^\9W^^9^'fA^ THE LIBRARY OF THE UNIVERSITY OF CALIFORNIA PRESENTED BY PROF. CHARLES A. KOFOID AND MRS. PRUDENCE W. KOFOID AN ACCOUNT YELLOW FEVER, AS IT PREVAILED IN THE CITY OF NEW-YORK, IN THE SUMMER AND AUTUAIN OF 1822. BY PETER S. TOWNSEND, M. D. Honorary Member of the Royal Jennerian Socipty of London; Fellow of the Literary and Philosophical and of Iho PhysicoMfdical .Societies of New York ; Mennbir of the American Geological Society, &c. Thncydidts. NEW- YORK : PUBLISHED BY O. HALSTED, No. 249 Broadway, corner of Murray Strest, 1825. BE IT REME'VIBPRED, that on the thirtieth day of January, iu- the forty sevp nth year o*" the Independence of the United States of America, O HaisieH, of the said distritl, hath deposited in this office the title of a hook, the. right whereof he claims as Proprietor, in the words and figures following, to wit : " An Account of the Yellow Fever, as it prevailed in the City of New-York in the Summer and Autumn of 1822 By Peter S. Townsend, IVl. D. Honorary Memher of the Rc\al Jennerian Society of London; Fellow of the Literary and Philosophical and of the Physii o-Mcdical Societies of New-York ; Member of the American Geological Society, &c. iial autoJ iitov aKKcvinaQXovjcis. — Thucy- dides.''' In conformity to the Act of the Congress of the United States, entitled, " An Act (or the en'ourag:pmeiit of Learnin"-, by securing the copies of Maps, Charts, and Books to the ftulhors and proprietors of such copies, during the times therein msntidnfd And also to an Act, entitled, " An Act, supplementary to an Act eniilled, -an Act for the encourag^m at, next to, and south of Rector-street. About five lighter loads Avere discliarged each day, amount- ing to nearly one half the cargo of either of the vessels. More than one half probably of the cargoes of the above four vessels was discharged within three or four days of the period mentioned. The cargoes were stored in the ware-houses which stand and open on the wharves to which they were brought. During the time the lighters were receiving their loads from the Havanna vessels, the thermometer ranged steadily at a high temperature, and the weather was unusually calm. At the house of the health officer, which is upon an elevated and airy position within the Quarantine ground, and open to the sea, and where the weather was of course much cooler than in the city, the thermometer in the shade, in all this period, comprised within the nine days, averaged at 2 p. M. 80°. At S in the morning, and 6 in the evening, the average was '7'7°. The medium for the whole day was 78**. Account of the Yellow Fever. ^5 The weather was so calm, that scarcely a breath of air was stirring, so that very little or none of the infected ntiatter adhering to the cargoes, could be blown off or dissipated. We thus see, that during all this period, an accession of cau- ses, each of which of itself was almost sufficient to have introduced yellow fever, was daily accumulating, and that too under circumstances peculiarly favourable for the intro- duction of the disease, at one particular point of the city. That the contagious matter did adhere in considerable quantities to the cargoes of the vessels, which had so re- cently arrived from Havanna, and where the 5'ellow fever was prevailing, at and after the time of their sailing, there can be no doubt. We have direct and positive proof, that two of the vessels, at least those in which several of the crew died, contained the poison in all its virulence. The boxes of sugar, to those who know the manner in which they are constructed, are extremely well calculated to im- bibe, as well as to retain this virus. They are made of rough pine boards, presenting an exterior surface of a porous or bibulous nature, which like fomites, and similar solid and spongy substances, for which the contagious poison of yellow fever is known to have so strong an affi- nity, must have been particularly well calculated to en- tangle and retain it. This will appear still more probable, when we recollect the compact manner in which these boxes are put together, and the great number of them that may be stowed in the hold of a vessel ; for this porous sur- face is thus multiplied to a prodigious extent. One of the vessels contained near six hundred boxes. There never perhaps had accumulated before, so large « mass of cargo from Havanna vessels, at that particular season, and in so small a space. This was owing to the circumstance of tlie frequent piracies in the West Indies. 2(5 Account of the Yellow Fever.- and particularly to the nest of pirates who infested the coast of Cuba, whereby our merchant vessels were obliged to come under convoy of our ships of war, in consequence of which a considerable number frequently arrived in port nearly at the same time. 1 have said, that the lighter-men had become habituated to the infected air of Havanna vessels, and were to a cer- tain degree insusceptible to the contagion of yellow fevec brought in such vessels. We will give one or two striking examples as an illustration, and which are abundantly sufficient to establish this fact. Two of these same lighter- men were employed at the foot qf Rector-street, in taking off cargoes from out the stores near the wharf at Rector- street, in the latter part of September, and one of them slept on board of a lighter for four nights at the foot of Rector-street. Not osie of the men thus exposed, took the disease. In addition to this, it may be stated^ that from the beginning up to the termination of the epidemic, labourers have been constantly at work in building out a dock at the foot of Rector-street, none of whom have taken the disease. The disease began at the two opposite corners of Rector- street where it terminates on the wharf in Washington- street, July lOth, 1822. As Washington-street has but one row of buildings, fronting the wharf. Rector-street, termi- nating also here, has but two corners. The N. W. corner was the cooper-shop of a Mr. Reder, and his house, a neat two-story building, stood next to the shop on the same lot but in Rector-street. The opposite corner was a building occupied as a grocery, by a Mr. Falkncr. The first cases were Reder's two little gir's, the one named Amanda aged 1 1 , the other named Caroline, aged 9, and Andrew Thomas, a young Scotchman, aged 23, of a robust, hale con- Jlccomtt of the Yellow Fever. 27 Stitution, who had only been in this coimtrj' three or four months, and who was clerk in Mr. Falkner's grocery. They all sickened July 10th, 1822. Dr. Walters was called to see Reder's two daughters the following day, July 11th. Thomas was sent immediately to the New-York hospital, without having been attended by any physician, and died there July 1 6th, with black vomit, but was not reported to the board of health, nor recognized in that institution, accord- ing to the best of my information, as a case of jellow fever. The great question now to be determined, is from what source these first cases derived their sickness. It is very evident, that both Thomas and the little girls, by falling sick on the same day, with the same disease, in two opposite though different houses, derived their illness from the same cause. At least it is hardly possible to suppose, that a coincidence so extraordinary as this should have happened by mere chance. It is also beyond all question, that this was the beginning of the pestilence ; for a few days after- wards an alarming number of persons took sick of the very same disease, most of whom died, in the houses in Rectoi'- street, next to Reder's, and to the grocery. We see that the lighters had been discharging their cargoes at, above, and below the wharf directly at the foot of Rector-street, and not more than fifty feet distant from the houses where the three first ca«es happened, up to the day before that on which they all sickened. This alone is sufficient to account for the origin of the disease, supposing the Reders and Thomas to have had no direct communication with the lighters. But in addition to this we know it to be a fact, thai the two Reder girls, at least, were still nearer than this to what we consider to have been the source of the disease. Reder, in his vocation of cooper, was constantly employ- ^ 'k 2§ Account of the Yellow Fever. ed along this wharf, in repairing water casks, boxes of sugar, Sec, and was at that very time engaged in this busi- ness. This much is certain, that the little girls frequently visited their father, while he was at work, and were in the daily habit of amusing themselves in playing about the dock. Why others did not fall sick until after the Reders and Thomas, and not at the same time with them, though many were doubtless exposed to the same original cause, cannot be determined. Because perhaps Thomas especi- ally was peculiarly predisposed to the disease, ana the Reder girls particularly exposed to the cause which pro- duced it. Because, moreover, the boxes as they were discharged from the lighters were immediately stored in the warehouses on the wharf, and thus in the same way as when shut down and confined under the hatches of a vessel, placed in a situation in which it was impossible for them to give off the fatal poison adhering to them. Here then we have detected the disease in its origin. There can be no confusion of dates and names and places ; no cavilling about the beginning of the disease, and the first cases of it, a species of subdety, which has been so often resorted to in previous years, and which to those who did not know the motives by which they who used it were actuated, has for a time passed off as a plausible objection to the doctrine of the importation, specific character, and contagious nature of yellow fever. We do say boldly, aiKl without the fear of having our assertion contradicted by any medical gentleman of this community, that before the cases of Thomas and the Re- ders, nothing this year of the kind had happened in any part of the city ; no disease which bore the least resem- blance to theirs, or with which it was possible to confound Account of the Yellow Fever. 23 ^^Jj^' their symptoms. The season had been uncommonly mild and serene, and continued so during the whole of the sum- mer and autumn, so that it was the subject of general and pointed remark, that the air had never been observed to be more perfectly free of fog, vapour, or clouds, the tempera- ture never more pleasant and uniform, nor the city more generally healthy before as well as during, and after the epidemic, except in that particular part where the yellow fever prevailed. There had been but little rain in all June, and the sky continued unclouded through all that, and the succeeding months of July, August, September and October. There were no sudden vicissitudes of exces- sive heats for three or four da^s, followed by remissions to which our climate is so subject. There were no forebodings of the approaching calamity, no long prevalence of dry winds, nor hot oppressive weather, no previous pestilential and ^morbid condition of the atmosphere, blighting the hopes of the harvest, corrupting the fruits and waters of the earth, and poisoning « ith death, not only human beings,, but insects, fish, and all the other tribes of inferior animals. The atmosphere never perhaps exhibited so few of the usual phenomena of the season. Most of the time, the weather was calm, or only a gentle breeze blowing from the South West or South East. Hence the scrupulous and studied silence w hich has been observed by the advocates of domestic origin on the subject of those general and imagi- nary causes, which under the various denomination of astro- logical and meteorogical influences, malaria, epidemic con- stitution of the atmosphere, and yellow fever periods, have heretofore been insisted upon with so much pertinacity. These fanciful pictures, drawn with so much apparent care and detail, but w hich are found to be the copies of ai> 30 Atcounl of the Yellow FevcT. antiquated and now obsolete superstition, are delineated with much more taste, by the immortal bard, than in the laboured productions of modern writers. Therefore the winds, piping to us in vain, As in revenge, have sucked up from the sea Contagious fogs ; which, falling in the land, Kave every pelting river made so proud, That they have overborne their continent : The ox hath therefore stretch'd his yoke in vain. The ploughman lost his sweat ; and the green corn Hath rotted, ere his youth attain'd a beard : The fold stands empty in the drowned field. And croziss are fatted with the murrain flock ; The nine men's morris is fiU'd up with mud ; And the quaint mazes in the wanton green. For lack of tread are undistinguishable ; The human mortals want their winter here ; No night is now with hymn or carol blessed : Therefore the moon, the governess of floods, Pale in her anger, washes all the air, That rheumatic diseases do abound : And thorough this distemper ature, we see The seasons alter : hoary headed frosts Fall in the fresh lap of the crimson rose ; And on old Hyems' chin and icy crown, An odorous chaplet of sweet summer buds. Is as in mockery set ; the spring, the summer. The childing autumn, angry winter, change Their wonted liveries ; and the mazed world, By their increase, now knows not which is which. Midsummer-Night's Dream. Account of the Yelloio Fever, 3T Audi alteram partem : " Arrive a Philadelphie dans le commencement du mois d? Aout, 1793, je n'ai pu dtudierles constitutions mddicales ante- rieures. Jc crois cependant n^cessaire de donner une idee de celle qui avait pr^c^de la maladie, d'aprts les rapports cer- tains qui me furents faits. Liiivcr avait (?te tres-doux, le prin- temps trcs-precoce, et lv-t<^ exeessivement chaud. // n^y avait eu ni pluies, ni or ages ; Vair avait eU tres-sec Les gens de la campagne avaient observe que la sueur des ouvricrs ne cou- lait point sur leur corps, comme a Vordinaire ; mais qu'elle ^tait absorb^e a mesure qu'elle se prt'sentait a la surface de la. peau. Les fruits furent de tres-inauvaise quulitc, teau des puits ircs-corrompiie et les rivieres ir^s-basses. On vit une grande quantite de poissons marts f otter sur les rivieres ; ceux de la mer, ainsi que les huitres qu''on portait au marche, eiaient maigres et d'«n gout fade tres desagreable. Les vents principaux qui soufflerent venaient de la partie du sud, et il y eut une quantiti extraordinaire d^ insectes. On observa avant VepidCmie une epizootic qui attaqua les chats ; il en mourut un grand nombre. La meme chose arriva en 1797. " Avant que la maladie se manifestut, il avail rcgnt beaucoup demaux de gorge, qui etaient evidemment d'un caractere in- flammtitoire. Quelques jours apres se develloppa cette ficvre jaune, dont les effets furent si funestes." Traite de la Fievre Jaxine,par Jean Deveze. p. 20. Paris, 1820. " The common atmosphere, far the most part, was opaque and smoky, as if the earth's surface were undergoing a slaw combustion. It seemed a heterogeneous mixture of particles, in a state of opposition and propulsion ; respiration frequent and unrefreshing. The sun, in mid-day height, appeared as a volume of blood, dark and angry. As it declined to the western horizon, its diameter widened greatl}^ ; and at an hour's height, or more, was almost invisible, or shrouded as with sack cloth. These appearances, however, were not constant." Account of o!2 Account of the Yellow Fever, the Yelloiv Fever, as it appeared at Boston, in 1798, By Samuel Brown, M. B. Boston, ISOO, p. 26-7. Reder's daughters appeared to be affected very much alike, without any inordinate excitement, but with some heat of skin and a soft frequent pulse. The symptoms of both went on, pari passu, from the beginning, but on the morning of the 5th day, Caroline had black vomit. That same day, in the evening, Monday, July 15th, John Re- der, aged 16, a son of Mr. Reder, and who had officia- ted as a clerk to his father, took sick. He and his sisters were pronounced, July 17th, by Dr. Walters, to be cases of Yellow-Fever ; being the first cases that had occurred this season, and the first that were reported to the board of health. Caroline died on the 16th. Aman- da recovered ; and John died on the 22d. Dr. Walters, be- fore reporting these cases, had mentioned them to Dr. Ho- sack, the Mayor, to Messrs. Phillips and Noah, the editors of the National Advocate, to Dr. Francis, and a number of other individuals, to all of whom he freely declared, that they were, in his opinion, unequivocal cases of yellow fever, and that we now had a disease among us that could not be indigenous. But the board of health, and some of the pub- lic prints, were unwilling to believe this unwelcome intelli- gence. Too many melancholy proofs, however, soon after- wards occurred of the truth of what he had asserted. Dr. Walters was so well satisfied that he could not be de- ceived in his opinion, that he recommended, at that ear- ly period, to Mr. , who lived in Rector-street, next to where Thomas sickened, and to Mr. Waldron B Post, who lived in Greenwich-street, in that neighbourhood, to re- move a= speedily as possible. Mr. moved accord- ingly with his family to Brooklyn, where one of his sons fell sick with yellow fever, and narrowly escaped death. Account of the Yellow Fever. 33 On the 20th of July, a little girl by the name of Louisa, daughter of Mrs. Rose, and who had been in the habit of playing with Reder's daughters, and who sickened the same day as John Reder, was reported at the corner of Greenwich and Rector-streets, about 80 feet from Reder's house ; and on the 26th, Euphemia Dobson, Mrs. Ed- wards, Leonard W. Archer, and Mrs. Waters, were all reported in the same house, where Miss Rose sickened and died. They took sick the 24th and 2.5th of July. As none of these cases after those reported by Dr. Wallers, were designated to ihe board under the appellation of yel- low fever, and as the Resident Physician, the oflkial adviser of the board, and who had seen these, as well as the first cases, strenuously persisted from the beginning, that there had been no yellow fever in the city, the citizens lulled themselves with these assurances into a fatal securit}^, until the 31st of August, when two of the cases at i\Irs. Rose's were now announced by Dr. Neilson, to the board, as having developed unequivocal symptoms of yellow fever. Six out of the whole number of reported cases having now died after a few days illness, and die board remaining still unconvinced, the public became alarmed at their extraordi- nary apathy, and feeling no longer that implicit confidence in their decisions which they were wont to in previous years, began to judge for themselves on the measures most prudent to be adopted, to stay the pestilence or escape its ravages. The Resident Physician also, finding that the course which the Board, at his instigation, pursued, had become the sub- ject of severe and general animadversion, at length ac- quiesced in the common belief, and on the 4th of August, nearly one month after the disease had begun, and w hen it was now no longer possible to stop the impulse 34 Account of the Yellow Fever. which it had received, or to stifle the truth, reported Mrs. N. Phillips, who had removed from Greenwich-street, near Rector-street, as a case of yellow fever, stating by way of explanation, that the infected air which had until then produced nothing but bilious fevers, had now become sufficiently concentrated to generate yellow fever. [See his Official Communication to the Board of Health.'] The dis- ease now began to radiate slowly and regularly in every direction from the spot where it began, proceeding as it were step by step, to the different houses in Greenwich and Washington streets, adjacent to this part of Rector-street, and on the 9th of August it had a.-cended to Lumber-street, halfway up the hill of Rector-street, on its course towards Broadway. In this short and narrow street, (Lumber,) ly- ing under tlie hill, and cramped up behind the high stone abutment, which supports the rear of Trinity church yard, and so shut in at either extremity, as to be deprived of a free circulation of air, the disease proves! uncommonly mortal. In the mean while, however, it had continued to extend. North and South, along the level of Greenwich and Washington streets, and as early as the 6th of August, had arrived also at the Albany basin. On the 19th of August, most of the inhabitants in the immediate vici- nity of Rector-street, having now retreated before the appalling malady, and fled from their homes, the disease kept steadily on its march, attacking the few persons who remained, and made its appearance in Cedar-street, another narrow street, running down to the wharf, beyond Al- bany-street, and parallel to, and at a considerable distance north of Rector-street. On the 22d, it had arrived to Li- berty-street, the cross s treet next beyond and parallel to, but wider than Cedar-street. On the 23d, it had completed thf Account of the Yellow Fever. So ascent of the hill of Rector-street, and reaching the ridge of Broadway, through this street, as well as by intercommu- nication between the yards of Lumber-street with those of Broadway, below Rector-street, now crossed Broadway, and began to descend again east towards the other side of the town, down the hill of Wall-street, and down the gentle de- clivity of Broadway, south, to the Battery, creeping at the same time at an equal pace along the dead level of Broad- way, north of Wall-street. On the 24th, it had passed out of Lumber-street, into Thames -street. On the 2Glh, it had descended to No. 19 Wall-street ; on the 27th it had begun to descend rapidly the declivity of Broadway towards the Battery. In the mean while it had passed southerly from Rector-street, along the level of Greenwich and Washington streets, where, finding nothing to afford it pabulum, as al- most all the inhabitants of this part of those streets had fled, it proceeded on the 28th, westerly up Beaver-lane, which, like Rector-street, also runs down from Broadway across Greenwich and Washington streets, to the river. Here it met another column of the infected air coming down Broad- way from Rector-street ; for we find, on the 26th, a case was reported at No. 96 Broadway, and on the day after, one at No. 84, and on the 28th one at No. 82, and two at No. 40 Broadway. On the 29th, it had descended southerly from Wall-street, into New-street. On the 1st of September, it con- tinued to descend Wall-street, towards Broad-street, and on the 2d, it had passed from Broadway, down the sleep de- scent of Garden-street, as far as the corner of New-street. On the same day it had arrived at Courtlandt-street, the cross street parallel to, and next above Liberty-street. It must be observed that, while the infected air appeared to 36 Account of the. Yellow Fever. liave taken the hill of Rector-street, as the most direct course to'Broadway,and no doubt first reached this spacious avenue through this route, it had soon afterwards attained it also through Beaver-lane, and through Greenwich, Wash- ington, and Marketfield streets on the south of Rector-street, and through Lumber, Thames, Cedar. Liberty and Court- landt streets, on the north of Rector-street. It had begun to descend Wall-street, as early as the 23d of August, as this was in the immediate vicinity of Rector and Lumber streets ; but having had to go some distance north in Greenwich-street, before it came to Liberty street, it did not reach the summit of that street at Broadway, until a short time before September 7th ; for on that day, we find it had already crossed Broadway at that street, and descend- ing as it had done, down Wall-street, reached the sugar house at the corner of Liberty and Nassau streets, in which building so many fatal cases occurred. Having now descended Broadway, south from Rector- street, and having before reached Broadway by a southern course also through Greenwich, Washington and Marketfield streets and Beaver-lane, we find on the 6th of September, that it had crossed Broadway, at Beaver-street, and had met the column of moving poison, which had passed down Wall and New streets, and down the hill of Garden-street from Broad- way ; for on that day a case was reported in New, near Beaver-street. On the 9th, it had got into Pine-street, where, as most of the inhabitants, being wealthy, had fled, very few cases occurred. On the 10th, in its course through Broadway and Greenwich streets, north, it is said to ha\ e reached Dey-street near Greenwich-street, next above, and parallel to Courtlandt-street ; and on the same day, showed itself at the foot of Broadway, in an opposite Account of the Yellow Fever. 37 direction, near the beautiful little park, called the Bowling- green, adjacent to the extensive promenade on the point of the island known by the name of the Battery. This is another proof how intensely concentrated was the poison, converg- ing and meeting, as it were, at this point from several quar- ters at once, and capable of infecting the three or four soli- tary individuals, who had been left to take charge of the superb dwelling houses in this open and airy section of the city. On the 1 1th, it is reported to iiave reached Maiden- lane, and to have already descended that street, on its way to the East river, as far as William-street. On the same day it is said to have ascended not only Courtlandt-street but also Fulton-streel, the street next above, and north of Dey-street, as high as Broadway. We have seen that it had already passed some distance down Wall-street. On the 13th, it descended from Wall down into Broad-street, one of the widest and most beautiful in the city. On the same day it is said to have reached Broadway, also at the summit of Dey-street, which is the cross street be- tween Courtlandt and Fulton streets. On the 15th of Sep- tember, having passed through Greenwich, Washington and Marketfield-streets down Broadway to the Bowling-green, it proceeded along Whitehall-street to the corner of Stone- street. But on the next day, viz. the l6th of September, three cases were reported at No. 4 Lombabdy-street. As these cases could not be traced to what had hitherto been consider- ed the infected district, and a- Lombardy sire et was at Itast half a mtle north east of any part of this di-tiict, the intel- ligence of ihe disease having appeared in ilii street occa- sioned considerable alarm. On the 20ih o! Scjueniber this alarm was greatly increased, for nn that and the next day five cases, none of which could be traced to the old infected dis- 3S Account of the Yellow Fei*e». trict, were reported in Cheapside-street, a narrow but remarkably clean street, parallel to, and next below, and east of Lombardy-street. Three of these five cases died^ and the board of health immediately recommended the aban- donment of that part of the town, and on the 21st they com- menced spreading lime through this street and Lombardy- street. On the 17th of September a case was reported also in Mill-street. On the 23d another case was reported in Cheapside-s;reet. On the 25th two women were reported, who had nursed Catherine Bailey, their sister, who had died in Cheapside-stieet. They were sent to Q^uaraniine, and died with black vomit. In the mean while the disease had now appeared not only in the ditfe rent streets between the Battery and the Park leading from the east side of Broad- way, but also at the various slips on the East river or oppo- site side of the town to that where it had begun. Thus, the 17th of September a case was reported at Old Slip ; at which place we recollect that the advocates of domestic origin had pretended to say that the yellow fever of 1819 had been generated ; on the 20th a case occurred at Fly market slip, and on the 26th one at Coffee house slip, cases occurring in the mean time in Water and Front streets (then mostly abandoned) which run along the East river in that part of the town. On the 26th, another case was reported in Lombar- dy-street, on the 27th another in Cheapside, and one at Fulton-slip on the East river. On the 30th, another case was reported in Lombardy-street ; and on the 3d of October, another case, Moses Ward, who came down from Corlaers Hook to No. 20 Cheapside-street to attend and assist at his father's funeral. On the 6th, another case in this street. On the 1 0th, another in Lombardy-street. On Account of the Yellow Fever, 39- the 1 1 lb, one at No. 36 Lombardy-street. On the 13lh, another In this street. On the 16th, one on the corner of Cheapside and Catharine streets. On the 1 9lh and 22d, two others in Lombardy-street. On the 23d and 25th, two others, traced to Gheapside-street. From the 1 7th of September up to November 1st, when the epidemic terminated, straggling cases continued to oc- cur also in Stone, Mill, Pine, Pearl, Nassau, William, Wa- ter, Front, and similar streets in that low and compact part of the city, between Broadway and the East river, but as nearly all the inhabitants had prudently abandoned this part of the old infected district at a seasonable time, those few only perished, who, from obstinacy, fool-hardiness, or indigence, remained behind. The following comparative table will give some idea of the progress of the disease, and its relative mortality in the different streets : street. Cases- Deaths. Street. Rector, 19 11 Courtlandt, Washington, 27 18 Broad, Greenwich, 22 11 Maiden-lane, Lumber, U 7 Fulton, Albany, 2 2 Nassau, Carlisle, 3 1 William Cedar, 8 7 Pine, Liberty, 16 9 Dey, Broadway, 33 20 John, Thames, -6 4 Beaver Wall, 7 4 Stone, Beaver-lane, 4 4 Mill, New, 3 2 Moore, Garden, 1 State, Cases. . DeatI, 12 8 14 7 10 4 4 2 10 5 11 4 2 1 1 2 1 5 2 3 1 1 2 3 1 40 ^^mr^ Account of the Yelloiv Fever. Street. Cases. Deaths. Cases. Deallis Pear], 13 8 Persons who fre- Water, 19 14 quented the in- Front, 3 4 fected district, Old-slip, 2 2 but resided in the Dutch, 6 2 upper part of Ann, 1 1 the city, 65 34. Ferry, 1 1 Persons who lived Chamber, 1 in or frequented the vicinity of Cheapside St., 46 28 Total, 401 230 In addition to which, 1 1 deaths occurred out of the city, and 10 after the Board of Health had adjourned. (Oct. 26.) Thus, then, we see that the disease being once fairly intro- duced at the foot of Rector-street, it spread from thence at a slow and measured pace over all the lower parts of the city. At first every case reported, could be traced to the immediate neighbourhood of Reder's and Rose's. Then, after it had enlarged a litde its boundaries, the cases were traced to the vicinity of those houses. After some days had elapsed, the air of Lumber-street also became imbued with the virus of the disease, for an alarming number of persons, the greater part of whom where found to have had com- munication with the neighbourhood first infected, were all taken sick in this street nearly or about the same time. Then the streets north, south and east of Rector-street im- mediately adjoining, and parallel to it, began to be includ- ed within the limits of infection more or less according as cir- cumstances favoured its introduction and propagation, so that, although the disease did appear to some to have ra- Account of the Yelloiv Fever. 41 ■dialed or divaricated as it were from a point or centre, and that we also have availed ourselves of this metaphor to make the description more clearly understood ; yet this ought not to be taken in the literal sense of the word. To make the language accord with the facts which really did occur in the progress of the epidemic, we ought rather to say, that there existed, or was created, one after the other, in all the lower part of the city, several centres, or foci, each of which had, indeed, either directly or indirectly, sprung from the point where the disease began, but when once established, constituted of themselves new foci of propagation. Many, however, who were impressed with the behef that the disease did radiate or diverge at an equal pace, and in all directions from the font of Rector- street, thought, in confirmation of this opinion, that ihey could make it appear that the infection had penetrated through brick walls, and over fences, with a determinate inarch, and in straight lines, so that it actually arrived at the same date to places which were equi-distant from the point where it began. So confirmed were several per- sons in this belief, that when the disease appeared at any given spot, they thought they could predict by the scale and compass where it would next show itself. The date at which the cases appeared in several places, did, at first view, seem to correspond with this opinion. It was, however, more specious than true, for the course of the disease, according to this hypothesis, was studied with reference merely to the absolute distances of these several places from the foot of Rector-street, as though the city were an open uninhabited plain, and without making any allowance for the obstructions which the infected air must necessarily have had to encounter from the angles, turn- 6 /2 Account of the Yelloiu Fever. Ings, and elevation of the streets. Tlie progress of the epidemic was, however, ceteris paribus, at an equal ratio from the point at which it was first introduced, which was a re- sult natural enough to be expected vviien it is remembered that it was from this place more particularly that the popu- lation commenced tlieir retreat, falling back and dispersing during the first month of the epidemic, exactly in propor- tion to the advances which the disease made. In several instances, however, we shall see that it anticipated its vic- tims, and by forming new centres of propagation where it was least expected, cut them off in ambush before they had time to reach there. THE CASES IN THE VICINITY OF CHEAPSIDE-STREET. This new focus of contagion, or the " upper infected district," as it was termed, was put into action by the seeds of the disease having been transplanted there from the ori- ginal, or lower infected district. Samuel Ward was re- ported sick of 3'ell ow fever at No. 36 Lumber-street, in the old infected district, on the 9th of August, 1822. His father, Nathaniel Ward, who lived at No. 20 Cheapside- street, and his mother and several of her sons and daugh- ters, came down into Lumber-street, then uninffcted, to see bim, and staid there on several occasions to nurse him until Friday, the IGth, when they had him carried up into their house in Cheapside-street. The introduction of a sick man into that street, considered and known at that time to be perfectly healthy, produced a great deal of alarm. Mr. Corgan, living about 10 doors below, on the corner of Chcapside and Catherine streets, together with Mr. Mes- senger, and a number of others of the most respectable per- sons in that neighbourhood, took the precaution before the Account of the Yelloiv Fever. 4'3 skk man came, to remonstrate to the Board of Health against having him brought there, at which the father was very much incensed. The petition was not taken no- tice of. We shall soon see what were the consequences. Ward soon recovered. He is stated to have brought with Lim his bedding; but this Mrs. Ward denied, feeling herself, I presume, implicated in the distress which had been occasioned in that neighbourhood, in some measure, per- haps, through her agency. As the sick man lived in Lum- ber-street, and as his father and mother and their children were constantly down there to see him before he removed, it is altogether preposterous to suppose that some of his clothing, at least, was not brought up into Cheapside-street. I learn from such authority as leaves no room for doubt, that the dirty clothes of Ward, which he had accumulated during his sickness, and before he was removed from Lumber-street, were all packed up in a large bundle, and taken along with him in the carriage, the day he arrived in Cheapside- street. On that and the succeeding day, the 17th, they were unpacked, washed and dried ; after which they were sent to his brother, Moses Ward, who lived with a Mr. N — , in Walnut-street, Corlear's Hook. From thence they were sent to Flushing, where the family of the sick man were then staying. Mrs. Ward also denies, but it is positively averred by the neighbours, that the bedding upon which Ward lay, was hung out, for several days, upon the fence which " separates the deep broad yard of Ward's house from that of Mrs. Brown's, next door, and which is No. IS. Ward's house stands on the street, but Mrs. Brown's stands back at the bottom of a deep yard, so that the front part of the house is but a few feet behind the rear 44 Account of the Yellow Fever. of Ward's. Fanny Ward, aged 6, daughter of Ward, Mrs. Ward his wife, and another of her daughters, and also two Misses Morrisons, who lived up stairs in Ward's house, all took sick about one week after the dirty clothes had been unpacked to be washed, i. e. about the 25th or 26th of Au- gust, but the attack being slight in all except Fanny, they soon recovered. Fanny remained sick in bed about a fortnight. When I first visited Ward's house, viz. Septem- ber 21st, the father was then lying dead of yellow fever. Hannah, aged 10, was sick of that disease in the same room, having been taken on the 19th, and Fanny was walk- ing about, but very feeble and emaciated. From the rela- tion which was given me of Fanny's symptoms, and from the deep greenish yellow tinge of her adnata and of the face, neck, arms and chest, there can scarcely be a doubt that her disease had been yellow fever. Ward, the father, sick- ened on the 15th or IGth of September, and died on the 20th, on which day he was reported by Dr. Boyd to the Board as a case of yellow fever. His skin, which I examined as he lay a corpse, was all over of the peculiar tinge of the disease. Hannah was also reported on the same day, and re- covered. On the 15th of September also sickened of yellow fever Mrs. Brown and her daughter, who lived, as we have al- ready stated, next door to Ward ; and on the same day also Catherine Bailey, an Irish girl, aged about i 4, who had been but a short time in America, and died in a cellar at Mr. Scott's, No. 12 Cheapside-street, three doors below Brown's. Sept. 9th, a Mrs. Carey and a Mrs. Snow her daughter^ sickened of yellow fever at No. 4 Lombardy, the street next above, running very near and parallel to Cheapside- street. The distance of their house from that of Ward's was Account of ike Yellozo Fe-oer. 4^ about 150 feet. Mrs. Carey died on the 14th, and Mrs. Snow on the 15th. They were both reported on the 16th. A young man by the name of Mott, who slept at this house^ also sickened September 6th or 7th. As the house of Ward was the source of the disease in Cheapside-street, so was that of Mrs. Carey the more immediate source of the dis- order which spread through Lombardy-street. For a few days before Mrs. Carey, Mrs. Snow, and Molt sickened, a son ofMrs. Carey arrived with his clothing and eflects in the ship Superior, captain Jocelyn, from New-Orleans. The yellow fever had already begun at New-Orleans, and spread to some extent before the ship sailed from that port, al- though no notice had yet been given of the existence of the pestilence either by the official aathorities or in the public gazettes. His mother, Mrs. Carey, was employed previous to her attack in washing Carey's clothes. His bedding had been destroyed before she sickened. Mrs. Brown and Catharine Bailey died. The latter was lying dead in the cellar when I made my first visit to Ward's house, September 21. The inhabitants of the street had also many of them abandoned it on that day, and the Board of Health had strewed it with lime. On the 22d two cases were reported in Bancker-street, the street next above and parallel to Lombardy-street, neither of which could be (raced to the old infected district. On the 24th, Mrs. Bailey and Eliza Bailey, sisters of Catherine, whom they bad nursed in Cheapside-street, were taken sick, and both were removed to the Marine Hospital, where they died with black vomit. I saw Eliza Bailey a few hours before her death, Monday afternoon, September 30tb, 1822 ; it was a genuine and strongly marked case. Her sister-in-law, Mrs. Bailey, died on the evening before. Eliza 46 Account of the Yellow Fever. was about 18. and her sister Catherine, who died of yellow fever in Cheapside-street, September 21., about 14. They had been but 17 months in America from Ireland. Mrs. Bailey was also Irish, but had been several years in the country. Eliza and Mrs. Bailey died both with black vomit within 24 hours of each other. Here we have a strong proof of the peculiar predisposition of northern con- stitutions ; but what is more important, a clear and unequi- vocal instance of the direct commuuication of the disease from Catherine to her sisters. On the 27th Mr. Vreeland was reported, who sickened the 21st, and who kept a grocery in Cherry-street, directly in the rear of Ward's and Mrs. Brown's, their yards join- ing upon each other. The disease continued to spread through Cheapside and Lombardy streets, as we have al- ready said, up to the arrival of frost. The following recapitulation will place this subject in a clearer light : August 9lh.— Samuel Ward, who had been down to the foot of Rector- street, was reported sick of yellow fever in Lumber, near Rector- street, He was the first case in that street. 16th. He was brought ^ick with his dirty clo- thing to his father's, No. 20 Cheapside- street. 16th — 17th. — Dirty clothes of Ward were washed. 26th — 30th. — Mrs. Ward sickened, also Fanny and another of her daughters. Two Misses Morrison in the same house. Account of the Yellow Fever. 47 September 6lh or 7th. — Molt sickened from No. 4 Lom- bardy-street — died in the country. 9th. — Mrs. Carey, at No. 4 Lombardy-street, sickened — died. — Mrs. Snow. 'in same house, sickened, died. 15th. — Mrs. Brown, next door to Ward's, sickened — died. Her daughter sickened. — Catharine Bailey, three doors below Mrs. Brown's, sickened — died. 16th. — Nathaniel Ward, father of Samuel, sicken- ed — died. 19th. — Hannah Ward, his daughter, sickened — recovered. 21st. — Vreeland, directly in the rear of Ward's and Brown's, sickened — recovered. 24th. — Mrs. Bailey sickened — died. And also Eliza Bailey, do. do. Both had nursed Catharine who died the 21st. 26th. — A case at No. 30 Lombardy-street was reported. 27th. — A case from No. 21 Cheapside-street re- ported, nearly opposite to Ward's. 30th. — One case at No. — , Lombardy-street, re- ported — died. October 3d. — Moses Ward, son of Nathaniel, died. 6th. — Another at No. 28 Lombardy-street. lOth. — A case at No. 53 Lombardy-st. reported. Uth. do. 36 do. do. 52 do. 13th. do. 28 do. 16th. — Corner of Cheapsideand Catherine. 43 .Account of the Yellow Fever. 19lh. from 31 Lombardy 22cl. do. 37 do. !23d. do. 7 Cheapside-street. 26th. do. 7 do. To Ward, therefore, who was brought sick of yellow fever with his dirty clothing into Cheapside-street, and to Carey, who brought his effects to his mother's house at No. 4 Lombardy-street, are we to attribute the sickness which began at these houses, and spread into the adjacent and neighbouring houses in those streets. How can we resist this obvious conclusion, when we see that the cases, like the continuity in the links of a chain, are all united together, and began regularly to succeed each other from Ward and from Carey immediately after their arrival in Cheapside and Lombardy-streets. Setting aside the cases of Mrs. Ward and one of her daughters, and those of the Misses Morrison, as all doubtful, there occurred in the two streets of Cheapside and Lom- bardy, within the short distance between Market and Cathe- rine streets, and comprising not more than 60 houses, the ex- traordinary number of twelve cases in Cheapside and eleven in Lombardy-street, though nearly one half of the houses mentioned, and nearly every house in Cheapside-street, were abandoned as early as September 21st. The distance between Catherine and Market-streets is about 500 feet ; the width of Catherine-street is 45 feet, and tliat of Market-street 60 feet. Both run down transversely to the river by a very considerable descent, being at their junction with Harraan- street, at their upper extremity, about 20 feet higher than Lombardy and Cheapside-street?, which on the other hand run parallel with the river, and are not more than 15 feet above its surface. Cherry- street, parallel to and next below Account of llie Yelloiv Fever. 49 Cheap&ide"street is 60 feet wide ; Bancker-street, parallel to and next above Lombardy-street, is 45 feet wide, being also from 15 to 20 feet higher than that street. I have purposely abstained from placing in the above list, the names of those cases which were reported in Banck- er-street, and that neighbourhood, because I have satis- factorily ascertained, beyond the possibility of contradiction, that each, and every individual of those persons, had had communication with the infected part of Cheapslde and Lombardy streets. The following is the order in which they occurred, and their history, derived from personal inquiries, made at the time, in company with Dr. Francis. Sept. 22. Mr. Scott, at No. 122 Bancker-street — died. Mary Mosier, at No. 125 Bancker-street — recovered. Oct. 16th. George Whetty, at No. US Bancker-street — died. 17th. Mary Kirk, No. 90 Bancker-street— reco- vered. Whetty, son of George, 118 — died 19th. Elizabeth Crawford, No. 12a Banker-street — died. Clarissa Chapeau, . . . — died Scott had been down to the shop of Mr. Jacobs, merch- ant tailor, at the corner of Maiden-lane and Nassau-street, for whom he worked as a journeyman, about five or six days before he was taken sick. This fact was not known to the board of health at the time he was reported. Con- sequently, as Maiden-lane, and particularly this very part of it, had been before that period included within the infected district, from several cases having previously occur- red there, he must be put down as having derived his disease 50 Account of the Ydloiv Fever. from that place, and none other. The next was a little girl, by the name of Mary Mosier, aged ten years. She had been in the daily habit of passing in the vicinity of the in- fected part of Cheapside and Lombardy streets, on her way to the market at the foot of Catharine-street. Although, therefore, we are fully persuaded, that she received her disease from Cheapside and Lombardy streets, we will, for ai'gument sake, suppose, not only that it was a genuine case of yellow fever ; but furthermore, that she had not been sufficiently near the infected parts of tliose streets, to have taken her disease from that source. Not until after Mary Mosier was reported, did, as far as I can learn, a single person remove out of Bancker-street. About /o?-?;y or ^?^ person only now left it, while the great mass of inhabitants continued still to reside there, with the most perfect security ; for we see that not until nearly after the lapse of an entire month, was another case reported in this street. This was George Whetty, at No. 116. His son was re- ported the day after at the same house. The father had been down several times through Cheapside and Lombard}^ streets, a few days before he sickened. He was an in- temperate man, and in the habit of ranging all over the city. The next is Mar}- Kirk, a J'oung girl at No, 90. She was taken sick on a Thursday, and ou the Sunday before, had walked through Lombardy-street. Tiie last two were Crawford and Chapeau, botli women of indifferent cha- racter. Crawford was taken sick of a Monday night. A short time before, and particularly on the Saturday pre- vious, she took a walk to that part of Cheapside and Lombardy streets, where they terminate in Catharine-street, being but a few doors from Ward's house ; Chapeau, foul* Account of the Yellow Fevei\ 51 or five dajs before she was taken sick, had been down into Lombardy and Cheapside streets, on her way to and from the market. If, indeed, the local accumulation of filth, crowded, damp and luiventilated apartments, the condensation of human eflluvia, and habits of excessive intemperance and depravity, can generate yellow fever in this latitude ; then surely ought the solitary case, which we have supposed to have occurred in Bancker-street, to be attributed to these sources. But why, if as some pretend, this part of the town produced from its own resources all these different cases, as well as the mortality also in Cheapside and Lombardy streets, and widiout the necessity of supposing any foreign cause ; why, I repeat, did not these domestic causes become operative at an earlier period ^ Wliy, out of the mass of dissolute popular lion in Bancker-street, none or but very few of the inhabi- tants of which fled then, or since, from the pestilence, while Cheapside became almost entirely, and Lombardy-street nearly all deserted, did not other cases also fall sick of yellow fever in Bancker-street i^ Why had the lower and extreme parts of the town, and especially the salubrious and cleanly neighbourhood of thq Bowling Green and Battery, and the terminations of Broad- way and Greenwich streets, suflbred so long before this period, and so severely from the pestilence, while Bancker- street, the very hot-bed of iilth, was enjoying for months, and until the middle of autumn, a peculiar exemption from dis^, ease of any kind.? Why, again, I finally ask, if Bancker- * There were not altog'ether more than fifty persona who fled from thisloDg and thickly populated street, during the whole geaspa, and no oae removed jintil al'ter Mary INIosier was reported. 52 Account of the Yellow Fever. street and filth, were the sources of the disease in this upper part of the town, did the first cases break out in Lombardy and Clieapside streets, both of which, and particularly Cheap- side-street, by being retired and never made use of as tho- rough-fares, are in comparison to Bancker-street, or indeed to most parts of the city, proverbial for their cleanliness, and for the reputable character and comfortable condition of their inhabitants ? Why, if this statement be, as we know it to be, true, after this solitary case in Bancker-street was reported, did no more cases originate there, while the disease continued up to the termination of autumn, to be limited and circumscribed to the narrow short streets of Cheapside and Lombardy, comprised between Market and Catharine streets, and con- taining both together not more than sixty houses. Whereas in the most fdthy and thickly populated and nearest and cor- responding part of Bancker-street, where each individual house almost contains from three to five or six families, nearly all of whom continued to remain there, not a case of yellow fever occurred ? The following notice from the New-York Statesman of Oct. 15th, 1S22, though we do not accede to the inferences which it makes in favour of the use of lime, will give some idea of the number of persons who continued to occupy this part of Bancker-street, up to that date. " In what has been called the upper infected district, about Bancker and Lombardy streets, lime has been xised in the streets, and in^the yards, alleys, sinks, kc. The yellow fever which has appeared there, has had a crowded and filthy population to spread among them its contagion or infection, but the disease has been arrested, because if the lime had done no good, the yellow fever would not have stopped its Account of the Yellow Fever, 53 ravages in a concentrated population of 3000. I say 3000, because the person now engaged, reported on Saturday morning 1997 persons, and he was little more than half done taking the census of the square lying south of Henry-street, to the East River, and between Catharine and Pike streets." From my own personal examination of Cheapside and Lombardy streets, and especially of the five adjacent build- ings in Cheapside-street, where the cases of the Wards, Bailies and Browns occurred, I can positively affirm, and with the concurrence of every physician who has been to those houses, that there is in no part of the city, five buildings of the same dimensions more cleanly and commodious in their apartments, nor furnished with more spacious and beautiful yards ; nor any streets, especially Cheapside, more free of filth or refuse of e\evy kind whatever.* If the yellow fever of Cheapside and Lombardy streets was generated there, the domestic causes must have been totally at variance with those which existed at Rector street. There was neither decayed wharves, nor putrid bilge water, noi* offensive limbeiK of shipping, not so much as a single grave yard within the compass of a whole mile, from which might ooze out the foetid distillations of human putrefac- tion ! What then were these peculiar domestic causes, which seemed so intense within the narrow limits of these two small streets ? I ask the question by anticipation, knowing * The yards are all of them from GO to 100 feet deep, and from 20 to 40 feet in width. 1 could not help admiring- the neat, dry and clean- ly manner in -which they were kept, and the numerous flower-beds and vines vrhich tastily adorned them, occurring to me at the time as s silent, but most eloquent ccmment Qii the theory of domestic oj-is^in. 54 Account of the Yclloiv Ftver. that although no person has yet had the boldness to offer, or the ingenuity to invent, any plausible explanation, on the principles of domestic origin ; something of this nature will in the course of time be advanced. I answer it, therefore, by saying that no such domestic causes did exist, and that whatever circumstances did exist there, being totally different, and indeed in direct opposition to those which, according to this hypothesis, are to be found at Rector-street, they could not, as the causes which did in reality exist, have done, produce the very same effects. In other words, contrary causes could not generate the same specific and identical disease. Wh}', too, if these cases of Cheapside and Lombardy streets originated from domestic sources, did the interme- diate section of the town between this and the lower infect- ed district, and that which had in previous years been con- sidered the seat of the pestilence, in other words, the whole of that compact, populous, and filthy part of the city, inclu- ded between Fulton and Catharine streets, escape its rava- ges, though it continued to be inhabited for some time after Ward, and many others, had died in the neighbourhood, of Cheapside-street i If domestic sources could possibly generate yellow fever, then at an early season might we have reasonably looked for it not only along the filthy wharves, docks and sewers, of Fayette, James, Roosevelt, Dover, Peck and Fulton slips, in this section of the town, but also along the whole range of docks on the East River between Fulton-street and the Battery. During the yellow fever in the vicinity of Old Slip in 1819, and also during the present season, the wharf from Dover to Roosevelt-Sircet, has been undergoing an entire 'alteration. The proprietors of that section of the town Account of the Yellow Fever. 55 liave sclliefl oul' a bulk head, wliich being still unfinished, stagnant water has collected in different places along the dock, where, from the filih, excrements from tubs, and dead animal and vegetable matters usually thrown in while fil- ling such places, the air, cspt'cially during the hot weather, and the progress of their decomposition, has been render- ed excessively olTensive. But neither in the yellow fever of 1819, nor during that of the present year, has a single instance of the disease occurred there. On the contrary, a short distance above Roosevcit-street, and between that street and James-street, several cases of yellow fever, just before the termination of autumn, occurred at Nos. 343 and 349 Water-street, two j^mall wooden sailor board- ing houses which stood about forty feet apart on the same side of the street. Although th's was close to the slips where, in previous years, the yellow fever had broke out, and been extremely mortal, [especially in the memo- rable year of 1798,] and aUhough this part of the town had been all the season placed as it were between the two fires of the upper and lower infected districts, the inhabi- tants continued to reside therewith impunity, and the ship- ping to remain at the docks. No one took sick in the si- milar dwellings opposite, nor in any part of the neighbour- hood. Even after these cases had happened no alarm was produced, for the season had now become quite cool and chilly, and a few days after the last died a frost actu- ally occurred. (October 23.) The people were, there- fore, satisfied, that it was absurd to imagine that any exha- lations from docks, privies, confined apartments or yards, would have bee-i harmless orsnspcnded during all the hot weather, and now at this late hour of autumn, just at the arrival of frost, become so intense as to generate yellow 5G Account of the Yellow Fever. fever. No one was fool-hardy enough to say it originated in the two houses. Consequently, upon inquiry, and per- sonal examination, accompanied by a medical friend, it was found that the sickness was as usual traceable to the old infected district. No. 343 was occupied by John Bres- land, and No. 349 by Mrs. Bolien. Bresland was report- ed Wednesday, October 9lh, and died that day. On Mon- day following, October 14, Martin Keaugh, a boarder in Bredand's house, a labourer about the docks, was taken sick. He was in the habit of seeing Bresland frequently while the latter was lying sick. The next day, Tuesday, October 15th, John Freeman, a sailor, and also boarder in Bresland's house, sickened. Kc had also seen Bresland repeatedly during hi^ illness. Bresland confessed, on his death bed, that he had been a few days before down to White-Hall, in the lower infected district. Keaugh and Freeman took it without doubt from him, and as is usual with the law by which the contagion of yellow fever is propagated, from four to six days after exposure to the disease. [See the valuable letter of Dr. Joseph Bayley, health officer of this port, KeW'York Medical and Physical Journal, vol. 1. No. 1.*] The ample experience, and close and accurate observation of this gentleman, has almost definitively settled this point. Keaugh died. Both he and Bresland were Irish. On Thursday, October lOih, Robert Smith, who had been complaining the night before, took sick of yellow fe- ver at Mrs. Bolien's, No. 349. He was mate of the brig Margaret, lately arrived from Turk's Island, and had been wandering about through the city in all directions, and on the Saturday preceding his illness, viz. October 6th, had * Edited by Drs. Francis, Dyckman. and Beck. Account of the Ydloio Fever. 57 »>ad€ an excursion on foot, down Broadway, and through the fences into the old infected district. He was quite frightened on his return, and told -f it, saying he had been " where the town had all been shut up." Mrs. Bolien's black woman who officiated afterwards as nuTse to Smith, rebuked him for his inconsiderate conduct, and asked him how he could be so rash. He endeavoured to excuse himself. Smith was now confined to his bed, which was in a very small apartment of low ceilings of about 12 feet square in the second story of Mrs Bolien's house. About four feet from Smith's bed slept, in the same con'racted apartment, an Irish- man, by the name of Joseph Curiel, on another bed. Cuiiel had been for a long time a cripple on crutches, and had not for five weeks been farther from the hou^e than the door. He had been a sort of clerk or a<:couniant to Mrs. B >lien ; consequently, this was no wanderer, and had been neither in the upper nor lower infected district. On the Saturday night, [Oct. I2th] foUoving, the day on which Smith sick- ened, this man also took sick, having continued from the beginning of Smith's indisposition to sleep in the same room. The room and bedding were perfectly clean, and without any offensive odour; and Curiel, beyond all doubt, took his disease from Smith. They both di^d. Curiel had unfortunately taken an emetic the second day of his illness at the recommendation of some person who told him his dis- ease was merely a bilious fever. This is one of the sad and fatal consequences of the unitarian system of confounding the symptoms as well as causes of all diseases togeiher. "To recapitulate : Oct. 0th. John Bresland reported sick of yellow fever at No. 343 Water-Street, died. 8 58 Account of the Yellom Fever. 1 0th. Robert Smith taken sick of yellow fever at N». 349. Reported Oct. 17th, died. 12th. Joseph Curiel sickened at No. 349. Reported Oct. 17 th, died. 14lh. Martin Keaugh, sickened at No. 343. Re- ported Oct. 17th, died. 15th. John Freeman sickened at No. 343. Re- ported Oct. 18'h. Thus while the slips and sewers above Fulton-sireet re- mained, during the whole epidemic, free from infection, those below Fulton street, comprehending Beekman, Fly- Market, Coffee-House, Old, Coenties, and Whitehall slips, afterwards included within the infected district, did not be- come so until the poison had, after the lapse of more than two months, been carried thither from tlie streets in the vicinity of Broadway, or those across the town, on the op- posite side of the city. " During the present season, the two long wharves on the east and west side of Coflee-house slip have, owing to the decayed state of the timber, been broken up. The work was commenced about the 10th of June, and con- tinued, by a great number of men, through the hot season, to about the middle of August : the logs were in dif- ferent states of decay ; some entirely rotten, which, with the discoloured earth, was piled in large quantities in front of the stores in South-street, about two rods distant, a part of which remained subject to the efiect of heat and moisture, until the 24th of October ; during which time it is said no bad efiects have been experienced from it, either by the workmen employed or others j and from its commence- ment, even during the present sickly season, the store at the corner of South-street and Coffee-house slip has been con- stantly occupied, and is within about two rods of the de- cayed timber, he. referred to. yiccount of the Yellow Fever. 69 " As this timber, so much decayed as partly to be thrown up with shovels, was taken out during the hottest season of the year, without producing any bad cff cts, it might be inferred (unless cases to the contrary could be referred to) that the timber saturated with, and decayed in salt-water, was less dangerous when exposed to the air than if decayed in other situations."* So far from these places being the generating foci of in- fection, as in previous years they were represented to have been, Catherine market and slip at the foot of Catherine- street, in the immediate vicinity of Cheapside-street, and Ful- ton market and slip, at the foot of Fulton-street, remained during the whole season exempt from sickness, insomuch that persons continued fearlessly to resort to those markets, njid the ferry-boats, between those slips and Brooklyn, to ply with their accustomed regularity. 3Iarket- street and Catharine-street, the street next above and parallel to it, and both in the immediate vicinity of Cheapside-street, as well as Cherry-street, immediately be- low and parallel to Cheapside-street, and lower and nearer than that street to the river, continued, with the exception of Mr. Vreeland, who lived directly in the rear of Mr. Ward's and Mrs. Brown's yards, free of sicknes, while the few indi- viduals in Lombardy-street, and the still fewer number who continued in Cheapside-street, one after the other fell sick of yellow fever, until the frost finally extinguished the poi- son. It was absurdly conjectured by some, that the part of Bancker-street corresponding to Lombarby and Cheap- side-streets, as it continued up to the termination of the * R. Bulkley's letter to the Board of Health, on the subject of pu- rifjing sewers. See New- York Statesman, Oct. 26, 1822. 50 Account of the Yellow Fever, dbease nearly as thickly populated as before, owed its exemption to the lime scattered through the street. I am not in the least prejudiced against the supposed disinfecting properties of this substance, but on the contrary am disposed to believe that it might prove of considerable utility. Those who have hazarded this opinion of its efficacy in Bancker street, and who, strange as it may appear, attribute at the same time the production of yel- low fever to domestic filth and confined apartments, forget that, while Cheapside and Lombardy streets, so much more cleanly, and so much less populous, than Bancker-street, were also strewed with lime, and almost totally deserted of their inhabitants, those few individuals who remained nearly all fell victims to the disease ! " Adverting icr the condition of the city of New- York, anterior to the American revolution, and before a regular system of police regulations was adopted ; to the offensive state of the town during the revolutionary war, whei\ inha- bited by the British troops ; to the immense collection of foul materials of ever}' sort in the cellars of the numerous buildings, destroyed by the great fire of 17 ?6, during the whole of which period, this city enjoyed a total exemption from the pestilential fever, we must be convinced of the limi- ted and incorrect views of those who look no farther for the origin of this evil. In like manner the offen- sive state of our slips, our wharves and our market places, until within a very few years ; the putrefactive processes at- tendant upon our tanneries, morocco, starch and glue manu- factories, slaughter houses, tallow chandleries, sugar houses, &c. &c. the filthy and neglected condition of our streets, and we may add. of many of our burial grounds, furnish incon- testible evidence, that these are innocent, when considered Jic<^ount of the Ydloxo Ftver. 6 i as the primary causes of the mortal epidemic, which ha? desolated our cities."^' Instead of yellow fever breaking out as by the laws of domestic origin, if such there be, it ought to have done in the densely populated, and low. dirty, and confined slips on the East river, especially in the ne:ghbourhood of the mar- kets and sewers, at the foot of Broad-street, and at Old, Burling, Fulton, Peck, Roosevelt, and Catharine slips,! we see it nfter the season was far advanced, and that it seemed to have expended itself on the lower and west side of the town, now entirely deserted, making a sudden irrup- tion into the clean and retired streets of Cheapside and Lom- bardy, in the north eastern suburbs o f the city, and where all the streets, with (he single exception almost of Cheapside and Lombardy, are unusually wide, and regularly laid out on a dry and sandy soil, sloped into the form of a long in- clined plane, elevated at the upper part at least 10 or 50 feet above the river towards which it descends. It is, in truth, no less extraordinary and unaccountable on the doc- trine of domestic origin, that the disease should have first broke out on the south-western side of the island, in what had hitherto with good reason been considered the most heaUhy, cleanly, and beautiful quarter of the city, than that it should afterwards have suddenly made its appearance near the high and airy suburbs on the East River, and at so great a distance from the place where it had proved most mortal, and to which, with this exception, it continued even afterwards to be exclusively confined. * Hosack on the Laws of Contagion, N ew-York, 1815, p. 69,noteE. f Any person who might visit, as I have done it often, our narrow and low streets, especially along the east side of tlie tow n, will be struck by, and convinced of the presence of a deadly air or offensive smell, mostly of the cloacina; kind." — Extract of a communication from Dr. Felix Pascalis, (vid. Commercial Advertiser, Oct. 22, 1822.) 6,2 Jiccount of the Yellow Fever, There is often, says a distinguished writer,* a blind im- pulse in public opinion, which arrives by a more speedy and certain method at the truth, than all the reasonings of phi- losophy. May not this too serve us as a guide in the strong sentiment of repugnance and open expressions of alarm and discontent manifested by all the inhabitants of Cheapside- street, when Ward was brought into that neighbourhood f What induced them to fear this intruder, and why do the world continue on all occasions to show that dread of ap- proaching near the persons of those who are doomed to be- come the victims of this cruel malady ? Does this show us that the theory of importation and contagion, as some persons have had the temerity to say, is an exploded phantom, en- gendered in superstition, and sustained by misicpresenta- tion and duplicity? Does this show that quarantine re- strictions are a libel upon the common sense of mankind, and an insolent usurpation of their rights? Wiiether the yellow fever of Cheapside and Lombardy- streets be ascribed to the clothing or person of Ward, or to the clothing and effects of Carey, or to both, we see the com- municable character of the disease brought home to our con- viction, without the possibility of mistake or deception. We see ourselves irresistibly compelled to believe that the dis- ease had, in reality, the power of propagating itself directly or indirectly from the sick persons to those who were well., and through those again the means, had such existed within the sphere of its influence, of multiplying itself by its own specific contagion, as it had already done in Rector street to an indefinite extent. Had not the population of Lom- bardy and Cheapside streets fled as precipitately as they did, or had the season been not so far advanced, hundreds * Abbe de Tradt Account of the Yellow Fever. 63 jnight have perished. Thousands of lives too have thus been saved to the public by the timely desertion of the lower parts of the city. It maybe asked why the numerous cases of yellow fever in uninfected parts of the town, and who had either taken the disease in, or were removed sick with it from the infected district, together with the large quantities of furniture, bed- ding and goods brought out of this district, did not also communicate the disease. With regard to furniture, goods, and other articles, it may be observed, that it was almost ex- clusively taken out of those streets which the disease had not yet reached, and moreover, that it was all carried into (he open suburbs of the city or to the village of Green- wich, to which last place the custom-house, post-office, banks and insurance companies, togedier with the great body of the merchants and tradesmen, removed as soon as it was ascertained that there was danger in remaining in the lower part of the city. So also with those persons, who lived and were taken sick in the infected district. Thosd of them who were removed were all carried, together with their effects, either to the suburbs or to the neighbouring vil- lages, or to some distance into the country, but very rarely or never into other parts of the citj. But Ward we see came doubly fortified with the powers of contagion. He not only contained it in his person, ihen labouring under yellow fever, but in the more virulent and concentrated form of fomities in his dirty clothing. Be- sides which he removed from Lumber-street, and had taken his disease in Rector-street, in the very heart and centre of the infected district, and where, from the great mortality which occurred in those streets, the poison must have been uncommonly virulent. I venture to say that no person was removed out of the infected district under circumstances so favourable as Ward to communicate the disease. Out of 41 .'? cases, which was as nearlv as can be ascertained, the whole §4 Account of the Yellow Fever. number that occurred between July 10th and November 5tb, when the disease terminated, about 70 were removed to the Marine Hospital at Staten- Island, 104 were sick of yellow fever in uninfected parts of (he city, 73 were removed to the country, 44 to the suburbs of the city, 16 to other parts of the infected district, 2 to the New- York Hospital, 1 to Bellevue Hospital, out of town. Of those taken to the Marine Hospital it may be remark- ed, that they were removed successively at distant intervals, and but two or three at a time, and therefore never accu- mulated. As the wards also of this spacious building were kept in the most perfect cleanliness, and from the healthy situation of the building exposed to the sea, are more roomy and airy than are to be found in most other hospitals ; and as there were also but (ew or no persons sick in the hou?e ol other diseases during the whole of the epidemic, there was nothing for the contagion of yellow fever to operate upon. There are but two phj'sicians attached to it, the Health Officer and Dr. Harrison ; and no person was allowed to have any communication with the sick but the three or four nurses of the establishment, who, like the physicians, had been long habituated to the care of yellow fever patients, and were therefore less liable to take the disease, especially in the diluted condition in which the poison must have ex- isted in the airy rooms of this fine building. Their effects, of course, were not allowed to accompany them. Out of the 104 persons sick of yellow fever in the unin- fected parts of the city 65 out of this number did not re- side in the infected district, but had been employed there «3F. m Jccount of the Yellow Fever. as labourers, or merely passed througli it. These, therefore, could have brought neither dirty clothing nor any other infected anicies with them. Why these, however, and the remaining thirty-nine scattered over various parts of the city, supposing some of them to have brought their bfdding or clothing with ihem, did not conimnnicale the disease to their physicians, nurses or attendants, or to the inhabitants living in the neighbouring houses, it is perhaps impossible to say. I will not deny, that several of tliese cases, from the confined situation of the apartments in which tiiey lay, and the inattention of their nurses, seemed to have been placed under circumstances particularly favourable to couimuni- cate the disease. But it must be remembered that all these were individual cases, and more or less insolated, not only by being placed in parts of the city remote from each other, but because they were in a great number of instances aban- doned through fear by their relatives as well as friends, by all indeed but their physician, and some d' sper.ite fellow whom cupidity more than philasidiropy tempted to do some few reluctant services to the forsakon sufferer. On the other hand, as an extraordinary exception, all the family of Ward seemed by their actions, as well as conversation, to set at defiance altOi;ether the idea of yellow fever being a contagious disease. Hence they continued to remain at their house in Chea'sside street through the thickest of the disease. The poisonous emanations from each individual, by being insolated, and therefore readily weakened by dilu- tion with the circumambient air, were not of diewselves sufficiently intense to infect the neighbourhood in which these cases occurred; but had they been concentrai d into one confined spot, as were the Reders, Thoir.as, &c. af the foot of Rector-street, or the Wards in Cheapside-si eet, and (he cases at Mrs. Carey's ; and had the persons in the ad- 9 66 Account of tht Yellow Feva'. joining hou«es continued under such circumstances to re- main, imprudenlly as they did in the vicrnity of Rector- street for several weeks after these emanations were put in motion, there can be no doubt that the result would have been precisely, and in every respect, the same. Mr. E. H. Brien, in his communication to the Transport Board, London, expresses very nearly the same opinion. He considers the disease not communicable to those conti- guous, when occurring only now and then in an individual, but h'ghly contagions when several were labouring under it, at the same time : [Banci-ofi^s Sequel, p. 162.] So also Dr. Cunie, of Philadelphia, says it can only become contagious when accumulated or concentraied in the atmosphere in confined unventilated situations. [Letter to Dr. Hosack, Amcr. Med. S^ Philos, Beg. p. 195.J To those whose obstinate adherence to preconceived theories will take nothing as true unless it squares precisely with their notions, this explanation will not of course be satisfactory. In return, therefore, I may be allowed to put certain interrogatories to them. Why, for instance, does the native of the West Indies es- cape yellow ftver^ while the northern man going to the tro- pics, is so peculiarly obnoxious to it,^ And why, on the other hand, are we ourselves far less susceptible to yellow fever, when introduced here, compared with Europeans newly arrived in our country ? Why, too, does the native of Vera Cruz take the yellow fever of Havana, and vice versa, though both those places are low in the tropics ? [Fid. Humboldt, p. 771.] All these are apparent contradictions j but yet no one would deny, that as a general law of yellow fever, northern are much more predisposed to the disease than tropical constitutions. I am not therefore bound to explain why the yellow fever of the present year has not Account of the Yelloio Fever. 67 propagated itself to other parts of the town in the same manner it did to Cheapside and Lombardy streets, any more than I am bound to trace out on a diagram the radii of contagion, and the precise mode and direction in which the disease has been communicated, or why it was not com- municated to every individual^ who has been exposed to its influence. What farther proof, I repeat, do we wish after its mortality in the lower part of the town, and the law of progression which it observed, of its power of propagating and multiplying itself by the force of its own specific poison, exclusive of all other aid or medium than that of human effluvia and a certain condition of temperature and humidi- ty, but totally independent of putrid, animal or vegetable exhalations. But to return to the subject of the disease, as it appeared in the lower part of the city, and where alone it became, in the true sense of the word, epidemic. The board of health, having been misled by the assurances of the resident physi- cian, unfortunately disbelieved the existence of yellow fever for nearly a month after it broke out in Rector street, and neglected to recommend the early abandonment of this part of the city. In consequence of which from the caries of the Reders, Thomas, Rose, Archer, and others, which occur- red in quick succession, amounting in all to thirteen cases wiliiin the narrow compass of 180 feet, six of whom died, the CONTAGION rapidly multiplied and spread over all that part of the city. The mortability in the high and spa- cious avenue of Broadway, as much admired as the Boule- rards of Paris or the Strada Toledo of Naples for its beauty, cleanliness and superb buildings by all the foreigners who come here, like the street called the New-street at Bar- celona during the last year, teaches us what devastation the pestilence might have caused had not as many persons 68 Account of the Yellow Fever. deserted this part of the city as did. While at Montpellier,! became acquainted with Dr. Bally, who was then on his re- turn from Barcelona to Paris. He stated his opinions very frankly, and told me that the disease which prevailed at Barcelona was the genuine yellow fever, and that the con- tagiousness of the disease, as well as lis importation, was de- monstrated by a thousand examples. Dr. BntUy appeared to be very conversant with the peculiar doctrines taught in the Medical Repository, and was by no means sparing in his stri-'ure? '>n th^' editors of th it work. or the physicians at Barcelona, nine-tenths he said coin- cided in opinioi with the commissioners. The reniaant who mamtaine'l the domestic origin of the disease, attributed it to a foul sluggish sewer in one of the streets, over whicn the stones were so loosely placed that the putrid vapour generated there exhaled freely into the air of the street. But, unfortunately for this ojinion, it was at the very mouth of this sewer, that three hundred fisher- men, alter the fever had first broke out at the little healthy village of Barcelonette, came to moor their barks. Not one of them look the disease, except four or five who went into the city. On the other hand, the street called the N'W-st! eet, the widest and most airy and beautiful in tow)!, snfi'ered most from the pestilence. By liie earlier advocates of domestic origin, we were told that yellow fever was a disease produced by marsh mias- mata, and therefore the same as the common autumnal re- miitents all over the world. But if vegetable miasms be the peculiar and proper source of ail these diseases why does not yellow fever, which Bancroft and a few other writers .all a higher grade of remittent, prevail among the boundless marf'hes. swamps, prairies and savannahs on the coast and in the interior of our country .'' Why is the Account of the Yellow Fever. 69 disease coiifineu exclusively to our sea shore and sea ports f It is indeed very extraordinary that this higher grade •of re- mittent shoald have proved so mortal in the city of New- York, huilt on an elevated ridge of primitive rock, entirely separated by the rivers, at whose conflux it stands, from the high surrounding country, and where, with some few excep- tions on tlie opposite side of the bay, and at the distance of several miles from the city, no marshes are to be found, and none that ever proved unhealthy. " It may also be remarked as an additional testimony to that stated by Dr. Stewart, on the yellow fever of Granada, (Amer. Med. ^ Philos. Regist. vol. 3. p. 183.) toprevethat the yellow fever does not derive its origin from decomposed vegetable matter^ that whenever the disease has prevailed in the United States, it has not appeared in the country where such vegetable matter is most abundant ; but has been chief- ly c annued to our largest cities, and those towns which are situated on the sea board ; a fact totally inexplicable upon the principle that the yellow fever is the product of vegeta- ble putrefaction, lam fully aware the opinion has been entertained that this form of fever prevails in the interior of our country, and especially in the vicinity of the lakes ; but whoever will consult the statements furnished by phy- sicians residing there, and who have had the best means of obtaining correct information, will find ample refutation of that opinion.'' Hosack on Contagion, JVote E. p. 68. — See the works referred to by that author, viz. Frisbre's Sketch of the Medical Topography of the Military Tract of the Slate of New- York ; and Brown's Sketch of the country watered by the Mohawk river, &c. Amer, Med. &; Phil. Register, vol. 4. — Needham's Sketch of the Medical Topography of Onondaga, slate of New- York, in Barton's 70 Account of the Yellow Fever. Med. h Phys. Journal, 1st supplement.— See, also, Letter of Dr. J. W. Francis, touching the opinions of Professor Ellicot, in Hosack's Observations on Medical Police, Ap- pendix, p. 71. One of the authorities of Bancroft, Dr. Gray, comes to the sweeping conclusion, that " the yellow fever of the West-Indies, the endemic fevers of Bengal, and of Bata- via, in the East, with those on the coast of Africa, and tne bilious remittent of the Mediterranean, and southern parts of Europe and America, spring from the same source, marsh miasmata, being in a more or less concenirated state, and modified by local circumstances of climate," &;c. p. 155. — But if Bancroft was well assured of this surpri- sing analogy, and that the jungle, or bilious remittent fe- ver, which makes such dreadful havoc in the East, was the identical yellow fever of the West-Indies, surely, in or- der to prove this, he does not need the accidental occur- rence of soTje twenty deaths happening to watering par- ties, at ivvo obscure and remote little islands in the Indian Ocean. — See his account of the sickness of some ships, crrws at (he Islands of Edam and Joannah, ib. p. 120. When yellow fever was at length found to be generated on 'ihip board, in the tropics, and out of sight of land, it was said to arise from putrid bilge-water, tbe rotten limbers of the ship, or the vegetable and animal exhalations arising from the bailast and hold. They even pretended that these emana' ions resembled, in every particular, tlio?e from marshes on land, pushing this idle and unfounded hy- pothesis, so far 3s to call this combin.ition of causes by the puerile epicHet cf ship-marshes . — [Vicl. Sequel to an Es- say on Yellow Fever, hi/ Dr. Bancroft, p. 211.] But as if the genius of truth was determined to give her enemies Account of the Yellow Fever. 71 no quarters, and to expose to the world the unwarrantable means that have been employed to counterfeit her image, we now find the disease " to make assurance doubly sure,'* and to prove, beyond all doubt, its specific and contagious character, and how little it has to du with terrestrial emdivx^- tions, exhibiting the same unalterable laws of propagation, not only in the lanes and streets of cities, on land, but on shipboard in fleets at sea. Under this aspect it has ap- peared in so new a light, that I feel confident the reader will agree with me that the important and highly interest- ing facts whicfi follow, and which confirm the observations I have made, ought not to be permitted to remain in obscu- rity. I am indebted for this communication to Professor Griscom. It was published in the New-York Evening Post of Oct. 8, 1822. " The following statement of the spreading of the yel- low fever in the harbour of Marseilles, during the last au- tumn, in consequence of the arrival of infected vessels from Malaga, in Sp.\iu, is taken from the official slatemenS of Drs. Labrie, Robert, Muraire and Girard, physicians and surgeons of the Lazaretto. Their statement was pub- lished in Marseilles, in one vol. 8vo. of 132 pages, 1822. An abstract of it is contained in the Reveu Enci/clopecUque for June last, received by the Stephania, arrived a few days since. This statement may serve to throw some light upon the disputed question of the communication of the disease. " When, during the last year, the yellow fever broke out in the city of Barcelona, and extended rapidly to Tortosa, Malaga, and Mahon, the vessels lying in this port sought safety in flight, and presented themselves in crowds before Marseilles, to obtain an asylum in its outer harbour j but 72 Account of the Ydhw F^ 10 Account of the Yellow Fever, cent and exotic, bow could Cadiz have been, during so many ages, the emporium of the commerce of Europe and the point of assemblage of the greatest squadrons ? The formi- dable expeditions fitted out against Algiers, Mahon, Colo- rsia del Sacramento, Gibraltar, Jamaica, &:c. what destruc- tion would they have not suffered in th.e port, if such a fever had been endemic within its precincts? Can it be, that the influence or causes, to which it is pretended to attribute the origin of the fever which have been inactive during so many ages at Cadi/, should happen to develope themselves at the precise moment when the most evident proofs of its impor- tation appeared f And can this phenomenon, so wonderful at Cadiz, have by another singular combination of circum- stances, occurred also at Barcelona, JMalaga, Leghorn, Po- megue, JMajorca, Canaries, &c. ? It would do much violence to credulity to assert such arbitrary suppositions ; this single reflection would have determined the society' to answer by a simple negative, if the importance that has been attached to the arguments on the other side, did not . oblige it to treat this subject somewhat more at length. Espejo, Ronda, Ubrique, Espera Jumilla, Arcos la Ram- bla, situated upon dry and elevated grounds without woods, marshes or lakes, to inft^ct t'le atmosphere, nor obstacles to impede its current, of very small population, whose manners are simple and employnients rural, were attacked by the contagion, which was propagated among their inhabitants. Veger, Tarifa, Chipiona, Conil, towns, some upon the very shore, and others surrounded by marshes and lakes, produ- cing the intennittents of the countr}-, have never suffered the disease, although surroun 'ed by infected places Arcos is nine leagues to the N. E. of Cadiz, upon a very high cliff, among hills and fruitful places abounding with trees and plants, and is verj healthy; it experienced yellow iever in ISOO and 1S04. Arxount of the Yellow Fever. 7t Tarifa, is in a hollow between two mountains, on the sea shore, fifteen leagues east of Cadiz, npon a low miry soil ; the fever has never been commimicatcd to its inh.abitants, even where some persons have come with it from abroad. Chipiona is to the north of Cadiz, on the coast between Rota and San Lucas de Barrameda, from north to east, ii is filled with vines and grovr s of pines ; it has some sni'^ll lakes near it ; its atmosphere is clear and well ventilated ; its inhabitants have always continued healthy, even at the time when all the neighbouring towns were infected. Conil, at seven leagues east of Cadiz, a town whose wharves fill it in the spring of the year with considerable quantities of putrid fish, has always continued in the best health. Medina Sidonia, eight leagues east of Cadiz, upon an elevated mountain ; within its bounds, are some small lakes that produce light intermittenis in such as work in their neighbourhood; the fever was not communicated to its in- habitants in the year ISOO ; but in 1801, when the towns were enjoying good health. Los Barrios. The town is eighteen leagues east of Cadiz ; half a league from the coast, in a plain surrounded by marshy lands, and adjoining the river Pahnones, autumnal intermittents are experienced by its inhabitants, the yellow fever was not known until the year 1804. San Roque, is eighteen leagues east of Cadiz; and half a league from the coast, on a height of considerable eleva- tion ; its soil is dry and very salubrious ; it has experienced the yellow fever only in the year 1804. Jimena is fifteen leagues east of Cadiz, and thirteen from the coast of the Mediterranean, on ground elevated about 100 yards above the level of tlie sea ; it had the fever in the year 1804. If follows from what has been stated, that neither the "S Account of the Tetlow PevAr, fceight or lowness of the ground, nor lakes, marshes uer shores have had the influence that some persons suppose to produce or prevent the yellow fever in the towns, and that it has depended more upon the greater or less degree of intercourse that they have respectively had with the infected places, and upon the prosecution or abandonment of mea- sures of precaution with respect to persons coming from them. Rota and Port St. Mary prove this, whose indis- prnsable trade with Cadiz has caused them to suffer the same epi-lemic with that city."* In addition to this overwhelming testimony of the Spanish Physicians, we subjoin an extract from Dr. Beck's Report, ©n the yellow fever of Middletown, in 1820. " The next four cases were those at the Upper Houses* The occurrence of these cases at this place is so very sin- gular, that it will be necessary to speak particularly of their locality, and of the circumstances attending them. They all tooli place in a cotton factory about four miles from the centre of the city, situated in a pleasant valley, and without any houses in the immediate neighbourhood. The distance between this and the river is perhaps about half a mile. Dr. Tully accompanied me to this place, and on visiting the factory we found nothing that was in the least offensive. From its situation, too, one would suppose that it must en- joy a constant and free circulation of air. It may be deem- ed by some of consequence to state, that the factory had beon closed for some time, and that thej commenced work- ing in it only a short time before. There were at that time 7 girls and 3 men employed in it. Such were the circum- stances at the factory, when John Wild, one of the men, was taken sick. This was the 7ih case. * Report of the Medical Society of Cadiz, to the Spanish Govern- ment, 1822, published in the 3d. vol. of the Medico-Chinirjjicaj! Journal of Cadiz, and translated for tbeEvcBicg Te^V ^Account of the Yellow Ftvcr. 1^ "7. John Wild, taken sick on the 19ih of June, and died on the 25lh. He had redness and wildness of the eye — yel- low skin — vomited a dark matter, and on the last day brought up some blood. On inquiring of the superintendant of the factory where Wild had been previously to his attack, we found, that two days before, he had been on board of a vessel from the West-Indies, called the brig Defiance, of Middletown, and then lying alongside a wharf about two miles below the factory. This brig had arrived here the 16th of June, and sailed again on the 19th. While in the West-Indies, one of her men was sick with yellow fever. She went up the Oronoko, and brought home a cargo ot hides, tallow, molasses, 8cc. The vessel is said to have been cleaa — between her and the shore there was a constant inter- course — numbers of people went daily aboard of her. I can- not learn that Wild was aboard of the brig Sea- Island, though at the time he was taken sick she lay opposite the factory, where she had grounded. It was while she lay here that H-arrington was taken from her and carried dowa to Middletown. " S. Abigail Treat, a girl employed at the factory, taken sick on the 2 1st of June, two days alter Wild was attacked, and with the same symptoms ; red eyes — great distress about the prEecordia, together witii irritability of the sto- mach ; brought up the same kind of matter. She had beea at the factory for one month. She recovered ; the fevet coming to a crisis on tl»e seventh day. " 9. Rhoda Clark, another of the girls working at the fac- tory, where she had been only three days, was taken sick on the 23d of June. She was immediately removed to her fa- ther's, about a mile and a half south of Middletown, wiiere Dr.Tully attended her. She had the red and muddy eye — great precordial distress — coma, and decided black vomit.:; She died on the 27th. 80 Account of the. Yellow Fever. " 10. Catherine Hubbard, another girl at the factory, where she had been one week, was taken sick at ti:e same time with Rhoda Ciark. Symptoms very similar to those of Abigail ^i'reat. She recovered. " It does not ajDpear that any of the three girls who were sick at the factory had been on board of any vessel. On the Sunday previoiu*, some of them had been down to Middle- town, but at this time the Sea-Island lay four and a half mile- above that place. "During Wild's sickness, the superintendant informed us, that ii'.e girls occasionally went in to see him, and that they slept in an adjoining room, with only a wooden partition be- tween them. Only one circiunstance more concerning the factory is worth noticing, and this is, that a state of invari- able general heallh has always prevailed about that place."* Surrounded thus on all sides, and driven to the last extremity, the sliifis and subttrfu^^es of which the advocates of domestic origin had heretofore availed themselves, being exploded were abandoned in despair ; leaV'ing us, so far as regards the promises which they had held out to us of clearing up tiiis matter, absolutely more in the dark than ever, except with tiie advantage of knowing that the im- mense mass of error and rubbish under which the truth has been so long hidden, and which has served so much to en- cumber the march of our discoveries, has now been removed cut of the way. The reviewers in the London Quarterly Journal of Fo- reign Medicine and Surgcr}', (a very useful work) though avowedly the advocates of domestic origin seem to have been aware of the necessity of relinquishing the old ground of this controversy as ultedy untenable. They have veered entirely round, and now propose that the domestic produc- tion of yellow ftver be attributed to the richer consiitmnts * New York RIcdical and Pliysical Journa], No. 2. Account of the Yellmv Fever. 8 1 of clay and ahuorbenl soils eliminated in the state of gas, and associated with aqueous vapour by the direct rays of the sun ! " This source of yellow fever we had obtruded on us, by observing that the most malignant type of this disease [on the coast of Africa] took place in situations where those deep and rich soils most abounded, and where they had been inundated during the rainy seasons." It was observed to be still more malignant after the rains, and during the dry season when the earth was cracked into deep fissures. [See their review of M. Deveze's work on yellow fever. Vol. III. p. 101.] Dr. Shecut, of Charleston, has made still greater concessions, and having abandoned both the earth and the sea, thinks he has discovered the source of yellow fever in a specif c gaseous poison, caused by an insufficient quantity of electric fluid in the air. \_Sec his Med. 4- Philos. Essays, p. 92, et seq.'\ We are not prepared to accede to this assertion without farther proof, although it must be con- fessed, that if the facts stated by Dr. Shecut are true, the condition of the atmosphere, which he speaks of, appears to have favoured the propagation of the disease. He says the years in which j'ellow fever has prevailed most at Charles- ton, viz. 1732 — 39 — 45 — 48 — have been either excessively hot and dry, or excessively hot and moist, and always at- tended with but little thunder and lightning, (p. 97.) But he afterwards states some exceptions, (p. 105.) After endeavouring to show that yellow fever depended upon this or that extraneous cause, and exhausting the whole catalogue of chemistry and meteorology, to find some substance with which to associate it, it has been at last found, that in the eagerness of the chase we have overreached ourselves, and been more prodigal of our conjectures than close in our investigations. Tht farther Tve have pushed this inquiry, the more do we find ourselves 11 82 Account of the Yellow Fever. compelled to admit that yellow fever is the product of a specific poison governed by its own laws, and capable of propagating and multiplying itself by contagion in an at- mosphere of a certain temperature, especially when aC' companied with humiditv, and rendered impure by human effluvia, bu^ often totally independent of soil or situation. The more it multiplies in any given spot, the more conta- gious it becomes, and the less dependent on human efflu- via. Hence, by the increase of the sick, the whole atmos- phere, to a certain extent, becomes charged as it were with the poison, and thus itself the source apparently of the disease ; so much so, that those whocomeoutof a dif- ferent atmosphere, and are immersed in any part of this, are almost sure of taking yellow fever, though the infect- ed part of the town may have, for some time before, been eniirely abandoned both by the sick and the well. In proportion to the number of sick, and the circumscribed limits which they occupy, facilitated, no doubt, also, in its progress by certain -ta'es of the air, and certain degrees of temperature and humidity, will be the danger of the poison spreading. Thrit yellow i'ever does usually prove most fatal in the place where it first appears, is a fact that no one will deny. Tiie reason is obvious and familiar to every one. Be- cause, when the first cases happen, the inhabitants in the vicinity, not being willing to abandon iheir homes before they are well assured ol the existence of (he disease, have generally delayed too long a time within 'he reach of its influence. Thus it happens, that the contagious poison, having had full time to propagate itself to the immediate neighbourhood, has become accumulated to so great an amount,'that no human means can stay its march. The spark being once kindled, it is too late to extinguish the Acount of the Yellow Fever. 83 flames. This, however, is not always truo, for on many occasions, yellow fever, bke other coniagoiis disea-es, has proved equally fatal in those places to which it had after- wards become propagated as in that particular neigh bur- hood into which it was first introduced. The inference of Bancroft, therefore, that yellow fever is not coniau,'ous from this circumstance, is unfounded. [Vide his Siquel to an E^say on Yellow Fever, p, 1 25.] The disease, after being introduced, has always multi- plied itself caeteribus paribus io a direct ratio \o the num- ber of individuals exposed to its influence, and the circum- scribed space which they occupied. The fever of the present year was equally as virulent, and more so in seve- ral parts of the town, and in several houses, far removed from the place where il first made its appearance. Thus it began on the two cornera of Rector-slreet in Washing- ton-street, on the dock, and the mortality in Rector-street between that point and Greenwich-street, which is only 183 feet disiant, was exceedingly great. But when, as we have seen, it had reached Lumber street, on its ascent up the hill of Recior-street to Broadway, and which was not until one mouth after it broke out, its mortality was observed to be greater than at any other lime. Again ; several weeks after this period, and at the distance of se- veral hundred yards from (he foot of Rector-streer, it be- came alarmingly fatal in the wide avenue called Broad- way, and about that part of the city at the intersection of Wall, New, and Broad streets, of which streets Broad and Broadway are remarkable for their width and salnbr.ty. So, also, did it cause much sickness in a house at No. 164 Broadway, still farther oif, where Mr. Dover lived, and who took fhe disease and died; having refused to renu've from a persuasion that this spacious street would, as it had 84 Account of the Yelloto Fever, in every previous year, enjoy an immunity from the disease. So, also, on the opposite side of the town, at Nos. 43 and 50 Pearl-street, and near the intersection of De- peyster and Front streets. But at the sugar house in Li- berty-street, which is nearly as remote as those from the foot of Rector-street, the disease proved so, uncommonly mortal, that it became the subject of a general remark. We. shall explain the reason of this in another place. And, lastly, at the distance of nearly two miles from the foot of Rector-street, and not until the beginning of Sep, tember, the disease was introduced into Cheapside and Lombardy streets ; in which streets, but only in that short section of them comprised between Market and Catha- rine streets, it proved nearly as mortal as in any street in the lower part of the city. Does not the gradual and regular progression of the disease, and this power which it possessed of multiplying itself at difl'erent points in the course of its march, as cir- cumstances happened to favour its propagation, prove most conclusively its contagious character ? What need have we to collect individual facts to prove the contagiousness of Yellow Fever, when the general his- tory of its progress, from its introduction into the city, to its extermmation by frost, constitutes of itself one entire mass of overwhelming evidence in confirmation of this truth ? To those who marvel at the disease having been trans- ferred to, and propagated through, Cheapside and Lom- bardy streets, from the clothing and person of Ward and the efl'ects of Carey, I might put in return the question why, in its regular march towards the north, in the old in- fected district, it seemed to have been suddenly arrested at Fulton-street. For, although the open space at the Park may, perhaps, account for its not proceeding any higher Account of the Yellow Fever. 6S up Broadway, no reason can be given, on the doclrlne of domestic origin, why it should not have crossed Fulton- street, and continued on its course on the west and east sides of the town. But allowing that the current of fresh air passing through Fulton-street, as it is the first street in advancing from the Battery north, that gives full sweep to the breeze from river to river ; allowing that this free draught and ventilation cut off to a degree the com- munication between the infected district and the upper part of Ihe city, it is scarcely credible that it should have put an effectual check to it. For the almost mathematical pre- cision with which it diverged, and slowly crept along, as it were, in every direction from the point wiiere it sat out, spreading wherever it found subjects to operate upon, proves that up to the time it had reached Fulton-street, it could have been but little influenced either by the winds and rains with vvliich the city was several times visited, or by the height, width, declivities or windings of ihe streets. This measured gait of the disease does not correspond with the irregular and undefinable march of an epidemic produced from general causes existing in the soil or atmosphere, breaking out simultaneously in places remote from each- other, an d levelling, as it were at one blow, whole popula- tions at once. On the contrary, this disease slowly and methodically enlarged its boundaries, and regardless of promenades or burying grounds, cist-pools or sewers, clean or dirty streets, pursued its retreating victims in every di- rection, wherever they tarried long enough to come within the range of its deadly influence. The advocates of domes- tic origin will find themselves puzzled to reconcile, or even to enumerate the endless variety of contradictory and dis- similar circumstances which they will be obliged to encoun- ter in following up the progress of this disease. 86 Account of the Yellow Fever, Why, then, T again ask, if the air had become all infected, and that the cause acrording to the theory of domestic ori- gin, existed from the beginning, and const-nnUy afterwards in the air itself, dispersed promiscuously over all the lower part of the city, without being at all modified; or rendered in the least degree more deleterious bv the disease which it produced, why did it n Jt extend beyond Fulton-street, to the other streets which are immediately above Fulton street; and which, though principally deserted before the disease had reached Fulton-street, continued to be i' habited by a •aj' greater number of persons '^ollectively, than could befoimd in all the s' reels together of the lower pari of the town, south of Fulton-street? This exefription is certainly no less extraordinary than the introduction of the disease into Cheapside-street at so great a distance from what had been denominated the infected district. We will now see that this difficulty entirely vanishes when we come to examine it on the principles of contagion. The poison had at first accumulated in prodigious quantities in the immediate vicinity of Rector-street and Lumber-street, owing to the narrowness of those streets, and from the in- habitants having neglected to move out in time ; but seeing at last that the only security was in flight, the panic ex- tended so far into the city, that the streets became entirely deserted up as far as Fulton-street, as early as Sept. 1st, and before the disease had actually reached there. In con- sequence of which, the quantum of poison necessarily di- minished from the want of subjects to operate upon, and though more atid more diffused, became of consequence, less and less intense, so that tlie few scattered individuals who afterwards fell sick on the confines of the infected district, below Fuiton-street, had not the power of communicating Account of the Yellow Fever. 87 the disease to those who continued immediately above it, and who were placed wilhout the radius of contagion. I consider the doctrine oi importation and cohtagion to be one and the same thing. If we admit that this disease may be imported, it follows conclusively, that it is conta- gious. Thus if it be true, that Yellow Fever may be brought here in a vessel from the West- Indies, it is no more unreasonable to suppose that it may be brought from Rector-street to Cheapside-slreef, or to any other part of the town. It was not until after a long struggle that the advocates of domestic origin have been driven to the necessity of acknowledging that yellow fever is in every respect a peculiar and specific disease, totally, and altogether different from Typhus, Plague, or Remit- tent, Intermittent, and Bilous Fevers, as much so as Hy- drocephalus differs from Small Pox. But they do not know how valuable a concession they are making to their oppo- nents when they grant that the disease may be imported. It is a subject of congratulation, however, that this opi- nion is daily gaining ground, showing that the simple and unsophisticated truth, though its march be slow and gra- dual, must in the end, triumph over all opposition. To give the appearance of a spirit of reconcilia- tion, or to ingratiate themselves in the eyes of the peo- ple, many have affected to declare that the doctrine of importation does not militate against that of domestic origin. and that both may be true. This is not only unphiloso- phically calling to our assistance a redundance of causes, but when we come to examine this double-fafed creed, which professes to harmonize all disputes and differences, we shall see that it is a gross imposture, purposely intend- ed to mislead the public into a snare. For we find in pur- suing the investigation, that such as maintain this opinion. 88 Account of the Ydlow Fever. are in fact advocates of domestic origin in disguise. Thus, say they, if a vessel possesses in itself those causes, or that combination of circumstances, which under the influence of a tropical heat, will generate yellow fever here, these causes may also in the hot season of our climate produce the same disease, while the vessel lies at our wharves This however, is no more than the identical doctrine of do- mestic origin, transferred from the land to the water. The advocates of this theory saw, though they were un- willing to confess, that the occurrence of yellow fever in the United States is some how or other always intimately con- nected with the shipping and tide water. They felt them- selves obliged to admit, what is now, with some few solitary exceptions, conceded, on all hands that this disease, unaccountable as it may seem, is invariably confined to ma- ritime situations. They have therefore consented, at last, to transfer the dispute from the marshes of the interior to the sea-board, and finally to the decks of the ship. I am afraid, however, that the field of controversy will be found too con- tracted for the broad and sweeping mode of warfare which they are in the habit of resorting to. If it were true, that the disease is not contagious, and was this year gene- rated in shipping at the wharf, I would ask how it came to break out only at that particular spot, where West-India produce happened at the time to be arriving in unusual quantities, and how it came to be propagated slowly and regularly from thence up to Broadway, and finally over all the lower part of the city. After affecting Thomas and the Reders, or others who were directly exposed to its influence, and within the radius of this supposed local cause, it ought, if this opinion were true, to have proceded no farther. For, having no means of increasing its amount but to a very li- mited extent, and the disease produced by it being, accord- Account of the Yellow Fever. S9 ing to this opinion, not contagious, and therefore not capable of multiplying itself in this way, why did it increase in a slow and regular ratio from the first cases, and afterwards, long after all the shipping had been entirely removed, spread into the interior of the city ? It ought to have been confined to the streets along the wharf, and to have extended up and down Washington-street, not directly back, and from one single point only of the wharf, up the hill of Rector-street, into the town. The merchants with their clerks remained in their counting houses on the wharf of Washington-street, close to the termination of Rector-street, employed in iheif business as usual for some days after the first cases occurred. The same may be said of the seamen in the shipping, and the cartmen and various labourers, and other persons in their different vocations about the docks. If the disease was generated on the spot, from the foul holds of the ship- ping which continued to he there, why ed, and the public not being aware of the danger that existed, did not abandon the neighbourhood until the disease had already preceded up into Lumber street. Grecinoich-street.—The width of this street, and its being on a level with the B:ittery, and therefore exposed to a free ventilation from the current of air which comes oft' the bay, together with the circumstance of its being inhabited by per- sons of the first respectability, and who were therefore in a situation to escape from the city in time, account for the small number of cases v/hich occurred in it. Hence, we see that it prelerred its way up the steep ascent of Rector- street, which is so much more narrow, and where the in- habitants, though comfortably situated, live in much smaller house>. Beside which, Rector-street is shut up at its ter- mination in Broadway, and being very precipitous at that Accoimt of the Yellow Fever. 105 f&n where it runs into Greenwich-street, is precluded in some degree, at least, rauch more so than Greenwich-streetj from ventilation. Hence, though Greenwich street is two miles long, and courses all the way upon a dead level the whole length of the city, the disease, though it did finally proceed along this street, north as high as Fulton-street, showed constantly a much stronger inclination to pass up (he cross and narrow streets which descend transversely into it, on their way from Broadway, and which in respect to ven- tilation, are all under the same disadvantages as Rector- street. Hence, therefore, the total number of cases in Green- wich-street amounted to but twenty-two, out of which ten occurred in four houses. Washington-street, — The small number of cases in this street is accounted for from several circumstances. In the first place, from Liberty-street to the Battery, all the build» ings, with the exception of six or seven small and indifferent houses, occupied by poor persons, are ware houses or stores ; and all on one side the street, and thus so completely exposed to the prevailing winds of the climate, as well as to those that blew during the continuance of the epidemic, that the air could not possibly have remained infected for any consi- derable length of time. Hence, too, the exemption of a number of labourers who were constructing a long pier di^ rectly at the foot of Rector-street, and who continued to work upon it about two hundred feet from Reder's house, with perfect impunity during the whole season,'* The situ- ation of Washington street explains also why the disease did not extend higher north through this street than Liberty- *A similar occurrence took place at Barcelona, dMriagf th« dreadl'iil «pidemic which desolated that city in 1821- H 106 AccBunt a/* the Yelhw Fever, streft, although it had pa sed up Greenwich-street, which, unlike Washington-street, is sheltered by houses on each side as high as F'ilton-street : Hence, of twenty-seven, the whole number which occurred in Washington-street, all were in the immec' ate vicinity of, or below Rector-street, an.l^re of these in two small dirty houses at Nos. 55 and 42, oi.ly a few doors, however, fr< m Rector-street. Lumber-street. — We have already adverted to the confined situation of this stree't as accounting for the great mortal- ity which occurred here ; in addition to which it may be re- marked that the houses being mostly occupied by poor per- sons, were crowded with inhabitants. Broadivay and Broad-street. — W« have also spoken of this street, and endeavoured to explain why the disease proved here so mortal. It will be observed, that this mortality was principally confined to the lower section of Broadway, be- tween the Battery and Rector-street ; in which street and in Lumber-street, immediately in the rear of Broadway, the disea!«eh(ly abandoned at an early period, the only twe cases tiiat occured were in the same house ; in Stone-street, Account ef the Yellow Fever, 111 to which the same remark applies — the only three cases in this street were in on e house ; in Dutch-street, which is quite short and narrow, and entirely shut out from the wind, and at the same time occupied chiefly by poor persons, the six cases that occurred were all in two houses ; in State-street, to which the same observation applies as to Pine and Stone streets, the only three cases that occurred were in two houses. We may thus form some idea of the havoc the disease would have occasioned, especially in these narrow streets, if there had been subjects for it to act upon.* It is the sick svho infect the air^ not the air that infects the sick. Cheapside, Lombardy and Bancker streets. We have already entered fully into the examination of the disease, as it happened in those streets. Fulton -street. — This seems to have been xheultima Thule, or extreme boundary of the lower infected district. I am of opinion, however, that neither this street nor John-street, the next below, ought at any time to have been included in the enumeration, of what is understood by infected district, any more than Ann-street, the northern part of Nassau- street, Vesey-street, Chamber-street, Ferry-street, or. any * Hence it happened, that as the contagion had no chance of multi- plying itself in this deserted part of tlietown, such as went through those streets where the disease had not existed, escaped; as was the case with labouring persons, several merchants, physicians and others, who made a constant practice of going down into this part of the town. This points out to us, in a still more imposing manner, the important fact, that the disease is only propagated by contagion, and that the air is in no other way infected than by the emanations from the sick. The watchmen, also, though double the number on this«side of the district, to those on the west of Broadway, generally escaped, whereas nearly one half the latter periehed' 112 Account of ihe Yellow Feur. other part of the town above Fulton-street. I have ah-eady expressed this, as my opinon, also in regard to those parts of Front, Water and Pearl streets, below Fulton-street, and which run along parallel with the East River, but at a con- siderable distance from the paralled and infected sections of Nassau and William streets. I mean those sections of these streets which are below Fulton-street. Some three or four cases, as we have seen, did occur in Ann, Vesey, Ferry, Cham- ber and Nassau above Fulton-street; but most, if not all, were upon examination found to have had communication with the part of the town below Fulton- street But we might with the same propriety say that those streets in the upper and thickly inhabited part of the city, to which pa- tients were removed sick with the disease from below, were also infected streets, which would be absurd. The same observations apply to Cheapside and Lombardy streets, to the full extent. In regard to the extreme limit of the lower, or original infected district, it is probable that the air never became actually infected higher north than Courtlandt- street and Maiden-lane, most probably not even beyond Libcrhj- street. The limit on the east side of the town did not per- haps extend farther than William-street, and its continuation through Stone-street to Broad-street, and thence to the East River. On the west, the infected air reached the Hudson. The infected district, therefore, ought properly to be comprised under the following boundaries : beginning at the intersec- tions of Liberty and William streets, and proceeding thence down William-street, south to Stone-street, throu':^h Stone- street to Broad-street, and thence to the East River, then following around the Battery or southernmost point of the island, jfnd taking the Hudson River as the western boun- dary, and as high north as Liberty-street, and thence through Account of the Yellow Fever. 1 l|v tSiat street again to the place of beginning. It is impossible to reduce things of this kind to exact measurement ; but I am firmly persuaded, that most, if not all the cases which occurred without these boundaries would, if this subject bad been closely investigated, have been found to have had communication with the part of the city comprised within the above limits. There were in all but fifty Jive cases which occurred without these limits, of which twenty -three are directly traceable to that part of the city ; leaving only twenty-tivo doubtful cases, concerning which the general impression is, that they all had been within the infected dis- trict. Many circumstances also are stated, which have left but little room to doubt, that they had actually received the disease there. Setting those aside, however, they con- stitute so small a number, in proportion to the grand total of cases, that it is of no manner of consequence to say any thing of them when discussing the general position which we have laid down. In the mean time, I must not be under- stood to mean by the word infected district, that the whole air of that part of the city included within the limits I have given was absolutely infected with the contagious matter of yellow fever. I do not believe that the whole number of eases, which occurred this season, when considered in re- lation to the space of ground which they covered, and the early abandonment of the lower part of the city, could have possibly infected so large a quantity of air. Nor do I believe, that the air itself ever becomes, to any considerable distance, and throughout, impregnated with the virus of tbe disease. Such an effect could not take place, or at all events if it did ever happen, it could, from the mobility of the atmosphere, continue so but for a wery short time, except perhapslow down in the air^^and in very narrow sheltered and •-•onnned streets, as in European cities, particularly tbo«e ijp il4 Account of the Yellow Fever, Ihe south of Europe — Italy, Fra nee, and Spain, for ex- ample, where, in order to be shaded from the rays of the sun, which is scarcely ever obscured in that brilli^ant climate, the houses are built to a great height, and the streets made uncommonly narrow. The long continued mild tempera- ture of those latitudes, together with the compact and un- healthy mode of constructing their cities, the crowded and small condition of their houses, the necessary concentration of human effluvia which must result from this state of things, explains why the yellow fever, when once introduced here, has always spread and multiplied with inconceivable- rapidity ; meriting, in every respect, the appellation of an epidemic. In the cities and sea ports of the United States, constructed in general upon a plan entirely diflerent, and tlie streets of which are, for the most part, spacious, and the houses in general never crowded to excess with inhabitants, the yellow fever seldom or rarely becomes epidemical, unless peculiar circumstances, connected with the introduction of the disease, have favoured its propagation. But never, as I h ve said before, can I believe that the air becomes univer- sally and totally infected with the contagion of the disease. What I mean by an infected part of the city, is where so many cases have occurred in particular houses, or particular neighbourhoods or streets, that the air to a certain extent surrounding those places more or less, according to the number of cases that have occuraed within a given space, becomes infected for a certain length of time, the duration of which depends, in a great measure, on the chemical and physical changes which afterwards take place in the state of the atmosphere. From whence it appears, that out of about 422 cases, the total number this season, 295, or very nearly two thirds, occurred in eighty-six houses, all of which were either Account of the Yellow Fever- 115 opposite to, or adjoining each other, or contained each from two to eight cases. What is still more worthy of re- mark, TWO HUNDRED AND SEVENTY-SIX of the whole num- ber of cases occurred in sixty-seven houses, and each one of these sixty-seven houses furnished from two to eight cases, and out of these same 27G cases 104 died ; that is nearly one. half oflbe whole number of deaths of yel- low fever on the records of the Board of Health ! This ac- cumulation of cases in particular houses appears in a still more striking light when we call to mind that out of the re- maining 146 cases, which did not occur together in the same houses, 65 were persons who resided in uninfected parts of the city or in the country, and caught the disease by exposioi^ themselves to those places in the lower part of the city where many persons had sickened. Thus, out of four hundred and twenti/-two, the whole number this season, there remain but eighty-one cases which did not occur in the number of more than one or as man}' as eight in the same house ; or in other words, there were but eighty-one cases which occurred singly in different houses. Facts such as this table exhibits do not need the embel- lishments of diction — their eloquence is irresistible. Though twenty-two out of the sixty-seven houses, and in which sixty- one cases and forty-one deaths were reported, were In a very filthy and crowded condition, the forty-five others, in which one hundred ami nine cases and sixty-five deaths occurred were, in every respect, perfectly clean. If num- bers therefore have any weight, the reasoning on this sub- ject ought rather to preponderate in favour of that opinion, which looks only to the specific contagion of the disease, and not to filth or uncleanliness, as the cause of its propaga- tion, since two thirds of these sixty-seven houses were clean, comfortable dwellings, and twice the number of cases 116 Account of the Yellow Fever. occurreH in such houses to the number which occurred m those that were fiUhy. It will be observed, however, that the average number of cases in those houses that were filthy or dirly, was greater than in those that were clean. Thus in the former it was nearly three cases to each house, while in the later it was only a little more than (wo in each. But the houses that were filthy were, it must be recollected, also crowded with occupants, which indeed was the principal cause of their filth. The habits of those who occupied them corre-ponded also to their condition of life, which accounts also for the mortality bei' g somewhat greater than in the clean houses, the families of which were, of course, respecta- ble persons. The concentration of human effluvia in the crowded and filthy bouses, facilitated, without doubt, the propagation of the disease; but whether their loose and in- temperate habits predisposed them to it is not so certain. Thejilth with which they were surrounded is generally ad- mitted to have a contrary tendency. The more, I suspect, we examine into this subject the less we shall find that filth has to do with the propagation, and infinitely less with the generation of yellow fever. It it cer- tainly true that in the lower part of the chy, and especially on the west side of it where the disease broke out, there are few or no houses which can with any propriety be denomi- nated filthy. Tiie inhabitants are all of a respectable cast, and most of them wealthy and of the first consideration in society. Very little or no business being carried on on that side of the town except in the counting houses of the mer- chants along Waslfington-street, it is not, as 1 have said be- for«', a place of resort. The houses being almost exclusively dwelling houses, are none of them over crowded with occu- pants with perhaps some eight or ten exceptions. There are besides no manufactories in this nor in any other part of the Jlccount of the Yellow Fever. 117 city below Fnlton-street, nor any work shops or places where unwholesotne fiimes or exhalations are emitted in the differ- ent processes of the arts. On the east side of the city, how- ever, which is, at the same time so much older and more, compact and filthy than the other, nearly all the trade and commerce of the port is concentred. Along Front and Water-streets especially, which are near the East-River, there are a great number of indifferent buildings occupied by mechanics and tradesmen, or persons who keep board- ing houses or small groceries, fruit shops, he. The popu- lation of this pari is therefore crowded ; and hence it is, that from the conr entration of human effluvia more especially, and not so much from the accumulation of filth attendant upon this condition of things, that yellow fever, when intro- duced into this part of the city has always spread so rapidly among the inhabitants. Two thirds of all the cases of the yellow fever during the present epidemic occurred, we have seen, either in adjacent or opposite houses, forming small clusters, scattered here and there, over different parts of the city. Does this look like a disease arising from a pestilential condition of the atmos- phere spreading over the whole city, and as abundant in one street as in another.'* But to say nothing of this fact, which of itself is sufficient to set at nought the whole theory of do- mestic origin, let us come more directly to the point. Why did nearly all those cases occur in so kw houses .'* How came it to pass that two hundred and seventy-six out of the fovr hundred and twenty two reported cases of yellow fever^ occurred in sixty-seven houses ; and that from two to eight cases occurred in each and every one of these houses ? Can any one be so mad as to suppose that a local cause existed in each of those buildings sufficient to produce this disease .'' Admitting, for a moment, that such a cause could exist> 118 Account of the Yellow Fever would any person in his senses hazard the assertion that *his cause was identically the same in each house ? For this is the necessary inference, seeing that each and every one of the cases fell sick in those houses, wiih the same identical disease. If then these local causes were different, what was it that brought about that peculiar arrangement, or combi- nation of circumstances which produced the very same dis- ease in each house ? Can it be possible, that these causes may be apparently different, and yet, that all the variety of combination, of which they are susceptible, may each gene- rate yellow fever ? Is the production of yellow fever a matter of so little difficulty ? If that were true, one would say, that the chemist in his laboritory could at any time artificially produce it. Ought not these causes, also, which were so promiscuously dispersed over different parts of the eity, and in streets and houses between which no one ever before discovered any particular analogy ; ought not these causes to have begun to give out their morbific exhalations nearly at or about the same period ? Can we conceive that the causes which produced such frightful mortality at Mrs. Rose's, at the foot of Rector-street, in the beginning or mid- dle of July, would remain inert and innocuous, during all that month, and even during the warm months of August and September, and up to the cool of autumn and middle of October, and then prove so deadly m the houses of Bresland and Bolien, in so distant a quarter of the city from that where the disease began ? Can we conceive, that these local causes, strewn about in this manner over the city, and the activity of which are supposed to depend upon particu- lar states of temperature and the humidity of the air, would one after the other begin to go into operation in defiance of all the changes of wind and weather, occurring in this long interval between the beginning of July and last of October ? Account of the Yellow Fever. 1 19 if, too, this local condition of things existed in each one of those houses, were not the occupants or residants in each ^like exposed to it? And ought they not, supposing the predisposition to sickness to have existed, or to have been necessary, ought they not in each house to have one and all fallen sick, nearly, or about the same time ? But now let us see what did actually happen. Instead of cases falling sick in different parts of the city, nearly at the same period of the season, the disease occupied a range of several months and weeks as progressively from place to place, occording as circumstances, more or less favoured its introduction and propagation, through particular neighbourhoods. Instead of the inhabitants in each of the sickly houses falling sick simultaneously, or nearly at the same time, they fell sick in succession, one after the other, and nearly all at de- terminate intervals. Supposing all the inhabitants of any given house to have been at a certain time exposed to any given cause of disease, it is utterly impossible to believe that the constitution of each, should have been affected in so peculiar a manner, as to cause ihem to fall sick, one after the other, and that too exactly within a given period of time. Supposing, then, that where five or six took the disease in the same house, that all had been at the same time exposed to places or reighbourhoods, where the air was admitted to be infected, it is altogether impossible to think that they would have fallen sick in regular succession. Let us even imagine, for a moment, that these five or six cases were all exposed to this source of disease, one after the other at intervals would be observed in the different times in which they fell sick. Could an occurrence like this take place in any considerable number of instances ? Is it possible to believe, that this could happen in two thirds ©fall the cases reported? In every direction, in which 120 Account of the Yellow Fevtr. we examine this theory of domestic origin it leads us always^ to the same preposterous and absurd conclusions. On the other hand, we know for a certainty, there were not more than tm or fifteen cases out of the izoo humhed ind seventy six that fell sick in the same house simnltane usiy, or at such long intervals that their disease could noi be attributed to one another. If, then, it be found in this long catalogue of cases con- stituting the great bulk of all that occurred that in the sixty-seven houses mentioned, the cases in each house oc- curred in succession and at regular and determinate periods. or intervals of time ; are we not bound to believe, that they were in some way or other, intimately associated or linked together, some how or other dependent upon each other after the manner of causes and effects. Although we mav never see the chain which binds them, the same philosophy applies here, that forms the basis of the greatest discoveries that have ennobled human nature. The same process of reasoning, and the same deduction from cause to effect, hold true in studying the affections of the human body, or in investigating the sublime subject of the mechanism of the universe. If then, from the case which first fell sick, the rest fol- lowed after, each in its turn, and at the lapse of a definite number of days, and that the disease in each was, in every respect, identically the same ; it is of no manner of conse- quence for us at present to consider from whence the first derived his sickness. In other words, the disease with which he was afflicted caused the disease in the one who succeeded him, and so on in regular order ; proving that it was cmmunicuted from one to ihe other, or, which is the same thing, that it is a contagious disease. Account of the Yellow Fever. 