Footnotes:[103]Histoire des Maladies de Saint Domingue, p. 112.[104]Epidemics, book XI. sect. I.[105]Les Maladies de St. Domingue, vol. I. p. 193.[106]Account of the Yellow Fever of 1793.[107]In the account of the effects of morbid action and inflammation, in the Outlines of the Theory of Fever, the author neglected to mention the change of certain fluids from their natural to a dark colour. It appears in the secretions of the stomach and bowels, in the bile, in the urine, in carbuncles, and occasionally in the matter which is produced by blisters. All these changes occur in the yellow fever, and, in common with the other effects of fever that have been enumerated, are the result of peculiar actions in the vessels, derived fromonecause, viz. morbid excitement.[108]Essay on the Malignant Pestilential Fever introduced into the West-Indies from Beullam, p. 137.[109]Page224.[110]Epidemics, book ii. sect. 2.[111]Historia Febris Anomalæ Batavæ Annorum 1746, 1747, 1748, cap. i.[112]Epidemics, book IV.[113]Page117.[114]De Morb. Popular. lib. VII.[115]See Sydenham, vol. I. p. 212.[116]Account of the Yellow Fever of 1793.[117]Page141.[118]Account of the Yellow Fever in 1793.[119]Page129,130.[120]Page40,41. See also p.111,230,231. vol.I.[121]Page140.[122]Wallis's edition, p. 211. vol. i.[123]Vol. ii. p.212.[124]Vol. ii. p.108.[125]Medical Essays and Observations, p. 28.[126]Vol. i. p.55.[127]Medical Essays and Observations, p. 29.[128]Account of the Yellow Fever of 1793.
Footnotes:
[103]Histoire des Maladies de Saint Domingue, p. 112.
[103]Histoire des Maladies de Saint Domingue, p. 112.
[104]Epidemics, book XI. sect. I.
[104]Epidemics, book XI. sect. I.
[105]Les Maladies de St. Domingue, vol. I. p. 193.
[105]Les Maladies de St. Domingue, vol. I. p. 193.
[106]Account of the Yellow Fever of 1793.
[106]Account of the Yellow Fever of 1793.
[107]In the account of the effects of morbid action and inflammation, in the Outlines of the Theory of Fever, the author neglected to mention the change of certain fluids from their natural to a dark colour. It appears in the secretions of the stomach and bowels, in the bile, in the urine, in carbuncles, and occasionally in the matter which is produced by blisters. All these changes occur in the yellow fever, and, in common with the other effects of fever that have been enumerated, are the result of peculiar actions in the vessels, derived fromonecause, viz. morbid excitement.
[107]In the account of the effects of morbid action and inflammation, in the Outlines of the Theory of Fever, the author neglected to mention the change of certain fluids from their natural to a dark colour. It appears in the secretions of the stomach and bowels, in the bile, in the urine, in carbuncles, and occasionally in the matter which is produced by blisters. All these changes occur in the yellow fever, and, in common with the other effects of fever that have been enumerated, are the result of peculiar actions in the vessels, derived fromonecause, viz. morbid excitement.
[108]Essay on the Malignant Pestilential Fever introduced into the West-Indies from Beullam, p. 137.
[108]Essay on the Malignant Pestilential Fever introduced into the West-Indies from Beullam, p. 137.
[109]Page224.
[109]Page224.
[110]Epidemics, book ii. sect. 2.
[110]Epidemics, book ii. sect. 2.
[111]Historia Febris Anomalæ Batavæ Annorum 1746, 1747, 1748, cap. i.
[111]Historia Febris Anomalæ Batavæ Annorum 1746, 1747, 1748, cap. i.
[112]Epidemics, book IV.
[112]Epidemics, book IV.
[113]Page117.
[113]Page117.
[114]De Morb. Popular. lib. VII.
[114]De Morb. Popular. lib. VII.
[115]See Sydenham, vol. I. p. 212.
