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*:. 
 
 
 
      YELLOW  FEVER

             AND ITS

TREATMENT HOMEOPATHICALLY;

  TOGETHER WITH SOME GENERAL REFLECTIONS
             UPON ITS

 ALLOPATHIC MEDICATION
              AND
      NON-LOCAL  ORIGIN.
              BY
AN ALLOPATHIST AND A HOMEOP ATHIST.
       GALVESTON, TEXAS:
PRINTED AT THE "DAILY CIVILIAN AND GAZETTE " BOOK AND JOB OFFICE.
             1868. 

NATIOp. L!BR£f?Y GF f7D!CIN|
1 
 
 
PREFACE.
   A few  words of explanation are necessary to render this
 little pamphlet clear and intelligible in its aims and purpo-
 ses, and to explain its extraordinary aggregation of matters,
 which may be considered as almost totally incongruous.  In
 the first place, its  prominent object is to place  the Homeo-
 pathic treatment of yellow fever before the public in such a
 point of view as would render its statements and pretentions
 worthy  of every  confidence.   For this purpose, a key is
 afforded whereby the modus operandi of their  infinitesimal
 doses of medicine are made patent, and their power of con-
 trolling diseased action rendered evident.  This accomplish-
 ed, the public have no more right to question its own facts in
 its favor than they have to question those of  the old system.
 But still farther, to strengthen its claims upon the considera-
 tion of the public, a status has been conferred  upon it by a
 review of  it bv Dr. Forbes ; and, although that review was
 intended to crush  it out as a system of therapeutical  medi-
 cine, yet, as will be seen by our quotation from that perform-
 ance, he has defined its position before  the  world with so
 much justice and accuracy as will fix its claims to the very char-
 acter which he labored to deprive it of, and will forever give
 it stability and a formal recognition  among mankind, as a
 successful means of curing disease.  But the Southern  mind
 has been so little directed to its claims as a system of medi-
 cation, that incredulity as to it? powers, generally prevails  ;
 hence the effort to place it before our communities in its true
 character—that is, as a great system of curative medicine—
 standing, in this respect, side by side with the old.
   The two short chapters—one on the non-local origin of yel-
low fever within our borders, the other on the general princi-
 ple of treatment of the disease—were intended (the former
by implication and inference) to show  the efficiency of quar-
antine in excluding it from our shores ; and the latter, to  re-
strain  a  meddlesome criminality on  the part  of doctors,
nurses, and officious  intermeddlers, in giving  medicine to
cure it.                                        W. R. 
 
PART  I.
HOMEOPATHY  AND  ALLOPATHY.
WRITTEN FOE THE " SUNDAY TELEGRAPH."
   Two systems of treating disease now occupy the attention
of the world, viz : Homeopathy and Allopathy.   The latter,
confident in its past history, its great truths being  deduced
from the earliest records  of medicine, and studiously syste-
rnatised into a  grand whole, imposing both for the symmetry
and  solidity of  its  structure, looks with disdain upon  its
parvenu rival, and its efforts to  overthrow it.   Hence ridi-
cule and contempt are  the  only weapons it has deigned to
employ against it ; and truly it would  merit no other, if
Homeopathy  sought to establish itself  upon the downfall
of the great principles  of Allopathy.   But such is not the
fact.   The  two  systems  are so entirely distinct, that the
truths of the one do not inpugn those of the other—Homeo-
pathy may assert its great formula, " semilia semilibus cur-
anter,"  without the slightest conflict with a single principle
of Allopathy;  and vice versa.   The  reason of this want of
conflict  between  the principles  of the two systems, and the
difference in the relative doses of medicines, will be found to
have its origin in the distinct media, which are employed to
reach the pathological  point intended  to be acted upon by
their respective remedies.  The  Allopathist, in order to reach
this point, gives his large  doses, which by assimilation arrives
at it  through the blood, and asserts  its presence by a con-
            2 
6
trolling effect upon the parts to which  it is addressed.  But
the Homeopathist reaches the seat of the disease through  a
different medium. By the provings of his remedies, he know?
precisely  the nerves or  the  system  of nerves to which they
will address  themselves,  and  these are precisely the ones in-
volved in the disease for which he prescribes.   By adopting
the most attenuated form in the administration  of his reme-
dies, spiritualizing tbem  as it were into a mere aura, they
reach directly the nerves, which become the  media of their
transmission, thus avoiding the transmuting process of assi-
milation,  by  which they  would be destroyed.   We have an
illustration of this mode of operation in prussicacid, nicotine,
chloroform,  ether,  &c,  which  evidently  reach the  great
central  organ of the nervous system, without  traversing the
route of the blood vessels.
  But the most vulnerable  part of  Homeopathy, and that
which exposes its pretensions to ridicule, and calls in ques-
tion  its validity as a system,  is its infinitesimal   doses of
medicine.  The  above  suggestion as to the medium through
which  they  operate, ought to remove or greatly lessen the
force of this objection; a fact, however, can not be controverted
by a priori  reasoning, and that these doses do cure diseases?
is not furnished  by ignorant charlatans  but by  associations
of the most scientific men of both Europe  and  America,
whose testimony  stands  upon as unimpeachable grounds, as
any  presented by Allopathy, in favor of  its own results in
the treatment of disease.    Let  those  who cavil at Homeo-
pathy, upon this account, be certain  that these cavils have
some  other  foundation  than their  own ignorance and pre-
judice, before they parade them  before the  world ; and until
they can  show  that their doubts are based upon facts and
deductions, they are unworthy of a moment's  consideration.
  But as illustrations have  more force on some minds than
facts  themselves, let me ask one of the  objectors if he can
state precisely the amount of miasm requisite  to produce an
ordinary chill and fever ; whether a smaller or larger dose
of this miasm, or altogether a  different one, produces con-
tinued or congestive fever ; and  finally, if he has weighed in
a balance the virus of small pox, measles, scarlatina, the zy- 
i
motic  poison  of yellow fever, etc?  Although  these are the
most  deadly morbific agents known, yet are they so inappre-
ciable  in  quantity,  as to defy us in  our attempts to place
them in any relation that would enable us to define them ai
matter?  Yet  we cavil at Homjopatliy, notwithstanding  she
has not exceeded the limits of  appreciable materiality in  the
attenuations of her remedies.  Until we are better informed
upon these and correlative subjects, let us put aside our arro-
gance  and  cease  to  arraign  Homeopath*,*  for setting forth
her infinitesimal  doses of medicine, and claiming for them
remedial powers.
  But  again it may be objected, even admitting, that the re-
medy  goes  directly to the nerves  implicated in the  disease
for which it was prescribed, how does iu cure it, seeing that
it produces effects coincident  with the  morbid phenomena
previously existing in the parts ?  If its remedial powers are
thus coincident with  the morbific force, should it  not  dy-
namically rather increase than remove this force. If a priori
reasoning was conclusive upon  this point and the inference
deduced from  the  hypothesis that the  remedy exerted its
powers in  virtue of its dynamical force in  controlling the
morbid action, then  nothing could be clearer than the result
arrived at by  this process ol reasoning, viz, that the remedy
would increase and not remove the disease.   Homeopathy
must,  therefore, abandon either its theory of dynamic force
for its remedies, or all pretensions to cure diseases.  But the
latter  it cannot abandon, because  it stands upon the basis of
fact and observation ; it must then adopt some other theory,
to  solve the problem of the modus operandi of its remedies.
