I have before remarked, that one reason why most of our physicians refused to admit the presence of the yellow fever in the city, was because they could not fix upon a vestige of its being imported. On the 25th of August, the brig Commerce arrived in the river, from St. Mark, commanded by Captain Shirtliff. After lying five days at the fort, she came up to the city. A boy, who had been shut out from his lodgings, went, in a state of intoxication, and slept on her deck, exposed to the night air, in consequence of which the fever was excited in him. This event gave occasion, for a few days, to a report that the disease was imported, and several of the physicians, who had neglected to attend to all the circumstances that have been stated, admitted the yellow fever to be in town. An investigation of this supposed origin of the disease soon discovered that it had no foundation. At the time of the arrival of this ship, I had attended nearly thirty persons with the fever, and upwards of a hundred had had it, under the care of other physicians.
The generation of the yellow fever in our city was rendered more certain by the prevalence of bilious diseases in every part of the United States, and, in several of them, in the grade of yellow fever. It was common in Charleston, in South-Carolina, where it carried off many people, and where no suspicion was entertained of its being of West-India origin. It prevailed with great mortality at that part of the city of Baltimore, which is known by the name of Fell's Point, where, Dr. Drysdale assures me, it was evidently generated. A few sporadic cases of it occurred in New-York, which were produced by the morbid exhalation from the docks of that city. Sporadic cases of it occurred likewise in most of the states, in which the proofs of its being generated were obvious to common observation; and where the symptoms of depressed pulse, yellowness of the skin, and black discharges from the bowels and stomach (symptoms which mark the highest grade of bilious remitting fever) did not occur, the fevers in all their form of tertian, quotidian, colic, and dysentery, were uncommonly obstinate or fatal in every state in the union. In New-Haven only, where the yellow fever was epidemic, it was said to have been imported from Martinique, but this opinion was proved to be erroneous by unanswerable documents, published afterwards in the Medical Repository, by Dr. Elisha Smith, of New-York.
The year 1795 furnished several melancholy proofs of the American origin of the yellow fever. All the physicians and citizens of New-York and Norfolk agree in its having been generated in their respective cities that year. It prevailed with great mortality at the same time in the neighbourhood of the lakes, and on the waters of the Genesee river, in the state of New-York. From its situation it obtained the name of the lake and Genesee fever. It was so general, in some parts of that new country, as to affect horses.
Thus have I endeavoured to fix the predisposing and remote causes of the yellow fever in our country. The remote cause is sometimes so powerful as to become an exciting cause of the disease, but in general both the predisposing and remote causes are harmless in the system, until they are roused into action by some exciting cause.
I shall conclude this account of the symptoms and origin of the yellow fever by relating two facts, which serious and contemplating minds will apply to a more interesting subject.
1. Notwithstanding the numerous proofs of the prevalence of the yellow fever in Philadelphia in the year 1794, which have been mentioned, there are many thousands of our citizens, and a majority of our physicians, who do not believe that a case of it existed at that time in the city; nor is a single record of it to be met with in any of the newspapers, or other public documents of that year. Let us learn from this fact, that the denial of events, or a general silence upon the subject of them, is no refutation of their truth, where they oppose the pride or interests of the learned, or the great.
2. Notwithstanding the general denial of the existence of the yellow fever in Philadelphia, and the silence observed by our newspapers relative to it in 1794, there was scarcely a citizen or physician who, three years afterwards, did not admit of its having prevailed in that year. We learn from this fact another important truth, that departed vice and error have no friends nor advocates.
OF THE METHOD OF CURE.
The remedies employed for the cure of this fever were the same that I employed the year before. I shall only relate such effects of them as tend more fully to establish the practice adopted in the year 1793, and such as escaped my notice in my former remarks upon those remedies. My method of cure consisted,
I. In the abstraction of the stimulus of blood and heat from the whole body, and of bile and other acrid humours from the bowels, by means of the following remedies: