opinion, that the plagues which occasionally desolated most of the
countries of Europe, in former centuries, and which were always said to
be of foreign extraction, were of domestic origin. Between the years 1006
and 1680, the plague was epidemic fifty-two times all over Europe. It
prevailed fourteen times in the 14th century. The state of Europe, in
this long period, is well known. Idleness, a deficiency of vegetable
aliment, a camp life, from the frequency of wars, famine, an uncultivated
and marshy soil, small cabins, and the want of cleanliness in dress,
diet, and furniture, all concurred to generate pestilential diseases. The
plagues which prevailed in London, every year from 1593 to 1611, and from
1636 to 1649, I believe were generated in that city. The diminution of
plagues in Europe, more especially in London, appears to have been
produced by the great change in the diet and manners of the people; also
by the more commodious and airy forms of the houses of the poor, among
whom the plague _always_ makes its first appearance. It is true, these
plagues were said by authors to have been imported, either directly or
indirectly, from the Levant; but the proofs of such importation were as
vague and deficient as they were of the West-India origin of our
epidemic. The pestilential fevers which have been mentioned, have been
described by authors by the generic name of the plague, but they appear
to have originated from putrid vegetable exhalations, and to have
resembled, in most of their symptoms, the West-India and _North-American_
yellow fever.
I shall resume this interesting subject in another place, in which I
shall mention a number of additional facts, not only in support of the
domestic origin of the bilious yellow fever, but of its not spreading by
contagion, and of course of its being impossible to import it. I shall at
the same time enumerate all its different sources, and point out the
means of destroying or removing them, and thus of exterminating the
disease from our country.
With these observations I conclude the history of the epidemic fever of
the year 1793. A few of its symptoms, which have been omitted in this
history, will be included in the method of cure, for they were discovered
or produced by the remedies which were given for that purpose.
[Hand] The following page begins an account of the states of the
thermometer and weather, from the 1st of January to the 1st of August,
and of the states of the barometer, thermometer, winds, and weather, from
the 1st of August to the 9th of November, 1793. The times of observation,
for the first three months are at 7 in the morning, and 2 in the
afternoon; for the next five months they are at 6 in the morning, and 3
in the afternoon. From the 1st of October to the 9th of November, they
are as in the first three months.
_January, 1793._ _February, 1793._
+----+---------+----------------------+---------+---------------------+
| | Therm. | Weather. | Therm. | Weather. |
| D. | 7h | 2h | | 7h | 2h | |
+----+----+----+----------------------+----+----+---------------------+
