“On the other hand, if, as the French physicians pretend, this is nothing else than the malignant putrid fever, often prevalent in Hispaniola, how happens it that those medicines and that mode of treatment which were so frequently successful in the colonies have no sort of success when administered to Americans, and seldom with Europeans? Why is this fever attended, in its very first stage, with vomitings of blood, bile, black spots, purples and other alarming symptoms, which they frequently have at Hispaniola? How comes it that the West India planters, who, while they resided in the colonies, had frequent attacks of putrid and often inflammatory fevers, enjoy the most blooming health ever since they have been on the American continent? And why are they not taken with those putrid and inflammatory fevers, at a time when those who have given them an asylum are the daily victims of it? Finally, if we must attribute the epidemic to no other cause than the immoderate heat of the summer, which is really greater here for two or three months than at Hispaniola, where a land and sea breeze tempers its violence, why does it not stop its ravages when the heat moderates? We have observed in the epidemics of New York and Philadelphia, that they were less destructive in the burning dog-days than in the months of September and October, when the mornings, evenings and nights begin to be cool, and even cold enough to allow people to go clothed as warmly as in winter.
“We have now a recent and striking example that it is not heat only which causes the epidemics; since there were only, in the month of September, three or four days of great heat. The rest were very cool. It may even be said that from the 22d it was cold, especially on the 28th and 29th, when a violent north wind obliged many people to have a fire. The number of deaths never were, however, so numerous as they have been since the 20th of September. The funeral list, which in July and August amounted to 40 per day, reached on the 20th of September to 78, the 22d, 68, the 23d, 71, the 24th, 63, the 25th, 80, the 26th, 77, the 27th, 96, the 28th, 106, the 29th, 76, and from the 29th at twelve o’clock, to the 1st of October, same hour, the number was 170; a number as prodigious as it is frightful: we could not therefore even flatter ourselves that the severest frosts of the end of October would dispel the epidemic, did not experience afford us that comforting hope.
“What then is the physical cause of this scourge, which all human prudence and science are unable to avert? The ministers of religion will not fail to ascribe it to celestial wrath, and to advise prayers, fast and charity to appease it. Those pious practices cannot assuredly do harm; but the philosophical observer, who does not conceive that Philadelphia and New York should have excited the Heavenly wrath more than those of other cities of the continent, will seek for more natural causes, and will examine whether they should not be attributed to some local and peculiar vice of those two unfortunate cities, and perhaps to the temperament, the diet, the mode of life, of their inhabitants. Respecting this, we do not find, in the localities of New York and Philadelphia sufficient reasons, nor in the constitutions or mode of life of their inhabitants sufficient variations, to mark them as the victims of the yellow fever, while the inhabitants [of other places] are free from it.
“I am however inclined to think that New York and Philadelphia, more than any other cities, contain causes of corruption or putridity, occasioned by their size and the extent of their commerce, which, added to the high mode of life of the Americans, may be the source of the calamity which now affects them.
“In effect, we observe that in these two cities the epidemic has constantly manifested itself in those parts which are not only the most commercial, but also where the common sinks of the city meet; where the houses, inhabited by the poorer class of people, being smaller, and more crowded together; where the stores contain most provisions liable to fermentation and putridity; where the shipping crowded in the wharfs render the water stagnant; where immense quantities of dirt and litter are brought from every quarter for the purpose of filling up new wharves and other places designed to be taken from the sea, to enlarge lands to build upon; finally, where the water used to drink does not reach the pumps of the lower part of the city until it has filtrated through the burying-grounds and privy-houses of the upper parts, most of which have no walls, and are never emptied.
“Let us add to all those causes of infection the dead dogs, cats, pigs, and rats, which are thrown into the common sinks and docks, the rotten fish, and the privies, which in several houses, especially at New York, are nothing but tubs, which are emptied weekly on the sea shore, and we shall have less reason to wonder at the putrid exhalations which issue on the eastern part of New York, and at Philadelphia on that part contiguous to the Delaware, and which are capable of infecting the whole atmosphere, and to impair the health of those who live in it. If the people who dwell in those parts are not scrupulously sober, if they frequently indulge in the use of spiritous liquors, if they feed on such food as is generally known to be unhealthy, is it to be wondered that, with such a mode of life, their blood should be more disposed to inflammation and to be dissolved and corrupted, in the midst of an air already corrupted and loaded with destructive miasmata?