121 EXAMPLES OP THE CONTAGIOHS NATURE OF YELLOW FEVEK. Tiie numerous instances in the lower part of the city of individuals falling sick one after the otiier in the same build- ing, were of such frequent occurrence that very few or uo persons took the pains to note them. Though we are un- able, therefore, to give, with as much precision as we could wish, the exact periods of time which elapsed between their sickness, enough may be gathered from th« dates on which they were reported to the Board, and those on which their deaths were afterwards announced, to serve as a criterion by which we may arrive at an estimate very near the truth. We shall find that the whole together is sufficiently distinct in all its parts, and that it will constitute, with the details we have given of the progress of th'- disease, from street to street, a mass of evidence in favour of the doctrine of con- tagion. / 1st. To begin with the house of Reder, where two of thf first cases happened. Caroline and Amanda sckenet! Jay lOdi — Caroline died July i6th. On the same day her bo- ther John, aged 1*1, sickened, and died on the 2-'d. ^e- der was from Holland, and is, as h proverbially iflown of the Dutch in every part of the i?6rlfl, uu<'oraino/y neat and p rticular in his mode of liyAig. H^s family was not large, and his house was in ev^i'y respfCt commodious, and always kept clean, as we^ as the yard attached to it. Dr. Walters parti ularlyemarke*' this circumstance in his attendance upon the^^mily ; rfid observed to me, that it would have been r'eposterouj to attribute the sickness in his house to an^^o^al causes. Though Reder himself es- caped, perhar '"'^'^ ^^^ '"^^ of life, and his constant habit of exposure ^lo''.^ the docks to an atmosphere more or less impurp, it is, nevertheless, highly probable that he iiad copimunicated to a certain degree the natural predisposi- 16 122 Account of the Yelloiv Fever. tion of his constitution, and which those from the north of Europe never entirely get rid of in this latitude, to his children. Is it not also probable that the age of his children, all of whom were between nine and sixteen, and their high health also rendered them, as well as Thomas, who lived opposite, and who had in addition to this been but three or four months in this country, more particularly liable to an attack of yellow fever ? The brother took it from the girls, and it was communicated probably on the first or second day of their illness having four days for a development. 2. But when we'come to the neighbouring house of Mrs. Rose, at the corner of Rector and Greenwich streets, and about 120 feet from Reder's, the contagious nature of the disease is illustrated iw so overpowering a manner, that no one could any longer doubt, though it were the only solitary instance on record. This is a small two story vooden building, 'he lower part of which was occupied as a small grocery ; consequently, the unusual number of occu- p^its who resided here were crowded in the upper story. Frtm this circumstance the disease was the more readily prop* gated from one individual to the other, and thus proves uncommonly n^rtal. It was the mortality in this house, which abtnit the I st of July first occasioned so great an alarm through ^le city , though the Board of Health, while the pestilence w^s immo'oting hs victoms took no pre- cautionary measures, but, contintod, under the consoling assurances of their official aViser, to^iumber upon their oars until it was too late to remefy the e;,[. They did not give official notice of their havrng had ^ meeting to take this important subject into cons'>deration mij July 31st. On the following day Mr. Coleman, the editor ->f the Even- ing Post, and who, though not a member of the profession, by his unremitting vigilance and able defence of the dotirine Account of the Yellow Fever. . 123 of contagion, merits the highest eulogium, published this meeting in his Evening Post, together with the judicious re- marks which accompany it. As it contains the particulars of what o( curred at the house of Mrs. Rose, under the sign ma- nual of the Resident Physician, we cannot do better than in- sert here the part which more immediately relates to this matter. Board of Health, July 3l5<, 1822. On the 20th, the Resident Physician visited Miss Rose, at the corner of Greenwich and Rector streets, and reported that she was seven years of age, had sickened on the 16th of July, and had bilious fever. The child died on the 24th instant. On the 26th lie visited Euphemia Dobson, at No. 10 Beaver-street, aged 38 years : she sickened on tlie 24th, and removed from the house of Mrs. Rose, at the corner of Greenwich and Rector-streets, whe^e she had assisted in nursing the child that died on the 24th. H' also visited Mrs. Edwards, aged 46 years, sister to Mrs. Rose, and a resident in the same house ; she sickened on the morning of the 25th with bilious fevpr. Also, Leonard W. Archer, aged 23 years, nephew to Mrs. Rose, and residing in the same house; he sickened on tlie morning of the 25th in- stant, and has bilious fever. Tlie Resident Physician was also informed that a Mrs. Waters, aged 53 years, had like- wise sickened at the house of Mrs. Rose on the evening of the 24th- but was afterwards removed to Brooklyn. She had been indi'^posed for the last three months, and died on the evening of the 29th, with very malig- ant symptoms. This person was not seen by the Resident Physician. On the 29th, the Resident Physician reported that he had visited another child of Mr. Reder, who was sick with the same disorder as those before reported ; that he had alse 124 Account of the Yellow Fever. visited Susan Buck, aged 1 1 years, residing at 24 Rector- street, opposite the house of Mr. Reder ; that she sickened on Friday, wiiU bilious fever. On the 30th he visited Mrs. Jones, at No. 115 Washing- ton-street, who sickened on fhe 27ili, and has bilious fever. He also visited John Hamiiton, a cartman, whose stand was in the vicinity of Rector- street ; lie resides at No. 20 Howard- street, and sickened on the 27th with bilious fever. On the 31st, Dr. Neilson reported to the Board ofHeakh two c?^ses of yclloiu fever, viz. Leonard VV. Archer, and Mrs. Edwards, both at the house of Mrs. Rose, corner of Green- wich and Rectr.r-streets. On Monday last Dr. Neilson ap- peared before the Board of Health, and declared these two cases to be bilious fever. The resident physician visited those patients again this day, and reports ihena as bilious fever. There has no case of fever occurred in that vicinity within the knowledge of the Board of Health, for the last three days. By order of the Board of Health. STEPHEN ALLEN, President. KEMARKS. *•' Such remarks as my duty calls upon me to make on the above report, I shall submit to my readers, regardless of any offence they may give to any individual. Disclaiming any desire to interfere with medical men or medical science, I am well aware that these will not, and perhaps ought not to attract much serious attention ; but let them pass for what they are worth, valeanl quantum valere. " The Board of Health is the source of information to which the people are taught to look for the real situation of the city, as to its being healthy or otherwise ; and some go so far as to declare that we are bound to give implicit credit Account of the Yellow Fever. 125 io their official reports, when published. Without giving an opinion on this point, we may at least be allowed to ex- press some doubts, when those reports contain the opinions of physicians which stand stating in the face of each other; I say, I caDnot thiiik it improjicr, or arrogant, in such a case, for any plain man to entertain and to express doubt as to which of them is riglit, since it is very evident both can- not be. In the report before us, we h >ve the opinion of tiie Resident Piiysician, an officer of the Bourd, and co; sf quent- ly entitled to our confidence, that tlse disease which now exists in a certain quarter of the city, and agitates and alarms its inhabitants, is but a b lious fever of ordinary oc- currence, and ought not to excite any alarm, and that those extraordinary measures of precaution which aro somi times resorted to by the guardians of the public health, would be superfluous and unnecessary, and we find it stated in the same report, that another equally respectable physician, after having formerly, when he first saw the disease, expres- sed the same opinion of its characier with the Resident Piiy- sician, yet now, having attended it and watched its symp- toms and progress for a week, deeming it due to truth, to himself, his fellow citizens, and to the Board of Health, to acknowledge that he was mistaken in that opinion, and to pronounce it a clearly marked case of yellow ievev, that justly dreaded scnurge of our cities when once it has been inlrofhiced into them. And here I beg permission to ask. if, in such a case as this, where the health and prosperity of a city is at stake, it would be any violation of the delicate rules of politeness and etiquette, if the Board should invite other respectable gentlemen of the faculty, to visit the pa- tients and report their opinions to them ? But it so happens here, that although the physicians above alluded to have not given in detail the reasons on which thev have founded tiieh- 126 Account of the Yellow Fever. opposite judgments, 3 et the facts rn the case are recorded with sufficient particularity. It appears that no less than sixteen cases of fever, (using the general term,) have appear- ed in quick succession at the lower part ot Rector-street, near the wharf, since the 10th of la.-t month, and that of these, six have died, the disease having run its course in from four to six days, that one recovered, that three are consi- dered convalescent, that six are yet ill, and their fate un- certain.* Now we submit these facts, without one word of profane comment, (which would render us liable to the charge of quackery) to the judgment of exp'^rienced physi- cians, (whether their theories be those of domestic or foreign origin,) and request them to say whether they are the cha- racteristics of yellow or bilious fever. We merely will add, that we have been informed, that the c^ses alluded to have been seen and examined since yesterday morning, at the im- portunate solicitation of many of our most respectable citi- zens, by a number of our first physicians, and particularly by Dr. Hosack, all of whom, we are told, unite in the opi- nion that the disease in question is decided yellow fever. " We now expect from the wonted vigilance and activity of our Board of Health, the immediate adoption of those prompt and vigorous measures the occasion imperiously demands. Better in such a case, is it to err on the side of over-precaution, than on that of hesitating procrastination. We hope this plain and zealous language will be excused by the candid on consideration of the motives of the writer. The explanatory Letter of Dr. Neilsoyi is also annexed. TO THE PUBLIC. " From the manner in which the Report of the Board of Health is worded this morning, it would appear that I had * One of these, Leonard W. Archer, died this morning-. Account of the Yellow Fever. 127 made two contradictory statements to that hoAy. Justice dem mds an e\planation of the facts. " By an ord nance of the Board of Health, every physi- cian is required to report all cases of malignant fever which may fall under his care. In compliance with this regula- tion, on Monday last I reported to the Board of Health two ca^es of malignant fever, at the corner of Greenwich and Rector str els. On being asked whether I reported them as cases of yellow /t'c, I answered. No — but as cases of bi- lious fever of a very malignant character. I also strongly urged the propriety of measure- being taken to have the family removed to a more healthy situation, as they were not in circumstances to remove themselves. Although the Resident Physician and Health Commissioners, upon whom I called, saw these cases, no farther notice was taken of them ; and the malignancy of the symptoms increasing, on Wednesday morning I reported them as cases of ydlow fe- ver. It may be remarked, that the disease of the young man (A e'er,) was ushered in bj' copious bilious vomiting. '' Now, if a yellow skin ; red, suffused eyes ; cool surface and extremities ; pulse nearly regular ; tongue red and dry j and, as the disease progressed, vomiting of black Jlocculent matter, and bleeding from the gums and nose, all of which symptoms took place — if these do not constitute malignant fever, in its worst form, I should be glad to know from the Resident Physician, or Health Commissioners, what more is wanting. These symptoms your Resident Physician was, or ought to have been, acquainted with. Some of^ these did not tievelope themselves, until after I had the honour to appear before the Board of Health, and declared the disease to be, in my opinion, bilious malignant fever — net simply bilious fever, as is erroneously expressed in the report of the Board of Health. 128 Account of the Yellow Fever. " The young man died this morning. Mrs. Edward continues very ill. JNO. NEILSON." Thus the contagion passed from the daughter of Mrs. Rose to her nurse, Mrs. Dobson, to Mrs. Waters, to Mrs. Edwards, and to Archer, all living in the same house, and who had had constant intercourse with the little girl in the small apartment in which she lay during her illness. Miss Rose had been sick eight days, and Mrs. Dobson. and Mrs. Waters sickened on the day of her death, viz. the 24th day of July, and Archer and Edwards the day after. Supposing the interval from the reception to the development of the contagion requires from two to four days, the contagion must have been received from her the first or second day, or between the first and third day of her illness. Miss Rose had passed the house of Reder and Mr. Falconer's groce- ry daily, on her way to Mrs. Melraoth's school in Washing- ton-street, a few doors from Reder's shop : a few days be- fore she sickened she called at Reder's stoop to inquire after Amanda's health. 3. From Rector-street we shall go on to the numerous parallel instances of contagion in other houses, taking them up according to the dates at which they were reported to the Board of Health. Matilda Ann Hill, aged 16, sickened at No. 6 Albany- street, next street but one north of Recior-s'reet, on the evening of the 4th of August, and died on the 7th. Mr. John Hill, her father, aged about 40, an Englishman, who had been in this country for years, and was a coppersmith and pewterer by profession, sickened on the evening of the Tth, and died the 13th. Bo+h father and daughter had been in great dread of taking the disease. The house in which Account of the Yellow Fever. 129 iliey lived is a wooden three story building and clean, but the family very large. 4th. John Scorgie, a Scotchman by birth, aged 49, grocer, and his daughter Mary, who had both been frequently to the foot of Rector-street, removed from No. 55 Washington- street, between Rector-street and Beaver lane, on the J 5th of August, and were reported on the 17th following — they both sickened on the 16th — the father died on the 19tb. His wife, also Scotch, and aged 48, and therefore, like him, predisposed, sickened on the IQih, and died the 23d. This places the periods of communication and development near- ly the same as in the last cases. 5th. John M'Kenna, an Irishman, and grocer, aged 27, sickened on the 17th of August, and died on the 20th. He lived in a two story wooden building at the corner of Green- wich and Cedar-streets. He was the first case that had oc- curred so high north in this street. Edward Arcularius, who had been frequently with M'Kenna during his illness, and in whose arms it is said M'Kenna died, sickened at the same place on the day of M'Kenna's death. This agrees with the other cases. Arcularius's father is a .German. The house was perfectly clean, and also the yard. 6th. Miss Jenkinson, a dress maker, who had been through Cedar-street, where cases had occurred, sickened on the 20th of August, at No. 62 Broadway, in which street no case had yet occurred, and died on the 26th. Elizabeth Jackson, a mulatto woman, aged about 50, who had been nursing her, sickened on the 27th, and died on the fourth day of her illness, with black vomit. The contagion was here sufficiently concentrated, it would seem, to overcome even the natural insusceptibility which coloured person^ are usually found to possess. 7{h. The first case reported in Conrtlandt-street, which is 17 130 Account of the Yellow Fever. remarked lor Its cleanliness and the elegance of its buildings, was Ellen Kearney, an Irish servant girl of Mr Morse, keep- er of the York Hotel, at No. 5, a (ew doors from Broadway. This is a very respectable hotel, and being much resorted to, and at the same lime a small building, is therefore most of the time crowded. The boarders moved away on the 24th August. Mr. Morse came to a determination to move his family on the 30tli. On that day, in the evening, Ellen Was taken ill, aivd vomited considerably. She had been down into the infected part of Broadway as far as the Citi/ Hotel a few days before. It was attributed to fatigue in pre- paring to reiuove. The next morning early she appeared a little better, but grew worse in the course of the day. Mr. and Mrs. Morse moved away that morning. Ellen remained. In the course of the day her brother John, aged 20, who was a clerk, and her sister Mary, and both from Ireland, came ta stay with and nurse her. Mary did not leave tlie house. They continued with her until the 5th of September, when they both sickened. John was removed to Orange-street, and Mary to Kip's bay^ out of town. John died September 8th, and Mary the 13th. When Mrs. Morse moved away she was not sick, but was taken down on the 5th of Septem- ber following, and died on the 11th. She had not been be- low Courtlandt-street, but had seen Ellen several times du- ring the first twelve hours of her illness. Though Ellen recovered, as Mary and her brother John, and also Mrs. Morse, all took sick on the sixth day after having seen Ellen, there is no doubt they took the disease from her. As Mrs. Morse saw her only during the first twelve hours of her illness, she must have received the contagion from her at that early period of the disease, though it did not take effect until five days afterwards. After it had begun to take effect, however, it ran its course with much greater rapidity Account of the Ydloio Fever, 131 than in Mary, in whom it took effect sooner, for she did not die until two days after Mrs. Morse. This is also to be accounted for from the circumstance that Mrs. Morse had not been in good health for some time previous. 8th. About the 20th of August, Mrs. Aphya Colfax, aged 34, was taken sick of yellow fever at No. 69 Courtlandt-street. She kept a respectable boarding house at this place. Her nrjother had gone out of town the day before, and her board- ers had moved away about a week before she fell sick. She remained sick a fortnight, and recovered. On the 4th day of September her daughter Mary, aged 10, and who had not been out of the house, took sick of the same disease, and also recovered afier sixteen daj's illness. Three days after Mary sickened, namely, on Saturday September 7th, Mrs. Mary Merrit, aged 32, from Connecticut, sister of Mrs. Colfax, and of an asthmatic habit, also took sick, and died on the ISlh. Three days after Mrs. Merrit sickened, namely, on the 10th, her husband Charles Merrit, from Massachusetts, and her son Frederic Forsyth, a boy, both of whom had nursed Mrs, Merrit, and frequently lain on the same bed with her during her illness, also took sick, but both recovered. After Mrs. Colfax's mother and boarders had removed, she and the four others whom we have said fell sick, were the only persons who recovered in the house. As it was next to impossible to procure a nurse, in order to assist each other, they all lived together, but in the same room, which is an apartment of low ceiling in the back part of the house on the first floor, and not more than fifteen feet square ! Whether this was not enough to con- centrate and propagate the disease I leave the impartial reader to decide. Mrs. Merrit was perfectly well assured that she had taken her disease from her niece, and said before her death that she might 4iave saved her 132 Account of the Yellow Fever, life if affection had not forbad her to desert her. Mr, Merrit also was satisfied that he and his step-son had both received their sickness from their attentions to Mrs. Merrit. It is of no consequence where Mrs. Colfax received her disease — who will deny that the others owed their illness to her ? It seems that the intermission between Mrs. Colfax and her daughter's illness was much longer than that be- tween the others. It is curious to observe how the poison multiplying itself through the mother and daughter did not prove fatal until it had reached Mrs. Merrit, and afterwards seemed to have lost again its intensity when it reached die husband and son. But the circumstance of habit and time of life are to be taken into account. 9th. The contagion of the disease spread in a most remark- able manner through the family of Mr. Bunn, shoemaker, who lived in a small confined but clean house at No. 69 William- street. Mr. Bonn's family consisted of himself, wife, and ten children, beside three or four other persons, who lived or were employed in the house, all of whom continued to remain, though this part of the street had been for some lime before entirely abandoned. There are perhaps very few houses in the city of the same size which contained so many individuals under the same roof. Hence, their situ-> ation must have necessarily been very crowded, and the air of the apartments loaded with human effluvia. The mo- ment the spark was introduced it communicated to almost every individual ; but what is singular, the disease, though strongly marked in the greater part of them, proved fatal to one only. No cases had yet appeared in ihis street. Amelia Torbuss, aged 22, the first, sickened Wednesday, Augusi 28th — recovered. Sally Bunn, aged 14, sickened 29th August — recovered. Rosetta Bunn, aged 8, sickened September 5th — reco- vered. Account of the Yellow Fever. 1 33 A black woman who was a servant, sickened September 13th — recovered. Mrs. Bunn, the mother, sickened September 14th— reco- vered. An infant of Mrs. Bunn's, aged 2 years, sickened Sep- tember 1 7th — recovered. Mr. Bunn, the father, aged 52, sickened September 19th — died. Sophia Bunn, aged 12, sickened September 29th — re- covered. Mrs. Mount, sickened September 26th — recovered. Thomas Bunn, aged 19, sickened September 30th — re- covered. The disease was no doubt introduced by Amelia and Sally, the first two cases. They had been in Broadway, where there were several houses in which cases had previ- ously occurred. Rosetta, the third case, slept in the same room with Sally, to attend upon her. Mrs. Bunn, and the black woman, had both been employed in taking care of Sally, Amelia, and Rosetta, and Mrs. Bunn frequently slept in the same room with them. Mr. Bunn had devoted him- self to his wife and children during their sickness, and died 24th September, in the arms of Mrs. Mount, who took sick two days after. Thomas had also assisted in nursing his afflicted sisters and parents. The family did not remove until after Mr. Bunn's death. Mrs. Bunn and the black women took the disease probably from Rosetta ; and the infant, the husband, and Sophia, from Mrs. Bunn. Though the contagion did not prove mortal until it had reached Mr. Bunn, twenty-two days after the first cases sickened, its iutensity, or at least its power of propagating itself, ap- peared to have been as great before as after his death. Its 134 Account of the Yellow Fever, fatality in him was attributable perhaps to time of life, na- ture of bis occupation, or some other circumstance. 10th. Mr. James Woodhull, kept a very respectable pri- vate boarding house, a neat three story brick building, at No. 'S5 Maiden-lane. He continued to remain there with his wife and three or four boarders until most of the neighbourhood had removed, and cases had begun to occur in the ad- jacent streets south of Maiden-lane. Cases had already oc- curred near Maiden lane in Broadway^ but none near Mr. Woodhull's. Retook sick September /4th. a day or two after all his boarders removed, and amouiz them Mr. Alexan- der Murray, who went to Powles Hook but ramp daily to see Mr. Woodhull until the 20th, when he was a'so tviken sick. Mr. Woodhull recovered, but Murray died on the 23d, at Powles-Hook. Mr. Woodhull moved himself with his family from Maiden-lane September 21st, and on the 23d his wife Mrs. Harriet Woodhull, aged 33, v^^ho had been nursing him, also sickened, and died the 29th. Thus Mr. Woodhull, who was sick about seven days, and escaped nevertheless, communicated the disease to Murray, and to Mrs. W. who both diied : in the first the contagion was re- ceived and developed within the first ^re days of Mr. Wood- hull's illt;es having yet occurred in that neighbourhood. Phelan di«d the 13ih. His son Andrew Phelan, who had been taking care of his father, took sick immediately after his death, knd died the 19th. 21st. Catherine Jones, aged 37, sickened of yellow fever at No. 7 Ch«apside-street, and nearly opposite to where Ca- therine Bajley had died, on Wednesday, October 16th, at noon, and died on the 23d with black vomit. Her daughter Henrietta, agrd four years, sickened in the same house, October Hst, that is, on the beginning of the sixth day of her mother's illness, and died on the 30th. The con- tagion here a!so was received probably on the first or se- cond day of her mother's illness^ leaving from two to four days for ii to become developed;. CHAPTER II. ANALYSIS OF THE SYMPTOxM^. . INVASION. The invasion was generally sudden, and at night ; somje= times in the morning, and most usually like that of an ordi- nary fever, with, or sometimes without chill ; also gaping, yawning, loss of appetite, languor, hurried respiration, faintness, nausea, and in some instances vomiting of bilious matter, or rejection of drinks and food : most usually acute pain in the head and back, and sometimes violent affection of the nervous system, and severe rigors. In a few instances^ the patient had been complaining for some hours before he was taken dowu; and imagined that he had caught cold, to which the first symptoms of the disease do, in fact, bear some analogy. FIRST STAGE. Most usually considerable excitement, especially In full habits, and in children, and nervous temperaments, or in the sanguine, as in the Irish or English. The increased 144 Account of the Yellow Fever. tone whicli the excitement gives to the system may explain why the vomiting, which sometimes manifested itself in the invasion of the disease, is now, for the most part, obscured or suspended, showing, at the same lime, as Moseley has remark- ed, that it was with more probabiHty owing to irritation in the stomach, not to plenitude or engorgement of bile, as some have supposed. There is now almost invariably, severe pain in the head, especially in the forehead, and in the back and loins, sometimes extending down the legs to tbs calves. Eye. — Usually inflamed, and tinged or swollen, and often at the same lime dull and suffused with tears, or of a drunk- en appearance, the interstices between the red vessels of the adnata remaining white, and the cornea natural or un- commonly brilliant. In several instances the adnata was so crowded with vessels carrying bright florid blood, as to give it a beautiful pink colour and the appearance of be- ing blood-shot. I saw this in two instances. It was also remarked by Dr. Neilson. This brilliant tint, finally dis- appeared altogether, leaving the adnata of a deep greenish and dirty yellow. : sometimes the eye was almost natu- ral in appearance, with a bright yellowness of the adnata, and the red vessels upon it not more numerous than in health, and both easily accounted for, from the intem- perate habits of the patient, which ought always to be re- collected when the physician is called to the poor or la- bouring classes. Pain usually over and across the eyes, and through the eye-balls, often very severe, and locating itself more especially along the superciliary ridge, causing the patient to contract his eye-brows, or about the centre of the forehead, extending occasionally through the head to the occiput. In some (ew instances the pupils were un- usually dilated, and in others the eye was intolerant of light. Sometimes the patient described the pain as deep seated, ap- Account of the Yelloiv Fever. 145 parently at the bottom of the orbits. This was observed by Dr. Francis, in the present epidemic, and by Dr. ETugh M'Lean, in that of 179S. Tongue. — Generally thick and somewhat swollen, more frequently pointed than broad ; mo-t usually in the begin- ning covered with a dirty white or lead coloured fur; darker towards the base. In one mild case there were no other symptoms than a slight retching on the first day, with some nausea and lan- guor, a pulse little more frequent than natural, and dilata- tion of the pupils, without the least redness of the eye until the sixth day, when a slight hiccup came on, and lasted for a few hours — on the seventh day the pulse was 72, and then came on a dingy yellow hue of the adnata with a little suf- fusion. The tongue from the beginning had been of a livid colour, moist, and unusually thick and broad, and utterly destitute of slime or fur until the seventh day, when it grew a little brown and dry only towards the base. In some few instances the tongue was besmeared with a thin white moist slia:e or paste until towards the termina- tion of the disease. In one very mild case, the fur was of a bright and light yellow hue, and the tongue unu- sually flat and thin ; but the red vessels, and afterwards the yellowness, succeeding upon the adnata, though it never reached ihe neck and trunk, and also the red clear mnrgin on the tongue, (which however was less distinct and nar- rower than in any other case I saw,) together with the con- stant nausea and oppression, without vomiting or irrita- bility, and only slight pain on pressure ; and also, what was of more importance, the slow measured pulse of convales- cence, are sufficient to show that it was a genuine case eff 3^el!ow fever. In a few instances ilie tongue was very nar- row and pointed ; but in one or two others, so broad, thick, 19 146 Account of the Yellow Fevei\ and swollen, that it was with difficulty the patient could thrust it out of his mouth. Pulse. — Varies from 90 to 120, and in children, 150. — Somrtimes as low as 80, and e.ven 60, and 55* from the beginning of the attack ; in which case the s!age of excite- ment had not existed at all, or passed within a few hours into that of collapse ; generally full, but in a majority of in- stances, not sufficiently strong to resist any considerable pressure. In a case attended by Dr. Minor, it was 60 on the first day, and never afterwards rose beyond 80. The patient recovered. In a case under the care of Dr. Francis, the pulse, six hours after ilie invasion of the disorder was 45^ and never became more (requtnt than 70. In such cases the skin was, for the most part, unnaturally cool from the begin- ning. Skin. — Flushed, generally hot, and somewhat dry in this stage; the degree of temperature corresponding with the force of the circulation ; moist often throughout, but rarely or never characterized by the biting, stinging heat and dry surface of typhus. The skin is sometimes, (says Warren,t) though rarely, parched and dry, but oftener, and indeed generally moist, and disposed for sweat. Respiration. — Hurried in proportion to the violence of the excitement: and almost invariably attended with deep sighing, evincing the influence of the poison on the nerves. Boioels. — Generally constipated in this stage, but after they had been opened the evacuation continued often natu- ral in colour and quantity, without foetor, and as Lining says, rarely bilious, soft or liquid, during the whole progress of the disease. * The case of Mr. Dusenberry, attended by Dr. Blachley. The pulse was 55 the first day, and rose afterwards to 60 and 70. f Warren on the Mahgnant Fever of Barbadoes. p. 9. Account of the Yellow Fever, 147 In three fatal cases, one of which was unattended with hiccup or black vomit, the disease came on with a diarrhoea, which continued uniil a few days before death. And in an- other case, which was attended with black vomit, but reco- vered, the menstrual discharge, and dysenteric symptoms, accompanied with tenesmus and griping, supervened in the last stage of the disease. The catamenia were, in this case, more copious than usual. Stomach. — Usually calm, but sometimes a constant nau- sea or sense ot oppression at the praecordia, accompanied occasionally with cruriations and cardiaigia. Sometimes, but very r^irely. extreme distress and pain at the praecordia from the beginning of the attack, producing violent spasms and retraction of the abdominal muscles and legs on the sli2;htest pressure. 1 saw this in a case attended by Dr. Francis. Urine. — Variable" ; often natural in every respect; but in many cases the urine was scanty and high coloured ; in some few the discharge was copious or natural. Countenance. — Most usually natural and flushed ; often a wild rsiare and gaze of the eye, and not unfrequently the expression of the countenance remained unchanged to the last. Position and actions of the patient. — Invariably lies on his back, and has an inclination to throw his arms above his head. Rouppe also observed the position of the patient. " Semper in dorso jacuerxtnt cegri,^^ intellectual functions. — Occasional delirium, attended with coma, especially if the excitement be great. SECOND STAGE. In some few instances the first stage was protracted even to the fifth day. In the case of Denn, in Barclay- -treet, attended by Dr. Francis, there was a state of high ex^ 148 Account of the Yellow Fever. citement until the morning of the fifth day. Deveze also saw it protracted to the fifth day. But most usually the first stage having continued from 24 to 48, or sometimes to 72 hours, there now comes on, not a re- mission, but a sudden proslralion of all the animal forces producing what is termed a state of collapse or metaptosis, as denominated by Dr. Moseley. The excitement falls, the countenance is more or less pale and shrunk, and the pa- tient becomes calm and composed, and though languid and debilitated entirely free of pain. The blood retires appa- rently from the surface to the interior organs, which ac- counts, in the opinion of some, for the stomach being now more irrifable and more predisposed to haemorrhage. But it must be remembered, that this predisposition to haemorr- hage exists also in the external passages, which shows that it is not so much owing to the retiring of the blood as to the subsidence of the circulation, and tlie general loss of tone in the contractility of the capillary arteries, occasioned doubt- less by the paralizing influence of the poison. E^e. — The red vessels begin to disappear, while a yellow- ness is now first observable at the angles, especially at the outer angles, accompanied at the same time with, or followed soon after by a yellowness in the rugas, running down from the alse of the nose to the corners of the mouth ; also around the e)es and borders of the lips, and between the lower lip and chin — as this stage advances the red vessels gradually dis- appear, and the eye becomes less turged as the adnata be- comes more and more yellow.* Tongue, — The fur often remains moist and still of a dirty white, or leaden colour, but most usually accumulates and * We cannot sa}', with that accurete observer Dr. Lining-, that we ever saw the inflammation of the conjunctiva to increase at this stadium. ^Sccount of the Yellow Fever. 349 becomes at the same time with or before the adnata, of a brownish yellow hue, and ('ry and darker 'owan's the base, surrounded alniost invaiiably by a moist clean red or livid margin, now distinctly contrnsted wi h 'he thick, dark fur, and extending along the sides and round the apex of the superior surface — thepapillas on the apex also frequently in- flamed and swollen. An unfavourable symptom, and which frequently happens at the termination of this stage, is a spasmodic movement of the tongue when thrust out of the mouth, as is often seen in typhus- Lips. — Most usually dry and cracked, or somewhat parched. Pulse. — Sinks to ninety, eighty, oj- seventy, rarely lower, varying a little more or bss, from m the sallowness of her complexion ; delirium frequently, but most usually a listless state of pervigilium, convulsions, d< ep, anxious and frequent sighs, pensive sadness of countenance, great distress and irritability at the praecordia, particularly on pressure; dys- enteric symptoms, with tenesmus, griping, and frequent but scanty discharges of black foetid matter ; a fiery r: d tongue, besmeared with blood, inarticulate moaning, retracted legs, petechiae ; towards the termination a petechial or purple efflorescence, or extravasation in large blotches on the trunk a^nd limbs. In addition to these, a painful swelling of the jaws and cheeks and of the parotid glands, and an ulcerated * Sir Gilbert Blane was the first, I believe, who particularly notic-oi this peculiarity. — Vide Diseases of Seamen, p. 40(5-7. 152 Jiccount of the Yellow Fever condition of the inner liniv'g of the !ips with a mercurial fosior (though she had takiui no mercury,) all of which continued and even increased during convalescence. The breath was exceedingly ofiensive from the coagulated and decomposed bloo'J coliecied under her tongue and between her lips and teeth. What was remarkable, the menstrual discharge came on, though it was not the period, and was protracted until near the termination of the disease. This, by Lining, and especially Deveze, is considered a favourable symptom. The excoriations also produced about the anus and thighs, by the involuntary discharges of the catamenia and from the bowels, towards the last days of the disease caused distressing pain, and bled considerably. She was a native, of the melancholic tenriperament, tall and robust, with jet black eyes and hair, and very dark skin, aged 40. She was neither bled nor blistered, nor but once or twice gently purged. In a young Frenchman, at quarantine, the chafing between the scrotum and highs from lying, also, brought on hae- morrhage, during convalescence. Deveze, in his Traite de la Fievre Jaune, mentions a case where the general organs were very much inflamed and greaily augmented in size, ending in gangrene of the scrotum, (p. 92.) In the yellow fever of Cadiz, in ISOO, there was often observed a con- siderable irritation of the urethra, similar to patients labour- ing under an attack of stone.* Towne, also, sometimes saw in the decline of this disease, painful pustules, and aphthae in the mouth, and dangerous imposthumations in the throat. \_Diseascs of the West hdks, ^rc. p. 51. ed. 1726.] Lind says, buboes and a swelling of the parotid glands are un- usual, though salutary symptoms. * Reports on the pestilential disorder of Andalusia, p. ^ij. Lond. im5. Account of the Yellow Fever. 153 Petechiae, not always an unfavourable symtom, consisting of Utile spots of variable shape, of extravasaled, purple or pink-coloured blood, without any elevation of the cuticle, are now observable about the forehead, cheeks, and on the neck, but more especially on the backs of the bands, and on the arms and chest. Mr. Baliy thinks they are favoura- ble, if they preserve a rose colour, but unfavourable if they pass to a violet, or brown. I observed in one or two fatal cases, a vesicular eruption about the corners of the mouth, interspersed with petechiae: but Rush says, it is a favourable symptom. In one strongly marked case, (a German from the sugar house, Li- berty-street, attended by Dr. Van Arsdale,) which recovered, a miliary vesicular eruption appeared all over the surface, on the third da}'. This was frequently observed in the yel- low fever of Spain. Moscley has remarked, thHt a prickly beat has often saved the new-comer in ihe West Indies. War- ren has seen the patient recover by a large critical erup- tion of boils, or small abscesses all over his body Sir Gil- bert Blane observed, that an eruption of white pustules on the trunk, at the termination of the disease, was a favoura- ble symptom. It is otherwise with anthrax, which now and then, but very rarely, has been observed to form on some part of the body, being always an unfavourable symp- tom, atid not appearing until the la^t stage of the disease. Out of 425, the whole number of cases, there were only two instances of anthrax. Oye was a female patient at- tended by Dr. Nelson. The tumour formed about the Iowc;r jaw and parotid gland, and went through all the sta- ges of that affection Tlse other occurred on the knee of a boy in Vesey-street, who died. It was mentione.i to me bv Dr. Pasculis. Out of seven thousand deaths of 154 Accounl of the Yellow Fever. yellow fever in Cadiz in 1800, Arejula saw only three instan- ces of carbuncle, two of which proved fatal.* Respiration — Continues perfectly natural and easy, except that the sighs are now deep, long, and frequent. In one case only (Mrs. Clear, 75 Cheny-st.) there was oc- casionally a hacking loose cough. It had existed for years. In another (Mrs. Brown, in Cheapside-st. attended by Dr. Howe, there was haemorrhage from the gums, and also from the lungs, accompanied with cough just before death. The respira- tion, Deveze says, is always difScult in this stage. One would suppose, by the indistinct manner in which some writers speak, that the respiratory functions were as much disturbed in this disease as in pleurisy. This want of pre- cision in their language must lead to a gross, misconcep- tion of the nature of yellow fever; for the sighing is the peculiar and only phenomenon which the lungs exhibit. Bowels. Stools occasionally become foetid and dark ; but in a great number of cases retain their natural colour, and remain in every respect unchanged, to the termination of the disease. Stomach. This stage being formed, the patient generally begins to reject his drinks and medicines, and about the third or fourth day of the disease, complains of a soreness, tenderness, shght burning, or irritability at the pit of the stomach, and appears in great distress on pressing the hand upim this part, or on giving him any thing unusually cold or hot to drink ; at the same time the heat appears to be con- centrated on the surface of thai region. In most cases, this irritabdity was unaccompanied with nausea, but sometimes there were distressing flatulence and cardialgia from the be- ginning of the disease, but unlike remittent and bilious fe- * Sir James Fdlowes, p. 56. Account of the Yellow Fever, 155 vers, seldom or never with continued or severe retching, or vomiting after the invasion, or first day of the disease. But at no time of the disease was there pain or tension of the right hypochondrium. Urine. — Generally diminished, and of a deep yellow co- lour, where the yellowness had extended over the trunk. Sometimes entirely supjbressed for several days, which usu- ally proved to be a fatal symptom. In one instance of a male paiient, aged about twenty-eight years, attended by Dr. Francis, there was a total suppression of the urine, at- tended with great distress in the region of the kidneys, which continued for three days. The patient was finally relieved by saline cathartics and the use of the sweet spirits of nitre. Hence a plentiful discharge of urine, as Sir Gilbert Blane has also remarked, was observed to be a fa- vourable symptom. In a case attended by Dr. Van Arsdale, it was critical. Countenance. — Usually more or less ansious and melan- cholic, or marked by an expression of pensive sadness. Never or very rarely entirely deprived of its florid colour, though this is somewhat modified or changed to a damask hue by being blended with the yellow. Intellectual Functions. — Sometimes muttering delirium, but the delirium was never long continued; at other times more or less comatose and disinclined to talk during the whole disease. Most usually constant pervigilium, occa- sionally interrupted by dozing;* the eye now frequently has a wild fixed gaze, and appears inattentive to what is *The patient whose case is detailed, [Cadwell] had been quite deaf for years, but could now hear a whisper, but lost the sensibility of this organ again on becoming convalescent. Dr. Rush, however, says that in some eases there was observed a deafness and also dimness of the sigiit. 156 Account of the Yellow Fever, passing, as if the mind was abstracted; the patient being disinclined to talk, but always answering prorapt'y to any qnestioDS that are put; showing, as does indeed also the dis- tressing pervigilium which characterizes this disease, that the sensibihty of some of the nerves is often morbidly increased. The only author in whom I have seen this peculiarity of yellow fever noticed, is Rouppe, who describes it in so ac- curate a manner, ihat it would be impossible to mistake it: " cPg;" i, insuper anxii, inqui^ti, leviter deliraiites, adn.odum incuriosi, nihil sestimantes, nihilque querantes, evaserunt ; altamcn adquassita fere semper, recte responderunt."* Some- times, however, the patient affects a forced gayety, becomes exiremr ly loquacious, talks over his afiairs to all that enter the room, and propt>-es to himself schemes of business and of pleasure. He appears to be under the dominion of a de- lusive train of ideas, and a fatJ confidence that he has re- covered fi om his illness and is about to resume on the mor- row his wonted occupations. In a case attended by Dr. Francis, (Denn, already mentioned,) the patient began to count over his money and examine his accounts and papers, as he lay in bed on the seventh day of his disease. He died on the ninth day. In others this hallucination changes to a particular species of derangement, and the patient g-^ts up out of his bed, dresses himself, and says he wishes to go home, the muscular powers remaining uni'r paired to the last moment i)f life. He does not seem to recogiiize his nearest relations, and lo'es alfo the consciousness of his own per- sonal identity, thinking that some other individual is talked of when his own name is mentioned, and joining in the conver- sation as though he were a liiird i)erson. In one case there were convulsions for a quarter of an * De morb. Navigant. Account of the Yellow Fever. 157 hour on two successive occasions, but there was little or no mental derangemeut, the patient lying constantly in a listless or torpid slate, disinclined to talk, but not comatose. Pofilion and actions. — It is unfavourable at this time to see the patient showing an inclination constantly to keep his legs drawn up to his abdomen ; for this position is as- sumed to obtain- momentary relief from the distressing burning of the stomach. Another unfavourable symptom is an irregular twitching and restless motion cS the hands and arms, as if the patient were affected with chorea. THIRD STAGE. The second stage continues from two to four, five, six or even to seven or eight days. The transition from the second to the third stage is much less perceptible than from the first to the second. The symptoms are all rather aggravated than chan-ed. The countenance becomes more anxious, the adnata of the eye of an unnuural green yellow of the deepest hue, and entire- ly clear of rrd vessels, which, contrasted with the brilliant colour of a blue or hazel cornea, give^ the look an unnatural and grotesque appearance. The globe of the eye seems now to have resumed its natural shape, and the wild stare is rarely seen at this late period. In two orthreecases I observed a short time before death a purulent secretion from the meibomian glands, of so glutinous a nature in one fatal case, (William Cisco, a remarkably robust and light-colaured mulattoe, attended by Dr. H- rriot.) that the patient could scarcely open his eyes with the aid of his fingers. The lids also in this case were puffy, livid and bloated, and the inn( r lining of them deeply inflamed and pi-uruig out a bioodj' sanies. In several strongly marked cases, I observed towards the close of the disease, a dark extravasated appearance under the lower eye-lids. Dr. Walker also informs me that he 158 Account of the Yellow Fever. saw in one or two cases livid spots on different parts of the surface before death. Rouppe also, one of the oldest and best writers on yellow fever, mentions this : <' in nonnullis magnas lividas vidi maculas."* The aspect of the face does not materially change. In fatal cases, and sometimes also in strongly marked cases which recover, the yellowness generally becomes of a deeper and stronger tinge, and continues to extend farther down the trunk and upon the lower extremities, often however not reaching the feet until just before or after death : and where the case terminates in death, before the seventh day not usually reaching below the trunk, as in White in Franklin street, a printer who returned to town from the country, and died on the seventh day, attended by Dr. Walker. Sometimes the patient has furious delirium, and cries out in inarticulate sounds, expres- sive of his distress, particularly when he has inclination to vomit. Sometimes the skin, circulation, and other organs, all assuming as it were, their natural functions, give for a few hours the fairest assurances of speedy recovery. Sud- denly, and without cause apparently, the pulse is observed to become greatly accelerated, amounting perhaps to one hundred and ten and one hundred and twenty, at the same time full but exceedingly weak and compressible, while a corresponding glow and warmth is suffused over the sur- face and extremities, giving the appearance of a feeble effort in the system to produce a paroxism or exacerbation. But in a few hours it sinks again, or retaining the same ve- locity, becomes thready and vermicular to the feel, and at length entirely imperceptible at the wrists. Though these exacerbations and remissions may occur several times in the last twenty-four hours of the disease, and the surface and * De moxb. Navigant Account of the Yellow Fever, 1 59 extremities become alternately heated and flushed, or cold and damp, they observe no certain periods, and are alto- gether too irregular and adventitious to be mistaken for the symptoms of a remittent. Should the pulse retain its natural size, though soft, and subside gradually to forty or fifty beats in a minute, and move with a slow measured and regular pace, accompanied with a natural condition of the other functions, it shows that the force of the poison is spent, and is one of the peculiar and most characteristic indications of conva- lescence. It is astonishing indeed to see how long a time it takes for the circulating functions to regain their tone, and to recover from the deleterious and deadening in- fluence which the poison seems to have produced upon the contractility of the arterial system. The extremities now begin to lose their heat enlirely, and are pervaded by an unnatural coldness and clammy mois- ture, which finally extends over the forehead, shoulders, chest, and thighs, the surface at the precordia still retain- ing its heat. There was in two cases which came under my notice at this late hour of the disease a gene- ral tremor of the whole body as if from a chilly sensation, or when the blood retires from the surface. [The case of Eliza Baylej, and that also of Mrs. Clear, Cherry- street.] In one case there was an hour or two before death, a subsultus of the muscles of the mouth, gastroc- nemii, and of the eye, producing in the latter a strabimus, ac- companied at the same time with remarkable dilatation of the pupils. [White, in Franklin-street, already mentioned.] The tongue cleans or sloughs off, and becomes drv and of a fiery deep red colour, sometimes moist, but very fre- quently having its surface parched brown towards the base, and rough to the feel. The only author I have met with who has accurately de- scribed the appearance of the tongue in this stage, is Dr. 160 Account of the Ydlow Fever. Bruce of Barbadoes, published in Lind. "Lingua in princi- pio, muco albesf enli obducta, squalescit circa finem morbi et in media scabra. colovh primum rufi,dein quasi, nigrescenlis, horrida apparet," Tbe guais and inside of the lips also, as Lining and Jack- son have remarked, became spong}' and of a deep florid red colour, while the lips externally perhaps, were pale or livid. The blistered surfaces also became of a deep red colour, as if they were highly inflamed, and in many cases the inner lining oftlse eye-lids also became engorged with blood as in ophlhalmia tarsi. These ouglit all to be considered very unfavourable symp- toms, as they indicate a stale of engorgement and hsemorr- hagic disposition in the capillary vessels; all doubtless^ at- tributable to the sedative and relaxing influence of the poison, and not to the excitement caused by the reaction of the blood vessels in the beginning of the disease. The patient was now observed occasionally to be hoarse, and compliinc d of a huskiness or dryness of the throat, and of great thirst and a strong desire for cold water. A soreness of the throat, which came on in several instan- ces at this period, was observed to be a fatal symptom. But thirst is usually a rare occurrence in the earlier stages of th s disease. Dr. Rush considers it, in the last stage, an . alarming symptom. Blood of a bright florid hue and watery consistence dis- tilled in a number of instances from the gums and nose, and besmeared the tongue, or, becoming dry on the teeth and lips, encrusted them with a black sordes, as though they had been covered with soot, resembling the appearance of the teeth and lips in the last stage of typhus, where, however, it proceeds not from the bloody but from the foul n(ss of the excretions. Account of the Yellow Fever. 161 In one formidable instance, besides black vomit, there was hficmorrhage from the mouth, nose, and also from the bHstered surfaces. Dr. Francis also saw in a case under his care, haemorrhage from the blistered sur- faces, which commenced forty hours before death. In another there was black vomit, and haemorrhage from the nose, mouth, ears, and eyes. This was a black, attended by Drs. Francis and Clinton. Lining also mentions having seen haemorrhage from blistered surfaces ; and in the years 1739 and 1745, one or two instances of" hcemorrhage from the skin, without any apparent puncture, or loss of any part of the scarf skin." If the stomach becomes more irritable, as most usually happens at this late period, the patient now complains of a distressing burning, and incessant, though not acute or daiting sensation at the praecordia, causing him to wince and cry out on the slightest pressure, though the surface is not blistered, nor his drinks rejected. He sighs more fre- quently, and every now and then hiccups, which causes him to place his hand involuntarily on his stomach, and forcibly to draw up his legs, the pain producing in some cases loud cries and shrieks, which may be heard across the street. The disease having now reached the sixth, seventh, or perhaps eighth day, and the burning sensation at the sto- mach, continuing to increase, the patient rejects every thing that is taken, and begins to vomit up, from time to time, a reddish brown, turbid-looking, insipid, and perfectly inodorous matter, which settling in, but without co- louring the beer, porter, water, or other drinks he has reject- ed, resembles very much coffee grounds, or blood that has undergone partial change, from having lain some time in the stomach, mingled with mucus, which gives to it a ropy and glutinous teel, and causes it to stain and dry upon the blankets, sheets and pillow. There were also seen floating 21 162 Account of the Yellow Fever in this coffee ground substance, transparent pieces of gelati- nous matter here and there streaked or tinged with florid red blood. These may have come from the trachea in vomiting, as the blood which they contained appeared more of a natural colour, and not at all coagulated. The ropy mucons coffee-ground black vomil wa? also observed by Jackson to be sometimes streaked with bloo 1, which indu- ced him to believe that it came from the throat or gums, "i uiay now add, says he, that streaks of blood were some- times found to be joisied with them, [villous or mucous flakes,] tlie greatest part of which seemed to come from the throat and gums." I cannot by any meins concur with this learned physician in opinion, that " the black colour of the vomited matter was evidently owing to a mixture of vitia- ted bile." An old and faithful delineator of this disease in 1760, and who had ample opportunities of studying it in the West Indies, did not discover this intermixture of bile in the matter of black vomit : — " Remittente dein febre sanguinem fuscum sat copiose voniitu rejecerunt et hi fere omnes obie- runt, et quidam paucis horis post hujus symptomatis appa- ritionem."* Rush does not consider this coffee-ground matter black vomit ; but applies the term to some other discharges from the stomach, of which, however, he does not give any defi- nite description. When the coffee-ground matter was examined by the so- lar microscope, it appeared to be an inorganic mass. Strained through coarse linen and dried on paper, it retain- ed its dark brown and red colour, and by the mucus which it contained adhered to the paper in streaks. When the re- siduum of the first straining was passed through fine mus- Rouppe, de Morb. Navigant. p. 304 et"ent year. The same may be said of the symptom of sighing, which though sometimes a symptom of typhus, and of other diseases, was next to the appearance of the tongue, perhaps, more constantly present than any other symp- tom. The eye was less constantly affected than could have been anticipated, had we depended for our diagnosis on the representations of most writers on the yellow fever, for this is usually their leading symptom. The pain was in the beginning of the disease a good criterion ; for al- though the distress over the orbits is common to many other diseases, and especially to those fevers that are attended with or cau>ed by a deranged condition of the alimentary functions, yet it was found, on tracing the direction of this symptom, that it observed a peculiar route, and affected almost constantly and exclusively a particular set of nerves. Thus it rarely or never failed to become seated in the balls of the eyes ; ofien towards the bottoms of the orbits, almost invariably passing through the head to the occiput, and down the back and loins : less frequently, however, ex- 174 Account of the Yellow Fever, tending to the thighs and calves, but rarely or never af- fecting the anterior part of the trunk, nor the chest nor ab- domen, except occasionally when there was present an universal soreness of the surface. The pulse was only remarkable in a negative point of view, by retaining in so extraordinary a manner after the first stage had passed off, nearly all its natural phenomena, at the same time that other functions were characterized by the most alarming symptoms. The quiet state of the cir- culation, and the calm, tranquil and confident manner of the patient, interrupted only by occasional sighs, often led the friends and attendants to indulge in flattering hopes, which were but too soon to be destroyed. The pulse be- came unnatural only in convalescence, of which its slow and measured pace, as well as the long protracted debility of the body, were found to be the most characteristic symptoms. The same remark applies to the stomach, which, never- theless, unerringly proclaimed its fidelity to the dominion of the disease, at all events before its termination ; fully justifying the eloquent words of Dr. Warren, that this is " the chief seat or throne of the furious conqueror." CHAPTER IV. DIAGNOSIS. After determining the pathognomonic symptoms of yel- low fever, or those which give to it a specific and idiopathic character and contradistinguish it from all other diseases, our next object is to contrast it with those particular dis- eases, to the symptoms of which some of those belonging to yellow fever, bear a resemblance, and with which they might possibly be confounded. This constitutes the Diagnosis of 3'ellow fever, and requires in the practitioner, as a preliminary step, a thorough knowledge, not only of the pathognomonic symptoms of yellow fever, but also of those symptoms, which are never, or only sometimes, present in that disease, as well as an intimate acquaintance with the symptoms of those diseases, which most nearly resemble it. I am not acquainted with any author who has not, as far as I am able to judge, scrupulously avoided entering into the examination of the diagnosis, though undoubtedly the most important subject which could possibly claim the at- tention. I have been induced to undertake it, fully sensible of my incompetency, to perform it in the manner in which 176 Account of the Yelloiv Fever. it ouffht to be done. I shall feel the satisfaction, at least, of having opened the way for others. We shall confine the diagnosis 'o the following diseases: Synocha, Typhus, Intermittent Fever, Remittent Fever, Plague, Gastritis, Enteritis, Hepatitis, Phrenitis, Catarrh, Intoxication, and Asthma. Fevers. — To this order, the febrile action present in the beginning or first stage of yellow fever, renders this disease more or less analogous. But what particularly distin- guishes the pyrexia of yellow fever from them, is, that it is constituted of but one paroxysm followed by a sudden re- mission, which remission, though accompanied usually by a moist natural skin, an abatement of heat and entire absence of all previous pain, is not followed by an immediate solu- tion of the disease, as in fevers of a synochal type, particu- larly : nor by a periodical exacerbation of arterial excite- ment after a determinate lapse of time, as in those of a remittent or intermittent type, but by great prostration of the system. The remission of yellow fever, therefore, is an alarming state of collapse, though it comes under so insi- dious a disguise. It behooves us, therefore, to have closely watched the preceding symptoms, with the greatest care, in order that we may be prepared to undeceive the by-stan- ders and friends of the patient, of those flattering expecta- tions, which they are too apt to form, of the favourable ter- mination of the disease, at this stage of it. Synocha. — In fevers of this type, there is usually more general heat and dr^'ness of skin diffused equally over every part of the surface. The pulse, also, is strong the tongue covered universally and without a margin or clean edges, with a bright white fur, not slime ; yellowish when bilious symptoms are present. The eye, also, does not present that unusual redness, or turgid watery appearance, seen in yellow fever. The activity and tone of the absor- Account of the Yellow Fever. iT7 bents produce raiher diminution of the lachrymal, as well as other secretions. Hence, synochal fevers, are sometimes Called ardent and inflammatory fevers. There is rather a dryness or ariduess of every part of the system than moisture in the first stage of the disease. There is, also, most generally a universal soreness, or pain over the sur- face. The pain does not observe, as in yellow fever, a de- terminate and peculiar course, nor is if, as in yellow fever, almost invariably located along the superciliary ridge and through the eye-balls, except when the stomach is particu- larly deranged from engorgement of bile, in which case the pain of the head, though seated more particularly in the forehead, is diffused over that part. The respiration is hurried, but without sighing : the analogy between i^fla- raatory fevers and yellow fever, however, soon vanishes when the second stage of the latter disease arrives. Typhus. The beginning, or first two or three days of typhus, may much more easily mislead the unguarded prac- titioner than synocha. For as in yellow fever, there is never present that vigorous and unremitted impetus in the movement of the arteries which characterizes, in so peculiar a manner, fevers of inflammatory action ; it will be found, however, that the pulse in typhus is far more frequent, and, what is more striking, quicker, smaller, and more irritable than in yellow fever ; whereas, on the contrary, it is most usu- ally full, bounding and soft. The tongue is not particularly marked in the commencement of typhus. The pain, also, is chiefly located in the occiput, but follows, as in yellow fever, the track of the vertebral column. The heat, also, is universally distributed over the surface in this disease, and is characterized by producing a remarkable sensation of a biting or stinging nature, called calor mordax, totally t^iflerent from the skin in y.ellow fever, which even in the Itg Account of the Yellow Fever. first stage is often pliable, soft, and suffused with a degree of moisture. There is a hebetude or sluggishness, also, of the intellec- tual functions and a loss of energy in the organs of sense j symptoms rarely or never present in the beginning of yellow fevev. Afterwards the tendency to continued coma as contradistinguished from the distressing pervigilium of yellow fever, places the disease in a relief too bold and imposing to be mistaken. We often hear pliysicians speak of yellow fever terminating in typhus or typhoid symptoms. I never saw ihis phenomenon, but must be permitted to declare, that as far as my experience goes, this disease is throughout its course totally unlike typhus, and especially so in its con- cluding stages. I have already adverted to this in the chapter on Analysis of Symptoms ; but I cannot refrain from observing, that the tongue, and in a more especial man- ner, the eye, the cold, clammy moisture of the skin, the regular, full and soft pulse, the precordial anxiety, and abscence of pain in all other parts of the system, together with the untainted and inodorous condition of the excretions and the remarkable self possession of the patient, remove the pathognomonic and diagnostic character of yellow fever too far from that of typhus, for any person, possessed of ordinary apprehension, to confound the two together. Instead of the parched black scales, collecting on the tonjiue. from the foulness of the excretions, the surface of this part, at this stage of yellow fever, is most usually of a deep fiery red colour, often soft to the feel, or only a little rough to- wards its base, and most generally besmeared with fluid arterial blood. The b^ood also, which oozes from the gums in yellow fever, and dries on the teeth, of a black colour, thouii;ii it resembles the sordes often observed upon the teeth in typhus, is a haemorrhage, which has undergone this Account of the Yelloto Fever. 