| 1 | 27 | 30 | Cloudy. | 9 | 26 | Fair, hazy. |
| 2 | 30 | 41 | Fair, cloudy. | 25 | 34 | Rain, ditto. |
| 3 | 30 | 33 | Cloudy, rain. | 33 | 37 | Cloudy, fair. |
| 4 | 38 | 41 | Rain, cloudy. | 25 | 46 | Cloudy, fair. |
| 5 | 35 | 42 | Fair, cloudy. | 36 | 44 | Cloudy, ditto. |
| 6 | 33 | 47 | Cloudy, fair. | 35 | 46 | Cloudy, rain. |
| 7 | 38 | 51 | Fair, fair. | 36 | 40 | Cloudy, fair. |
| 8 | 32 | 49 | Fair, ditto. | 28 | 44 | Cloudy, ditto. |
| 9 | 33 | 48 | Hazy, fair. | 42 | 50 | Rain, fair. |
| 10 | 38 | 51 | Fair, ditto. | 38 | 40 | Cloudy, fair. |
| 11 | 35 | 48 | Fair, clouds. | 19 | 27 | Fair, cloudy. |
| 12 | 31 | 42 | Fair, ditto. | 20 | 28 | Snow, cloudy. |
| 13 | 28 | 42 | Fair, ditto. | 22 | 31 | Cloudy, snow. |
| 14 | 25 | 27 | Hail, snow, sleet. | 27 | 39 | Cloudy, fair. |
| 15 | 32 | 37 | Clouds, mist. | 18 | 40 | Fair, ditto. |
| 16 | 37 | 39 | Rain, ditto. | 29 | 42 | Cloudy, ditto. |
| 17 | 37 | 45 | Rain, snow, fair. | 44 | 48 | Rain, ditto. |
| 18 | 32 | 52 | Fair, ditto. | 39 | 49 | Cloudy, fair. |
| 19 | 37 | 48 | Fair, ditto. | 31 | 41 | Cloudy, rain. |
| 20 | 33 | 47 | Hazy, cloudy. | 52 | 53 | Rain, fair. |
| 21 | 36 | 47 | Cloudy, fair. | 37 | 49 | Fair, ditto. |
| 22 | 27 | 32 | Fair, ditto. | 29 | 34 | Fair, ditto. |
| 23 | 22 | 37 | Fair, ditto. | 22 | 34 | Snow, cloudy. |
| 24 | 30 | 39 | Cloudy, ditto. | 54 | 59 | Rain, cloudy. |
| 25 | 30 | 41 | Fair, hazy. | 34 | 35 | Cloudy, ditto. |
| 26 | 31 | -- | Fair. | 35 | 43 | Rain, mist. |
| 27 | 23 | 38 | Fair, cloudy, snow. | 43 | 43 | Rain, cloudy. |
| 28 | 35 | 45 | Cloudy, fair. | 14 | 26 | Fair, ditto. |
| 29 | 29 | 37 | Fair, ditto. | | | |
| 30 | 22 | 23 | Snow, hail. | | | |
| 31 | 25 | 32 | Cloudy, fair. | | | |
+----+----+----+----------------------+----+----+---------------------+
_March, 1793._ _April, 1793._
+----+---------+----------------------+---------+---------------------+
| | Therm. | Weather. | Therm. | Weather. |
| D. | 7h | 2h | | 7h | 2h | |
+----+----+----+----------------------+----+----+---------------------+
| 1 | 20 | 38 | Fair, ditto. | 45 | 70 | Cloudy, fair. |
| 2 | 31 | 51 | Hazy, cloudy. | 47 | 71 | Fair, ditto. |
| 3 | 48 | 63 | Rain, fair. | 56 | 80 | Fair, ditto. |
| 4 | 43 | 61 | Hazy, ditto. | 51 | 72 | Cloudy, fair. |
| 5 | 51 | 52 | Rain, fair. | 53 | 61 | Cloudy, rain. |
| 6 | 32 | 50 | Fair, ditto. | 60 | 76 | Misty, fair. |
| 7 | 36 | 62 | Fair, ditto, clouds. | 51 | 65 | Fair, ditto. |
| 8 | 54 | 60 | Cloudy, rain. | 46 | 74 | Fair, ditto. |
| 9 | 26 | 41 | Fair, ditto. | 55 | 71 | Fair, cloudy. |
| 10 | 29 | 51 | Fair, ditto. | 50 | 56 | Fair, ditto. |
| 11 | 43 | 55 | Rain, ditto. | 37 | 63 | Fair, ditto. |
| 12 | 40 | 43 | Cloudy, ditto. | 54 | 62 | Cloudy, rain, fair. |
| 13 | 38 | 39 | Cloudy, fair. | 49 | 62 | Fair, ditto. |
| 14 | 26 | 44 | Fair, ditto. | 50 | 70 | Fair, ditto. |
| 15 | 32 | 59 | Fair, ditto. | 45 | 55 | Rain, cloudy. |
| 16 | 52 | 62 | Cloudy, fair. | 46 | 62 | Cloudy, fair. |
| 17 | 51 | 72 | Cloudy, fair. | 48 | 67 | Fair, clouds, fair. |