   A fact which conflicts  with our preconceptions, without a
theory to explain it is of doubtful authenticity—the mind must
generalize it,  and refer it to some known phenomena, witn
which it can be assimilated, ere  it yields it implicit credence.
Let us*see if this  fact  can be thus generalized and  made to
assume a  credible  place  among the admitted phenomena of
science.
   It is well known to physiologists that all organized beings
contain within themselves a system of vital chemistry, under
whose guidance their living economy is regulated, governed 
8
 and preserved.  It is in short this vital chemistry which was
 the  architect  of their  diversified  structures,  and preserves
 them through  the period of their existence from the destruc-
 tive powers of the elements which  sorround them.  It is the
 steam engine which propels existence for a time against the
 adverse current of  the general laws of nature—the heart is
 the force-pump which sends the current to supply the mate-
 rial out of which the power is generated for keeping the ma-
 chine in motion. Every deleterious agent or  miasm which
 acts upon us,  produces  a  responsive  effect  upon  this
 controlling power of  our systems.  Every- thought, every
 pulsation of our hearts, every breath we draw, derive their
 dynamitism  from it, and tend to disarrange its equilibrium.
 Disease, then,  may be defined to be nothing more than a dis-
 arrangement of the vital chemistry of the parts affected, and
 its removal—the restoration of the harmony of its elements,
 by countervailing the  morbid impress  which  has disturbed
 them.  By the Allopathist this is effected by sending his re-
 medies in dynamic  force  through the  sanguiferous system,
 either to  the  part affected or neighboring organ, to arouse
 secretion,  by which the peceant matter is thrown off.   These
 views of the Allopathic modus  operandi of  remedies here
 and elsewhere presented, are too general to be strictly true,
perhaps, in all instances, but they conform sufficiently to  the
rule of action  to serve  the purpose of illustrating the differ-
 ence between  the two systems of cure under consideration.
  Before we proceed to state our theory of the  modus  ope-
 randi of Homeopathic remedies, it is necessary to recapitulate
 to some extent, what  has been before said of  the media
 through which their effects are produced, in order that the
 theory may stand in immediate connecion  with that view of
 the subject.
  Nearly  all diseases are  produced by miasm, including un-
 der this head every species of gaseous poison, whether eman-
ating from the animal,  vegetable or mineral kingdom,  but
devoid  of any  recognized  chemical  or physical qualities.
These we inhale in the  air we breathe, in infinitesimal quan-
tities ; therefore these noxious agents do not enter the system
 through the  digestive and sanguiferous apparatuses,  and 
9
 even if swallowed  with  our food,  it is  inconceivable that
 they can be  amenable to the laws  of assimilation, as gross
 materialities are, since these have, and those have not, pro-
 perties which fit them for this process.  Then they must find
 their way  through  its nervous filaments, to the great central
 organ,  the brain, and by it are referred  to the sensitive ex-
 tremities of  those  nerves which are  most appropriate  for
 giving  expression to the injury done—in other words they
 become the seat of disease.   Homeopathy, by attenuating its
 remedies until  they become almost infinitesimal in  their
 quantities, fits them for taking the  same route,  and  by its
 provings of its  remedies, it sends  them direct  to the seat of
 disease where they  encounter the  poison,  to which they pre-
 sent an incompatibility in the chemico-vital relations ot the
 parts and neutralize it in situ.
   Then let us state in one sentence  the differences between
 the two systems of cure : Allopathy sends its  remedies by
 the blood  vessel system to the seat of disease, and stimulates
 the  parts  by their  force  to secretion, while  Homeopathy
 reaches the same point by the same channel which  was taken
 by the poison which produced  the disease, and offers  its re-
 medies as  chemico-vital  incompabilities to the cause  of the
 mischief.   What conflict, then, is there between them ? May
 they not both be equally true,  and equally available in the
 treatment  of disease ?
   Homeopathy  works  no miracles—does not  even deal in
 the  marvelous   or  ridiculous,  when she   undertakes  to
 cure, and does cure  disease, with her incalculably attenuated
 remedies.   On  the contrary, her means  are in conformity
 with the deductions of the  strictest rules of phylosophysing
 —she encounters an infinitesimal cause  of disease with an
 infinitesimal antidote.    Her achievements  are  performed
 without a dire stuggle for supremacy, between  the dynamic
 forces of disease and remedy, as happens  in the coarse mate-
 riality of Allopathic practice, in which the best that can be
 accomplished is  a mere  substitution of one malady for  an-
other.  The cures of Homeopathy, then, have this advantage'
over the old  practice,  that they are, so far as the patient is 
10
concerned, accomplished, cito, titto, et jucunde,  leaving  no
residum  of remedial infliction to be  struggled  against in a
tedious convalesence.
  The foregoing article was written  to show that the true
ground of difference between the old and new systems of prac-
tice, was simply in the application of  their Therapeutics,
and to indicate the cause or reason of that difference.  With
this key  to the solution of the modu3 operandi of the infi-
nitesimal doses of the  Homeopath, the reader will have no
difficulty in admitting their potency in controlling morbid ac-
tion.  'But we make a great mistake  when we suppose that
the Homeoptith is ruled down to the  infinitesimal mode of
administering his remedies ; on the contrary, as long as they
are given  upon the sirnilia similibus  principle,  he is within
the legitimate sphere of his profession,   although  he should
adopt  Allopathic  doses of medicine   in his  prescriptions.
The enquiry  may here be made :   " Why does  he not, then,
adopt them ?" For the simple reason that if he did, the small
number of remedies that possess  the  sirnilia similibus  prin-
ciple found  in that materia medica,  when given in  bulk,
would leave him almost without the means of combating dis-
ease.   Remedies only  acquire the property of creating sys-
temic disturbance, by which they produce simulative diseases,
by  attenuations, and  by these means they are carried di-
rectly to  the sensitive nervous centres upon which their effects
are produced.  Hence  the  Homeopath, from  necessity as
well as choice, adopts his infinitesimal doses.
  Another great mistake we make  in the South is, that a
Homeopath  is necessarily  ignorant  of every   qualification
that a physician should possess.  In this  we  are  greatly
mistaken.  In their numerous schools, both in  Europe and
America, the different  chairs are  filled by men of great eru-
dition  who teach to their classes anatomy, physiology  path-
ology,  therapeutics, chemistry, &c, as thoroughly asthey are
taught in any Allopathic school.   Hence their writers, par-
ticularly  in Germany, from which country their founder was
driven, have been  enabled to triumph so far over their eru-
dite rivals as to  have  the new system  restored to its nation- 
11
 al birth-right, which they could not have done had they not
 been able  to  meet them in  every department  of medical
 science in which they chose to make their attacks.
   But to show the true character of the founder,  and his fol-
 lowers,  and the actual  position  of the science at that time,
 we will here quote an  article, contained in the  British and
 Foreign Medical Review, in the Jan. number of said Review,
 1846.   The article  was written by  the Editor, Dr. John
 Forbes,  and was occasioned  by  a  publication made by Dr.
 Henderson, Professor  of Pathology, in the  University  of
 Edinburgh,  detailing  a number of cases  treated by  him
 upon the New System.  Preliminary to the review of Dr. H.'s
 book,  a high tribute  of respect is paid to the founder of
 Homeopathy, whom  he pronounces  to  have been a man of
 great learning," industry, untiring energy and perseverance,"
 who  founded a  system of  medicine  as ingenious as many
 that preceded, and destined  probably to be the remote, if not
 the immediate cause of more important fundamental changes
 in the practice  of the healing art,  than any that have been
 promulgated since the days of Galen himself.  In  the history
 of medicine, the name of Hahnemann,  will appear  in the same
 list with  those of the greatest systematists and theorist, un-
 surpassed for  the ingenuity and originality of his views—
 superior to  most  in having substantiated and carried out his
 doctrines into actual and extensive  practice.   By  most medi-
 cal men  it  was  taken for granted  that the  system was  one,
 not only visionary in itself, but was the result ol a mere fan-
 ciful  hypothesis, disconnected with facts of any kind, and
 supported by no process of ratiocination or logical inference,
 whilst the author and his apostles and sucessors were looked
 upon either as  visionaries or quacks,  or  both.  It  is but an
 act of simple justice to  admit that many  of his followers
have been, and  are sincere, honest, and learned men.
 " On these grounds then it appears to us reasonable that the
 claims of Homeopathy, regarded as  a system of medical doc-
 trine, ought to  be admitted so  far as to be entitled to investi-
 gation at least: and in undertaking such an investigation, we
have no more right to reject the evidence supplied by its pro-
fessors than we have of rejecting any other evidence in favor 
12
 of any other medical doctrine, theoretical or practical." Pages
 4 ond 5.  Again, page 21. " No doctrine, however ingenious,
 not based upon  positive  demonstrable facts, will any more
 b* regarded but as a piece of poetical speculation, which in-
 deed  may amuse the  fancy, but can never influence the con-
 duct  of scientific men.   But Homeopathy  comes before  us
 in a much more imposing aspect, and claims our attention oi>
 grounds which  can not be gainsaid.  It presents itself as a
 new art of medicine ;  as a mode of practice utterly at vari-
 ance  with that  long  established  in the world ; and claims
 the notice of mankind on the irresistible grounds of its supe-
 rior power of curing disease  and preserving human life. And
 it comes before us not in  the garb of a  suppliant, unknown
 and helpless, but as a conqueror, powerful, famous and trium-
 phant.  The disciples of Hahnemann are spread  over the
 whole civilized world.  There is not a town of any consider-
 able size in Germany, France, Italy, England,  or America,
 that does  not boast of possessing one or  more Homeopathic
 physicians, not a few of whom are men of  high respectability
 and learning,  many of them in large practice, and patronised
 especially by people of high rank.   Numerous hospitals and
 dispensaries for  the treatment of the poor, on the New Sys-
 tem, have been  established, many  of which publish reports,
 blazoning its success not merely in  warm phrazes, but also in
harder words, and still  more  hard figures  of statisticals
tables."
  In  commenting  upon those furnished  by Dr. Fleishman
Superintendent of the Charity Hospital of Vienna, he re-
marks, page  26.  " Not  merely  do  we see thus cured all the
slighter diseases,  whether acute or chronic, which most men
of experience know to be readily  susceptible of cure under
every  variety of treatment,  and under no treatment  at all,
but even the severer  and more dangerous diseases, which
most physicians,  of whatever school, have been accustomed to
 consider, as not only needing the interposition of art to assist
 nature in bringing them to  a favorable, but speedy termin-
ation,  but demanding the employment of prompt and  strong
measures to prevent a fatal issue in a considerable proportion
 of cases.   And such is the nature of the promises that there 
                            13

can hardly be any mistake as to the justness of the inference.
Dr. Fleishman is a regular, well educated physician, and as
capable of forming a true diagnosis as any other practitioner,
and he is considered by  those who know him, as a man of
honor  and respectability.   We can not, therefore, refuse to
admit  the accuracy of his statements  as to matters of fact.
The amount  of deaths in the  fever and  eruptive diseases is
certainly below the ordinary proportion."  On next page, in
continuation of his remarks on Dr. F.'s report, he say-s :  "But
the results presented to  us in the severer internal inflam-
mations are certainly  not  such as most physicians would have
expected to  be obtained under the exclusive administration
of a  thousandth, a millioneth,  or billioneth of  a  grain of
phosphorus, every two, three or four  hours.  It would be
very unreasonable to  believe  that out of 3G0 cases  of pneu-
monia, 224 cases  of pleurisy, and 105 cases of peritonitis (in
all 629 cases) spread over a period of eight years, all the cases
except the fatal ones (27  in number) were slight, and such as
would  have  seemed to us hardly requiring treatment of any
kind.  In fact, according  to all experience, such could not be
the case.   A few of these, pneumonia  for instance,  we have
reason to know were  not  of this character.  A few  of these
cases are reported by Dr. F. himself, and we have ourselves
had the statement corroborated by  the private testimony of
a physician, not a Homeopath, who attended Dr.  F.'s wards
for  three months.  This gentleman watched  the course of
several cases of  pneumonia, and  traced  their  progress by
physical  signs through  the different  stages of congestion,
hepatization  and  resolution, up to  a perfect cure, within a
period  of time, which would have  appeared short under the
treatment of Allopathy."
  What further testimony would any one require, not blinded
by prejudices, to convince him of the power of Homeopathic
doses to  cure diseases?    But what-says Dr. F. to these ad-
missions.  "For  reasons already stated, no conclusion favor-
able to  Homeopathy can be thence adduced."  A volatile
Frenchman would certainly have shrugged his shoulders, and
elevated  his eyebrows up  to the very top  of his forehead, at
this remarkable announcement,  and ejaculated,  "  Perquoi, 
                           14

Doctor ?'*  He answers, because the Homeopathic practice
being new, its pretensions to cure diseases by doses such as
above specified, must undergo the experimentum crusis be-
fore they can be received as admitted facts.
  I have  no  doubt any  Homeopath would readily join you
in  your  incredulity, as  to  the cures  effected by the doses
you have specified, any one of  which may have been admin-
istered indifferently, and selected from  your list  without any
regard to  the  immeasurable difference in their sizes.   You
have assumed a recklessness of statement in regard to doses,
that would mislead  your reader and induce him to believe
that the Homeopath was perfectly indifferent to his attenu-
ations, provided they were high enough ;  or  that a million-
eth, a trillioneth, or  a  thousandth  part of a grain,  was re-
garded by him as mere equivalents in producing results.