1 79 alteration ; whereas In typhus, it is an excretion. More- over the lips in 3'ellow fever, though often dry and some- what cracked and scaly, are not covered with that thick black excretion observed in typhus. On the contrary, they are often pale, liviii and clean to the hour of death, which never holds true of typhus, where the universal taint and putrescency of the fluids shows itself in every excretion, insomuch so, that the body itself emits a tainted, cadaverous and extremely offensive odour. Tlie subsultus tendinum, sighing, tremulous motion of the tongue and palsied state of some "of the secretory organs, form points of resemblance too imperfect to merit atten- tion. Intevmittents. — I shall not dwell on the resemblance of yellow fever to this well-defnied order of fevers. The common symptoms of intermittent fevers are as familiar to the uneducated million as to the most skilful practitioner- It may be observed of one striking symptom of these fevers, the chill, that it is not commonly present in yellow fever. It would be preposterous to discuss, at this age, whether yellow fever be a type of the intermittent. It may serve the purposes of those who are hard pressed for arijuments to show the domestic origin of yellow fever ; but it will never do to be brought into a serious debate on the specific cha- racter of this disease. Remiltents — The same remarks apply to these, but in a more limited sense. The remission observed in these fevers is like that of yellow fever, a part of the train of phenome- na which characterizes the disease, but does not bear so de- ceitful a resemblance to that perfect state of apyrexia, which constitutes the solution or termination of synochal fevers, as the state of collapse in yellow fever. When this stage arrives in yellow fever, the hasty ob- ISO Account of the Yellow Fever, server is apt to imagine from the regular and nearly natural pulse and the cool temperature, softness and moisture on the skin, that a perfect apyrexia or absence of fever and an entire solution of the disease have taken place until the unnatural slimy fur and margin on the tongue, the frequent sighing for breath, and above all, the burning itritation at the prsecordia particularly on pressure, show the physicaii that all is not going on right, but that he has more danger^ perhaps, to apprehend from this contradic'ory assemblage of symptoms than if they existed separately. He will be still more deceived if, under the erroneous impression that yellow fever and remittents are descended from the same parentage, be waits to see a return of the exacerbations and remissions- There are sometimes bilious symptoms associated with remittents. It is these which have given rise, per- haps, to more errors on the pathology and diagnosis, and^ I lament to say, treatment of yellow fever, than any other circumstance. I will not undertake to say that the yellowness in yellow fever has no connection whatever with the bile, though I am very much inclined to be of this opinion, not only from its being always of a hue or tint totally different from that pro- duced by the bile ; but because, as we shall afterwards see the biliary organs! in this climate, at least never or very rarely participate in any degree with the symptoms of yel- low fever. The subsidence of the red blood from the eye in yellow fever is followed by the dusky tinge which spreads over the adnata in the place of it, and afterwards the yel- lowness comes out methodically and in regular succession, first around the eyes, nose and mouth, then down the neck and over the breast and shoulders and arms, finally spread- ing* over the lower part of the trunk and the legs, the patient sometimes dying before it reaches the knees. Is this the Account of the Yellotu Fever. 181 order followed by a suiTusiou of bile over the surface ? Does not the bile, as in jaundice for example, spread at once over the whole or the greater part of the body ? Is it not always also a harmless symptom ? But in yellow fever, who does not know the formidable dangers of which it is too often the harbinger. In remittent fevers, bilious symptoms are altogether ad- ventitious. They may occur in typhus, and in synocha, and especially in hot seasons or climates ; also in all the phlegmasiee ; in short, in any disease. But there is another set of bilious symptoms which con- cern particularly the stomach. It is contended that the vomiting, retching and irritation of the stomach in yellow fever, are all to be ascribed to an engorgement or redundancy of bile in that organ, and that the disordered state of the stomach so frequently present in remittent fevers, is pre- cisely the same as these symptoms. A very serious and im- portant objection to this opinion is, that the gastric and prae- cordial irritation in yellow fever arc attended with a deficien- cy in the quantity of bile as well as of other secretions in the stomach ; while in remittent fevers they are entirely attribu- table to a redundancy of this secretion. Moseley points out this in the most clear and explicit nianner : " The nausea and bitter taste in the mouth in yellow fever indicate the quality, not the quantity of the offending secretions. The vomiting is from irritation in the stomach, not from pleni- tude." I refer also to Sir Gilbert Blane on the Diseases of Seamen, and other authors, for illustrations of this truth. What proves that the bile cannot have any share in this disease is, that the biliary organs exhibit very rarely any functional or organic derangement during life, or morbid appearances after death. In all cases of the yellow fever thai came under my observation, I never saw one complain 182 .Account of the Yellozo Fevtr. of distress in the right h^'pochondrium or region of the liver and gall bladder. There is another discrepancy which occurs to us in com- paring the g stric irritation of yellow fever with the vomiting present in bilious fevers of a remittent type. It conclusively puts this dispute at rest j for it appears that the gastric irrita- tion in remittents is never or very rarely of an inflammatory character, and that it comes on in the invasion or first stage of the disease from inordinate secretion of bile, and may be effectually removed by cleansing out the stomach with emetics, whereas, in yellow fever it is of an inflammatory character, and in a great majority of cases, does not exi si at all as far as eur senses are capable of judging, until the third da>j or afterwards, but unlike that of remittent fevers, becomes more and more aggravated from day to day, es- pecially if emetics are given, until the burning distress at the proBcordia and black vomit close the scene. Though a slig-it rom?^ing sometimes attends the invasion, it may be set down as an almost invariable rule that the irrita- tion of the stomach rarely, and the yellow tinge of the eyes and skin never, come on until about the third day ; whereas in remittent fevers the yellowness most usually comes on at or soon after, and in some instances, before the accession of the fever. Dr. Hosack, in his Nosology, has happily made use of these peculiarities to contrast the two diseases. The diagnosis we have given has been verified and confirmed in every case of yellow fever that has fallen under my no- tice. It is also corroborated in every particular by the de- scription of those authors who have treated of the Jungle fever of the East Indies, the Bilious fever of Africa and the Mediterranean, and lastly by our own authors (already quoted in chap. 1st,) who have treated of the Remittent and Intermit- tent fevers of the lakes and marshes in the interior and louthern parts of the United States. Account of the Yellow Fever. 183 The cases of yellow fever also that were transported from this city to the Marine Hospital at Staten Island, prove the idiopathic and specific character of the disease, and its total dissimilitude from bilious fevers in the most conclusive man- ner. It must be recollected that those persons who are sent to this public hospital, are of the most indigent and gene- rally of the most depraved description of the community. Consequently, from the habits^of intemperance and irregular life so common among that class in this country, we ought to look naturally for hepatic obstructions and bilious symp- toms in any disease that might befal them. Let us see if those expectations were realized : for, certainly, if yellow fever be a bilious remittent fever, the type of the disease, assisted by this powerful predisposition in their systems to disorder of the biliary organs, ought to have developed bi- lious symptoms. But out of seventy cases taken to the hospital, four only had hepatic obstruclions, which, how- ever, did not commence until after they had recovered from the yellow fever. Of this lujmber two or three died. Dr. Warren, of Barbadoes, whi had the good fortune to ■ live at a time when the wholesome admonitions of common sense were more implicitly obeyed than the illusions of the imagination, and when it was not thought derogatory to the interests of science to apportion a certain part of their duties to a close observation of facts, has dwelt with so much force, clearness and truth on the fallacy of those spec- ulations which have deduced the identity of yellow fever and bilious fever from the symptom of yellowness which charac- terise the former disease, that I am sure I shall be pardon- ed by the reader for having transplanted his invaluable re marks into the pages of this work. In describing the symp- toms of yellow fever, he comes to the second stage. " Thi.-. is the second stage of the distemper, which I rliof-c to call 184 Account of the Yellow fev^r. by the plain name of the yellow state ; for the word bilions or icieritious, I take to be very improper and inadequate terms. This yellowness, I am persuaded, chiefly arises from a more complete colliquation or dissolution of the red glob- ules of the blood into a yellowish serum, which will naturally soon give that tincture to the whole skin. The same is often observable on human bodies soon after the bites of some poisonous serpents or other venomous animals; and in such case it cannot with any reason be supposed to proceed from a suffusion of bile, but rather from a colliquation, and per- haps gangrenous diathesis of the sanguineous mass, occa- sioned by the force of the deleterious venom that had been infused into it. What is observable every day in all com- mon bruises of the flesh, may serve somewhat farther to il- lustrate this matter ; for here when the texture of the extra- vasated blood begins to loosen and dissolve into a liquid serous consistence, in order to acquire a proper fluor and permea- bility for passing on and being received again into the mass of circulating juices, a very visible yellowness does always appear in and about the part ; but this soon goes ofl' again, when the matter is fully absorbed back into the vessels, where it commits no hu t, but is readily overcome by the force of nature, as the quantity of such dissolved blood is small, and at the same time very innoxious. I do not, how- ever, deny, but that through a great propensity and straining to vomit, some quantity of bile may be thrown into the blood ; but then I must observe that the yellowness of this distemper I am speaking of, very frequently shows itself when there has been no voniitmg or retching at all, or scarce any sensible sickness of the stomach, for the truth of which I can appeal to many."* * Warren on the Malignant Fever inBardadoes, p. 11, et seq. . Account of the Yellow Fever, 185 Plague. — As I have not had an opportunity of seeing this disease, I shall not enter into a detailed comparison of its symptoms with those of yellow fever. The frequent oc- currence, however, of carbuncles and buboes in plague, and dieir very rare occurrence in yellow fever, besides several other symptoms and peculiarities of plague, are sufficient to show that the two diseases are radically different. Out of forty-eight thousand cases in Cadiz in 1800, Arejula saw only three carbuncles, two of which proved mortal.* In the yellow fever of the present year, out of four hun- dred and twenty-five cases of yellow fever, there were two of caibancles, one of which proved mortal. Buboes are rare- ly or never seen in yellow (e\ er. Gastritu\ — This is a local disease, and begins with all the strongly characterized symptoms of inflammation of the stomach, accor.panied constantly with those common to other phlegmasiae. The ; rincipal of the e are the pale visage, hard, small, frequent pulse, tenderness to the touch at the preecordia^ and rejection of drinks, &ic. There is no particular afiection of the head or eyes, or back or limbs, as in yellow fever, where the gastric irritation do' s not an- nounce itself distinctly till the third day, before which time gastritis has generally terminated in gangrene or sphacelus. Enlerilis. — It is hardly necessary to describe the pecu- liar symptoms of this disease, as they are so well known to every practitioner. What has been said of gastritis applies for the most part also to this disease. Its course is equally rapid. It is scarcely possible to confonnd this local affec- tion with yellow fever. * See Sir James Fellowes' Keports on the Pestilential Disordsr flf Andalusia, p. 50,56. 24 186 Account of the Yellow Fever. Hepntilu — Under the head of Remittents, I have said that there are rarely or never present in yellow fever any symp- toms of disorder in the biliary organs. Hepatitis is to be considered as included in that remark. As yellow fever therefore and hepatitis are as distinctly characterized from each other as it is possible for a general and local disease to be distinguished, and as they never come into collision with each other, it is scarcely necessary to compare their symp- toms. Phrcnitis. — This is a local affection, confined altogether to the head, and very rapid in its course. The affection of the head proceeds from an inflammation of the membranes and substance of the brain, and is therefore much more vio- lent and of an entirely different nature from that of yellow fever. Catarrh. — There is no disease, perhaps, which might be so readily mistaken at first sight for yellow fever as this. The pain along the superciliary ridge, the redness, suffusion and pain in the eyes, flushed countenance, with a pulse of- ten full, frequent, bounding, but somewliat compressible, and a skin frequently soft and moist, with pain in the back and limbs, resemble so nearly the first symptoms of yellow fever, that an inoperfect examination of the disease might lead to the most serious results. A close inspection, however, of the symptoms, will soon unravel the difficulty. It will be found hat the pain over the eyes is owing to an inflamed condition of the mucous membrane, lining the frontal sinuses, and that this inflammation follows the membrane through the nares and throat, passing from thence into the trachea and lungs and through the esophagus into the stomach. It is found on questioning the patient, that the voice is evidently altered, that a glairy fluid distils from the nose, and that the patient, in most instances, every now and then coughs. All Account of the Yellow Fever. 187 these are quite different from yellow fever. Arejula consi- ders '' dry nostrils" as one of the symptoms of the disease. Infoxication.- — The stupor, insensibility and comatose condition in wi)ich persons labouring under intoxiration are usually found, together with the spirituous odour gene- rally perceived in the breath, are sufficient to prevent the phyrician from being misled by the redness of the eye and flushed countenance. Besides which, as the stupor goes off the patient evidently improves in proportion, and the vomiting is followed by relief. The nature of the dis- charges from the stomach will also throw light on the cause of his comp'aint. Aslhma. — 1 have been induced to put asthma in the list, because 1 have observed, by the careless and very errone- ous manner in which authors have spoken of the respira- tion, many would s-uppose that this function was as seriously impaired in yellow {ever, as in asthma or pleurisy : and one writer. Dr. Pascalis, I observe by a description of this disease, which he has published in one of the public prints, has led us to infer tliat the anhelation throughout the disease is so great that it very nearly lesembles the condition of a patient lalouring under as'lima. Nothing is so well calcula- ted to mislead those who have never seen the disease as remarks of this kind. It is true, I have myself spoken of this anhelation, and compared it to whal is observed in asth- ma ; but it must be remembered that it is by no means, properly speaking, one of the characteristic symptoms of the disease — but the last laborious efforts of respiration, which indicate the near approach of death, and which never appear until 24 or 36 hours before that event happens. — Moreover it is not uncommon in other diseases, though it is unusually frequent in this disorder, owing no doubt prima- 188 Account of the. Yellow Fever. rily to the same cause as the sighing, and which I have attempted to explain in the chapter, on the Pathology of the disease. There is nothing of this anhelatlon seen in all the first and second stages, and throughout the greater part of the last stage of yellow fever. CHAPTER V. AUTOPSIC APPEARANCES. Owing to the dread with which the living world look upon the body of a person who has perished of yellow fever, and the common, bat erroneous notion, that it is a putrid offensive mass, ready to drop to pieces by its own corrup- tion, the sick have been in almost every instance, not only abandoned during life by their relatives and friends, but after death wantonly hurried to their graves, almost before the last spark of life was extinguished ; sent off as it were " before their time," in violatiou of the solemn rites of bu- rial or ties of kindred. Though all nearly that have died have been in private families, this has not protected their remains. Hence the difficulties which were opposed to the strong desire evinced by difiereni members of the profession to make autopsic examinations. The following intereiti g account therefore of the ap- pearances in this disease after death, and f t which I am indebted to the parricular kindness of Drs. C. C. and E. S. Blaichle), wil' b- highly accep'able. •' Ansel Keith, who de*! of yellow fever August 21st, 1822, on the tifth day of the disease, was examined by us 190 Account of the Yelloiv Fever. about two hours after liis decease. Extravasations of a livid colour were noticed in the lips, ears, blistered surfaces, scrotum, &c. The cellular membrane, the stomach, the liver and its substance, the mesentery, dura mater, apex of the heart, pleura, peritoneum, and internal membranes ge- nerally, were tinged with yellow. The blood in the heart was fluid ; the lungs were very brown or black ; the liver was unusually tender, and seemed small ; the omentum and dura mater appeared a little congested ; the glands of the mesentery were somewhat enlarged ; the spleen was natu- ral ; the bladder was nearly empty, the patient having made no zcaler for thirty-six hours before his death. The gall bladder was neither empty nor full. The patient had had no black vomiting, but the stomach was found to con- tain about a pint of the matter of black vomit. The villous coat of the stomach was lined with a cv.al of black matter or bloody extriivasation, and its texture was so very tender that it was easily removed.* The brain and spinal medulla looked quite natural ; they were without marks of inflam- mation, but seemed slightly congested externally. *' Another patient examined was so similar to the above that it is needless to repeat particulars." I have been politely furnished also with an account of the autopsic examinations made by Dr. Harrison of the Marine Hospital at Staten-Island, of the cases which occurred there during the last summer, and which will throw addi- tional light on ihis subject, and supply, in some measure, the want of experience in the cases of the present year. * M. Bally observes, that the gangrenous state of the stomach has been too much exaggerated, and says, that where it does exist it is almost always confined to the mucous membrane, and rarely extended over a great surface. Account of the Yellow Fever. 191 " There was no appearance of active inflammation on opening the abdomen, but only a slight blush over the sur- face of the internal membranes generally. The internal coctof the s omach was extremely tender and easily abraded, particularly in those places where there were observed small livid spots. The gall bladder generally contained the usual quantity of bile, sometimes a little inspissated, but resembling in no way zohatever the matter of black vomit. In one case nearly two quarts of the matter of black vomit was found in the stomach, and in distinct masses in the in- testinal tube, especially in the colon. But there had been in this case no black vomiting." In a communication on the late ie\c\\ with which Dr. Francis has favoured me, 1 have been gratified to find a no- tice of two cases of dissections, which fell under the obser- vation of Dr. A. D. Wilson of this cit}', which also I here insert. '• I have not myself, says Dr. F. made any post mortem examinations of persons dead of yellow fever, and can hence only communicate to you what 1 have heard from those who have. Yet, what little is known, in this way, goes to confirm the pathological fact, that the stomach is primarily the seat of irritation, and that the ravages of the disorder are most conspicuous in this organ. The cases, neverthe- less, which Dr. A. D. Wilson has sent me, give also evidence, that the pestilence occasionally induces morbid changes in the hepatic viscus. I enclose you Dr. W^ilson's note. Ko-cemher 10, 1S22. Sir, 1 enclose you a brief account of the appearances I noticed in the dissection of two persons who died of the late yellow fever. The cases exhibited the disease throughou' in a very formidable manner. They were both male subjects, and about thirty years of age. 192 Account of the Yeltozv Fever CASE I. Mr. A had been ill of the characteristic symptoms of yellow fever, which terminated with black vomit of a tinder-like appearance. He died on the fourth day. Tlie external surface of the body was of a deep yellow hue. — The whole internal surface of the stomach was in a state of gangrene and sphacelus. The on>entum exhibited a state of violent inflammation, which in some places had terminated in almost its entire destruction. The liver was of the ordinary size, and presented slight appear- ances of incipient decomposition. Something like a cre- pitus was observable upon making an incision into it, and a fluid of a frotliy appearance and of a brownish red colour escaped. The resistance made to the pressure of the fingers was very trifling. The small intestines were also in many parts highly vascular. CASE II. Mr. B died on the fifth day of his illness: his symp- toms were violent from the commencement of the second day. He had not black vomit ; but sufl'ered much from praecordial anxiety, and great tenderness of the abdomen. The appearances in this case were much the same as in the preceding one. Though the disease was of longer standing, the abrasion of the inner coat of the stomach was not so great ; no morbid change of the brain itself was per- ceived. The membranes of the brain and the peritoneal in- vestures were tinged with a deep yellow colour. " I remain, your's, A. D. WILSON.'* To Peof. Francis. CHAPTER VI. PATHOLOGY. Though no disease is better characterized than yellow fever, when fairly and fully developed and none more diffi- cult to distinguish than its milder and more evanescent forms, it will not be disputed, that those causes which influ- ence all otlier diseases subject this also, to slight modifica- tions. Such are the qlimate or situation in which it occurs, the vicissitudes of the weather and the character and condi- tion of those who are the subjects of it. H'»wever varied, or combined, may be these different influences, the type of the disease always so far retains its original character, that no one who is in reality conversant with its symptoms, can ever be led to confound them with those of other fevers. The yellow fever of the present year, according to the testimony of practitioners who have had an opportunity of comparing it with the epidemic of former years, has not as- sumed any appearances materially difierent from those which have always been observed to accompany this disease; The last cases were as well defined as the first. The organs of voluntary motion, the glandular and lymphatic systems, and the thoracic, as well as all the abdominal viscera, except -25 194 Account of the Yellow Frver. the stomach and lungs, have as usual been generally exempt from affection. Except in bilious temperaments and in foreiijners of full habits unaccustomed to the warmth of the climate, the hepatic viscera have been but little affected. If the season had not been unusually temperate, or had the summer heats been as excessive as we have sometimes experienced them, there can be no doubt but the disease would have been much more inflammatory, and consequently more frequently ushered in with bilious evacuations. In the few instances in which they did occur, they seemed to depend entirely on the excitement attendant upon the invasion or first stage of the disease, or the peculiarity of the habit or tempera- ment ; unlike bilious fever to which the disease has been compared, disappearing entirely after the first or second day. The circulating system, was for the most part, in the first Stage of the disease considerably agitated, and the pulse, in several instances, hard and inflammatory. This excitement in the beginning of the disease, is the reaction opposed to the deleterious influence and first effects of the poison upon the nervous system ; for the heart and arteries soon after seemed to have lost their momentum, and the disease pass- ed abruptly into the stage of collapse. That there was, generally, less disposition to black vomit and other haemor- rhages than was manifested in previous years, was owing perhaps, to the mildness of the season, as there can be no doubt that the heat of the weather by rarefying the blood and augmenting its impetus, increases the natural tendency to haemorrhage which characterizes this disease. Hence, also, the reason why the eye, though for the most part affected with acute pain, was less than ordinarily inject- ed with red blood ; a symptom which has been thought so characterestic of the complaint. Jlccount of the Yellow Fever. 195 The haemorrhage, from tlie gums and tongue was most freqU' lit. That from the nose was next most common, and it was observed that the patient who had this haemorrhage, had a constant propensity to pick his nose. This was par- ticularly the case in Fowler, mentioned in Chapter II. This peculiarity is adverted to, also, by Sir James Fellowes, in his account of the yellow fever at Malaga in 18C4.* The haemorrhage next most common was that from the stomach, commonly called black vomit. Tlie iiaemorrhage from the ears and eyes wa>^ observed in but one or two instances. I s-iw a slight haemorrhage from the eyes and also bleeding from blistered and excoriated surfaces. Though the disease was for the most part unattended with any inordinate excitement, in the beginning of the attack or excessive has norrhage in its termination, it was, notwithstanding, as fatal as in any former year. Does not this prove, that this disease expends its force chiefly on the nervous system, without the necessity of supposing with Moseley, Bancroft and others, that it is an ardent fever, or that its fatality is at all dependent upon any particular derangement of the circulation,! ninch less upon any mate- rial change in the condition oi the blood, as Hillary has supposed. I do not believe with Hillary, or Lining, that the blood is putrid ; but there is much reason to think that it is in a much more dissolved or limpid condition than in * Reports on the Pestilential Disorder of Andalusia, p. 203. f The vulgar opinion, and one that is encouraged also by those who deny the specific character of yellow fever, is that the patient often bleeds to death ; whereas the haemorrhage is never, or very rarely, con- siderable enough even to hasten this event Sir James Fellowes men- tions a case of epistaxis in this disease, where the exhaustion produced by the bleeding is thought to have accelerated the patient's death. 196 Account of the Yellow FevtSr. health or in most other diseases, which accounts, to a certain extent, for the engorged state of the capillaries, the petechial extravasations, the tendency to haemorrhage before, and the livid discolorations immediately after death ; perhaps, also, for the compressibility of the pulse. The engorged state of the capillaries, the petechias and the tendency to haemorrhage are likewise attributable to a preternatural dilatation of the extreme vessels. The blood, also, when drawn, was observed to coagulate less readily than in other diseases. Towne, one of the oldest writers on yellow fever, [Lon- don 172G,] and whose bold, original and accurate account of this disease is drawn in colours which will never fade, and which stand unrivalled even in the present times, also remarked this condition of the blood. He says [p. 26.] that there is too great a division of its constituent parts, and [p. 45.] that it is rarefied to an exceeding degree. Hillary, also remarks that by the dissolution of the blood in yellow fever, and its diflusion into the small vessels, the mo- mentum of the circulating fluids is diminished, and the pulse retarded. This condition of the blood resembles, perhaps, in a less degree, that v.hich is produced in persons who die from the bite of venomous animals,* or who have been kill- ed by the electric fluid, to the operation of which, as well as tp that of the bite of venomous animals, the poison of yel- low fever may possibly bear some analogy. Warren, Lind, and Dr. Bruce of Bn'badoes, also observed that the blood was remarkably dissolved. The words of the last author are, " Colorem exhibit floridum, rutilum et quasi rarefactum crassamenlo vix cohaerente sero luteo croceo." * See Moseley on Tropical Diseases, p. 29. dccount of the Yellow Fever. 197 Physick and Catlirall, have also obs^ rved, that the blood found in the lieart after death was fluid, and similar to that of persons who had been hung or struck by lightning. In corroboration of this remark, a singular fact, and of which mention, I beiieve, is no where made in any of the histories ef yellow fever, h;Hs been noticed by Dr. Walker of this city. In the more malignant cases of the disease, and especially towards the crisis, he has found that the sudden occurrence of a thun<'er storm, has greatly aggravated the disorder. The first flash of lightning has sometimes, even in sleep caused the sweat to pour out profusely upon the surface; wi)ile in others it has waked the patient, with fright, brouglit on the Ijlack vomiting, and shortly after ended in death. Dr. Walters, has also made a similar observa- tion. This militates against the hypothesis which ascribes disease to a the origin of thedeficency of electric matter in tthe atmosphere. As the season advanced the disease became as usual less fatal, though in conformity with what has been remark- ed before, it attacked a much greater number of persons than in the beginning of the season. Hence during Sep- tember, the cases of recovery gained very fast upon the number of deaths, so that the proportion of the latter to the sick became as one to two, while in the latter part of July, when the disease began, and during all the month of August, the proportion of deaths to the cases was much greater. Whereas in the month of October, and particularly about the middle of the month, just before the termination of the epidemic, and whtn the cool weather began to set in, though the number of cases now greatly diminished, the disease again became as fatal, or indeed more so, tl)an at its com- mencement ; the proportion of deaths being to the pro- portion of sick as thr-e to four ! Thus, on October 17th, when the citizens had began to flatter themselves from the 198 Account of the Yellow Fever. cold weather of the two preceding days, and the small num- ber reported, that they were speedily to return to their homes, the report suddenly swelled to nine cases, the follow- ing day to six, and the next to ten, while nearly all who had been reported sick a few days previous, were now reported dead. This dampened ag.^in very much the public feelings, but it was what always has occurred under similar circum- stances in previous years. A sudden change of the weather checking the perspir ti^n. and driv ng the flu ds into the in- terior, by prevenfing the poison whit h had beei. lying per- haps for some time dormant in the system, from bt^mg carried out, concentrated, perhaps its forre, and thus developed the disease in those who were before apparently well, while it proved for the same reason f aal to tliose who were sick. No. of cases. Deaths. Proportion. July 10th to August 1st, - 15 - 7 - +1 — 2 August 1st to Sept. 1st, - 95 Sept. 1st to Oct. 1st. - - 211 Oct Ist to Nov. 5ih - - 93 The eleven deaths that occurred of persons who removed to villages in the country, are not included here. We may be >aid to hnve this year seen yellow fever in its most siaip'e and unadulterated form, which has thus placed it in our power to determine the real position which it oc- cupies in the system ad the ruling tissues that sustain the brunt of the disease If the exper ence of ihe present year ought to have any vv igh', it has been in our opmion. clear- ly established, that yellow fever is fundamentally and prima- rily a disorder of the nervous system.* From the regular '* Jackson has made a species of yellow fever, in which he says, " symptoms of nervous aSection are more obvious than symptoms of putrescency ; and in wliich yellowness and black vomiting are rare 58 -+1— 2 09 - 1—2 G9 - 3—4 Account of the Yellow Fever. 1 99 period of time which, like other contagious diseases, it usu- ally requires for fhe poison to opf-rale after exposure, it is nevertlieless probable th it the fluids may serve as the medium of its introduction into the system. It seems probable that like most contagious diseases, it is first inhaled through the nose and mouth into the lungs. Some think it innocuous to the system in its natural state, but that it becomes deleterious on being decom|)osed by the secreting vessels at the sen- tient extremities of the arteries, where in its now altered state it b( gins lo show its effects first on the nervous sys- tem. I cannot think this opinion true, for the affecuon of the eye, forehead, and tongue in the fiist sta^e, and the epistaxis afterwards, obviously lead to the inference that these symptoms are rather to he attributed to direct absorption of ihe poi-on on its pass;ige through the mouth and nose, than to its influence upon those paits after being changed by the acti n of the fluids. The affeciion of the stomach as well as the hremorrhagic tendency in the ex- treme vessels arrive at a much later period, and therefore perhaps show that ihe poison produces these effects indirect- ly, by passing first into the circulation ; thus proving al^o, if my firs as-^umption he correct; that the materies morbi is not alteied in its passage through the blood. Apparently the pathology of tlie disease changes, for the nerves first bear the onus of the disorder, ar.d then towards the close, the vessels and their fluids, as manifested bj' the general tenden- cy to haemorrhage, the dissolved condition of the blood and occurrences." But the number of cases of black vomiting^, and of 3'el- lowness in the fever of the present jear, and as we have seen the al- most universal absence of typhoid symptoms, show that the necessary connection which he supposes between black vomiting, yellowness, and a putrescent condition of the body has, in reality, no foundation. 200 Account of the Yellow Fevtt\ entire absence of pain in those parts which were afiected in the beginning. We have seen that in a great number of fatal cases there has not been the slightest haemorrhage frooi the stomach, in many others none or very little, from the external passages, and in but very iew instances an inordi- nate quantty or vitiated condition of the bile and other se- cretions ; that the excretions, as the swe t, sahva, breath, urinary and alvine evatuaiions, unlike typhu* fever to which it has been compared, have all b^en, tor the nnost part, un- tainted with any peculiar or offensive odour, and most nsually unchanged in their character; in fine, that hp rhy- lopoietic aid assistant chylopoietic viscera have often per- formed heir offices w lb a precision and regularity wnich. fo those who have heietofre thought the fluids or their vessels, the nidus of the disorder, has appeared almost miraculous. What furthermcre corroborates the view we h.-ve taken of the state of the fluids, is the fact, that tiie blistered surfa- ces, tiiough engorged and red with blood in the lasi stage of the disease, rarely sphacelate or become gangrenous. Dr. Rush also noticed this, and adduces several oiher powerful objections against the supposed putre-cency of the flu ds in yellow fever- " The smell emitter; from persons affected by this disease, was far from being of a putrid nature; and if this had been the case, it would not have proved the exis- tence of putrefaction in the blood ; for a putrid smell is often discharged from the lungs, and from the pores in sweat, which is wholly unconnected wiih a putrid, or perhaps any other morbid sate of the blood. There are plants which discharge an f-dour which conveys to the nose a ?ensation like that of putrefaction ; and yet ihese plants exist at the same time, in a state of the most healthy vegetation ; nor does the early putrid smell of a body which perishes with this fever prove a putrid change to have taken place in the c6ccount of the Yellow Feve,r. 201 blood before deaih. All animals which die suddenly, and without loss of blood, are disposed to a speedy putrefaction. This has long been remarked in animals that have been killed after a cha*e or by lightning. The poisonous air samiel, which is describedby Chardin, produces when it de- stroys life, instant putrefaction. The bodies of men who have died by violent passions, or after strong convulsions, or even after great musculu' exertion, pulrify in a (ew hours after death." [Medical Inquiries and Observations, vol. iii. p. 70.] He furthermore adds, that in yellow fever " putrefac- tion did not take place sooner after death than is common in any other febrile disease under equal circumstances of heat and air." lb. p. 71. That a morbid irritability of the stomach was always present, and that it invariably increased as the disease ad- vanced, without, however, at any time excessive retching or vomiting, was obvious to all. But does not the highly or- ganized condition of the stomach and the vast supply of nervous energy which it receives, together with the frequent absence of haemorrhage, prove that this irritability was more a nervous than an iajlammatory afftction. Does it not prove, and do not also the regularity of the abdominal func-' tions generally, show that yellow fever has no more to do with gastritis than with remittent fever or with hepatitis or enteritis.'* If the irritability of the stomach was a pure in- flammatory affection, and a symptom of gastritis, surely this ought to be greatest on the first day of the disease, for it is then only that the arterial excitement exists, and not come on afterwards when the vascular system has lost its force, and the relaxed capillaries are pouring out drops of blood and sweat. Besides, it is the character of gastritis, enteritis, and all •ther inflammations of highly organized membranes, to be 26 202 Account of the Yellozo Fever. accompanied with excruciating pain, and a tense pulse, and to terminate speedilv, within a tew hours from the attack, in gangrene or sphacelus. To me it would seem impossi- ble, that any practitioner, who has had opportunities of observing the yellow fever of the present year, could ven- ture to confound its symptoms with those of a remittent or intermittent. It has burne not the slightest resemblance to either of those autumnal fevers, neither in its beginning, its progress, nor termination. It has been of the pure conti- nued type of one paroxysm, terminating in a state of col- lapse; but never attended with, nor passing into remissiins, and exacerbations, either regular or irregular. Instead of beginning or going off in a remittent or intermittent, its in- vasion and convalesrence have bosh been as strungly cha- racterized, and as tot clly different from 'hose of remiUents and intermittents, as the symptoms of the disease itself We will here m.ike one single remark, to show how little dependence is to be put upon the deductions of Dr. Ban- croft, the great authority on domestic origin, and non-conta- gion, to prove that yeliovv fever, is no other than a higher grade of intermittent, remittent, and bilious fever, and that they run into and out v)f each other, with a supleness which is almost inconceivable, and depending entirely upon cir- cumstances. He quotes Mr. Lea. snrgeon of the 26th regi- ment at Gibraltar, as having had ample experience in the yei'ow fever, which occurred there in 1814, and as being therefore entitled to the highest confidence. Now it appears that Mr. Lea had under his care three hundred and four- teen cases, enough to be sure to afford any man ot com- mon apprehen ion a clear and accurate conception of the nature of the disease. But what is incredible, Mr. Lea lost GUI of this large number only twenty cases! We a reigi;ing constitution, who I am persuaded will readily own, that taking away blood in a large quantity, or often, and especially alter the first day, has always aggravated the disorder, and exasperated all the symptoms, and laid a sure foundation for inevitable ruin.'- p. 30. The violence with which the disease is always ushered in under the influence of a high temperature, and the conse- quent danger of the organs breaking down under the impe- us of the shock, ex plains why bleeding has been found so Account of the Yclloiv Fever^ 209 much more serviceable in the tropics* than in Spain or in the northern latitudes of the American continent.! The remedies, however, which seemed most to be de- pended upon, and which, to use the emphatic language of Jackson, did most, perhaps, towards " changing the genius of the disorder," were active doses of calomel in the begin- ning, followed by saline, alkaline, and emollient cathartics, frequently repeated, in the course of the disease, together wiih strict attention to the skin by frictions, stimulating em- brocations, warm ablutions, and mild tepid drinks, so as to withdraw the excitement and fluids to the surface and to the bowels ; and by keeping these important passages of the system open, give every opportunily for the disease to es- cape. The early application of blistfrs to the epigastrium, chest, back of the neck and extremities, in order to anticipate by counter-irritation upon the surface, (he da! gerous affection of the stomach which almost constantly supervened as the disease advanced, was in many instances found advanta- geous. Too often, however, fomentations, rubefacients, sinapisms, and other temporizing measures were trusted to as substitutes, while the more efficacious mode of freely blis- tering was timidly withheld until it was too late to do good ; the blood having retirt d from the surface to the internal parts of the body, and the irritation of the stomacli advanced * " 'Tis true indeed, (says Dr. Warren, of Barbadoes,) that comraoQ fevers in these hot and sun-burnt parts of the globe, do generally make a much greater progress than in colder climates, and consequently re- quire large and speedy evacuations at the beginning." p. 31. f Vid. Jackson on fevers. — Also, the late Reports of the French Phy- sicians sent to investigate the fever of 1G21 at Barcelona. — Vide also Sir James Feilowes, p, 467, kc. 27 . 210 Account of the Yellow Fever, so far, and the tone of the circulation become so much im- paired, that no benefit could be derived from this applica- tion. Sir James Fellowes thinks that sinapisms of mustard, vinegar and soft bread to the feet were preferable to blis- ers.— [p. 407, 8.] D;-. Perkins found anodynes extremely serviceable in calm- ing (he irritability of the stomach. Dr- Harrison also, at the Marine Hospital, has used opiates in protracted c^ses witli great benefit. Dr. Francis foiind them do harm. In most cases the bowels after the excitement of the first stage had subsided, were not particularly inactive, nor were the repeated evacuations which the medicines procured usu- al!}' followed by a seiisible change or mitigation of the dis- order. It seemed in some cases as if this mode of depletion did not, in any respect, alter the character of the complaint ' The same may be observed of the sudorific plan ; for ma- ny cases proved fatal, in which the discharge from the skin was free and copious during the whole progress of their illness. Diuretics might, perhaps, have had a beneficial efiect upon the disease, could the most powerful of that class of medicines have been retained on the stomach ; for it was observed, that in many cases, tlere was often for several days a great diminution and in some, as was afterwards proved by autopsic inspection, an actual suppression or suspension of the urinary secretions. We are inclined to believe, however, that those diuretics more especially should be selected, which would have a tendency to overcome the partial paralysis which seems to exist in the nerves of the kidneys, rather than those which are directed more parti- cularly to the vascular functions of those organs.* * Tmct. muriatis ferri, for example, and which is of such signal benefit jU the torpid state of the secretory functions of the kidneys so often met with in the last stage of typhus. Account of the Yellow Fever. 211 Dr. Francis, guided by the same reasoning, in a case accompanied with a dangerous suppression of urine, found the use of ether highly advantageous. It was from similar pathological views (hat some writer has ingeniously pro- posed to produce a metustasis of the disease by creating an artificial dysentery with injections of cantharides. I have already mentioned, that in a remarkable case where the dis- ease, through neglect, had been left to pursue in a great measure its own course, the accidental occurrence of the catamenia and dysenteric symptoms, probably gave a favourable turn to her complaint. In a strongly marked ca'se, attended by Dr. Hosack, a dysentery which superven- ed towards th%crisis was, he informed me, in his opinion the means of saving the life of ihe patient. The frequent and alarming suppression of urine in this disease seems to have suggested also to Towne the use of diuretics, [p. 34 of work on the Diseases of the West Indies.] The efiect of cantharides upon the bladder, as a diuretic and irritant is another motive w th Towne fir recommending the use of blisters. But then it was under the erroneous belief i hat there was a redundancy of bile in this disease, and that the increased discharge of urine might help to carry ofi" the inordinate secretion of this fluid. When the formidable and apalling affection of the stomach which had been apparently slumbering in the first days of the disease, and which the phy-ician had in vain endeavour- ed to parry, now .began to develop itself; it became necessa- ry to abandon this important point of ihe system, and to seek some other place for attacking the disease. At this late perioci, however, it was impossible to make any particu- lar impression upon the complaint, either through the me- dium of the skin or by means of enemata. The attention «f the physician was therefore turned, as a primary step, 212 Account of the Yellow Fever. towarfis the restoration of the stomach, aud to endeavour to overcome the nausea, hiccup, eructations and 2:a^trjc irri- tability, by absorbents, anti-emetics and emollient drinks ; all of wlich, however, proved in most cases to bean unavailing and hopeless attempt. Besides lime water and milk, porter, beer, the effervescing draught of Riverius, &ic. several physicians employed, also, stimulating drinks, such as ordinary punch, lemonade, pyroligneous acid, in the form of lemonade, essence of spruce, ar;d in some instances pulve- rized charcoal. The charcoal was used at the suggestion of several recommendations, which appeared at the time in the public prints, on the erroneous supposition, 1 presume, tha» yellow fever was a putrid disease ^hii h required antisepti(;s ; but it proved of no service. In one fatal case, 1 particularly recollect the irritafinu; properties of this crude and mineral-like substance aggravated the gastric irritation, and renewed the vomiting. Two patients whom I saw, one under the use of the pyroligneous acid,* and the other of the sprure,j' have both recovered ; but how. far their recovery is to be attributed to these remedies it is not, perhaps, possible to say until we have had more ample experience. By some physicians it has been with great plausibility maintained that the vomiting is a symptom of debility ra- ther than of excessive action, and that the stimulating plan begun early in the second stage of the disease has, by pro- during a new, healthy, and more powerftil excitement, en- tirely subdued the morbid irritability of the stomach, and re-establi^herMhe tone of this organ. I ought not to omit to mention that several cases reco- vered after the alarming symptom of black vomiting. Of * Attended by Drs. Van Arsdale and Walters. I Attended by Drs. Miner and Waltersv • Account of the Yelloiv Fever. 21 s these four fell ucider my own observation. One occurred hi the case of a black woman at the Marine Hospital. Two were patients of Dr. Walker, one an .'rishman, the other a boy, who was a native. The fourth was Cad well, whose extraordinary case is detailed iit Chapter II. Sir Joseph Gilpin observes, that '' a r< petition of purga- tivp injections, and the patient's refraining for some hours (shou'd his strength adinit of it,) from swallowing eiiher m dicine or food, has a good effect" in cal ning the sto- mach.* Although the exprrii^nce of the present year has not throwai any new light upon the successful treatment of the disease, it has neverthele-s served to point out to us some of the rocks that we ought to shun. The pernicious effects of tartar emetic, in every stai^e of the complaint, has, we are bold to say, been fairly tes'ed and established. It had al- ready been condemned by the almost unanimous sentiment of the profession, which did not, however, deter a number of physicians, some of whom were, perhaps, governed also by an erroneous patholo^^y of the disease,f fr' 254 Account of the Yellow Fever, render it a more difficult medium of transmission to the contagious emanations from the sick. The prevalence of the disease, however, in the most arid state of the atmos- mosphere, shows that the propagation of the poison does not absolu(el)' depend upon an abundant -upply of moisture in that element. Human effluvia, as it is a compound of animal exhalations, very naturally forms, as we have seen, the most ready conductor of ihe contagion of the disease, which is itself a specific emanation from the body. This renders it probable that this contagion is communicated through the brealh. It was observed in Spain, that in those infected towns where theinhabitants were unwilling to refra'-n from attending mass, more persons always fell !«ick on the days immediate- ly succeeding those on which that religious service was performed.* This contagion thus associates most easily with those matters which it more or less resembles ; but how far it assimilates such matters to itself is another question. In as much as it is of a gaseous nature, and therefore possessed of great mobility ; its volume, as happens in the experiments of mixing certain known gases, may, in the opinion of some, become much enlarged when it comes into contact with human effluvia. I very much doubt, however, from the facts which are related in the first chapter, whether this union increases its virulence ; for as these substances must be more or less analogous, the association is most probably a simple union. Certain it is, that after all the methods that have been employed of disinfecting the air, the ad- mixture of pure air, next to frost, seems to be the most power- * See the Report of the Physicians of Cadiz to the Spanish goverD- ment ; also the work of Sir James Fellowes, passim. Account of the Yellow Fever. 2^5 ful antidote with which we are acquainted. Hence the i^i^ • importance of ventilation with pure air, which, when effectual- ly performed, is equally salutary in ihe chambers of the sick in arresting the propagation of the disease, as a storm or vio- lent tornado would be in the streets and lanes of a city. Does not this affinity of the contagion of yellow fever to human effluvia prove that it is an exhalation or excretion from the living body, not an emanation from dead matter in a state of putrefaction, nor the product of vegetable or animal decom- position ? It is an offence against all chemical laws, and mere sophistry, to pretend to get over this difficulty in the way of the theory of domestic origin, by saying that the exhalations from the living body 're in a state of putrescency at the very moment they are ;iiven off. We see that the pure chemical clement of the atmosphere seems to be of a nature directly opposite to the gaseous and contagious matter of this disease ; for when they are mixed, they produce a new substance, which is totally innocuous. Is it pot most probable that this mixture is something more than the ordinary mixture of one gas with another; something different, also, from mere dilution, the term commonly us* d to express the asso- ciation? Is it not mure probable that it is a chem cal union, and that a new compound is formed, and the conta- gion decomposed and precipitated. The importance of ventilation and admission of pure air, are strikingly illustr^ited in what takes place in removing the sick of yellow fever into the country. Tiie contagion is rarely communicated, unless in a very crowded apartment, and under extraordinary circumstances, accidentally favouring the accumulition of human effluvia, and the retention of the virus about the per- son of the patient; whereby a state of things is brought about, which resembles very nearly wh «t occurs so frequent- ly in cities ; thus accounting, in the most simple manner, for the reason why the disease is so much more readily propa- 29 226 Account of the Yelhw Fevtr. gated in cities than in village?; or country towns. Cases of contHgion, however, do now and then happen in the pure. air of the country, as well as in the best ventilated and most elevated, spacious, and cleanly streets of cities. Where this occurs in a pure country air, the person who takes the disease has, in g^-neral, been peculiarly predisposed, or come into immediate contact with the sick, and of course with the contagious exhalation emitting from his body. For the constant admission of new masses of pure air must successively destroy the contagion as it is given out, and therefore very much contract the radius of communication. Where these cases of contagion have ap- peared in high and spacious streets, as this year in Broadway, they arose from the circumstance of that part of this street becoming infected which was in the immediate neighbour- hood, and adjoining, as it were, the part of the city where the virus of the disease had accumulated to a prodigious amount, and had become, therefore, of great intensity. It is probable that frost, also, acts by decomposing the unknown elements of this destructive virus, and which, from their losing their affinities at the point of congelation, are obviously in union with a certain portion of water when ia their gaseous or natural state. May not th se facts, in re- gard to the probable chemical action of atmospheric air, or a freezing temperature upon this mysterious substance, help to throw some light upon its real nature ^ But can we from this ever hope to discover any artificial combina- tion or substance which will as effectually destroy the con- tagion or arrest its progress as frost or pure air .'' We will allow it is possible thai in the brilliant march of chemical philosophy, something may be discovered which will actual- ly dO; to a certain extent, what nature herself now does with her grand laboratory of the elements. But is it probi^ble that there ever will be found out a niethod of furnishing Account of the Yellow Fever. 227 this artificial antidote in sufficient quantity? We can hardly imagine that we shall ever become possessed of this means. It may serve to check the progress of the dis- ease, which itself would bean incalculable blessing, but then its power would be circumscribed. It could have but little avail, perhaps, when applied over the extensive sur- face of a wide street, and still less when used to disinfect the whole city. We cannot expect to cope with such pow- erf(d means, as nature herself shows us she is obliged to use before she can subject this pestilence to her dominion. As we cannot command the changes of heat and cold, but mustvvait patiently the arrival of the frost, when the disease is once introduced, and as ventilation cannot be carried into effect in cities, but under great disadvantages, we should be particularly careful to make our streets wide and regular, and to leave as many open spaces and squares as possible, and those of large dimensions,* for those small parks which are to be met with here and there in modern cities are more ornamental than useful, as may be illustrated by the fact of persons taking the disease in the vicinity of them and also of grave-yards, which are of the same nature. All these spaces, however, are serviceable to a certain degree ; and Dr, Rush has very properly included grave yards among them, as being excellent reservoirs of pure air. There is no doubt that the spacious cemetery of St. Paul's church, and also the Park, had, this year, considerable influence in staying the march of the disease towards the north, though the desertion of the city, the only certain and secure de- pendence, did much more. Yellow fever, though it does sometimes, in order to apprise us of its power, show itself, as we have seen, even on mountains or in cities built on high rocks where men had thought themselves secure, yet this has been favoured generally by the circumslance of the ■<= Vide Ilosack on Contagion. 228 Account of the Yellow Fever. population of such places being too compact and crowded, and the streets, for the most part, extremely narrow and con- fined, and deprived of ventilation. This was always the case in the south of Europe, where this fact has been repeat- edly noticed, although it appeared perfectly mysterious and miraculous to the believers in domestic origin, because in these dry and elevated places, they could not find a stagnant collection of water to generate the vegetable or marsh mias- mata which they aver to be the cause of the disease. Yel- low fever will, when introduced into cities and towns, con- structed like those we meet with in tbe south of Europe, al- ways spread Nay, it would, under such circumstances, be propagated on the top of the Andes or Alns, did not that region of perpetual snow form an eternal barrier against the introduction of the contagion. Although the imperfection of medical science places the cure of this disease too often beyond our control, and that our means of counteracting its progress are limited, a wise Providence has indemnified us for these losses, by putting in- to our hands an efiectual method of totally preventing the recurrence of the disease, by shutting out its introduction from abroad. It is left for us to carry into execution what our own judgment must now teach us is the only resort that is left. As 1 firmly believe the source of the disease can only be cut off" by a rigorous code of quarantine restrictions, so am I persuaded that that which is now in operation is totally in- eflScient. We must not depend merely upon civil restraints and tribunals. Our quarantine ought to be, as in other countries, (as in Marseilles, for example, the model of all great maritime cities in similar latitudes,) an institution es- sentially military. The execution of its provisions should be vested in a military and naval armament, but under the directio;: of nedical o.Ticers of high respectability, and of the most responsible character. Accouni of the Yellotv Fever. 229 Our health laws, which are now perhaps of too general an applicaiion, and in this respect too severe, ought to be limited more particularly to the West In lia ports and isl- ands, against which they should be made more rigid thin at present, h f. e direct intercourse between the city ol New- York and the West Indies were entirely prohibited during lie months of June, July, August September and October, the temporary embarrassment which our commercial rela- tions with *hat p;ir! of the world might experience, would, in our judgment, be far more than counterbalanced by the exemption of this city from the irreparable di>asters and dis- tress which always follow the introduction of yellow fever. The dangers to which the heahh of the city is exposed by the admission of Havanna, Port au Pnnce and oth( r West- India vessels, into our ports during the warm weather, may be conceived, not oaly from the disastr ius event of the past season, but by what occurs here every year. Scarcely a week passes over from the first of July to the first of No- vember but from two to four, or sometimes more patients, ill of yellow fever, arrive nmong the passengers and crews of the ves^^els ihat are constantly entering the harbour during that period from sickly ports in the West-lnd.es. [See the weekly reports of the Heal;h Officer to the Board of Health, passim ] In one year the sick arrived in such numbers that they amounted at length to several hundred^ so that the Health Officer was obliged to encamp them in tents. It is true that the disease has not generally spread from the sick to the persons employed in the quarantine ground, nor to the adjoining setllement immediately outside the walls of the establishment ; because the communication be- tween the sit k and well has been interdicted as much as possible, and that the sick have arrived successively and been carefully separated from each other, so that they were 230 Account of the Yellow Fever. placed under the same circumstances as in the pure air of the country, particularly so at this place, as its situation fronting the bay, narrow^, aud ocean, opens it to free ven- tilation from every point of the compass. There are several melancholy exceptions, however, to this remark, and one that occurred during the last autumn, owing to a dreadful storm, which drove a very considerable number of infected vessels which were lying at anchor, upon the i^hores ot the quarantine ground * But when we consider that during all the warm season there has been every year a constant imercourse be'ween the Village adjoining the quarantine ground and the city, by persons passing in packet boats, and by lighters, trans- porting cargoes of West-India vessels into the very ware- houses of the city — that during the last few years this inter- course has been doubled, by the increase of the West-India trade, and by the daily passage of steam-boats, for the ac- commodation of passengers, is it not almost miraculous, that until this year the disease never has been communica- ted through this channel ? Does not also a system, which is so lame and defective in its provisions as ours is known fo be, seem more like a bur- lesque upon (he principle of quarantine restrictions than a serious effort to prevent the introduction of the disease from without ? I have no doubt but that a supply of pure and wholesome water into the city, and the erection of permanent fountains in different parts of it, as in the cities of all warm climates, would have a most salutary effect upon the public health. A strict attention also to the cleanliness of the streets, and to the correction or removal of nuisances of every kind, * See New- York Medical and Physical Journal. Accomil of the Yellow Fever. ' 25i particularly during the warm season, would render the at- mosphere more pure, and therefore secure us from those diseases which filth and animal and vegetable putrefaction are sometimes known to produce. But in carrying these measures into execution, we ought to be careful that our attention is not diverted from what 1 have endeavoured, and I believe successfully, to show, is the only sure and efficient mode of preventing the reappearance of the pestilence. All the schemes, however that may be devised, will have but a partial effect, so long as the country is unprovided with a nationaVcode of quarantine laws. Unless one gene- ral system of this kind be adopted by all the sea ports of the union — unless an unbroken line of lazarcitoes be estab- lished along the whole coast, to guard against the pesti- lence at every point, we never can hope to be entirely secure. What will iivail the mo'^t efficient system of quarantine laws, established here and there in a few cities on the coa-^t, if all the intermediate and adjoining towns, with whom a con- stant intercourse is going on freely, admit vessels coming from infected places .? The whole of our maritime towns must act in concert ; otherwise the attempts to carry into full effect quarantine restrictions in any particular place will always be liable to be f)iled.* There is one mode of prevention, or rather of meliorating the evils of pestilence which falls more immediately within our province, and to which the public attention ought to be in a particular manner directed, in as much as no specific or definitive provisions on this subject have hitherto been made. I mean the establishment of Fever or Lazaretto^ Hospitals placed on elegible sites at a proper distance from the city, and exclusively designed for the reception of patients ill of yellow fever, or other pestilential diseases, * To Dr. Hosack belongs the honour of having first recommended a aational system of quarantine. [See;his Discourse on Medical Police.] t After the manner of European cities. 232 * Mccovni of the Yellow Fever. The believers in dompslic origin and in importation and contagion will all agree in the propriety of creating institu- tions of this nature ; for no one will deny that the accumula- tion of a great numi^er of sick, either in the itjfected or unin- fected parts of the town, must necessarily render the air of such places better fitted to generate and propagate the disease. The Marine Hospital at Staten Isiand* is the only place which has been opened for the reception of the sick. But besides being intended for other objects than the accomoda- tion of persons ill of yellow fever, it is entirely at too great a distance from the city. The sick, who Rave been trans- ported there, are obliged to be carried in boats across the bay ; in consequence of which, from the exposure and fa- tigue to which they are subjected, they have rarely been benefited by the removal. We had occasion of bestowing upon Dr. Hosack praise which we think him fully entitled to for having first agitated the great subject of a national s«stem of quarantine. To the same gentleman are we also indebted for having first distinctly brought before the notice of his fellow citizens the proposition of establishing hospitals for the exclusive ac- commodation of persons ill of yellow fever, or other pestilen- tial diseases. I cannot do better than serve myself wiih his language : * The late Dr. De Witt, Vice President of the College of Physicians and Surgeons, a man whose indifference to fame caused his splendid talents and his attainments to be unappreciated at the time at which he lived, has the honour and merrit ef having- devised the plan of tliis beautiful building ; surpassed by few in Europe, and by none in this country : he was then Health Officer of the port. He fell a victim to yellow fever, taken on board a vessel he visited the succeeding year ; making {hejifth out of xeven Health Officers, who have perished at that plaee in the same manner since its establishment. Account of the Yellow Fever. 233^ " Under the conviction" says Dr. H. " of the benefits to be derived from a permanent establishment to receive the sick poor, and to separate them from the well, and the-eby to arrest the progress of infection, I early in the past season [1820.] called the attention of the Board of Health to this subject, and recommended, upon the first appearance of typhus fever in our city, the instantaneous removal of the skk, either to Bellevue, or some other suitable place to be provided ; but such removal, owing to the want of accommodation, to the extent desired, proved impracticable. I then earnestly urged upon the Board the necessity of some permanent provision being made on that subject, commensurate with the increasing population of this city. " A committee was accordingly appointed to make the necessary inquiries, relative to the expediency of such an establishment, and to ascertain the site most proper for such an institution. A spot of ground, connected with the public property at Bellevue, was found to possess every advantage that can be derived as it regards air, water, and other means of accommodation. B\' several members of that committee such an institution was deemed of great utility, and they concurred in the opinion that the plan proposed ought to be carried into effect without delay ; while by other members it was considered lo inv^-lve an expense altogether inexpe- dient during the present depression of the times. But whea the Board of Health and the Common Council shall be con- vinced that the sufferings of the poor will be alleviated, and many valuable lives preserved to their families and to the community ; that by arresting the progress of contagion, the inhabitants will be secured from the further diffusion of an infectious disease, they cannot but unite in their approbation of such an establishment. When it is also taken into con- sideration that an abundant quarry of excellent building stone, the property of the Corporation, is on the premises : 30 234 Account of the Yellow Fever, that mechanics of every description that can be required are to be found in the Penilen iary, perfectly competent, under the direction of a ski ful architect, to erect the plain un- adorned structure that is contemplated, and, thus make some return to the state for their maintenance ; and, consequently, that the chief expense to be incurred will be for lime and timber, I cannot but indulge the belief that the Corporation will take the necessary measures to carry the plan proposed into operation, in time to meet the exigencies of the ensu- ing year." If, as I believe, the recurrence of this pestilence can only be prevented by the institution of a rigorous and well-organ- ized system of quarantine ; so is the conviction equally strong upon my mind, that the code at present in force is totally inadequate for the purposes for which it was intended. We must take as our model the sound policy of Marseilles, and other southern cities of Europe, which, like ourselves, have no doubt suffered dearly in their day by the combined influence of ignorance and chicanery. It was to Dr. Hosack, who has exerted himself with se much ability, perseverance and success, to prove the foreign origin, and specific and contagious nature of this disease, to whom the honour, as we have said, is due of having first pointed out to his countrymen the importance of establish- ing a national and universal system of quarantine.* Though the recommendation of Dr. Hosack has now died away, and Congress have not thought proper to make it the subject of their dehberations, the time will doubtless come when not only this city, but the country at large, will have reason to respect his memory for the deep interest he took in their welfare, at this early period of our history, * See hii Discourse oa Medical Police. JJccount of the Yellow Fever. 236 and the many valuable lessons which he has left in his works on the subject of promoting and preserving the pub- lic health. While we are on this subject, I will take the liberty of suggesting some improvements in regard to the mode of organizing a Board of Health. I am firmly persuaded that the care of the health of the city ought to be committed, as at present, to some of our more distinguished citizens, who have an interest at stake in the city and whose consideration in society gives to them a weight and responsibility of character. Were it exclusively made up of medical gentlemen, there is too much reason to fear that their difierent opinions might lead, as too often happens, to interminable disputes, and to most disastrous consequences. There should be, however, a sufficient number of medical gentlemen attached to the Board to serve as advisers ; to be ready at all times to inform the Board of the true state of the health of the city ; and to recom- mend the most effectual means of guarding against the in- troduction of pestilence. They should be persons of liberal education, or at least those whose natural and uncultivated powers of understanding we e s • strong and so clear, that they might serve as a substitute for this deficiency. They should have seen much practice, and especially have become familiarly acquainted with the various forms of fever before they presumed to ofier themselves as candidates for this situ- ation. It is difficult to STy of how large a number the medical department of the Board of Health ought to consist. They should, at least, be a minority to the citizens who are not physicians, and who constitute the other part. I a^u of opinion with his honour the Mayor, in his late p oposed re- visal of the health laws, that the health officer and the com- missioner ouglit to be appointed by the State, and the rest of the medical department by the Board of Health itself. It 236 Account of the Ydlow Fever. is the opinion of Dr. Walters, and I have heard none which I more approve of than his, that the physicians to be ap- pointed by the Board ought to consist ofjivp resident Phy- sicians^ and tliat the city ought to be divided into^-ye dis- tricts, apportioning one district to each Resident Physician. These Physicians should have equal powers in the Board, and when --^ susp>cious case occurs in any part of the lown^ the Board should immediately cause a consultation of the whole number. The past season has convinced us that it is placing too much responsibility on one person, and paying too dear a pri<:e to make the welfare of 1 20,000 individuals depen- dent upon his mere opinion. We would have little to fear from procrastination, or theories concerning the bilious nature of this disease, if five respectable, e^periented prac- titioners of liberal opinions and high sentiment of honour,, were placed in that i oard, to determine what was yellow fever, whence it originated, and where it fiist appeared in our city. CHAPTER IX. IMMUNITY AND PREDISPOSITION. It lias been staled, on the high authority of Dr. Pym, Arcjula, Sir James Fellovves, and Sir Joseph Gilpin, that the yellow fever, as it has appeared in Andalusia, and at Gibraltar, has never hern known to attack the same per- son twice. It is impossible to call in question the testMTiony of the gentlemen who have mtide this ndix to Dr. Pifin?s Ob- servations. " This same peculiarity marked the pestilential fever of Spain. According to Sir James Fellowes, it never has been known to attack the same person a second time in that coun- try. ' This fact,' says Sir James, ' which wa-^ first observed by the native practitioners, ha> now been confirmed by the experience of several years, and by the concurrent testimony of all the surviving inhabitants of ihose places where the disorder had most prevailed.' Introduction, p. xxiii. " I have dwelt so long on the performances of Sir Jame5 Fellowes and Dr. Pym, as almost to be deterred from re- ferring to any other authority ; yet I cannot forbear making a short extract from an account of the epidemic fever which occurred at Gibraltar, in the years 1804, l8lO, aud 1813, and for which the public are indebted principally to Dr. Gilpin, one of the inspectors of the hospitals. The paper throughout is one of singular merit, and eminently calcula- ted to do away the doubts of the sceptical, and strengthen the faith of the wavering. It is gratifying to the philaiUhro- pist to read the answer given by Dr. Gilpin to the eighteenth ijuery, addressed to hina by the Medical Board of the army. 240 Account of the Yellow Fever. " The points embraced in this query involved the consi- deration of several matters, to wit : were many of the at- tendants of the pick in {>rivate houses and hospitals attacked with the same disease, and where this did not happen, were there any circumstances evident, that might have rendered such persons unsusceptible of the contagion ; such as their age. previously having had a like disorder, particular pre- cautions, he. f " ' In private houses, in most cases,' replies Dr. Gilpin, ' the attendants were attacked. There were undoubtedly many exceptions in the hospitals ; but it was to be accounted for, as, generally speaking, the attendants were persons who had had the disease previously, either in the West Indies or in Spain, or here, in IS04. At the commencement of the disease last year, it was calculated that there were about five thousand persons within the walls who had previously passed through it; and after careful inquiry, there does not appear to be one well authenticated case of a person's having re- ceived the infeciion a second time. I heard, indeed, of three or four; but as the nature of the previous fever could not be exactly known, these exceptions liave but liille weight in so momentous a question. The exemption from a second at- tack, 1 am credibly informed, is firmly believed in Spain. At Cadiz, last year, though the fever put on the very worst symptoms, and destroyed the patient frequently in forty- eight hours, the deaths did not exceed, in a population of upwards of seventy thousand, fifty a day; and these were chiefly strangers. The Spaniards are so fully convinced they cannot receive the infection a second time, that having passed the disease is matter of great rejoicing among them : a medical certificate of the fact is a sufficient passport into an infected town, which they enter without the smallest ap- prehension." Consult the Transactions oi that active and Account of the Yelloiv Fever. 241 distinguished association, the Medical and Chirurgical So- ciety of London, vol. 5, for more ample details. " The immunity of the constitution from a second attack of yellow fever is a peculiarity so strikingly characteristic of most disorders of an acknowledged specific nature, and of such great practical interest both in a social and political point of view, that it is extraordinary it should have met with so little notice before Professor Arejula made mention of it in the year 1806. "The yellow fever at Andalusia," says Arejula, (I avail myself of the translation of his account in Sir James Fellowe^''R'^p"rts, p. 67.) " attacks persons but once in their lives, and it is of great importance to the physi- cian to know this, in order to form his prognosis and his plan of eure,as well as for the individual who may have passed through this disorder, that both of them being assurr d of this fact, may step forward wiihout fear to the relief of their fellow crea- tures who may hereafter be afflicted with so dreadful a ma- lady." Dr. Pym, however, enjoys the rep'itation of being the first English phyi^ician who promulgated this principle. I have not the sources of information at hind to enable me to determine how many of the writers on the malignant fever, as it has prevailed in our country, have entertained this opinion, though I well recollect Dr. Lining to have been one ; as may be seen in his account of the fever in Charleston, published more than sixty years ago, in the Edinburgh Physical and Literary Essays, volume second. In the interesting correspondence on the yellow fever which was maintained a short time anterior to this period by Dr. John Mitchell, of Virginia, and Lieut. Gov. Golden, of New- York, nothing is alluded to from which we might infer their knowledge of this law of the disorder. See the American Medical and Philosophical Register, vols. Ist and 4th, In 31 242 Accounl of the Yellow Fever,. the Facts and Observations of the Collece of Physicians of Philadelphia, on thf N 'ture and Origin of the pe--ilen- tial fever, after establishing the identity of the yellow fe er which existed in that city in 1793, 1797. and 1798 wi»h *he West-India pfstilenre, the C Hege staie, that it is a cir- cumstance that deserves particular attention, that ' very few, ifany,of the Creole French in thiscity, [Plnladelphia,] suffer- ed from the contagious maligitant fever which prevailed here in 1793, 1797. and 179S, though the disease was introdu ed into their families ; and children born in this country of Creole parents, died with it last auumn, while the parents and the children born in the West Indies were entirely ex- empt from it." We look in vain, if my memory serves me for any thing of ih^ same sort in the Additional Facts and Ohservaiions, a subsequent publication of the College of Philadelphia. "In the Sketch of the Malignant Contagious Fever as it appeared in the same city in i793, Dr. Cathrall oht-erves, " it does not appear to affect the same person tw ce. Al- though careful inquiry," adds he, " has been rande by seve- ral of my medical iriend* and myself, it only ap ears that some of the patients had a slight relapse of fever, but without any of the distinguishing sympsoms of the diseasf, and very soon recovered." It is much to be regretted, that the several histories of this disease published by that able me«.ical an- nalist the late Dr. Rush, should have been so confused and unsatisfactory on so momentous a matter. In his account of the bilious yellow fever of 1793, you will, nevertheless, find that the refugees from the French Wes-t Indies " uni- versally escaped the disorder/' thouj^h this was not the case with the natives of France who had been settled in the city. On the other hand Dr. Currie, of Philadelphia, in his Trea*" tisp on the Syncchuj. Icterodes, states, that several instances occurred of the disease affecting the same individual a se'- Account of the Yellow Fever. 514S conrl time, and un l»^r circumst'^nces so unequivocal that it could not be fairly ascribed to a relapse. This assertion, you will see, is not strongly made, and may be deemed rather metier of opinion than matter of fact. " D ■. Currie also tells us, that the French West-Indians, particularly those from St. Domingo, almost to a man, escaped the disorder, though they made use of no prec lU- tion tor the purpose, • while those from France were as liable to it as the Philadelphi.ms.' N thing in relation to the security from a second attack of the disease is advanced by the late Professor Bayley, in his excellent volume on the Epidemic Fever of New-York in 1795; though in the Collection of Papers published by Mr. Webster, ihis writer on the epidemic of New-York, of the same year, alleges that he knew not a decided instance ;;f an indivdual labouring under a second seizure. But at present I am not duly prepared to enlarge on this point, by reference to other American auihorities. "Dr. Pym has referred me to a passage in S^uvageson this disease, in which it is asserted, tlmt it operates upon the constitution but once. Typhus icttiodes conta^iosus est. Albos tantum, maxime j^eregrinos ex regionibus frigi- dis advenas, Indos, Hybrido . mulatros omnes, exceptis infanlibus, una tantum vice afficit : nigri vero ab eo morbo nonquam afBciuntur." See Nosoiogia Methodica, torn i. p. 316, of the quarto edition of 1768. We must here bear in reco'lection, that Sauvages has depended mainly on Li- nir.g, ts authority for this peculiarity. Does your own ex- tensive experience in the malignant epidemic of New York agree with the opinion that the human constitution is invul- nerable to a second attack of yellow fever, corresponding in this respect with small pox, and other specific disorders .' 244 Jceouni of the Yellow Fever. In answer to this question, which has frequently been put to me by practitioners of medicine in England, I have uni- formly ventured to assert that it holds good as a general fact. Those who have once had fhe disf^ase are certainly less susceptible of its influence a second time. " Permit roe now to make known to you the important results cf the recent deliberaHons of two (f the most distin- guished medical associations of this kingdom The deci- sions of the Royal College of Physic an- of London and of the Army Medical Board are at length brought to a close. These two learned bodies, alike disting' ished for scientific attainment ^md practical knowledge, have been for a consi- derable time pa-t devoted to a consideration of all the facts connected with the nature and character of the yellow fever, pariiculiirly as it has of late years appeared in Spain. The Royal College have pronounced that the yellow fever is a highly contagious disease, which decision tliey have report- ed to the Lords of tiie Privy Council. With respect to its attarking the human framf but once, they say they think it extremely probable, but that upon a point of such impoitance they cannot venture to give a decided opinion. The Army Medical Board at the head ot which presides Sir James M'Gregor, have also given it as their opinion, that the yellow fever is in its nature contagious j and they further add their conviction, that the fever of Spain is not only strictly conta- gious, but like other disorders of a sp( cific character, it af- fects the homan frame but once. 1 have been kindly fa- voured with an abstract of these proceedings, and I here- with enclose an extrac from the official report on Dr. Pym's publication made by the Army Medical Board. The ope- ration of climate, soil, and other local causes, in adding viru- lence to febrile contagion, may be considered almost an Account of the Yellow Fever. 245 axiom in physics ; and the necessity of a strict adherence to your improved system of quarantine laws, ai d all municipal regulations for the purpose of domestic cleanliness, cannot be too 'trongly enforced. On this subject the Royal Col- lege and the Army Medical Board are united in opinion. (COPY.) EXTRACT FROM THE REPORT UPON DR. PYm's PUBLICATION BY THE ARMY MEDICAL BOARD. Army Medical Board Office, 6th May, 1816. " It is due to Dr. Pym to state, that we consider hioi lo have been the hrst English medical man who^proujuigated the opinion, that the disease in queslion (the Bulam fever) is capable of attacking the human frame but once; and if that opinion be correct, which we beheveit to be, it is cer- tainly an important tact, and led Dr. Pym to employ those persons as attendants on the sick, who had undersjone 'he disease, and therefore were not likely to be affected by the contagion of it, and thus probably saved many lives. Un- der these impressions, we beg leave to recommend the indus- try and research displayed by Dr. Pym. in his book, to Lord Palmerstone's favourable consideration. " Signed, " J. m'gregor, "Vf. FRANKLIV, " W. SOMERVILLK." " The advocates for the unity of disease will, I believe, iyid it insuperably difficult to reconcile with their theory the facts which I have thus hastily communicated to you; while the fundamental principle, that there is a radical dif- ,246 Account of the YdlowFevejr* fereiice between remitting fever and y .Dow fever, between fevers depending upon marsh miasms as their source, and those that take their rise from human contagion ; in short, that yellow fever is a distinct idiopathic disease, acquires additiunal support. It may not therefore be of disservice to make known the purport of this letter. The doctrine • maintaining that different fevers are of one common origin, is in reality so unfounded in fact and so pernicious in its consequences, that the sooner it is discarded the better will it be for the interest of science and humanity." The immunity of the human constitution from a second attack of yellow fever, which subject has occupied the special deliberations of the Army Medical Board of Great Britain, and the seasonable communication of their deliberations to the physicians of this country, have been the means of exciting our practitioners to this interesting fact. Since the appearance of Dr. Francis' Observations on Febrile Contagion, in a pamphlet form, in 1816, to the present day, additional light has been thrown on this subject, and we believe, many medical men, who have witnessed the ravages of yellow fever in different parts of the United States, con- cur in opinion that the pestilence rarely or never afflicts the same individual a second time. In the MS. communicat on of Dr. Francis, concerning the late fever oi New York, to which I have more than once already referred, speakiiig on this point, I find the following language :— " 1 hope," -ays Dr. F. " you will pay due attention to the question, whether the s^ame individual is affli- ted a second tim^ with yellow fever. Suice I have addressed this query to the medical practitioners of this country, the almost uni- form renly is, that the constitution is rarely subjectf d to the action of a second illne-^s from the disorder. Several of the most experienced physicians of our city affirm it, as their Account of the Yellow Fever. 247 belief, that the constitution is invulnerable to a second attack of the disease. The late Dr. Richard S. Kissam was con- spicuous in this number. His Excelleucy Governor De Witt Clinton, who was president of the New-York Board of Heal'h during the prevalence of the disease in this city, in 1805, and who had ample opportunities of acquiring a knowledge of the peculiarities of the fever, assures me, that no case, so far as he learned, came to the cognizance of the Board of the same person being twice under the influence of yellow fever. Dr. Walters, who has been practically conver- sant with ye'low fever since 1798. is of a similar opinion. " Dr. Hosack, who has recently paid much attention to thi* pec uliarity of the jellow fever, states, that the sys- tem is rarely or never liable to bfcome twice afflicted by it, and his correspondence with several eminent physicians, in diflerent sections of the union, corroborates the correctness of this belief. I shall observe, in conclusion, th ;t Dr. Rogers, the President of the Medical Society of New-Orleans, a gentleman, who since the year 1804, has witnessed the ra- vages of yellow fever in that city, gives me the strongest as- surances, that the human constitution enjoys perfect immu- nity from a second attack of the disorder. He has never seen an individual sick of the complaint a second time. But I forbear to enlarge on this head." There is another species of immunity which is said to belong particularly to the natives of those latitudes to which yellow fever is indigenous. This differs from the kind of which we have been speaking, because it gives to the con- stitution an exemption from even a first attack of yellow fe- ver. The other is acquired ; this is congenital ; but the for- mer is said to be a more perfect protection to the system than the latter : for if we are to believe the observations made in Spain, those who have once had the disease, as in other con- 248 jSccounl of the Yellow Fever. tap-ious diseases, are ever after exempt from it ; but those who owe their esc-i'je from it to their birth-place, are known to lose this immunity by living a few years in a cold lati- tude. With regard to this immuniry from birth-place, it is now almost reduced to a certainty that it does not strictly belong to the inhabitants of any part of the territory of the United States, even to those parts of our continent which are nearest to the tropics. There is, however, a certain degree of in- susceptibility to this disease, which the natives of the Uni- ted States possess, derivable, no doubt, from this cause, and existing in a more and more perfect state the nearer they reach to the equator. But this does not amount to that positive and absolute immunity to which we have reference, and which is possessed in so eminent and remarkable a de- gree by the natives of those places where the causes which generate this disease are known to exist. Hence it happens that although those who have migrated to the United States from the northern and higher latitudes of Europe, constitute but a minimum of the population of any of our sea-ports, they have, notwithstanding, always been peculiarly obnox- ious to yellow fever, even though they may have resided here several years, as is shown by the epidemic of the late season. The disease spread over the lower part of the city where the wealthiest portion of the inhabitants reside, almost all of whom are natives, and where there are very few foreigners ; for this description of persons being chiefly Irish and poor, dwell almost exclusively in the suburbs and upper parts of the town. Yet, as we shall soon see, nearly one half the deaths were foreigners. The same has been observed when yellow fever has prevailed 'n any of our cities. These facts show that the unsusceptibility to yellow fever growing out of birth-place belongs, in a certain degree, also, to the na- Account of the Yellow Fever. 249 Uves of the continent of North America, as well as to those who inhabit its islands in the Carribean sea. Thatsomeofiis do not possess this immunity in a higher de- gree seems strang^e, when w^* recollect that Pensacola is in 30^ 30' noi th latitude, New-Orlean and St. Augustine in 29^ 5S', a.'d Havanna in the island of Cuba, 23*^ 12 , which is only a lit:le more than sir degrees farther south than the two last mentioned sea ports of the United States. But that this peculiar difference between 'he islands of the West-In- dies as well as tlie towns on the continent within the tropics, (such as Vera Ouz, Carthagena, Sue.) and the sea ports of the United States, does actually evist, every year, almost, furnishes strong and positive proof; aiid particularly in what occurred this very season at the little town of Pensaco- la. Though the greatest number who perished of the yel- low fever which recently made such dreafiful havoc in this small town, were emigrants from tlie northern states ; the old residents and natives also, such as the Spaniards and French, and even the Creek, Indians themselves, who are the aborigines of the soil, as well as a considerable number of ' Nfgroes fell victims to the dis^^ase ! The epiden)ic broke out on the 25th of July, abnul ten days after the arrival of a ves- sel from Havanna, (hat came directly up to within a few feet of the town, and landed a car.o of damaged fruit. There were then one thousand inhabitants. Six hundred fled a few days after into the woods, leaving about three hundred Spaniards, French, Netrroes and Indians, and one hundred A;nericans, Irish and English. Of these there perished up to the 1st of October:* * See letter of Mr. Barber, of Pensacola, dated Pensacola, Sept. 20, 1822, published iothe New -York papers. 32 250 Account of the Yelloio Fever. WOO American and Irish, ^ Adults and ' 5 iOO French &i Spaniards, ) children. 50 Negroes, "> 50 Negroes, ) Adults and 30 Indians, 5 30 Creek Indians. 5 children. 280 2S0 It is remarkable that from Oct. 1st to Oct. 26th, out of the three hundred of all descriptions then remaining in town, there were one hundred and twenty who' had died, nearly all of whom were children of Creole (i. e. native) parents, and who on that account, from being natives of the town, had been considered safe ! From facts like these, we are constrained to believe that yellow fevr is indigenous to no part of the territory of the United Stales, and that it has n'ver appeared in any of our cities without having been brought there from some West- India port. For this repugnance in our organization to bfcome so modified as to acquire a perfect iwimnnity froixi the disease, is strong pre- umptive pronf.hat yellow fever cannot be a native prot'uction of our sod or climate. To return !o the subject of min.unity from a second at- tack, it is conjectured that out of more than four hundred casps of yellow fever which have occurred this .season, none have had the disease before. One half, at least, were fo- reigners from England, Ireland, Germany, or France, or persons from more northern parts of ihe United Spates, and who had never bad yellow fever. 01 the remaining half, no instance has come to my knowledge, of the disease having attacked the same person twice. From a review of the whele controversy on this subject, we are led to believe that an immunity from a second at- . Account of the Yellow Fever. 251 tack does belong to yellow f^ver as well as to most other contagious diseases : but under this modification, which will, we think, express the terms of the law in an unexceptionable manner. Those who have passed through yellow fever once, very rarely take it a second time, especially if they continue to re- side in the country where they first had the disease. The fact was first stated very nearly iu the same lan- guage, by Dr. Mc Arthur, late physician to the Naval Hos- pital at Deal, in his Report on this subject to the Commis- sioners for the service of transports, and sick and wounded seamen, &c. " I have reason to. conclude, (says this phy- sician ) from my own experience, that it rarely attacks the human frame more than once, so long as the objects of its attacks continue in the country, or do not commit irregu- larities." [Bancroft's Sequel, p. ^bj] The total number of deaths of yellow fever in the city, re- corded on the books of the City Inspector, Dr. Cumming, during the summer and autumn of 18i2, was one hundred and sixty four. They were from the following countries and states : Foreigners. Ireland, 32 Americans. New-York, 58 England, Germany, Scotland, - 26 9 3 Connecticut, Massachusetts, New-Jer>ey, - 14 France, Holland, - 2 2 Pennsylvania, Maryland, _ Rhode-Island, - Total, De-aihs, 74 90 164 Nova Scotia, Total, 90 252 Jlccount of the Yellow Fevtr. Of the ninety Americans, .the following came from lati- tude- mnch higher north than that of the city of New-York. Thus from Conneciicut, - - 14 Massachusetts, - - 7 Rhode- Island, - - 1 Nova-Scoiia, - - 1 « 23 These of course were much more predisposed to the disease than the natives of the city. It was observed also in the yellow fever of Cadiz in 1810, that those Spaniards who had fled from the northern parts of Spain to take re- fuge in th;it city from the French armes, were more obnox- ious to the disease than the natives of Cadiz.* Out of the whole number of deaths, in New-York, during the late epidemic, 5 were between 1 and 10 years of age. 17 - - 10 20 40 - . 20 - ■ 30 40 - - 30 ■ - 40 36 - - 40 . ■ 50 15 - - 50 • . 60 S - - 60 - 70 2 - . 80 ■ - 90 Of which six only were coloured persons, of whom three were blacks and three mulatioes. There were fifty line fe- males. The number of females was therrfore to that of males a litile more than < ne to three. Out of the whole number of females, it is worthy of re- mark, tiiat twenty three were foreigMers, and eleven from the _____„______ _ ,— * See Sir James Fellowes, p. 219. Account of the Yelloio Fever. 253 more northern parts of the United States, making the ratio of suscepthility between those of northern constitutions and those who are acclimated, hold nearly true in respect to fe- males also, as well as to both sexes, when included to- gether. Of the whole number of deaths, two thirds it appears w^^re between the ages of twenty and fifty ; and of the re- maind{-r nearly as many under twenty as over fifty. There were more than three times as many between ten and twen- ty as between one and ten ; and nearly twice as many be- tween fifty and six'y a-; between sixty and ninety. It is a littl- remarkable that very nearly the same numbers died between twenty and thirty, beiween thirty and forty, and be- tween forty and fifty. A number of blacks, who had been emp1o3'ed as watch- men, or to take furniture and goods out of the infected parts of the town, were thus particularly exposed to the disease long after the original inhabitatits of the district had deserted it. Dr. Lining says he nevt r knew an instance of a hlat k taking the yellow fever fit Charleston. There were much few< r of the night watch who took the disease than of those who were employed also on the day watch. Dr. Rush attri- butes it to habitual exposure to the cool night air. There were also five or six Germans took sick, who continued constantly to work in a sugar-house in Liberty-street, near Nassau-stree', long after that neighbourhood had become infected — they lived in the upper parts of the town, and several of them died. This circumstance excited a good deal of remark. It was no doubt rendered more fatal in this building from the peculiar predisposition wiiich all foreigners have to this disease. Their occupation also by ex- posmg them to an intense heat in confined apartments, may have contributed, perhaps, to render them more liable to the 264 Account ^fihe Yelhw Fever. disorder. Deveze remarks, that blacksmiths, bakers, &c. are, on th^t account, panicularly subject to take this < om- plaint. Sir James Fellowe?, speaking of the yfHovv fever in Spain says, that those who were obliged to remain long near the fire, as cocks Sec. were very liable to the disease. The disease, as usual, prevailed most among the poorer classes — first, because they either wantonly, or from ne- cessity, exposed themselves to it more than the rich — and secondly, because the small apartments In which they usually live, rendered impure by human effluvia, became a more ready medium of contagion. At least one half, and perhaps two thirds, were labourers and mechanics; but no particular occupation appeared to be more obnoxious to this disease than another. Its fatality seems to have been regulated more by the condition of life than by the occupation or tempera- ment. For we find it proved remarkably fatal where the air must have been from necessity impure and surcharged with human effluvia, as in boarding houses, and as was re- marked, in previous years, in small sailor taverns and similar houses, usually resorted to by the poor. In two respectable boarding houses in Broadway, the mother and her daughter, in each, took she disease, out of which number three died. Out of three respectable boarding houses also in Court- landt-street, in two of them the ladies who kept them died, besides six other person? belonging to the houses. In two small sailor boarding houses ;n VV. ter-street, (see Chap. I.) there were five taken down with yellow fever, four of w horn died. There were scarcely any persons of consequence, and very f vv of the weaithitr part of the inhabitants who fell vici nia to itj with the exception perhaps of five or six, who unnecessarily exposed themselves, by remaining too long in the infected district, though it was in their power to escape. Account of the Yellow Fever. 255 When it is considered that this c\\y counts upwards of 10 or 12,000 coloured persons among its inhabitants, and that the greater part of them remained, no doubt, in town, at the time the yellow fever prevailed, and were as much or more exposed to the chances of taking the disease as others, it must be confessed, tl;at the disproportion in the number of them who died, to that of the whites, was very great; showing, what was long since pronounced to be true, but lately atie.nptpd for certain purposes to be controverted, that this description of persons do, in reality, possess a much higher degree of insusceptibility to the disease than whites. Contrary, however, to the positive assertion of Rush, I must say, that some of the most malignant cases of this disease, and particularly those in which there was most apalling haemorrhage, have been among this small number of blacks who died. CHAPTER X. WEATHER. By nolicing the highest range of the thermometer during the summer and antumnal months, it is found that iheie has been at no time those excessively hot days, wiiich liave usual- ly been observed to occur in July or A'lgust. This is cor- roborated by the fact, as we shall see in the chapter on deaths which succeeds this, that there have been but very few deaths from drinking cold water, tf which there are every year a considerable number during the prevalence of extreme hot weather, as is shown by the list of mortality for 1820, and by the preceding years. The thermometer on such occasions has usually exceeded 93° and 100. But this year tlie ther- mometer was at 2, P. M. during ali June only six times above 90° and then b' t two or three decrees higher than that point. In July, at the same hour, it exceeded 90 on ten occasions, and only four times before the first cases of yel- low fever sickened. In August it was only seven times over 90° at 2 P. M. but it never during all the summer exceeded 96, and did not reach as high as that point except on one day, which was the 20'h of July, at 2, P. M. In September, the mercury on five days rose as high as 90° ; but in Octo- ber it did not reach as high as 80° except on three occasions ; Account of the Yellow Fever. 257 ©0 one of which, viz. the 20th, it attained at 2 P. M. 84°. Nor was there at any time those sudden depressions of the thermometer which occasionally happen ; for during all the summer, the quicksilver did not fall below 60°, and ne- ver as low as that, excepting one day, viz. the 14th of June, at 9 P. M. During September, al.-o, it did not fall below 60°, except on five day?, at 7 A. M. on one of which, viz. the 18th, it was as low as 5i°. In October, however, towards the latter part of the month, it sank as low as 37'^ on the 23d, on which day, ice was for the first time found in the immediate vicinity of the city. On the 26th. the day on which the Board of Health adjourned, the mercury fell to 36^ at 7 A. M. From that day to the 4lh of November, there happened thir'een deaths of yellow fever.* From the 23d of October to Noveuiber 1st, it was asserted in the public prints, that ice had been several times seen in the city. Of this, hfiwever, there was no substantial proof, which is confirmed by the fact that the quicksilver did not, at any time of this month, fall to the frteziug point: The thermometer which we have used as our standard is kept at the New-York Hospital, which is considered to be one of the most open and elevated places in the city, the air having free admission to it from all quarters, and the building being surrounded with a large enclosure, at the distance, on every side of it, of more than one hundred or one hundred and fifty feet from the buildings of the city. Ice, however, may have nevertheless formed in some of the * When the first part of this work was printed off, the report of deaths from yellow fever had not been entirely completed. Hence instead of ten additional cases having occurred after the Board adjoui-ned, I should have stated the number ct tliirtcen. 33 258 Account of the Yellow Fever. more sheltered places of the town. If it did freeze, it was prohably on the north west or shaded side of the city upon the Hudson. It could not ha\e formed on die East River or south-eastern '*nd sunny side of the city ; for the cases that occurred between Oct'!ber26th and November 4th, af- ter the Board of Health adjourned, were in this part. Other- wise we shall be obliged to admit that yell tw fever may, to a certain extent, go on to prevail after freezing vveaiher. I did not myself ascertain the existence of frosi in tie city until early in the morning of Nov. 5th, when the ground in shaded places was covered with it, and continued so for some lime after the sun had risen. That a general frost had not occurred in the city until this dale, is furthermore confirmed by the fact, that the very last case of yellow fever that happened died on the day be- fore, to wit, Nov. 4ih. Cases. Deaths. From July 10th to August 1st, there occurred 15 7 August 1st to September 1st, - 95 53 September 1st to October 1st, - 211 109 October 1st to November 5th, - 93 69 July was mild, and for the raon part clear, but the air was unusually humid compared with the preceding month. The average of the thermometer at 2 P. M. was very nearly 88^, and in June, at the same hour, only 83"^. The yellow fever may be said to have begun to be propa- gated about the 15th of July, that is five days afier the first three cases sickened. Notwithstanding the humidity of this month, and that the atmosphere, though no' particularly calm, was at no time disturbed by violent }tiodu( tion of this pestilence, had not abaudoued their homes, still the Account of the Yellow Fever. 259 disease at first seemed to have made bui little progress, foF during all the remaining half of the month, there did not oc- cur h\x\ fifteen cases ! Con(brmal)le as the state of the elements seemed to be with the hypothesis of domestic origin, the disease was too stub- born to acknowledge its authority, but sternly obeyed its own laws. But if a long continuance of hot, dry, clear weather also, would generate the disease, why did it not break out in Jun^ f There was certainly heat enough in that month- But June must be reserved, I presume, in or- der that the preparatory concoction wiiich the elements re- quire, might have full time to be matured. The average heat in August also, was 86® at 2 P. M. nearly the same as that of July, but there occurred only ninety-five cases, a proportion four times as great as in July, but yei not a very extraordinary number, considering that the mass of the pop- ulation in the lower part of the city still remained there, and that the temperature uf the air seemed to be favourable to the propagation of the disease. The season indeed seems to have given the theviry of domestic origin a fair trial. First, a dry hot month, which could produce nothing, then a hot and very moist month wliich produced but very little j and lastly, a dry hot month again when the proportion of cases was only quadrupled. But in September there was much more wind than during all the summer, though no violent commotion of the air, and the average heat at 2 P. M. was 81* only, being two degrees less than that of June. There was also a medium quantum of moisture, compared with the three preceding summer months. This state of things, that is, a moderately high heat and moderate degree of humidity in the air, seems to have been most favourable for the propagation of the disease, for in this month, though 260 ' Account of the Yellozo Fever. nearly all the lower part of the city below Fulton-street was deserted as early as the first of the month, yet more than tzoo hundred and eleven cases occurred, being more than twice the number of what had occurred in the previous month. How are these discrepancies to be reconciled with the hypothesis of domestic origin ? Will it be f-aid that in July there was a good deal of electrical matter in the air, and that this counterpoised the delet^-rious influence of an excessive humidity. But in June the temperature was near- ly the same as in Soptemher, and there was not only a great deficiency of moisture in the atcnosphere, but much less thunder emd lightning than usual, which, however, was also the rase in September. In September ihe cause which pro- duced the disease seemed 'o h'jve been more active than at any other time, though less mortal than in ihe succeeding monih. When the thermometer began to fall towards the middle of autumn, the disease, as usual, became in correspondence more circumscribed in its limits, but more fatal ; for in Oc- tober there were ninety-three cases, the same number as in August, lacking only one, but the proportion of deaths to the cases increased, and became as three to four. Upon the whole, it would seem from the meteorological phenomena of the present season, that this disease e^ets at defiance the ordinary vicissitudes of the atmosph^^ie. Neither its progress nor its origin seem to depend, as many would have us believe, upon any definable state or condi- tion of the elements. Nor have those sudden and extreme chuiges of the weather which sometimes char .cterize the seasons, any more to do with the production of yellow fever than the usual train of atmospheric phenomena. If we can repose confidence in one of the oldest and best writers on j9ccount of the Yelloiv Fever. 261 this subject, this fact holds true also in the West-InHies^ which we are generally accustomed to consider as the birth- place of this disease. " Neither the alteration of the weather or winds, nor the different seasons of the year, have ever of themselves been able to produce this contagious disease among us. Many years (I may safely say se\ en or eight or more successively.) have, to my certain knowledge, pass- ed over, when the sultry heats and long intolerable droughts of some, the almost incessant rains of others, or the tempes- tuous weather of many, and that from uncommon points of the compass too, mu-t surely, in some degree or other, have given rise to such an epidemical malignity, if it could pos- sibly be derived from such causes ; a:id }et no footsteps of the tever did appear all that time."* It would be almost useless to enter into a comparison of the state of the weather this season with what was observed in previous epidemics, for it briitgs us out to the very same results. Taking September as our criterion, all that we can positively affirm is, that i\w propagation, in other words, the contagion of yellow fever, appears to be favoured by a steady range of temperature, somewhere at or a little above 80'^; and perhaps also hy a moderate share of humidity in the air. But whether a deficiency o( electric matter in the atmos- phere, which Dr. Shecut, of Charleston, avers, gives rise to the generation of the disease, has any thing to do with fa- cilitating or retarding its progress, I cannot pretend to say. The contagion this year seems, in truth, to have been mul- tiplied with much greater rapidity during the month in which there was scarcely any thunder or lightning observed * Treatise concerning the Malignant Fever in Barbadoes, by Hen- ry Warren, M. D. London, 1741. 262 Account of the Yellow Fever. than in August, when there was a good deal noticed, or in July, when there was a still more frequent recurrence of electrical phenomena, and when the number of cases, though the propagation of the disease seemed to have been appa- rently favoured by other circumstances, was unusually small. May not this increase of cases in September be owing also, in some measure, to the fact, that this i* always one of the most sickly months of the year, and that he al- ternations of chilly evenings and hot days, which so pev uliar^ ly characterize this month, must predispose the body to dig* ease, and render it of course more susceptible to morbific in- fluences of every kind, and therefore more vulnerable t- the poison of yellow fever, as well as to all other causes of dis- ease ? The tables of which we have availed ourselves in the foregoing observations, are kept by Dr. R. Pennell, and by him published it) the New-York Medical and Physical Journal, edited by Drs. Francis antl Beck. As they are dravvti up with uncommon care and accuracy, and are intimately connected with the subject under considera- tion,! have thought it not irrelevant to insert the months al- luded to entire, together with those of May and November. Account ©/ the Yellow Fever, 263 METEOROLOGICAL OBSERVATIONS FOR MAY, 1822. Made at the New-York Hospital, by Richaud Pennell, M. D. ~j] Thermo- f Baromster. --■ 1 Winds. Rain. Weather. — 7 2 9 11 7 .2 : II 7 i t- Gaun;e. 4 M P M r M \ M 32 P M 84 P M 70 \ M -W P M SW P M SW 1 30 10 30 08 30 06 variable 2 30 06 30 06 30 2u 61 88 75 se sw sw cloudy 3 iO 25 30 25 30 25 63 75 .6 ne ne ne variable 4 30 25 30 25 30 03 58 no 52 ne ne ne —.74 cloudy 6 ^9 70 29 70 29 78 60 55 47 ne nw nw do. 6 >9 88 29 96 29 96 46 72 54 w w w clear 7 30 0(j 30 00 30 00 34 74 ti4 w nw 11 v\ variable 8 29 96 30 00 30 li'. 60 76 62 nw nw nw cloudy 9 30 20 30 26 30 26 56 71 58 nw IlW inv do. 10 30 35 30 27 30 27 54 70 58 ne sw w clear 11 30 27 30 27 30 34 56 75 S:; w sw sw do 12 30 45 30 47 30 47 o5 74 57 sw sw SW do 13 30 47 30 4i 30 44 58 75 6-;' sw sw sw do 14 30 40 30 .■'.8 30 3 J 61 78 61 sw s s do 15 30 16 30 10 30 2. 60 7u 68 s s n — .1 cloudy 16 M) 24 30 24 30 28 6'^|7.' 64 n sw sw —.(•5 do 17 .^0 35 30 o5 30 35 j8|6i, 6G sw s s do 18 -.0 30 30 26 3 « 22 n2 7b !'8 s sw nw —.28 do 19 30 20 30 2- 30 2.; 4 80 ^.^ s s sw variable 20 30 30 30 30 iO oO 63 'to 8 s s cloudy 21 30 30 30 24 30 1. b4 7(. •w s s s — 05 do 22 30 06 29 9h 29 9( Oh 85 75 s w w —.20 do 23 30 00 3o 01 30 08 70 8(. ?*w sw sw do 24 30 22 30 2» 30 3b ■.4 '5 ■( ne nw nw variable 25 30 6iJ 30 6C 30 60 30|6. 6u sw sw sw clear 26 30 6e 30 5; 30 4b 8|Tf "f. se se sw —.10 cloudy 27 30 34 30 34 30 26 -6!6f 6i sw sw sw —.05 do 28 30 U 30 li 30 1"^ 64|8r 7. sw sw sw clear 29 30 OC 30 IS 30 2( li J8C li sw se se variable 3(> 30 2f )30 2^ 30 2 h } 7! } 7( se se ne —.07 cloudy 31 30 28 '30 28 30 2C h m 7C Me s 11—02 1 do The quantity of rain which fell in May, is 1 inch and 74-lOOths. On the Bth, a few drops of rain from a passing' cloud. 16, at 7 p. m. lightning, with very loud thunder, and a small quantity of rain ; 1 8th, mode- rate showers; at 7 p.m. thunder. On the 22dv 10 p. m. a gust of wind from the S. W. thunder, 4^0. The sun was obscured on the 4tb, 18th, and 39th. Fog on the moruing's of the 7th, 14th, aad 15th. 264 Account of the Yellow Fever. METEOROLOGICAL OBSERVATIONS FOR JUNE, 1822. Made at the New-York Hospital, by Richard Pennell, M. D, — 1 Thermo ; Barometer. | meter. Winds. Raiii ■^— 7 1 2 9 7 2 « 7 2 9 Weather. - 1 P M PM iM PM PM AM PM PM Gauge. = E 130 20 30 20 30 16 68|84 70 s s s 772 cloudy 2130 lolsO 10 30 io!'^3!90 79 se sw sw 784 do 3'30 10|30 10 30 10^7 88 74 nw sw sw 720 clear 4:30 I0L3O 10 30 18 70191 65 sw sw ne —.24 760 cloudy- 5|30 29 30 3230 30 61 174 64 ne se se 648 do 630 32 30 30 30 30 64 73|64 ne ne ne 64:^ do 730 27 30 18 30 08 65 74 68 sw sw sw 643 variable 8J29 90 29 90 30 04 7r85?4 sw sw sw 620} cloudy 9,30 04 30 04 30 04;70 89 75 nw sw sw 595 clear 10'30 06 30 06 30 06j70 93 75 w w w 57'i do 11 '30 00 30 00:30 00;73 88 72| w sw sw —.15 600 variable 12'29 97 29 97 30 10'73 93 731 n n n 584 clear 13 30 25 30 30 30 34 65 80 70i n s s 580 do 1430 48 30 48 30 50 65^7 60j se se se 575 cloudy 15 30 50 30 .50 30 25 65 85h5 se sw sw 584 do 16 30 02 30 00 30 00 7089}72 sw sw nw 572 clear 17 30 00 30 00 30 00 70j88|72inw nw nw 573 cloudy 18 30 00 30 00 30 00 64:;2j64 nw nw sw 573 do 1930 12 30 12 30 12 62^80164 sw sw sw 586 clear 20 30 18 29 94 29 94 64'65|64 sw se se 1. 01 608 cloudy 21 29 94129 90 29 90 6480!70 s s s 616 do 2229 90 30 00 30 08 70|85|72 nw w w 600 clear 23 30 18 30 18 30 18 70 84 71 w sw sw 594 do 24 30 18 30 18 30 18 72:85 75 sw sw sw — 22 634 cloudy 25 30 18 30 18 30 18 70;74 67 ne sw sw — 19 660 do 2630 18 30 10 30 iO 688168 e e e —.04 704 do 2730 18 30 20 30 20 6684I72 ne ne sw 690 variable 28 30 20 30 20 30 20 64 88|:5 sw sw sw 626 clear 29^30 20 30 20 30 20 7292 78 sw sw sw 628 do 30-30 20 30 20 30 20 7592 I 78 sw sw sw 639 cloudy The quantity of rain which fell this month is 1 inch and 85-lOOtli. At the commencement of this month the atmosphere was very humid, and the moniing-s foggy ; there was but little thunder and rain. On the 2d and 21st, there fell a small quantity of rain from Nimbus, pairing' over. The sun was obscured on the 20th and 25th, and the greatest part of the 1st and 8th ; the sky generally was clear at night : those days on which there was but little wind t'le heat was very oppressive, espe- cially on tlie 10th and llthl Vespertine lightning on the 2d, 16lh and 30th". * This is avory ne-it instriiineiif, invented by Capt. K.iter, iji which the spare between cstrernc moisi'ire and extreme dryness is divided into 1:J()0 eqi::il iJaiis. Account of the Yellow Fever. 265 METEOROLOGICAL OBSERVATIONS FOR JULY, 1822. Made at the New- York Hospital, by Richard Pennell, M. D. Thermo- Barometer. meter. Winds. Rain 7 2 9 7, 2 9 7 2 9 Weather. A M P M PAI AM PM PM A M P M P M Gauge ££ 1 30 18 30 18 30 18 78 94 16 sw sw s —.16 65:^ cloudy 2 30 18 30 12 30 10 75 87 71 s sw sw 1. 63 683 do 3 30 08 30 00 30 00 76 87 76 sw sw s 700 do 4 30 00 30 08 30 18|76 93 75 s s s 686 do 5 30 20 30 24 30 2075 88 76 s s s 694 do 6 30 20 30 20 30 20 77 87 75 s s s 1. 84 720 do 7 30 20 30 10 30 10 78 92 75 n s s —.18 736 do 8 30 04 29 94 29 90 75 92 74 sw sw sw 748 do 9 29 90 30 04 30 18 -6 85 76 nw nw nw 660 clear 10 30 33 30 33 30 30 73 91 80 nw sw sw 6S3 do 11 30 30 30 22 30 16 77 85 76 sw sw sw 650 variable 12 30 08 30 08 30 08 75 86 74 sw sw nw —.34 710 cloudy 13 30 10 30 10 30 00 76 84 72 nw nw nw —.67 726 do 14 30 00 30 00 30 00 7288 78 sw sw sw 732 variable 15 29 96 29 98 30 06 78,87 72 sw w w —.11 730 cloudy 16 30 10 30 18 30 24 72;88 76 w nw nw 700 variable 17 30 30 30 30 30 30 7087 77 nw nw sw 660 clear 18 30 30 30 30 30 30 75J92 79 sw sw n —.06 663; variable 19 30 30 30 26 30 20 76 92 78 n s s 665! do 20 30 18 30 10 30 10179 96 78 sw sw sw —.04 656; cloudy 21 30 18 30 18 30 18 79 90 78 sw sw sw 645 clear 22 30 10 30 06 30 00 76 86 78 w w sw 645 do 23 30 00 30 00 30 00 76 90 76 sw sw sw —.28 675 do 24 30 00 30 00 30 00 78 88 71 sw n n 655 cloudy 25 29 94 29 98 30 00 72 82 76 w w w 665 do 26 30 08 30 20 30 26 68 80 70 w nw nw 630 clear 27 30 20 30 28 30 28 65 81 73 nw nw nw —.32 645 clear 28 30 20 30 12 30 12 7088 75 s s nw —.03 670 cloudy 29 30 10 30 26 30 26 73|8373 nw n n 650 clear 30 30 40 30 40 30 40 70 85 74 n e e 634 do 31 30 47 30 47 30 40 71 87 70 e e|e 650 do The quantity of rain which fell this month, is 5 inches 66-lOOths. This month was remarkable for its unusual humidity, and its numerous and heavy falls of i-ain. We were visited by thunder, lightning, and rain on the 1st, 2d, 6th, 7th, 18th, 20th, 24th, and 28th. Vespertine, lightuing on the 3d,' 7th, and 28th. The sun was totally obscured on the ^th. The vain on the 27th fell in the ni2;ht. 34 266 Account of the Yellow Fever. METEOROLOGICAL OBSERVATIONS FOR AUGUST, 1822. Made at the New-York Hospital, by Richard Pennell, M. D. Thermo- Barometer. meter. Winds. Rain ii 7 2 1 9 7 2 9 7 2 9 Weather. AM i P M P M AM PMPM AM PM PM Gauge. si 1 30 40 30 40 30 38 70 84 72 e e sw 656 clear 2 33 30 30 22130 20 71 87 73 sw sw sw —.27 670 cloudy 3 30 16 30 16130 10 75 89 76 sw s s 705 do 4 30 03 30 00 29 80 76 94 74 s • s nw —.42 Gi^S do 6129 90j30 06 30 10 74 80 70 nw nw nw 665 clear 6 30 10130 22130 28 64 78 67 ne ne ne 647 do 7 30 38130 40I3O 40 67 75 68 e se se 643 do 8 30 47 30 47|30 47 64 82 72 se ne ne 638 do 9 30 47 30 4030 40 72 86 70 sw s 3 645 do 10 30 40 30 4030 34 72 88 72 s s 650 da 11 30 30 30 3030 30 72 92 74 sw sw sw 645 do 12 30 30 30 2830 23 74 90 79 sw sw sw 648 do 13 30 23 30 2030 20 75 89 79 sw sw sw 652 do 14 30 32 30 32 30 22 70 85 70 nw nw nw 670 cloudy 15 30 10 30 00 30 00 74 92 75 s s 3 —.02 662 do 16 30 17 30 17 30 17 70 90 76 nw sw sw b50 clear 17 30 17 30 17 30 17] 74 91 78 sw sw sw 664 do 18 30 20i30 20 30 20 70 86 74 ne ne ne 680 cloudy 19!30 15'30 15 30 00 72 85 75 se s s —.17 700 do 20 30 OOI3O 00 30 00 77 94 76 s s s 660 do 21 30 OOlSO 00 30 0075 88 75 nw nw nw 660 do 22!30 08 30 10 30 18 73 86 74 e e e —.17 660 variable 23 30 2530 25 30 2£ 66 80 71 e ne ne 672 cloudy 24130 25 30 25 30 2- 69 80 ,75 se se s —.03 670 do 25I30 36 30 36 30 36|66 86 174 s ne se 660 clear 26l30 36 30 36 30 30,70 84 70 se se se 660 do 27i30 30 30 30 30 2068 78 |68 ne ne ne 656 do 28130 16 30 16 30 16|67 80 70 ne ne ne 660 cloudy 2930 20 30 20 30 20 72 88 73 ne ne ne 660 clear 30130 40 30 40 30 4064 81 69 ne ne ne 656 cloudy 31 130 40 30 40I3O 40165 82 70 ne ne ne '666 do The quantity of rain which fell this montli is 1 inch and 8-lOOths. This month attracts our notice for the number of devastating tornadoes that happened in different parts of the United States ; its arid atmosphere, clear starry nights, and moderate rains. 4th. Clear morning, wind S.; at 3 P. M. wind changed to N. W. ; it soon began to blow tremendously ; the dust ascended in large quantities, so as to obscure some parts of tlie city ; it laid prostrate a number of trees, and did considerable damage ; it was accompanied with loud thunder, lightning and rain, which lasted until half past 4 P. M. We had likewise tlmnder, &c. on the lotli and 22d. A beautiful double rainbow was seen in the south on the 15th, at 7 P.M. Vespertine lightning on the 4th, 15tii, 19th, and 20tii. On the HJghts of tlie 9tb and 10th I observed a number of shooting meteors. Account of theYellow Fever* 267 METEOROLOGICAL OBSERVATIONS FOR SEPTEMBER, 1822. Made at the New- York Hospital, by Richard Pe NNELL, M. D. Barometer. Thermo- meter. Winds. Rain Gauge 2 7 2 9 7(2. 1 ^ ^ 2 9 Weather. A M P M P M am;pm IPM A M P M P M ^ 1 soTs? 30~30 30 22 70 85 74 se se se ^08" 685 variable, 2 30 10 30 04 30 00 76 81 70 s s nw —.90 724 cloudy variable 3 29 90 30 00 30 00 69 87 74 sw sw sw 704 4 30 08 30 20 30 20 66 82 67 sw sw sw 684 clear 6 30 26 30 26 30 26 62 81 69 sw sw sw 656 do 6 30 26 30 26 30 26 65 82 71 ne sw sw 645 do 7 30 26 30 26 30 15 68 88 76 sw sw sw 636 do 8 30 15 30 15 30 15 70 88 75 uw sw s 638 cloudy do 9 30 10 30 10 30 22 72 85 76 sw s s 672 10 30 20 30 20 30 20 70 90 76 s s sw —.01 690 clear 11 30 14 30 14 30 14 75 94 78 sw sw sw 687 cloudy clear 12 30 27 30 27 30 27 76 91 77 sw sw sw 660 13 30 27 30 27 30 27 78 94 79 sw sw nw 684 clear 14 30 27 30 20 30 20 72 84 72 sw se sw —.31 695 cloudy clear 15 30 14 30 14 30 00 74 90 74 sw sw nw 670 16 29 90 29 90 30 10 72 82 69 sw nw nw 638 do 17 30 30 30 44 30 56 60 68 60 nw nw sw 622 do 18 30 64 30 60 30 52 54 71 62 nw SVT sw 619 do 19 30 38 30 38 30 30 64 79 68 s w sw nw —.38 660 cloudy do 20 30 00 30 00 30 00 69 75 69 se nw nw 1.62 680 21 29 90 30 00 30 12 65 72 62 sw sw nw 650 clear 22 30 36 30 36 30 40 58 70 62 nw nw nw 645 do 23 30 57 30 57 30 57 55 70 60 nw nw nw 642 do 24 30 50 30 50 30 50 58 73 62 nne ne sw 648 do 25 30 44 30 44 30 44 59 74 68 cal. sw sw 650 do 26 30 44 30 30 30 30 64 75 73 sw sw sw —.07 718 cloudy 27 30 30 30 16 30 16 70 77 74 sw s s 800 do 28 30 16 30 16 30 00 73 83 75 s se se —.03 832 do 29 30 00 30 00 30 00 73 78 72 s se se 834 do 30 30 00 30 00 30 12 68 77 70 nw nw nw 750 clear The quantity of rain in this month, amounted to 3 inches and 40— )00ths. The thermometrical range for September was considerably higher than for the same month in the precedingyear ; it was unusually moist, especially towards the latter part. Very thick fogs and light winds, on the mornings of the 3d, 9th, 24th, and 26th. The autumnal equinox made its appearance at 10 P. M. on the 19th. and continued until the evening of the 20th. The sun was obscured the greatest part of the 14th, and completely so on the 20th, 26th, and 27tb, The thermometer, placed in the sun, on the 6th, at 2 P. M. stood at 106°. Thunder, lightning, and rain, on the 2d and 14th. Vespertine li^htaiog en the lUh and J 3tb. The rain on the 1st, letb, and 19th, fell in the Bight. 268 Account of the Yellow Fever. METEOROLOGICAL OBSERVATIONS FOR OCTOBER, 1822. Made at the New-York Hospital, by Richard Pennell, M. D. Barometer. ^ lermo- Tieter. Winds. Rain T'' 1 Weather. 7 2 9 7 "2~ 9 ? 2 9 Gauge. s A M F H P M AW PM PM AM PM PM X ~1 50 27 JO 27 30"27 5fc I^56| DW nw nw :iO clear 2 30 80 ^0 30 30 46 5C 58 34 nw ne ne 696 cloudy 3 JO 47 30 -iO iO 36 51 62 )5 ne ne ne 690 variable 4 30 30 JO 30 30 3>5. "^ •,- ne ne ne 687 clear 5 30 30 30 3(» $0 30 5f . :'3 -ss ne ne ne 693 do 6 30 30 3) 30 30 30 51 ) 16 61 ne se se 710 do 7 30 2S 30 19 JO !0 6 )18 68 se se se 724 cloudy 8 3o 08 30 08 30 08 6 3 80 651 nw nw nw —.07 730 clear 9 30 20 30 2n 30 18 6 3 73 63 nw 529 6C 29 8C 29 87^ 5 54 45 w w w 650 do 3( )29 9£ \>9 9( 30 03 H 1 5: 48 w w w 650 clear 3 JsoO^ 30 00(30 OO]. 2 6S 56 sw sw sw 650 do Tbe quantity of rain which fell this month, is 2 inches and 32— lOOths. The weather of the month of October, was, for the most part, pleasant and dry. The nights were generally clear and starry On the mornings of the 4th and 18f h, there were heavy dews, with light winds. . The sun was obscured on the 2d, Uth, Uth, 27ih, and 2l;(ti On the 22d there was ice at the villaRes of Bloominedale and Hobokfn, a few miles from tliis city, but the ther- Mometer, it will be seen, stood at 37° on the same morning, in • S. r. ispeaure, at 7 o'clock. I'he rain, oo the 8tb, fell 9 short time b«for« tuarise. Accadnt of the Yellow Fever. 269 METEOROLOGICAL OBSERVATIONS FOR NOVEMBER, 1822. Made at the New-York Hospital, by Richard Fennell, M. D. Barometer. Thermo- metei. Winds. Rain Gauge. 5 s 5 So 7 2 9 7 2 y 7 2 9 Weather. A M P M P M 4M PM PM AM PM PM >> a: 1 zr9o 29~94. J0"05 4-. 57 44 nw nw W 644 clotidy 2 30 05 30 05. 30 00 38 54 46 w w W 638 variable 3 30 00 30 18. 30 34 -14 61 45 w w n 635 clear 4 30 44 30 44 30 34 36 GO 43 n n n 630 do 5 30 44 30 44. 30 38 35 ^H 48 n n n 632 do 6 ;J0 30 30 28 30 28 44 59 51 nw nw nw 645 cloudy 7 30 28 30 22 30 16 49 59 56 nw sw sw —.66 682 do 8 30 04 30 18 30 34 56 75 60 sw sw sw —.13 695 do 'J 3o 48 30 50 30 56 44 51 45 ne ne ne 687 do io :!0 67 30 67 30 64 40 50 49 ne ne ne 6';o do 11 30 50 30 46 30 32 48 61 56 ne ne ne 710 do 12 30 30 30 30 30 30 51 60 58 se se se 758 do 13 30 30 30 18 30 08 56 49 48 ne ne ne 2.80 758 do 14 30 00 29 82 29 98 48 51 42 ne nw nw —.57 763 do 15 30 2-1 30 36 30 42 37 58 46 nw nw sw 746 clear 16 30 48 30 48 30 48 42 61 50 sw sw sw 734 do 17 30 48 30 48 80 4() 41 64 42 sw sw sw 728 do 18 30 36 30 36 30 29 45 51 47 ne ne ne —.78 742 cloudy 19 30 2- 30 29 30 34 45 54 47 nw nw nw 741 variable 20 30 34 30 30 30 26 44 58 50 nw nw nw 741 cloudy 21 30 20 30 20 30 14 50 61 55 sw sw sw 741 do 22 30 00 29 84 29 70 46 47 44 n ne ne 1.94 746 do 23 29 60 29 98 30 08 44 57 4-1 w w w 735 do 24 30 20 30 38 30 56 40 46 40 nw nw nw 716 variable 25 30 56 30 30 30 26 35 59 44 nw sw sw 727 do 26 30 26 30 26 30 26 36 44 39 nw nw nw —.20 710 do 27 30 26 30 26 30 26 34 45 40 nw w w 705 clear 28 30 16 29 90 29 98 40 53 50 s s s —.36 736 cloudy 29 30 00 30 00 29 95 47 58 45 w w w —.10 765 do 3G 29 90 29 84 29 84 56 69 61 s a s —.31 774 do The quantity of rain which fell this month was unusually great, being 7 inches and 85— lOnths. The 8th was very sultry, with vespertine lightning, and rain, at 9 P. M The grass and house-tops were white with hoar frost on the mornings of the 4lh, 5th, and 17th. ©n the 18th, moderate rain all day, with lightning in the S. W at 7 P AI. The sun was par- tially obscured on the 29th and 30th, and totally on the 7th, lOth, Ilth, 13th, Uth, I8th, 21st, and 22d. On the 26th the sun was overclouded a short lime after it had risen; raiu soon commenced, intermingled with large Hai;es of snow, which instantly melted when they came in-contact with the earth: it continued until U A, M. when a clear afternoon and a starry night succeeded. CHAPTER XI. DISEASES. As the weather durhig the present year has not bee* characterized by any extraordinary vicissitudes of tempera- ture, or humidity, different from what has been observed in previous years, so neither have the diseases indigenous to this climate been distinguished by any unusual phenome- na. The general, as well as local affections, incidental to the different seasons, have each reigned in their turn pre- cisely after the manner of preceding years when no yellow fever existed, and without becoming at any time epidemic, or assuming other than tlie ordinary type and symptoms which always accompany them.* The inclement seasons of winter and spring have, as usual, brought with them de- * " During the tyranny of this fever," says Dr. Warren of Barbadoes, speaking of the malignant fever, whicb occurred there between 1733, and 1738, "common sporadic distempers appeared now and then as usual, such as anginas, peripneumcuias, asthmas, pleurisies, rheu- matisms, colds, coughs, diarrhoeas, dysenteries, &c, which, however, were not so general as to deserve the name of epidemics, nor did they seem to have any relation to the predominant constitution of the year." p. 69. Account of the Yellow Fever. 271 fluxions upon the chest in the form of consumptions, catarrhs, croup, pleurisies, &c. which may be considered the predomi- nant, and most fatal diseases of the climate. So great is the determination upon the chest, produced by the severe, unsteady cold of winter, and the chilly, rainy months of our long spring, that its effects are seen in the diseases of all the succeeding months of the year. Thus contradictory as it may seem, consumptions continue to preponderate even during the summer and autumnal months ; and it is not unusual to find the diseases of other ogans, as well as all the different forms of febrile complaints, which are natives of this latitude, at times more or less complicated with pulmonic symptoms. The summer is acknowledged to be our most healthy season ; the very season, however, in which yellow fevcF usually makes its appearance, as if to fill up a space in the catalogue of diseases which would otherwise be incomplete. This of itself shows that there can be no morbid condition of the atmosphere, naturally existing at that period of the year, and is, therefore a strong, presumptive argument in favour of the foreign origin of this disease ! — The only dis- ease which may be said to prevail during summer, is the cholera infantum. (Febris Remittens Infantilis of modern au- thors,) which carries off great numbers of children under the ages of fu'o and three years : towards the close of summer, and during the first two months of autumn, defluxions upon the bowels in the form of dysenteries, diarrhoeas, &;c. become the reigning diseases, but rarely or never epidemical ; after which there is a truce of one month, during November, which is usually considered a very healthy month. The re- vulsion upon the bowels now changes again to that upon the 272 Account of the Yellow Fever. chest, and the diseases succeeded each other in the same routine as before. The contagion of measles, seems to be more readily propagated during the spring, and that of whooping cough during summer. COMPARATIVE VIEW OF DEATHS Prom prevailing diseases, for June, July, August, September, and October, 1820, 1821, and 1822. 1820. 1321. 1822. 79 63 23 fr. fever, 12 13 11 bilious fever, 13 12 13 bilious remittent. none none none hectic fever, 5 3 1 inflammatory fever, none 4 6 intermittent fever, 4 3 3 puerperal fever, 15 21 17 remiilent fever. 3 1 1 scarlet fever. 85 57 51 typhus fever. none 3 none malignant fever. 17 6 6 apoplexy, 2 none none catarrh, 30 11 16 cholera morbus, 269 284. 233 consumption 106 81 71 convulsions, 31 35 45 diarrhoea, 51 54 32 dropsy, 10 10 15 dropsy in the chest, 72 74 48 dropsy in the head, 216 122 83 dysentery. 167 no 111 infantile flux, Account of the Yelloio Fever. 27 o 1820 1821 1822 6 6 2 fr. , haemorrhage, 1 2 6 haemoptysis, 37 46 34 hives. 1 1 none inflammation of the bladder, 38 25 34 inflammation of the bowels, 11 15 9 inflammation of the brain, 37 37 29 inflammation of the chest, 12 17 18 inflammation of the Hver, 4 3 4 inflammation of the stomachy 9 7 5 jaundice, 21 34 13 marasmus, 45 16 none measles, 2 none none menorrhagia, 14 6 6 peripneuraony, 5 2 1 pleurisy, 2 1 2 pneumonia typhodes, 2 7 6 quinsy, 1 1 1 schirrus of the liver, 1 5 11 sore throat, 14 15 11 sprue, 54 44 43 tabes mesenterica, 1 none none vomiting of blood, 14 53 10 whooping cough, 12 6 10 worms, These include all the diseases, with the exception of cases of old age, still-born children, and a few casualties and sur- gical cases. It is remarkable to see how the numbers, with few exceptions, correspond for each year, showing most conclusively, that there was this year, no more than in pre- vious years any epidemic constitution of the atmosphere, neither before, during, nor after the prevalence of the yellow 35 274 Account of the Yellow Fever, fever. The deaths, from difierent diseases, were not parti- cularly affected this year by the removal of ihe inhabitants, for they merely changed their residence f;om one pan of the city to another, and not a great many more went into the country than usually go durirtg the hot weather. I haye not enumerated, in the list of diseases, for 1S22, those from yellow fever. Several deaths, reported under the naoie of different local and general disorders have been ascertained to have been cases of yellow fever, which must be therefore deducted from the amount of tho'e diseases as set down in the tab*e. The City Inspector, Dr. Cuming, has politely favoured me with the list of these cases, which, as it leads to some curi- ous inferences touching the patiiological and nosological views entertained concerning this disease, deserves to be inserted here as a precious morceau of medical his- tory :— 3 deaths from yellow fever were reported under the name of fever, 3 - - bilious fever, 2 - - remittent fever, 1 - - inflammatory fever, 1 - - liver complaiut, 1 - - inflammation of the brain, 1 - - inflammatiot) of the stomach, 1 - - inflammatory bilious fever, 1 - - insanity. Tt. 14 We look in vain, in the general list of diseases, for those local and general affections with which yellow fever, if we are to believe the romantic doctrines of some writers, is Account of the Yellow Fever. 