Port au Prince, Sept. 1797.
At an early hour on the morning after my arrival at Port au Prince, I
was roused by the sound of martial music, and upon looking out from my
bed-room window was struck with a general display of military movement:
the whole square and all the streets within reach of the eye presented a
very animated scene; bodies of troops of various nations and hues,
negroes, hussars, British and foreign infantry and cavalry, were
assembled, with halberts, sabres, bayonets and firelocks glittering in
the sun; colours waving in the air; officers and dragoons galloping
through the streets; bands playing, drums beating, and all around
uniting in the busy clamour of an active military station: every thing
bore a warlike aspect, all was in motion, and the general appearance
evinced that the enemy was at the gate.
At breakfast-time I was visited by Dr. Jackson, who afterwards
accompanied me in search of my baggage; and having procured it, he
conducted me to his quarters, requesting that I would take up my abode
with him during my stay at Port au Prince.
A vacant chamber was accordingly allotted me, in which were placed my
mattress, a small deal table, and a single wooden chair. I have ever
since been an inmate of the Doctor’s quiet dwelling. My room is at the
back part of the house; it is still and private; the window opens into a
small garden, and all is so tranquil, that instead of feeling myself to
be in a large town, and at the head-quarters of the army, I might fancy
that I am placed amidst the seclusion of a country village.
When I entered the house in the evening, all within was silent; and the
Doctor had retired to his contemplations. I was struck with the
stillness and unornamented appearance of the habitation. An impressive
gloom overspread the entrance-chamber; a jug of limpid element stood on
the table; the floor was of brick, the furniture of the plainest order;
and a single female attendant constituted the whole domestic
establishment. Being conducted to my bed-room, I gazed at the naked
simplicity of my couch and all around it—viewed the bare roof and wooden
walls—looked at the sable Leonora, and could have fancied myself in
Penruddock’s cottage upon the heath, had not the warlike indications
without, reminded me that, instead of the solitary abode of a peaceful
philosopher, fortune had thrown me into the tranquil barrack of a
philosophical soldier.
The mode of life observed by my esteemed and learned comrade, in this
perilous climate, affords a striking example of the benefits to be
derived from abstemiousness and well-regulated habits. Ardent in the
pursuit of knowledge, and actuated by amiable and philanthropic
feelings, Dr. Jackson is industrious, and even laborious, in the
execution of his duty. Zealous to procure every possible relief for the
sick, and to obtain extensive and precise information concerning the
disease which has raged so fatally among the troops, he spares no
personal toil. Long accustomed to combine military habits with literary
pursuits, he supports self-privations without regarding the endurance of
them as a hardship. His wants are limited by his necessities; and he
concerns not himself about luxuries, or indulgences. Vegetables are his
food, water is his drink, and a bare hammock his resting-place.
Disencumbered of all superfluities, he takes the exercise of much daily
walking, preserves his health and strength, and is free to march,
whenever the service demands it.
You will conclude that our conversations are often directed to the
subject of yellow fever; and as you always express yourself anxious
regarding this direful scourge of our army, I may tell you that my
opinion, as expressed to you from Guiana, respecting the nature of this
disorder, is sanctioned by that of my intelligent and accurate friend;
and as our inquiries made at so great a distance, and without any
communication with each other, have led to similar conclusions, I have
much satisfaction in finding my remarks confirmed by those of so able
and correct an observer. Dr. Jackson views the disease as only a
modification or very high degree of the common fever of the country. He
remarks that “it is frequently attended with remissions,” and that if he
be called to the patient “at an early stage of the complaint,” he has
the power in most cases “of changing its type, and can often convert it
into a regular remittent.” He regards early venæsection as a sovereign
remedy, and esteems it important to the cure, that the quantity drawn at
the first bleeding should be ample.
I learn with much sorrow, that the fever has been even more fatal here,
than in the windward colonies; but of late, as in Guiana and the
Charibbee Islands, its malignity has abated, and the proportion of sick
is, at this moment, very considerably less than it was, during the
twelve months immediately subsequent to the arrival of the army; nor is
this simply an appearance consequent upon the diminished number of
troops; the disease is actually milder in its form, and the men, from
becoming seasoned to the climate, are less subject to its invasion: in
proof of which I may remark, that the greater part of those who are now
sick, are suffering from the chronic remains of former malady, and not
from any recent attack of the fever.
