In a collection of _facts_ and _observations_ by the College of

Physicians, published last year, we find the following remarkable

accounts tending to prove that the disease was introduced by the ship

Deborah, from Port au Prince and Jeremie in St. Domingo: 1. In a letter

from Dr. Stevens to Dr. Griffiths it is stated, that “the yellow

fever prevailed in almost all the sea-port towns in the French part

of Hispaniola, particularly at Cape Nichola Mole, where it raged so

violently that it obliged the British to abandon the post sooner than

they intended. About the same time it appeared in the harbour of St.

Thomas, and was so destructive to foreigners, that it obtained the name

of _the plague_.” The Doctor saw several cases of it in St. Domingo,

during the months of August and September, 1798, and “these were

entirely confined to _American seamen_, while the native inhabitants of

the city were totally exempt from it.” 2. From this very sickly coast

arrived the Deborah on the eighth of July. 3. On the 12th of August

John Lewis, mate of the Deborah, informed Dr. Currie, that the vessel

had lost _seven_ persons with fever on board during her passage, and

one by accident; _and that she had been employed as a transport in the

British service_ previous _to her taking in her cargo at Jeremie._

4. Mr. Thomas Town informed Dr. Wistar, that, on the first of August,

1798, he was told by Alexander Philips, of Water-street, that he (Mr.

Philips) had brought up two or three sick people from the Deborah, in

one or two boats. Some of them he had brought to his own house; and one

was dead. Philips himself was sick at the same time, and died a day

or two after. 5. Mr. Purdon informed Dr. Currie that he had a similar

account from Mr. Philips, whom he saw on the first or second of August

in apparent good health, and that he died on the Saturday following.

All this, and further evidence seemingly equally strong, was set aside

with the greatest facility by bringing counter-evidence, particularly

that of Mrs. Philips, who denied that there were any sick people in

the house; and by bringing instances of the fever existing in town

before the vessel arrived. It is needless therefore to trouble the

reader with any further discussion of this evidence more than the rest.

As the ancient Britons, in their letter to Aetius, lamented that the

_barbarians_ drove them to the sea, and the _sea_ drove them back to

the barbarians, so may we lament, in the present investigation, that

the uncertainty of theory drives us to _facts_, and the uncertainty

of supposed facts drives us to _theory_. Still, however, we shall not

despair. The introduction of a disease into a large city is much more

difficult to be traced than in a smaller one. In the year 1794 the

disease appeared in the town of New Haven in Connecticut. Dr. Monson of

that place informs us, that it appeared on the 10th of June, when Mrs.

Gorham, residing on the _Long wharf_, was visited by Dr. Hotchkiss, who

found her affected with symptoms of the yellow fever. In three days

her complaints suddenly vanished, and she was supposed to be in a fair

way of recovery, but the same evening she vomited matter resembling

coffee-grounds, and died next day. On the same day that Mrs. Gorham

died, Dr. Monson visited her niece, a girl of eight years of age, who

had staid a week with her aunt, and was taken ill three days before.

The day after the Doctor saw her she was suddenly relieved as her aunt

had been, but in a few hours vomited matter like coffee-grounds, and

died next day. These and some other similar cases having alarmed the

select men, inquiry was made, when “it appeared, that, in the beginning

of June, capt. Truman arrived from Martinico, in a sloop that was

infected with the contagion of the yellow fever; that this vessel lay

at the _wharf_, within a few rods of Mrs. Gorham’s residence; that she

had on board a chest of clothes which had belonged to a mariner who

died of the yellow fever in Martinico; and that his chest was carried

into Mr. Austin’s store, and opened in presence of Capt. Truman, Mr.

Austin, Henry Hubbard, and Polly Gorham: the three last died in a short

time after their exposure to the contents of the chest. Hence it is

highly probable that Mrs. Gorham caught the disease from the infected

sloop or clothing. Mr. Austin’s store stands within three or four rods

of Mr. Gorham’s house; and no person in town was known to have the

yellow fever previous to capt. Truman’s arrival.”

In his further account of this fever Dr. Monson shows that it was

contagious in the highest degree, and that Mr. Gorham’s house proved a

kind of seminary from whence the disease spread itself. “June 26 (says

he) Isaac Gorham lost an infant child with the yellow fever; and soon

after his son and daughter were affected with it: the former died.

Solomon Mudge died on the 30th; Jacob Thomson’s negro woman on the 1st

of July; Archibald McNeil on the 9th; Polly Brown on the 3d of August;

John Storer, jun. and John Hide, on the 8th; and widow Thomson on the

10th. Jacob Thomson’s negro woman, Solomon Mudge, John Storer, jun.

and John Hide, had visited Mr. Gorham’s house a few days before their

illness; Polly Brown and Mrs. Thomson nursed in Mr. Gorham’s family;

and Archibald McNeil nursed Solomon Mudge. Elias Gill died on the 12th

of August, and Samuel Griswold’s wife on the 7th: the former visited

Mr. Gorham’s house, the latter nursed in his family.

“There were a number of persons who caught the disease at Mr. Gorham’s

house, and recovered.

“Mrs. Thomson, on the first day of her illness, was moved half a

mile from Mr. Gorham’s, into George-street. Luther Fitch caught the

disease from Mrs. Thomson, and communicated it to his servant maid.

Both recovered. Mr. Fitch lives in College-street, nearly three

quarters of a mile distant from Mr. Gorham’s house. I could trace the

disease throughout the town. No person had the yellow fever unless

in consequence of attending the sick, or of being exposed by nurses,

infected houses, clothing, or furniture.

“I have inquired of several aged persons in this town relative to the

yellow fever, whether they knew of its having ever been here previous

to June 1794, and there is but a single instance; the facts relating to

which are these: In the year 1743 a transient person, by the name of

Nevins, who came from the West Indies, lodged at the house of Nathaniel

Brown, an inn-keeper in this city. The man was taken very sick in the

night, and died shortly afterwards; and his body was very yellow after

death. Mr. Brown’s wife sickened in a short time, and died of the same

complaint, which was at that time supposed to be the yellow fever.

“I am credibly informed that several persons at Mill-river, in

Fairfield county, and also at New London, died with the yellow fever in

August and September, 1795. It was propagated there by infected persons

from New York.

“Capt. John Smith died in this town, the 20th of August, 1795. He

caught the disease in New York, and communicated it to one of his negro

servants.”

On the whole, Dr. Monson concludes, “that the yellow fever is seldom

or never generated in this country, and that it is always imported

from abroad. An objection to the idea of its being generated in this

country is, that it was never known in the interior of this state, or

of the United States, so far as I can learn. Had it ever appeared in

Connecticut before the year 1743, and June 1794, we should undoubtedly

have had some record of the fact. There is no such record, and no

person remembers to have heard of such a disease, but at these periods,

prevailing in any part of the state. There are numbers of aged persons

in New Haven who remember the putrid ulcerous sore throat, small pox,

measles, dysentery, &c. raging here with great mortality, but have no

recollection of any yellow fever. Hence we may rationally conclude that

it never did appear in this state but in the years 1743 and 1794.

“It is evident, from facts before mentioned in this letter, that the

yellow fever was propagated in no other way than by contagion, and

that this is a _specific contagion_, and no more diversified, in its

operation on the human system, than that of the small pox and measles.

“If the citizens of large commercial cities were attentive in tracing

the origin of the yellow fever, on its first appearing among them,

they would often find that the disease was imported. In some instances

it would be extremely difficult to discover the origin. But the

mischief lies in this; that the inhabitants of such cities, whenever

a contagious disease makes its appearance among them, endeavour to

suppress all rumour of it, from an apprehension of alarming the

country, and injuring their commerce; unwilling to believe that there

is evil in the city, till the disease spreads in every direction. Then,

indeed, when it is too late, they are solicitous in the use of means to

arrest its progress. As it extends itself slowly at first, seasonable

exertion might both detect its source, and prevent its increase; but

when it is diffused through a city, it spreads with rapidity, and it

is no longer possible to discover where it began. But as, whenever the

yellow fever has appeared in the United States, it has always been in

sea-port towns, and originated near wharves, docks, and warehouses,

there seems to be high probability that the disease is imported.”

The evidence here seems so strong, that no counter-evidence that

can be brought appears likely to invalidate it. The coincidence of

the commencement of the fever with the arrival of the ship hath not

been denied, as in other cases; and, though it has been attempted to

prove that a fever might have arisen from the quantity of putrid or

putrescent matters at that time in the town, yet the circumstances of

those who were present at the opening of the chest of clothes being

taken with the fever, and those who were sick of it in so many cases

infecting one another, cannot by any means be overthrown. But the fact

is, that even those who contend most violently against importation, do

yet allow that it may in some cases be so; but they contend that if

proper care be taken it will not spread. Dr. Smith in his letter to Dr.

Buel says, “that infection may be brought into any place from abroad;

that, under certain circumstances of the place where it is introduced,

it becomes very destructive; but that, when these circumstances do not

exist, however the person immediately affected, if it be introduced

by a sick person, may suffer, it is harmless so far as the general

health of that place is concerned. If the subject were viewed in this

light, as most assuredly it ought to be, the question of importation or

non-importation would sink into its merited insignificance.” But, with

due respect to the memory of Dr. Smith, this must surely be accounted

a very inconsiderate mode of reasoning. In the instance he speaks of,

that of the Zephyr lately mentioned, he allows that Dr. Treat _might_

have caught the disease on board the vessel,[158] “but (says he) as _no

other_ person is known to have been infected by that vessel, and as

the Doctor communicated it to no person, the advocates for importation

would not be greatly benefited by the concession.” Surely we must

look upon the life of Dr. Treat himself to have been a matter not

entirely insignificant, and if he caught the fever by going on board,

a number of others who went in full confidence of the _impossibility_

of importation, might have done the same. As far therefore as the

prevention of such accidents can be accounted a matter of importance,

it is also of importance to believe the doctrine of imported

contagion. It is true, Dr. Smith, in the passage just quoted, adds

immediately after, that “no such concession (with regard to Dr. Treat)

is necessary;” but, in p. 104, he does make an ample concession, as we

have seen, viz. that the contagion may not only be imported, but, under

certain circumstances, _be very active and destructive_. The question

therefore rests here: Can we at all times promise that, with the utmost

care that can be taken, the circumstances of a place may not be such as

to give activity to an imported contagion? In the nature of things it

is impossible that the docks, wharves, streets and alleys of a large

town can be absolutely clean. It is equally impossible that _all_ men

can be advised to be temperate, cleanly, and neat in their lodgings;

and we are unable to determine how far people may deviate from the

_rule of right_ in those respects without danger. Before any theory

of this kind could be supported, it would be absolutely necessary to

bring an unequivocal proof that yellow fever had been in _one_ instance

at least produced by local causes; but this cannot be done. Among the

Hottentots, the dirtiest people in the world, no such disease exists.