275 said to inosculate so freely, some of which are averred before tlie appearance of 'his disease to have become epidemi- cal, and to be, as it were, the forerunners, or avant-couriers, of this fatal malady. No unusual affections of this kind were observed to prevail either before, at, or after the time at which this foreign disease was brought into the city ; no pe- culiar gaslritic, enteritic, hepatic, or cerebral disorders; no bilious fevers or influenzas, no quinsies, sore throats, scarla- tinas, haemorrhages, or carbuncles. It was with a view particularly of upholdi»ig the hypothesis of domestic origin that yellow fever has been so often engrafted upon the indi- genous disorders of this latitude. For if it could be proved that there was a strong analogy and close affiliation be- tween any of the reigning aud ordinary diseases of the sea- sons, and yellow fever, very kw would doubt that all were alike natural to the soil. Hence, those who have pushed this doctrine to its farthest extent have always been scrupu- lously tenacious of this poijit, and particularly careful to place it in the foreground of the argument. The total amount of deaths from April to December of ]82'2, also sho.vs, when compared with the deaths in the corresponding montlis of 1821 and 1820, that the present year has been throughout an uncominonly healthy year, which is corroborated also by the univer-al health which, with the exception of the yellow fever of Pensacola and New-Orleans, existed in every part of the Union, as well as by the fact ttiat the products of the earth have never been of superior quality nor more abundant in quantity. The crops of urass in some parts of the state were injured by the drought in June. 76 Acxount of the Yellow Fever. Total of deaths for six months. 1820. 1821. Total, 2076 19aO 1822. May, 214 257 237 June, 204 223 235 July, - 374 331 318 August, - 503 456 370 September, 439 360 328 October, 342 • • 323 306 1794* * Exclusive of Yellow Fever, and without taking into view the ia- crease of population. CHAPTER XIL CONCLUSION. The facts and arguments adddced in the foregoing pa2;es go to prove the truth of the following propositi -is. which may be taken in some sort as an analysis or summ.iry of the work. 1. Yellow fever is a contagions disease, propagated in no other way than by means of a peculiar poison generate! in the hum^.n body, and transmift d from one individual to an- other, either by direct nd immediate contact, or through the medium of the air or fouiites.* Because we have di- * We will here take occasion to remark, that many have been led to doubt the contag-ious nature of j ellow fever, because they do not clearly understand the distinction between direct and indirect conta- gion. Direct contagion takes place where the disease is communicated from the sick person to the relations, physician, nurses, or other at- tendants, either through the medium of the air in the chamber of the pa- tient, or by personal contact. Indirect contagion is where a person takes the disease either from fomites, or from the open atmosphere, which has become tainted or infected, in other words, charged with the contagious matter of the disease in the immediate vicinity of houses, neighbourhoods, or streets where numbers of persons have previously fallen sick of the disease. But it is as much cont-agion in the one case as in the other, whether it be taken directly and fresh from the breath 27 S Account of the Yellow Fever. rect and absolute proof of its contagiousness : because, moreover, no other theory than that of the contagious nature of the disease can rationally and satisfactorily account for its origin, progress, and propagation ; and that all the at- tempts that have been undertaken to explain its phenomena on other principles, have led to endless absurdities and con- tradictions. 2. Yellow fever is not a native disease of this latitude, but a specific, idiopathic, and peculiar disease of foreign origin; because it occurs here but very seldom ; because it is always ci>iifined exclusively to our sea-ports, and bears no analogy whatever to those of our dis' ases, which all acknowledge to be indigenous; because, moreover, (he inhabitants born in this latitude, are frequently the subjects of it, which is con- trary to what has been observed in the tropics where yellow fever is known to be indigenous ; and lastly, because when the disease has appeared in this city, it has always been di- rectly traced to some vessel or vessels coming from Havan- na or other ports where yellow fever was prevailing be- fore such vessel or vessels sailed. 3, Yellow fever cannot be produced by what is termed an epidemic, or previous pestilential and morbid constitution of the atmosphere. Because if such constitution of the air existed, it would be di 'used over all the city, whereby those living in such atmosphere, and prepared to take the disease, would fall sick at or nearly about the same time in streets and other exhalations of the patient, or from the same unaltered poison as it is found, mingled with the air or entangled in fomites. It is in both cases the very same material, derived from the very same source, to wit, the human body, and the disease produced by either is precisely, and in all respects, the same disease. Account of the Yellow Fever. ' 279 remote from each other ; whereas in yellow fever, the cases occur in regular succession, spreading like all other conta- gious fevers, from those individuals who are first attacked, to (hose who have connection with them, or with the houses in which they sickened, and thus gradually multiplying it- self from house to house and from street to street, in an in- creased ratio in every direction, wherever there are subjects for it to act upon ; so that there is often a space of four months between the first and last cases, or between the pe- riod at which it was introduced to that at which it has reach- ed any considerable distance from the point where it set out. Because, moreover, neither the weather nor diseases before, during, or after the prevalence of yellow fever, have differed in any respect whatever from the weather and diseases, which prevailed in the corresponding months in other years, when no yellow fever existed. But on the contrary, with the exception of yellow fiiver, the season has, in some years, been less sickly and more mild and serene when yellow fever has prevailed, than in other years when it did not prevail. 4. The origin of yellow fever in this or any other lati- tude, cannot be ascribed to animal and vegetable putr-fac- tion, whelhir in the form of marsh miasmata, exhalations from m;jnufactories, ware-houses, or grave-yards, or from sinks, sewers, gistpools, gutters, decayed wharves, or new- made grounds; nor to decomposition of any kind whatever; as is abundantly proved, not only by the pointed experience of the present year, which is totally adverse to this theorj' ; but also, as we ha^seen, by the overwhelming testimony of the highest medical authorities, among whom may be enu- merated, Warren, (of Barbadoes,) Chisholm, Stewart, (of Grenada,) Blane, Hosack, Pjm, Fellowes, Gilpin, Bally, Pariset, Arejula, and the physicians of Cadiz in their late Report to the Spanish government, &;c. 280 Account of the YeUoio Fever. 5, Yellow fever cannot have beengenorated in the filthy holds and decayed cargoes of shipping 1\ ing at .)ur wharves, otherwise the disease when it has appeared, would have been sometimes traced not only to West-India vessels, but also to those conjing from northern latitudes, as from the Baltic, from the German ocean, from England, Ireland, &£c. and particularly to those vessels which so frequently arrive frtn Germany and Ireland, crowded with emigrants, where, from the great number of persons, (araoiinUng sometimes to four or five hundred in one vessel,) who are confined to- gether in a small space, great quantities of filth must neces- sarily collect, and the air become extremely foul and un- healthy. But although typhus fever has frequently broke out on board these vessels during their voyage, and continu- ed to prevail up to their arrival in j)Ort, Yelloiv fever has never, in any instance, been traced to such sources.* * This is confirmed by the " Statement of Facts" concerning the fe- ver of Banker-street in 1820, by Drs. Hosack, P. S. Townsend, and J. Bayley, Commisswners of Health. " A hig-h grade of typhus, attend- ed with bilious symptoms, has oftentimes occurred in this as well as other countries, at the same season of the year at which t'nis disease prevailed ; and a very remarkable instance of it took place in the year 1801, when many vessels, unusually crowded with passengers, arrived at this port from Ireland during tlie summer and autumn. Out of at least seven hundred and fifty patients who were admitted into the Marine Hospital, almost all of whom were sick of this disease, nearly three hundred died, besides a great number who pe«5hed on their passage. The disease, which was simply typhus, on boara the ships wliich first arrived, became, as the vessels progressively arrived later and later in the season, (from the same ports, chiefly from Belfast,) combined with bilioussymptoins,wLich acquired more and more intensity as the sea- son advanced."— p. 9. Account of the Yellow Fever. 281 fl. Yellow Fever is m re readily introduced and propagat- ed in cities of tempi rate latitudes, when thf air remains steadi- ly within a certain range of temperature, somewhere about 80"^ of Fahrenheit's thermometer. 7. That y How fever may have the power of becoming epidemic, from those whom it first attacks, the conti'gious matter must be accumulated to a certain amount, and cir- cumscribed to a confined and crowded neighbourhood, the atmosphere of which is more or less charged with human effluvia. 8. Human effluvia are the most powerful conductft's of the contagion of yellow fever.* * The following' facts, in addition to those in the body of this work, strikingly illustrate this law : " It was rcmaked as a curious fact," says Sir James Fellowes, in his account of the yellow fever of Gibraltar in 1 804, " that the Jews who were very numerous in Gibraltar, and who it was thought would have been more predisposed to disease, from their habits and mode of life, were not generally attacked by the prevailing disorder, until aftoi the 18th of September, the day of atonement, on wliich the Hebrew nation meet together in the synagogues. " On the 19th, four Jews were reported to have died, but it was not ascertained how long they had been ill. The Feast of the Tabernacles took place on the 13th or 16th of September ; andit is customary at this time for the friends and acquaintance to meet at each otlier's houses and to enter the synagogue. Previous to this, the Jews had cautiously kept to their own families at home, and not one of them was said to have been ill of the prevailing disorder, until after the feast alluded to, when there was rejoicing, and permission given for the admission of strangers amongst them. " This assemblage of tlie Jews, and the communication which fol- lowed evidently facilitated the propagation of the malady, and after- wards occasioned such a mortality, that between seven and eiglit hun- 36 282 Account of the Yellow Fever. 9. The radius of communication is increased in a direct ratio to the quantity of the contagious matter emitted from the sick within given limits. 10. Though the disease (as during the present year,) may be sometimes rapidly propagated solely by the force and in- tensity of its specific contagion,* without being sensibly mo- dified in its direction or fatality, either by the width, eleva- tion, narrowness, declivities, windings, cleanliness or filth of Streets, or by the ordinary humidity or movements of the atmosphere, yet as a general rule, it is usually most mortal and'moSt -readily propagated in confined, low, narrow and sheltered streets, where the population is most dense, be- cause in such places the air is stagnant, and the morbid as well as healthy effluvia emitted from the body are more concentrated, and therefore more virulent.f dred fell victims to its fury." — Fellowes on the Pestilential Disorder of Andalusia, p. 108-9. It has also been generally observed in Spain, that in those towns where yellow fever prevailed, and where the people did not refrain from attending^ mass, and going- in processions, that greater numbers always fell sick a fesv days after the performance of those religious ceremonies, — Vide Report of the Physicians of Cadiz to the Spanish Government, 1822. In the late epidemic, the churches of this city, and which are chiefly in the infected district, were all closed soon after the beginning of September, immediately after the time at which we have said a panic fortunately seized the people and depopulated all that part of New York south of Fulton-street. * Proved by such evidence as it is impossible to invalidate in the novel and highly important facts already quoted from the able report of the physicians of Cadiz to tlie Spanish government. — See Chapter I. supra. f That animal and vegetable putrefaction have nothing to do with .Account of the Yellow Fever. 283 11. Violent commotions of the atmosphere, whether in the form of wind, thunder-gusts, or storms, by washing away, diluting, decomposing or dispersing the poison, al- ways check the progress of the disease. 12. A calm, stagnant, and at the same time moist state of the air, when long continued, favours the accu- mulation of contagious matter, and the propagation of the disease.* 13. The sudden depression of the thermometer for several days during summer, or the gradual approach of the cool weather of autumn, has always diminished the number of cases, but rendered the disease more mortal in those who were sick ; while it developed the contagion in those in whom it would, perhaps, have otherwise lain dormant. > 14. The occurrence of black frost destroys the con- tagion, and totally extinguishes the disease. 15. Extreme heat by volatilizing, or decomposing the the generation of this disease, I refer the reader to the facts detailed in this work, and to the overwhelming' evidence produced by that learned and disting-uished ornament of the profession, Dr. Chisholm, and also bj' Dr. Stewart, in Hosack on Contagion, p. 60. note E. * " It has also been remarked of the plague, as well as of yellow fever, that the infection spreads most rapidly when the atmosphere was not only heated and loaded with moisture, but when it was least agitated by wind or thunder-storms. During those calms, when the air may be said to be relatively at rest, it has been uniformly remarked that the contagion of tlie yeUow fever has multiplied itself most extensively, as was always very apparent by the greater number that were seized within fire or six days after such close weather Iiad been observed ; all which circumstances certainly CMispire to piomote the fermentative process that has been contended for." — Hosack on Contagion, j)- 39. 284 Account of the Ydlozv Fever. matt'n* of contagion, and thus rendering it inert, has, also, alwa} s been observed to arrest the progress of the disease.* 16. Though the contagious principle of yellow fever is of a subtile, gaseous rarefiable nature, it hns a stiong affini- ty for porous, spongy or bibulous substance s in the form of v>'hat is terme-'- fomites ; i:i which state t; e virus is found to be highly concentrated and n alignant f * Hence, as was first remarked by Sir Gilbert Blane, the febrile con- tagion of yellow fever, like thut of typhus, rarely becomes epidemic in the t"opics. That of the plague is so volatile, that it has nevei been found either in the East or West Indies. Typhus, which seems to come next to it in this property, is less frequently epidemic in the tropics than yellow fever. Hence too, M. Gerardin has been induced to make two species of 3-ellow fever: 1st. Non-contagious, indigenous, sporadic, tropical yellow fever. 2d. Contagious, imported, epidemic yellow „ fever of temperate latitudes. [Memoires sur la Fidvre Jaune par J\L Gerardin, Paris, 1820- p. 49-63.] •j'E'ence the reason why the contagion is so frequently imported under tliis form. In respect to its affinity for those substances, it resembles the contagious matter of dysentery, which from the attraction it has for solid matters, or from its being, according to Pir Gilbert Ek.ne, more gross and lens volatile, is most usually found associated with the excre- tionc, acd therefore more contagious in hot climates than fevers We may thus explain, also, why the contagion of yellow fever, when intro- duced Dr afterwards generated by the sick, seems to adhere with so "much tenacity, nnd for so great a length of time, to the apartments of those building?in which many cases of the disease have occurred ; and to the scone pavements, wooden and stone stoops, and brick and stone T7all3 of houses, and wooden fences of yards, in streets that have become infected from the great mortality that has occurred in them. Ko strong is this aliin ity between the contagion of yellow fever and solid substances Account of I he Yellozo Fever, 2C5 17. Those who luive passed throiiirli yellow fever once, very rarely take it a seconcJ time, especiaDy if they continue to reside in the » ountry where they first had the disease. that many streets and neighbourhoods have remained infected throug'h all the vicissitudes of the weather, and the occurrence of storms of rain and thunder gusts, until the arrival of frost, though it would have been thougiit that these commotions in the atmosphere would have citlier blown or waslied away the poison. Dr. Bush, in his account of the yellow fever of Philadelphia in 1793, says, that there was a great mor- tality, observed in wooden houses, owing probably, he supposes, to the small size of those houses, their want of cleanliness, and to the miasma- ta becoming more accumulated by adhering to the wood. As ttie buildings in that part of New- York where the disease this year prevailed are almost without exception of brick, there was no means of determining whether the contagion has a stronger affinity for wood or for mineral substances. When the disease occurred in wooden houses there was great mortality ; but their apartments were always smaller ; and from the rent being cheaper always than that of brick houses, they were crowded with tenants, and those generally of the Io%vest description of persons. Perhaps this affinity may be assisted, also, by this animal poison, which the disease throws off, being of a ponderable nature. If that be true, it must always occupy the lower stratum of the atmosphere, and never rise to any considerable height. It is not very probable from the circumstance of its great specific gravity and affinity for solid sub- stances., tli^ it enters into a chemical combination with the atmosphere ; but this union is probably only a state of mixture. If it were in the simplefit slate of chemical combination with the air, that of solution for example, it holds to reason that the disease would become much more rapidly spread through it than we find that it is. The radius of con- tagion, in this case, would soon be extended to an interminable distance ; and tne disease, instead of creeping along slowly, from house to house. 28t> Accovut of the Yellow Fever, ] 8. Gradual and habitual exposure to the contagion of yellow fever, the habit of breathing impure air,* certain periods of life, the feminine sex, African extraction, self possession, &;c. ; all impart to a certain degree an immunity or exemption from an attack of4be disease. 19. On the other hand, the indulgence of the venereal appetite, the sanguine temperament, the constitution of a high northern latitude, particular occupations, and the state of pregnancy in women, strongly predispose the system to be acted upon by the contagion of yellow fever. and from street to street, employing several months to perform its tour throug-h a space of one or two square miles, would most probably infect a space of quadruple dimensions, in one tenth of the time. But the contag'ioii being, according to our supposition, of a ponderable nature, and only in a state of mixture with the atmosphere, remains in or near the place where it was first generated bj' the bodies of the sick. Hence no house or neighbourhood became infected, unless a number of cases of yellow fever had previously occurred there. The march of the dis- ease always preceded that of the infected atmosphere, which was its effect, not its cause. When I use the word creeping, as applicable to this dis- ease, I do it metaphorically, and must not be understood to imply that the cause of the malady is either an insect or an animalcule, possess- ing life and locomotion ; an opinion which many persons, during the late epidemic have maintained, with more ingenuity, however, than success. * See the works of Blane, Hosack, &c. This proposition is striking- ly proved by its inverse ; for several remarkable instances occurred during tlie late epidemic, of persons who came out of the pure air of the country, and from bravado went through one or two infected streets ; but in a few days after paid for their unpardonable folly with the loss of their lives. Account of the Yellow Fever* 287 20. The air does not in general become universally in- fected neither in particular streets nor in particular sections of the city, except in those cities or towns which are built unusually compact, and crowded with population ; but that part of the atmosphere only becomes infected which imme- diately surrounds particular houses or neighbourhoods, where many persons have been taken sick of the disease, and in a direct ratio to the number of cases which had pre- viously occurred, and the circumscribed space they occu- pied. 21. The air continues infected in any given place a lon- ger or shorter time, ceteribus paribus, in proportion to the quantity of contagious matter which has been generated. 22. Yellow fever, like other contagious diseases, possesses a peculiar, determinate and constant type, in its invasion, existence and decline.* 23. The period of reception, \ or that at which the conta- gion is received, is most u-ually between the first and third days of the disease. Because it appears that during this interval the contagion is given off more abundantly than at any other time.J * Vid. the late work on the subject, by Professor Brera, of Padua, 1819. f I have made use of this word to express what has hitherto been al- luded to under a circumlocution. I In this it is the reverse of the contagion of small pox. Sir James Fellowes is of opinion, that the contagion is given off most abundantly in the latter periods of the disease. It is most reasonable to believe, however, that the contagion has less intensity, and is in a much more natural state when it is beginning to act upon the system in the irst stage than afterwards. It is at least certain, from tlie eases detail- 288 Account of the Yellow Fever. 24. The period of devd'pmml, ov that required for the contagion so take effect * aftei being received is for ihe most part from three to six days. 25. The period of duration is most usually from three to seven days t ed in Chap. I. that it is emitted from the body at the very moment al- most when the disease is beginninfr to be developed. It is presumable that in the second and third stages, tlie contagious property of the dis- easehas tmdergone a considerable change, and betomemuch weakened ; for it must be allowed that at that time a considerable modifica- tion has taken place in the phenomena and aspect of the dis- ease. The concluding stages may be considered, with more propriety, as the effect or consequences wrought upon the body by the poison, not its direct and legitimate operation. This subject has lately elicited the notice of Baron Larrey. He says the virus of yellow fever is more fugacious and subtle than that of any other contagious disease. " It lasts but a moment at the highest point of the disease, and then loses the power of transmitting itself." But he does not say at what time of the disease this takes pace. * This period is usually known under the name of the interval be- tween exposure and the formation of the disease, but we have endea- voured to make the language on this subject more precise, and conform- able with what precedes and follows it. t Out of 106 deaths, 8 died on the 3d day 22 - 4th 18 - 5th 31 - 6th 12 - 7th 6 - 8th 5 - 9th 2 - - 10th 1 - nth 1 - - 13th. Account of the Yellow Fever. 2S9 26. The periods of reception, development, and duration, are retarded or accelerated in a direct ratio to the quantity of contagious matter taken into the system. * 27. The period of reception, development and duration do not necessarily observe any precise or determinate rela- tions to each other, but vary in the same individual accor- ding to adventitious circumstances, arising from predisposi- tion, state of the atmosphere, treatment, &ic. 2 J. The fatality of the disease varies from one sixth to two thirds of those who are taken sick of the disease, amounting most usually to one third or one half. 29. The only effectual barrier against the introduction of the ye'low fever is a rigorous system of quarantine, di- rected more especially against West India ports. The re- strictions at present in force being by the frequent occur- rence of yellow fever, proved totally inadequate to accom- plish the purposes for which they were enacted, ought, therefore, to be entirely revised and remodified, or abroga- ted and replaced by such as will fulfil this object. 30 When yellow fever, however, beat any time unfortu- nately ir>troduced, the only means which are placed in our power to prevent lU spreading is, to depopulate as speedily and as thorougly as poss ble, not only the itifected neigh- bourhoods and streets, but ail the adjoining and surround- Two thirds it appears died on the 4th, 5th and 6th days. As many as six-sevenths of the whole number died between the 3d and 7th days. The greatest number, it appears, died on the 6th day, and more than two thirds of the whole number of deaths were previous to this period. If this table may serve as a ^uide, the disease must be stated as having terminated more frequently on the 6th day than on any other day con- sidered separately. Tliere was one case in which death was protracted to the 1 3th day. Arejula saw a similar case 37 290 Account of the Yellow Fever, ing sirpets where the disease has not yet appeared; tore- move the sif k into the pure air of the country, and to inter- dict in the most absolute manner all communication what- ever beiween that part of th?- city which has been de- serted, and those parts which continue h' althy ; because by clearing out the populiit on fo a considerable distance, and in all directions beyond the places that are infected, a natu- ral cordon is thrown around he disease, which completely interrupt? its progres'^, and cuts off the means of ils propa- gating itself to thehnalthy parts of the city. 3i. The contagious nature of yellow fever, especially among the crowded population of cities, proves the necessity of removina, the sick into the purer air of the country and the necessity, therefore, of establishing what are called Fever Hospitals or Lazarettoes, where they may be comfortably acrommodated, and placed in a situation in which there is no longer any danger of their communicating the disease. APPENDIX. No. I. Statement of Dr. Joseph Baylev, the Health Officer, in relation to the Introduction and Origin of the Yellow Fever of New- York, in 1822. [Extracted from a letter addressed to the Hon. Stephen Allen, Esq. President of the Board of Health, and published in the New-York Medical and Physical Journal, Vol. I.] " It is well known to our inhabitants, that as often as we have been visited by that awful calan>ity, it has never commenced at the same place, and never has it begun in the interior of our city. It has commenced its ravages as early as June, and as late as September, in seasons nowise remarkable for their peculiarity 5 while we have some years escaped the pestilence, when the combined action of heat and moisture has been excessive ; which causes are universally admitted to give increased activity to the decomposition of putrescent substances. In the present year we have witnessed its spreading over the highest, cleanest, and most airy part of our city, and far from the spot where it com- menced. " As it does not appear that the vessels above referred to, or the local causes that existed in Rector-street, aflord a satisfac- tory explanation of the origin of the late pestilence, I beg leave to call your attention to another foreign source, that has hither- to received too little attention, but which, on close investiga- tion, will probably appear more adequate to its production than either of the foregoing. It has been so repeatedly proved that 292 Appendix. vessels from sickly ports have given rise to the yellow fever, where no local causes existed for its production, that even those who helieve in its domestic origin admit that it may be imported. If, then, pestilential air escapes from a vessel at the wharf, while the cargo is discharging, may not the cargo of such vessel, immediately transported in lighters, under particular circum- stances, retain a portion of pestilential air, and the cause of dis- ease be conveyed to the city in this manner ? The following statement of the transportation of cargoes from sickly Havanna vessels, or which sailed from that pOrt when yellow fever pre^ vailed there, has been carefully compiled from the records kept by the revenue officer at quarantine. June 14 3 lighter loads from the brig Rapid, 363 boxes of sugar. 15 2 do. do. 189 do. 28 1 do. brig Spanish, Soldier, 77 do. 29 1 do. do. 100 do. J«ly 1 2 do. brigs Span. Soldier & Abeona 177 do. 2 3 do. brigs S. Soldier, Abeona, and Ambuscade, 260 do. 3 3 do. do. do. do. 181 do. 5 4 do. do. do. do. 216 do. 6 5 do. do. do. do. 384 do. 8 4 do. do. do. do. ) and ship Eliza Jane, ) 317 do. 9 1 do. do. 106 do. Aug. 5 1 do. brig Packet, 70 do. 6 1 do. do. 70 do. 7 2 do. do. 145 do. 8 1 do. do. 75 do. 2730 " From the above particulars it appears that 2730 boxes of sugar were transported in thirty-four lighters from several sickly Havanna vessels, (and those not sickly were navic^ated by persons who had made frequent voyages to that port,) be- Appendix. 293 tween the fourteenth of June and eighth of August, and landed at the wharves, within the limits of one hundred and tAventy yards on each side of Rector-street : but the circumstance to which our attention ought chiefly to be directed, is the impor- tant fact, that more than two-thirds of the whole quantity, amonntmg to 1918 boxes, the entire cargoes of the three brigs Spanish Soldier, Abeona, and Ambuscade, and part of the cargo of the ship Eliza Jane, were conveyed in twenty-four lighters, between the twenty eighth of June and ninth of July ; and even nineteen of the twenty-four in the short period of six days, from the second to the eighth of August. The lighters were generally loaded before noon, at which time the weather was frequently calm, consequently the infected air adhering to those boxes could not have been completely driven off in passing them from the hold of the vessel to the hold of the lighter The heat of the weather in the shade at Staten-Island, between the twenty-eighth of June and ninth of July, was above eighty de- grees at 2 P. M., and upwards of seventy-seven at eight A. M. and six P. M. ; and for the whole period between eight A. M. and six P. M. the average was more than seventy-eight de- grees. It has been erroneously stated in some of the public prints that it was my opinion that the pestilence had been con- veyed in boxes of sugar. I never entertained such an idea ; but I conceived it possible that infected air, shut "up in the hold of a vessel during a West-India passage, would as readily per- vade, and be retained in the spongy texture of rough pine boards, of which those boxes are made, as the more dense structure of smooth ovk planks, of which vessels are built ; and that several lighters, loaded with such cargoes, being landed daily at or near one place, would probably convey as much pes- tilential air as a single vessel discharging at the wharf, and which has been known to produce the disease. In the instance before us we have the cargoes of three vessels discharging at the ',same time, and near the same place. '' It may be asked, if the cargoes from sickly vessels, or from 294 Jlppevdix. sickly ports, have not been brought to other parts of our city where no evil has been produced from them ; and if the pesti- lence can be conveyed in that manner, how could such places he exempt from it ?* To answer this question, I have ascer- * The cargoes of the following vessels from Havanna were dis- charged at other parts of the city than at or near Rector-street : At Old-slip. June 20 1 lighter load from schooner Retrieve, 60 boxes of sugar, 50 bags of pimento. 22 2 do. from schoon. Retrieve, 172 do. 20 hhds. do. and 50 bags of coffee, from schoon. Cerena, 30 do. 26 hhds. do. do. 35 do. do. 35 do. At Fulton-street wharf. from the brig Venus 256 hhds. Molasses. At Stephens'' wharf. from the schr. Virginia Packet 135 boxes of sugr. do. do. 191 do. do. do. 82 do. Between Old and Cojfee-House-sUps. " ^ ^ o ( 1 do. each day, sch. Kennebeck Trader, 200 do. 1 15 hhds. and barrels do. 28 1 do. 29 1 do. July 1 1 do. June 21 ^ 22 i 24 ( 25' ) >1 do. June 27 2 do. 28 2 do. 29 1 do. 12) 16 s J^ear Old-slip. 18 1 do. brig Fame, 108 do. 19 1 do. do. 47 do. 20 2 do. do. 140 do. 22 1 do. do. 106 do. 23 2 do. do. 141 do. Aug. 1 1 do. brig Packet, 84 do. 5 1 do. do. 67 do. 27 1565 boxes— 497 hhds. Appendix. 295 tained the amount of produce from Havanna, which has been landed at all parts of the city, other than was discharged near Rector-street, and find by the revenue officer's reports, that 1618 boxes of sugar, and 361 hogsheads and 107 barrels of molasses and sugar, have been transported in twenty seven lighters, between the twentieth of June and the eighth of Au- gust ; (after which time no cargo was brought here from sickly vessels, except such as was purified by washing the casks, &c.) "But the greatest number of lighter loads, landed at or near one place in six successive days, did not exceed seven, which occurred only in a single instance. From the eighteenth to the twenty-third of July these lighters conveyed the cargo of the brig Fame, on board of which vessel no person had been sick during the voyage ; whereas nineteen lighter loads, from three vessels, were discharged in the same number of days, near Rector-street, from the second to the eighth of July. This, in my opinion, is an obvious difference ; for a small quantity of pestilential air may be inoperative by mixiuo- with a large por- tion of atmospheric air, while a greater quantit}', existing in a more concentrated state, proves fatal. The fever which took place at the quarantine ground in 1821, when many vessels were there driven on shore, is an example directly in point : it was evident that the foul air issuing from those vessels at the same time contaminated the pure atmosphere of the country, which occurrence never before happened from a small number at the wharf. Other circumstances, that might make a differ- ence between the cargoes which were landed at Rector-street and othor places, could have been ascertained, when the ves- sels arrived here, if I had been aware that any such particulars would have been of any practical use : such as the place where the vessel laid in the harbour, as some positions being healthier The crews of those vessels, except the brig Venus, were healthy during the voyage : that brig lost one man, June 7. Dr. Morrel, a passenger on board, it is said, died of bilious, and not yeUow fever. 296 Appendix. than others ; and whether the cargo came immediately from the country, or had been stored in a sickly part of the city. It is a well authenticated fact, that vessels coming from Havanna, loaded with molasses, are healthier than those loaded with dry sugar, although the bilge water of the former is much more offensive than that of the latter : the reason of this difference in the healthiness of their crews is attributed to the circumstance that the first are loaded at a village called the Regulars, situated on the opposite side of the bay to the city of Havanna, where it is generally healthy. The following extract from the same letter relates to the experi- ments made by Dr. Bayley, to ascertain the temperature of the earth. " Many persons who believe in the local origin of the yellow fever in our city, attribute it to the gas arising from the decom- position of animal and vegetable matters generated at some depth below the surface of the earth. It was readily perceived by those persons, that if they ascribed it to the putrefictive pro- cess, which takes place on the surface, then its effects would be felt much earlier in the season, than at the last of August or first of September, at which period the pestilence has often begun ; for the heat of the weather was as great and often greater duriflg the two preceding months, than it was when the disease com- menced ; consequently, the noxious gases produced from such decomposition must have been diffused in the atmosphere a much longer period, before its evil consequences are experi- enced, than facts will warrant us in allowing. But to account for the continuance of the disease in autumn from this cause was a difficulty of still greater magnitude, as the evolution of gases from the decomposition of putrescent substances on the surface would be checked or prevented by cool weather. Since then the gases from the decomposition of animal and vegetable substances on the surface of the ground, do not satis- Appendix. 297 lactorily explain the origin and continuance of yellow fever, we were induced to examine into the more plausible theory, that the noxious gases which are said to give rise to it, were pro- duced at some depth below the surface of the ground, which would better explain why the disease did not appear until the sun had been long acting on the earth, and imparted its heat to it, and why it continued after cool nights had checked decom- position on the surface. For this purpose we made a number of experiments between the 18th of September and 26th of October, by burymg the thermometer m the earth from three inches to seven feet, and letting it remain there from six to twelve hours. In thirty experiments made on different days at or near sunrise, the thermometer, lying on the ground, stood at some point between 35 and 72 degi ees, and when taken out of the ground after being buried twelve hours at various depths, from three inches to seven feet, it ranged between 44 and 67 degrees. To the depth of nine inches, the temperature of the earth was altered by alternate changes of atmospheric heat, but very little variation was observed in the thermometer when bu- ried between one foot and seven feet, although the change was considerable on the surface of the ground. For instance, when the thermometer, lying on the ground, was at 52 degrees on the 24th, and 64 degrees on the 27th of September, it was 64 de- grees one foot below the surface on both those days. Also, on the 5th, 9th, and 11th of October, when the instrument was laid on the ground, it was 51, 54, and 69 degrees, but when it was dug up from the depth of four feet the same days, and at the same time, it was 64 degrees each day. " In twenty-two experiments made in the same manner, be- tween one and three o'clock, P. M. the thermometer, laid on the ground in the sun, ranged from 76 to 91* degrees, but when buried for six hours in the earth at various depths, as between three and twelve inches, it varied from 66 to 76 degrees, accord- ing as it was placed near to or at a distance from the surface ; for instance, on the 18th, 21st, and 23d of September, the ther- 38 298 Appendix. mometer laid on the surface of the ground, in the sun, was 84, 90, and 90 degrees at one o'clock, P. M. but after being buried six hours, and the sun acting all the time on the same spot, when the instruments were taken up at one o'clock on the same days, from the depth of three inches, stood at 74, and at the depth of^ six inches at 70. But when placed below the depth of one foot, it was as little affected by the heat of the sun as when buried in the shade, for it stood at 68 and 64 degrees, at various depths between one foot and seven feet, while the instrument laid on the same ground in the sun varied between 80 and 91 degrees. From those experiments made in ground not materially different from that which I saw dug up at the foot of Rector street, it ap- pears that the earth a foot below the surface, in the latter part of September and in October, varies very little in its temperature when the sun-beams have been acting upon it for seven hours, or when it is shaded by twelve hours night, the heat being about 64 degrees.* This is a much lower temperature than I have ever heard would give origin to the cause of yellow fever ; the heat of the earth one foot below the surface not being more than 64 degrees in September and October, we must therelbre infer, that the continuance of the disease in autumn by the ex- traction of gases from the depth of several feet in the earth, is not a more satisfactory explanation of the cause of it, than that of the noxious gases emitted from the surface of the ground. We are not prepared to adopt this theory of the origin of yellow fever, unless adequate fermenting masses, producing internal * On the 24th and 25th of September two thermomettrs, which had been buried for twelve hours, to the depth of nine, twelve, fifteen, and eigtiteen inches, when taken up at sunrise, stood at 63 and 64 degrees, although the instrument lying on the surface was 52 and 50 degrees. But when the thermometers were buried at similar depths, for seven hours on the same days, the sun acting on the same ground all the time, they stood at 63 and 64 degrees at 2 P. M. although the instrument laid in the sun on the same place was 80 and 83 degrees. Appendix. 299 heat, and sending oflF pestiferous gases, are proved to exist constantly in the neighbourhood where pestilence prevails. " I have thus presented to you a plain statement of facts, upon which I have formed my opinion of the introduction of the cause of the late pestilence, and offered a few observations connected with the subject, which I have been induced to do from a persuasion that they may be of some practical utility, and contribute to the improvement of our quarantine system. ♦' With great respect, Your most obedient and very humble servant, JOSEPH BAYLEY." No. II. Statement of Dr. Walters in relation to the first cases of Yellow Fever in this city. [Extracted from a letter addressed to the President of the Board of Health dated Dec. 17. 1822.] " On the evening of Thursday, the 1 'th of July, 1822, 1 visit- ed Mr. Reder's daughters, Amanda and Caroline, the former aged eleven, and the latter nine years. I found them both la- bouring under the general symptoms of a violent fever. Their mother informed me that they had sickened on the preceding evening. Mr. Reder resides in a neat, airy, brick house, two stories high, situated at the west end of, and fronting Rector- street, one door from Washington-street. This spot, in com- mon with all the west side of the city, was always, until the present season, justly considered remarkably healthy, and, in- deed, its local advantages in favour of health are certainly very great, as it lies entirely open to the cooling and ventilating ope- ration of the southerly and westerly winds which prevail nine- tenths of the time during our sunrnaer months. " Friday the 12th. — I found my patients without any abater ment of fever. 300 Appendix^ " Saturday the 13th was a rainy day, and being myself indis- posed, 1 therefore did not visit them. " Sunday the 14th. — 1 saw them at 10 o'clock in the morn- ing, and found that all their feverish excitement had entirely subsided ; their eyes, necks, and breasts had become tinged with yellow, and Carolme had black vomit. At this juncture it was not easy for one who had marked the symptoms from their commencement with fever to their present malig >ant change, to be mistaken with respect to the nature of the dis- ease ; I therefore, in a guarded and private manner, expressed my opinion to a few of my friends, for at this time I did not mean to give the alarm, in anticipation of the measures of the Board of Health, nor even to name the disease to the public. " Monday the 15th. — I found Amanda much as on the 14th, but Caroline appeared to be fast approaching to the fatal ter- mination of her malady. After visiting my patients on this morning, I called on Mr, Waldron B. Post, with whom I had some business. He resides in Greenwich near Rector-street; I informed him that the yellow fever had appeared in his neigh- bourhood, and that the safety of himself and family required bis attention to the circumstance ; which I believe he immedi- ately did, by looking out without delay for a place of retreat. Towards evening on this day, in a walk down Vesey-street, I met with Doctors Hosack and Francis ; I informed them that yellow fever had broken out in Rector-street. Dr. Hosack inquired, whether I had reported it to the Board of Health. I answered in the negative : he replied, ' If I knew it to be yel- low fever, I would report it as such.' " Tuesday the 16th. — On the morning of this day I found Amanda convalescing, and Caroline growing worse ; but John, an interesting youth of seventeen years of age, had sickened during the preceding night ; from the violence of the first symptoms I juogeu thtt his case would in its course become highly malignant. On my way from Rector-street, in Broad- .Appendix. 301 way I met Dr. Daniel W. Kissam, in company with a gentle- man -,vith vviiom I was unacquainted. I informed them that yellow fever had made its appearance in Rector-street. I now proceeded directly to the City Hall, where I reported the cases nearly in the words of the following conversation^ which took place between his honour the Mayor and myself: *' ' Sir, there are three cases of fever under my charge, which I think dinnand the attention of theBou-d of Health.' " • What are the names of the persons sick, and where are they to be found ?" " ' They are the children of Mr Reder. who Uves in Rector- street, next door to the corner of Washington-street.' " ' What kind or description of fever do you think they have ?' " ■ I think it such a fever as our soil and climate are not cal- culated to produce ; a fever depending on the mtroduction of foreign poison for its origin, and exotic in our country, and such a fever as is likely to do great injury, if it be allowed to spread ; and I wish the Resident Physician may be requested to examine the patients, and name the disease ; and I further wish, that neither Dr Hicks, nor any of the assistants of the Board, be permitted to visit them at present ; if, however, you think it would be agreeable to the Resident Physician, I will wait on him, and introduce him to the patients.' " The Mayor replied, ' I will write him a note to that effect, and request him to await your call at his own house at four o'clock this afternoon.' " Agreeably to the ahove arrangement, I called, in company with Dr. W. Miner, on the Resident Physician at four o'clock, when the following conversation took place between us : ♦' ' Doctor, your patients in Rector-srreet have bilious fever.» " ' Have you seen them, Doctor ?' " ' Yes, after receiving notice from the Ma)'or this morning, 1 happened to be in that part of the city, and I thought it more eonvenient to visit them before dinner. » 302 Appendix. " « Well, I am glad you found the disease nothing worse. I fear, however, it will give you some trouble before you have done with it ' " After some other observations on the subject of our dif- ference of opinion, I left the Doctor, not at all offended at his having visited my patients at an earlier hour than had been sug- gested to him by the Mayor." " Wednesday the 17th. — On this day Caroline died, and John grew worse. The Board met at 2 o'clock, when the Resi- dent Physician stated, ' that he had no report to make.' He had, to be sure, visited my patients in Rector-street, and found them ill with bilious, but not yellow fever. Finding the Boaird about to take no measures on the subject, and that, of course, not onlv my friends, but also the public in the neighbourhood of the disease, would be exposed to the danger of a spreading pestilence, I resolved at once to throw off the caution which I had hitherto observed, and state, to every inquirer, my opinion on the whole matter. I accordingly lost no time in declaring to every member of the Board, with whom I was acquainted, and to all its assistants, that the disease m question was positive- ly YELLOW FEVER. Among the members thus informed, were his Honour the Mayor, Aldermen Fairlie and Hall, Doctor Dyckman, the Health Commissioner, General Morton, the Clerk of the Board, and the Assistants, Doctors Cutter and Hicks, and Captain Mills. Three days after this. Alderman Taylor, of the eighth ward, with whom I was unacquamted at the time, learned my opinion of the disease, in a conversation which he commenced in the Mayor's office, as follows : ' Doc- tor, we think it very strange that you should tell your friends that there is yellow fever in Rector-street, when you have not reported it as such to the Board.' My reply was, ' I mention- ed the existence of this fever to the Mayor, on last Tuesday morning, in such terms as, I thought, might call the attention of the Board to it ; but, in that report, for particular reasons, I purposely omitted the ase of the word yellow ; but 1 now tell Appendix. 303 you, that it is positively the yellow fever, and, knowing it to be such, I consider it my duty to inform my friends of the fact, that they may be enabled to take care of themselves in time. 1 am aware that the Resident Physician is of a different opi- nion, but it is immaterial to me, as an individual, what either he, or the Board, may call the disease.' ' We think very highly of Doctor Quackenbos ; he was very correct in the year 1819.' « As a man, I think very highly of him too ; but my conduct in this affair must be governed altogether by my own opinion of the nature of the fever in question.' "Thursday and Friday the 18th and 19th. — John's symp- toms progressed from bad to worse, until Saturday the iiOth, when black vomiting began. On the morning of this day the Resident Physician visited him, in company with Doctor Manley, who started a new opinion of the nature of the dis- ease, by calling it ' Savannah fever,' which, by the by, is a species of bihous fever that is never communicated from vessels or goods to our shores, so as to become located, and to aflect the inhabitants. But, by some means or other, it happened that Doctor Manley was employed to attend John, with me, as consulting physician. We saw him together at 12 o'clock, and 1 observed the Doctor began to think his morning opinion not tenable ; and at his evening visit, he stood perfectly cor- rected ; for, as we left Mr. Reder's house, we met Mr. Noah, the editor of the National Advocate, at the corner of Rector and Greenwich streets, who made some inquiry of us touching the nature of the fever in the neighbourhood ; to which Doc- tor Manley replied in these word, : ' If I was obliged to give an opinion of this disease, under oath, I should say it is yellow fever ;' and to an observation of Mr. Noah, * We are in dan- ger here, if that is the case,' I answered, ' Yes ; while stand- ing on these paving stones, you may consider yourself as knee-deep in pestilence.' On Monday the 22d, John died. The only family, besides that of Mr. Reder, living in Rector, 304 Appendix. between Washington and Greenwich streets was that of Mr. De j.ange. Ihis man I advised to leave the neighbourhood, which he did on the SSd, but not early enough to escape suf- fering, as one of his sons had the disease severely, after retiring to Long- island. A few days after this time, the Board met with closed doors, in the small room <(djoining the Mayor'* office. I happened to be in the hall at the time, and was in- vited into the room before the assembled Board J he Re- corder expressed a wish to hear what I had to say on the sub- ject which had called them together. 1 stated, that ' I had been compelled, by the symptoms of the disease m Rector- street, to consider it precisely that variety of yellow fever which overran this city in the year ! 798.' " During my attendance on Mr. Reder's children, after much inquiry, whether any other person had sickened in the neigh- bourhood, I learned that Andrew Thomas, a young Scotsman, had been sent sick, on or about the I ith, from the south-west corner of Washington and Rector streets, to the New-York Hospital, where he died on the 16th. I mentioned these cir- cumstances to the Mayor, who caused inquiry to be made, from which it was clearly shown, that Mr. Thomas did die of strongly marked yellow fever in that Institution, without greatly disturbing the quiet of its managers. " As the Board seemed to feel itself bound to consider all in- formation, not derived from the Resident Physician, incorrect or unofficial, it of course continued to act in an undecided and hesitating manner, until the 5th of August, when the alarm- ing progress of the disease forced that officer to acknowledge its true character. Dr. John Neilson, to be sure, after a little disputation with the Board about that unmeanmg word bilious, did, on the 31st of July, report two cases of this disease as yellow fever, the symptoms of which he well described in a letter to the Board on the following day. His report. how-»> ever, as it did not come from the right source, Uke the declara- tions which for two weeks previous I had daily made on the Jippendivc. 305 same subject, was insufficient and unavailing towards influen- cing the decisions of that assembly. " The number of rases continued to increase daily until the 9th of August, when the Resident Physician seemed to think that the public mind demanded some little explanation, in or- der to enable it to account, in the most reasonable manner, for what was going on. This explanation he made in the follow- ing words : ' From the above facts it appears evident, that the cause or causes, which at first were only sufficient to produce bilious fever, have now become so concentrated as to create yellow fever.' This puzzling and unaccountably concentra- tion of the cause or causes of this disease, if it really took place, was certainly a manoeuvre calculated to mislead the most discerning. We have, however, good reason to doubt the fact, as the number of deaths before the announced con- centration of the cause or causes was fully equal to what hap- pened afterwards, in proportion to the number who really had the disease." — N. Y. Med. ^ Phys. Journal, Vol. I. No. III. Board of Health. J^ew-York, Aug. 9, 1822. The following Report was received from the Resident Phy- sician : — " The Resident Physician reports Mr. Milespaugh sick with yellow fever, at the corner of Sullivan and Houston- streets. This case appears to be mild. He sickened on the evening of the 5th inst. and had been employed as a labourer in a store at the corner of Washington and Carlisle-streets. The Resident Physician also reports Miss Roberts sick with yellow fever, at No. Lumber-street, directly in the rear of Trinity church. She is attended by Dr. Boyd ; from whom the following statements were obtained this morning, in relation to others. Dr. Boyd was called to see Miss Machett, 39 306 • ..appendix. who sickened with fever on the morning of the 7th inst. at the corner of Lumber and Rector-streets. She went yesterday to Newark. Dr Boyd was also called to see Miss Kayler, who sickened with fever on the night of the 7th instant, in Rec- tor, next to the corner of Greenwich-street, towards Lumber- street. She went yesterday to Harlaem. Dr. Boyd was called this morning to see Miss Myers, who sickened last night with fever in Lumber-street, third door south of Rector-street. She is about to leave the city. Dr Boyd states that all these per- sons are attacked in a similar manner, which leaves no doubt their diseaseis yellow fever. From the above facts, it appears evident that the cause or causes which at first ■were only sufficient to produce bilious fever, have now become concentrated ; and as the disease is now progressing towards Broadway, I suggest and recommend the propriety of enlarging the present enclosed lim- its, so as to include Grace and Trinity churches, thereby pre- venting any collection of persons in those places. Nich's I. QUACKENBOS. No. IV. Yellow Fever in Cheapside-street. Statement of Dr. Walters, relative to the Yellow Fever in Cheapside-street. [Extracted from the letter already quoted, and published in the New- York Medical and Physical Journal, vol. I.] " On or about the 7th of August, Mr. Samuel Ward, who re- sided in Lumber-street, within the infected part of the city, sickened with yellow fever, and was reported as such, by Doc- tor Perkins, to the Board of Health. Here he lay ten days verj ill During this time, his father's family, who lived at No. 20 Cheapside-street, manifested on this occasion the most laudable anxiety for his welfare. He was not only visited daily, or often- er, by his father and mother, but his brother, a dumb boy, fif- Appendix. 307 teen years of age, and a sister of thirteen, were constantly with him, as nurses or assistants. They slept at his house every night until the 1 7th, when it was thought that he had so far re» covered as to enable him safely to leave Lumber-street, which he did, and went to his father's house, from whence he set out for the country the next day. He brought with him from Lumber-street a quantity of clothing, which, however, was said to have been washed there ; that is, washed in pestilence, and dried in the poison of pestilence. About five days after he was gone, his brother and sister above-mentioned, who had returned with him to their father's house, both sickened with fever. The sister's case was not very severe ; but the brother wag extremely iU, and as he could not speak, he expressed his sense of pain by laying his hand on his head, his back, and stomach. On the fourth and tifth day of his disease he was taken with profuse bleeding from the nose : after this, they both gradually recovered. Now, there is not in my mind any manner of doubt, but that both these children had yellow fever. A few days after this, another daughter of the elder Mr. Ward was taken ill. Doctor Boyd was called in, who, no doubt very correctly, re- ported it yellow fever : and in a few days more, the elder Mr. Ward and another son were seized with the same fever, both of whom died. Mr Ward's house, and its immediate vicinity, may now be fairly considered a second infected district, located only about sixty or seventy feet from No. 4 Lombardy street." Remarks. — Dr. Walters' statement throws additional light on this subject, but differs from that of mine, [p. 46, Chap. I. su- pra,] in some minute and inconsiderable circumstances, which, however, do in no way invalidate the inferences that both of us have made. It seems, according to the information received by Dr. Walters, that a sister and brother [a dumb boy] of Samuel Ward slept at his residence for several nights successively, and constantly nursed and attended him, and also that Samuel was not brought up on the 16th, as I have stated, but on the day after, at which time he was nearly recovered from his illness. 308 Appendix. The next day he went into the country. It is also said, but not positively affirmed, that his clothes, instead of being brought up to Cheapside-street dirty, were washed in Lumber-street before he left there. The sister and brother mentioned must have fallen sick about the 23d or 24th. They also therefore^ and not Samuel only,froin whom they had taken the disease, were the source of it in Cheapside street ; showing that the mischief was on a much larger scale than 1 had imagined. About the 6th or 8th day of the illness of these two children, i. e. from the 30th to the 2d of October, must have been the time at which Mrs. Ward and Fanny [which last had not been down into Lum- ber-street,) took the disease. We have described Fanny s ap- pearance, and she had no doubt had the yellow fever. She was sick from eight to ten days. Her father, Nathaniel, took it from her, as he fell sick the tSth or 16th. I believe there was no case between them. The one spoken of by Dr. Walters, as reported by Dr. Boyd, must have been Hannah, who fell sick two or three days after her father, having taken the disease from him. It was with much difficulty th;T< Dr. Walters and myself have been enabled to ferret out the facts which relate to the intro- duction of yellow fever into that street ; the Ward family being unusually taciturn, and somewhat refractory in an affair in which they knew well their conduct was deeply implicated, and had been severely, and, as it proved, justly censured. The cir- cumstances, however, are now all brought to light, or a suffi- cient number of them to prove, in the most conclusive manner, that this disease may be transplanted from one part of the city to another quite remote, and there form a new focus of propa- gation. The cases of the Wards are not only highly interest- ing as the source of the disease in Cheapside-street, but as be- ing one of the most powerful examples of direct and unequivocal contagion that has, perhaps, occurred in the city. While the different members of the family were successively falHng sick, and at the determinate periods of time usual between the re- Appendix.- 309 ception and development of the contagion of yellow fever, the outward air was pure, wholesome and uninfected. The re- monstrance of the highly respectable inhabitants of Cheapside- street, as well as the evidence of those who visited that place at the time, indisputably establishes this fact. There were no sewers in this clean and secluded street, nor sinks and ciest- pools in the spacious and beautiful yard of Ward's house to generate the disease. It was by contagion alone that it spread through the house. Enough of the poison was generated in this single building to have infected a much larger space than it did, had not the timely arrival of cool weather suspended its progress. The following is the remonstrance presented to the Board of Health, Aug. 16th, by the inhabitants of Cheapside-street, against the removal of Ward from Lumber-street into that street, 'i his clear and energetic appeal reflects great praise on their foresiglit and prudence, and on the just views which they took of the nature of the complaint. " We whose names are hereunto subscribed feel ourselves most lamentably aggrieved in having an unfortunate sufferer with the yellow fever brought from an infected neighbourhood, di- rect into the middle of Cheapside-street, where, at present, nothing but health prevails ; for from this circumstance, we may expect nothing short of being driven from our homes, with the loss, probably, of some of our dearest relatives. We therefore earnestly request your immediate investigation of this business ; and if found as herein represented, we trust and hope a removal may be ordered without delay, or we shall be of an opinion, that instead of correcting and regulating this un- fortunate malady, it will be instrumental of circulating its dread- ful eftects throughout the city ; for nothing can possibly tend to this object more than suffering various parts of your city to be planted with the disease, by placing the infected with the healthy." \Signed by Messrs. Corga7i, Messenger, 4'C.] 310 Appendix. No. V. Yellow Fever in Lombardy-street. By the following extract we learn, that the Board of Health, of New-Orleans, held a meeting on the third September, 1822v " Board of Health, " JVew-Orleans, September 4, 1822. " At a meeting of the Board on Tuesday, the third of Sep- tember, 1822, the following address was adopted and ordered to be published : " It becomes the duty of the Board of Health to state to the public, that five cases of fever have lately occurred, m which all the symptoms which are usually exhibited in the yellow fe- ver, were observed. It is hoped, from the favourable state of the weather that the disorder will not spread, as it has not oc- curred except in persons who had undergone great exposure to fatigue, and had been much exposed to the sun. The precau- tions taken to render more strict the measures adopted to pre- vent all communication between this city and the places abroad, and in the vicinity where the disease prevails, will check its progress. This hope is more confidently indulged from the cir- cumstances of no new cases having been reported to the Board as having originated within the last two days. With the excep- tions noticed above, the city never has been more healthy, and it is believed that the mortality during the last three months has not much exceeded that which took place during the three months preceding them. " I certify the foregoing to be a true copy from the minutes. H. K. GABON, Secretary." This is altogether a very curious and suspicious looking do- cument. We cannot but admire how cautiously it is worded, and how very scrupulously the Board have avoided touching upon the terra firma of dates and names, determined to leave us in the dark, among the rocks and quicksands of a Jesuitical Appendix. 