“In cases of very laborious respiration, which was frequently in an extreme degree distressing, especially after the first 36 or 48 hours had elapsed, blisters, applied either to the chest or extremities, had a favourable effect; on the latter, they were most useful in the advanced stages of the disease, by exciting to action the debilitated vessels, and by restoring circulation and warmth to the parts. In the same intention, wine, snake-root, and the bark, were sometimes used with advantage.
“The diet was generally of the lightest and most cooling nature; barley-water, apple-water, and spruce-beer, were generally both grateful and salutary. The warm bath was often exhibited with apparent success, especially in the beginning of the disease, and when a copious sweat had been induced by it. The cold bath was also resorted to by some respectable practitioners, and perhaps, under some circumstances, with good effects; but I have no reason to think it was generally advantageous.
“Upon the whole, I believe that the most efficacious remedy, and the only one to be relied on, is mercury. It is certain that, as far as my observation has extended, under no other method of treatment did so many recover; and there were but few instances of a fatal termination, when it had been administered from the commencement of the fever.
“Various have been the causes assigned to this disease. That its origin was domestic, I have not a single doubt. No instance of the arrival of any vessel from the warmer latitudes, with this sickness on board, has been discovered; and it is believed that the local causes are sufficiently numerous to account for its existence. At most of the places, where its ravages have been made, very large quantities of putrid substances had been for some time accumulating. The offals from the fish market, as well as damaged fresh and salted fish to an immense amount, had been thrown into the dock. A very great number of raw hides had been imported, and stored in places contiguous to those in which business was constantly going on. The influence of a continued heat through the summer, to a degree scarcely before known in this country, had rendered these articles highly putrid; and from the same cause several articles of provision, such as barrelled beef, &c. which had been prepared for exportation, but, by reason of the restraints laid on our commerce, retained in store, had become tainted. The effects of these were in some instances incontestibly evinced; three lads, who had been employed in repacking beef, were at about the same time seized with the disease in its most fatal form; and a person, who had purchased some of the hides at a low price, immediately after their removal fell a sacrifice to his folly.
“Two or three thousand of the inhabitants removed into the country, and began to return about the middle of October, when the decline of the disease justified the measure.”[192]
SECTION III.
Methods of Prevention and Cure.
IN the yellow fever, as in the plague, where an attack is frequently made with such violence as to bring on death in twenty-four hours, or even a still shorter time, it is plain that much more dependence must be placed on prevention than the efforts of the most skilful physician after the disease has once begun; for, in such violent attacks, medicines, though ever so powerful, have not time to act. In countries therefore where this terrible disease exists, the first consideration necessary for every individual is, whether he is one of those likely to be attacked by it. Now, from the general testimony of those who have seen this fever, it appears that such as are newly arrived, the young, and in other respects the healthy and strong, the laborious, and the intemperate, are most liable to be attacked. Dr. Nassy of Philadelphia seems alone to afford an exception to the general testimony. Speaking of the cause of epidemics, after having ascribed them to some constitution of the atmosphere, he says, “If the air is not infected, diseases cannot be epidemic; and this is so, indeed, though it only attacks the natives. What can be the cause of that corruption of the air? For what reason are the natives, and those inured to the climate of Philadelphia, alone infected with the prevailing disease, while foreigners escape it?” Dr. Chisholm particularly points out those who, in 1793, were most liable to the Boullam fever. These were, “1. Sailors; more especially the robust and young; those least accustomed to the climate; and those most given to drink new rum. 2. Soldiers; more especially recruits from Europe; and the most intemperate. 3. White males in general lately arrived; more especially young men from Europe. 4. All other white males; more especially the lower classes; and of them the most intemperate; those debilitated by recent sickness. 5. White, females, more especially those connected with the shipping; and those lately from Europe. 6. People of colour, from Mustees to Cabres. 7. Negro men; more especially sailors and porters. 8. Negro women; more especially house wenches. 9. Children; more especially those of colour.” It is certain, however, that, when the distemper rages with great violence, natives as well as foreigners are liable to be attacked. We cannot suppose that all who perished at Philadelphia in 1793 and 1798 were foreigners. Though the latter therefore have the greatest occasion to fear, the natives must not think themselves absolutely secure; neither are foreigners to be terrified in such a manner as if they could not escape. With respect to the general modes of prevention, then, to which it is the business of every individual to attend, the following things are to be taken into consideration:
1. Every one who comes from a cold to a warm climate may be assured that on his arrival the temperature of his body is higher by three or four degrees than that of the native inhabitants.
2. In this situation he must consider himself as necessarily about to undergo a change of constitution; and such change he may likewise be assured will best be made by the gradual operations of nature; concerning which we know so little, that it does not seem adviseable to use any artificial method of promoting or accelerating it.