Among the peasants of Poland, who likewise live in a very dirty manner,

their mode of life is said to produce not a fever, but a disease of

the hair, called the _plica Polonica_. In the Medical Repository,

vol. i, p. 276, Dr. Mitchill of New York describes a disease called

_elephantiasis, liktraa, or scurvy_, occasioned by loathsome,

putrefying diet, such as rotten fish, fish-livers and roe, fat and

train of whales and sea-dogs, congealed sour milk, with little or no

vegetable provisions, and by exposure to wet and cold. This disease

prevails in Iceland, in the Ferro islands, in two districts of Sweden,

and in _Madeira_; yet this disease is not the yellow fever, though it

is said to make the person afflicted with it more like “a putrefying

corpse than a living man.” The _cold_ seems to be assigned as a reason

why the disease does not assume a febrile form; but, however this may

hold with Iceland, it cannot with Sweden, where the summer is so hot,

that the sun has been said to set forests on fire. This is probably a

fable; but we are assured by Pontoppiddan, in his Natural History of

Norway, a country to the full as cold as Sweden, that in summer the

heat is very great. His expression is, that it is enough to “make a

raven gape.” As to _Madeira_, where the climate is warm, there can be

no such objection. But a particularity of this disease is, that it is

infectious. Supposing then that by any means it should be exalted into

a fever, have we any reason to imagine that in such a case it would lay

aside its infectious property? Surely not. If this then is the case

with a disease produced by the same causes with the yellow fever, we

have the very same reason to suppose that the latter is infectious, as

that the former would be so if it could lay aside its present form,

and assume that of fever. Another proof that mere dirtiness cannot at

all times produce a distemper, or even propagate its infection, may be

deduced from the sixth case quoted p. 355 from Dr. Russel, where he

says that a poor Jewish family lived in a place such as he had always

considered as one of the receptacles of contagion, yet only one in six

of those who remained in it was taken with the plague. In all cases of

plague, or of violent epidemic disorders, it has indeed been observed

that the poor were more subject to an attack than the rich. This was so

remarkable in the plague of London in 1665 that Dr. Hodges says it was

called the _poor’s plague_; and Dr. Ferriar tells us from Diemerbroeck,

that in some parts of Italy it was customary in the beginning of

a pestilence to drive out the poor; and likewise that this cruel

expedient was used at Marseilles. The bad success of the experiment at

this last place, however, shows that people of any description, and in

any circumstances, may be attacked. A very probable cause, entirely

distinct from any mode of living, may be assigned in this case, viz.

that the poor are more exposed to infection than others, both from

their circumstances and their rashness; for it will be evident to

those who converse with the most uninformed people of any country,

that the Turkish notion of predestination is far from being confined

to Mahometans. It is not, however, denied, that dirtiness, as well as

other local causes, may do much hurt, and occasion the spreading of a

disease which otherwise would not spread; because uncleanness of all

kinds seems to be the proper vehicle of infection, in which it appears

to delight to take up its abode. In the Medical Extracts, vol. ii,

p. 174, we have from Goldsmith the following anecdote concerning the

concentration of pestilential infection in the plague of London:

[158] Webster’s Collection, p. 98.

“A pious and learned schoolmaster, who ventured to stay in the city

during the plague, and took upon himself the humane office of visiting

the sick and dying who had been deserted by better physicians, averred,

that, being once called to a poor woman, who had buried her children

of the plague, he found the room where she lay so little, that it

could scarce hold the bed on which she was stretched. However, in this

wretched abode, beside her, in an open coffin, her husband lay, who had

some time before died of the distemper, and whom she soon followed.

What shewed the peculiar _malignity_ of the air, thus suffering from

human miasmata or effluvia, was, that the contagious steams had

produced spots on the very _wall_ of their wretched apartment. And

Mr. Boyle’s own study, which was contiguous to a pest-house, was also

spotted in the same frightful manner.” This shows not how infection

may be _produced_, but how it may be concentrated in such miserable

apartments. The appearance on the walls brings to remembrance what is

said in the book of Leviticus concerning the appearance of the leprosy

in walls and clothes.

But, supposing we should allow that dirtiness may bring on a yellow

fever (and it is plain that this cannot be proved) we have, in the case

of the Busbridge Indiaman, a _demonstration_ that cleanliness cannot

keep it off.[159] This vessel sailed from England for the East Indies,

in the year 1792, much about the same time that the Hankey sailed for

the coast of Africa. She had on board 264 people in all, viz. 109

belonging to the ship’s company, 130 recruits, and 25 passengers. She

had very boisterous weather at first setting out, but crossed the

equator on the 26th of May, where the weather was sultry, with heavy

showers of rain. The disease now made its appearance first among the

recruits, and in a fortnight spread among the ship’s company. It

was common for six or seven to be attacked with it daily from the

commencement; “and in the space of twelve weeks almost every person in

the ship not only had laboured under it, but many had suffered repeated

relapses.” For several weeks the weather was hot and sultry; but, when

in the vicinity of the Cape of Good Hope, they experienced a reverse,

and were driven by a storm as high as S. lat. 42. Here the thermometer

indicated a temperature only 13° above frost, but no material change

in the disease took place. Afterwards, when returning into the warm

latitudes, they experienced the sultry heats of the Atlantic without

any change either for the better or the worse, and this for no less a

space than three months.

[159] Annals of Medicine, vol. i, p. 166.

As to the origin of the disease, Mr. Bryce the surgeon, though

inclined to ascribe it to contagion, could not trace it to any origin

of that kind, as the vessel had been six weeks at sea before it

appeared. It “could not be ascribed to want of air or cleanliness,

as _every possible_ attention had been used to preserve these: the

different apartments were thoroughly cleaned and fumigated with wetted

gun-powder; the decks were sprinkled with boiling vinegar; and the

windsails were attentively kept in order at each hatchway. Mr. Bryce is

inclined to conjecture that a peculiar combination in the circumstances

of diet, situation, and state of the atmosphere, may have given rise to

this calamity. But the same combination of circumstances so frequently

takes place _without any fever_, that it appears much more probable

the disease had its origin either from an _imported fomes_, or from a

_fomes generated in some individual in_ the ship, from whence it was

afterwards propagated to others by _contagion_.” The disease produced

on board the ship was not contagious to the people on board another

vessel with whom they had communication, nor to the people ashore

among whom the convalescents were put, nor to new passengers taken on

board the vessel in the East Indies; circumstances certainly not a

little surprising.

It doth not therefore appear, that, without the intervention of some

other cause, mere dirtiness can produce the yellow fever. Let us

next see what can be done by confinement, want of air, or, as it has

been lately called, abstraction of oxygen. On this, however, we must

observe, that in all cases where people are allowed to breathe, their

lungs must be filled with the due quantity of _some_ elastic fluid. If

the fluid they breathe contains a smaller quantity of oxygen, it must

contain a greater quantity of something else. If a disease therefore is

produced, it must be occasioned by the _presence_ of that other fluid,

as well as by the absence of oxygen. Now, in confined air, we know that

not only the oxygen is diminished, and consequently a larger proportion

of azote or septon mixed with it, but in addition to this increased

proportion of azote, there is also a positive augmentation of the

deleterious part of the atmosphere by the effluvia from the bodies of

those who are confined. These effluvia, as we have seen, p. 90, contain

a great quantity of fixed air. Others have shown that they contain

also azote; and it may be so; but still we are sure that the fixed

air predominates. Besides this, from the breath we know that a great

quantity of aqueous moisture proceeds. Experiments on the action of

these different kinds of fluids are yet in an imperfect state, yet some

important facts relating to them are known. 1. Oxygen breathed in great

proportion produces an augmentation of heat, and proves an universal

stimulant. See p. 118. By itself it quickens the pulse.[160] 2. Pure

fixed air breathed by itself destroys life with the circumstances of

increased heat, rarefaction of the blood, and rupture of the vessels.

See p. 206. 3. The circumstances attending death by breathing azote

are not particularly recorded; but we know that by breathing an

atmosphere lowered by it the consumptive fever is not increased,

but diminished; and there is an account in the Medical Annals of a

person who was perfectly cured of a consumption by the smell of the

bilge-water of a ship. 4. It has formerly been shown, from Dr. Black’s

experiments, that, when the vapour of water is condensed in the body,

a great quantity of heat must be thus communicated to it. In confined

air therefore there is a diminution of the oxygen which produces heat;

but there is an augmentation of the fixed air and of the aqueous

moisture which increases it; so that, on the whole, the balance must

be considered as in favour of the augmentation of heat in the human

body; not to mention the quantity of sensible heat continually added to

the atmosphere by that which evaporates from the body. This position,

however, doth not stand upon the uncertain ground of theory; it is

confirmed by the following remarkable fact: Commodore Billings, who

commanded a Russian expedition fitted out by the late empress, found,

in his travels through the northeastern part of Asia, that the cold of

the atmosphere exceeded not only what was known in other climates, but

even what most people had been able to produce by freezing mixtures.

Dr. Guthrie informs us that he was unable to produce a greater degree

of cold than 36 below 0 of _Reaumur_, though assisted by 20 below 0 of

natural cold, and the power of all the freezing mixtures he knew. “How

much then (says he) was I surprised to hear Mr. Billings assert, that

some spirit thermometers which he had with him, graduated according to

_Reaumur’s_ scale, were often as low as 40° below the freezing point

of water, that is, 8 deg. below the freezing point of mercury. And

once or twice he observed them at 42 deg. below the _freezing point of

quicksilver_.[161]

[160] In the Medical Extracts we find it recorded, that a young

gentleman having breathed pure oxygen for several minutes, his pulse,

which was before 64, soon beat 120, in a minute.

[161] This account is taken from the Annals of Medicine for 1798,

and appears in a letter from Dr. Guthrie at Petersburg to Dr. Duncan

at Edinburgh. It is drawn up with such _astonishing_ inaccuracy,

that we may well be surprised how the one physician should write,

and the other print it. There seems in the first place to have been

a mistake of Reaumur’s thermometer for Fahrenheit’s. But even this

will not rectify the account. The _zero_ or (0) on Reaumur’s scale

is the freezing point of water; on Fahrenheit’s it is the cold

produced by a mixture of salt and snow, 32 degrees below the freezing

point of water. The freezing point of quicksilver has been fixed at

39, 39-1/2 or 40 degrees below the cold produced by salt and snow.

When the thermometer therefore fell to 40 deg. below the freezing

point of water, it was only eight degrees below the cold of salt

and snow, and not equal to the congelation of mercury by more than

thirty degrees. The difference between this and _forty-two_ degrees

below the freezing point of quicksilver is enormous and incredible.

It indicates a degree of cold hitherto unobserved on the face of

the earth, and scarcely equalled by the latest experiments made

at Hudson’s bay, where, by means of vitriolic acid and snow, the

thermometer was made to indicate a degree of cold 40 degrees below

the freezing point of quicksilver. The inaccuracy and confusion of

this account, however, does not affect the subsequent part relative

to Mr. Billings’s journey.

“During this severe cold (probably 42 below 0 of Fahrenheit) the

Nomade Tchutski (a wandering nation on the northeastern extremity

of the Asiatic continent) who were conducting him along the coast

of the Frozen ocean, in sledges drawn by rein-deer, encamped every

night on the frozen snow in low tents, which they quickly formed with

the skins of rein-deer, spreading some of them on the surface of the

snow, on which they all slept; and he assured me, that, so far from

suffering from cold during the night, the heat was so excessive in

these fur tents, where from ten to fifteen slept together, according

to its dimensions, that no one could bear even a shirt; but all lay

in a violent perspiration, naked as they were born, till dawn of day,

without the aid of fire, excepting a train-oil lamp, which lighted each

tent.”

From this account it seems pretty evident, that, by the accumulation of

animal effluvia, a heat may be communicated to the atmosphere greater

than that of the human body. We cannot suppose the heat of the tent

which put the people in a violent perspiration to have been less than

90° of Fahrenheit; and, supposing the temperature of the external

atmosphere to have been at a medium 30° below 0, there must have been

a generation of 120 degrees of heat; but the heat of the human body

does not exceed 97 degrees, and it cannot communicate more heat than

it has. But we must suppose the tents to have been capable, had they

been filled to the top, of containing twice the number who did sleep in

them. They could communicate to the air therefore only one half of 97

degrees, or 48-1/2°; the remaining 71-1/2° therefore must been derived

from the breath and perspiration of the body.[162]

[162] Here no account is made of the heat that the very cold snow

upon which they lay must have absorbed, which we know must have been

very considerable, though it cannot be calculated.

Let us now attend to the consequences which must naturally and

undeniably follow from this fact. If, in such a violently cold climate,

the effluvia of fifteen human bodies could produce a heat sufficient to

induce a violent perspiration, what would they not have done had they

been in a climate where the heat of the atmosphere was upwards of an

hundred degrees greater, or between 70 and 80 above 0 of Fahrenheit?

