Volume 4 — AN ACCOUNT OF THE BILIOUS YELLOW FEVER, AS IT APPEARED IN PHILADELPHIA, IN THE YEAR 1805.

For a history of the uncommonly cold and tempestuous winter of 1804 and 1805, the reader is referred to the Account of the Climate of Pennsylvania, in the first volume of these Inquiries and Observations.

During the months of January, February, and March, there were a number of bilious catarrhs and pleurisies.

On the 7th of April, I visited a patient in the yellow fever with Dr. Stewart. He was cured, chiefly by copious bleeding.

The weather was rainy in May. After the middle of June, and during the whole month of July, there fell no rain. The mercury in Fahrenheit fluctuated, for ten days, between 90° and 94°, during this month. The diseases which occurred in it were cholera infantum, dysenteries, a few common bilious, and eight cases of yellow fever. Three of the last were in Twelfth, between Locust and Walnut-streets, and were first visited, on the 14th and 15th of the month, by Dr. Hartshorn, as out-patients of the Pennsylvania hospital. Two of them were attended, about a week afterwards, by Dr. Church, in Southwark, and the remaining three by Dr. Rouisseau and Dr. Stewart, in the south end of the city.

On the third of August, there fell a heavy shower of rain, but the weather, during the remaining part of the month, was warm and dry. The pastures were burnt up, and there was a great deficiency of summer vegetables in the neighbourhood of Philadelphia. The water in the Schuylkill was lower by three inches than it had been in the memory of a man of 70 years of age, who had lived constantly within sight of it.

In September, a number of cases of yellow fever appeared in Southwark[9], near Catharine-street. They were readily traced to a large bed of oysters, which had putrified on Catharine-street wharf, and which had emitted a most offensive exhalation throughout the whole neighbourhood, for several weeks before the fever made its appearance. This exhalation proved fatal to a number of cats and dogs, and it now became obvious that the two cases of yellow fever, that were attended by Dr. Church, in the month of July, were derived from it. An attempt was made to impose a belief that they were taken by contagion from a ship at the lazaretto, which had lately arrived from the West-Indies, but a careful investigation of this tale proved, that neither of the two subjects of the fever had been on board that, nor any other ship, then under quarantine.

The fever prevailed during the whole of this month in Southwark. A few cases of it appeared in the city, most of which were in persons who had resided in, or visited that district. It was brought on by weak exciting causes in Southwark, but the cases which originated in the city, required strong exciting causes to produce them.

A heavy rain, accompanied with a good deal of wind, on the 28th of September, and a frost on the night of the 7th of October, gave a considerable check to the fever.

But few cases of it came under my care. Having perceived the same disposition in nature to relieve herself by the pores, that I observed in the years 1802 and 1803, my remedies were the same as in the latter year, and attended with the same success. Dr. Caldwell and Dr. Stewart, whose practice was extensive in Southwark, informed me, those remedies had been generally successful in their hands.

The only new medicine that the experience of this year suggested in this disease, was for one of its most distressing and dangerous symptoms, that is, the vomiting which occurs in its second stage. Dr. Physick discovered, that ten drops of the spirit of turpentine, given every two hours, in a little molasses, or syrup, or sweet oil, effectually checked it in several instances, in patients who afterwards recovered. It was administered with equal success in a case which came under my care, after an absence of pulse, and a coldness of the extremities had taken place. Dr. Church informed me that he gave great relief to the sick in the city hospital, by this medicine, by prescribing it in glysters, as well as by the mouth, in distressing affections of the stomach and bowels.

Dr. Stewart observed that all those persons who had been affected by the yellow fever in former years, had mild remittents in the same situations that others had the prevailing epidemic in a malignant form.

In one of four bodies the doctor examined, he found six, and in another three intussusceptions of the intestines, without any signs of inflammation. He discovered the common marks of disease from this fever in other parts of those bodies.

The deaths from this fever amounted to between three and four hundred. They would probably have been more numerous, had not those families who were in competent circumstances fled into the country, and had not the poor been removed, by the board of health, from the infected atmosphere of Southwark, to tents provided for them in the neighbourhood of the city; and they would probably have been fewer, considering the tractable nature of the disease, when met by suitable remedies in its early stage, had not the sick concealed their indisposition, in many instances, for two or three days, lest they should be dragged to the city hospital, or have centinels placed at their doors, to prevent any communication with their friends and neighbours. While these attempts were made to check the progress of the fever, it did not escape the notice of many of the citizens of Philadelphia, that not a single instance occurred of its being communicated by contagion, in any of the families in the city, in which persons had sickened or died with it, and that while the sick were deprived of the kind offices of their friends and neighbours, lest they should be infected, physicians, and the members of the board of health, passed by the guards every day, in their visits to the same sick people, and afterwards mixed with their fellow-citizens, in every part of the city, without changing their clothes.

The yellow fever appeared early in the season in New-Haven, in Connecticut, and in Providence, on Rhode-Island, in both of which places it was derived from putrid exhalation, and was speedily and effectually checked by removing the healthy persons who lived in its neighbourhood to a distance from it. Several sporadic cases of it occurred during the autumn in Gloucester county, in New-Jersey, and in Mifflin and Chester counties, in Pennsylvania. It was epidemic in New-York at the same time it prevailed in Southwark and Philadelphia. The following extract of a letter from the health officer of New-York, to one of his friends, contains a satisfactory proof that it was not, in that city, an imported disease.

Quarantine-ground, Sept. 7.

I most sincerely and tenderly deplore the unfortunate situation of our city. What do people say now of the origin of the disease? You may state, for the information of those who wished to be informed, that not a single vessel, on board of which a person has been sick with fever of any kind, or on board of which any person has died with any disease, while in the West-Indies, or on the voyage home, has ever gone up to the city during this whole season. This we know, and this we vouch for; and farther state, that all the cases of fever that have come down as from the city, have been all people of, and belonging to the city, and unconnected with the shipping, excepting one, a sailor, who had no connection with any foul vessel. There is not a shadow of proof or suspicion that can attach to the health-office, or to infected vessels, this season. I am, &c.

JOHN R. B. RODGERS.

Having concluded the history of the bilious yellow fever, as it has appeared in eleven successive years, since 1793, as an epidemic, or in sporadic cases, I shall proceed next to enumerate all the sources of that fever, as well as all the other usual forms of the summer and autumnal disease of the United States, and afterwards mention the means of preventing them.

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