| 18 | 58 | 69 | Hazy, cloudy. | 52 | 66 | Cloudy, fair. |
| 19 | 53 | 59 | Fair, ditto. | 52 | 75 | Fair, ditto. |
| 20 | 42 | 61 | Fair, ditto. | 52 | 49 | Rain, cloudy. |
| 21 | 41 | 43 | Rain, cloudy. | 44 | 47 | Cloudy, ditto. |
| 22 | 31 | 47 | Fair, ditto. | 43 | 46 | Rain, cloudy. |
| 23 | 35 | 57 | Fair, ditto. | 42 | 63 | Fair, ditto. |
| 24 | 37 | 50 | Fair, ditto. | 44 | 68 | Fair, ditto. |
| 25 | 35 | 59 | Fair, ditto. | 45 | 65 | Cloudy, ditto. |
| 26 | 47 | 54 | Cloudy, rain. | 53 | 57 | Cloudy, rain. |
| 27 | 43 | 51 | Fair, cloudy. | 47 | 46 | Rain, ditto. |
| 28 | 33 | 45 | Fair, clouds, fair. | 44 | 54 | Rain, cloudy. |
| 29 | 34 | 57 | Fair, ditto. | 40 | 59 | Fair, ditto. |
| 30 | 41 | 58 | Cloudy, fair. | 40 | 65 | Fair, ditto. |
| 31 | 42 | 61 | Cloudy, fair. | | | |
+----+----+----+----------------------+----+----+---------------------|
_May, 1793._ _June, 1793._
+----+---------+----------------------+---------+---------------------+
| | Therm. | Weather. | Therm. | Weather. |
| D. | 7h | 2h | | 7h | 2h | |
+----+----+----+----------------------+----+----+---------------------+
| 1 | 45 | 69 | Foggy, cloudy. | 53 | 61 | Rain, showery. |
| 2 | 52 | 73 | Fog, clouds, fair. | 54 | 64 | Clouds, showers. |
| 3 | 60 | 63 | Rain, ditto. | 55 | 62 | Cloudy, rain, fair. |
| 4 | 60 | 80 | Fair, ditto. | 54 | 60 | Rain, do. cloudy. |
| 5 | 55 | 56 | Cloudy, ditto. | 58 | 72 | Cloudy, fair, rain. |
| 6 | 47 | 58 | Cloudy, fair. | -- | 71 | Cloudy, rain. |
| 7 | 50 | 68 | Cloudy, fair. | 68 | 78 | Fair, ditto. |
| 8 | 59 | 78 | Cloudy, fair. | 65 | -- | Fair, ditto. |
| 9 | 61 | 79 | Foggy, fair. | 70 | 88 | Fog, fair. |
| 10 | 65 | 71 | Rain, hazy. | 74 | 90 | Fair, ditto. |
| 11 | 55 | 75 | Cloudy, fair. | 76 | 90 | Fair, ditto. |
| 12 | 61 | 76 | Cloudy, rain. | 75 | 88 | Fair, showers. |
| 13 | 57 | 78 | Fair, ditto. | 74 | 81 | Cloudy, rain. |
| 14 | 59 | 83 | Fair, cloudy. | 63 | 77 | Fair, ditto. |
| 15 | 60 | 71 | Fair, ditto. | 63 | 82 | Fair, hazy. |
| 16 | 50 | 69 | Fair, ditto. | 67 | 85 | Fair, ditto. |
| 17 | 48 | 74 | Fair, ditto. | 74 | 89 | Fair, showers. |
| 18 | 61 | 81 | Cloudy, fair. | 73 | 88 | Fair, ditto. |
| 19 | 65 | 85 | Fair, rain. | 77 | 91 | Fair, ditto. |
| 20 | 65 | 87 | Fair, ditto. | 79 | 88 | Fair, rain, fair. |
| 21 | 68 | 86 | Fair, ditto, clouds. | 75 | 85 | Cloudy, rain. |
| 22 | 72 | 80 | Clouds, gusts. | 58 | 78 | Cloudy, fair. |
| 23 | 94 | 79 | Cloudy, fair. | 58 | 78 | Fair, ditto. |
| 24 | 58 | 75 | Fair, ditto. | 60 | 79 | Fair, ditto. |
| 25 | 52 | 70 | Fair, cloudy. | 67 | 74 | Cloudy, rain. |
| 26 | 61 | 66 | Rain, ditto. | 66 | 69 | Cloudy, rain. |
| 27 | 68 | 84 | Cloudy, fair. | 68 | 80 | Cloudy, fair. |
| 28 | 70 | 68 | Fair, clouds, rain. | 71 | 85 | Cloudy, fair. |
| 29 | 57 | 62 | Cloudy, rain, clouds.| 77 | 88 | Cloudy, ditto. |
| 30 | 54 | 57 | Cloudy, rain. | 74 | 90 | Fair, ditto. |
| 31 | 54 | 60 | Clouds, ditto. | | | |
+----+----+----+----------------------+----+----+---------------------+
JULY, 1793.