[115]See Sydenham, vol. I. p. 212.
[116]Account of the Yellow Fever of 1793.
[116]Account of the Yellow Fever of 1793.
[117]Page141.
[117]Page141.
[118]Account of the Yellow Fever in 1793.
[118]Account of the Yellow Fever in 1793.
[119]Page129,130.
[119]Page129,130.
[120]Page40,41. See also p.111,230,231. vol.I.
[120]Page40,41. See also p.111,230,231. vol.I.
[121]Page140.
[121]Page140.
[122]Wallis's edition, p. 211. vol. i.
[122]Wallis's edition, p. 211. vol. i.
[123]Vol. ii. p.212.
[123]Vol. ii. p.212.
[124]Vol. ii. p.108.
[124]Vol. ii. p.108.
[125]Medical Essays and Observations, p. 28.
[125]Medical Essays and Observations, p. 28.
[126]Vol. i. p.55.
[126]Vol. i. p.55.
[127]Medical Essays and Observations, p. 29.
[127]Medical Essays and Observations, p. 29.
[128]Account of the Yellow Fever of 1793.
[128]Account of the Yellow Fever of 1793.
In my account of the yellow fever, as it appeared in Philadelphia in the year 1794, I took notice of several cases of it which occurred in the spring of the year 1795. Before I proceed to deliver the history of this disease as it appeared in 1797, I shall mention the diseases and state of the weather which occurred during the remaining part of the year 1795, and the whole of the year 1796. This detail of facts, apparently uninteresting to the reader in the present state of our knowledge of epidemics, may possibly lead to principles at a future day.
The month in of April, 1795, was wet and cold. All the diseases of this month partook of the inflammatory character of the preceding winter and autumn, except the measles, which were unusually mild.
The weather in May was alternately wet, cool, and warm. A few cases of malignant fever occurred this month, but with moderate symptoms. In June the weather was cool and pleasant. The measles put on more inflammatory symptoms than in the preceding months. I had two cases of mania under my care this month, and one of rheumatism, which were attended with intermissions and exacerbations every other day.
The weather on the 19th, 20th, 21st, and 22d days of July was very warm, the mercury being at 90° in Fahrenheit's thermometer. The fevers of this month were all accompanied with black discharges from the bowels. Mr. Kittera, one of the representatives of Pennsylvania in the congress of the United States, in consequence of great fatigue on a warm day, was affected with the usual symptoms of the yellow fever. During his illness he constantly complained of more pain in the left, than in the right side of his head. His pulse was more tense in his left, than in his right arm. During his convalescence, it was more quick in the left arm, than it was in the right. He was cured by a salivation and the loss of above 100 ounces of blood. His head-ach was relieved by the application of a bladder half filled with ice to his forehead.
Most of the cases of bilious fever, which came under my notice, were attended with quotidian, tertian, or quartan intermissions. In a few of my patients there was a universal rash.
Dr. Woodhouse informed me, that he had seen several instances in which the yellow fever appeared in the same place in which some soldiers had laboured under the dysentery. These facts show the unity of fever, and the impracticability of a nosological arrangement of diseases.
The cholera infantum was severe and fatal, in many instances, during this month. It yielded to blood-letting in a child of Mr. Conyngham, which was but four months old. In a child of seven weeks old which came under my care, I observed the coldness, chills, hot fits, and remissions of the bilious fever to be as distinctly marked as ever I had seen them in adult patients. In a child of Mr. Darrach, aged 5 months, the discharges from the bowels were of a black colour. I mention these facts in support of an opinion I formerly published, that the cholera infantum is a bilious fever, and that it rises and falls in its violence with the bilious fever of grown persons.