  It is not surprising that these cures, iu order to be believed
as resulting phenomena, from the administrations  above cited,
must be  subjected to the tests he proposes.   Homeopathy
must submit  to undergo the humiliation of  standing in the
pillory,  side by  side with Nihilopatliy, until  Dr.  F. can de-
cide upon their respective merits in the cure of disease ; but
we  fear that the Dr., by no process of calculation devised yet
by man, can approximate the period when such a trial could
be  brought to  a close, since the patients of  the former are
likely  to  have administered to them  the millioneth or bil-
lioneth  part  of  a grain of any of these  medicines, whilst
those of the  latter have even  just nothing at  all given  to
them.   Now let any one—be he of  the Old, New, or any
other school—state the difference between the patienis,  as to
treatment, and thence deduce the end of the experiment if be
can—both being negatively  treated.
  But the Dr. was  greatly wanting in courtesy to this new
system of medicine, which I have christened  Nihilopatliy  or
he.would have proposed, in all fairness, to subject  Allopathy
on  one side,  and the New system on the other of innoxious
A'ihikpathy,  to  the  experimentum  crusis, by which means he
could  have determined  which of these was the most trust-
worthy savior of mankind.  This  would have been not only
an  act  of simple justice to the two contestant pathies, but 
15
also to Nihilopatliy, which according to his argument deduced
almost ab origins mundi, had had  no opportunity to evince
its  powers of curing disease, owing to the intermeddlesome
interference  of  medication  in all  stages of society.   But if
this experimentum crusis had  resulted in favor of  Homeo-
pathy, no conclusion thence  deduced  would  have  availed
any thing  in establishing its claims,  to be considered  as a
true  system of  medication, seeing that it is  inconceivable
that the infinitesimal doses relied on to produce these results
could have had  any such an effect. Ergo, the zymotic poison
of  yellow fever, and other reputed  contagions, being  infi-
nitesimal in their attributes, it]is inconceivable that any  such
results  as  have been referred to them, could have been  pro-
duced by them.   But as his favorite  auxiliary, in such emer-
gencies, the vis medicatrix, can not be invoked,  to account for
these diseased phenomena, there still  remained  to him thews
aegrostatrics* upon which he could have relied to assist him to
a solution of them, and thus have saved himself from the
humiliating admission  that infinitesimals of any sort can be
operative.
  His admissions nevertheless contradict his averments as
to  his want of confidence  in  the operative power of   their
doses, in contra distinction to. his  doses, because  no  cue
claims that such  as he sets down  would be operative—since
he concedes that Allopathy  would  have been perfectly satis-
fied with these results, if they had  occurred in  that practice.
As  curative systems, then, they stand upon the same  ground,
and must be regarded as equally available, or equally nuga-
tory, so far as the treatment of disease  is concerned.  Indeed,
be claims no superiority, in  this respect, for the old over the
hew system, being satisfied if  the former can maintain an
equality  with the latter  in its achievements.   That we have
not  misstated the  purport  of his admissions,  we quote in
point, page 28.   After  reciting a number of  cases  treated
Horneopathically by  Dr. Fleishman, he says :   " As  we ad-
vance to the still more  dangerous diseases, we find  the loss
proportionally greater.   The only  cases in the  list, which do
  *  As there exists a vis medicatrix, I see no reason why its counter-
part ought not to have a place, at least in  our nomenclature.  The above
word is offered to supply  this deficiency. 
16
not seem, on first sight, to come within the above category,
are the cases of endocarditis and pericarditis (31) which are
all reported cured. These are, no doubt, severe diseases, and
this may seem an uncommon amount  of success ;  yet when it
is considered that the number  of eases is not great, that the
diagnosis of  endocarditis, and even pericarditis, is less easy
and certain than that of many other  diseases, and that  it is
not so  much  in their primary condition as in their ultimate
effects,  that  these diseases are  dangerous, we believe  that
even the degree of  success here recorded  can  not  be ad-
mitted, in fairness, as any deviation from the ordinary events
in Allopathic medification.
  What is this but  a studied argument  to prove  that the
success of  Homeopathy, in the  treatment of a class of di-
seases  known to be  dangerous, may  be accounted for under
certain supposed contingencies, whereby Allopathy could se-
cure to itself the benefit of a  peradventure, by which it
might  be enabled to claim a possible fsuccess  equal  to  that
here detailed.   But  is it rational to suppose that all these
cases were  treated in their primary  condition, in which we
are led to believe that they are easily cured ?  Besides,  is it
probable that Dr. F.  was deficient in medical records  and
hospital reports, that he could not have turned to his author-
ities- and produced an equal number of cures by Allopathy,
if such a  list  had  existed, instead of  resorting to  a xlisin-
genious  hypothesis  in  order to  depreciate  the success of
Homeopathy ? or that the credit of her cures might be held
at least in  abeyance by ingenious  interpositions  of supposi-
tions, until Allopathy might make its  appearance  side by side
with her?  His whole object seems  to be to deprciate the
cures of the New System, so as if possible to make and  keep
honors easy between it and the old.
   But his  attack upon Homeopathy has resulted  much more
disasterously to the old  than to the  New System.  For the
verification  of this  statement, I appeal to any one who
has read his  book ;  and venture  to  predict that the result
of  his reading it, has  been to  give him a much  more ex-
alted  idea of the New System, and corresponding depre-
ciated one of the old.  If he were to be indicted for a  libel. 
17
on account of  this attack upon Homeopathy, I opine that it
would  puzzle  a Philadelphia  lawyer  to  find the  flagrant
point in it  upon which a prosecution would lie.  It must be
admitted nevertheless, that he expended a  certain amount of
innoxious, but " facile ridicule," upon a certain effete part of
Hahnemann's  system, as delivered to the world in a moment
of excited enthusiasm, when he had made the great discovery
of the dynamitization of his remedies by attenuation, and be-
lieved that the process could be carried almost ad infinitum ;
but whether the learned Editor intended any thing malicious
or not, is not rendered very clear by any future development
of his purposes. The next averment he made, which might be
construed as intended  to bei:prejudical to the New System,
was that he could not yield his belief in the operative powers
of these doses in the cure of disease.   But this want of belief
on his part was so entirely  a  matter personal to himself,
that no bad effect to Homeopathy could  result  from it  ex-
cept, by operating  upon minds  as  much  overshadowed by
prejudice as his own.  But the learned Editor had informed
us  previously, that the same amount of credibility would be
yielded to the statements made in its favor by its advocates,.
as  there  would  be  to  the statements made  in favor of any
other system  ; yet in the face of  this just  and reasonable de-
claration, he  denies that Homeopathic doses arc operative,
although  the  fact is  attested by thousands, yea  clouds  of
witnesses,  whose respectability,  truthfulness, and ability to
make correct  observations and note results, he will  not ven-
ture to question.  But why does  he thus deny their powers?'
