1. A sudden drying up, or breaking out of an old sore; fresh eruptions in different parts of the body; a cessation of a chronic disease, or a conversion of a periodical into a continual disease. Of this there were many instances in Philadelphia, in the year 1793.
2. A peculiar sallowness of the complexion. This was observed to be general in Philadelphia, previous to the yellow fever of 1793. Dr. Dick informed me, that he had observed the same appearance in the faces of the people of Alexandria, accompanied in some cases with a yellowness of the eyes, during the summer of 1793, and previous to the appearance of a violent bilious fever on the banks of the Potomac.
3. I have observed one or more of the following symptoms, namely, head-ach; a decay, or increase of appetite; costiveness; a diminished or increased secretion of urine; a hot and offensive breath[14]; constant sweats, and sometimes of a fœtid nature, or a dry skin; wakefulness, or a disposition to early or protracted sleep; a preternaturally frequent pulse; unusual vivacity, or depression of spirits; fatigue and sweats from light exertions; hands, when rubbed, emitting a smell like hepar sulphuris; and, lastly, a sense of burning in the mouth; to be present in different persons, during the prevalence of our malignant epidemics.
The means of preventing the different forms of our summer and autumnal disease come next under our consideration. I shall first mention such as have been most effectual in guarding against its malignant form, and afterwards take notice of such as are proper in its milder grades. These means naturally divide themselves again,
I. Into such as are proper to protect individuals.
II. Such as are proper to defend whole communities from the disease. And,
III. Such as are proper to exterminate it, by removing its causes.
I. Of the means of protecting individuals.
Where flight is practicable, it should be resorted to in every case, to avoid an attack of a malignant fever. The heights of Germantown and Darby have, for many years, afforded a secure retreat to a large number of the citizens of Philadelphia, from their late annual epidemics. It were to be wished our governments possessed a power of compelling our citizens to desert the whole, or parts, of infected cities and villages. In this way the yellow fever was suddenly annihilated in Providence, on Rhode-Island, and in New-Haven, in Connecticut, in the year 1805. But the same power should rigorously prevent the removal of the sick, except it be that class of them which have neither homes nor friends. The less the distance they are carried beyond the infected atmosphere, the better. The injury sustained by conveying them in a jolting carriage, for two or three miles, has often been proclaimed in the reports of our city hospitals, of patients being admitted without a pulse, and dying a few hours afterwards.