Perhaps this was never thoroughly tried except in the black hole at

Calcutta. Here an hundred and forty-six men and one woman were enclosed

in a dungeon only 18 feet square, and consequently affording scarce

eighteen inches square to each. This happened in a very hot climate, in

the month of June; so that we cannot suppose the temperature to have

been less than 80° of Fahrenheit.

On being confined in this manner, the vital powers endeavoured, by

a most profuse perspiration, to send off the superfluous quantity

of heat thrown into the body. This was exactly what took place with

Dr. Guthrie; but, in the case of the black hole, there was, besides

the quantity of heat produced by the warmth and perspiration of the

body, _an hundred and ten_ degrees more to be added, on account of

the natural heat of the atmosphere. For we cannot suppose the heat at

Calcutta, in a sultry evening in the month of June, to have been less

than 80, which added to –30, supposed to be the temperature among the

Tchutski, makes 110°. The perspiration was extremely profuse, and was

soon accompanied with excessive thirst; nature being unable to supply

such a quantity of liquid, or this liquid to carry off the heat from

the body. The want of pure air began then to be felt by a difficulty of

breathing; and Mr. Holwell, having in despair retired from the window,

found the difficulty of breathing increase, attended by a palpitation

of the heart. Aroused by his sufferings, he returned and was relieved

by drinking some water, and having air at the window. The difficulty

of breathing diminished, and the palpitation ceased; but, finding the

thirst not to be quenched by water, he sucked his shirt-sleeves, which

were wet with sweat, and endeavoured as much as possible to catch all

of it that he could. The taste was soft and agreeable. A pungent steam

was now felt like spirit of hartshorn. A number had died, and Mr.

Holwell, once more rendered desperate, retired from the window, and

lay down upon a bench, where he soon lost all sense. Next morning only

23 survived, of whom Mr. Holwell was one. He revived on being brought

out to the fresh air, but was instantly seized with a putrid fever,

as well as all the rest of the survivors. In this situation they were

obliged to walk, loaded with fetters, to the Indian camp; at night they

were exposed to a severe rain, and the day following to a sultry sun;

yet, notwithstanding this ill treatment, they all recovered; having an

eruption of large and painful _boils_ all over the body. Mr. Holwell,

however, said that he never afterwards enjoyed good health.

Another melancholy proof of the bad consequences resulting from a want

of fresh air we have in the evidence given by Dr. Trotter, when the

question concerning the slave trade was agitated before the British

House of Commons. He deposed that the slaves were confined 16 hours out

of 24, and permitted no exercise while on deck. They were kept in rooms

from 5 to 6 feet high, imperfectly aired by gratings above, and small

scuttles in the sides of the ship, which could be of no use at sea.

The temperature of these rooms was often above 96 of Fahrenheit, and

the Doctor says that he never could breathe in them, unless just under

the hatch-way. “I have often (says he) observed the slaves drawing

their breath with all the laborious and anxious efforts for life which

are observed in expiring animals subjected by experiment to foul air,

or in the exhausted receiver of an air-pump. I have often seen them,

when the tarpaulings have been inadvertently thrown over the gratings,

attempting to heave them up, crying out, in their own language, ‘We

are suffocated!’ Many I have seen dead, who, the night before, had

shown no signs of indisposition; some also in a dying state, and, if

not brought up quickly on the deck, irrecoverably lost. Hence, in one

ship, before her arrival in the West Indies, out of 650 slaves, more

than 50 had died, and about 300 were tainted with the sea scurvy.”

A third example of the effects of want of air, though conjoined with

other causes, may be reckoned the case of the Hankey, formerly related.

The people there were not indeed confined as much as in the black

hole, but it is impossible to suppose that there could be a proper

circulation of air, and the length of time the passengers were confined

might be equivalent to the violence of the cause in the case of the

black hole. In the latter, however, the disease produced was not the

yellow fever, but seems to have been a kind of non-descript eruptive

one, more resembling the small pox, or rather _Job’s disease_, than

any other. From Dr. Chisholm’s account of the Boullam fever also, it

seems to have been more of an eruptive nature than the common yellow

fever; so much, that Dr. Chisholm is of opinion that it partook “in

no small degree of the nature of the true plague.” He says that in it

he “did not observe _carbuncles_ on any who died; but that in many

who recovered they were numerous, large, and very troublesome.” He

considered them also as a critical discharge, and the only one in this

fever; but in the plague they certainly are not; neither is it at

all probable that they were of the same nature with the pestilential

carbuncles.

In p. 207 of this treatise it is inferred, from some experiments of Dr.

Davidson and Dr. Chisholm, that the fevers in warm climates _are not_

owing to a deficiency of oxygen in the atmosphere; but in a treatise on

the yellow fever in Dominica by Dr. Clarke, we have other experiments,

which, if they can be depended upon, certainly overthrow that doctrine,

or at least render it very dubious. Dr. Clarke endeavoured to ascertain

the purity of the air by Mr. Scheele’s apparatus, and which was

likewise used by Dr. Davidson, viz. filling gallipots with flowers of

sulphur and iron filings well mixed and moistened, and putting these

upon a stand under a glass vessel, which was placed on a stool in a

pail of water. The glass vessel was marked and divided on the outside,

and, allowance being made for the space occupied by the gallipot,

the water rose only one fifth in the glass vessel, after standing 24

hours. When the disease abated, it rose near one fourth; and upon many

trials afterwards it never rose above one fourth. When the emigrants

fled towards the mountains, where the air is very pure, they always

avoided an attack of fever, or soon recovered if in a convalescent

state. This is similar to what is stated by Van Swieten concerning the

plague at Oczakow, viz. that the atmosphere was so loaded with some

kind of vapour, that in certain parts of the town polished sword-blades

were turned black. This seems to have indicated a great prevalence

of inflammable or hepatic air, or both, in the atmosphere; but it is

extremely doubtful whether this could produce a _fever_, much less the

true _plague_. In Dr. Clarke’s experiments it were to be wished that he

had examined the nature of that part of the atmosphere which was left

after the absorption of the oxygen. It is by no means probable that

at any rate the addition of a fifth part of azote could have rendered

the air so unwholesome; and besides, we are entirely at a loss whence

to derive such an immense quantity; for certainly the quantity of air

which surrounds us, even for a few miles extent, is so great, that

any considerable alteration in its composition could not take place

without a very evident cause. The probability therefore is, that the

experiments did not give an accurate statement of the quantity of

oxygen contained in the atmosphere. Experiments on this subject must

always be uncertain; and of all the modes of trying the qualities of

the air, perhaps that with sulphur and iron filings is most liable to

variation. It may vary, from the nature of the sulphur,[163] from the

cleanness or the impurity of the iron filings, or lastly from the

accuracy of the mixture. It is also a misfortune in this case, that

though a great absorption proves the existence of a large quantity of

oxygen in the atmosphere, yet a small one does not prove the contrary;

for it is more reasonable to suppose that we have failed in our

experiment, than that the constitution of the atmosphere has changed.

Dr. Clarke’s experiments therefore cannot prove any thing, until more

accurate methods of investigating these things be found out.

[163] If sulphur be a _simple_ substance, as the new chemists

pretend, there ought never to be any variation in its properties,

except what arises from mere impurity; but the following is a

remarkable instance to the contrary: Dr. Crawford (brother to the

celebrated Adair Crawford) informed me, that for his oil of vitriol

works at Lisburn, in Ireland, he had purchased _five tons_ of

sulphur produced from copper mines in the island of Anglesey. The

sulphur looked well, and was not more impure than what he commonly

used; but, on trial, the produce of acid fell so much short of

what he had been accustomed to receive, that it would not afford

the expense of manufacturing. An experiment on such a large scale

could not be erroneous. If sulphur is a simple substance, the fact

is unaccountable: if it is composed of phlogiston and acid, an over

proportion of the former will easily account for it.

We must now proceed to investigate a third cause assigned for the

production of fever, and that is the putrefaction of animal and

vegetable substances. This hath been very much insisted on. Dr. Rush

ascribes the fever of 1793 to the exhalations of putrid coffee, but

allows also the distemper to have been contagious, and says, that “for

several weeks there were two sources of infection, viz. exhalation and

contagion. The exhalation infected at the distance of three or four

hundred yards, while the contagion infected only across the streets.

The more narrow the street, the more certainly the contagion infected.

Few escaped it in alleys. After the 15th of September the atmosphere

of every street was loaded with contagion; and there were few citizens

in apparent good health, who did not exhibit one or more of the

following marks of it in their bodies: 1. Yellowness in the eyes, and

sallow colour on the skin. 2. Preternatural quickness in the pulse.

3. Frequent and copious discharges by the skin of yellow sweats. 4.

A scanty discharge of high-coloured or turbid urine. 5. A deficiency

of appetite, or a preternatural increase of it. 6. Costiveness. 7.

Wakefulness. 8, Head-Ach. 9. A preternatural dilatation of the

pupils.... Many country people who spent but a few hours in the streets

in the day, in attending the markets, caught the disease, and sickened

and died after they returned home; and many others, whom business

compelled to spend a day or two in the city during the prevalence of

the fever, but who escaped an attack of it, declared that they were

indisposed during the whole time with languor or head-ach.”

Thus, according to our author, the fever of 1793 _began_ from putrid

effluvia, and _was continued_ by contagion. But many attempts have been

made to prove that putrid effluvia _alone_ both begin and continue

it. The limits of this treatise would not allow (even were it but

beginning) of a particular account of all that has been said upon the

subject; neither indeed is it needful. A single well attested instance

would decide the matter; but we have already seen the difficulty of

procuring that instance on either side. Certain it is, that we have

instances of the yellow fever arising where it is not pretended that

there was any considerable collection of putrid matters. In the Medical

Repository, vol. ii, p. 149, we find an account of the yellow fever

appearing “in a country village, near a fresh river, _on low marshy

ground_, seven miles from Portland, so that no suspicion could arise

of the disease being imported. _Several other cases of yellow fever_

occurred _in different parts of the country_.” This stands on the

authority of Dr. Jeremiah Barker of Portland, so that there can be no

doubt of its authenticity; and though it cannot prove that the yellow

fever _may not_ arise from putrid effluvia, yet it certainly shows that

it _may_ arise without them. It does the same with marsh effluvia; for

though we may, in the case of the village, suppose that the marshy

ground on which it stands occasioned the disease there, yet what shall

we assign as the cause of its being dispersed in different parts of

the country, where there were neither marshes nor rotten beef? The

proofs indeed of animal effluvia being the cause of yellow fever are so

equivocal, that Dr. Davidson[164] supposes putrid _vegetable_ matters

to be more active in this way than the former. For this supposition

he gives as a reason, that Dr. Rush has observed, that butchers, and

those who lived in the neighbourhood of shambles, scavengers, grave

diggers, and others of similar employments, escaped the yellow fever

in Philadelphia. These, the Doctor justly observes, were more exposed

to what he calls the _gazeous oxyd_ of azote, than any other class;

and he likewise takes notice, that sailors, who during long voyages

feed on putrescent food, which might be supposed to produce a great

quantity of this acid, are thence subject to scurvy, a disease not

only different from fever, but entirely opposite to it. This exemption

of people conversant among the dead has been also taken notice of by

Dr. Mitchill,[165] who brings as an argument against the contagious

nature of the disease, that “seven men belonging to the alms-house of

New York were employed, during the whole of the sickly season of 1798,

in putting the persons dead of the plague (yellow fever) into coffins,

and though they handled in the course of their service upwards of _five

hundred_ corpses, in different stages of putrefaction, and though they

were much incommoded with the pestilential quality of the air in the

rooms they entered, and frequently were obliged to vomit, not one of

them was so much indisposed, during the whole season, as to discontinue

his employment.” This is no doubt a very remarkable fact, but in the

present instance it proves too much; for if, from it, we conclude that

the disease is not contagious, we must also conclude that it cannot be

produced by putrid animal substances. Yet in the very next sentence Dr.

Mitchill assures Dr. Currie, “that exhalations from corrupting _beef_

and _fish_ have excited sickness as malignant, and as deadly, as any

which has occurred.” If exhalations from putrefying beef and fish have

produced this sickness, why did not exhalations from putrefying _human

bodies_ do the same? and if we are assured that the latter _did not_,

we have as little reason to suppose that the former _did_; unless we

establish a difference between the corrupting flesh of one animal and

of another, which no experience hath countenanced in the least.

[164] Medical Repos. vol. i, p. 170.

[165] Medical Repos. vol. ii, p. 313.

The exemption of those employed in burying the dead, even in the true

plague, is observable. Dr. Canestrinus supposed it might be owing to

the use of garlic, which they were wont to bruise and rub their hands,

face and breast with, and likewise to chew, before they entered into an

infected house; but this cannot be supposed a very powerful antidote.

Dr. Rush is of opinion that grave diggers escaped in Philadelphia by

the circumstance of their digging in the earth; and he says also that

scarce an instance was heard of those employed in digging cellars

being attacked with the disease. “There seems to be something (says

he) in the fresh earth, which attracts, or destroys, by mixture,

contagion of every kind. Clothes infected by the small pox are more

certainly purified by being buried underground than in any other way.

Even poisons, are rendered inert by the action of the earth upon them.

Dogs have long ago established this fact, by scratching a hole in the

ground and burying their limbs or noses in it, when bitten by poisonous

snakes. The practice, I am told, has been imitated with success by the

settlers upon new lands in several parts of the United States.”

This reason is very plausible for the exemption, of such as work in the

ground, from contagion; but it cannot do for scavengers and butchers,

who by the nature of their employment are frequently exposed to steams

from the vilest matters. We may, on the contrary, derive from thence

a very strong argument that these steams are by no means essentially

connected with contagion. We have already seen from Dr. Fordyce (p.

169 of this treatise) that contagion or infection is not the object of

sense. Dr. Rush, though he doth not absolutely say that the contagion

of the yellow fever hath no smell, yet informs us, that “the smell of

the contagion, as emitted from a patient in a clean room, was like

that of the small pox,[166] but in most cases of a less disagreeable

nature. Putrid smells in sick rooms were the effects of a mixture of

the contagion with some filthy matters. In small rooms, crowded in some

instances with four or five sick people, there was an effluvium that

produced giddiness, sickness at the stomach, a weakness of the limbs,

faintness, and, in some cases, a diarrhœa. The contagion adhered to

_all kinds of clothing_. It was in no instance communicated by paper.”

From so great authority we may certainly conclude that, _according

to the best observation_, there is an _essential difference_ between

the contagion of a disease and the effluvia of a putrefying carcase;

and that, though the latter may be the vehicle of the former, and may

increase its virulence, either by being partly assimilated to its

nature, or by affording it a proper _nidus_ for concentrating itself;

yet that originally the one is not the other; and, though contagion may

bring on a fever without putrid effluvia, yet putrid effluvia cannot do

so without contagion. With regard to pure contagion, I shall here, to

the evidences already produced, subjoin the testimony of Dr. Davidson,

formerly quoted. “I must declare[167] (says he) I have seen the disease

evidently propagated in this way (by contagion;) but in many instances

it could not be traced. I have known three cases of the fever brought

on by persons bathing in the sea along side the vessel, some distance

from the shore, and neglecting to dry themselves properly afterwards.

The seminia of the disease were here present, and, like the electrical

jar charged, required only the approach of a conductor.” This shows an

amazing subtilty and diffusibility in the contagion, scarcely indeed

credible, if it were not known to be equally subtile in other cases.

In the correspondence between Dr. Haygarth, of Chester in England, and

Dr. Waterhouse, professor of medicine at Cambridge near Boston, the

latter informs us, from Dr. Rand, that by burning, in a field near

Charlestown, the bedding, furniture, &c. belonging to a person who had

been ill of the small pox, the people who lived in the wake of the

smoke proceeding from it were attacked with the small pox, and the

disease spread. This is similar to an observation formerly quoted from

Huxham; but the following are much more remarkable: “A vessel arrived

at Charlestown from Lisbon, laden with salt, and lemons in boxes.[168]

A person had the small pox on board, and the small pox officers would

not suffer the lemons to be sold, without being first unpacked and

the paper surrounding each lemon taken off. These papers were kept

by themselves in a storehouse for several weeks; and after this, by

order of the overseers, they were brought out and burnt; when, of two

children playing round the fire, one, named Manning, took the disorder,

and broke out at the usual time....

[166] Account of the Bilious Yellow Fever, p. 107.

[167] Med. Repos. vol. i, p. 171.

[168] Haygarth’s Sketch of a Plan to exterminate Casual Small Pox,

vol. ii, p. 270.

“Dr. Rand was called to a lady, whom he found hot and feverish with

a violent pain in her head and back; but he had no suspicion of the

small pox. He bled her, and a Mrs. Brandon held the vessel to receive

the blood, some of which spirted on her hand and arm. Next day the

small pox appeared on the lady who was bled; and she was of course

immediately separated from Mrs. Brandon; notwithstanding, in twelve or

fourteen days, Mrs. Brandon was seized with the small pox, and died.

Several other persons present were also liable to the infection, yet

no one took the disease but this woman, who stood over the blood while

it was running, and received some on her arm, except Mrs. Benjamins,

to whom the bason of blood was handed over the bed, who also took

the small pox from the effluvia of the blood. The same physician was

called to the child of Manning (who was supposed to have taken the

small pox from the burning of lemon-papers as aforesaid;) he found the

child bleeding at the nose in its mother’s lap, who was then in the

ninth month of her pregnancy. The next day the small pox appeared on

the child, and it was of course immediately separated from its mother

and all the family; nevertheless, in about fourteen days the mother

was seized with the disorder, and not long after delivered of a dead

child, which child _had distinct eruptions over its whole body_.”

These facts are of the utmost importance in determining the nature of

contagious diseases. In conjunction with others, they show that such

diseases originate in the blood, and from thence are communicated to

the rest of the body. They show also, that the contagion is in all

cases truly _specific_, and _immutable_. Thus the contagion of the

small pox, whether existing in the matter of a pustule, in the smoke of

burning clothes or paper, or in the effluvia of blood, is invariably

the same, and never produces any other disease. It is the same whether

applied to the human body, or to that of a brute animal; of which

we have a remarkable instance in the Medical Repository, vol. i, p.

258. “A peasant of the county of Essex, in England, seeing a great

many children carried off by the natural small pox, was desirous of

inoculating his two boys; one nine, and the other twelve years old.

Not being able to employ a surgeon, he collected the scabs of a child

then sick of the disease, powdered them, and sprinkled the powder upon

slices of bread and butter. The two sons ate them, and gave a bit to

the house-dog. They had a mild small pox, and got well without any

remarkable accident. The dog remained sick for two or three days, drank

a great deal, and refused to eat: on the fourth he had a very decided

variolous eruption: on the ninth the pustules were full ripe, and dried

up and fell off like those of the two children. An English author says

he has seen the same epidemic in a flock of sheep, the greater part

of which were infected, and communicated it to two cows, one of which

died. The symptoms that manifested themselves in these animals in the

course of the disease were in every respect the same as in the human

species.”

This instance, partly quoted in the former part of this treatise,

likewise is a strong proof of the contagion of small pox being first

communicated to the blood; for, by swallowing it along with the

aliment, it would, in the common course of digestion, be absorbed by

the lacteals, and enter the blood with the chyle. The experiments

with dogs made by M. Deidier, of which an account is given p. 268,

show that the contagion of the plague is equally specific with that of

the small pox; and we see that it acted in all cases in which it was

tried by being mixed with the blood. Being thus first mixed with the

blood, it is plain that the contagion must have passed from this fluid

to all the other parts of the body; and, if diseased blood is capable

of communicating its disease to all the sound parts of the body in

which it circulates, we must own that this strongly corroborates Dr.

Waterhouse’s suspicion, “that the blood is capable of producing the

infection before the disease is so far advanced as to be apparent on

the surface.” If the disease originates in the blood, the latter should

indeed seem more capable of communicating it at first than afterwards;

because we must suppose that the diseased parts would be thrown off to

the surface, and so pass off altogether. On this subject Dr. Waterhouse

also quotes the opinion of Dr. Holyoke of Salem, “who, for his

learning, professional abilities and integrity, is justly esteemed one

of the first physicians in this country, and whose extensive practice

has afforded him ample experience in the small pox.” He writes to Dr.

Waterhouse, “that, although he has reason to believe that an infected

person seldom gives the disease till after the eruption is considerably

advanced, yet there are facts which make it probable that it is

sometimes communicated earlier.”

In the same letter Dr. Waterhouse gives other instances of the

inconceivable subtilty of variolous contagion, no less remarkable than

those already mentioned. One is of Dr. Brattle, who, having visited

patients infected with the small pox, “used the common precaution of

covering his clothes with a loose gown, &c. but neglected his _wig_. In

consequence of this small neglect, after riding six miles on horseback,

he gave the disease to a person in a room through which he passed,

where he did not stay to sit down.” Another is, if possible, still more

remarkable: “David Anthony, esq. one of the overseers of the small pox

in Rhode Island, after going into the hospital, and using the common

precautions, neglected to _smoke his wig_. In his way home, two miles

from the hospital, he called at the house of his daughter. He did not

dismount, but sat on his horse, and talked to her through an open

window; and, at the common period (by which we usually understand about

fourteen days) she took the disease and died. Many such instances, adds

the Doctor, could I relate, where wigs have given the infection, after

being exposed to the open air during the passage of several miles.”

From all this it appears how difficult a task they undertake who

contend for the domestic origin of the yellow fever, without contagion.

In all cases they must have recourse to something visible and obvious

to the senses. Thus putrid beef, putrid fish, ponds of water, marshes,

&c. are all easily seen, and we are able to prove their absence as

well as their presence. But we certainly know that the yellow fever

has arisen where none of those supposed causes have existed, as in the

Busbridge Indiaman; and, on the other hand, all the supposed causes

have existed without the production of any fever. Of this last Dr.

Chisholm, in the conclusion of his defence against Dr. Smith, gives the

following remarkable instance:[169] “During a considerable part of the

years 1776 and 1778 my duty led me very much to reside in New York; and

during my residence, particularly in the summer and autumn of 1778,

which were remarkably hot, and insufferably so in the lower streets of

New York, no disease of a very alarming nature, and none which assumed

the form of an epidemic, appeared among the troops or inhabitants.

The smell from all the ships, and from those in particular delineated

by Dr. Seaman (who has written a treatise on the subject) was in the

highest degree offensive. The police at that time was by no means

strict: putrid substances of every description were accumulated in the

ships, and in many parts of the city unconnected with wharves, and yet

no disease was the consequence.”

[169] Med. Repos. vol. ii, p. 291.

Some particulars above related may perhaps appear, to those who deny

the existence of contagion, in rather a ludicrous point of view. It

is indeed too common for people to laugh at what they cannot answer;

but if we consider the instantaneous and inexplicable action of the

poison of serpents, and in how little time they produce a mortal

disorder, or even death itself; when we consider that contagion is

only a volatile poison, and that it for the most part takes up an

incomparably longer time to bring on death than the bites of some

venomous animals; we cannot be surprised that a quantity of this

volatile matter inconceivably less than that of animal poison should

be capable of bringing on the disorder; for the length of time may

be supposed to make up for the deficiency of quantity. Yet, if we

consider the extreme activity of some animal poisons, the wonder at the

small quantity of contagion necessary to produce a deleterious effect

will in a great measure cease. In the former part of this treatise it

has been observed, from Dr. Mead, that the whole quantity of poison

emitted by a viper, when it bites, does not exceed the bulk of a _good

drop_. An ordinary drop from a vial weighs half a grain, so that we

cannot suppose a large drop to be more than a whole grain. But there

are instances in which effects equally deleterious are occasioned by

the bites of animals the whole bulk of which is scarcely equivalent

to that of the poison of the viper. In the northern climates of the

Old World, _spiders_ do not grow to any remarkable bulk, yet the

bite of the poisonous spider of Russia is as mortal as that of the

rattlesnake.[170] The effect of the _furia infernalis_ of Linnæus is

still more to our purpose. It is an insect found in the forests of Kemi

in Lapland, and likewise in Sweden and Russia; and, if we can give

credit to Mr. Pennant, in some of the Western Islands of Scotland. This

insect falls down out of the air, and, if it happens to light upon any

uncovered part of the human body, it almost instantly penetrates down

to the bone, occasioning the most excruciating pain, and death in a

_quarter of an hour_.[171] Now, should we suppose the whole body of

this insect to be poison, as it is probable that it is not, it is so

minute, that though the whole were volatilized into contagion, it might

be well supposed to adhere to a _wig_, or even a more diminutive part

of the clothing; and, considering the virulent effects of even this

small quantity of contagion when concentrated, it would easily follow

by fair calculation, that a very _minute proportion_ of even this

_small quantity_ might bring on a dangerous disease.

[170] See Medical Annals, vol. iii, p 400.

[171] The following account of the poisonous insects of Russia,

extracted from Dr. Guthrie’s letter to Dr. Duncan (Med. Annals vol.

iii, p. 396) may be not unacceptable to the reader: “I have lately

seen (says Dr. Guthrie) a woman with her hand and arm in a most

violent state of irritation from the lodgement of the lumbricus

melitensis, a worm not much thicker than a horse-hair which had

entered her thumb whilst at work in a marshy spot, and was, when

I saw her, a day after the accident, on its way up the arm, with

excruciating pain. I must own that I should not have known the nature

of the disease, if a fellow-peasant had not immediately declared

that it was produced by the dangerous worm; which many of these

people are acquainted with to their cost, as an inhabitant of the

stagnant pools and marshes in that district, about sixty versts to

the southwest of Petersburgh. I must farther acknowledge, that I was

happy to hear the patient was to be instantly transported to another

village, where a famous operator lived, well skilled in the art of

extracting the venomous insect; as I should certainly have gone very

awkwardly to work if I had been obliged to operate; though the simple

peasants perform it with success and safety, gradually winding the

worm round a quill, till the whole animal be extracted; a work of

much patience and perseverance. I was very sorry that duty obliged

me to be in town the same evening, a drive of sixty versts. It was

therefore impossible for me to accompany the patient, though I was

very desirous of witnessing this village-operation.

“But Russia is pestered with a still more dangerous worm; the furia

infernalis. It is still smaller than the former, not being thicker

than a human hair. This infernal insect, from its extreme lightness,

is often carried up into the air, with the dust, by whirlwinds; and,

if it unfortunately falls on the uncovered part of a man or beast, it

enters the flesh in an instant, and soon proves mortal, if a remedy

be not quickly applied.

“Our new vice-governor of Petersburg lately came down from Siberia,

where he was commandant of a fort. He tells me, that in the district

of Nerchinsk, where he commanded, the peasants, as well as their

cattle, are often destroyed by an insect falling upon them. To

prevent this accident from proving fatal, the part is instantly

scarified, and rubbed with a mixture of snuff and sal ammoniac.

“This I am convinced must be the furia infernalis; more especially as

he assured me, that the insect was so very minute, that none of the

peasants had ever seen it when it fell upon them, and that they had

no idea of its nature and form. But one circumstance of his, recited,

almost staggered my belief; that the carcase of an animal killed

by this insect is almost as dangerous as the insect itself. This

phenomenon I cannot account for in any other way but by supposing,

as the accident always happens in the hot months of the year, that a

high degree of putridity is produced by the venomous worm, when the

case proves fatal.

“I informed the vice-governor of the manner in which the Dalecarlian

peasants in Sweden treat the accident, in order that he might

communicate their mode of cure to his Siberian acquaintance, which

is merely applying to the part affected a piece of sweet curd. The

insect possibly prefers this to flesh, and leaves the one for the

other. I am, however, much afraid that this simple remedy will seldom

be at hand in Russia, as the peasants are unacquainted with the use

of rennet, but prepare a sour curd by means of heat, throughout the

whole empire; evidently taking its origin in the Tartar Koumis, and

shewing them to be a people of Scythian extraction. They likewise

separate butter from milk by heat, instead of the churn; a curious

circumstance probably unknown to you before.

“These two dangerous insects are, however, not all which threaten

the life of man in this empire: the southern provinces are infected

with a third, the bite of which is as mortal as that of the deadly

rattlesnake, if the part be not instantly scarified, and rubbed

with fresh butter. This is a species of crab-spider, the phalangium

acaroides, resembling the tarantula, but rather thinner and smaller.

It however kills and devours that formidable spider in a few minutes,

which, when compared with it, is an innocent animal.

“Your acquaintance, Mrs. Guthrie, lately returned from a tour on

account of health, along the north shore of the Black Sea. Among

much important and curious information, she gave me some account

of the cure employed for the bite of this mortal spider, which

finds many lurking-places among the ruined buildings of the ancient

Chersonesus Taurica, or Crimea, laid waste in the last Turkish war.

It is a curious fact, that animal oil counteracts the venom of the

spider tribes, as vegetable oils do the venom of serpents. I suspect,

however, that either of them would counteract both poisons; indeed, I

think we have a proof of animal oil acting wonderfully on serpents,

in the anecdote related by Bruce, when the deadly cerastes, or viper

of the Nile, turned away its head from the oily breast of the prime

minister of Fenaar, when he carelessly took it up in his hand, and

applied it to his naked bosom, to show Mr. Bruce how innocent it was

to men of his colour, whose very skin sickened the animal, and made

it avoid all contact.”

Lastly, it may be urged on the side of contagion that, when a vessel

arrives from a sickly country, it is no proof that she has not brought

a disease with her, that the people aboard are in health. There is

abundance of evidence that very dangerous maladies may be communicated

by those who do not labour under the same. The prisoners at the

Oxford assizes were not sick at the time they communicated a dreadful

distemper to those around them. Dr. Brattle and Mr. Anthony were in

perfect health when they communicated the contagion of the small pox,

yet the effect was not less fatal. In short, _contagion_ being a

power certainly known to exist, though invisible and imperceptible,

it is impossible ever to prove that it is absent; neither after the

contagion of any disease has once got into a country can we be assured

that it may not revive. The experience, we may say, of the whole world

testifies that it does adhere particularly to clothing. Dr. Lind thinks

it may adhere to the timbers of ships; and there is the greatest

reason to believe that it may also adhere to the walls of apartments in

houses. The appearance of fever therefore without any new importation

cannot prove that it has not arisen from contagion. But it is now time

to state the evidence on the opposite side.

In Webster’s Collection we find the domestic origin of yellow fever

supported by Drs. Valentine Seaman, and E. H. Smith of New York; and

by Drs. Taylor and Hansford, and Dr. Ramsay of Norfolk. Dr. W. Buel of

Sheffield has also given an account of a fever, but so unlike that of

which we treat, that what is said of the one cannot be applicable to

the other.

The arguments used by Dr. Seaman are, 1. Several persons were infected,

who had taken the utmost care to avoid all communication with the sick,

who had not been for several weeks out of their houses, or within

_eighty_ feet of an infected person. 2. The nurses and attendants in

some places were infected, but in others generally escaped. Neither did

the disease spread into the country, as was reported; the Doctor having

inquired into these reports, and found them groundless. 3. Dr. Lining

says in his letter to Dr. Whytt,[172] “If any person from the country

received it in town, and sickened on his return home, the infection

spread no further, not even to one in the same house.”[173]

[172] See p. 387.

[173] The same physician, in the very letter quoted by Dr. Seaman,

says that all the times this fever had appeared in Carolina, the

origin of it was evidently traced to some vessel arrived from the

West Indies.

Several other arguments of the same negative kind are adduced, which,

being not essentially different from those already quoted, it is

needless to detail. The following are rather of a different nature: 4.

Some contagions are propagated by contact only, others at a distance;

but at any rate we may suppose that contact will propagate contagion

more readily and more powerfully than any other mode that can be

imagined. Yet multitudes of dissections have been made, and those who

made them are still alive. 5. “Specific and acknowledged contagions

all seem to arise from themselves only: hence it would be almost as

hard for me to believe that the siphylis, small pox, or measles, could

be produced from any other cause than their own proper virus, obtained

from persons affected with the like disease, as it would be for me

to conceive of the formation of a plant without its having received

its seed, or _radical_, from one of the same nature.[174] Contagions

seem to fix in the soil of our bodies, and there seed, as naturally

and regularly as vegetables do on the earth. But the yellow fever has

been produced from _other causes than contagion_.[175] Does it not

then admit of a doubt, whether it _can possess_ a power of propagating

itself?” 7. Contagions respect no persons, but all of every clime and

colour are equally attacked with them; but the yellow fever is known

to attack some much more readily than others. 8. Contagious diseases

generally have a determined time of invasion after an exposure to their

cause: but the advocates for contagion in the yellow fever cannot

be confined in this manner. “Their doctrine requires that it (the

contagion of yellow fever) be permitted to act at any time between that

of the exposure and the sixteenth day; otherwise it would not embrace

cases enough to give it a currency.”[176] 9. “Contagions act more or

less at all places and seasons, simply of themselves, without the aid

of any particular circumstance of air or climate; but the supporters

of the yellow fever being contagious are obliged, _by the force of the

foregoing observations_, to acknowledge their _imaginary fondling_ to

be but a _half-formed monster_, and perfectly inactive without being

assisted by the concurrence of a predisposing constitution of the

air. (Rush on yellow fever.) This fever exists only in warm weather:

hence its cause in this city (New York) was perfectly extinguished

by the frosty nights in the 10th month. It is confined mostly to low

situations in thick-settled places; otherwise our almshouse and the

surrounding country would have sadly experienced its deleterious

effects.”

[174] Arguments of this kind involve us in an endless dispute

similar to that relative to the _equivocal generation_ of plants

and animals; that is, the production of plants without a seed, and

animals without parents. As some diseases are confessed to arise

from some kind of seed, we are puzzled to account for the origin of

the _first_ disease of that kind. Nevertheless, as these diseases do

exist, the difficulty arising from a consideration of their origin is

overlooked. In the yellow fever, which is not of so long standing,

the origin is more disputed. But it is likewise undeniable, that some

contagious distempers (the itch particularly) though capable of being

propagated by contagion, may yet arise from want of cleanliness, and

living on particular kinds of food. May not this also be the case

with the yellow fever? And is it not the safe and rational way to act

as though it might not only be produced at home, but imported from

abroad?

[175] This is the very point in question; but our author, instead of

enumerating the facts by which his position may be supported, refers

to Dr. Lind, whose evidence shall be afterwards considered.

[176] No greater latitude, or very little more, is required by

the advocates for the contagious nature of the yellow fever than

Dr. Seaman must allow in a distemper which he himself owns to be

contagious. It is well known, on the eastern continent at least,

that a gonorrhœa will come on at any time between the first and

_fifteenth_ day after the infection is received. Dr. Guthrie supposes

the time intervening between the reception of pestilential contagion

and the appearance of the symptoms to be four days; and Dr. Chisholm

thinks that in the Boullam fever it is somewhat short of two days:

but it is plain that much must depend on the quantity of contagion,

and the predisposition of the body to receive it.

This argument merits a particular consideration, as involving a

question of very great importance, namely, concerning the constitution

of the atmosphere, which we have had occasion formerly to speak

of, and which is by some thought to be sufficient of itself to

produce epidemics, without the intervention of any other cause. This

constitution of the atmosphere is, it is true, something _unknown_;

and, when people appeal to it, it is only in other words owning their

ignorance; but the necessity of recurring to some cause imperceptible

by our senses has in all ages been obvious. So much indeed has been

said in this treatise on the causes of plague (which may apply also to

yellow fever)[177] that more would be superfluous, even if our limits

would admit of it. The dilemma (and it is equally insoluble let us

say what we will) stands thus: If the yellow fever is produced by the

effluvia of marshes, by putrid streams, or by any thing else, how comes

it to pass that it has been so frequent in the United States since the

year 1792 in comparison of what it was for 30 years before? Have the

American cities all at once become sinks of filth and nastiness? Have

the seasons been changed, or have the inhabitants given themselves

up at once to swinish intemperance and gluttony, devouring, like

savages, their meat half-rotten, half-roasted or half-boiled? From

some declamatory publications indeed one might be apt to think that

the authors certainly meant to bring such accusations against them.

