible cure. Kemaining motionless and food- less in the open air for four days and four hours eliminated the effete material, to wit., the bile, and the cure became inevitable. To remain motionless and foodless in the open air, in epidemic Hme, for two days before he got the fever, eliminates the effete material, to-wit., the bile, ren- dered prevention infallible, inevitable. The suggestion, the indication furnished by the corpse, revealed the nature of the complaint; revealed that it was a heat of fermentation, and not a fever heat. The suggestion of the corpse revealed the nature of the complaint, that it was a fermentation. The suggestion < f the corpse told the way to cure it. The suggestion of the corpse told the way to prevent it. Remaining half the time, to-wit., two days, foodless and motionless in the open air, before he gets the fever, renders prevention inevitable. So true it is that prevention is easier, is better than cure. Remaining half the time foodless and still in the open air, before he gets the fever, eliminates the effete material, the bile, and renders fermentative heat impossible, utterly impossible. The say- ings of Omnipotent Nature cannot be gainsayed. A turtle, to obtain food for its young, will abandon them and go three hundred miles in the ocean, and return to them in a straight line. A bird taken circuitously in the interior of a ship some hundreds of miles, will return in a straight line. My treatment having been the reverse, the antipodes of that practiced for all time before me, and to the present day, I had it enacted, reduced it to practice, at the peril of my life. The people were sunk into as deep and dark a prejudice in favor of the custo- mary treatment as any superstition ever inspired. On one occasion, when treat- 13 ing nine patients in a very inferior frame house on Julia street, corner of Earn- part street, I had them removed from the badly ventilated, contracted rooms and put, one and all, on mattrasses, on the ground floor, between the front and back doors, with vigorous instructions to keep not only the front and back doors, but all the openings in the house, open day and night. Crowds passing would stare and exclaim : Remove those yellow fever patients to their rooms; put four blankets, at least, on each of them; close up every opening in the house, and sweat them for four days, otherwise they will -all be dead before morning. They would return every day, expecting to find them dead; and finally finding that none died, and that all recovered, they were as much grieved as surprised. On other occasions, I have been informed'that crowds had determined and sworn to murder me, unless patients, then under my care, under my treatment, recovered. On all occasions an awful verdict awaited me unless successful. Would I have dared to place my patients in the open air, in a draft, unless convinced of the result? I was as sure of the result as I was that I had a head on me; (Otherwise, I would not have risked it. Are not these six or seven hun- dred cases, so many practical illustrations, positive proofs of the nature, cause, prevention, and cure of the complaint ? Having inhaled the lacking quantity of oxygen in a free exposure of ventilation for four days and four hours, health and recovery awaited with the certainty of the rising of the sun. I make these assertions in the city where I attended the patients, and where they can be seen, and where they are the living evidence of all that has been advanced. The Complaint a Condition of Economy. To cure it only needs atmospheric air, water and repose. To prevent needs only atmosphere, water and repose. After four days and four hours he feels as if the complaint fell from him; on the instant he feels empty, hungry: he implores food; he feels a weakness from want of nutriment. On that day he takes a little broth; should not get much. On the next day he can take one-third the usual food. The next day he can eat as usual. He feels his strength returned, and quits his bed and walks. That is all the complaint cost him. Hi? strength returns as quick as it quit him. In an economical point of view, it is a saving of food for six days. It is a loss of time of one week; of one week only. Notwithstanding, hundreds of thousands are sent here under the mistaken impression that the complaint consists of a famine, rather than a disease, needing only repose and abstinence; millions are sent, be- lieving it to be an extensive mortality, the result of a dearth, while the reverse is the case. The complaint is rather an aristocratic one, to which the devotees of indul- gence and the patrons of good cheer are chiefly liable. It is worthy of notice that the inmates of the Parish Prison, condemned to re- main all but motionless, and subjected to a temperance which they can't trans- gress; denied the power of indulging in obscene revels and tumultuous brawls; reduced in body and mind to all but a passive, inert condition, enjoy an immuni- ty from the complaint. They have been seldom, if ever, attacked. Invalids, emaciated from sicimess, and the indolent and poverty-stricken, emaciated from want, from