Medical Inquiries and Observations, Vol. 4 / The Second Edition, Revised and Enlarged by the Author

by Benjamin Rush

The intestinal state of our summer and autumnal disease requires several specific means to prevent it, different from those which have been advised to defend the blood-vessels from fever. Unripe and decayed fruit should be avoided, and that which is ripe and sound should not be eaten in an excessive quantity. Spices, and particularly Cayenne pepper, and the red pepper of our country, should be taken daily with food. Mr. Dewar, a British surgeon, tells us, the French soldiers, while in Egypt, carried pepper in boxes with them, wherever they went, to eat with the fruits of the country, and thereby often escaped its diseases. The whole diet, during the prevalence of intestinal diseases, when they are not highly inflammatory, should be of a cordial nature. A dysentery prevailed, a few years ago, upon the Potomac, in a part of the country which was inhabited by a number of protestant and catholic families. The disease was observed to exist only in the former. The latter, who ate of salted fish every Friday, and occasionally on other days of the week, very generally escaped it. In the year 1759, a dysentery broke out in the village of Princeton, in New-Jersey, and affected many of the students of the college. It was remarked, that it passed by all those boys who came from the cities of New-York and Philadelphia. This was ascribed to their having lived more upon tea and coffee than the farmers' sons in the college; for those cordial articles of diet were but rarely used, six and forty years ago, in the farm houses of the middle states of America. I mentioned formerly that the cordial diet of the inhabitants of our cities was probably the reason why the dysentery so seldom prevailed as an epidemic in them.

Another means of preventing the dysentery is, by avoiding costiveness, and by occasionally taking purging physic, even when the bowels are in their natural state. A militia captain, in the Pennsylvania service, preserved his whole company from a dysentery which prevailed in a part of the American army at Amboy, in the year 1776, by giving each of them a purge of sea-water. He preserved his family, and many of his neighbours, some years afterwards, from the same disease, by dividing among them a few pounds of purging salts. It was prevented, a few years ago, in the academy of Bordentown, in New-Jersey, by giving all the boys molasses, in large quantities, in their diet and drinks. The molasses probably acted only by keeping the bowels in a laxative state.

As the dysentery is often excited by the dampness of the night air, great care should be taken to avoid it, and, when necessarily exposed to it, to defend the bowels by more warmth than other parts of the body. The Egyptians, Mr. Dewar says, tie a belt about their bowels for that purpose, and with the happiest effects.

II. I come now, according to the order I proposed, to mention the means of preserving whole cities or communities from the influence of those morbid exhalations which produce the different forms of summer and autumnal disease, and, in particular, that which is of a malignant nature.

As the flight of a whole city is rarely practicable, it will be necessary to point out the means of destroying the morbid miasmata.

1. Where the putrid matters which emit them are of a small extent, they should be covered with water or earth. Purchas tells us, 500 persons less died of the plague the day after the Nile overflowed the grounds which had emitted the putrid exhalations that produced it, than had died the day before. During the prevalence of a malignant fever, it will be unsafe to remove putrid matters. A plague was generated by an attempt to remove the filth which had accumulated on the banks of the waters which surround the city of Mantua, during the summer and autumnal months[18]. Even a shower of rain, by disturbing the green pellicle which is sometimes formed over putrid matters, I shall mention in another place, has let loose exhalations that have produced a pestilential disease.

2. Impregnating the air with certain effluvia, which act either by destroying miasmata by means of mixture, or by exciting a new action in the system, has, in some instances, checked the progress of a malignant fever. The air extricated from fermenting wines, during a plentiful vintage, Vansweiten tells us, has once checked the ravages of a plague in Germany. Ambrose Parey informs us, the plague was checked in a city in Italy by killing all the cats and dogs in the place, and leaving them to putrify in the streets. Mr. Bruce relates, that all those persons who lived in smoky houses, in one of the countries which he visited, escaped bilious fevers, and Dr. Clark mentions an instance, in which several cooks, who were constantly exposed to smoke, escaped a fever which affected the whole crew of a galley. The yellow fever has never appeared within the limits of the effluvia of the sal ammoniac manufactory, nor of the tan-pits in the suburbs of Philadelphia, nor has the city of London been visited with a plague since its inhabitants have used sea-coal for fuel. But other causes have contributed more certainly to the exemption of that city from the plague for upwards of a century, one of which shall be mentioned under our next head.

3. Desquenette tells us, the infection of the plague never crosses the Nile, and that it is arrested by means of ditches, dug and filled with water for that purpose. Dr. Whitman has remarked, that the plague never passes from Abydos, on the Turkish, to Mito, on the European side of the water of the Dardanelles, which forms the entrance to Constantinople. The yellow fever has never been known to pass from Philadelphia to the Jersey shore, and the miasmata generated on the east side of the Schuylkill rarely infect the inhabitants of the opposite side of the river. Many persons found safety from the plague of London, in 1665, by flying to ships which lay in the middle of the Thames, and, it is well known, no instance of yellow fever occurred in those Philadelphia families that confined themselves to ships in the middle of the Delaware, in the year 1793. But three or four, of four hundred men, on board a ship of war called the Jason, commanded by captain Coteneuil, perished with an epidemic yellow fever, in the year 1746, at St. Domingo, in consequence, Dr. Desportes says, of her hold being constantly half filled with water[19]. I have multiplied facts upon this subject, because they lead to important conclusions. They show the immense consequence of frequently washing the streets and houses of cities, both to prevent and check pestilential fevers. What would be the effect of placing tubs of fresh water in the rooms of patients infected with malignant fevers, and in an atmosphere charged with putrid exhalations? Their efficacy in absorbing the matter which constitutes the odour of fresh paint, favours a hope that they would be useful for that purpose. I have mentioned an instance, in the Account of the Yellow Fever in Philadelphia, in the year 1797, in which they were supposed to have been employed with evident advantage.

4. Intercepting the passage of miasmata to the inhabitants of cities. Varro, in his Treatise upon Agriculture, relates, that his namesake Varro, a Roman general, was in great danger of suffering, with a large fleet and army, from a malignant fever at Conyra. Having discovered the course of the miasmata which produced it to be from the south, he fastened up all the southern windows and doors of the houses in which his troops were quartered, and opened new ones to the north, by which means he preserved them from the fever which prevailed in all the other houses of the town and neighbourhood. Mr. Howard advises keeping the doors and windows, of houses which are exposed to the plague, constantly shut, except during the time of sunshine.