But it undoubtedly will be found an hard matter to prove that the

general cleanliness of the country is inferior to what it was, or that

the people are less virtuous than they were before. Besides, has not

the vigilance of the magistrate, ever since 1793, been exerted to the

utmost to procure a removal of those nuisances from which the disease

might be supposed to arise? Yet their efforts have not availed; for

it is confessed that the attack in 1798 was the most severe ever

experienced. If cold could have exterminated the disease, certainly the

three last winters have been abundantly sufficient to do so; yet it

is certain that cases of the fever did appear in the end of December

last, when the cold must certainly have been deemed sufficiently

intense to put a stop to putrefaction of every kind. No wonder then

that people, unable to see the causes of these things, should have

recourse to something invisible, which they called the _constitution

of the atmosphere_. On this subject Dr. Haygarth of Chester makes the

following objections to the commonly received opinions concerning

epidemic constitutions of the atmosphere:[178]

[177] See p. 166, & seq.

[178] Sketch of a Plan to exterminate Casual Small Pox.

“1. Dr. Odier of Geneva, in a letter to Dr. Haygarth, writes thus:

‘I believe it would not be difficult to prove that the state of the

atmosphere is in no respect the cause (of the regular epidemics of that

city;) for the villages and towns which surround it do not experience

the same epidemic all years as Geneva, although they are situated under

the same heavens, and exposed to the same vicissitudes of atmosphere.’

2. Sydenham conjectures that some effluvia, issuing from the bowels of

the earth, produce epidemics. Were this true, it might advance one step

towards a solution of the difficulty by discovering a local difference

in the atmosphere. But it has never yet been pretended that any such

vapour was perceived. Yet every part of the earth must be capable of

furnishing it; as no portion of the whole habitable globe has been

discovered where the air could not propagate the small pox.... 3. Hence

we may safely conclude, that the slight variations of the same climate,

and the same season, must be altogether insignificant and nugatory.

What important difference of atmosphere can be supposed to exist for

weeks or months together in two neighbouring villages, or in the

adjacent streets of the same town? This remark is plainly applicable

to the propagation of the plague and other infectious distempers. Yet

the latest and most respectable authors continue to be misled by this

groundless hypothesis.”

Objections of this kind do not solve the difficulty. The excessive

disparity of seasons with respect to the spreading of epidemic

diseases, the long cessation of them at some times, and their sudden

revival, as if with redoubled fury, at others, indicate the operation

of some cause invisible to us; but whether that cause resides in the

earth or in the air, cannot easily be known. As contagious matter seems

to operate by being received with the air into the lungs, it would

seem rather probable that the ultimate cause of epidemics resides also

in the air. Dr. Haygarth complains that the _vapour_ arising from

the earth, supposed to produce epidemics, should be invisible; but

the contagion of the small pox, or of any other infectious disorder,

is equally so. It must, he says, be diffused all over the earth. The

electric fluid is so; it issues from the earth in every part of its

surface, as is demonstrated by the common experiments of electric

machines; and there are the strongest reasons to believe that it issues

at some times and in some places in much greater abundance than others.

But enough has been said on this subject; we must now consider matters

a little more obvious.

Though it is not easily seen in what manner the proportion of the

ingredients which compose the atmosphere can be changed, and we are

unable to discover the operation of the more subtile fluid contained

in it, yet we are certain that its constitution must be different in

different parts of the world. Islands, from their being surrounded

on all sides by the sea, must of consequence have an atmosphere

considerably different from that of the internal parts of continents,

where the air always passes over large tracts of land. Hence the

continent of America, being situated between the two vast oceans

called the _Atlantic_ and _Pacific_, must possess a constitution

of atmosphere considerably different from that of the Eastern. Of

consequence, the diseases of Europe and Asia, when transplanted to

America, or to the American islands, will probably, sooner or later,

assume a type different from that which they had in their own country.

Dr. Waterhouse has taken notice of this in his letter to Dr. Haygarth,

and thinks that it may hold good even in the small pox. “May not the

small pox (says he) operate differently in the two countries? It has

certainly had a different appearance, and required a somewhat different

treatment, almost every time it has come among us. That the difference

in the virulency of the small pox, observed at different periods, when

epidemic here, may be attributed to a peculiar constitution of the

atmosphere, no one seems to doubt; and why may not the difference, so

reasonably to be expected between the atmosphere of your island and

this continent, allow us to suppose that there is some difference in

the facility of receiving the infection?” This is also an important

consideration, and may throw some light on the cause, as well as the

mode of prevention, of this disease.

Lastly, Dr. Seaman attempts to disprove the authenticity of some cases

which have been brought as positive proofs of the disease having

been received by infection. These belong not to us to consider; it

being impossible, by reason of the invisible nature of contagion, to

determine from a simple consideration of any patient’s case whether

it was infectious or not. Dr. Fordyce has laid down the proper rule

for judging in such cases.[179] One only of the instances brought

by Dr. Seaman therefore we shall mention, and that, not because it

proves any thing, but on account of its singularity. “Daniel Phœnix,

city-treasurer of New York, is supposed without doubt to have taken

his complaints from contagion: the corporation, some time past, having

issued into circulation, for the accommodation of the inhabitants, a

great number of paper penny bills, it has been concluded that he must

have received contagion through the medium of some bundles of these

bills, which he opened, that had been nearly worn out, to be exchanged,

and which he opened and examined to ascertain their amount some days

after he had received them.” The Doctor allows that he might have been

infected by the bills, but ascribes it to putrid effluvia.[180]

[179] See p. 169.

[180] Dr. Seaman, having at last, as he thinks, completely overthrown

his adversaries, and ranked himself with the _more considerate_ and

_reasonable_ part of the community, likens those who differ from him

to such as believe in the _power of imagination_ to mark the child

in the womb; and which he is of opinion that the women of America

would not disbelieve, though all the physicians on the continent

were to unite in persuading them to the contrary. On this subject

the writer of this treatise is happy at having it in his power to

declare himself of the same opinion with the ladies, and to offer,

in support of their opinion and his, the following fact. A pregnant

woman, having been employed in dyeing some cotton yarn, and rinsed

it, after it had got the colour, in cold water, threw it, while wet

and cold, about her neck. It touched the skin on the back part of the

neck, and part of her arm. The woman started, shivered, and instantly

said that her child would be _marked_. It happened exactly according

to her prediction. The back part of the neck, and corresponding part

of the arm to that which the cotton touched, being covered with

purple spots in the child, exactly similar to what might have been

made by drops of the purple liquid in which the yarn was dyed falling

upon the skin. Of this fact I am as certain as of my own existence;

having been present when the cotton was dyed, having heard the woman

call out as above related, and seen the child after it was born, and

particularly inspected the marks.

Dr. Smith, in his letters to Dr. Buel, insists much on the vitiated

state of the atmosphere, and is at some pains to describe the persons

who were most subject to it. These, in 1795, were for the most part

_foreigners_; under which denomination the Doctor comprehends those

who came from other states, from the West Indies, and from Europe, or

who had not been many months or years settled in the city. The number

of citizens who suffered he does not suppose to have exceeded one in

seven; but he remarks, that, both among foreigners and citizens, the

severity of the disease fell chiefly on the poor. This mixture of

different nations he accounts, and with great probability, one of the

causes of the distemper. In confirmation of it he quotes Dr. Blane,

on the diseases of seamen, remarking, “that it sometimes happens that

a ship, with a long-established crew, shall be very _healthy_; yet if

strangers are introduced among them, who are also _healthy_, sickness

will be mutually produced.” The same observation is made by Dr. Rush,

who, besides a general reference to the history of diseases, adds the

following remarkable fact: “While the American army at Cambridge, in

the year 1775, consisted only of New England-men, whose habits and

manners were the same, there was scarcely any sickness among them. It

was not till the troops of the eastern, southern and middle states met

at New York and Ticonderoga, in the year 1776, that the typhus became

universal, and spread with such peculiar mortality in the armies of the

United States.”

This confirms the observation made in the former part of this treatise,

when speaking of the English embassy to China. It may likewise with

probability be assigned as one reason why large manufactories are

generally so unhealthy. In them there always is a collection of people

from many different and distant parts; and what holds good on a large

scale must also do so on a smaller one. But this does not disprove the

doctrine of contagion, but rather confirms it; for, if the discordant

effluvia rising from healthy bodies of different _constitutions_ can

_generate_ a disease, much more may we suppose the effluvia from sick

persons capable of continuing and propagating it.

Now, let us consider the account, imperfect as it is, which we have

been able to collect concerning the appearance of the yellow fever on

the Western Continent. We have seen (p. 377, n.) that, at the time

the plague was in England, five of the Americans were transported to

that country; two of whom, after staying some time in England, were

sent back, with other strangers, to America. This first colony having

failed, another was sent; the Indians went to war among themselves,

and the yellow fever is supposed to have made its appearance. Here a

suspicion naturally arises, that a slight pestilential taint had been

imported by some of these strangers, and that what would have been the

_true plague_ in Europe or Asia, by reason of the peculiar constitution

of the atmosphere in the New World, there became the _yellow fever_.

The same may be said of the original importation of it into Martinico.

Sauvages expressly says it was the _plague_ which was imported. Moseley

and others deny that any such disease as the yellow fever exists in

Siam; and indeed it seems at any rate to be a new disease. It seems

_possible_ that diseases may change their nature; and Dr. Ferriar has

given a dissertation on the conversion of diseases. As therefore the

true plague never made its appearance in America or the West Indies, it

seems not unreasonable to suppose that these countries are incapable

of receiving it, but that the pestilential poison, when transported to

the Western Continent, may assume a different, and in many respects

an opposite, nature; the two diseases being thus like the opposite

poles of a magnet, scarce agreeing in any thing but the common work of

destruction.

It is needless to spend time in attempting to investigate the cause

of this disease appearing at different periods. That of 1793 has been

the most remarkable and the most destructive; the disease having never

since that time ceased its ravages. Previous to its appearance at

Philadelphia that year, Dr. Rush observes, that, “during the latter

part of July, and the beginning of August, a number of the distressed

inhabitants of St. Domingo, who had escaped the destruction of fire

and sword, arrived in the city. Soon after their arrival the influenza

made its appearance, and spread rapidly among the citizens.” The

yellow fever quickly followed; for on the 5th of August the Doctor

mentions his being called to his first patient. To the same purpose

we are informed by Dr. Clarke that “the fever made its appearance in

Dominica about the 15th of June, 1793, a few days after the arrival of

a great number of French emigrants. They were not sick, and the fever

had not made its appearance in Martinique when they left it. From the

1st of July to the 1st of October it was computed that eight hundred

emigrants, including their servants and slaves, were cut off by this

fever; and about two hundred English, including new comers, sailors,

soldiers and negroes, all fell victims to it in the same space of time.

Few new comers escaped an attack, and few recovered. It spared neither

age nor sex among the Europeans and emigrants; and not only the people

of colour from the other islands, but the new negroes who had been

lately imported, were all attacked. Such as had been long on the island

escaped.”[181]

[181] Medical Review, vol. iv.

These facts seem to point out one of the causes, and very probably a

principal cause, of this dreadful distemper. They show very evidently

that there is a connexion between war and diseases. It has formerly

been attempted to point out a natural connexion between the horrid

practices of men, on these occasions, and the production of disease.