scarcity, the dependants on chance for a stray morsel or scanty meal, are equally exempt, exult in the same immunity, and laugh at the visitations of the prosperous, at the pets of fortune. Cause of Yellow Fevek. Patholo y recognizes chieny three kinds of causes, to-wit., a remote or determ- ining cause, a proximate or intimate cause, and a predisposing cause. The prox- imate or intimate cause is the tissue, organs, fluid or gas of the body which are disordered or disturbed in their substance, in their functions, or in their relations. Caloric is the remote determinining cause of yellow fever. The effete matter of the human system, remaining in the system, not elimiua- ted, is the proximate and intimate cause of yellow fever. Caloric, the remote external cause, acts by reducing the quantity of air, oxy- gen, by rarefaction, and by reducing its efficiency by increasing its elasticity. Therefore, caloric acts by decreasing the quantity of oxygen and impairing its efficacy; and, in consequence, there is an absence of the normal quantity of available oxjgen in the lungs during respiration. The air deficient in quantity and efficacy in the lungs, the effete material re- mains in the system and ferments. The effete material remaining in the system, not eliminated, fermenting and generating the symptoms and conditions, before and afcer death, so often stated, embrace the proximate cause in full. Oxygen so links the remote and proximate causes that it is difficult to say to which it be- longs. Through derived from the air, and an outward agent, it may be considered an intrinsic, essential gas of the human body, for the body can only live three minutes without it. Its absence in the lungs, its abnormal quantity, its disturb- ance in proportions and relations with the effete material, and with the vital ma- terial, namely: the iron globules and red blood, cause, engender the complaint Restore oxygen in its normal quantity, temperature and efficacy, and no fever is possible. Restore oxygen in its normal quantity and efficacy during the fever, and the latter is dissipated, dispersed, cured. Caloric alone can impair its normal quantity and efficacy. Therefore, caloric is the remote, primitive, external, determining cause of yellow fever. Caloric is the only remote, external cause. It acts by impairing oxygen in quantity and efficacy. The instant result is, the effete matter remains in the system; the next instant result is the effete matter ferments; the next instant results are heat of person, yellowness of person and inability of muscular motion. The three are simultaneous. The next in succession, but at a slight interval of time, is a dark fluid rejected; the next, in quick succession, is a dark fluid of metallic hue rejec- ted; the next in quick succession is death. After death heat continues, and the yellowness assumes a most intense, terriffic, vengeful hue. The corpse is buried and the heat continues. To recapitulate. Caloric, and only caloric, is the remote, determining, specific, external cause of yellow fever. The effete matter of the system, remainiug in the system and fermenting, is the proximate, intimate, internal cause of yellow fever. The four conditions before death, and the two after death, viz: heat, yellow- ness, inability of motion, rejection of a dark fluid — a dark fluid of metallic hue — and -the intense yellowness and supernatural heat of the corpse, constitute the nature and essense of yellow fever. Curing the complaint consists in flooding the system with atmospheric air or oxygen, and eliminating the bile. Prevention of the complaint consists in flooding the system with atmospheric air, and remaining motionless and foodless for two days. Why foodless? Man is one-third carnivorous and two-thirds herbivorous. Vegetable nutriment becomes in the system similar to bile, and subserves the same purpose, viz: to engender heat. Eating while bile was being eliminated would be introducing it as fast as it was being eliminated. Why motionless? Exercise engenders bile internally It would, in like man- ner, be creating it internally while eliminating it externally. Gentlemen, convinced of all that is herein stated, I proclaimed, in the thick of the epidemic of 1853, that it could be checked in a few days; and I published the prophylactic, hygienic observance which, if enacted, would have done so. It would have been worth a million of dollars to the city, and would have saved her the loss of millions, in addition to thousands of lives. City authorities seldom comprehend scientific demonstrations, consequently seldom can recommend them. Had the money, sent them this year to defray epidemic expenses, been sent to a body of the most learned medical men, as you gentlemen, includiug Drs. Barthelot, Ranee', Mercier, Borde and D'Aquin, etc., who know the wants of destitute sick much better than laymen, and who would be glad to receive scientific facts and demonstrations. I am persuaded the scientific prophylactic and positive cure would be now fully established. As in 1853, I published this year the scientific prevention and cure for over thirty days in the City Item. It was as follows: YELLOW FEVER. Dr. J. J. Hayes' preventive for yellow fever, in accordance with pamphlet pub- lished and copyrighted in 1858, wherein it has been scientifically demonstrated # 15 that the fever, as an epidemic, could be checked in a day or two; as a complaint could be cured in an hour or two. - The preventive means consists of four medicinal doses and a hygienic observ- ance, viz: A privation of food, a respite from labor, exertion, and a free expos- ure to the open air for a few da vs. The medicinal doses being only auxiliary the hygienic, observance was the principal, the all essential, and in consequence a copy, a formula was attached to each phial, and was as follows: Take one dose of the preventative medicine e-very day for four days; take it in the morning. 1st Day — Eat nothing; don't work or take exercise; remain in the shade, in a draft or in a current of air as much as possible, and sleep with open doors and windows, or in the open air. 2d Day — Eat nothing, but might take some broth; the rest as on first day. 3d Day — Take broth, some bread and meat, but the less the better; the rest as on first day. 4th day — Take food as usual, but the less the better; the more temperate the better; the rest as on first day. To resume: 1st — Take one dose of the preventive every morning lor four days. 2d— Fast as rigidly as possible for two days. 3d — Fast as much as possible for the two succeeding days. 4th — Keep in the shade, in a current of air or in the open as much as possible for the four days. 5th — Dont work or take exercise for the four days. Having done as above the due relation between the system and the increase of atmospheric temperature becomes restored, and yellow fever, which is the off- spring of the disturbance, is no longer possible; in other words the system is now acclimated. It may be easily seen that the preventive consisted of abstinance, in order to reduce the material of nutrition in the system ; and make the requisite amount of atmospheric air predominate. When the supply of air in the system predominates over the material of nutri- tion and the effete material of the body, there can be no yellow fever. When the fever takes place; again making the supply of air preponderate cures the fever. Hence, atmospheric air is the agent which prevents the fever; atmospheric air is the ag^nt which cures the fever. The hygienic regimen, as stated, was the maximum necessary for adults of the laboring classes. Ladies and children would be protected by eating less than usual — half enough for a day or two — and admitting, day and night, all the air their doors and windows admitted of keeping them open day and night. Did a million of men, laborers or soldiers, enact the observance, viz: The privation of food; the respite from labor, and sleep out in the open air on dry ground or planks, and take, not medieal doses, but a teaspoonful of salt — table salt — (chloride of sodium) in coffee, every morning for four days, not ten, no, not one, could take yellow fever that season, as sure as there is a God in yonder sky. All persons living in well ventilated houses would be protected by eating less than usual, leaving the openings open; desisting from exertion and using salt in coffee three times a day. A teaspoonful for adults; half for ladies, and less for children. J. J. HAYES, M. D. The yellow fever pamphlet of 1858, soon to be issued, will much more fully explain the modus operandi of the prevention and cure. In the daily Picayune, another city journal, of the greatest circulation, the fol- lowing was inserted for days: TO THE PEOPLE OF NEW ORLEANS. Citizens: — It is an object to all of you to know the nature, cause, prevention and cure of yellow fever. An article now in the City Item reveals them. Then you are earnestly entreated to get the article and preserve it. All further proof you can desire of the truth thereof you will receive in a short time. Therefore, preserve the article and request your respective physician to inform you whether *. 16 it is true or not. Your request will induce, make it incumbent, on them to ex- amine and study it and truth will come forth. If you would dispel this scourge, which is only a phantom, appeal to your physicians; appeal to the presidents of the benevolent societies to submit it to four physicians of long and well known merit, namely: Dr. Kennedy, Dr. Laba- tut and the Drs. Lewis, Third District. Thus appealed to, before three weeks they will solve the question, and all future danger will be averted. In addition, I will take all care and pains to have it submitted to the Universities of Berlin, Paris and London. The inquest is sure to sustain the truth advanced by me, and no longer will your lives be in danger; no longer will wives and children be swept from husbands and vice versa. I again beseech you to keep the article in the City Item. With all due and full consideration, etc. J. J. HAYES, M. D. Nobody having made the appeal the duty devolves upon me. Gentlemen, I have the honor of being your obedient servant, J. J. HAYES, Surgeon and M. D, New Orleans, December 16, 1878.