The disposition to faint, so common in the yellow fever, is supposed by Dr. Jackson to arise from a kind of torpor in the nervous system, rather than the usual causes of fainting. For this opinion he assigns as a reason, that “the patient was often able to stand upright for some time, and even to walk to a considerable distance; and, when at last overcome, was observed to fall down in a torpid, rather than a fainting, state.”
In dissections our author observed that the omentum and all its appendages were in a dry and parched state, and of an uncommon dark grey colour. But, along with this dark grey colour, and want of unctuosity and moisture, usually met with in the abdomen, the stomach and intestines had a dirty yellow appearance, were highly putrefied, and much distended with wind. The liver and spleen were generally enlarged in size; the former of a deeper yellow than any of the other abdominal viscera; while the texture of the spleen was often less firm than natural. The bile was usually black and thick, like tar or molasses; the blood-vessels of the liver bearing marks of uncommon distension. A quantity of black fluid, similar to that ejected by vomit, was found in the stomach, which fluid our author says positively derived its blackness from the bile, the flakes observed to float in it being parts of the villous coat of the stomach abraded. He denies that the black colour of the matter vomited is owing to blood, as many authors have supposed. He says that the passage of the bile might be easily traced from the gall-duct into the pylorus.
This being in the Doctor’s opinion the only true kind of yellow fever, we shall not follow him through the description of the other two species, but proceed to consider that remarkable and excessively fatal distemper which appeared in the year 1793, first in the West India islands, and then on the American continent. Dr. Chisholm, who has described the distemper very particularly, derives it from the coast of Africa, and gives the following account of its origin on the authority of a Mr. J. Paiba, “one of the adventurers in the Boullam scheme; and who, despairing of success, left the coast of Africa in a vessel called the Hankey. This vessel sailed from England in April 1792 with stores and adventurers for the intended colony at Boullam. The people were all in good health: that part of the coast of Africa on which they touched is remarkable for its healthiness; only it is destitute of water except what can be procured by digging temporary wells on the beach, and which is brackish, and consequently unwholesome. The ferocity of the negroes who inhabit that part of the continent prevented them from being accommodated on shore, so that they found themselves obliged to remain on board the Hankey for nine months. As the rainy season came on almost immediately after their arrival on the African coast, they attempted to shelter themselves by raising the sides of the vessel several feet, and covering it with a wooden roof.” Thus were upwards of two hundred persons, among whom were many women and children, confined in such a manner as must be supposed capable of producing fevers of a bad kind, if they could be produced by such causes. Accordingly a malignant fever did break out; the vessel was not ventilated, nor were the bed-clothes, &c. of the sick destroyed; from whence Dr. Chisholm concludes that the infection remained on board the vessel. The Doctor then proceeds to give the following account of the vessel after her departure from Boullam:[148] “Capt. Coxe, finding the water at Boullam unwholesome, proceeded with his ship to Bissao, where there is a Portuguese settlement, for a supply. The ship was navigated by about twelve seamen, most of whom had not experienced sickness, and had probably been procured from Sierra Leone: at any rate they were then taken on board for the first time. Of these, before the return of the Hankey to Boullam, nine died; and the remainder, with the captain, were reduced to a deplorable state. The time for which the Hankey was chartered being expired, Mr. Paiba, with his family, intended to return to England in her; but as no seamen could be procured they put to sea, having on board the captain, sick, and only the mate, Mr. Paiba and two seamen to navigate the ship. With much difficulty they arrived at St. Jago, where they fortunately found the Charon and Scorpion ships of war. Capt. Dodd of the former, humanely rendered them every service in his power, and on leaving them put two men of each ship on board the Hankey. With this aid they proceeded to the West Indies; a voyage to England being impracticable in their wretched state. On the third day after leaving St. Jago, the men they procured from the ships of war were seized with the fever, which had carried off three fourths of those on board the Hankey at Boullam; and, having no assistance, two of the four died: the remaining two were put on board here in the most wretched state possible. Capt. Dodd, on his arrival at Barbadoes from the coast of Africa, was ordered to convoy the homeward-bound fleet of merchantmen. In the execution of his orders he came to Grenada on the 27th of May, and, hearing of the mischief which the Hankey had been the cause of, mentioned that several of the Charon’s and Scorpion’s people were sent on board the Hankey at St. Jago, to repair her rigging, &c. that from this circumstance, and the communication which his barge’s crew had with that ship, the pestilence was brought on board both ships; and that of the Charon’s crew thirty died, and of the Scorpion’s, about fifteen. The Hankey arrived at the port of St. George’s (in Grenada) on the 19th of February, in the most distressed situation, and for a few days lay in the bay, but was afterwards brought into the careenage. From this period are we to date the commencement of a disease before, I believe, unknown in this country, and certainly unequalled in its destructive nature.”