311 phraseology, the precise meaning of which it is impossible to interpret. They tell us the cases lately occurred, but when or where, or who they were, is left for us to guess. They say these cases had all been much exposed to fatigue and the sun. This is the old story that has been rung in our ears ever since the prepos- terous hypothesis of domestic origin first bewildered our Ame- rican physicians. It lets us immediately into the secret of what kind of materials the New-Orleans Board of Health is com- posed, and shows us that we must be extremely careful how we make up our opinions from any statements of facts, documents or addresses, coming from such a quarter. If the disease de- veloped, as they say it did, all the usual symptoms of yellow fever, it was yellow fever — it was that, and no other disease. What need then was there to say that it occurred only in such as had been greatly exposed to the sun and fatigue ? Do they mean that this exposure was a predisposing, exciting, or real and original cause of the disease ? Were the sun and the fatigue the actual cause of the disease, or was it produced by that specific cause alone which produces yellow fever ? Were these cases to be understood as exceptions to th» dis- ease, and yet bearing all its characters ? This disingenuous- ness, to call it by no worse name, is unworthy of a solemn de- liberative council appointed to so important and responsible a station as that of the guardianship of the public health. A kw lines farther on they have accidentally let fall a word which seems to call in question what is stated inlhe beginnino-. They speak, at first, of only five cases, but now they speak of the vicinity where the disease prevails. How long had the disease prevailed ? One, two, or eight or ten weeks ? And how many had died of it ? These are questions to which we fear no answers will ever be given. Again; near the conclusion it is fondly hoped the disease will be arrested, among otlier reasons, because no 7iew cases had been reported to the Board as having originated within the last two days. Now, as far as our limited observation goes, cases are 312 Jippendix. rarely or never reported to Boards of Health until they have existed at least three or four days ; and I should, therefore, not think it strange at all that no new cases had been reported, which had originated within the last two days. At that very time, however, the Board in all likelihood, may have known of the existence of twenty cases that had originated within the last three or four days ! For from the manner in which they mention the five cases in the beginning of their address, we are induced to beheve that they were the most malignant cases only. Our physicians here are not so much in a hurry in reporting, for experience has taught them that the cases which they had too often precipitately believed to-be yellow fever, afterwards turned out to be other diseases. This, therefore, was a false foundation to build their hopes upon, and' they should never have attempted to lead astray the public feelings and expecta- tions by what they must have known at the time to be an un- meaning quibble. After this impartial analysis of the component parts of the address, no person, I think, will deny that the Board evidently attempted to conceal from the public the true state of things then existing at New-Orleans. Does not conduct like this authorize us in doubting the whole of their statement ? May we not conceive that where a Board like this existed, yellow fever might have been prevailing for weeks, nay, for months, without their deeming it worth while to notice it ? Is it probable that such a Board would have been induced to go into a sitting for a public address, without some very urgent cause ? Is it not probable, indeed, ih.;t the disease at the time at which this address was made was desolating the city to an alarming extent ? For we remember well that the next arrivals almost to those which brought the account of this meeting, brought also disastrous tidings of the progress of the pestilence. The general impression here is, from information derived from va- rious sources, and which may be fully relied on, that the yel Appendix. 313 low fever broke out in New-Orleans as early as the beginning or middle of July. In this city it was prevailing one month be- fore our Board of Health publicly announced it, although they were constantly on the alert, to give intimation of its intro- duction, whenever that should occxir. They had met for this purpose privately for many days before. In New-Orleans, where both the citizens and Board of Health have ever shown so much reluctance and unwillingness to acknowledge the exis- tence of the disease, is it not extremely probable that as has often happened heretofore, it might have been prevailing for more than two months even before they took official notice of it 1 The disease had probably been progressing slowly, until just before the termination of August, when, having got fairly into the city, it suddenly spread, as it is wont to do, after existing some time, and multiplied to so alarming a degree, that the Board was compelled to make an official publication, as a feeble effi^rt to calm the fears of the people. But arguments on this subject are quite superfluous, since we have the facts to show that the disease actually prevailed in New-Orleans at least for .more than a month anterior to the meeting of the Board of Health. " The second grand division of causes," says Dr. Wal- ters, in the letter already alluded to *' which were likely to originate the late fever in Rector-street, comes next to be ex- amined. These, all of foreign origin, are to be sought after in suspicious vessels, which were permitted to come to the wharves in that vicinity, or in goods landed there from vessels known to be infected. The officers of the quarantine establish- ment for this city, have designated, as four-day vessels, a cer- tain class, which are always to be^ regarded as suspicious, be- cause, owing to a defect in the law, they are privileged to carry pestilence wherever they go ; thus jeopardizing the lives of thousands, and rendering all other quarantine regulations use- less. To prove the above allegation, it is only necessary to state a few facts. First, it is well known, that the ditferent 40 314 Appendix. Boards of Health of the cities and towns on our seaboari are, five times out of six, among the last public bodies which come to the knowledge of pestilence in their respective dis- tricts. Hence, in almost every case where a pestilential fever appears in any city, from one to two months elapse bef -re its Board of Health become officially informed of it. During this period the public authorities of the place continue to issue clean bills of health to every vessel sailing from it. One of these vessels, though infected with the poison of yellow fever^ may have arrived at this port with a healthy crew, or one or two of her lands may have sickened or died on her passage, and the officers, as it is always their interest so to do, may disguise or conceal the real character of the disease. This vessel, on her arrival here, is liable to be stopped only four days at the qua- rantine ground, to undergo the too often useless operation of white-washing. She is then permitted, by law, to come to our wharves, with a strong probability in favour of her kiodlmg pestilence wherever she touches. Cases of the above descrip- tion are by no means of rare occurrence ; it is, however, un- necessary to mention more than one or two. The ship Asia sailed from New Orleans some time in the month of August last, and arrived here on the ISth of September. She left three of her crew sick with yellow fever, in the hospiial of that city ; yet, strange as it may appear, she brought a clean bill of health, signed by the proper authorities of the place. And, during the first three weeks of the late fever in this city, it is well known that vessels sailed daily from this port with clean bills of health ; one of these, the ship Illinois, however, which left Rector-street wharf, on the 16th of July, did lose a passenger by yellow fever." Mr. Ludlow Morton, who was one of the crew of the Asia, arrived at this port some short time after the Superior, and in- formed me that he was one of the persons who had had the dis- ease, and whom the ship was obliged to leave behind. He had been ill sixteen days before the ship sailed, which was on or about the last of Aug. Consequently he must have takenthe dis* Appendix. 315 ease sbmewhere about the middle or towards the beginning of August Dr. Flood i iformed him, he says, that the disease had been prevailing for a month before he was taken ill. It is for these reasons that we believe the yellow fever to have existed at New Orleans at the time the ship Superior sail- ed. The following statement, communicated to me by a Mr. Banta, together with that of Dr. Walters, accompanying it, and especially the circumstance of the destruction of the mattress upon which Carey was lying, and which Mrs. Snow never would have directed to be done without some good cause ; and also Capt. Snow's opinion, who must have known something about its history, are sufficient, in my judgment, to show that through the instrumentality of Carey, the contagion of yellow fever was brought into his mother's house. The current opin- ion is that he had the disease in New Orleans. That the mat- tress belonged to some person who had died of it is conclusively established by Dr. Walters' statement, and that person must probably was some friend of Carey in New Orleans ; for we shall see by what follows that Carey called this, as well as the chest, his own property ; but said that they had belong-ed to a person who had died of yellow fever. Consequently he knew how this property had now come into his possession, and was therefore, no doubt, acquainted with all the circumstances of this mysterious affair. Banta's Statement. I called upon Banta about the middle of November 1822, and the following is an accurate transcript of the statement made by him to me, of all the particulars and circumstances with which he was acquainted, relating to the sickness in the family «f Mrs. Carey, and the probable source of it. He says he is a labouring man by profession, and that his wife goes out to wash and to do days work.* * The house in which they live is a small wooden building on the north side of, and adjoining that in which Mrs. Carey and Mrs. Snow died. 316 Jlppendix. On the eighth day of September, 1822, he says he was called upon late at night by Mrs. Snow, to go down town after Doctor Webb, and to request him to come up there and see Carey, (Mrs Snow's brother,) who was taken with epileptic Jits, to which he had long been subject Banta's wife and himself both went in the house the same night to assist him. The Doctor also came, and in the course of prescribing for Carey, the lat- ter spoke of a vial of medicine which he had in his chest. Ban- ta went down into the kitchen where the chest was, and took the vial out. The chest was filled with dirty clothes, such as bed and body linen, consisting of sheets, pillow-cases, &,c. It was the same chest that had been brought to the house some days before. Carey had arrived at this port from New-Or- leans August 18th, in the ship Superior, to the crew of which vessel he belonged [This ship brought a clean bill of health, dated July 27"h, 1822. She had been quarantined for six days after that period.] The mattress upon which Carey was lying was extremely filthy and offensive, and had been brought to the house with the chest. Mrs. Snow told me I had better take it out of the house and destroy it. Another bed was procured for him, and I destroyed the mattress that very night before twelve o'clock. The next morning (Monday, Sept. 9th,) Mrs. Carey took sick, and in the evening of the same day, Mrs. Snow. Mrs. Snow continued to be attended by Banta's wife and himself. On Saturday, the fourteenth of September, Mrs. Carey died ; and on the next evening, Sunday the fifteenth, Mrs. Snow.' That Sunday afternoon, and before Mrs. Snow's death, and after Mrs. Carey had died, Mrs. Snow lying at the time on the first floor, where Mrs. Carey also had lain, and the weather being very warm, the people in the street, principally the neighbours, having heard of the sickness in the house, collected around it in considerable numbers, and gazed in the windows, which were at the time hoisted. There were as many as twenty or thirty persons collected before the house. After the death of Mrs. Carey and Mrs. Snow, the people began to move Appendix, 317 out of the street. The disease, however, never extended be- yond that section of it included belween Catharine and Market- streets, in which distance there are about forty houses, each of which was occupied upon an average, by five persons, amount- ing altogether to about one hundred and twenty inhabitants. About forty or fifty of these persons moved away. Captain Snow, the husband of Mrs Snow, was persuaded that the source of his wife's disease was connected with the mattress and effects bronght into the house. Dr. Walters' Statement. No. I. (copy.) Jonathan Darrow, cartman. No. 5 Jefferson-street, in the city of New York, being duly sworn, deposeth and saith : That on or about the second day of September, in the present year, he was requested by a young man, at or near the New Market, at the bottom of Catharine street, in the city aforesaid, to take up and put on his cart, two chests, a bed, a hammock, and a bundle of clothes, tied up in a blanket. This young man had with him a sailor, as from his dress he appeared to be, who appeared to own a part of the things aforesaid. The young man first mentioned, after the articles were put on the cart, got ou himself with them, he then requested this deponent to drive to number four Lombardy-street, which request was compbed with. While on the way thither, a conversation took place between this depo- nent and the said young man, in which the latter observed, " a part of these things now on the cart does not belong to me, but they did belong to a young man who lately died of yellow fever," or words to that ef- fect. And this deponent further says, that he drove his cart to the bouse, number four in Lombardy street, where he delivered that part of the goods, to wit, one chest, one bed, and the blanket containing the clothes, which tlie young man above mentioned had charge of, to an old woman and a young woman, who both received the goods, and placed them in tlie entry of the house number four Lombardy street. And this deponent further saith, that be then drove into Bancker-street, about half way between Catharine and Market streets, where he deliver 318 Appendix. ed the remaining part of the goods, to wit, one chest and a hammock. And further this deponent saith not. (Signed) JONATHAN DARBOW. Sworn before me, this 18th day of December, 1822. (Signed) HAREIS SCOVELL, Assistant Justice. No. ir. (copy.) We, whose names are hereunto subscribed, hereby certify, that we saw, during the first week of Septemqer, in the present year several different times, a chest on which was placed a bundle of clothes, or bedding, as they appeared to be, tied up in a blanket, as we believe, standing in the entry of the house number four in Lombardy-street. Given under our hands, the IStb day of December, 1822. (Signed) WILLIAM H. MOTT, FRANCIS SCHRODER, ELEBRED POLHAMUS. No. III. (copy.) I, Sarah Potter, residing at number twenty.three Lombardy street, hereby certify. That I was employed by the late Mistress Cary and the late Mistress Snow, ^n Tuesday, the third day of September, in the present year, to wash some bedding a nd clothes, which I was informed had, or did belong to some person who had been sick, and that I accordingly did wash one rose blanket, one bed quilt, one pair of socks, one handkerchief, one waistcoat, and three shirts, and that the shirts were very offensive and very yellow. And that, while I was washing the said clothes, the late George Washington Mott came near to the washing tub, and inquired of me whether I took in washing. Given under my hand, this 8th day of December, 1822. (Signed) SARAH POTTER. " On two occasions, it seems that infected clothes or bedding may be peculiarly mischievous, viz. when they are first opened Appendix. 319 in a warm atmosphere, after having been long closely packed up ; and again, when they are put into warm water, for the purpose of washing. The profuse vapour of warm water seizes the matter of infection with the utmost avidity, and conveys it, in its most active state, to the noses, mou hs, and lungs of the bystanders. This fact was shown in a very striking manner ; for, at th^ time the clothes referred to in document No. 3, were washing, George Washington Mott, having that day come to the city, was, with Mrs. Carey and Mrs. Snow, standing by the tub : they all sickened with yellow fever on the same day, and all died within a few hours of each other. The infection in Lom- bardy and Cheapside-streets reached to Catherine-street ; thus taking possession of three principal avenues which lead lo the wharves and the New IVJarket. from the upper part of the city : and to this second infected district, no doubt, we may justly charge some cases of»fever which occurred to the eastward and northward of it, and which were not at the time fairly traced : a case in point was that of Mr. D. Rogers. There were, how- ever, three or four cases that fell under my own observation, which were reported to the Board of Health as yellow fever, in the upper part of the city ; about which I shall not speak, un- less I was disposed to trace a drunken frolick, or something as unlike yellow fever as drunkenness, to the infected district. " 1 shall conclude with the case of yellow fever that follows, and which was among the most mischievous that occurred in the upper part of the city, during the late autumn, causing more alarm, and consequently more unnecessary removals than any other. This was owing to two reasons ; first, the supposition of it being impossible to trace it to the infected district ; second, it being ascribed to a broken sink in the neighbourhood, a thing which too often happens in like cases. The subject of the case here alluded to, was Mr. Scott, who resided at 122 Bancker- street, by trade a tailor. He had received his work for months by the job from Messrs. Pierson and Jacobs, whose store is at the corner of Maiden-lane and Nassau-streets. For wages or 320 Appendix. work he went there two or three times a week during August, and until the 10th of September, on which day the store was closed on account of the alarming progress of the fever in the neighbourhood, as several cases had already occurred at the noted sugar- house a few yards distant, which terminated fatally. On this day, the 10th of September, he settled with his em- ployers, hut was detained there much longer than usual, owing to some difficulty in his accounts. After receiving his wages, as he stated, on his return home he went through Maiden lane to Broadway, merely to witness the desolation of that part of the city. Six days after this, to wit ; on the 16th of the same month he sickened of yellow fever, and died on the 23d. Another journeyman employed by the same firm, who was at the store on the same day, sickened about the same time that Scott did, and was reported to the Board as a case of yellow fever, but recovered. Mr. Pierson, one of the partners of that firm, how- ever, soon after this topk the disease, and it f>roved fatal."* The ship Superior was released from quarantine on the 24th or 25th of August, and a day or two after came up to Brooklyn, a village on Long-Island, on the opposite side the East-River, and about three quarters of a mile distant from the city. She lay consequently directly opposite to the foot of Catharine-street, and part of the town where Mrs. Carey hved. It is therefore highly probable that the things which the Cartman took from the wharf, at the foot of Catharine-street, had been brought there from the ship opposite. Dr. Walters informs me, that the cartman observed a small boat near where the articles lay, and that the sailors in it appeared to be acquainted with the transaction, and were most probably the persons who had just landed the things spoken of. The following statement tends to confirm what has been said, and also accords with that of the cartman, as to the time the * Letter of Dr. Walters, in the New- York Medical and Physjcat Journal Appendix. 321 chest and other articles were brought to the' house. It was made to me on the same day as that of Banta, by a respectable coloured woman, who lives in a small one story wooden building on the south side of, and adjoining the house in which Mrs. Carey and Mrs. Snow died. It may be remarked !)y the way as a circumstance somewhat curious, that almost every other house in which cases of yellow fever occurred in this street are two story wooden buildings, while this in which the disease broke out is a spacious three story brick building, and the only one in that part of the street where the disease pre- vailed ! We would ask those who when cases of yellow fever have been reported in certain houses were in the habit of searching in the yard or cellar for some sink or cist pool, or other local nuisance, in which of the two kinds of houses in Lombardy-street it is probable the yt;llow fever would have originated if it had been owing to domestic sources ? E. C LYNTON S STATEMENT. Ellender Clynton, a respectable black woman, aged about sixty-five, and brought up with Mr. Richard Lawrence of Flushing, on Long-Island, has been living during the past year in a Small one story wooden building, adjoining the three story brick house No. 4 Lombardy-street, and in which the disease broke out. Early on the Monday morning of the day, on which Mrs. Carey sickened, that is September 9th, 1822, Mrs. Carey came into EUender's room to borrow some coals — she com- plained of feeling very unwell. Ellender then asked her what was the matter ? Mrs. Carey said she had been washing some clothes which her son had brought up with him to the house when he came from the ship. Ellender told her it was no won- der, for she thought when she saw Mrs. Carey hanging up the clothes in the yard to dry that it might make her sick. She had seen Mrs. Carey's son come to the house some days before, about the beginning of the week, with a sailor's chest and a large bundle of clothes tied up m a blanket, which she under- 41 322 Appendix, stood came from a ship. The clothes which Mrs. Carey wash- ed Ellender says were those which Carey brought to the house when he first arrived in port, and consisted of three or four pieces, chiefly shirts. Ellender did not go into the house after Mrs. Carey sickened, being afraid of taking the disease. The cartman who brought the things did not know, it seems, who the young man was that hired him at the dock and rode with him to the house to which the things were taken. But by Ellender's statement we learn the important fact, that it was Mrs. Carey'' s son. With him, therefore, rests the true secret of this affair ; but whether any measures will ever be taken, or inducements offered to have it divulged, is more than we caa say. As it was Carey himself who was on the cart, he has made known enough for our purpose, inasmuch as he has confessed that the articles brought to his mather's, to wit, the mattress, chest, &:c. had belonged to a person who had died of yellow fever. With the rest of the story we have nothing to do. We have proved that the matter of contagion was brought into Lombardy-street before the yellow fever prevailed there. It appears that Carey's own things were not brought from the ship until about the twelfth of September, that is three days after his mother and sister sickened. No. VI. Proofs of the ine^cacy of our present (Quarantine Laws. From the following table some idea maybe formed of the active and extensive intercourse maintained between this port and the West-Indies, and especially with those islands and towns where yellow fever most usually prevails. It fully justi- fies what we have said on this subject under the head of pre- vention ond purification. No one certainly can feel more real gratification than myself, in beholding our country prosper in all the varied pursuits which engage the bold, persevering, and enterprizing genius of her citizens. But when the lives of some hundred thousand individuals are placed in jeopardy to gratify Appendix., 323 the cupidity of an inconsiderable portion of the community, I cannot hesitate to withhold my assent to any measure, the object of which is to perpetuate this unnatural condition of things. There are, doubtless, those in whom avarice would obliterate every noble feeling ; but I trust and believe, that there are very few of the mercantile community whose philanthropy as well as patriotism would not induce them to make large sacrifices of their own private interests rather than bear the imputation of doing any thing that might be detrimental to the public welfare. I am therefore satisfied in my own mind, that when propositions come to be advanced before our legislative tribunals to remodel and perfect the quarantine system none will go farther than such persons towards rendering it as complete and efficient as possi- ble. They will see at once the glaring inconsistency, the mon- strous absurdity, and the wrong done to the pubHc, in expend- ing enormous sums of money to maintain this mummery and mockery of a quarantine, which, instead of barring the door against the pestilence, serves, as a depot to receive and fos- ter it. List of Vessels arrived at JVew-York, during the summer and, autumn of 182 2, /ro/n West-India ports where Yellow Fever usually prevails. Arrived, QuarantiDed June 11th. Brig Rapid — 1 died of yellow fever, May 31st, 30 days. 16th. . Schooner Retrieve — none sick, do. 18th. Brig Venus — 1 died of bihous fever June 7th, on the passage. do. 22d. Brig Aspasia — 2 were sick on the passage do. 23d. Schooner Virginia Packet— none, do. 25th. Serena — none, do. 324 • 'ippcndi'x. Arrived Quarantined June 25th. Brig Spanish Soldier— \ died on shore at Havanna. probably of yellow fever — 1 died on the passage June 17th, of yellow fever [passenger,] 30 days, 28tb. Abeona- none, do. Ambuscade — none, do. July 1st. Ship Eliza Jane— 1 died of yellow fever on shore at Havannah, June 10th, [mate]-r-l died June 18th, of yellow fever on the passage, do. 2d. Brig Nancy — 1 sick in Havanna, do. Schooner Lively Hope — none, do. 8th. U. S. Brig Enterprize — sick. " This vessel,'' says Dr. Bayley, in his weekly report to the Board of Health, " arriv- ed here the 8th inst. 24 days from Ha- vanna, (where she remained three days off the Moro Castle and about one mile from the city,) via Charleston. At the latter place she remamed eight days. Lieutenant Coxe was taken ill the day nfter she arrived at that port, and died on the 1st of July. Ten persons [of the crew] were sick of malignant fever when she arrived here on the 8th and txeelve have since been taken ill. Those persons who died have all had that fatal symptom, the black vomit.'' do. July 9th. Schooner Kennebeck Trader — none, do. 12th. Tartar — I died of yellow fever on board on the J 0th, [seaman,] do. Pirate — none, do. 13lh. Brig Fair American — 1 sick [seamtui] left at Havanna, do. 15th. ■ Fame — none, do. Appendix. 325 Arrived, Quarantined July 15th. Sloop Wave — none, 30 days. Steam Ship Robert Fulton — 1 sick of fever, left at Charleston, do. 27th. Brig Francis — 1 died on shore at Ha- vanna [seaman.] do. 29th. Packet — none, do. Aug. 3d. Brig Betsey — none, do. 15th. Lucy Ann — 4 died of yellow fever, 3 on shore at Havanna, 1 on the 10th on the passage, to 1st of Oct. H. B. M. Brig Dotterel-- none, 30 days. Schooner Three Sisters— 1 died of yel- low fever at Havanna [seaman,] do. New-Orleans— none, do. Dolphin — 2 sick of fever at 20th. 21st. 31st. Sept. 2d. Havanna, [cSptain and a seaman,] Huntress — none. Oct 12th. Ship Thomas Wilson — none, 14th. Brig Factor — 3 died of yellow fever [crew] 1 died Aug. 22d, onshore at Ha- vanna, 2 on the passage, Sept. 6, and Sept. 8th, — 1 sick of yellow fever arrived convalescent, [passenger,] 20th. American — 4 sick, captain and 3 of the crew at Havanna. 28th. Neptune's Barge — none, , 3d. Packet— 4 died of yellow fever, 1st and -id mates and one seaman on shore at Havanna, and a new first mate on the passage, Sept. 21st, 8th. Abeona — none, 15th. Fair American — none, 17th. Schooner Neptune — none, Richard — 3 died of yellow fever do. do. do. do. do. do. do. do. do. do. do. before sailing, In the space of 128 days arrived 38 vessels, in which 57 were sick, of whom ^ihad yellow fever^ of which 21 died. 32€ Appendix. MATANZAS [Cubu.] Arrived, Quarantined June 11th. Brig Agenoria — none sick, 4 days. Ship Shamrock — none, do. 18th. Brig Emma, do. 24th. Margaret, do. July 1 St. Helicon — 2 sick, arrived with yellow fever, a third had yellow fever on pas- sage, 30 days. 7th. Mary — 1 sick at Matanzas [seaman,] do. 15th. Planter — none, do. 30th. Schooner St. Stephens — none, do. Aug. 2d. Brig Radius — none, do. 7th. Schooner Planet — none, _ do. Sept. 3d. Brig Betsey — none, do. 20th. Prize — none, 10 Oct. 8th. Castor— none, 7 In the space of 119 days arrived 1 3 vessels, in which 4 were sick, of which 3 had yellow fever. ST. JAGO DE CUBA. Tune 14th. Sch'r Industry — none sick , - 30 days. 30th. Brig Georgiana — 2 died of yellow fever on shore there, [seamen,] do. Sept. 19th. Traveller— 1 died of yellow fever, 20 Oct. 20th, Mermaidn— none - 6 In the space of V21 days arrived 4 vessels, of which 3 of the crews died of yellow fever before sailing. PORT- Au- PRINCE, [Hispciniola .] June 21st. Brig John, London — none sick, 9 days. July 7th. Sch'r Nile. do. 30 Appendix. 327 Arrived, Quarantined. July 17th. Sch'r Ariadne— 2 sick with fever ; one on passage, the other at Port-au- Prince, - - - 30 days Aug. 4th. Brig Buck— 2 died of yellow fever ; one on passage July 13th ; the other at Port-au Prince, [seamen,] - do. 15th. Sch'r Combine- 2 died of yellow fever on shore at Port au-Prince, [seamen,] do. Brig Vorwartz - 2 died do. do. do. Harmony -none, do. 20th, Sch'r Atlanta- -none, do. Sloop Active— none. Went through the Sound, Sep. 13th. Sch'r William Henry — 1 sick [seaman,] on passage. - - - 18 28th. Brig John, London— none. Went thro' the Sound. Oct 12th. Sch'r Nile— none. - - 5 13th. Brig Francis Jarvis— none, - do. In the space o/" 118 days, arrived 13 vessels, in zvhich 9 were sickf of whom 6 had yellow fever, and all died. VERA CRUZ. July 17th. Ship Victoiy-— 12 sick while there, [seamen,] and 2 died there [mates] 8th and 18th of June, - 30 days. 27th. Brig John— -1 sick with fever there [seaman] - - - do. 28th, Sch'r Swan— -4 sick there with fever, do. In the space of \l days, arrived 3 vessels, in which 1 9 were sick with fever at that port, of whom 2 died. 328 .appendix. Arrivals from. Havanna, JVb. of vessels. 38 JVb. of sick. 57 Sick of yellow fever. 44 Diedof yel- low fever. 21 Matanzas, 13 4 3 St. JagodeCuba, 4 3 3 3 Port au Prince, i3 9 6 6 Vera Cruz, 3 " 19 — - - 2 Total, 71 92 56 32* In addition to this it may be observed, that the intercourse kept up between the different ports of the Union, or what is called the coasting trade, is incessant, especially during the warm weather, and between this city and New-Orleans, Pensa- cola, St. Augustine, and other towns in the southernmost part of our territory, and which, from their proximity to the West-In- dies, are almost every year afflicted with the visitation of yel- low fever. We have this year seen what distress it has occa- sioned at Pensacola and at New-Orleans. We perceive by this table that vessels often arrive here from sickly ports, and that the first intimation we have of the disease prevailing in such places, is the death of sqme of the crews during the passage. Vessels from the same ports, and which sailed and arrived perhaps some three or four days pre- vious, are permitted, after the short detention o{ four days at quarantine, to go up to the city, on the presumption that such ports were healthy. So that pestilence may have been carried in cargo loads to our wharves and into our houses, before the Health Officer can be aware of its introduction, and when it is too late to repair the disaster. For, by the letter of Dr. Bayley, in Chap. I. p. 92, 3, we learn, that although none may have * This is exclusive of the deaths of the crew of the U. S. brig Enter- prize. Appendix. 329 died or been sick on board such vessels, and that although the vessels may have been in a perfectly clean condition, with no taint in any part of them perceptible to the senses, yet if yellow fever prevailed in the ports whence they sailed, the air of their holds may come surcharged with the contagious poison of this malady. Notwithstanding, therefore, the Health Officer has good grounds to be suspicious of all vessels arriving from such ports, it would be considered a very harsh measure on his part, and would, no doubt, excite much clamour, if he under- took to throw so great an obstruction in the way of the West- India trade as to use the discretionary power with which he is invested* of detaining these vessels thirty or more days. Such are the loose ideas entertained by many, of the nature of quarantine laws, and such the leniency and inefficiency of our present code, that I have no doubt if these indulgencies were not granted, the Health Officer, however meritorious he might seem in the eyes of those who are aware of the absolute neces- sity of a fixed and unyielding line of conduct in those who hold these responsible situations, would be thought little better than a despot. What happened this year in regard to the port of Matanzas, is in point. Between June 11th and 24th, /owr i^esse/s arrived here ffom that place. On July 1st, that is, six days only after the last arrival, came the brig Helicon, on board of which came also two cases of yellow fever ; and a third had had the disease on the passage. The four first vessels were quarantined but four dajs, and then went up to the wharf in the city. It was on this account that the disease was attributed by some to the ship Shamrock, w^ich arrived from Matanzas on the 1 1th of June, and hauled into the wharf very near the foot of Rector-street. Health Laws, sect. 3. p. It. 1820. 42 330 appendix. There can be no doubt that the four vessels which arrired be- fore the Helicoa, at least those that arrived only a few days be- fore her, were perfectly well apprised of the state of the public health at Matanzas before they sailed. Thus, besides the danger to be apprehended from vessels which may in this manner illicitly introduce the poison of yel- low fever directly into the city, we never can possibly feel ourselves secure while we are maintaining, under the name of a quarantine, and at the distance of but six or seven miles from the city, an institution which, did it not seem too much like tri- fling with a subject too serious for ridicule, might be said to )ne intended rather to prolong the existence of this deplorable ma- lady than to contribute to its extinction. When we compare the large proportion of the deaths from yellow fever of the vessels from sickly West India ports, to the number of cases of that disease, it is evident there can be no mistake as to the name and character of the complaint. And when in connexion with this, we look at the total number of vessels, and consider that there were as many as seventy-one arrivals from yellow fever ports; that these arrivals all took place in the short space of one hundred and thirty d>;ys, in the hottest season of the year, that near one hundred persons were sick of the crews and passengers of these vessels, much more than half of whom had yellow fever ; and that the length of the voyage was not usually much more than from twelve to twenty days ; those who confess them- selves unable to resist the evidences in favour of im- portation, will be ready to acknowledge, that here are abundant sources for the introduction of yellow fever. No. VII. Sickness in the Sugar-House in Liberty-street. I have already said, under the head of Immunity and Predis- position, that the sickness of the Germans was owing, doubtless to their continuing to frequent this building long after the neigh- Appendix. 331 bourhood, from the number of persons who had fallen sick in the vicinity of that building, was well known to be infected ; and that the predisposition of a foreign constitution had also probably contributed to their illness. By a reference to Chap. I. and to the reports made to the Board of Health, it is found, that cases had already occurred in that vicinity, in William- street, and also in Broadway north of Liberty-street, as early as the latter part of August. To become better assured, however, of what I believed to be the true explanation of this sickness, I addressed a letter, con- taining several queries, to B. B. Seaman, Esq. one of the pro- prietors of that establishment, who in his answer, dated January 1st, 1823, pohtely furnished me with a minute and very satisfac- tory detail of all the circumstances connected with the cases which had occurred there. This statement corroborates, in every respect, what I had -asserted. It appears that the house was not actually closed, nor did the Germans cease to go there until October second. Mr. Seaman says they avoided, as much as possible, in their routes to and from the sugar-house, those places that were con- sidered infected. They were, however, in the midst of it ; besides which, their high susceptibility to the disease would have rendered them the subjects of it if only a partial stream of the poison had been wafted from a distance to the building, while, to a native, perhaps, it might have proved perfectly harmless. I shall insert the answers of Mr. Seaman at full length, though I do so without his permission ; being fully persuaded, that he will excuse the liberty I have taken from ray unwillingness to withhold from the public the interesting information which they convey. The fact related of Martin Hauser, in the 10th answer, is particularly worthy of remembrance, being the longest period [fourteen days] from the reception to the development of the contagion that occurred. In two other cases the poison lay 332 Appendix. dormant ten days, and periods somewhat longer than fourteen days have been observed occasionally, but very seldom, by Arejula and others in Spain. " Sir, *' In reply to your first query, which will also be an answer to the second, I assure you that we had not. for a long time pre- vious, or during the continuance of the fever which prevailed this last season, any sugars from the Island of Cuba, excepting such as had forfeited their right to a drawback of the duties ; they must, of course, have been at least one year in the coun- try. 3 " The sugar-house has never been closed in any former season, but was always kept in full operation. 4th. " Nor has there ever before occurred a case of fever in it. 5th. " Germans, almost exclusively, have been employed in our business. 6th. " Our men who have families lodge at home, in the up- per wards of the city, above an east and west line intersecting Chatham-street, at the commencement of the Bowery. The single men reside in the building attached to the sugar-house, and also adjoining to the yard of the New Dutch Church. 7th. " The men, both married and single, continued their regular habits until the 21st September, with the exception of three, (one of whom, Martin Hauser, is mentioned in my 10th answer) who left the sugar house entirely on the 9th day of September, and did not return until the fever disappeared. Af- ter the 21st September, the single men discontinued lodging at the sugar house, but occasionally worked there in the interval between the 21st September and 2d October, when they ceased to iio there altogether. It ought to be mentioned here, that the boiler, or foreman, continued to live there until the first day of October, and one of the men during the whole season, both of whom continued he-^Uhy. 8th " The men m their routes to and from the sugar-house Appendix. 333 avoided, as much as possible, what was considered at the time the infected parts of the city. 9th. " The first case which occurred among our men was Lear Bush, on the evening of the second September He ate a hearty supper, of a very indigestible nature, laid himself down on a bench level with the sill of an open window adjoining to, and also level with the surface of the church yard, where he slept until morning. When he awoke he complained of violent pains in every part of his body, and removed to a lodging house in Mott street, where he died qn the 9th of September 10th. *' Christopher Fisher was next taken sick, on the 7th of September, while at work in the sugar house. He returned to his family in Forsyth-street in the evening, and laid for some time very ill, but recovered. Martin Hauser, (one of the three men referred to in my seventh answer) left the sugar- house entirely on the 9th September, and took lodgings in Stuyvesant's lane ; he was reported as a case in September, at least fourteen days after his removal, (during which time he assured me he had not been below Canal-street) and died on the fifth day. Herman Hartman worked at the sugar- house until the first of October, went at evening to his boarding house as usual, but was out that night very late, and returned intoxicated and wet, having been exposed no doubt in that state to the effects of a severe storm : he was taken down the next day, and died on the seventh. Lawrence Wendenman, the last man who was taken sick, had left the sugar-house on the 21st with the rest ; he returned to work seven days afterwards, and early in October was taken down ; he died on the ninth day. 11th. " With most of these cases I was personally intimate, and during the whole time of their sickness was in the habit of visiting them at least twice a day, and remainmg some time in the same room with them, assisting occasionally in removing them : neither I, nor their constant attendants, were ever af- fected in the least by the disorder. 12th. " Our men are certainly exposed to a considerable degree of heat in the performance of their labour, but it has 334 Appendix. always been supposed by them, as well as ourselves, that it rendered them less susceptible of infection, and I think we will be borne out in this opinion by medical authority, who gene- rally (1 believe) think that constant and profuse perspiration i^ one of the most effectual safeguards against fever. I am satis- fied in my own mind on this subject, and beheve that if we had kept the house in full operation, and consequently the men in the same regular habits, to which the disciphne of the house subjects them, we should have saved one or more of the single men. 13th. " In reply to your last query, I have to refer you, in part, to my last answer, and to add, that we have had repeated visits of examination, from the proper authorities, who were always satisfied from the healthy appearance of the men, that there could be nothing injurious to health in their occupation, and that every attention was paid to cleanliness consistent with the nature of so large an establishment. The steam arising from the sugar, when boiling, is the only thing about the manu- factory which can possibly offend the neighbourhood. But this steam, although it may' be offensive when met in such large quantities, is, I believe, frequently used to purify the air of a sick room. " I am, your obedient servant," " B. B. SEAMAN." Dr. Townsend. A''ew-York, January 1, 1823. No. VIII. Burial Grounds. . Letter of Professor John W. Fbancis, addressed to the Author. J^ew-York, December 24, 1822. " Dear Sir, " In answer to your query, ' What agency, in your opinion, had the Trinity Qiiirch yard in the origin of the late yellow Appendix. 335 fever ; and were you at any time during the prevalence of that disease sensible of noxious exhalations arising thence P I deem it my duty to state : " From a candid and impartial examination of all the facts which I have been enabled to collect, I am convinced that the late yellow fever arose from causes in nowise connected with public burial grounds. The evidence on this head is ample ; and as I am persuaded you will be able to put the matter in its true hght, at least so far as concerns the church yard, I shall not here enlarge. '• As to the second part of your query, a regard to truth in- duces me to give an opinion in opposition to what has been repeatedly asserted the past season. During the prevalence of the late fever I had frequent occasion to visit parts of ihe city in the neighbourhood of the cemetery of Trinity Church, and of other places of public interment. On no occasion did I ex- perience any perceptible effect in those situations. This opi- nion will perhaps have the greater weight when I add, that these visits were often made at a period when the fever was at its height ; during the hottest weather of the summer, at differ- ent times of night, and of day, and in all the varieties of wind and temperature. I know that what 1 have advanced differs from the speculation of many respectable persons ; but I am em- boldened to affirm it, because the observations I have made are the deductions of personal experience, and I suspect the con- trary opinion has been too hastily adopted. Moreover, I am strengthened in my sentiments by the testimony of others, who had every opportunity of correct information. ♦' The farce got up in Trinity Church yard, during the prevalence of the fever, is now better understood, and I shall dismiss it without comment. Yet one cannot but regret, that among those who gave it countenance were several of the public authorities of our city. •' I am not aware that any apprehensions have ever been entertained by the intelligent of the deleterious consequences of burial grounds in the large cities of Europe, and the theory 336 Appendix. which attributes yellow fever to such source in our own coun- try is equally novel and false. remain your s, JOHN W. FRANCIS. Dr. Townsend. No. IX. Additional facts in support of Contagion. CASES OF THE BAILIES IN CHEAPSIDE-STREET. The death of the two females by the name of Bailie, who went out of the uninfected parts of the city to take care of their sister in Cheapside-street has already been alluded to in the first chapter, as a marked instance of the contagious nature of yellow fever, and of the pecuhar susceptibility of a northern constitution. The particulars relating to their sickness, and which the de- sertion of the city rendered it impracticable to procure at the time I visited Cheapside-street, I have since had the satisfac- tion of receiving from Mr. Scott, with whom it will be remem- bered, Catharine, the first of the three cases that sickened, lived. She was an Irish girl of robust, sanguine temperament, and fourteen years of age, of very regular habits, and, unlike most other persons of this description, rarely left the house, or mani- fested any disposition to ramble about the city. She was ta- ken ill Sunday, Sept. 16th, about noon. Ward's house is about fifteen yards from that of Mr. Scott's, but Mr. S. says she had no communication whatever with the family. As so much sickness, however, had already occurred at Ward's before Catiiarine was taken ill, and as her system, from her short resi- dence in this country, [being, as we have before said, but seventeen months from Ireland,] must have been highly pre- disposed to the disease, there can be scarcely a doubt that if she had merely passed the house, the degree to which the air Appmdix. 337 without must hare necessarily been infected, was all sufficient to have dreated the disease in her, although others more habitu- ated to breathe the morbid effluvia of sick chambers, and who were natives and long resident in the cit}', might, as we have seen in numerous parallel instances, remain for hours in such an atmosphere with perfect impunity. Mr. Scott cannot possi- tively affirm that Catharine was not a few days before her illness near the house of Ward, "As the pump stands near it, howe- ver, there is every reason to believe that in going to fetch water she must have been much exposed to take the disease. Mr. Scott is of opinion that she took the complaint in another way. It appears that next door south of Mr. Scott's house, there stands a small back two story building, which fronts upon the rear of his yard, and the windows of which open upon it, not to ,exceed t'wcnty feet distmce from the cistern. On the Monday previous to Catharine's being taken sick, i. e. the 9th of Sep- tember, a painter by the name of Williams, died in the front tipper or second story room of this building. Dr. Joseph M. Smith informed me that from the representations which had bcin made of Williams' symptoms, there was every reason to- believe that it was a genuine case of yellow fever. No one, however, could precisely tell the manner in which he had re- ceived it, though the current opinion is that he had been em- ployed in painting the cabin-work of an Havanna vessel, or had been visiting infected parts of the city. That he had been down into the lower infected district is not denied. A few days before he sickened he told of his intention to go there to do some %vork, and said in justification that in hard times hke these it was necessary for poor folks to run some I'isk. I have the documents in my possession which prove these facts, but I have not thought it necessary to insert them. The day of his death the bedding upon which he had died was hung out of the window of his chamber. It so happened that nearly all that day Catharine was constantly employed in washing at the 43 338 Appendix. cistern, and of course was directly exposed to the effluvia that must have been exhaling from the chamber as well as from the bedding. Just six days after this exposure Catharine sickened. If Williams died of yellow fever, though not a reported case, Catharine then had. in all likelihood, taken in from this .source some of the seeds of the poison, enough, perhaps, to have gene- rated the disease in her person. She may also have received more or less of it from having approached too near Ward's house. Mrs. Bailie, sister-in-law to Catharine, came to see her on the I8th of September, and again.it is said, on Friday ; but did not stay with her constantly. Eliza, however, the sister of Catharine, and who had arrived from Ireland at the same time with her, came to see her on Monday the 16th, and remained with her day and night until her death. Catharine died Satur- day morning early, Sept. 2 1st. Mrs. Bailie and Eliza took sick in Orchard street on the 24th following, and both died at the Marine Hospital ; Mrs. Bailie on the 29th, and EUza on the 30th. It is somewhat remarkable that Eliza and Mi's. Bai- lie should both have sickened on the very same day, although Eliza was exposed to the contagion during the tirst, second and third days of Catharine's illness, and Mrs. Bailie not until the fourth ; and it is also still more surprising that the disease in Mrs. Bailie, who had been several years in this country, and whose susceptibility would have been thought much less than that of Eliza's, should have evinced higher marks of malignity, and been also of much shorter duration. These anomalies, though apparently irreconcilable, were doubtless owing to circumstances which, in the present imperfect state of our knowledge of the laws of this disease, our senses are incapable of taking cognizance. It is obvious that Mrs. Bailie did not receive the contagion from Catharine until the conclusion of the third day, or beginning of the fourth day of her illaess. Appendix. 339 Cases of Yellow Fever on Brooklyn Heights. The following is a copy of a deposition made at my request, by Mr. Thomas Baiseley, an old inhabitant of Brooklyn, whose veracity is unimpeached. His verbal declaration would have been sufficient, but the severe etiquette of controversy obliges me to adopt this form, for the narrative of the facts I have ad- duced. " Brooklyn, King^t County, state of Mew-York, ss. " Thomas Baiseley, of Brooklyn, being duly sworn, deposeth and saith, that on or about the ninth of August, 1822, John Davis, coacbsmith, of New- York, who lived in Washington- street, hired, and a few days after removed into the upper part of the house occupied by this deponent, in Poplar-street, Brooklyn. That the said Davis removed from the city to Brooklyn in consequence of the fever which prevailed in the part where he had resided. That on or about the first day of September he, the said Davis, went into the most infected part of the city, to wit, in Washington-street near Rector-street, for the purpose, as this deponent believeth, of procunng his tools of trade. " This deponent further saith, that on the tenth day of Sep- tember following, being Tuesday, the said Davis sickened of yellow fever, in the apartment which he had hired of this de- ponent, and that the said Davis died, and was buried the thir- teenth day of September. That on the sixteenth day of Sep- tember, Samuel Isaacs, coacbsmith, who lived and boarded with Davis, and had helped to lay out Davis, also sickened of yellow fever ; was removed to quarantine on the twenty-third, and died on the twenty-fifth. Isaacs had accompanied Davis in his visit to Washington street. This deponent further saith, that Mr. Davis told his, the deponent's wife, that her husband, Davis, had passed blood by stool during his the said Davis' illness. 34U Jlppendix, " This deponent further saith, that after Davis died, the bed- ding upon which he died lay out in the yard for several days exposed to the sun, and that no care was taken to avoid it by any persons living in deponent's house. That on the eigh- teenth of September, the son of this deponent,Nicholas Baiseley sickened of yellow fever, and died the twenty-fourth following. That the said Nicholas had black vomit, but that he had not been m the room where Davis lay during his sickness, and no nearer to him ihdn in the entry on the same floor with the room in which said Davis was lying sick. This deponent further declareth, that the room in which Davis was sick opens into the entry where Nicholas had been. " This deponent also sailh, that his daughter Antoinette took sick of yellow fever on Thursday the nineteenth day of Sep- tember, and died on Monday the twenty-third day of Septem- ber. That Nicholas, for the Jast fen days previous to his taking sick had not been in the city of New- York except in that part of the city with which intercourse from the town of Brooklyn was constantly maintained, to wit, the foot of Fulton-street, on the East-River, and no where else, to which place the horse ferry boat continued to ply from Brooklyn during all the epi- demic That Antoinette had not been in the city of New-York since the fourth day of July, which was previous to the exist- ence of yellow fever there. But that she had during the illness of Davis been in his room, and where he was lying ill with yel- low fever for the space of about one quarter of an hour ;: and that after Davis died she had slept, as his wife informs him, and as be believes with Mrs. Davis, on the same bedding upon which he, the said Davis, lay during his illness. " This deponent also saith, that he hath heard a strange report, that his daughter took her disease from a chest in the room in which she was accustomed to sleep ; but that there could be no manner of foundation for any such belief, because the che.st had never been opened since June, and that Isaacs and Nicholas Appendix. 341 had often slept in the same room with it, as well as several other persons ; and lastly, because it contained only some books of a Mr. Levi Dyer, of Norfolk, together, as the said Dyer said, with some clothing of his wife, who had, according to the said Dyer, died in Norfolk, as far back as the year 1821, in the month of November ; but not of yellow fever. This deponent saith, that the said Dyer was an Englishman, and that the said chest was brought to deponent's house, then iu James-street, Brooklyn, about the twelfth day of December, 1821. This deponent saith, that from the time Davis moved into deponent's house, to wit, a few days after he had hired the apartments of deponent. Antoinette ceased to sleep in the room where the chest was, as the room was one of the apartments hired by Davis ; and that Isaacs and Davis' son slept there with the chest until it was removed. This deponent further saith, that in consequence of the rumour about the trunk it was ordered to be buried by the Board of Health of this town, and was buried just before the death of Antoinette. " Furthermore, this deponent declareth,that the wives of his two sons, to wit, Nancy, wife of John, and Sarah, wife of David Baiseley, also were taken sick of yellow fever. That Nancy was much frightened, and only went into the entry, but not into the adjoining room where Davis lay, and that said Nancy a few days after had the disease very severely, and that Doctors Ball and Wendell declared her complaint to be the genuine old yel- low fever. That Sarah, wife of David, frequently visited and sat up with Nicholas just when he was about getting black vomit, and took sick the day before he died of yellow fever ; and that neither Nancy nor Sarah lived in deponent's house ; that Nancy had not been in the city in six weeks, nor Sarah all summer. ♦' This deponent also saith, that his wife also took sick of yellow fever, on or about the sixteenth of September, and was serious- ly ill for three days. This deponent further saith that Antoi- nette was eleven, and Nicholas Baiseley twenty-two years of 342 Appendix. age, and that be, the said deponent, fully and firmly beheres that the sickness in his house was occasioned by Davis. " THOMAS BAISELEY. " Sworn to the seventeenth day of January, in the year eigh- teen hundred and twenty-three. WILLIAM FURMAN, Judge." By this highly important document we learn : 1st. That Davis took sick on or about the tenth day after ex posure in the city. 2d. That Isaacs who had been at the same time with Davis near Rector-street, did not take sick until sixteen days after exposure. 3d. That Isaacs boarded and lived m the house with Davis before and during his, Davis' illness, and helped to lay him out. 4th. That Nicholas Baiseley had not been in any infected part of the city previous to his illness. 5th. That Antoinette, Nancy, Sarah, and Mrs. Baisley, all of whom had yellow fever, had not been in the city within the last six weeks previous to their illness. That Davis took his disease in the city is obvious ; Isaacs must have taken his from Davis, for the interval between the time of his exposure and falling sick was too great to suppose that he had received it from the same source as Davis, whereas the interval between the time of Davis and Isaacs' falling sick is precisely in accordance with the usual period required for the development of the contagion, viz. from three to six days. It has also been almost invariably observed, that persons who have been exposed to the contagion of yellow fever if they take the disease, fall sick, cceteris paribus, very near, or at the same time with each other, as is proved by innumerable recorded facts. Among other sources of information on this point 1 refer the reader to Dr. Bayley's account of the yellow fever at the quarantine ground, in 1821, pubhshed in the first volume of the New-York Medical and Physical JournaL Appendix. 343 In the case of Nicholas there is no ambiguity. To show that it would be extremely improbable to suppose that he visited any infected part of the city before he sickened, I may mention a circumstance related to me by his mother. When he heard that Davis had died up stairs he declared to his mother, with much emphasis and anxiety, " I would not, on any account have had this thing happen, for now we shall all be sick." If the cases of Isaacs and Nicholas in the opinion of rigid partisans of domestic origin, be thought to admit of doubt, that of Antoinette, though it were an unsupported and isolated case, is one of the most lucid and triumphant proofs of contagion that could have possibly happened, and one that, as far as my in- formation goes, has never been openly or seriously contested. Many would have wished to let this subject sleep. I was well aware of its importance, in illustration of the opinions which I have espoused in this work, and therefore took some pains to procure the details of what had happened in Mr. Baiseley's house, and was not a little surprised to find that a number of other, equally convincing proofs of contagion, had occurred in the same family, but the details of which had hitherto been cautious- ly withheld from the public. These are the wife and daughters-in-law of Mr. Baiseley, to whom may be added Mr, Baiseley himself, who was slightly in- disposed about the same time. But as none of these died, no doubt many will indulge in the common scepticism, that the dis- ease could not have been yellow fever. For Nancy's case we have the authority of Drs. Ball and Wendell, her physicians ; and it is equally probable the disease of the rest was the same. To Davis, therefore, all these cases are directly or indirectly traceable ; for as to the rumour about the chest, the part of the deposition relating to that must, it seems to me, convince every person, that it was a most ridiculous and improbable tale. In conclusion, it may be observed, that the house of Mr, Buiseley is situated in the suburbs of Brooklyn, on a remarkably elevated platform, known by the name of Brooklyn Heights, and at the distance of about one quarter oi a mile from the bay, 344 Jlpptndix. and seventy-fire feet above the level of the water. The Heights terminate at the bay by a sandy abrupt steep descent or bluff. This fine table land, exposed to the winds from every quarter, overlooks the city and harbour, and is chiefly occu- pied by villas, and boarding houses, to which, during the sum- mer merchants retire from the dust and warmth of the city to refresh themselves — to breathe a pure air, and to enjoy the superb prospect which it commands. Mr. Baiseley's house is a small two-story wooden building, the rooms of the ordinary dimensions, and corresponding to the size of the house— consequently, they are small, and the ceilings low, but uncommonly clean and comfortably furnished. The entry is very narrow. The room in which Davis was sick is probably twelve feet squai'e. The small size of the apart- ments, and the large number of its occupants, no doubt favoured the spread of the disease. Brooklyn Heights is uni- versally esteemed, both at Brooklyn and in this city, one of the healthiest and most agreeable spots in the vicitiity of New- Yerk. The town of Brooklyn is below, and on the side of the hill, and some of its low streets which run parallel and near to the water are narrow and dirty. But while Bi'ooklyn Heights, where the bouses are mostly separate and wide apart, with pretty gardens, engendered such mortality from the disease in the family in which it was introduced, the town of Brooklyn itself, well known frgni what has occurred in previous years, to pos- sess no peculiar exemption from yellow fever, and where the houses are compact and conjoined as in a city entirely es- caped, with the exception of two or three cases wlio had been into the infected district of New York. As Davis and his family moved so long back as the ninth of August, and of course carried their household eifects at the same time to Brooklyn, the disease which he brought into the house of Mr. Baiseley was not brought in these articles. The clothes he had on also in his visit to Rector-street could not have been more imbued with contagious matter than those of Isaacs, who Appendix., 345 was with him in the very same atmosphere. If the disease had been brought in this shape, the inhabitants of the house never would have fallen sick in succession, at least Isaacs, who had his full share without caUing upon Davis, would not have been so extremely backward in getting the disease as to wait very respectfully until Davis had gone through his sickness before he himself began to complam. He would not have needed the stimulus of Davis' disease to put his into action. If Isaacs, un- luckily for the believers in domestic origm, had not been with Davis, to be as a standing evidence against the misrepre- sentations which this aflfair might hereafter give rise to, great stress would have been laid upon what is denominated personal infection. Now they are held at bay by this fact, and do not know what to advance. In short, the commanication of the disease from Davis's person, not from his clothes nor tools, to Isaacs, Nicholas, and Antoinette, and the three Mistresses Baiseley, is just as clear and obvious as if Davis had flown from Rector-street to Baiseley's house, without a particle of clothes on his back. Proofs of Contagion at .Yexi) -Orleans. To the examples already given it may not be irrelevant to subjoin in this place a few facts, noticed during the prevalence of the yellow fever at New-Orleans, m 1820, also facts in rela- tion to fomites in 1809 and 1817. I am indebted for this com- munication to Professor Hosack, who received it from a gentle- man of that city, recently in New-York : " It is well known to nearly all the inhabitants of La Fourche, that in the year 1809, captain Edward D. Turner and his wife, who resided at Point Houmas Plantation, lost their lives by opening a trunk of clothes, which had been sent from New- Orleans during the prevalence of yellow fever ; that they im- mediately sickened, and died with black vomit, as did also the negro nurse who attended them. In 1817, a trunk of dry goods or clothes, were forwarded to the Choctaw agent, who caught the same disease by unpacking that trui^, and died ia 44 346 Appendix. the same manner. This circumstance, as well as his name, is well known to Mr. Flower, of Orleans. " During the present season, (1820) a Miss Oudin, daughter of the watcbmaker, who had lately arrived from France, and resided with a Miss Vignon, whose father hves near the Catholic Church, caught the yellow fever, and was sedulously attended night and day by her friend till given over by her physician, when, to avoid the distressing scene of her decease, Miss Vignon retired to the school of Mr. La Fort, up the coast, which, till that moment, enjoyed perfect health. Miss Vignon, a Creole, was not affected with the disease, and it did not occur to Mr. or Madame La Fort, that she could communicate it by means of her clothes, &c. Mark the result ! — she who had been the bed-fellow of M^as Oudin also slept with one or both of the Misses Gloverys, nieces of Madame La Fort, who both took the fever and died of its worst symptoms ! Fortunately, the medical attendant on that institution is one of those liberal prac- titioners, who so far from seeking to persuade others that this disease is not infectious, (and thereby being the means of its circulation) enforces every possible precaution ; and at his in- stance the pupils were immediately dispersed to places of secu- rity ; one orphan boy, John Rouve, of Bayou Sarah, only ex- cepted ; and he, having no place of refuge, fell a victim to the black vomit. Not one of those who left the seminary at the first alarm took the disease. " If you are acquainted with that part of the upper suburbs called the Nun's Point, (a little below Rousseau's plantation,) you must have remarked its high and healthy situation, eleva- ted several feet above the level of the city, at a great distance from the swamp and all stagnant water. There the inhabitants enjoyed the state of health to be expected from the purity of their atmosphere, entirely insulated from that of the city, till the following circumstances spread amongst them desolation and death. Next door to Robin de Logny's there is a very inferior kind of boarding house, kept by a man of the name 'of Marsh, who it seems wd|t to town in quest of sick boarders, and having appendix. 