Mr. Webster, in his eighth letter to Dr. Currie on the subject of pestilential diseases, quotes from the Doctor’s letter to Mr. Wynkoop, of October 5th, 1797, the following passages: “Thomas Story and Joseph Gough relate, that a malignant fever prevailed in Philadelphia in 1699, introduced from the West India islands. . . . Dr. Mitchill ascribes the yellow fever as it appeared in Virginia in 1741 and 47 to specific contagion, and mentions that it had been twice imported into Virginia by his Majesty’s ships of war. Dr. Leamy (Lining) in the Physical Essays in Edinburgh, informs us, that the yellow fever which has prevailed at different periods at Charleston, South Carolina, was always traced to some infected person recently from the West Indies. In 1741 it was introduced by a chest of wearing apparel which had belonged to a person who died of it from Barbadoes.” These quotations are made by Mr. Webster with a view to dispute the contagious nature of the disease. Here they are introduced only to show if possible the time that the disease first entered the United States; and the introduction of it into Philadelphia in 1699 (though we are not sure if even this was its first appearance), still corresponds extremely well with the date of its introduction into Martinique mentioned by Sauvages. Dr. Lining says it had been four times epidemic in Charleston before the time that he wrote; viz. in 1732, 1739, 1745, and 1748. Hence we may conclude, that this fever, on the northern part of the continent of America, has been nearly coeval with the settlement of the British colonies there; for we cannot suppose that we have accounts of the very first time that it made its appearance any where. Numbers of individuals would probably be affected with it, and their cases pass unnoticed, till the general malady attracted the public attention.
In the Spanish dominions it seems to have been otherwise. Dr. Moseley quotes Don Ulloa saying that “the vomito prieto, or black vomit, was unknown at Carthagena, and all along the coast, till the years 1729 and 1730. In 1729 Don Domingo Justiniani, commodore of the guarda costas, lost so considerable a part of his ships’ companies at Santa Martha, that the survivors were struck with astonishment and horror at the havock made among their comrades. In 1730, when the galleons under Don Manuel Lopez Pintado came to Carthagena, the seamen were seized with the same dreadful mortality, and so sudden were the attacks of the disease, that persons, walking about one day, were the next carried to their graves. Unhappily, after all the experiments of the surgeons of the galleons, and physicians of the country, no good method of treating the disease has been discovered; no specific for curing it.”
This fatal disease, however common in the southern and warm part of the continent of America, seems not to have exerted its power in the more northern and temperate climates till the year 1793. Since that time its ravages have been too well known to require an enumeration here. To describe the symptoms, inquire into the causes, and the means of prevention and cure, is a work of more importance, and to this we must now proceed.
SECTION. II.
Symptoms of the Yellow Fever, as described by various authors.—Comparison between them and those of the Plague, with an inquiry into the Causes.—History of the Distemper as it has appeared in various parts of the United States since the year 1793.—A discussion of the question Whether the Yellow Fever is Contagious or not.
OF all those who have attempted to give an account of this fatal disease, none appear to have exceeded Dr. Moseley, either in his accuracy in enumeration, or perspicuity in description, of the symptoms. According to him the yellow fever is a species of the kausos of Hippocrates, Aretœus and Galen; that is, the febris ardens or causus, aggravated by climate, incidental only to the gross, inflammatory and plethoric at any season of the year, totally different from the remitting bilious fever to which all habits of body are subject in hot climates, particularly after rains, and in the fall of the year. The causus, seldom seen in the temperate climates of Europe, never appears there with the violent symptoms which attend it in hot climates. “Whether in the latitudes (says he) so mild as those of Spain, Greece, Italy and the Archipelagan islands, the causus has ever been attended with black vomiting, as in the West-Indies, I cannot tell. Lommius mentions the vomiting of blood, and voiding black liquid stools and black urine. Critical and symptomatical yellowness of the skin in the causus are enumerated by Hippocrates among its symptoms, and Lommius mentions the danger of that appearance before the seventh day. The affinity of the symptoms, progress and termination of a causus in Europe to those of the yellow fever in the West-Indies, excepting the black vomiting, leaves no room to doubt that the difference of climate constitutes all the difference that is found between them.”
For these reasons Dr. Moseley adopts the name of endemial causus; and he takes notice that many difficulties have arisen to young practitioners, and to strangers in the West-Indies, from the various names improperly given to it from its ultimate and not from its primary symptoms. Some call it a burning bilious fever; Warren, a putrid bilious fever; but, though they have disputed about their terms, Dr. Moseley thinks that neither of them have proved whether bile be the cause or the effect of the disease. To call it the black vomit or the yellow fever, he thinks also improper, as a stranger would not know the disease until some of these symptoms appear; both of which are generally fatal, and neither of them constant.
The West-India causus he says is no more putrid than the small-pox, or any other acute disease; which may, after it has passed its inflammatory state, change to putrefaction, and end in death with an extraordinary dissolution of the fluids. The disease is in truth an inflammatory one in the highest degree possible; accompanied with such symptoms in a greater extent as attend all inflammatory fevers, and most strikingly the reverse of any disease that is putrid, or of one exacerbation. It obeys no season of the year, and attacks such people, and under such circumstances, as are seldom the objects of putrid diseases, viz. all who are of an inflammatory diathesis, and do not perspire freely.
This distemper attacks sailors in the West-Indies more than any other set of men, even of new comers. For this the Dr. assigns as a reason, that they eat, drink, and sleep, so much at sea, use no exercise, and are always of gross habit of body. To this he adds the heat and dampness of harbours, generally in the neighbourhood of marshes, and their exposure to land winds at night; the labour they endure on board vessels in port, and the carelessness and excesses frequently committed by these people after long voyages.
When a stranger newly arrived feels a sudden loss of strength, with a continual desire of changing his position without finding rest in any, we may expert a causus. If he has exposed himself to any of the causes just mentioned, the probable consequences would be, that on the morrow he would feel an heaviness, lassitude, oppression and loss of appetite.[147] Next day, or perhaps within twelve hours from the first indisposition, the violence of the disease commences with faintness, generally giddiness of the head, with a small degree of chillness and horror, but never any rigor. These symptoms are succeeded by a high fever, great heat, and strong beatings of the arteries, particularly those of the temples and carotids; flushings of the face, gasping for cool air; tongue white tinged with yellow, after the retchings have commenced; excessive thirst; redness, heaviness, and sensations of burning in the eyes; heaviness and darting pains in the head, small of the back, and often down the thighs; the pulse generally full and strong, but sometimes quick, low, and vacillating; the skin hot and dry, though sometimes it has a partial and momentary moisture. There is a sickness of stomach from the beginning; retchings succeed immediately after any liquid is swallowed, which bring up bilious matter. There is an anxiety with stricture, soreness, and intense heat about the præcordia; great restlessness, heavy respiration, sighing, urine deep coloured and in small quantity.