This account of the introduction of the fever (which however is by Dr. Chisholm accounted very different from the yellow fever above described) is so clear and distinct, that, at first reading, it commands our belief. It hath not, however, met with universal approbation; and even the facts, for which both parties appeal to Mr. Paiba and capt. Dodd, vary from one another in a surprising manner. Dr. Trotter, in his Medicina Nautica, p. 328, gives the following account: “Dr. Chisholm tells us, that the ships of war on the African station, having sent men to assist the Hankey, after numbers had perished from the fever, received the infection by means of this communication, and that in the Charon thirty died, and fifteen in the Scorpion. Capt. Dodd, who at that time had his broad pendant in the Charon, now commands the Atlas of 98 guns in the fleet; Mr. Smithers, the surgeon, is at present in the Formidable, a second rate, also in the fleet; from them I have copied the following narrative of their transactions with the Hankey:
“When the squadron under commodore Dodd came to St. Jago in 1793, the Hankey lay there in great distress for want of hands; having buried above one hundred persons, men, women and children, from the time she had been at Bulam. The fever was now overcome: Mr. Smithers saw two men that had lately recovered. He left a quantity of bark. The Charon and Scorpion sent two men each to assist in navigating her to the West Indies. The Hankey at this port was cleaned, washed with vinegar, and fumigated. No fever appeared in either of the men of war, in consequence of this communication; they arrived at Grenada in perfect health, but did not go into the same part of the island to which the Hankey went. The Charon, at this harbour received some seamen from the merchant ships then taking in cargoes for England; she had afterwards fourteen cases of yellow fever, of which one died; but it is remarkable that the Scorpion did not bury a single man during the whole voyage.[149] It is probable from these facts, that the Hankey did not import the infection that produced the Grenada fever; for, after the disease was worn out, she had a passage to make to the West indies of many hundred leagues. It is also doubtful how the effects left in the Hankey could produce the fever, for the bedding was thrown away, and what clothing remained had been aired, and probably had scarcely been in contact with the body after being sick.”
The discordance between this and the foregoing account is abundantly evident. Dr. Chisholm’s account of the bedding, &c. is also very different. “Our lieutenant governor, Ninian Home, esq. some time after the disease became epidemic, informed me, that, in consequence of the information he had received of the clothes, &c. of the victims of the fever at Boullam being still on board the Hankey, he ordered Capt. Coxe to be brought before him and some gentlemen of the council. He then acknowledged, that all the effects of those who had died were then on board his ship, and said that he would not destroy them, unless he was indemnified for the loss he might sustain, should the heirs of the deceased call on him for those effects. Every argument was used to induce him to destroy the articles, but the only one which influences a man of this description, indemnification; and he of course carried the seminium of the disease to England.” It was this consideration which induced the governor to write to the secretary of state, and in consequence of his representation the vessel was obliged to perform quarantine in England, a circumstance which Dr. Trotter mentions without approbation.
Thus far the matter of fact seems to be very much obscured; and the more we investigate, the more we are involved in darkness. In the Medical Repository, vol. i, p. 484, we find the following severe censure passed upon Dr. Chisholm by the late Dr. Smith of New York: “It belongs to another part of this paper to assign the probable motives of Dr. Chisholm for maintaining that the fever was imported into Grenada: certain it is that he avowed a different opinion to Mr. Paiba, to whom he freely declared, that he could by no means trace the disease to the Hankey; and that he believed it to be of local origin, owing to the unhealthy condition of the careenage, and the particular prevailing winds: and, to confirm this notion, he informed Mr. Paiba that a similar disease, from the same cause, though in a less degree, had existed in St. George’s some years before.”