+-----+------------+-----------+-------------+--------------------+
| | Barom. | Ther. | Winds. | Weather. |
| | 6 3 | 6 3 | 6 3 | |
|Days.|A. M. P. M.|A. M. P. M.|A. M. P. M.| |
| | | | | |
| 1 |30 0 29 9| 77 88 | W W |fair. |
| 2 |29 8 29 7| 77 81 | W |fair, showers. |
| 3 |29 9 30 0| 74 80 | E E |cloudy. |
| 4 |30 1 30 0| 70 83 | E SW |cloudy, fair, rain. |
| 5 |30 0 29 9| 76 90 | NW SW |fair, ditto. |
| 6 |29 9 29 9| 78 91 | SW SW |cloudy, thunder. |
| 7 |29 9 30 0| 73 88 | NE NW |fair, clouds. |
| 8 |30 1 30 1| 72 85 | E E |cloudy, fair. |
| 9 |30 0 29 8| 73 81 | S SW |cloudy, ditto. |
| 10 |30 0 30 0| 70 84 | W NW |fair, ditto. |
| 11 |30 0 30 0| 74 88 | NW NW |fair, clouds. |
| 12 |30 1 30 2| 70 84 | N N |fair, ditto. |
| 13 |30 1 30 0| 68 83 | NW NW |fair, ditto. |
| 14 |30 0 30 0| 65 80 | N Calm |fair, hazy. |
| 15 |30 0 29 9| 66 75 | SW SW |cloudy, ditto. |
| 16 |29 8 29 7| 70 83 | W W |rain, fair. |
| 17 |29 8 29 9| 68 81 | NW NW |fair, ditto. |
| 18 |30 0 30 0| 66 86 | W SW |fair, ditto. |
| 19 |29 9 29 9| 75 85 | SW W |fair, cloudy, rain. |
| 20 |30 0 30 0| 72 87 | W NW |fair, ditto, shower.|
| 21 |30 1 30 1| 70 86 | NW NW |fair, ditto. |
| 22 |30 0 30 0| 72 87 | SW SW |fair, ditto. |
| 23 |30 0 30 0| 73 91 | SW SW |fair, cloudy. |
| 24 |29 9 29 9| 75 89 | Calm W |cloudy, fair. |
| 25 |30 1 30 1| 71 83 | NW NNW |fair, ditto. |
| 26 |30 2 30 2| 63 82 | N NE |fair, ditto. |
| 27 |30 2 30 1| 64 81 | S calm S |fair, cloudy. |
| 28 |30 1 30 0| 72 85 | Calm NNE |cloudy, fair. |
| 29 |30 1 30 1| 74 85 | SSE NE |cloudy, ditto, rain.|
| 30 |30 1 30 0| 73 86 | S SW |cloudy, fair. |
| 31 |29 9 29 8| 76 80 | SSW SW |cloudy, rain, fair. |
+-----+------------+-----------+-------------+--------------------+
AUGUST, 1793.