347 found one (GilfiUan, of the state of Pennsylvania) with the yel- low fever, he brought him to his house in a carriage, regardless of the safety of the other inmates. On the second or third day after his removal GilfiUan died, next a Mrs. Jones of Virginia, then Mr. Crane, Madame and Mr. Granville, all of Ohio ; a young child of Mrs. Howell ; and lastly, one of Marsh's own children, all died with black vomit. A Mrs. Dodderidge, and a mulatto woman likewise had the yellow fever ; the former was saved by being removed to a female hospital, and the latter re- covered. Marsh, his wife, and Mrs. Howell, who had the dis- ease last year, appear to be the only persons in that house who did not take the infection. " There is a long red building opposite to Madame Na- drand's, the properly of John Mornay, which is divided into six tenements, and is usually occupied by as many families. In this building there were the following persons : Madame Odri- gues, a Creole ; Mr. and Mrs. Schofield ; Mrs. Hill and her daughter, the widow Jones, both of which families had several children ; Mr. Rodgers, chairmaker, and his wife ; besides these there lodged at Mrs. Hill's a Mr. Nappen, a carpenter; and at Madame Odrigues, John Smith, a mason. The fever was first brought amongst them by Nappen, who caught it in the city, and died at Mrs. Hill's ; a negro woman caught it of him, and recovered ; next Mrs. Jones, who also attended Nappen, caught it and died ; next Mrs. Hill, whose body being taken to the grave by John Smith, he complained of the unusually offen- sive smell, and sickened and died also. All these were marked cases of yellow fever, and terminated in black vomit. Two younger children of Mrs. Hill's, and two of Mrs. Jones' also had the disease, but recovered. In the same building Mr. Rodgers and his wife, both had the yellow fever, the latter died. Mr. and Mrs. Schofield likewise had it. Within gun shot of the same spot, in the kitchen of John Mornay's former abode, lives an honest German, usually called ' Dutch Joseph.' This man being on board a German vessel in the river, infected with 348 Appendix, yellow fever, found an acquaintance extremely sick, and was induced by compassion to bring him to his own Jwelling, where the man shortly died of that disorder having first communicated it to Joseph's own wife and a young girl, both of whom also died ; and but for the attention of Dr. Forsyth, and the intro- duction of Guyton Morveau's fumigation, it is probable the whole household would have perished. " The above facts are not only confirmed! by eye-witnesses among the survivors, but by Dr. Forsyth himself, who attended most of the above patients, and who has very properly taken notes of the circumstances, under the most solemn conviction, that the above numerous cases of fever originated in the con- tagion communicated by the three individuals respectively staled " In the mean time there are famihes within view of the three last described houses, and one consisting of a dozen persons, unseasoned to the atmosphere of the city in the sickly months, who have remained exceedingly healthy and perfectly secure from malignant diseases, by vigilantly guarding against any com- munication with the sick. " Having thus detailed to you the manner of the yellow fever being introduced by four infected individuals, into as many dif- ferent habitations, all of these situated in n pure atmosphere, free from every predisposing cause of disease, and shown, that including the four first cases, about thirty persons have caught the infection ; of whom not less than eighteen have died, I beg you to reflect on the probable consequt-nces of four similar cases being introduced sraong the d^mse populution of any city in the union ; and whether thousands would not have fallen victims, unless effectual measures were adopted to interpose a barrier between the sick and the sound. " There were one or two other st/ iking instances of contagioa that occurred below the city. An Irishman who went from town to General Wilkinson's plantation, fell sick shortly after his arrival, and died with the black vomit. He was attended Jlppendix. 349 hy a man who had not been to town during the season ; he also caught the disease and died. 'I lie yellow fever was likewise taken to Mr. Fleckner's plantation by a white man from town, who there died ; p.ho the negro nurse who attended him, and the nurse of that negro also. " Mr. Livingston's overseer, who had not been near the city, visited one of those sitk white men, [whether at the Gene- ral's or Mr. Fleckner's, I do not exactly know,] and he also took the disease, and died with black vomit." No. X. State of the. Weather for thirty four years during summer and autumn from the year i'liid mclusive, to August, I8'i2. The abstracts which follow are made out from the tables of the lite W. Laight, Esq. to which I have alluded in the pre- face. It is believed that they are the only tables of the wea- ther extant in the city, as it has not until very lately been the practice either in private life or in our public institutions to pay that attention to this subject which its importance merits. Our colleges, hospitals, and other public establishments, mar.y of which have been formed for more than half a century have nevertheless, as far as I have been enabled to learn, totally ne- glected this very interesting department of physical science. The tables of Mr. Laight bef ire the year 1800 were kept during the warm weather at his seat at Corlaer's Hook, and since that period successively in Greewich and Courtlandt streets, and in Robinson street, (now Park Place.) Though C orlaer's Hook is in the environs of the city, it is situated on the east and warmest side of the Island, while Greenwich, Courtlandt and Robinson streets, are on the north-west or op- posite side, and by their proximity to the Hudson and spa- cious dimensions constantly exposed to cool and refreshing breezes. The difference, therefore, in the degree of heat in the two places must have been quite immaterial. 350 Appendix. In confined narrow streets, shut out from ventilation, the heat may have been somewhat higher than in the wide airy streets of that part of the city, where the thermometer of Mr. Laight was suspended. This does not, however, affect the relative changes of the thermometer, nor invalidate in the least respect the inferences that may be deduced from them. Be- sides which it must be borne in mind, that the discrepancies of thermometers are more frequently owing to some difference of construction, or to the quality of the quicksilver, than to the situations in which they are exposed. This is very forcibly exemplified in the extraordinary disagreement between the thermometer of the New- York hospital and that of Mr. Laight. According to the tables at the New-York Hospital, and which we have used in the chapter on the weather for the year 1822, the quicksilver must have ranged several degrees higher than in Mr. Laight's thermometer. Mr. Laight's tables for that year are wanting after the month of July ; but it is obvious, from comparing the months of .'une and July of Mr. Laight's tables uith the same months in Dr. Pennell's tables, and with the previous years of Mr. Laight's tables, that this difference is not to be taken as absolute, but merely relative. What renders the table of Mr. Laight still more perfect is, that the same instrument has been used during the whole time. The hours at which the heat was taken are between 7 and 8 of the morning, between 2 and 3 of the afternoon, and between 8 and 11 in the evening. Our averages are made out for the middle period. There are some trifling omissions which will be found noted in the abstracts in which they occur. In calculating the averages, and also the sums of the averages, I have taken particular care to accompany the integers With the decimals, so that their accuracy may be fully depended upon. Appendix. 351 In Table I. it was inconvenient to annex the fractional parts to the averages, but they enter into all the succeeding tables. In this table I have added one to the integers, where the deci- mal was over .70. The quanty of rain was not taken, but the rains and show- ers noticed in a very particular manner, sufficiently so to ena- ble any person to judge of the degree of humidity in the air. The thermometer used is that of Fahrenheit. 352 Appendix. > rr. ^ (U « fe ... i^ O) o 0) >> p s « is .£3 ?' H 0) (U o^ 0) __o_ -.'-!. CO CD •* t> CO CO C3^ lO *s 1 CO ^O ©J G^ CO 1 c^ CO lO -" *§ s; 1 Tf — &J 03 i O CO CO 1^ *3S 1 en "eo' 1 ?3 2 ?§_^_ C- CO -o 1 i2SS^ lO _ 'o •o « c 5 •-' I CO CO 3^ CO <-< __CN__ I t- 00 CO o I o oTirTi^ G^ I CO CO CO *a) I o o CO CO "so >S'"ci ^ 1 t- CO .D I - CO CO CO CO CO CO CO CO t- t- CO -^ lO ©i c: CO C5 *E r- C3 — t^ *^ c: CO t- CO (>} t- CO CO ■* 03 CO CN r- 05 t- CO CO CO — »- CO r^ 05 03 Ol CO CN l> C CO O OJ r- o; CO >— J> 00 CO — *: ^ "re j= < ffi i-j laic-' Appendix. 353 *?; 1^ - , 05 £) - &J 3^» 1 ,i X fA -3 iM *^- 1 05 — 1 t- Oi CO o CO ;i 1 .^ CO G^ c- r» 1 CO •* o CD i CO CO 1 t- 00 iO 1 CO -r 1 t- CO :: 1 c- o 1 f- » .^ X) ■ ^ 1 i^S CO i- G^ 1 ^ GC 1 I- CO 3^ CO O r- ~ 1 c~ cc 1 l^CO G^ CD o 1 ;5 5 5 0^« G< C5 c C- CO ■:0 O CO -^ CD t- CO so CO o c- -r L- CO 2 '± =•' § o CO Oi *?2 gg CO :?< PS CD c- — *?? ?^s G* CO iO — o t- CO CO *3 t- CO 8 C^03 c- CO gT OS *o 5S CO CO t- so 05 15 -^ — *C5 CO ^ § CO CO 05 — CO CO o C5 CO o C- C5 CO 0-0 CO C5 §£ 50 T C3^ Sg CO CO *s .?S CD •o — § CD t- -, CO J> CO "2 o ©♦ eo CO 1 0< iQ I 1> 03 j rC 00 I t^ co^ I a, -- 1 - CO CO -v ■* T-^ CO lO . r; G* X> O l> t^ CO «ft ii C- 05 £- CO ^o .-- •* ^ i-" "* O C?» I- -0 -r o t- CO lO 1-0 c> S" CO I;- oo ^ S *5' ;d CO uO l> — ■ 8 o 00 to 3i *? s CO ao 5 O *,^' — 5 r5 ^ (?< J^ 1 *'i t^ oo OKOO. *'^. ^ d, r^ K> — -O s s? G^ G^ uO *r s t^ Ic ~ a § C5 S ■O S t^ ,^ CO *u 1 C^ 1 O c>< 1 -. G* .0 "^ 1 CO t- CO . o 1 O G< — GO 1 uo )■• CO *2 Uo ^ ;:? ^^ CO i i^ 5 |i =^ l> 1 lO O '-I CO 1 o i> so CD 1 gg?^ O 1 CO O CO CD 1 « O CO -T 1 s.^^'^ :n issi:5«= o* t '- J* lO CO 1 O t- CO '- s?^;^- ■ :5 s?^^^ 05 SS§- CO ISS??^ ^ 9^.0^0. o en ;o cc CO lO f^ -o -5 CO -.i^ X lO o ■ri:;-- *o l§ - G^ o *5 -* CO O i CO t> -v 50 — O 1- CD t- -* § '^ •* '-0 CO n CO r — r *a^ ^. O T' O L-O t- ?0 *g ^ CO O >« -o :d CO S 1 *i 05 3^« o *S 1 05 -i-^z^ s CO CO oi -^ — >^ t^ GO GTS O 00 00 l> : CO :0 *05 CO G^ CO 04 lO t- CO ^ ^^^^ 00 >o So CO -c "S 75 ^- = i - - J « o " •O — t n lis ic^-S r/l r (N a ^.= is i c — i S s - ■- 3 •fl — 1 J. ^ r^ -a -3 V .u ■o t^- = J J= »- s r) ^, -JX! x: j: s S" S?:f^ = ■ s o oS H = £ ? = 5t: = 2 45 354 Appendix. TABLE II. Average heats of June, for 31 years 74.07 for 33 years 74.04 July, 78.50 78.44 Aug. 77.36 77,43 Sept. 70.38 Oct. 58.89 Sum of the Average Heats of June, July, August, September and October, for 31 years, 359.20 Sum of the Average Heats of June, July, and August, for thirty-three years, 229.91 Sumofth ic Average H« lats of Ju ne, Sum of the Average Hf^ats of June, July and Aug. (that is 92 days.) July, Aug. Sept. and Oct. (that it 153 days.) 1789, 231.44 354.72 1790, 222.. 37 347.01- *179I, 233.85 357 50 1792, 228.58 355.72 1793, 235.82 365.84 1794, 230.02 for 90 days 359.45 for 142 days. *1795, 232.78 do. *1796, 223.94 for July Aug. and Sept. 282.89 for July, Aug. Sept. and Oct. 1797, 236.63 for 63 days. wanting. *)798, 23 2. .32 364.37 *1799, 228.72 356 29 1800, 230.20 for 84 days 361,10 for 145 days. *1801, 231.07 369.12 1802, 228.6^ for 91 days. , 363.80 for 152 days. *J803, 234.76 365.2^^ for 146 days. 1804. 227 64 367.83 for 147 days. * 180.5, 236.77 366.53 18U6, 231,89 361.10 1807, 230.14 359.28 1S08, 229.0© 358.63 355.74 332.73 365.89 349.36 Appendix. J 809, 221.67 1810, 22o.07 1811, 231.44 1812, 224.91 1813, . 226.12 for June, Aug. and Sept. 28r3.03 for June, Aug. Sept. and Oct. 1814, 227.91 357.34 1815, 230.34 357.54 1816, 219.71 344.26 1817, 222.96 348.36 1818, 231.76 359.36 *1819, 236.07 367.78 1820, 235.09 364.71 1821, 227.98 361.01 *1822, 153.52 for June and July. 35g TABLE III. Sum of the average Heats for June, July, Aug. Sept. and Oct. (that is 153 days) in seven years, when yel- low fever prevailed. Sum of tJ^ average Heats for'June, Jul}-. Aug-. Sept. and Oct. (that is Ijwdajs^ in seven years when yel- low lever did not prevail. 1791, 357.50 [1793, 365.84 1798, 364.37 1800, 361.10 for 145 days. 1799, 356.29 1802, 363.80 for 152 days. 1801, 369.12 1806, 361.10 1803, 365. 22 for 146 ds. 18J1, 365.89 1803, 366.53 1820, 364.71 1819, 367.78 1821, 361 01 2546.81 264-^.45 2543.45 Excess, 3.36 356 Appendix. VARIATIOK. 369.12 356.2» 12.83 VARIATION^ 366.89 361.01 4.88 TABLE IV. S>tim of tlieAverage Heats for June, July and AuiV (tliat is SZ days) for eight years when .} t How fever prevailed. 1791, 23.3.85 1795, 232.7 8 1798, 1 23^2. 32 1799, 228.72 1801, 231.07 180.3, 234.76 1805, 236.7T 1819, 2o6.07 for 90 days. VARIAXrOK 236.77 228.72 8.05 1866 34 Sum of the Average Heats for June, July and Au^. (that is. 9id days) tor eight years, in which there was no yellore fever. 1789, 231.44 1793, 235.82 180(:, 231.89 1807, 230.14 1811, 231.44 1815, 230.34 1818. 231.76 1820, 235.09 1837.92 1866.34 VARrAxrow. 2.%5.82 230.14 5.68 8.42 Appendix, TABLE V. 357 Sum of the Average Heats for June, July and Aug. of the years in which yellow- fever appeared in lUe immediate virinity of New York. 1804, 227. 64. yellow fever at the Wallabout. 1809, 221 67 yellow fever at Brooklyn. 1811, 231.44 yellow fever at Amboy. 6J80.75 Sum of the Average Heats of three of the warmest years, in New-York, in which there was no yellow fever, viz. 1793, 1806, and 1820. is 702.80 680.75 Sum of the Average Heats for June, July 'ind Auu'. in eight years, in which yellow fever prevailed in New York, or in its immediate vicinity. Excess .05 Sum of the Average Heats for June, July and Aug. m eight years, in which yellow fever did not prevail in New-York, uor in its vicinity. 1791, 233.85 1795, 232 78 1798, 232.32 1799, 228.72 1801, 231.07 *1804, 227.64 11809, 221.67 |1811, 231.44 1839.49 1793, 235.82 1794, 230.02 1797, 236.63 1800, 230.26 1806, 231.89 1807, 230.14 1818, 231.76 1820, 235.09 1861.61 1839.49 VRRIATION. 233.85 221 67 22.12 VARIATION. 236.63 230.02 a2.18 6.61 * Ai the Wallabont. * Brooklya. $ Amboy. 3S8 Appendix. TABLE VI. AGGBEGATE VARIATION OF THE THERMOMETER FOR JUNE) JUL if AND AUGUST, FOR 34 YEARS. Year 1739 82" 90 67 91 76 92 86 93 80 67 1 72 96 00 97 00 98 1 99 73 78 00 70 01 02 64 76 03 82 04 65 00 iVar \\m 07j03|09i iOj 11 j 12j i;J| I4j I5j lb 17 18 j 19 20 83 21 76 22 00 00" 84 96 137 92 84 1 7i 1 00 85 1 75 1 (05 90 82 1 127 TABLE VIL SHOWING THE RELATVE DEGREES OF TEMPERATURE AND HUMIDITY Ilf THE DIFFERENT MONTHS. May. June. July .4ugu< September. October. ' 1789, wet hot drv warm dry warmv. wet warm drv 80, dry (Old wet cooi dry cold wet cold wet 91, dr>- hot dry hot .^Id wet 1800, nioist cold dry hot dry warm moist cold V. dry 1, dry warm v. dry hot v.'dry warm we V. hot dry V. hot dry 2, moist cool dry cool dry V. hoi dry warm mhist hot dry 3, dry hot dry V. hot dry arm v. dry 4, wel cool moist coo! moist Whrm moist hot dry 5, V wet warm dry V. Lot dry V. hot dry V hot moist warm dry 6, dry V hot d.y hot dry cold wet cool wet 7. moist cool moist V. hot 'dry warm v. wet cool dry 8, V wet hot dry warm moist cool dry hot dry 9, V. wet cold wet V. lold rnoiit cold moist cool dry 10. V dry rool moist V. cold moist cool wet hot dry 11, moist hoi dry V. hot dry warm dry hot drv V. cold moist 12, moist cool moist cool moist V, cold moist 13, wet hot wet V. hot dry y. hot dry 14> moist cool dry cool dry warm dry warm moist 15, moist cool dry y. hot dry coo) moist cool moist 16, moist V. cold dry V. cold dry cool dry V. cold wet 17, dry 18, wet V. . o'd wet V. cold moist cool wet warm dry ^. hot dry hot wet V. cold moist cool dry V. hot dry 19, wet ir. hot dry V, hot dry V. hot dry 20, wet V. hot dry V. hot dry V. hot jnoist V. hot dry 21, wet ool dry cold dry hot dry V. hot dry hot dry 22, dry warm dry hot moist The letteri) denotes very. In order to express the relative degrees of temperature, the arerage htntof each momh for The whole nun.ber ofj.-ars ro:lc,t,rely, was used as a stwdafd, Sd compared wUh toe monthly averages of Mch year .epajately. Appendix. f59 Remarks on particular years accompanying the PRECEDING tables 1791. — The Spring of this year was remarkably pleasant. June. On the 25th there was a very severe gust of wind, which lasted about 6 minutes, and covered the whole city with dust, so that persons could not see across the street. This was according to the appearance of the table a clear, dry and warm month. July. A dry, clear and hot month. August. Dry and warm. Gusty and heavy thunder on the 26th. The yellow fever which broke out this year near Peck-shp, the middle of the month, was the tirst that had occurred since 1762.* It terminated, according to Dr. Addoms, about the middle of October, which corresponds with the table for this month, • as snow is mentioned to have occurred as early as the 18th, on which day the thermometer was at its lowest elevation, viz. 38 degrees at 8 A. M. 38 degrees at 2 P. M. and 40 at 8 P. M. The middle of August was cooler than the rest, for the thermometer was above or at 80 only on the first ten and last 1 days. September. Cool wet weather this month, yet the fever went on. 1793. — June. Clear, dry and warm. Though the average temperature of this month is above the medium, it was quite cool and unpleasant from the 26th of May to the 6th of the month. A vei'y heavy gust was observed on the 2Uth, P. M. July. A very heavy rain on the 6th. Clear, dry and exceedingly hot month. August. Heavy gale and rain on the 25th. The yel- low fever broke out this month in Philadelphia, and proved fatal to more than 4000 of the inhabitants. Weather of this month very dry and excessively hot. September. An extremely dry and very warm September. October. A light snow on the 28th ; thermometer 35, 37, 36 degrees at 8, 2, 8 hours. The fever at Philadelphia ceased a few days after. 1794.— More rain fell from the 23d to the 29th of May than had ever been remembered in the same space of time. June. * See Dissertation on this fever by Dr. J. S. Addoms, p. 7. Alsf> Hosack OB Contagion, p. 3$ 360 Appendix. A cool month, and incessant rains from the S'^d of May to th 12th of June, which did much damage in New-Jersey by car- rying away bridges, dams, kc. and drowning cattle. July and August. Strong gale on the 12th of July, and heavy rain on the 19th ; July nor August neither of them wet, mostly clear and warm. September. Yellow fever appears in JVew- Haven and Baltimore. Some of the crew of a ship from An- tigua, and also some persons who worked on board of her, are said to have died during this month of a severe and putrid fe- fever, the poison disseminated from which may have been dis- persed by the heavy gale and rain on the 20lh. This month was not particularly moist. The weather was evidently pre- pared for the reception of the yellow fever. October. Heavy gale and rain on the 2-th, 24th and 25th, with the wind easter- ly. November. Snow on the 1 4th. 1796. — June. Moderate, clear and dry. Very heavy rain on the 10th. July. The last thirteen days of June and firnt ten days of this mouth, making twenty-five days, were excessively dry, and those in July very warm. There was no rain in all this period except one little shower on the 8th of July. On the 12th very hot, and a heavy gust and shower at 2 P. M. From the 12th to the 20th moderate, and some apprehensions of yellow fever near Whitehall-slip. From the 20th to the end of the month mo- derate, with much rain and some thunder. No traces of the fever discovered. August. A moderate dry month. Heavy squall and thunder gust on the 1st. Thunder again on the 9th and 29th. Pleasant and moderate weather during the whole month. Very dry from the 16th to the 24th. In this interval, about the 21st or 22d, the yellow fever again appears ; the thermometer at 2 P. M. being from 70 to 80 degrees. On the 24th it abates. A thunder gust and rain on the 29th ; and rain and fresh breezes on the 30th and 31st. The rains in the latter part of July may have checked the disease, but the drought brought it out again. September. Remarkably tempestuous, but moderate and ex- treme dry throughout the month. On the 14th, at night, a Appendix. ,361 heavy gust and showers, accompanied with more and severer thunder and lightning than had been observed in three years. Yellow fever, however, continued to prevail, though at a lin- gering pace, during the whole month ! There were fresh gales on the 1st, 7th, 8th, 17th, 18th, 19th, 20th ; on the 22d, with a gust and thunder ; fresh breezes on the 23d and 26th, and much rain on the 28th. These violent commotions of the atmosphere counterbalanced, in some measure, but could not overpower, the morbific influence of the heat and drought. October. Moderate, clear and pleasant month as usual ; strong gales on the 2d and 3d from the N, E. and the fever disappears about the 7th or 8th ; the thermometer in the in- terval between the gales and termination of the sickness never having been lower than 48 degrees, which it was on the first, and which is the lowest elevation of this month, except on the 18th, when it was 40 degrees at 8, A. M. Therefore a frost may have occurred on the night of the first. A strong gale again on the 18th, with rain, which probably helped to venti- late the city, and to clear it of the poison. It was subdued du- ring all September by the stormy state of the w«ather, and received a severe shock from the gales of the 2d and 3d of this month. November. Moderate month, and very dry. Strong gales and heavy squalls on the 1st and 6th, after which there was an Indian summer, and no rain to the 24th, the month terminating in blustering cold weather. 1798. — There had been scarcely a shower from the 1 1th of April to the 23d of May, making a drought of 52 days ! June. Calm 23d and 30th. A warm month without much rain. — July. Moist and warm. Heavy gust from the N. W. on the 3d, with rain ; also on the 8th, and on the 29th, when there was thunder ; heavy showers and thunder also on the 25th. Calm 15th and 30th. The thermometer on the nine last days from 80 to 89 degrees at 2 P. M. August. Very hot month, and mostly clear, but considerable rain, which fell at intervals. A keavy shower on the 13th j and on the 14th an. extraordina- 46 '3BS Appendi±» vily heavy rain for three hours. On both occasions there v/sM thunder and lightning ; heavy rain also on the .6ih and 28th, and on the "2..'d, when it was accompanied with thunder, About and after the 15th, the heat was very oppressive, and the air extremely humid. The yellow fever broke out on the 20th. On the 26th and 27th it was most fital in Pearl- street, between Beekman [now Fulton,] and Burlmg slips, and on Golden-hill, and in Cliff-street, [then very narrow.] The disease was attributed by some to tainted beef and pork ia pickle ; by others to the sewer in Burling-shp. A remarkable number of calms, viz. on the 6th, 12th, 17th, 18th, 28th, and 31st, which, all, except the tirst, must have assisted very much the progress of the disease. The great heat of the last days of July continued through most of this month. From the 4th to the I4th, the thermometer at 2, P. M. ranged from 81 to 89 degrees. On the 14th and 16th it was below fcO degrees. On the following seven days from 80 to S3 degrees ; on the 23d 72, on the 24th 76 ; on the 25th 86, on the 26th 88, and on the 27th 81. September. Clear on the third. The fever had abated so much that only one new case was reported, owiu,?, perhaps to a sudden reduction of the thermometer on the 28ta August, the heat between that and the 3d September ranging between 78 and 64 degrees ; and on the fourth, in the middle of the day, it rose again to 80 degrees. Very distressing accounts, however, continued to arrive from Philadelphia. On the 4th, very heavy rain and thunder early in the morning, which had no effect on the progress of the fever ; for on the 10th, there were twenty-five deaths; on the 13th 42 died; on tha 1 4th, 28. Early on the morning of the 19th there was a heavy rain, and next day 54 deaths. Oa the 21st, in the morning, a heavy rain and thunder, which does not seem to have at all suspended this dreadful distemper. For on the 27th, fifty deaths were reported, and on the 28th, 46 ! On the 28th also, there was a strong breeze from the N. W. and a gale all next night from the same point of the compass. Calm on the Appendix, 86% 24th. October-. Clear, very warm and dry. On the 2d, a very heavy dew. Up to the 5th the deaths were about 30 a day. Oa that day they were 24, the next 22, the next 10. On the 9tb, 14 ; and on the 1 Jth, 12. This decrase was caused, perhaps, by the rains and gales in the last days of the preceding month. On the next five days, however, the deaths, amounted to 1 5, 22, 12, i6, 24. On the 17tb, there was a very thick fog and calm ; and on the 18th, a very heavy dew and fresh breeze, on which day there were 13 deaths. The next day, the 19th, afresh gale all night, and also on the succeeding day, when there were 10 deaths ; but on the 22d, the gradual approach of the cool weather of autumn, together with the gales of the 19th and 20th, began to take effect, for on that day eight deaths were re- ported, and but four only on the 23d ; the thermometer be- ing, on the latter day, as high as 62, 60, 56 degr£es, at 8, 3, 8 hours ; havmg been once only as low as 60 degrees in all the previous part of the muuth, viz. ou the 13th, at 8, x'... M. On the 24th, there were fresh gales all night, and nine deaths ; and on the four succeeding days the deaths were 6, 10, 9, 7. On the 2&th, the thermometer was 5i', 54, 50 degress ; '..nd on the next day it sank suddenly to 40, *2, S6 degrees, vthich produced a frost that night, the first that had occurred. C^ the 30th, five died, and the thermometor stood ct SO, c-o, 34 degrees. And on the 31st, 34, 38, 34 Crgvees — Cf'm, 2d, 10th, 1 6th, 28th, November. Though September iind Octo- ber had both been warm, there was snow on the fi.'st of thig month, and three deaths ; the mercury standing ."^S, S<\ 34, de- grees at 8', 2, 8 hours. On the 2d, 1 1 ceaths, end the thermo- meter at 34, 42, 40 degrees. On the 3d, 7 deaths, and the thermomfeter 38, 40, 36 degrees. On the 4th, there died only four, and the thermometer stood at 36, 43, 40 degrees. The fever here terminated. If we suppose the frost to have actually occ\xrred on the 29th, the day on which the epidemic after- wards ceased, throws some light on the period required for the ilevelopment of the disease \ fof those who died after the frost> 364 Appendix* in other words between the 30th of October and the 5th day of November, must have received the contagion before the 30th, Presuming that those who died on the 4th received the disease on the 29th, it places the period of development precisely at fromj^t'e to six days, which agrees in a most remarkable man- ner with the united experience of the most approved writers. Calm on the 16th. 1799. — June. Moderate and moist as usual. Very heavy thunder on the 18th, followed by rain in the evening. Heavy rain and thunder on the 22d, early ; and a very heavy gust at 6, P. M, on the 26th. Calm on the I'th, leth, and 24th.— July. Warm and exceedingly dry month. Rain twice only, viz. very heavy gust with rain on the 13th, and a shower and gust also on the 26th. On the third there were rumours of yellow fever at Philadelphia. Calms frequent, viz. on the 15th,. 17th, 24th, 28th, 30th. August. Moderate, clear and very dry. The rains in this month ivprp mostly showers, and the weather was, for the most part, pleasant and clear. From the 5th to the 16th, the thermometer at 3, P. M. ivas constantly between 80 and 85 degrees. On the 15th there were appear- ances of yellow fever, which produced so much alarm that one third of the inhabitants had removed before the 27th of the month, although it was thought on that day to have totally dis- appeared. The previous year was too recent to be forgotten, and it is not to be wondered at that this panic should have seized them, when they had lately learned by so many melan- choly lessons, the danger of procrastination. The pestilence was only smothered, and this apparent occupation of the diaease was produced probably by the tempestuous weather, which occur- red between the 16th and the 2 1st, for we find in that period there was a constant succession of strong gales, which for those days sank the mercury to 73, 70, 69, 67, and &Q degrees. As late as the last davs of the month, one of the most eminent physicians of this city declared it the most healthy August he had ever remembered, confirming what has been Appendix. 365' repeatedly remarked, that yellow fever is totally unconnect- ed with what is termed a pestileutial condition of the at- mosphere. Calm on the Itth. September appears to have been a cold wet month. The yellow fever at length made its appearance, for it is now stated to have increased on the fourth, and that ten persons died of it daily from the first to the tenth of this month. From the 11th to the 20th there were generally from 13 to 8 and 6 deaths daily. On the 20th there was a heavy gale at night, and rain, but it produced no effect on the progress of the malady, for, from that date to the end of the month there were daily from 16 to 10, and 9 deaths : the thermometer being constantly above 50 degrees. October. The average heat for this month was not great. From the 1st to the 18th the deaths varied from 8 to 7, 4, 3, 2 ; and on the 18th only one died. Up to the 17th the thermometer was con- titantly above 50 degrees, and from that to 70 degrees, except on the 16th, at 8, P. M. when it was 49 degrees. On the 17th^ it stood 36, 46,40 degrees. On the 18th, 34, 52, 45 degrees ; on which date, [probably the night previous,] there was z frost, and afterwards no more yellow fever. Though the mercury on the 19th rose again, and averaged 56 degrees at 3, P. M. for the remainder of the month ; not sinking below 40 degrees, ex- cept at 8, A. M. on the 24th ; yet no more cases occurred. About tbe 26th, there was a general movement of the citizens' to their homes. Calm on the 2d. JVovember. Tbe weather, most of the month, was what in this country is called an Indian summer, being most usually characterized by a hazy atmosphere and a mild temperature, and occurring generally at this time of the year, though occasionally in winter. The thermometer ranged from 35 to 45 degrees. " The sun," says Mr. Laigbt^ " was seldom visible, and the air extremely humid." 1801. — June. Clear, moderate and extremely dry. On the 16th, there were refreshing showers, lightning and thunder. Towards the close of the month very hot. No calms noticed. July,— The weather was hot and continued uncommonly dry 366 Appendix. throughout this month. There had heen no rain worth spealt- ing of since the 6th of May, to the 21st of July, making a drought of seventy Jive days ! Very heavy gust and shower on the 3d and 16th. A fresh gale on the 1 1th and steady rain on the 2ist. No calms noticed. August Compared with July, was a very wet month. The first eight days were exceedingly pleasant. Rain on the 9th at night ; thunder and lightning and heavy showers on the 10th, and heavy rams on the 12th and 1 5th. Dr. Richard Bayley, Health Officer, died at the quarantine of yellow fever on the 17th ; showing that the seeds of the disease had, as usual, reached there, though they had not yet been transplanted into the city. September. This appears again to have been generally a very dry month, which is as un- usual for September as for June. It was also clear, and the hot- test September of the whole 34 years. There was a thunder gust on the 1st ; and the first ten days of thi month were very humid and the heat oppressive, but the city to all appearance remained healthy. This humidity of the air was owing, I pre- sume, to the previous rains in August, about the 20th and Slst^ rumours were heard of yellow fever, owing to one or two sudden deaths. Total eclipse of the 7noon on the 22d. T7ie last four days of the month were very cool, the thermometer having sunk on the 2'7thfrom 6ii and 78 and 86 degrees, which it had been all the month, down to 45 degrees, between which and 64 it ranged, during the remaining days. It was so cool that fire was agree- able. No calms noticed. October. Clear and dry as usual, and very warm for this month. The thermometer had not been low enough in the last of September to produce a frost, for between the 1st and 6th, a number of persons actually died of yellow fever between the Coffee House and Fly Market Slips, and the disease continued to prevail more or less during this month. The thermometer from the 1st to the 8th of the month ranged between 54 and 70 degrees. On the 8th, Dr. Til- lary reported 35 deaths of yellow fever since the 1st. Thift sudden mortality was occasioned, without doubt, by the succeg- Appendix. S67 sion of cold days in the last of September, the sick having taken the disease before, when the heat was high. On the same day of this report [the 8th] the thermometer fell again to 44, 56, 48, degrees, at 8, 3, 8, hours, and continued to range as low as between that and 65 degrees from the 7th to the 12th ; in which interval the mortality consequently again increased ; for we find that 23 persons who had probably taken the disease during the first seven warm days of the month, now suddenly died, owing to the change on the Blh. On the 13th, there was another sud- den change, the thermometer rising to 67, 70, 65 degrees, between which and 58 degrees it continued to range until the 18th, with a very humid atmosphere. The Jive days of cool weather previous to the I3th, had again suspended the progress of the disease, for we now hear of no more cases until the 24th, when 3 deaths were reported, who had doubtless taken the disease between the 13th and 18th, when the heat was high. The thermometer from the 18th to this date, [24th,] had sunk to 60, 50, 48, and 46 degrees, &.c. and on the 24th stood 50, 60, 54 degrees, on which day the first ICC is mentioned to have occurred, probably during a sud- den change in that or the preceding cold nights. On the 26th one died and none afterwards^ though the weather during the days which immediately succeeded the Frost, were\warm and excessively dry. November. The month came in with an Indian summer, and on the 7 th there was a hard frost. 1803. — June. Clear, warm, dry. Hail storm and gust on the 1st P. M. The hail stones were two inches in circumference. Hail and rain on the 14th, with lightning, which struck a house in Pine-street. From the 23d to the 26th very hot. July. Ge- nerally clear, and very hot. Heavy showers and rains on the 2d, 14th, 16th, 18th, 23d, 26th, and 29th, but of short duration, and no thunder except once, on the 18th, when it was heard at a distance. A sickness among the cats prevailed about the 27th. Between the 28th and 31st rumours of the yellow fever. About this time several vesse/j /taxnn^ sick on board were ordered froni 36$ Appendix. the Coffee-House slip to the quarantine ground. A Mr. Chan- dler, who had removed from the Coffee-House shp to Mr. Shay's, opposite, died on the 30th, after two days illness. The ther- mometer had been 15 times in the month between 80 and 89 degrees ; and on the last three days was also above 80 degrees. On the 1 2th, the thermometer stood at 85 degrees at 3 P. M. and on the 13th and 14th, at 89 degrees ; and, for the following six days from 87 to 8 1 degrees ; the next two days a little below, the next three a little above 80 degrees, and the next three again a little below 80 degrees, which brings it to the 29th. August. Dry, hot, and no thunder scarcely during the whole of the month. On the 1st, a number of persons are stated to have died of yellow fever about the Colfee-House-slip. On the 6th, the Mayor reports that 33 have been sick of a malignant bilious fever, of which sixteen had died, and nine remained sick. On the 8th the fever increased. A day or two after the Mayor issued a proclamation, recommending the inhabitants of the S. E. section of the t®wn to remove as expeditiously as possible. On the first six days of the month the thermometer was between 80 and-87 degrees at 3 P. M. From the 8th to the 13th there were 3 and 4 deaths daily. On the 1 3th a violent gust and heavy shower, with some thunder at night. There were four •deaths that day, but the thunder gust had no effect upon the.fever for, on the 17th, the deaths increased to 9, 8, and 7, and con- tinued so until the 26th, when they decreased, without however the intervention of any particular change of temperature or other phenomenon to cause this diminution, and too long after the thun- der gust to be attributed to that. On the 1 5th, the Health Officer reports 44 persons sent from the city to the Marine Hospital, of which 21 had died. On the 19th, the New-York and United States Banks removed to Greenwich, and on the 24th the Mer- chants' Bank. Dr. Ledyard, the Health Officer, died at qua- ■rantine about the end of the month. September. Moderate, and 'frery dry month, and complaints of drought all over the state, «nd great part -of the United States. The deaths increased again Appendix. 269 pn the 1st to 8, and continued through the month, from 15 to 12 11, 9, 7, 6,3, &c. daily. Very dry. The Manhattan Bank moves on the iA, and the Custom House, &c. both to Greenwich. A gust on the 15th, and another on the 26th, both with rain, but they produced no diminution whatever in the number of deaths. . October, Warm. The thermometer was once as low as 48 de- grees, and at another time at 45 degrees, between the !st and 18th. At all the other hours it was above 50 and oO degrees. In this interval there were two or three rains, and the deaths, averaged daily from 18, to 7, and 6. On the 1 7th there was a gale all night, and on the 18th, at 6 A. M. the quicksilver was as low as 37 degrees. Very probably, therefore, a frost had oc- curred the night previous, for the thermometer rose again next day above 60 and 4u degrees, and cotitinued from thai to bO and 65 degrees up to the end of the month, while the deaths, on the contrary, which were 10 on the :1st, diminished the day after to 6, 4, 3, 2, and 1 daily. The fever had received its death blow from the change of the weather on the luth, and expired with the month, when the Health Committee ad- journed. There were in all 1639 cases, and 606 deaths, during the epidemic. It is strange, that many persons had begun to move in as early as the 14th, and that as early as the 20th ;md 21st, the houses, almost all over the city, were opened for airing, and the inhabitants of which removed into them a day or two afterwards. November. The last deaths of yellow fever recorded are four on the 1st of this month. The Banks moved in the next day, On the 7th the thermometer fell to 40 de- grees, and on the succeeding days to 35, 35, 33, 27, 27, de- grees. 1804. — June. During all the summer of this year there was scarcely any thunder. About the last of this month some persons were taken sick and died at the Wallabout of yellow fever. The thermometer on the last 12 days of the month was, at 3 P. M. not once higher than 79 degrees, being on those days at that hour 75, 67, 67, 68, 71, 72, 68, 74, 79, 76, 74, and 68 degrees, the 47 @70 ApftnUae. weather most of the time rainy, misty, or 'clouded, and the winds easterly. No remarkable phenomena in this month. The weather was moderate and moist. July and August. Mode- rately warm and moist. September. Though the heaf of thii month was considerable, there was black frost at Hellgate, • few miles from the city, on the 30th. The weather was gene- rally dry and clear. October. As cariy as the 26th snow an inch deep ; the thermometer being 45, 44, degrees. 1805. — Jutie. Warm, dry, and clear. July. The thermo- meter this montli indicated an unusually steady range of high heat, being at j^^ P. P^. almost con^tanliy be^iween 80 and 86 de- grees.. The weather clear ?.nd dry. Heavy showers, with thunder, on the 6th and 23d. Afeout the \bih, a person wlio if said to have had yellow fever, wjs removed from Maiden-lane to quarr.ntice, where ho died. Denied by Dr. Hosack and otheis to be yellov/ fever. About ths last of the month inter- course was interdicted with Providence and HezoHaven, incon- sequence of jellovy itiver having appeared in those places ; and a parson nm renaoyed about thirs time from No. 127 Water- stiwCl, sick with yetlov; fever, to quarsatine, having previously been on board a vessel at that place. AugurA. Dry, clear, and very hot. Showers with thunder en the 3d and 8th. Gust, with rain, on the i3t!i ; and showers on the 'iZCii anil 31st. One death oi' maliguani fsver is mentioned on the ii4th, and another on the 3 1st, About the i^9th, the yellow fever appears at Phi- ladelphia, Thermometer almost constantly above 80 degrees. September. Remarkably hot and moderately moist ; and hottest September, except two, of the 34 years. The Health Commit- tee reported «q the 6th, that between that day and the 2d there had been ten cases of malignant fever, five doubtful, and four deaths ! It prevailed in Frtnt and Water-streets, between Wall- street ani the Fly Market. The thermometer from the 19th to the 28th of August had been from 80 to 88 degrees at half past 2 P. M. From thence to the 5th of this month betweea 75 and 78 degrcei, the winds Gbieflj southerly; anil the weathet Jpptndix. 371 Jull, rainy, and cloudy. The deaths for the remainder of the month of this fever varied from 16 to 13, 1 1, 9, 7, 8, t, I. Sic. daily. There were heavy showers on the 3d, and on the 26th, when there was thunder. A heavy gale on the '28ih from the N. E. when the thermometer sunk on that day, as well as on the two succeeding days, as low a« 43 and 55 degrees. October. Came in warm again, and the thermometer continued above 40 degrees to ths 25th, when it fell to 35 degrees, and the deaths, which had been daily all the month from 14 to 7, 4, 3, &c. now suddenly C2ased. On the 25th the Board of Health adjourned announcing that the exiled inhabitants might now return. On the 28th and C9th the inhabitants returned to town. 1 806. — Ju7ie. Clear, dry, and very hot month. The average heat, for this month, was unusi-illy high, and the ra:tge very steady, bemg the hottest in aH the 34 years. There ^ras one heavy gale the 2l6t, and a heavy shower oa the 25i,h, but no extraordinary rains or tempestuous Ti,*eather nor thunder to disturb the atmosphere, the heated condition of which ought to have produced yellow fever, if caloric clone, as some acssrt, has that power The believers in domestic origin, as in pre- vious years, anticipating that the spark might probably be kindled, as the door they knew was- open and the fuel ready to receive it, put in circulation, about the 21st, rumours of yellow fever ; but this visiter was now too familiar to the inhabitants to be mistaken, and the false alarm created by it soon died away. The great ecUpse of 111 digits of the sun took place on the 16th. There had been but about two inches of rain in May. July. Dry, clear, and hot month. The tempera- ture continued high through this month, and no unusual pheno- mena occurred. No thunder is mentioned. There were heavy showers on the 18th, 22d, and 28th. No yellow fever. Aw^ust. The rains in this month were remarkably heavy on the 2d, 5th, 12th, 15th, 23d, and 24th. A gust on the 8th, and heavy gale on the 24th. This wet weather must have occa- •ioned the reduction of the average temperature, for we find it 372 Appendix. near three degrees less than June ! September. Moist and mo- derate. One case of malignant fever is mentioned on the 6th,, October. All this and the preceding month the quicksilver kept steadily at a high range, and would have greatly favoured the spread of yellow fever had it heen previously introduced in June or July, the weather of which months seemed to be in a condition so peculiarly well adapted to receive the poison. 1807. — June and July. June moist and moderate. July very hot and dry. The only occurrences mentioned are two or three heavy showers in each of these months. Not a rumour of yel- low fever. August. The rains of this month reduced the tem- perature three degrees below that of July, and may, like the August of 1806, have thus saved the city from the horrors of pestilence. Heavy showers on the 3d, and on the 7th, with thunder ; on the 8th, with hail and thunder ; also on the 29th and 31st. Heavy gale on the 13th. " If heat, moisture, and filthy streets," says Mr. Laight, " produce yellow fever, we shall certainly have it this season." The influenza reigned throughout the forepart of the month ; but if the poison of yel- low fever had heen introduced in that interval, it would, as on other occasions, have taken the mastery of this and all other diseases September. Dry, cool month. Heavy shower on the 7th, also on the 4th, with thunder. Heavy gale on the loth. Towards the latter part of the month news received of the yel- low fever at Charleston and Savaniiuh. November. Snow on the Ist. 1808. — June. Warm, clear and dry. Heavy thunder ; shower on the 7th, during which several houses were struck with lightning. July. What is remarkable in this month, the heat was more variable than generally observed, and rose to 92 degrees on the 2d at 3 P M., higher than had been known since 1788, though the average heat for the month is rather less than usup.l. The day previous it was 91 degrees. 'J here was considerable rain feil during the month, mostly in showers, as usual at this season. Heavy showers on the 2d and ii6th ; and Appendix. 373 a heavy gale and rain all night on the 8th. The latter part of the month rainy, close, and quite cool. August, September, October. November. One or two heavy showers in August and September, and a heavy gale in September. Snow on the 15th of November. 1811. — June, July, and August. June was warm and dry ; July, hot and dry ; August, moderate and dry. Notwithstand- ing the thermometer was during July three times above 90, at 3 P. M. viz 92 on the 4th, 91 on the 5th, and 92 on the 6th, the average, as in 1800 and 1808, is less for this month than in some years when the highest elevation was much less. In the week ending on the 1 9th, there had been 1 7 deaths from drinking cold water. September. Warm and drjf. In this month a comet apppeared, and the sun on the 17th was lOi digits eclipsed ; a very heavy gust on the 25th. 1 8 i 9. — June Clear dry and hot following a wet May. July, A comet appears about the 1st of the month. Heavy gust on the 11th. A very hot dry month. August. Hot and dry. On the 1st the quicksilver rose to 91 degrees at 3 P. M. ; on the 2d, to 90 degrees, and continued five or six degrees above 80 for 12 days afterwards, except on the 5th, when it was 79 degrees.. In the week ending on the 7lh, there were three deaths from drinking cold -water. Repeated showers and rain during the remainder of the month. About the 19th, news of yellozv fever at Baltimore. The thermometer \5 times above 80 degrees in this month. September. Except 1801 and If 05 the hottest September of the 34 years, and very dry. On the 5th, the Board of Health reported malignant fever at Old-Slip, and recommended the part of the city on the East River, between that sUp^g^d Coifee- House slip to be abandoned. For the first nine days of this month the thermometer was above 81 degrees, and about the 10th or 11th, Dr. Dewitt, the Health Officer, died of yellow fever at (Quarantine. Owing to the vigilance of the Board of Health, in clearing the infected district of its inhabitants and 874 appendix. promptly fencing it in, but few cases occurred, and these at in- tervals from 7 to 4 and 2, on a day. A remarkably high tide on the 21st, which filled most of the cellars near the East Rirer and in that part of the city where the disease prevailed ; but the number of cases was not diminished by this event, and con- tinued as before. 'J he high steady heat of the three summer months, and of September was particularly favourable to the introduction of yellow fever ; but the energetic measures adopted by the Board of Health, and dry state of the air in all this period, prevented the spread of the disease. October, Mo*' derate. The cases continued to occur in the same manner up to the the 9th, when there was a heavy gale during the night ; between which and the 16th, 3 or 4 died, which were the last cases, the fever having disappeared on the 17th. The communi- cation between the healthy and unhealthy parts of the city hav- ing been entirely intercepted, there were no subjects for the poison to act upon, in consequence of which its genera- tion ceased to go on ; that which remained in the vicinity of the houses where cases had occurred, having been probably blown away by the gale of the 9th. The aurora borealis was very strong on the !3th. On the 18th the Coffee House was re- opined, and the Insurance Companies, merchants, brokers, &c. returned to Wall street. On the 22d, the Mayor proclaimed the city free of pestilence. The thermometer on the 14th had sunk below 40 degrees, and stood at 35,55, 49 degrees, at 7, 3, 10 hours, so that there was in all probability a frost that night, though not mentioned. 1820. — A wet May. June. Hot, dry and clear. Heavy showers c^the 9th. July. Heavy showers on the 14th, and heavy rain during the day on the 29th ; appears to have been a dry and extremely hot month. To show that the range was very steady and remarkably high, it is sufficient to mention that the heat was twenty two days of the month from 80 to 89 de- grees, viz. the first thirteen days, also from the 16th to the Slst, from the 24th to the 29th, and on the 31st. This and the pre- Jippendtx% 375 viou9 month also, was very hot and dry, but with some show- ers. Why was not yellow fever generated ? August. Hot and moist. There were a very considerable number of showers in the fore part of this month, which was the cause, perhaps, why its temperature was lower than that of July. There were heavy showers on the 6th. Thunder was observed on the 10th at night, and on the 12th there was very severe thunder and lightning, with a gust and shower. On the 2d news had been received of yellow fever in Philadelphia. About the 17th a Mr. King, who had just arrived from that city, took sick and was sent to quarantine, where he died with black vomit.* The next day the Mayor issued a proclamation interdicting inter- course with Philadelphia. In the week ending on the 19th, seven deaths from drinking cold water, though the thermometer in the previous 7 days had been but twice above 80 degrees. They had died probably at or immediately after the termination of the previous week, for on the 12th the heat was 90 degrees, and the three preceding days above 80 degrees. There were an unusual number of calms noticed in the month, viz. on the 1st, 4th, 9th, 20th, and 21st. Thus in counting up the alleged local atmospheric sources of this disease we have a calm stag- nant state of the air, a high steady range of temperature, and a moderate share of humidity immediately succeeding to two re- markably hot and dry months, and withal the disease existing next door to us, yet the combined influence of these united •auses unable to set the disease in motion here. Leaving all arguments out ofthe qucsiion, what more direct and convincing proof could be required, that this disease is not the product of any particular condition ofthe atmosphere. September. Clear dry and warm. On the 12th, heavy rain for several hours. About the 25th news received of the yellow fever prevailing • A fact to rrhich I can testify myself, as I saw him at quarantine s flKW hours before his d«atb, tbs author b»iiig at that tim« Health Crnnmisfiojier, 376 Appendix. at New-Orleans and Savannah. Ten aud a half digits of the moon eclipsed on the 21st. November. On the 12th, snow four inches deep, and a heavy gale from the N. E. 1821. — The May was, as usual, wet. June. Heavy showers on the 20th ; weather moderate and generally dry. July. '\ his was a cooler July than usual, though not wet. About the 6th, accounts of the yellow fever at Baltimore. Considerable rain on the 20th, and heavy showers on the 23d, 24th and 25th ; in the last of which a woman was kille.d by lightning in Duane- street. August. Clear, and very hot and dry. Seven digits of the sun eclipsed on the 27th. September. Clear, dry and warm. A great gale on the 3d, from 5 to 7 P. M., which blew down se- veral chimneys, dismasted vessels, and damaged the wharves : wind at 8, 3, 10 hours S. S. E. ; and the thermometer at 75, 75, 72. Kovemher. Snow on the 1 9th. 1822. — The May was clear and &Ty. June. A dry month diminished very much the crops of hay. Heavy showers on the 20th and 24th. The mercury did not ascend to 80, at 3 P. M. but five times, viz. on the 2d, 4th, 10th, 29th, and 30th ; wea- ther warm, clear, and dry. July. Moist and hot. The following were the winds and thermometer for the first fifteen days of July : Winds. Weather. Heat. 8 , 3 , 10 8 . 3 10 8 3 10 X M P M PM A M P M P M AM PM ^M 1 1 JW s s Clear cloudy clear 740 ■i'i° 70° shower from 6 to 8 p. m. 2 ne s clear clear rail 7'J m 71 heavy rain from 6 p. m. 3 « clear clear clear 7,^ HI 75 to 1 A. M. 4 s clear clear cleat 75 a-^ 75 ft se clear clear cloudy 75 8:i 75 6 sw 8 riondv c ear 75 M |75 rain from 6 to 11 p. m. 7 s clear clear cloudy 7 8.' I76 heavy. f sw sw cloudy clear clea. 75 H4 79 mu^y weather, ■ool and pleasant. 9 nw n n clear clear clear 70 78 73 1 TO 8 clear clear clear 72 n 77 1 11 8 clear clear cloud> 7fi SI 73 1 1? 8 sw cloudy show'r clear 76 72 74 1 shower from 2 to 3 p. ii. 13 sw S > lear rain rain 74 72 70 i heavy rain. 14 SW clear clear , lear 7H {! 7fi 15 9 clear cloudy clear ; 74 80 73 light showers. .appendix. 377 It is remarkable, that the range of the thermometer should have been so uniform and exact between the 2d and 9th ; the very interval, we remember, in which Dr. Bayley remarks that nineteen lighter loads of boxes of sugar were discharged out of the twenty-four brought up from the quarantine to the wharves at Rector street, between the -'8th of June and 9th of July. The facts contained in the preceding pages lead to the fol- lowmg conclusions : 1. 1 hat the appearance of yellow fever is usually preceded by, but does not essentially depend upon, a high steady range of atmospheric heat See Table V. also Table II., years 1793 and 1820, in which the mass of heat, during the summer, was greater than in any of the years in which yellow fever prevail- ed, excepting two. See also Remarks on the year 1809, when the yellow fever prevailed in Brooklyn, opposite the city, and when the mass of heat for the summer months was hss than that of the whole thirty-four years, excepting the cold summer of 1816, when the spots appeared upon the sun, and when the mass of heat for the same months was only 1 ° 90 less. 2. That the propagation of the disease,.on the contrary, though it is favoured by, does not by any means require an elevated range of temperature, but when introduced may go on to spread more or less, and independently of the variations of the ther- mometer, provided such variations do not include the point of congelation. See Remarks on September, 179 1, September,. 1799, October, 1803, September and October, 1805. 3. That the propagation of the disease is notwithstanding more retarded by a reduction of temperature, than by any other atmospheric influence. See the Remarks in those years in which yellow fever prevailed, passim, and particularly October, 1796, September, 1798, and the month of October of the years 1798, 9, 1801, 3. 4. That a succession of heavy rains, for several days, may check, but rarely or never puts an end to yellow fever ; and that their power in retarding the progress of this malady de- 48 378 Appendix. pends more on the reduction which they eflfect in the tempera- ture of the air, than in washing away or diluting the poison sus- pended in it. See Remarks, passrm. 5. 1 hat, on the contrary, rainy, wet, and particularly moist weather, preceding, and especially when following a long drought, or associated with a high temperature, may. by fur- nishing the atmosphere with a convenient medium to disseminate the poison, have a pernicious tendency, and favour the propa- gation as well as introduction of yellow fever. See Remarks, anrf Table VI., August, 1796, August and September, 1798, August, 1801, September, 1803. 6. That the introduction or propagation of yellow fever doe« not depend essentially upon the quantity of electric fluid in the atmosphere, but that the recurrence of thunder gusts or thun- der showers may have, to a certain degree, a salutary influence in purifying or dispersing the air in which the poison is diffused. See Remarks on August and September, 1796, June, July, Au- gust, and September, 1/98, July and August, 1803, Summer of 1804, and Table I. passim. 7. That a succession of heavy gales, by ventilating infected places, and supplying them with renovated masses of pure and fresh air, has a more powerful influence than any other modi- fying cause, except frost, in suspending the progress, and total- ly dispersing or destroying the poison of yellow fever. See Remarks, October, 1798, August, 1799. 8. That an unusually dry state of the atmosphere, especially when accompanied by a high degree of heat, favours, more than any other known circumstance, the introduction of yel- low fever. See Table VI., years 1791, 196, 1803, K^06, 1811, and 1819, where the seasons were throughout uncom- monly dry, though differing greatly in the degree of tempera- ture. 9. That although certain conditions of the atmosphere seem to be more favourable than others to the introduction and pro- pagation of yellow fever, yet that those years in which yellow Appendix. 379 fever appeared in this city, or in itsimmedate vicinity, have ex- hibited as great, and frequently a much greater variety and di- versity of combination in their meteorological phenomena, and differed as much, and often much more, from each other, than those years in which the disease did not prevail. See Tables II. Ill IV. V. VI. VIL, and particularly the year 1796, as compared with the other years referred to in the preceding proposition ; and also the references in proposition 6th. In Tables III. IV V. and VI., it will be seen that the variation is generally much greater in yellow fever years, and in Table VI., that this variation in 1819 exceeds, by a great number o degrees, the aggregate variation of the same months in any year. In Table III and IV. it will be seen that the aggregate heat fo» a given number of months and years in which yellow fever prevailed, sometimes exceeded, by eight degrees, the mass of heat for the same number of months and years in which this disease did not prevail. But if we include, as we ought to, and have done i-i this comparison, the years in which this disease prevailed in the immediate vicinity of New York, the excess amounts to 22 degrees on the other side '. Vide Table V. We thus see that in whatever point of view we examine the phenomena of the atmosphere, whether in relation to its heat, its moisture, or its electricity, they are in every respect at war with, and totally irreconcilable to, the hypothesis of do- i»estic origin. We have not leisure, at present, to extend our work to ano- jiher article, in order to see how fnr astrology «r astronomy may lt>e interested in this inquiry. So little, however, is known of the influence of celestial bodies, and their revolutions, upon human diseases, that until further data on this subject are brought to light, speculations which affect to account for the ♦rigin of yellow fever from such causes neither merit nor re- quire refutation. 380 Appendix. No. XI. Letter of Dr. Francis on the Yellow Fever of St. Avg^tS' tine in 1821. New-York, December 31st, 1822. Dear Sir. — I send you an account, which I some time since promised, of the mahgnant fever which devastated St. Augus- tioe. You may confide in its accuracy, as it rests upon the testimony of several competent and dismterested witnesses, among whom I may particularly mention Judge Andrews, Mr. Delespine, and Colonel Forbes. Colonel Forbes is the author of the work entitled " Sketches of the Floridas," and was the chief magistrate of St. Augustine at the time the yellow ferer prevailed there. St. Augustine, prior to the late fever, had been remarkable for the salubrity of its climate and the health of its inhabitants. There is, I believe, but a sohtary instance of its having at any time before the late calamity, been subjected to the ravages of a pestilential disorder. When in the possession of the British, with a garrison of four thousand men, scarcely a death was known to occur in the year among them. This was doubtless to be accounted for cheifly from the circumstance that the population of the place was composed, almost exclusively, of Spaniards and natives of the tropics, who are less susceptible to the disease ; for frequent communication must necessarily have existed between Havana and this port. The diseases which ordinarily occur there are few in number, and in no re- spect characterized by symptoms of malignancy. Nothing especially worthy of notice occurred in the weather or ordiniry diseases of St Augustine, in the season of i82I. About the beginning of September of that year, some cases of a disorder of an unusual character made their appearance ; but shortly after they became more frequent, and excited more ge- neral alarm. The disease was at its height from the first to the Appendix. 381 tifteenth of October, during which period the greatest mortality prevailed. Towards the close of December, the fever ceased. The disorder attacked, in an especial manner, persons of a full and robust constitution ; and, without a single exception, was confined to new comers from higher latitudes The emi- grants from the northern parts of the United States were those particularly who were subjected to its influence. It is stated, that not a single individual from the West Indies, or native of the country, nor any one who had previously suffer- ed from yellow fever, became its victim. This immunity of the constitution from a second attack was manifested in several striking instances. The fever was strongly characterized by all the prominent symptoms of the yellow fever as it has occurred in the sea ports of the northern states. It was marked with great prostration of the muscular system and disturbance of the intellectual powers : in a majority of cases it invaded suddenly, and generally termi- nated fatally within the third, fourth, or fifth day from the at- tack. Sometimes death took place on the second day ; very rarely was the disease protracted to the sixth. The peculiar yellow suffusion of tiie surface, and injected state of the vessels of the eye, as they are exhibited in yellow fever, were often observed ; and that precordial anxiety, so uniformly noticed in the same complaint, was found to occur in a large majority of the cases of the fever of St. Augustine. In many instances the black vomit terminated the sufferings of tht- patient. Forty or fifty deaths occurred among the newly arrived emi- grants bffore the alarm became general. Eleven deaths was the greatest number that happened in any one day. This mor- tality took place in October. Of the inhabitants of St. Augustine, about two hundred were exposed to the influence of the disease. Of this aggregate, one hundred and forty were attacked, of which one hundred and thirty two died. In these deaths are included three blacks. The fever also afflictedthe troops in garrison : forty deaths took 382 Appendix. place ill a body of one hundred and twenty soldiers. The to- tal number of deaths from this malignant fever, was consequent- ly one hundred and seventy-two. in the treatment of this disorder blood-letting, which was had recourse to in a few cases, upon the comm.enceraent of the pestilence, invariably proved fatal. Calomel, when it could be prescribed so as to affect the general system, and produce its peculiar action upon the ^outh and gums, was serviceable : but this salutary action was very rarely brought about, the pa- tient yielding to the poison of the disease before any evidence of mercurial excitation could be induced. Moreover, several instances were noticed, where, although the salivary glands became affected by mercury, the disorder triumphantly pur- sued its course. 'J he early application of blisters to the epi- gastric region was a practice that was generally adopted : there was reason to believe it advantageous; it occasionally miti- gated the praecordial distress and laboured respiration of the sufferer, and no bad effects followed from the blistered sur- face. The oil of turpentine was internally prescribed, and it was thought with benefit, in a few cases of deep gastric irrita- tion. The black vomiting was scarcely ever controlled ; in one case of the disease charcoal was given, and the patient re- covered. But it must be admitted that the best efforts of the healing art in the fever of St. Augustine proved too generally unavailing. Of four physicians who attempted to relieve the sick three died. There is every reason to believe that the disease was inti*o- duced into St. Augustine from Havana, and the grounds of this belief rest upon the following circumstances : 1'he Schooner Florida, Capt. Johnson, was employed as u cartel to transport to Havana certain citizens of St. Au- gustine, who. were desirous of leaving that place after its ces- sion to the United States. She made a passage to Havana in the month of August ; the yellow fever prevaihng at the time at that place with great mortality. The disorder was in- Appendix. 383 troduced oo board : a number of her crew beside the captain took the disease, several of whom died. Upon her return to St. Augustine a quantity of clothing was sent on shore in order to be cleaned This labour was performed in the house of an Irish family of the name of Develin, which consisted of a woman who washed the clothing, her husband, and five children 'J hey all took the disease, and four died. Two other persons in the same dwelling also took the fever, and died in the same house. These were the first cases of the disorder, and until this oc- currence, not the least evidence of the hazardous condition of the place had come to the knowledge of the inhabitants. The schooner Alexander, Capt. Rogers, which had sailed in company with the Florida, on a similar mission, returned also a the same time. Her crew contracted the fever at Havana and all of them, five in number, including the captain, died on the passage. She was brought into St Augustine by two Spa- nish sailors who were passengers. The clothing ol the Alex- ander was ordered by the city council to be destroyed, but was secretly conveyed on shore. A mattress which wag thrown overboard was picked up in the river and taken to Judge Fitch's, whose residence was distant in the country. Unknowingly he slept on it. He took sick, and in rapid succes- sion his wife and three children, all of whom had the fever in a malignant form, and ended their lives with black vomit. These were the sources of the pestilence, whence it extend- ed itself throughout the city. Believe me to be your's, &c. JOHN W. FKA\(JIS. Dr. Towrf6E"Ni>. ERRATA. Page 19, for the words from 5 to 10 two story dwcllin«:s, &c. rpad from 4 /o(> inv story dtifltings. gcnfrally of wood- on the south aide of th^ strett, an.1 Ino only onthf north side. For the words iiotmorf than three or (bur hous- es, &f. read not more than two or three, houses, &rr For the worda heini^ chiefly orcnpied by ll)e yards. &( read icing on the north side of the slteet'chirfly occupied by the yard of the corner house, &c. 20, for the words about 180 A^' ref.d 80 houses 'J3, 3d line from the l>ottom, for Eliza Ann. read Eliza Jant. 27, for three or four months, read seven nreks — , for the words They all sickened July 10th, read They all sickened July \Olh and 1 I/A. For th^ words falling; sick on the s-ime day. rend falling sick within thirty-six hours qf each other, and for the words, up to the day ijtfon: that on whi<:h they all sickened, read up to the dffy before that on mhi>h Ihe Reders sickened 39, for up to November 1st, rewd vp to November 5th 40, for 10 after the Board, read 13, &c 45, for the yellow fever had already begun, read The yellow fever, it is stated, had already begun M, forfrotn 60 to lOO (note; read/nonJ 40 to 100. 97, for the effect was to show, rewd the object was to show. 104, for out of lO cases, read out of 19 cases. 106, for this street, read the.^ streets 131. foi the only persons who recovered in the house, read the only per som rvho remained in the house. \b2. for gener »l organs, read genital organs. 163, for o\it of seven thousand deaths, read ou< o/" 480OO cases and 70QD diaths S(c. 210, for after forty years &o. read after twenty-nine years, t(C. 275 for December read November, :_'87, for less intensity, read jmst intensit>u note %