“Now every man knows that those who live contiguous to the river at New York, and the Delaware at Philadelphia, mostly sailors, shipwrights, truckmen, labourers, tavernkeepers, &c. seldom trouble themselves about the quantity of their foods and drinks, but indulge copiously in the use of strong liquors, of which an astonishing consumption is made in those parts. They are not in other respects more careful as to cleanliness in their narrow and low houses. There, in a hole called a bedroom, and on a feather-bed half rotted, in a heap of rags half devoured by insects still more disgusting, two and sometimes three individuals, covered with sweat, often drunk, sleep, and still increase the filth by their shameful and dirty mode of life. Shall we find it strange that those infected haunts should shed forth in the morning a mephitic air, capable of suffocating the most robust and vigorous men? Shall we wonder that those who breathe this pestilential gaz are suddenly seized with a fever? in itself perhaps not very dangerous, if it were treated in a suitable manner. But what is their method of treating it? They do not even know the name of ptisan, still less the use of anodynes, nor that of salt of nitre, nor of camphor, so proper to prevent putridity. Punch, made with rum; water mixed with gin and molasses; a sort of soup made with Madeira wine; fish; raw oysters, &c. these are their first medicines. If their wives or friends go to consult the apothecary, he advises the castor-oil, or the famous calomel pills or powders, whose virtues the quacks extol for every disease. Finally, if the fever increases, the doctor is called, who administers a light puke of 12 or 15 grains of tartar emetic, a plenty of laudanum to procure sleep, and who, seeing the case desperate, withdraws, saying that he was called too late![156]
“Although the inhabitants of the other parts of the city who are in better circumstances follow a mode of life more regular, feed on more wholesome aliment, and are much more cleanly in their houses (except however feather-beds and lower bedrooms) it is nevertheless a fact that they are much inclined, the men especially, to eat salt meat, meat half cooked, green fruit, and still more to drink spiritous wines. Several of them allow themselves an immoderate use of the latter between dinner and tea-time, the strength of which, added to that of the high-spiced food, and liquors, must necessarily increase in their blood that fermentation already excited by the heat of the season. Now, shall we not concede that bodies thus predisposed ought to be more susceptible than others of the impression of the corrupted miasmata which are constantly exhaled from every thing that surrounds them; from the common sewers, the wharves or the docks; from the dirt and litter of the alleys and lanes; from the sulphureous bilge-water of ships; from the cellars and from the stores; in short, from those houses which contain sick, dying and dead persons?”
Here the author, after stating objections on both sides, seems at last to determine that the disease is produced by putrid effluvia. The dispute on this subject, however, hath continued so long, that we can by no means expect to settle it in this treatise. At first view one would think that nothing could be more easy than to determine whether the disease arose soon after the arrival of foreign vessels, or in places which had no connexion with maritime affairs. But when we come to particulars there is such a strange disagreement and contradiction concerning facts, that we are in every instance driven back into the wide field of theory and argumentation. One instance of this we have already had in the case of the Boullam fever said to be imported by the Hankey. Let us now try another. Dr. Currie of Philadelphia, in a letter to Mr. Wynkoop of date October 10th, 1797, says that the fever at New-York, of 1795, was proved “by unquestionable facts,” to have been introduced from Port au Prince by the brig Zephyr; and for a proof of this he refers to a letter of the health committee of New York to the governor, dated September 8th of that year. From this letter it appears that Dr. Treat visited this vessel on the 28th of July, where he found three men ill of what he called a bilious remitting fever, and the body of one who died that morning. Two days after, the Doctor was taken ill, and died in eight days, with unequivocal symptoms of yellow fever. On the 25th, four persons from on board the ship William, from Liverpool, which arrived several weeks before (the crew of which till this time had been healthy) were taken ill of fever, and died with similar symptoms in seven days. Nothing can be more direct than this evidence, yet it did not give satisfaction.
The fact was impugned by the late Dr. E. Smith, in a letter to Dr. Buel,[157] who produces such evidence as, in his opinion, “establishes it beyond a contradiction, that neither Dr. Treat nor any other person contracted a fever, such as prevailed in New York in 1795, from any sick or dead man, or any thing else connected with the vessel in question.”