+-----+------------+-----------+-------------+--------------------+
| | Barom. | Ther. | Winds. | Weather. |
| | 6 3 | 6 3 | 6 3 | 6 3 |
|Days.|A. M. P. M.|A. M. P. M.|A. M. P. M.|A. M. P. M. |
| 1 |29 95 30 0| 65 77 | WNW NW |cloudy, fair, |
| 2 |30 1 30 1| 63 81 | NW SW |fair, fair, |
| 3 |30 6 29 95| 62 82 | N NNE |fair, fair, |
| 4 |29 97 30 0| 65 87 | S SW |fair, fair, |
| 5 |30 5 30 1| 73 90 | SSW SW |fair, fair, |
| 6 |30 2 30 0| 77 87 | SW W |cloudy, fair, |
| 7 |30 12 30 1| 68 83 | NW W |fair, fair, |
| 8 |30 1 29 95| 69 86 | SSE SSE |fair, rain, |
| 9 |29 8 29 75| 75 85 | SSW SW |cloudy, fair, |
| 10 |29 9 29 9| 67 82 | W SW |fair, fair, |
| 11 |30 0 30 0| 70 84 | SW WSW |cloudy, cloudy, |
| 12 |30 0 30 0| 70 87 | W W |fair, fair, |
| 13 |30 5 30 0| 71 89 | SW W |fair, fair, |
| 14 |30 0 29 95| 75 82 | SW SW |fair, rain, |
| 15 |30 0 30 1| 72 75 | NNE NE |fair, cloudy, |
| 16 |30 1 30 1| 70 83 | NNE NE |fair, fair, |
| 17 |30 1 30 0| 71 86 | SW SW |fair, fair, |
| 18 |30 1 30 1| 73 89 | calm SW |fair, fair, |
| 19 |30 1 30 0| 72 82 | N N |fair, cloudy, |
| 20 |30 1 30 12| 69 82 | NNE NNE |fair, fair, |
| 21 |30 15 30 25| 62 83 | N NNE |fair, fair, |
| 22 |30 3 30 35| 63 86 | NE SE |fair, fair, |
| 23 |30 25 30 15| 63 85 | calm S |fair, fair, |
| 24 |30 1 30 1| 73 81 | calm calm |cloudy, rain, |
| 25 |30 1 30 1| 71 66 | NE NE |rain, gr. rain, |
| 26 |30 15 30 2| 59 69 | NE NE |cloudy, cloudy, |
| 27 |30 2 30 2| 65 73 | NE NE |cloudy, cloudy, |
| 28 |30 2 30 15| 67 80 | S calm |cloudy, clearin. |
| 29 |30 16 30 15| 72 86 | calm SW |cloudy, fair, |
| 30 |30 1 30 1| 74 87 | calm SW |fair, fair, |
| 31 |30 0 30 0| 74 84 | SW NW |rain, fair. |
+-----+------------+-----------+-------------+--------------------+
SEPTEMBER, 1793.