I suppose it is because his conclusions are deduced from the
high attenuations of Hahnemann, from  which he  seems afraid
to separate himself,  lest  be  should surrender the  only battery
from which he can throw a shot  to annoy his adversary.  If
he had  the  ingeniousness to disentangle himself from these
cobwebs  by which  he permits himself to be enthralled, for
the sake of the supposed advantage ground they afford, per-
haps he might change his point of observation,  and cease to
struggle against difficulties of his own creation.
   But he not only denies their power  to  cure diseases,  but
also that of producing  the effects upon  the  healthy  human 
18
subject, as announced in the provings of their remedies.  In
order to show  the  unreasonableness of  this inference, we
must remind the reader  that  these  provings  of  their  al-
most illimitable materia medica, are and have been, sim-
ultaneously  conducted,  and repeated over and over again,
in every country embraced  within the limits of Christendom,
with such  a  uniformity of result as to enable practitioners
in every clime  in which the New System is represented, to
select the same  specifics  for the same symtoms.   Could such
a uniformity of result be produced by any system of frauds
and collusions, even the  most perfect and extensive that was
ever devised by the combined ingenuity of men, in favor of
this or any other delusion  ever  practised  upon the world ?
But  as  this denial here given  to  the operative powers of
Homeopathic doses of substances administered in health, and
the  reasons assigned for that  denial, are the most important
of  the series of objections made to the New System as a
true one for the cure of disease,  it  must therefore  receive
something more than a mere passing notice.
  This denial purports  to be based upon  the inertness of
some of the  most important  substances  here introduced as
active agents, of which ounces, nay  pounds, may be gestated
in the stomach without any other effect than the mere incon-
venience of  bulk.   The  Homeopath, without a  moment's
hesitation, will  yield  his  assent to  the  truth  of this state-
ment ;  but  will  subjoin   this   simple  counter statement,
that he never  claimed  for them,  any virtues or potences
until they were  confered upon them by attenuations as to their
inertness in bulk ; that is entirely an extraneous matter which
has nothing to  do with  the question of  fact long since es-
tablished by the above process.  But every body seems to
halt before  this appalling solecism,  and demands  to know :
Why are substances, naturally inert in bulk, active in a state
of high attenuation?  Causa latet  vis est notifima is true in
this as in many other instances.  If the reader  will take the
trouble to remember that it has been heretofore  explained as
a nervous  phenomenon, he need not be startled  by its ap-
parent incongruities  in  its effects in its two states, or its
non-effect in the one and activity in the other.  But when a 
19
Fact is established by numerous and indubitable proofs, all
doubts arising* from  our inability to account for  it should
have their end in rational acquiescence.  But is this fact thus
established ?  If any  fact in history, science,  or any depart-
ment of human knowledge, was ever so established, then on
equal grounds has been established, that of attenuations con-
ferring active powers upon substances which had relatively
to the human system no  such powers anterior to  its  being
subjected to that process, and in  developing  a  new order of
properties in those which, when,  administered in  bulk, were
known to produce definite effects upon the human organism.
This great and important fact is  placed beyond all question
or cavil,  by its being made  the basis of a grand  system of
practical medicine, and the concurrent testimony of thousands
of observers, learned  professors many of them, converts from
the  old  school, men  of  talent and abilities, who are every
where testing it by repeating experiments either to confirm
what  others had  stated, or   satisfy their own minds, as to
these  reputed results ; yet these furnish but a tythe of the
proofs going to establish it, that is derived from the thousands
of physicians who practice  the  New System as an healing-
art,  daily and hourly, among  ail classes of  patients,  in all
ranks  of  life,  throughout  the  civilized  world.  What  a
delusion here  startles the world by  the  magnitude and
grandeur of its developments—a delusion  starting seventy
years ago,  from  a given point, spreading thence  over half
the  habitable globe,  overturning  old systems, trampling
under  foot dogmas thousands of years old, and now proclaim-
ing  itself the champion  of the age in the healing  art,  and
no one to oppose its  triumphant  career, except the learned
Editor of the aforesaid Journal.   His courage is  certainly
commendable, but  we can no more admire his prudence than
we can that of a certain knight who fell  into a serious dif-
ficulty with a wind-mill.  But is it to be credited  that Dr.
F., by expressing  a sneering  skepticism as to  the  value  of
these  provings of their  materia medica,  expects to over-
throw,  the peleon-upon-ossa  testimony  that has been pre-
sented before  him, without the aid of Jupiter's thunder ?   If
he docs, then the only curative measure that is  applicable to 
20
his case, is to give him over to the solitude of his own medi-
tations, as from these alone we can derive-that solace  which
wounded  vanity  ever craves, after being defeated  of its
object.
   The last proposal of  the experimentum crusis to  be ap-
plied  to  the provings of  the remedies of  the New System,
certainly  betrays  a mind in the  last  stage  of  cynicism,
brought on, perhaps, by an agony of fruitless effort to over-
throw that which it found it could not overcome. Could any
one, unless he were nearly demented  by  blind rage, have
asked  or proposed, as an act precedent to  bis admissione of
these  provings, that his  right to demand a parallel number
of healthy  persons should be set down  to record all their
sensations for several days after taking no medicine, must be
admitted.  %his  the Homeopatliist  can not  give us.   No
man  of sane mind could  ever  have seriously coupled his
assent to a given proposition upon  such  silly terms  as are
here set  forth ; therefore, unless we are to understand his
last experimentum crusis to be nothing more nor less  than a
contemptuous sneer at the New System and its followers, it
is as meaningless as it is unworthy of the source from  which
it eminated.
  Yet, to Dr. Forbes, Homeopathy is more indebted than to
any other writer on his side, for the respectable antagonism
to the old system,  which  it now presents to the world.  In
examining  its claims  to be considered as a great but novel
system of the healing art, in the true spirit of a lofty crit-
icism, he placed her side by side with the  old ;  and in this
position her pretensions were canvassed.  This high position
will ever hereafter screen her from low  cavilings  of   igno-
rance, interested scurrility, and blind prejudice ; and whoever
approaches her now, with the view of criticism, must do so
with the  becoming dignity of a scholar, duly impressed with
the great importance of his subject.  The reign  of taunts,
sneers^and " facile ridicule," so  far as "applying them to
Homeopathy is concerned, is now over,  and he who should
hereafter  avail  himself of these ignoble weapons for such
a purpose, will find that he can harm himself with them, but
Can do nothing more. 
21
 Regarding Dr. F.'s as the text book on his side of the ques-
tion, we have employed much more time and space upon it than
perhaps, we should have done, had we had a regard simply to
its isolate merits alone, however great these may have  been.