About the latter end of this month and the beginning of August, there were heavy showers of rain, which carried away fences, bridges, barns, mills, and dwelling-houses in many places. Several cases of bilious yellow fever occurred in the month of August. In one of them it was accompanied with that morbid affection in the wind-pipe which has been called cynanche trachealis. It was remarkable that sweating became a more frequent symptom of the fevers of this month than it had been in July. Hippocrates ascribes this change in the character of bilious fevers to rainy weather. Perhaps it was induced by the rain which fell in the beginning of the month, in the fevers which have been named.
Among the persons affected with the yellow fever during this month, was William Bradford, Esq. the attorney-general of the United States. From a dread of the lancet he objected to being bled in the early stage of his disease, in consequence of which he died on the 23d of August, in the 39th year of his age, amidst the tears of numerous friends, and the lamentations of his whole country.
On the 30th and 31st of August, there was a fall of rain, which suddenly checked the fever of the season, insomuch that the succeeding autumnalmonths were uncommonly healthy. Several showers of rain had nearly the same effect in New-York, where this fever carried off, in a few weeks, above 700 persons. It prevailed, at the same time, and with great mortality, in the city of Norfolk, in Virginia.
In both those cities, as well as in Philadelphia, the disease was evidently derived from putrid exhalation.
In the same month, the dysentery prevailed in Newhaven, in Connecticut, and in the same part of the town in which the yellow fever had prevailed the year before. The latter disease was said to have been imported, but the prevalence of the dysentery, under the above circumstances, proved that both diseases were of domestic origin.
The fever, as it appeared in Philadelphia, yielded in most cases to depleting remedies. After purging and blood-letting, I gave bark, where the fever intermitted, with advantage. It was effectual only when given in large doses. In one instance, it induced a spitting of blood, which obliged me to lay it aside.
The winter of 1796 was uncommonly moderate. There fell a good deal of rain, but little snow. The navigation of the Delaware was stopped but two or three days during the whole season. Catarrhs were frequent, but very few violent or acute diseases occurred in my practice. The month of March and the first week in April were uncommonly dry. Several cases of malignant bilious fever came under my care during these months. A little girl, of five years old, whom I lost in this fever, became yellow in two hours after her death.
The measles prevailed in April, and were of a most inflammatory nature. The weather in May and June was uncommonly wet. The fruit was much injured, and a great deal of hay destroyed by it. On the 14th of June, General Stewart died, with all the usual symptoms of a fatal yellow fever. Several other cases of it, in this and in the succeeding month, proved mortal, but they excited no alarm in the city, as the physicians who attended them called them by other names.
The rain which fell about the middle of July checked this fever. August, September, and October were unusually healthy. A few cases of malignant sore throat appeared in November.They were, in all the patients that came under my notice, attended with bilious discharges from the stomach and bowels. So little rain fell during the autumnal months, that the wheat perished in many places. The weather in December was extremely cold. The lamps of the city were, in several instances, extinguished by it, on the night of the 23d of the month, at which time the mercury stood at 2° below 0 in the thermometer.
The yellow fever prevailed this year in Charleston, in South-Carolina, where it was produced by putrid exhalations from the cellars of houses which had been lately burnt. It was said by the physicians of that place not to be contagious. The same fever prevailed, at the same time, at Wilmington, in North-Carolina, and at Newburyport, in the state of Massachusetts. In the latter place, it was produced by the exhalation of putrid fish, which had been carelessly thrown upon a wharf.
END OF VOL. III.
Transcriber's Note:The original spelling and minor inconsistencies in the spelling and formatting have been maintained.Obvious misprints have been corrected.Partly repeated chapter headings have been deleted.This book contains links to other books in the Project Gutenberg collection. Although we verify the correctness of these links at the time of posting, these may not work, for various reasons, for various people, at various times.
Transcriber's Note:
The original spelling and minor inconsistencies in the spelling and formatting have been maintained.
Obvious misprints have been corrected.
Partly repeated chapter headings have been deleted.
This book contains links to other books in the Project Gutenberg collection. Although we verify the correctness of these links at the time of posting, these may not work, for various reasons, for various people, at various times.