+-----+------------+-----------+-------------+--------------------+
| | Barom. | Ther. | Winds. | Weather. |
| | 6 3 | 6 3 | 6 3 | 6 3 |
|Days.|A. M. P. M.|A. M. P. M.|A. M. P. M.|A. M. P. M. |
| 1 |30 0 29 30| 71 86 | calm SW |fog, fair, |
| 2 |29 75 29 8| 73 86 | SW SW |fair, fair, |
| 3 |30 0 | 60 | NW N |fair, fair, |
| 4 |30 15 30 15| 55 75 | W W |fair, fair, |
| 5 |30 15 30 1| 62 80 | SE S |fair, cloudy, |
| 6 |29 97 29 95| 70 89 | WSW W |fair, cloudy, |
| 7 |30 0 30 0| 65 77 | WNW NW |fair, fair, |
| 8 |30 1 30 1| 64 70 | calm calm |cloudy, cloudy, |
| 9 |30 0 30 0| 66 80 | SE NW |rain, fair, |
| 10 |30 0 30 0| 64 72 | N NNE |fair, cloudy, |
| 11 |30 1 30 0| 62 72 | NNE N |cloudy, fair, |
| 12 |29 96 29 9| 58 76 | NW NNW |fair, fair, |
| 13 |29 95 30 0| 57 72 | NW N |fair, fair, |
| 14 |30 0 30 5| 58 79 | NW NW |fair, fair, |
| 15 |30 0 29 97| 65 80 | N S |fair, fair, |
| 16 |29 9 29 | 70 84 | S SW |cloudy, fair, |
| 17 |29 8 29 85| 66 67 | N N |cloudy, cloudy, |
| 18 |30 3 | 44 | N |fair, |
| 19 |30 4 30 35| 45 70 | calm SW |fair, fair, |
| 20 |30 3 30 15| 54 69 | calm SE |hazy, hazy, |
| 21 |30 0 29 0| 59 78 | calm |cloudy, fair, |
| 22 |30 0 30 0| 63 83 | calm |cloudy, fair, |
| 23 |30 1 30 1| 62 80 | calm SE |cloudy, cloudy, |
| 24 |30 2 30 2| 65 70 | NE ENE |cloudy, fair, |
| 25 |30 15 30 0| 61 68 | NE NE |cloudy, cloudy, |
| 26 |29 8 29 7| 58 79 | N N |cloudy, fair, |
| 27 |29 7 | 64 | NW NW |cloudy, fair, |
| 28 |30 5 30 15| 54 73 | NW NW |fair, fair, |
| 29 |30 3 30 3| 56 74 | NE ENE |cloudy, fair, |
| 30 |30 35 30 3| 57 75 | calm SW |foggy, fair. |
+-----+------------+-----------+-------------+--------------------+
OCTOBER, 1793.
+-----+------------+-----------+-------------+--------------------+
| | | | | |
| | Barom. | Ther. | Winds. | Weather. |
| | | | | |
| | 7 2 | 7 2 | 7 2 | 7 2 |
|Days.|A. M. P. M.|A. M. P. M.|A. M. P. M.|A. M. P. M. |
| 1 |30 15 30 5| 64 80 | SW SW |cloudy, fair, |
| 2 |29 9 30 5| 70 72 | W NNW |cloudy, fair, |
| 3 |30 2 30 15| 50 72 | W SW |fair, fair, |
| 4 |29 75 29 7| 59 72 | SW W |cloudy, cloudy, |
| 5 |30 0 30 1| 58 66 | N N |fair, fair, |
| 6 |30 3 30 3| 43 66 | NE W |fair, fair, |
| 7 |30 45 | 46 | calm |fair, |
| 8 |30 6 30 6| 53 68 | N N |fair, fair, |
| 9 |30 5 30 4| 53 70 | NW NW |fair, fair, |
| 10 |30 2 30 2| 49 74 | E NW |fair, fair, |
| 11 |30 0 29 85| 51 74 | W W |fair, fair, |
| 12 |29 6 29 55| 58 64 | SW NW |rain, rain, |
| 13 |29 85 29 9| 49 69 | NW NW |fair, fair, |
| 14 |30 5 30 0| 52 76 | SW SW |calm, fair, |
| 15 |29 75 29 8| 56 54 | SW N |fair, rain, |
| 16 |30 0 30 0| 37 53 | NNW N |fair, fair, |
| 17 |30 1 30 1| 37 60 | NE NE |fair, fair, |
| 18 |30 1 30 1| 41 62 | NW NW |fair, fair, |
| 19 |30 0 29 9| 51 66 | N N |cloudy, fair, |
| 20 |30 0 30 0| 44 54 | NW N |fair, fair, |
| 21 |30 0 30 2| 49 59 | N NW |fair, fair, |
| 22 |29 6 29 5| 51 65 | NW NW |fair, fair, |
| 23 |29 8 29 8| 47 60 | W W |fair, fair, |
| 24 |30 3 30 4| 36 59 | W NW |fair, fair, |
| 25 |30 4 30 3| 46 71 | S S |cloudy, do. h-w. |
| 26 |30 2 30 2| 60 72 | calm SW |cloudy, cloudy, |
| 27 |30 3 30 3| 44 44 | NNE NNE |cloudy, cloudy, |
| 28 |30 2 30 1| 34 37 | N N |cloudy, cloudy, |
| 29 |29 85 29 85| 28 44 | NNW NW |fair, fair, |
| 30 |30 1 30 1| 28 49 | calm SW |hazy, hazy, |
| 31 |30 15 30 2| 42 45 | calm NNE |cloudy, rain. |
+-----+------------+-----------+-------------+--------------------+
NOVEMBER, 1793.