Since the chief direction has devolved upon my zealous and active
colleague, Dr. Jackson, the arrangements of the department have been
new-modelled; general hospitals have been done away, and all the sick
are received into the hospitals of their respective regiments; the
officers of the medical staff being employed only in the occasional
duties of superintendence and inspection.
Like every other regulation projected by my esteemed comrade, this is
intended for the benefit of the service; and during a period when the
troops are stationary, and the sick but few in number, they may,
probably, be accommodated in this manner with convenience, and at a
considerably less expense to government than in general hospitals, since
the higher rate of stoppages, taken from the men in sickness, may
suffice to provide all the necessaries for them, whilst they are under
recovery. But in a time of active service, when the troops are exposed
to frequent and rapid movements, when the sick list is very numerous, or
when any epidemic, or malignant disorder prevails, it is impossible that
justice can be done to the sick upon this system, or that it can be
continued with any advantage to the service. An important objection
against this alteration is, that it deprives the staff officers of all
their professional employment, rendering them mere inspectors of
regimental hospitals, while it supposes the youngest surgeons of
battalions, and even the assistants, who have seen no service whatever,
to be equally competent to prescribing, in all cases of disease, as the
most experienced physicians and surgeons of the army.
Together with Dr. Jackson, and some other officers of the medical staff,
I have been lately employed upon a board of inspection, to visit all the
hospitals at Port au Prince, in order to ascertain what number of
patients might be invalided, on account of not being likely to recover
in this climate; and I am sorry to add, that we have been obliged to
mark a long list of sufferers, whom we have thought it advisable to send
to England for the chance of regaining their health; for, although the
yellow fever is less prevalent, dysentery and other visceral
derangements, low fever, extreme debility and atrophy present themselves
too generally as the distressing sequels of long-continued heat and
disease.
The officers of the hospital staff now at Port au Prince, are, I
believe, unanimously of opinion, that the safest and best remedy in the
yellow fever is early venæsection, and they have multitudes of cases in
proof of its efficacy; one more than commonly striking occurred among
the troops of the Dutch or foreign artillery. A party of this corps,
amounting in number to ninety-six, arrived at Port au Prince on the 10th
of August last, having reached the West Indies from Europe, in the month
of July preceding; very soon after their arrival at this place, many of
them were attacked with fever, but as they happened to be immediately
under the eye of the gentlemen of the hospital staff, venæsection was
freely employed in the earliest hours of the disease. During the course
of a month only one man died: and it is remarkable that he had been
detained from the hospital until the second or third day after the
attack.
This is a strong example of the high utility of early bleeding, and it
is much strengthened by an additional fact related to me by Mr. Young,
who although not a medical practitioner, is a very intelligent and
accurate observer. The ship which brought this division of the artillery
was the Bangalore: she arrived with all the troops in perfect health,
and with her ship’s company, consisting of the captain and twenty-three
men, as well as they had been in Europe; but within the month from the
10th of August to the 10th of September, eight of the sailors and the
captain had died of the seasoning fever. These unfortunate people had
not the same medical attendants as the soldiers; but the captain being
particularly careful of his men, sent them on shore to the house of an
experienced French nurse, the moment any symptoms of disease were
manifested, in order that they might, under her care, be regularly
attended by a medical practitioner of the town. Unhappily this gentleman
was not of opinion that bleeding was the most efficacious treatment;
and, therefore, according to his judgment, employed other means; the
result very lamentably evinces which mode of practice was best advised.
Of the sailors, more than one third had died within the short period of
a month. Of the soldiers, although a greater number had suffered the
disease, only one of ninety-six had been lost within the same period;
the disproportion is frightful, and becomes melancholy, when we reflect
that it must have arisen in a great degree from the difference of
professional treatment! The unfortunate captain of the Bangalore was
seized on the Saturday, and died on the Monday following.