  Having now, we think, fairly  established the operative
power of Homeopathic doses of medicine, in controlling mor
bid action, and having offered  a plausible theory of their mo-
dus operandi,  which, when applied to that difficulty,  removes
and explains it, with an ease and facility which immediately
obtains the  acquiescence, of the reflective  reader  as to  its
truthfulness, we now pass to other subjects, of which  we pro-
pose to  treat  in  our subsequent remarks, which will have
reference principally to yellow fever, the laws which govern
its  propagation, and some  general  considerations  upon its
therapeutical amenibilities.
3 
PREFACE  TO PART  II.
  Having written a succinct account of the epidemic, as ob-
served by me in both Galveston and Houston, Texas, during
the  summer and  fall of 1867, my labors here might have
ceased ; but finding so  little written  in medical books that
could be relied on  in practice, especially  to meet  not only
every stage of the  disease,  but  the  ever  shifting  phases of
this protean monster, and knowing the deep horror, and even
terror, with which it is regarded by the unacclimated, there-
fore I came to the conclusion that my great experience, and
the  unparalleled  success which  attended  the  Homeopathic
treatment in the  various yellow  fever  epidemics occurring
along our  sea coast within the last  nineteen years,  would
warrant  me in tendering these  few suggestions in its man-
agement to my  professional brethren, thus  supplying,' in
an bumble way, a  desideratum in  founding  a system of thera-
peutics applicable to the disease, as well as a vade-mecum to
the  inexperienced.   Feeling that  the first  step  towards
treating  any disease  with  success,  is  to systematize the
remedies applicable  to  it,  and  thus form for it as it were a
code of practice, 1 have, in accordance with these  views, here
contributed to this end my mite, hoping that it may receive a
fair  consideration from the profession, and in giving to the
world  a  practice which I feel sure will be erelong realized,
by  which  this terrible scourge  of  the South will have no
more terrors than ordinary chills and  fever.
H.  C.  PARKER. 
PART  II.
 SOME ACCOUNT OF THE YELLOW FEVER
                   AS IT APPEARED IN

Galveston  anil  Houston,  Texas,  in   1867,
                   TOGETHER WITH ITS
         SYMPTOMS, TREATMENT, &c.
   This Epidemic made its first appearance in the former
city early in July.   As usual, much contention arose among
the faculty  as  to the true character of the disease, nor was
it  until about  the  middle of that month, that  it was pro-
nounced yellow fever, in an epidemic form.  Great numbers
of unacclimated persons .had remained in  the city until this
announcement was made, when they took the alarm and fled
in every direction, carrying  the seeds of the  disease in their
person and  scattering them broadcast  through  the villages
and towns in which  they took refuge, and where a large pro-
portion of them fell  ill of the disease.
   The writer, having practiced in the epidemic  of 1S48, and
treated 183 cases with  a loss of less than 6 per cent.—the
type being of a  mild character—and also in that of 1853. one
of the most malignant forms of the disease, which had,  up to
that time, ever visited our cities—having  under his charge
during its stay among us as many as 474 cases, with a loss of
less than 10 per cent.—felt that the triumphs  of Homeopathy,
from the success, together with its subsequent employment in
the milder forms of the fever in 1854'5 and '58, would justify
his trusting  to its powers  again in the  terrible ordeal
through which the above cities were about to pass. Accord-
ingly, after the  fever was declared epidemic, although from 
3
 impaired  health he had retired fow several years from prac-
 tice yet, he immediately repaired to Galveston, where he
 arrived about the first of August, and remained there until
 the disease had measurably  run its course.   By this time it
 had fully developed itself in  an epidemic form in Houston, to
 which city he now came  with  the view of encountering the
 ravager in one of his strongholds.   Here he remained until
 about  the  first of November, at which time  the epidemic
 had measurably subsided.
  The following were the symptoms of the epidemic under
 consideration, as they manifested themselves  in most of the
 cases seen by the writer, in both Galveston and Houston :
 The patients generally complained for several days  of  full-
 ness in the head, loss of appetite, constipation, and depression
 of spirits, together with a tendency to  acidity of the stomach.
 Pain in the head, back and extremities, next made their ap-
 pearance,  and continued to  increase in most instances, with
 rigors and chilly sensations,  with which  they  were  soon
followed—these  last  being  in  a short time superseded by
fever, which gradually reached its climax in from six to ten
hours, at which time the pain iu the above parts became very
great,  accompanied with strong  determination of blood to
the  head, and often with delerium, the sclerotic coats of the
 eye presenting an injected appearance, and the  countenance
 becoming much suffused  and flushed.
  The fever presented  great heat of surface,  accompanied
 with thirst, restlessness  and anxiety ; the bowels were con-
stipated,  urine  scanty, high colored, and in many instances
about the third or the fourth day of the attack,  entirely sup-
pressed ; the tongue was much thickened, and covered with a
 slimy coating—its  edges  and  apex  presenting' a  shining,
 smooth, red  appearance.  In many cases there  was  a great
 deal of nausea  and vomiting, with  much  distress  in  the
 epigastric region, especially  if the stomach was loaded at the
 time of the attack,  The  pain  in the head  was mostly  con-
 fined to the supraorbital and temporal regions, and in many
 cases attended by photophobia.  As  heretofore stated, the
 fever reached its achme  in from six to ten hours, soon 'after
 which  a free  perspiration would  break out, partial at first,
 but in favorable cases it soon became  general. 
4
  In the more  malignant forms of the  disease, the perspira-
tion soon disappeared, and  this subsidence was followed by
an increase  of restlessness and thirst—at this stage delerium
generally made its appearance.
  If the perspiration was continuous for twelve  or fourteen
hours, there was an amelioration in all the symptoms—the
fever gradually subsiding until the third or fourth day, when
it completely disappeared, giving place to the stage of col-
lapse,  with the cessation of all pain.  In the more  violent
cases,  the  fever did not subside until the fifth or sixth day,
the surface remaining  dry, and  the  patient restless, and the
disappearance of these symptoms  was followed by the  fatal
collapse—-the  black  vomit and death following  close in its
rear.  In the stage of collapse, in addition to the prostration
of the vital energies, there was a total relaxation of the sur-
face, over which a yellow hue diffused itself—the  features be-
came sharp, the eyes sunken, with a dark areola under them.
The termination of  the  collapse, whether favorable or un-
favorable, depended  in a great measure upon  the violence of
the preceding paroxism of  fever,  its  duration,  and  the
character of treatment received by the patient while passing
through it.
  Under favorable circumstances,  reaction was  fully estab-
lished  in a few hours, followed by free  evacuations from the
bowels  of  dark  and biliious matter, either spontaneously
taking place, or procured by the syringe ;  but in speaking of
the stage of collapse,  several  changes  occur ; but death  is
owing rather to their conjoint influence than  to either singly.
1st.  Exhaustation of vital power is always  present,  but not
to an extent sufficient of itself to arrest the organic functions.
2nd.  Deteriorations or changes of the blood obviously  takes
place, as is shown by  the state of  this fluid  both during life
and after death, but the nature of  this change  is not fully
sacertained ; whatever may be its  nature, it is  merely con-
sequent upon the altered state of organic nervous  influence.