These investigations, however chimerical they may be reckoned, are yet

supported by many facts, which undoubtedly prove that mankind cannot

always maltreat and torment one another with impunity. The affair of

the Black assizes, and Old Bailey session, in 1750, shows, that by

confinement and bad usage the human body, without being apparently

deprived even of health, may become poisonous to those around it,

and produce dreadful diseases. In like manner the inhabitants of St.

Domingo, having been put to the most dreadful distress, became properly

fitted for spreading destruction wherever they went.[182] It is even

probable that, in proportion to the degree of distress suffered by

these people, the disease communicated by them will be malignant; nay,

that new diseases may spring up, which cannot be treated with success

by any method yet known to physicians. With regard to the disease in

question, it seems plainly to have from some cause or other received an

additional malignity. Dr. Chisholm says that what he calls the Boullam

fever was supposed in Grenada to have been the common yellow fever of

the West Indies engrafted on the jail fever. Dr. Lind, Dr. Jackson, and

even Dr. Chisholm himself, agree that the former is not infectious:

but from what has been already said the evidence seems to prevail in

favour of the opinion that the latter is so. Should we then allow that

two kinds of this fever might exist at the same time, in one city, the

difficulty would be at once removed. But this has been reckoned by

many, particularly by Dr. Rush, as totally inadmissible; and indeed it

is a maxim consonant to general experience, that two epidemics cannot

exist in one place at the same time, or that two diseases can scarcely

exist at once in the human body. This however must be understood,

principally at least, of acute diseases, or such as affect the whole

system; for if any disease of a particular part shall take place, it

does not seem impossible that a fever may be superadded to such local

disease. The following considerations may perhaps throw some light on

the subject:

[182] Dr. Moseley who has written at some length on the interruption

given to military operations by diseases, gives an account of general

Dalling’s expedition in 1780, where the English troops, confined

in the castle of St. Juan, in an unhealthy situation on the river

Nicaragua, were cut off by diseases; but these were fluxes and

intermittents. He doth not mention the yellow fever among them. He

tells us indeed that the troops under general Garth brought the jail

fever along with them, and that those who returned to Jamaica were

harassed with obstinate intermittents, with diarrhœa, dysentery, or

painful enlargements of the liver and spleen.

It appears from the experiments of Dr. Adair Crawford, that, when

animals are immersed in hot water, the blood drawn from a vein is of

a florid red colour. In summer it is likewise observed to be of a

more florid colour than in winter. If heat thus gives a more bright

red to the blood, it undoubtedly also makes it more fluid, and in

proportion to its fluidity it will likewise become acrimonious; though

this acrimony is not necessarily connected with a florid colour, as

the blood of the arteries is not more so than that in the veins.

In the yellow fever, however, the blood sometimes, towards the end

of the disease, becomes endowed with extreme acrimony. Dr. Smith,

in one of his letters to Dr. Buel, observes, that “blood drawn in

the fever of 1795 was remarkably _wanting_ in floridity; especially

what was evacuated towards the close of the disease, whether by art,

or spontaneous effusion. In one instance it seemed endowed with a

caustic quality, and affected a lancet so as to leave a permanent

discolouration and inequality on its surface.” He observes also,

nay, considers it as _demonstrated_, that the yellow fever _is not_

a disease of vascular debility, and he says that it is attended with

an astonishing _fluidity_, or, as it is called, _dissolution_ of the

blood. Every one therefore who comes from a cold to a warm climate must

in some degree or other have his blood liquefied, and in a certain

proportion rendered more acrimonious than before. This acrimony may

be undoubtedly augmented by certain causes, and by none more probably

than immoderate drinking of spiritous liquors. Every one therefore

who comes from a cold country to a warm one, especially where the air

is also moist, may consider himself as already diseased, at least in

comparison with what he was when at home. For the blood is now exposed

to a greater degree of heat, and consequently is about to absorb,

or rather may be considered as in the act of absorbing, more, and

consequently of changing from a thicker to a thinner or more fluid

state; the latter being the natural situation of the blood in warm

countries. Dr. Rush, in his inquiry into the proximate cause of fever,

has accounted for the dissolved appearance of the blood in malignant

fevers to a tendency in the blood-vessels to paralytic affection. He

says that “it (the dissolution of the blood) begins in the veins, in

which muscular action is more feeble than in the arteries. This has

been proved by Dr. Mitchill in his account of the yellow fever in

Virginia in 1741. He found the blood to be dissolved when drawn from

the veins, which, when drawn from the arteries of the same persons,

exhibited no marks of dissolution.” This, as the Doctor observes, “is

a fact of great importance;” only we must remember, that, in every

thing relative to the human body, when we find two phenomena constantly

accompanying each other, it is extremely difficult for us to determine

which is cause or effect. Instances of this often occur; and in the

present case the dilemma is as great as any other. Though, from the

testimony of Dr. Mitchill, we cannot doubt that in yellow fever the

dissolution begins in the veins; and though it is likewise extremely

probable that this dissolution is attended with a paralytic tendency,

we cannot know whether the dissolution is the cause of the paralytic

tendency, or the paralytic tendency the cause of the dissolution. The

point, however, is of no importance. We see that in warm climates the

blood of a person newly arrived has a natural tendency to dissolution,

and of course the veins to the paralytic affection just mentioned.

The liver therefore, which is supplied with blood by a large vein

branched out like an artery, and terminating in other veins to carry

back the blood from the former,[183] must be much more affected than

any other part of the body; and this indeed seems a very probable

reason why all those who come to warm countries become much more

inclined to bilious complaints, which denote an affection of the liver,

than they were before. This hepatic affection may very probably be

greatly augmented, in new comers, by various causes. One of these is

hard labour under a greater heat than they have been accustomed to; a

second, that in the West India islands they have not access to that

plentiful supply of fermented liquor, abounding in fixed air, which

they had at home. This, though not generally taken notice of, is far

from being a matter of little consequence; for, though emigrants from

Britain and Ireland have been for the most part accustomed to drink

spiritous liquors, yet fermented malt liquors certainly constitute

the principal part of their drink. The total want of these, and the

substitution of ardent spirit and water, must certainly be detrimental,

even though they keep within the bounds of moderation, and much more

if they do not. Dr. Moseley relates,[184] from Dr. Irving, that, in a

bad kind of intermittent which broke out among the troops in service

on the Spanish main in 1780, “nothing was so grateful as _London

bottled porter_. Wine was neither so much desired by the sick, nor

so serviceable in corroborating and keeping up the powers of the

stomach; which, like the rest of the body, was soon reduced, from the

slightest indisposition, to the lowest state of debility.” A third

cause is no doubt their frequently drinking too freely of spiritous

liquors, perhaps not of the best quality; and which, as they are

neither conjoined with the fixed air nor with the mucilage which as it

were inviscate and blunt their force in malt liquors, cannot fail of

exerting their deleterious properties in a very remarkable manner.

[183] See p. 94.

[184] Treatise on Tropical Diseases, p. 173.

From these and other causes there must necessarily arise a

predisposition to hepatic diseases; and this predisposition cannot

be removed until the blood has assumed the state of fluidity proper

to the climate in which they are, and the body has acquiesced in the

change. They are then said to be _seasoned_ to the climate; and it is

seldom that this seasoning takes place without a disease; indeed so

seldom, that the first illness which happens to seize them after their

arrival is called the _seasoning_. Dr. Trotter indeed gives a very

different account of this seasoning. He considers those who come from

a cold to a warm climate as having a redundancy both of excitement

and excitability, and says that “to _wear out this accumulated

excitability_ by slow and gentle gradations is the grand explanation

of the word _seasoning_: it is the _secret_ which constitutes the only

difference between the inhabitants of England and Jamaica. The yellow

fever of the West Indies therefore, as it appears in the body of a raw

European, is a disease of the _utmost excitement_, in a constitution of

_accumulated excitability_; where a tense fibre and dense blood permit

it to be carried to the highest pitch of inflammatory tendency; which,

from the nature of the animal economy, speedily exhausts the powers of

life, even in a day or two, inducing putrefaction and death.”

Explanations of this kind may edify those who understand them;

but, though we should declaim ever so much about excitement and

excitability, it is plain, that, in every one who comes from a cold

country to a warm one, the liver is affected in a manner that the rest

of the body is not. In some constitutions, or from exciting causes

in any constitution, this affection of the liver may be augmented,

and no doubt at last produce a bilious fever, which may be varied

in a number of ways, according to the nature or the energy of these

causes. The pure bilious fever, being of itself properly a local

affection, may not be contagious; and we find it generally agreed

among physicians that the common yellow fever of the West Indies is

not infectious. Nevertheless, it seems by no means improbable that

from certain circumstances contagion may be joined with it, and it may

then spread and infect, even as the most deadly plague. Dr. Crawford

relates, that, in the year 1770, a new kind of fever broke out in the

Middlesex Indiaman, of which many died. It is not said that the disease

was contagious; but, on opening the bodies of some who died, the liver

was found enlarged, and of a more florid colour than it ought to be.

It cannot be deemed impossible that contagion, even that of the true

plague, might be mixed with this fever, which (as the affection of the

liver was probably the original disease, might have been accounted

little other than symptomatic) would then have assumed very malignant

symptoms.

We might now say that we have got to the end of our subject. Having

so amply discussed the question concerning contagion, and stated the

principal part of the evidence against it, it seems proper to conclude

the section with a short history of the disease in the malignant

form it has assumed in the United States since the year 1792. Still,

however, it is necessary to say something further of one or two of the

causes which have been commonly assigned as necessarily inducing this

disease. These are, 1. Extreme heat, and, 2. Marsh effluvia. The effect

of the former has already been partly considered as a predisponent

cause of yellow fever: but it doth not appear that merely from this

cause the disease has ever been produced. It hath indeed been observed

by very intelligent physicians, that in Virginia the remitting fever

has often been brought on by mere exposure to the sun. Dr. Oliver of

Salem hath obligingly informed me, that he has “in more than one

instance been seized with that disease after riding in the sun;” and

that an eminent practitioner in Virginia had informed him that he had

also more than once suffered in the same way. Drs. Taylor and Hansforth

observe, that, when the remitting fever proves mortal, it is generally

attended by sickness and perpetual vomiting; which is the termination

of the yellow fever. The above evidence is decisive with regard to

heat being able to produce a remittent, but cannot exactly apply to

the yellow fever, which has no remissions. Two sailors indeed, lately

brought from a coasting vessel to the Salem hospital, were attacked

with violent symptoms of yellow fever without having been, as is

said, exposed to any infection. But evidence of this kind cannot be

supposed to be incontrovertible. We have already seen the difficulty of

ascertaining _facts_; and if it is difficult to prove that contagion

_has_ been received, it must be still more so to prove that it _has

not_. The persons in question had both worked during a very hot day

in a vessel’s hold, they afterwards sat exposed in the damp air of

the evening on the deck until 10 o’clock at night, and then slept

in the vessel’s cabin with the windows open. One of them was seized

in the night with a most violent pain, and the other on the morning

succeeding. It is said that about 11 months since this vessel was at

New York, and that a person on board had the yellow fever; it is also

alleged that the vessel was not purified, and that the beds remained on

board. It has therefore been by some conjectured that the disease might

have been derived from this source.

Dr. Ramsay, in a letter to Dr. Currie of Philadelphia, censures Dr.

Lining for saying that the yellow fever was imported into South

Carolina. “The greater yellowness of the skin (says he) appears to be

the only circumstance in which it differs from the bilious remittent

fevers of hot climates, or very hot seasons of any climate.” Our

author also censures Dr. Lind of Haslar,[185] who, he says, has been

misled by the _misrepresentations_ of Dr. Warren and others. He also

gives into the opinion that contagion acts only by contact, or at a

very little distance; but this subject we cannot enter farther into

at present. If we can believe Dr. Moseley, the sure criterion by

which the yellow fever may be distinguished from any other is, that

the former hath no remissions.[186] If solitary cases of it appear in

Carolina and the southern States every year, this will not prove that

the disease was generated in the country, any more than that the plague

was generated in London, because it appeared there for many years

successively.