+-----+------------+-----------+-------------+--------------------+
| | Barom. | Ther. | Winds. | Weather. |
| | 7 2 | 7 2 | 7 2 | 7 2 |
|Days.|A. M. P. M.|A. M. P. M.|A. M. P. M.| A. M. P. M. |
| 1 |30 1 30 1| 40 41 | NNE NE |rain, cloudy, |
| 2 |30 3 30 25| 32 49 | NNE NE |fair, fair, |
| 3 |30 1 30 0| 43 56 | calm SW |cloudy, cloudy, |
| 4 |29 8 29 9| 55 67 | SW SW |cloudy, fair, |
| 5 |30 15 30 1| 50 64 | NE NE |rain, rain, |
| 6 |29 8 29 65| 63 67 | S S |cloudy, cloudy, |
| 7 |29 8 29 8| 44 64 | calm SW |fair, fair, |
| 8 |29 8 29 85| 43 56 | SSW SW |fair, fair, |
| 9 |29 9 29 95| 42 64 | SW SW |fair, fair, |
+-----+------------+-----------+-------------+--------------------+
OF THE METHOD OF CURE.
In the introduction to the history of the fever, I mentioned the remedies
which I used with success, in several cases which occurred in the
beginning of August. I had seen, and recorded in my note book, the
efficacy of gentle purges in the yellow fever of 1762; but finding them
unsuccessful after the 20th of August, and observing the disease to
assume uncommon symptoms of great prostration of strength, I laid them
aside, and had recourse to a gentle vomit of ipecacuanha, on the first
day of the fever, and to the usual remedies for exciting the action of
the sanguiferous system. I gave bark in all its usual forms of infusion,
powder, and tincture. I joined wine, brandy, and aromatics with it. I
applied blisters to the limbs, neck, and head. Finding them all
ineffectual, I attempted to rouse the system by wrapping the whole body,
agreeably to Dr. Hume's practice, in blankets dipped in warm vinegar. To
these remedies I added one more: I rubbed the right side with mercurial
ointment, with a view of exciting the action of the vessels in the whole
system, through the medium of the liver, which I then supposed to be
principally, though symptomatically, affected by the disease. None of
these remedies appeared to be of any service; for although three out of
thirteen recovered, of those to whom they were applied, yet I have reason
to believe that they would have recovered much sooner had the cure been
trusted to nature. Perplexed and distressed by my want of success in the
treatment of this fever, I waited upon Dr. Stephens, an eminent and
worthy physician from St. Croix, who happened then to be in our city, and
asked for such advice and information upon the subject of the disease, as
his extensive practice in the West-Indies would naturally suggest. He
politely informed me, that he had long ago laid aside evacuations of all
kinds in the yellow fever; that they had been found to be hurtful, and
that the disease yielded more readily to bark, wine, and, above all, to
the use of the cold bath. He advised the bark to be given in large
quantities by way of glyster, as well as in the usual way; and he
informed me of the manner in which the cold bath should be used, so as to
derive the greatest benefit from it. This mode of treating the yellow
fever appeared to be reasonable. I had used bark, in the manner he
recommended it, in several cases of sporadic yellow fever, with success,
in former years. I had, moreover, the authority of several other
physicians of reputation in its favour. Dr. Cleghorn tells us, that "he
sometimes gave the bark when the bowels were full of vicious humours.