This was plainly giving Dr. Chisholm the lie; which, whatever might have been the consequence between the two parties, absolutely supersedes, to any impartial and unconcerned person, the evidence of both, at least as far as regards the origin of this disease. It is not, however, to be supposed that Dr. Chisholm would pass such a censure unnoticed. He did accordingly reply in a letter to Dr. Smith, who had sent him a copy of the Repository, with a letter inviting him to defend what he had said. Dr. Smith died before this letter reached him, but the principal part has appeared in the Medical Repository, vol. ii, p. 285. In this Dr. Chisholm retracts what he had said concerning the mortality on board the Charon and Scorpion ships of war. “I have lately received (says he) from a gentleman of the navy here, a log-book of the Charon, kept by one of her officers during the voyage in question. In this I find, that no sickness took place in either of these ships in consequence of this interview. A log-book is unquestionable evidence, and I therefore admit it.” As to the more serious part of the charge, viz. that Dr. Chisholm had wilfully misrepresented matters, the Doctor replies, that the narrative published by him was in general such as he had from Mr. Paiba; not indeed in manuscript, as Dr. Smith stated his to have been, but in conversation; and that this conversation took place expressly with a view to elucidate the cause of the fever, which he (Dr. Chisholm) could not account for by any reasoning from local causes, but heard it very generally ascribed to infection from the Hankey. Mr. Paiba was introduced to Dr. Chisholm at the request of the latter by the Hon. Samuel Mitchill now (the letter is dated Sept. 6th 1768 probably 1798) the senior member of the council of Grenada. “Mr. Mitchill (says the Doctor) brought Mr. Paiba to my house, and was present during the greatest part of the time the conversation continued. I found Mr. Paiba very willing to give me every information in his power relative to the state of the Bulama or Boulam colony, and of the ship Hankey; but I found him strongly disinclined to fall in with the universally received opinion, that that ship introduced the disease. The particulars I have given, are those Mr. Paiba related to me in this conversation; and, in order to be correct, I immediately, after Mr. Paiba left me, committed them to paper. Mr. Paiba promised to favour me with a written account; and in order to direct that gentleman’s attention to the points I considered as of most importance, I drew up a set of queries, and Mr. Mitchill charged himself with the delivery of it. A copy of these I have now in my possession, and a slight attention will exhibit my view in framing them, and show the doubts respecting the nature of the epidemic which suggested them. Although I repeatedly, through Mr. Mitchill and Mr. Palmer, the gentlemen with whom Mr. Paiba resided in the country, renewed my request to have this promise fulfilled, Mr. Paiba left the Island without gratifying it. If no other strong proof existed of something peculiar in the fever which at that time prevailed, the circumstance of my formally applying to Mr. Paiba for information relative to the state of the Hankey, and of taking the trouble to obtain an interview with him, presents an evidence as conclusive as can well be required by reasonable men. But the belief of the infection of the Hankey was universal, nor was it by any means confined to those whose interest might have been affected by the prosperity of an infant colony on the coast of Africa.”
Another charge against Dr. Chisholm is, that he falsifies the date of the Hankey’s arrival at Grenada; and which in Dr. Smith’s paper is brought forward in the following words: “In p. 91 the Doctor remarks, that, ‘in the short space of time from the beginning of March to the end of May, 200 of about 500 sailors, who manned the ships in the regular trade, died of this fever.’ By this it appears that the fever in question broke out as early as the beginning of March. The disingenuousness of this author is particularly evident from this quotation, if the period of the commencement of the disease be correctly assigned: and that it is so is probable from the difficulty of concealing the fact; as there must have been thousands of witnesses to the progress of the fever. When therefore it was thought proper to fix the odium of introducing the disease upon the Hankey (a project of which Dr. Chisholm seems originally to have had no idea) it became necessary for him to fix an earlier date to her arrival. Now, that the Hankey did not arrive till towards the latter end of March, is verified by the concurring testimony of Mr. and Mrs. Paiba, and of Mr. Bell, of this city (New York) who happened to be in Grenada about that time, and was personally acquainted with Mr. and Mrs. Paiba in that island.”
In answer to this Dr. Chisholm repeats his declaration that the Hankey arrived at Grenada on the 18th of February, and not on the 19th of March, as Dr. Smith (supposed on the authority of Mr. Paiba) had stated. In proof of this he produces an incontestible evidence, viz. an extract from the St. George’s Gazette in Grenada, of date 19th of February, which begins thus: “By the ship Hankey of London, arrived here yesterday from the island of Boulam on the coast of Africa, we are informed,” &c. The remainder of the extract contains an account of the excessive mortality on board the ships; which, as it may perhaps be exaggerated, it is needless to transcribe.