[185] If physicians censure one another at this rate, how is it to be

determined who gives a true state of the matter?

[186] This position of Dr. Moseley is not universally received. The

meaning of the word _remission_ certainly is a temporary abatement,

and implies a recurrence, of the same symptoms which originally took

place. Dr. Moseley describes the yellow fever as beginning with one

kind of symptoms which suddenly cease and are succeeded after a

certain interval by others of a quite different kind; and he claims

the discovery as his own. If he be right in this description, the

yellow fever is certainly not a remittent; if otherwise, it must be

difficult to establish any true distinction between them.

But, if the heat of the sun cannot produce the true yellow fever, it

can kill suddenly without any fever whatever. This is said by Dr.

Moseley to be less frequent in the West India islands than on the

eastern and western continents. He says that he has felt as great

inconvenience from the sun’s heat at Venice, Naples, Rome, Montpelier,

and in Virginia, as in the West Indies;[187] but he concludes that the

_transitions_ from heat to cold are more pernicious to the human body

than any continued heat, however violent.

[187] At Strasburg, in Germany, our author says that he saw a man

who had been an idiot for more than a year from a stroke of the sun.

The 8th of July 1707 was so hot in England that many people died at

their work, and many horses and oxen were killed by the sun’s rays.

In 1743, _eleven thousand_ people perished from the 14th to the

25th of July in the streets of Pekin in China. On the 30th of July,

1705, the heat at Montpelier was so great, that eggs were roasted by

it. Chalmers, in his account of the weather and diseases of South

Carolina, says, that he has seen a beef-steak, laid on a cannon for

twenty minutes, deprived of its juices, and overdone by the excessive

force of the sun’s rays.

With regard to the effluvia of marshes, it is not denied that they

produce fevers, but those fevers are of the intermittent or remittent

kind. Dr. Smith indeed, in the first volume of the Medical Repository,

labours to prove that the plague described by Thucydides was not

essentially different from the fevers which sometimes prevail in

North America, and that it had its origin from marsh effluvia and the

ravages of war. That this distemper was not the plague described by

Russel we may gather from a single circumstance: for Russel tells us

that _sneezing_ never occurred in the plague described by him,[188]

while Thucydides says that it was one of the common symptoms of his.

Neither does the description of it (Appendix No. 1) at all agree with

any of the accounts of the yellow fever we have. The climate of Attica

no doubt was variable, and may in this respect resemble that of North

America; but so is the climate of China, yet no such diseases are

there produced. The Doctor concludes that the distemper originated

from _local_ causes; but the difficulty we find in proving such origin

of diseases in our own days, and in the country where we reside, must

certainly make us look upon the proofs which can be brought for the

local origin of a disease which happened two thousand years ago, and in

a distant country, as very equivocal. The following extract from the

Paris Medical Memoirs may be adduced as a proof of the intrinsic power

of marsh mud to produce fevers. It is contained in a paper written by

Dr. Perkins of Boston. “A farmer was in the practice of spreading,

upon about thirty acres of land, some new marsh mud, from October to

April annually, to increase the fertility of the soil. In the summer

of the third year, those inhabitants who lived to the northward and

eastward of the place were attacked with a very malignant fever, which

generally proved mortal. What is a proof that the marsh mud was the

cause of the disease is, its extent, which was not more than a mile and

an half from the farmer’s house, in the direction of the southerly and

westerly winds. Perhaps had this marsh mud been washed by plentiful

rains, the danger would have been less. Something like it happened to

the inhabitants of the marshes _in East Sudbury_, (les marais situes

a l’est dans le Sudberg) where the passage for the waters was too

deep, and too confined. In regular seasons they were attacked with

simple intermittent fevers; but, after wet seasons, there prevailed

among them malignant fevers, and very obstinate remittents. Since the

marshes have been drained, the inhabitants are no longer subject to

fevers, and are as healthy as those of others places. We know that

there are local epidemics, which are produced by a low, wet and rich

soil; such are, probably, those which prevail in the lower part of New

York, which, according to the informations obtained by Mr. Perkins, is

more unhealthy towards the end of the summer than the other part of

the city, and whose inhabitants are subject to diseases of a putrid

_caractere_.

[188] See the Table.

“It appears, from several observations, that the most mortal epidemic

fevers are not commonly produced by causes operating immediately; the

cause often existing several months before the disease even appears.”

The other arguments used by Dr. Smith in his letters to Dr. Buel

proceed upon the state of the city, the mode of living, &c. and the

condition of most of the emigrants, their bad accommodations, and

especially their abuse of spiritous liquors. The neglect of bathing

is also much complained of, and a comparison made with the conduct of

the French in this and other respects, greatly to the advantage of the

latter.

Drs. Taylor and Hansforth consider the disease which took place in

Norfolk in Virginia as only an higher degree of the common remittent

fever which usually prevails, and ascribe it to the long-continued

heat, putrescence, &c. Some French ships were said to have brought the

disease, but these arrived “so long before the disease appeared, that

(the Doctors think) it would be absurd to suppose even a possibility

of its being derived from them.” Mr. Webster adds, in a note, that the

French corvettes, three of which squadron were taken by the Thetis,

capt. Cochran, “anchored in Hampton Roads, May 18th. The fever did

not appear in Norfolk till August. Captain Cochran’s crew, however,

_took the fever from the French prisoners_, and twelve of them died

before the Thetis reached Halifax.” This is certainly a suspicious

circumstance.

Dr. Ramsay, in his letter to Dr. Mitchill concerning the same

distemper, observes that it was confined almost entirely to foreigners,

of whom he gives a very unfavourable account. The situation of the

town, putrescence, &c. are likewise brought in for a share, as well as

the season, which had been uncommonly warm.

These are the principal evidences that have been brought for and

against the origin of the disease which since 1792 has raged with such

violence in the United States. Innumerable pieces have appeared in the

Newspapers on both sides of the question, the most remarkable of which

are the letters of Mr. Noah Webster to Dr. Currie. These, however,

we cannot now consider, as we cannot expect indeed that they should

contain any thing else than a fuller detail of what has already been

set forth. Mr. Webster besides, in his letters, owns that he is not a

medical man; nay, that he had not “read above three or four medical

books.” I hope therefore the reader will excuse the preference given in

this treatise to the writings and arguments of those who are acquainted

with medicine both by reading and practice. The dispute between the

College and Academy of medicine can be settled only by themselves; the

only safe line of conduct seems to be to admit both doctrines, and

to take every method of preventing the introduction of the disease,

whether supposed to be generated or imported.

Whether the distemper which has so fatally prevailed since the year

1793 be naturally connected with the troubles in Europe and the West

Indies or not, it is certain that it has been cotemporary with them.

In New York the disease appeared in 1791, but we are not furnished

with any particular accounts of it at that time; nor does it appear to

have made any great ravages, either on the continent or the West India

islands, till 1793. At this time the war raged in Europe with fury; the

French royalists were every where driven out, and distressed in every

possible way. Desolation and slaughter prevailed at St. Domingo, while

an unbounded intercourse took place between the United States and all

those nations who were involved in the calamities resulting from the

unbridled passions of man excited to their utmost pitch of ferocity.

In the midst of this general commotion the fever broke out in the West

India islands, appearing first in the island of Grenada. We have seen,

that, according to Dr. Chisholm, this disease was brought to Grenada in

the Hankey, from the coast of Africa, on the 18th of February. About

the middle of April it began to appear on land. In the beginning of May

it reached a detachment of the royal artillery lying at a distance from

the focus of infection, “but (says Dr. Chisholm) by the communication

which the gunners in Fort George had with the 45th regiment, and the

predisposition of the men to receive the infection as far as that could

be induced by excesses in drinking, and other irregularities.” About

the first of June the disease began to appear among the negroes of

the estates in the neighbourhood of the town, but never attacked them

with the same violence that it did the white people. During the months

of May, June and July, it appeared in different parts of the country;

being, as our author supposes, carried thither by infected persons.

From Grenada, the Doctor says, the disease spread to the islands of

Jamaica and St. Domingo, and from the latter to Philadelphia, “by

vessels on which the infection was retained by the clothes, more

especially the woollen jackets, of the deceased sailors.”

This account of the origin of the fever at Philadelphia, as we have

already seen, is inadmissible by those who deny the contagious nature

of the disease; but as the latter have never given any distinct account

of its rise, or shown why it should first appear in one island and then

in another, instead of beginning in them all at once, we must adhere to

that of Dr. Chisholm, till we are furnished with a better.

In Philadelphia it has already been observed, that Dr. Rush was called

to his first patient on the 5th of August; but Mr. Carey mentions a

child of Dr. Hodges “as probably the first victim;” who was taken ill

on the 26th or 27th of July. This same month the unfortunate fugitives

had arrived from Cape Francois; and we have already seen, from Dr.

Clarke, that the arrival of some of their fellow-sufferers in Dominica

had the same dreadful attendant. Whether the disorder is to be ascribed

to the arrival of these people in either place, the reader will judge.

Other vessels are charged with having imported the same; but, facts

being disputed, we cannot enter into the controversy.

The disease began in Water-street, to a particular part of which, near

to that where the suspected ships lay, it was for some time confined,

but did not excite public alarm till about the 19th of August. From

this time to the 25th of the month the attention of the citizens was so

much aroused, that they began to move into the country; and on the 22d,

the city commissioners were peremptorily ordered by the mayor to keep

the city clean. On the 26th the College met, and addressed the citizens

on the subject; recommending such means of preventing the spreading

of the sickness as to them seemed most proper. Among these were, to

avoid any intercourse with the infected, to live temperate, keep their

minds easy, and to avoid fatigue. Lighting of fires was particularly

disapproved of; but the burning of gunpowder, and the steams of vinegar

and camphor, were recommended for infected rooms, and for using on

handkerchiefs, and in smelling-bottles.

In consequence of this address also the bells were stopped from

tolling, the constant noise of which had greatly contributed to

increase the public alarm. The people, who had been in use to light

large fires in the corners of the streets, being forbid on the 29th

by proclamation to do so, had recourse to firing of guns; which

was at last carried to such excess, that it also was prohibited by

proclamation on the 4th of September.

Notwithstanding all these precautions, the distemper continued to

increase in such a manner as to produce the most dreadful terror and

dismay. “Indeed (says Mr. Carey) it is not probable that London, at

the last stage of the plague, exhibited stronger marks of terror than

were to be seen in Philadelphia, from the 26th or 27th of August,

till pretty late in September.” This produced scenes of distress

unparalleled till this time in the city, and of which many instances

are to be met with in Mr. Carey’s account. It cannot, however, be

doubted that the violence of the distemper, its contagious nature,

and the consequent danger of visiting the metropolis, were greatly

exaggerated. Thus terror was struck throughout all the adjacent states.

At Chester-town, in Maryland, a meeting was held, on the 10th of

September, in consequence of which the Eastern shore line of stages was

quickly stopped. On the 10th of the same month it was ordered by the

mayor of New York that the names of all such persons as had arrived or

should arrive from Philadelphia or other place, by land or water, that

were or _should be sick_, should be reported to him, that those who

were sick of infectious diseases might be removed out of the city. Next

day the governor proclaimed that all vessels from Philadelphia should

approach no nearer than Bedlow’s island, about two miles from the

town, till license was given. But these precautions not being deemed

sufficient, a night watch was established, and next day an address

was published by delegates, purporting the insufficiency of all that

had been done, and again calling upon their fellow-citizens to exert

their utmost vigilance in detecting the fugitives from Philadelphia.

Various other resolutions were passed in New York; and throughout the

whole continent such measures were taken as seemed most likely to

proscribe the unhappy Philadelphians, and to prevent their having any

place of refuge from the sickness they so much dreaded. On the 1st

of October, however, the inhabitants of Springfield, in New Jersey,

passed a resolve, offering their town as an asylum for the people

of Philadelphia, and directing an hospital to be provided for the

reception of such as might fall sick. Similar resolutions were passed

by the inhabitants of Elizabethtown, and Elkton in Maryland.