The disease disappeared in the spring, but it spread afterwards through the neighbouring states of New-Jersey, Delaware, and Maryland.
I shall now add an account of the remedies which I administered in this disease.
In every case that I was called to, I began the cure by giving a vomit joined with calomel. The vomit was either tartar emetic or ipecacuanha, according to the prejudices, habits, or constitutions of my patients. A quantity of bile was generally discharged by this medicine. Besides evacuating the contents of the stomach, it cleansed the throat in its passage downwards. To ensure this effect from the calomel, I always directed it to be given mixed with syrup or sugar and water, so as to diffuse it generally over every part of the throat. The calomel seldom failed to produce two or three stools. In several cases I was obliged, by the continuance of nausea, to repeat the emetics, and always with immediate and obvious advantage. I gave the calomel in moderate doses in every stage of the disease. To restrain its purgative effects, when necessary, I added to it a small quantity of opium.
During the whole course of the disease, where the calomel failed of opening the bowels, I gave lenient purges, when a disposition to costiveness required them.
The throat was kept clean by detergent gargles. In several instances I saw evident advantages from adding a few grains of calomel to them. In cases of great difficulty of swallowing or breathing, the patients found relief from receiving the steams of warm water mixed with a little vinegar, through a funnel into the throat.
A perspiration kept up by gentle doses of antimonials, and diluting drinks, impregnated with wine, always gave relief.
In every case which did not yield to the above remedies on the third day, I applied a blister behind each ear, or one to the neck, and, I think, always with good effects.
I met with no cases in which the bark appeared to be indicated, except the three in which the disease proved fatal. Where the sore throat was blended with the intermitting fever, the bark was given with advantage. But in common cases it was unnecessary. Subsequent observations have led me to believe, with Doctor Withering, that it is sometimes hurtful in this disease.
It proved fatal in many parts of the country, upon its first appearance; but wherever the mode of treatment here delivered was adopted, its mortality was soon checked. The calomel was used very generally in New-Jersey and New-York. In the Delaware state, a physician of character made it a practice not only to give calomel, but to anoint the outside of the throat with mercurial ointment.