These humours (he says) are produced by the fault of the circulation. The
bark, by bracing the solids, enables them to throw off the
excrementitious fluids, by the proper emunctories[65]."
[65] Page 223.
I began the use of each of Dr. Stevens's remedies the next day after my
interview with him, with great confidence of their success. I prescribed
bark in large quantities: in one case I ordered it to be injected into
the bowels every four hours. I directed buckets full of cold water to be
thrown frequently upon my patients. The bark was offensive to the
stomach, or rejected by it, in every case in which I prescribed it. The
cold bath was grateful, and produced relief in several cases, by inducing
a moisture on the skin. For a while I had hopes of benefit to my patients
from the use of these remedies, but, in a few days, I was distressed to
find they were not more effectual than those I had previously used. Three
out of four of my patients died, to whom the cold bath was administered,
in addition to the tonic remedies before-mentioned.
Baffled in every attempt to stop the ravages of this fever, I anticipated
all the numerous and complicated distresses in our city, which
pestilential diseases have so often produced in other countries. The
fever had a malignity and an obstinacy which I had never before observed
in any disease, and it spread with a rapidity and mortality far beyond
what it did in the year 1762. Heaven alone bore witness to the anguish of
my soul in this awful situation. But I did not abandon a hope that the
disease might yet be cured. I had long believed that good was
commensurate with evil, and that there does not exist a disease for which
the goodness of Providence has not provided a remedy. Under the
impression of this belief I applied myself with fresh ardour to the
investigation of the disease before me. I ransacked my library, and pored
over every book that treated of the yellow fever. The result of my
researches for a while was fruitless. The accounts of the symptoms and
cure of the disease by the authors I consulted were contradictory, and
none of them appeared altogether applicable to the prevailing epidemic.
Before I desisted from the inquiry to which I had devoted myself, I
recollected that I had, among some old papers, a manuscript account of
the yellow fever as it prevailed in Virginia in the year 1741, which had
been put into my hands by Dr. Franklin, a short time before his death. I
had read it formerly, and made extracts from it into my lectures upon
that disease. I now read it a second time. I paused upon every sentence;
even words in some places arrested and fixed my attention. In reading the
history of the method of cure I was much struck with the following
passages.
"It must be remarked, that this evacuation (meaning by purges) is more
necessary in this than in most other fevers. The abdominal viscera are
the parts principally affected in this disease, but by this timely
evacuation their feculent corruptible contents are discharged, before
they corrupt and produce any ill effects, and their various emunctories
and secerning vessels are set open, so as to allow a free discharge of
their contents, and consequently a security to the parts themselves,
during the course of the disease. By this evacuation the very minera of
the disease, proceeding from the putrid miasmata fermenting with the
salivary, bilious, and other inquiline humours of the body, is sometimes
eradicated by timely emptying the abdominal viscera, on which it first
fixes, after which a gentle sweat does as it were nip it in its bud.
Where the primæ viæ, but especially the stomach, is loaded with an
offensive matter, or contracted and convulsed with the irritation of its
stimulus, there is no procuring a laudable sweat till that is removed;
after which a necessary quantity of sweat breaks _out of its own accord_,
these parts promoting it when by an absterging medicine they are eased of
the burden or stimulus which oppresses them."
"All these acute putrid fevers ever require some evacuation to bring them
to a perfect crisis and solution, and that even by stools, which must be
promoted by art, where nature does not do the business herself. On this
account an _ill-timed scrupulousness about the weakness of the body_ is
of bad consequence in these urging circumstances; for it is that which
seems chiefly to make evacuations necessary, which nature ever attempts,
after the humours are fit to be expelled, but is not able to accomplish
for the most part in this disease; and I can affirm that I have given a
purge in this case, when _the pulse has been so low, that it could
hardly be felt_, and the _debility extreme_, yet _both one and the other_
have been _restored by it_."
"This evacuation must be procured by _lenitive chologoque_ purges."