Volume 4 — AN ACCOUNT OF SPORADIC CASES OF YELLOW FEVER, AS THEY APPEARED IN PHILADELPHIA, IN THE YEAR 1804.

The month of January was marked by deep snows, rain, clear and cold weather, and by the general healthiness of the city.

In February there fell a deep snow, which was followed by several very cold days. There was likewise a fall of snow in March, which was succeeded by an uncommon degree of cold. Catarrhs and bilious pleurisies were very common during both these months.

In the beginning of April, the weather was cold and rainy. There were but few signs of vegetation before the 15th of the month. Bilious pleurisies were still the principal diseases which prevailed in the city.

The month of May was wet, cool, and healthy.

In June, the winds were easterly, and the weather rainy. The crops of grass were luxuriant. It was remarked, that the milk of cows that fed upon this grass yielded less butter than usual, and that horses that fed upon it, sweated profusely with but little exercise. On the third of the month, I was called upon by Dr. Physick to visit his father, who was ill with a bilious fever. He died on the seventh, with a red eye, hiccup, and black vomiting.

Four persons had the yellow fever in the month of July. One of them was in Fourth-street, between Pine and Lombard-streets, another was in Fifth-street, between Race and Vine-streets, both of whom recovered. The remaining two were in the Pennsylvania hospital, both of whom died. Remitting and intermitting fevers were likewise common in this month.

In August, those fevers assumed a chronic form. During this month, there died an unusual number of children with the cholera morbus.

The city was uncommonly healthy in September. A storm of wind and rain, from the south-east, proved destructive to the crops of cotton this month, on the sea coast of South-Carolina.

In October, intermittents were very common between Eighth-street and Schuylkill. One case of yellow fever came under my care, in conjunction with Dr. Gallaher, on the western banks of that river.

While Philadelphia and all the cities of the United States (Charleston excepted) were thus exempted from the yellow fever as an epidemic, the western parts of all the middle, and several of the southern states, were visited with the bilious fever, in all its different forms. In Delaware county, in the state of New-York, at Mill river, in Connecticut, and in several of the middle counties of Pennsylvania, it prevailed in the form of a yellow fever. In other parts of the United States, it appeared chiefly as a highly inflammatory remittent. It was so general, that not only whole families, but whole neighbourhoods were confined by it. Many suffered from the want of medical advice and nursing, and some from the want of even a single attendant. In consequence of the general prevalence of this fever in some parts of Pennsylvania, the usual labours of the season were suspended. Apples fell and perished upon the ground; no winter grain was sowed; and even cows passed whole days and nights without being milked.

The mortality of this fever was considerable, where those distressing circumstances took place. In more favourable circumstances, it yielded to early depletion, and afterwards to the bark. Relapses were frequent, from premature exposure to the air. Those only escaped them who had been salivated, by accident or design, for the cure of the fever.

This disease was observed very generally to prevail most in high situations, which had been for years distinguished for their healthiness, while the low grounds, and the banks of creeks and rivers, were but little affected by it. The unusual quantity of rain, which had fallen during the summer months, had produced moisture in the former places, which favoured putrefaction and exhalation, while both were prevented, in the latter places, by the grounds being completely covered with water.