A few instances occurred of adults, who walked about, and even transacted business, until a few hours before they died.
The intermitting fever, which made its appearance in August, was not lost during the month of September. It continued to prevail, but with several peculiar symptoms. In many persons it was accompanied by an eruption on the skin, and a swelling of the hands and feet. In some, it was attended by a sore throat and pains behind the ears. Indeed, such was the predominance of the scarlatina anginosa, that many hundred people complained of sore throats, without any other symptom of indisposition. The slightest occasional or exciting cause, and particularly cold, seldom failed of producing the disease.
The month of October was much cooler than September, and the disease continued, but with less alarming symptoms. In several adults, who were seized with it, the hardness of the pulse indicated blood-letting. The blood, in one case, was covered with a buffy coat, but beneath its surface it was dissolved.
In the month of November, the disease assumed several inflammatory symptoms, and was attended with much less danger than formerly. I visited one patient whose symptoms were so inflammatory as to require two bleedings. During the decline of the disease, many people complained of troublesome sores on the ends of their fingers. A number of children likewise had sore throats and fevers, with eruptions on their skins, which resembled the chicken-pox. I am disposed to suspect that this eruption was the effect of a spice of the scarlatina anginosa, as several instances occurred of patients who had all the symptoms of this disease, in whom an eruption of white blisters succeeded their recovery. This form of the disease has been called by Sauvage, the scarlatina variolosa.
I saw one case of sore throat, which was succeeded not only by swellings in the abdomen and limbs, but by a catarrh, which brought on a fatal consumption.
A considerable shock of an earthquake was felt on the 29th of this month, at ten o'clock at night, in the city of Philadelphia; but no change was perceived in the disease, in consequence of it.
In December, January, and February, the weather was intensely cold. There was a thaw for a few days in January, which broke the ice of the Delaware, but it was followed by cold so excessive, as to close the river till the beginning of March. The mercury, on the 28th and 29th of February, stood below 0 in Fahrenheit's thermometer.
For a few weeks in the beginning of December, the disease disappeared in the circle of my patients, but it broke out with great violence the latter end of that month, and in the January following. Some of the worst cases that I met with (three of which proved fatal) were in those two months.