3d. It is is  very probable that exhaustation of this influence,
and the resulting  changes in  the blood,  so  affect the irrita-
bility and tonicity of  the fibrous  and contractile structures
as to impair these vital manifestations, and thereby to favor or 
5
even to induce the alterations observed toward a fatal close,
particularly those affecting the capillary system  and mucous
tissues ;  for the vital tone of the extreme vessels, and of the
digestive mucous surface being thus impaired, and  the blood
being more fluid and dissolved, as well as otherwise altered,
hemorrhage readily occurs,  with  discoloration  of the  skin
and of membranous parts, the blotches, &c, observed during
the latter stages, proceeding from these pathological states.
That the head should appear to suffer especially, during the
period of excitement,  and  that the stomach  and  digestive
mucous surface should evince predominant disorder, atan ad-
van ced stage, may  be ascribed  to  the irruptions of acid or
vitiated secretions,  particularly  the billiary,  to  the  state of
the organic nervous power, and to the changes induced in the
blood.    Dr. Copland says of the changes that take place in
the advanced period of the disease, the most remarkable are
those affecting the blood and the digestive organs.  As the
stage of  excitement  merges into  that of exhaustion, the
blood changes  from a florid to a dark color—loses its property
of separating  into  crasamentum  and  serum, and of firmly
coagulating.  In unfavorable cases there is only  a  partial re-
action,  when a low typhoid  type of consecutive fever ensues,
characterized  by dryness along the center of the tongue, the
edges and apex of which became extremely red, lips parched,
great thirst, and in many cases distressing nausea and  vom-
iting supervened.  The surface now assumed a yellowish hue,
intermingled with  a dark, dingy, dirty appearance, and hav-
ing a husky dry feel, the eyes were suffused, the intellect be-
gan to  wander, and finally  delirium  fully set in—a general
sinking of the vital forces strongly marker! this stage. These
symptoms were aggravated in the  evening and the fore part
of the night, but were sensibly  ameliorated, in the morning.
During this stage, a  total  suppression of the secretions ex-
isted, especially of urine.    Hemorrhagic tendency was pre-
sent throughout the collapse, and the patient rapidly sunk.
Occasionally,  before the supervention of this  period "the ha*
morrhagic tendency showed itself in passive discharges of
blood from the nose, gums, bowels and lungs.   The two last
are of an unfavorable augury after the stage  of collapse had 
6
been reached whilst the two former often seemed to be criti-
cal and to have exerted a favorable influence upon the course
of the fever.  The consecutive  fever, or  more properly the
fever of the vital reaction, generally lasted from one to four
or even five days, these last  cases  generally  terminating
fatally.  Several peculiarities  marked  the course  of  this
Epidemic, and prominently among these was  a rash, which
was  much  more  generally developed among the patients in
Galveston  than in  Houston—in the former of which it al-
most equaled scarlatina.   This rash made its appearance on
the third or fourth day, or about the  decline of the fever, at
first partial, but  soon spreading all over  the body.  Upon
its first appearance,  the fever was frequently much increased,
as well as heat of surface, but upon its full development the
fever rapidly subsided.   In all  t\\p cases  in  which  it came
out full and complete, and was not repelled by an imprudent
admission of cold air to  the person of the patient, the re-
covery  was considered  certain  ;  but  in cases in  which this
happened, and the rash was repelled, immediately a irain of
untoward symptoms followed, such as  restlessness,  nausea,
and  sometimes  watery dejections, with great prostration.
The vestiges of  the  eruption now assumed a dark, purple
color, and  death soon followed.  Another peculiarity  was
the great tendency to form congestions in the large vital or-
gans.    Whilst  the brain was  the organ  most  frequently
attacked,  yet the stomach, bowels, and liver often suffered,
particularly if   superpurgation  had  been  induced  by  the
too free exhibition of cathartics.  The catamenia, as the fever
declines, often made  its appearance in females of proper age.
This  was considered a  favorable  symptom, but in  females
enciente, symptoms of abortion took place,  followed by a ra-
pid sinking, restlessness and death. Persons laboring under
pulmonary diseases  were generally disposed  to  congestion
of these organs, and  where it occurred,  it  immediately  ren-
dered  such cases extremely critical, and  often incurable.
They  were  almost  sure  to  sink when the febrile paroxysm
terminated, in the stage of collapse. 
7
         TREATMENT OF YELLOW FEVER,
AS IT PREVAILED IN THE CITIES  OF GALVESTON AND HOUSTON-
                     TEXAS, IN  1867.

  If called to a patient, within a few  hours of his attack, and
found any nausea, or disturbance of the stomach present, I im-
mediately prescribed an emetic of mustard and common salt, a
large sized teaspoonfull of each,  to half a pint of tepid water,
being for this purpose administered ;  the patient was then al-
lowed to remain quiet  for ten or fifteen  minutes,  but  if at
the  end of this  time  free  ernesis  did  not  take  place, the
mustard  was administered without  the  salt, less  it should
run off by the bowels, by which mischief might be done.  If
the  action of the emetic was not sufficiently free, warm water
was given until the stomach was entirely emptied.   I then
bad  his bed adjusted, and he  was covered with what bed-
clothes would have made  him comfortable in  health.   For
this purpose blankets  were preferred, and two generally suf-
ficed, one to be used during the warm part  of the day, and
the other on the approach of night, the object being to keep
up as uniform  a temperature of  the body as might be found
necessary to avoid a check of perspiration.  As regards the
amount of covering, the comfort of the patient was consulted
—to prevent on the one hand restlessness, from the oppres-
sion of a superabundance,  and ou the other to avoid a de-
pression of temperature, below the sweating point.  But the
cold air was carefully excluded,  and  the surface not allowed
to be exposed to  its  immediate  contact—the patient  being
kept  for this  purpose as quiet as  possible.  If  there was
much determination of blood to the head, recourse was im-
mediately had to aconite and belladonna in alternation, every
fi if teen or  twenty  minutes, until the  patient was discovered
to  be under  their influence, when the alternations were
changed to thirty minutes.  If the perspiration now became
profuse, the alternations  were  again extended to one, or
even two  hours : the   object of the remedial administration
being attained, when a uniform,  but  gentle perspiration was
kept up. As regards the quantities of the remedies, they must
b-°- varied according to the age, temperament, and sex, of the 
8
patient : for an adult male of  the bilious temperament,  ten
drops, each of the first decimal attenuation,  were added
to four ounces of water, and at the first administration, two
teaspoonfulls were given in alternation ; but after the patient
was fairly  impressed, the  quantity was  diminished to one
teaspoonfull, or the period of  alternation was extended, as
heretofore  indicated : these two remedies should  be  con-
tinued, until the  determination of blood to the  head is con-
trolled.  If darting, or shooting pains annoyed the patient, a
few doses of cimicefuga, at the first decimal attenuation, were
found  highly beneficial  in  allaying them, and  in quieting
the patient, an object of primary importance at this  stage of
the disease.  The room  of  the patient should  be kept  well
ventilated, by allowing a free current of air to pass  through
 it ; but  he must  be seduously guarded  against its passing
immediately over him ; and especially must a north  wind  be
thus guarded against, as  their unfavorable influence have
been often remarked.  Southern rooms, on this account, were
found  much preferable  for  patients, especially when alter-
nations of temperature begin to show themselves, upon  the
approach of the fall  season of the year.  Nevertheless, in
order to prevent  his  breathing the same  air over  again, a
plenty that is  fresh, is indispensable  to the patient, and as
the exhalations from  the lungs and  body readily contami-
ate it,  rendering it unfit to supply  a  proper quantum of
oxygen to the blood—a deficiency of which is well known  to
be the cause of most of the untoward  symptoms that present
themselves in the course, and at the close of the fever.  The
importance  of this injunction  can not  be too forcibly im-
pressed upon the mind  of the inexperienced  practitioner.
Should the surface become dry, and the patient  restless,
sponging  with warm  water, containing  in  it saleratus  or
some  other  alkali, may  be practiced with  great  benefit;
and if the heat of surfaee  be  very  great, even cold water
may be used in the same way,  as a substitute for the warm,
but under the same restrictions as to exposure of the person
of the patient to contact with the air. In this condition of the
patient, cold,  and even ice  water, may be freely applied  to
the face,  and even ice  itself to  the forehead and temples.
              b4 
9
Great dryness of the mouth, and fauces,  cause  intolerable
thirst;  but  if water be allowed in sufficient  quantities to
satisfy  the  thirst, it is  apt, after it  becomes warm in the
stomach, to create nausea and vomiting, accompanied  with
restlessness, all of which are to be deprecated.  I therefore
generally administered a teaspoonfull  or two of  cold water
every fifteen or twenty minutes, or allowed small lumps of
ice to be dissolved in the mouth, whilst cloths rung out of ice
water, were at the same time  applied to the head;  and the
face was freely bathed in it..
   As soon as the determination of blood to the head was
controlled by these means—which could be easily determined
to have been effected by the eyes becoming clearer, and the
subsidence of the throbbing pain in the temporal region—the
bryonia, was substituted, for belladonna and administered in
the same doses,  and at  the same  attenuation,  alternated
every hour,  with  the aconite, for the relief of the  intolerable
thirst, and  dryness  of the  mouth, and fiery redness of the
tongue.   By acting favorably  on the mucous  membranes,
it not only carries its benign influence  to that  organ, modi-
fying its central coating, but also relieves the fullness, tight-
ness, and dead aching pain,  just above the arch  of  the eye-
brows.  For  the purposes above  specified,  it is indispensable ;
and the two should be given in alternation, until the pulse
is reduced  to  seventy or eighty per minute.   In the mean-
time, should nausea  set in,  a few doses of ipecac, five drops
to two ounces of  water, in the dose of  a teaspoonfull, should
be administered—this  is given in the second decimal attenu-
ation, and if it fails, use tartar emetic, at the same strength
and dose.   If,  in despite of these remedies, the patient still
complains of great burning in  the stomach, and  intolerable
thirst, and restlessness, give arsenicum,  at about the sixth
attenuation, same as above  remedies.   Patients sometimes
complain of pains in  the stomach and bowels, as if produced
by accumulation of gas—that symptom occasionally becoming
distressing.  In this case interpose a few doses of nux  vomica,
at the first  attenuation,  five drops to  two ounces of water,
dose a teaspoonfull; if still unrelieved, in  a reasonable length
of time, give diascoria  same as  nux vomica.  But the inter- 
10
positions of these remedies  must not interfere  with  the gen-
eral  treatment of aconite and bryonia—their influence upon
the patient being  absolutely  necessary   to  conduct  him
through the crisis, viz. when the fever merges into collapse.
  In this  disease, the great tendency  to congestion, before
adverted  to, requires, for its  prevention,  all  the auxiliary
means  that can be pressed  into our service.  In every case,
congestion of  the spinal  column gives rise to intense  suf-
fering in the back, and to great restlessness.   Upon exam-
ination of a subject after death, it will be found that the blood
has settled along the spine,  throughout its whole length, but
more  particularly about  the  inferior ;nd  superior plexus
of nerves.  To relieve the great  suffering incidental to  this
congestion, I have used  with  great success a liniment, com-
posed of capsicum and common salt,  each ^ss, and strong
vinegar, a pint, simmered  over a  slow  fire for twenty or
thirty minutes.   This is ordered to be kept by the bedside
of the  patient,  and as  often as  he  complains of pain of the
back, he  was thoroughly rubbed with it  along the whole
length of the spine.   If the feet became cold, and the circu-
lation  irregular, the  inside of  the lower extremities were..
well rubbed with it,  a woolen cloth being prefercd for tlja
purpose, and the friction was kept up for five or ten  minutes,
and repeated  as often as  the  symptoms would indicate the
necessity  for its repetition.   After collapse has taken place,
this  remedy will be found to  exert a very beneficial influ-
ence in equalizing  the circulation, and  relieving the great
restlessness of the patient, when  all  other means have failed
to accomplish  these  desirable   objects.   Its  efficiency  for
these purposes was enhanced by its  being used  warm.  Inde-
pendent of its stimulating qualities—the saline ingredients of
the blood, in  this disease,  being very much impaired—the
absorption of the salt and vinegar seemed to act  upon  it
favorably, judging from the effects  which it produced upon
the whole train of  symptoms.   The pain  in the back  will
continue, more or  less violent, until the  bowels are  freely
moved, and discharges of a consistent character are produced.
Although  the fever may be  nearly off, yet if  the accumu-
lations  of  this dark peccant matter, is allowed to remain in 
11
 the alimentary canal, the pulse will indicate the distress, and
 oppression, under which the patient labors, no  doubt caused!
 by the absorption of a portion of this black, offensive matter,
 by which the blood  is still further  contaminated, and the
 secretions every where vitiated. To obviate all this, as soon
 as the fever begins perceptibly to decline, I have recourse to
 large enemas of cold water, say of the temperature of  about
 seventy-two or seventy-four, and in quantities of from one to
 two quarts, and repeat them two or three times a day—if the
 water alone  did not  answer the  purpose, salt was added.
 In a large majority of cases these means will be found quite
 sufficient,  especially if wet compresses be at the same time
 applied  over the stomach and bowels.  This is best accom-
 plished  by foldiug a  towel, several times dipping it  in cold
 water, and applying it to the parts  under cover, where it
 must  be retained for  some  time, and renewed as often  as
 circumstances would seem  to  require.  When  the  fever,  by
 these  appliances, has subsided, and the pulse reduced  to its
 normal standard in  frequency, the nux vomica is substituted
for aconite, in mild  cases, but in those of a more malignant
character, in  which  there are great thirst and restlessness,
 which at  this  stage indicate  that black vomit is imminent,
 arsenicum, at the sixth attenuation, is  now preferred to the
 nux vomica.   The nux vomica, in the milder form of the di-
 sease, nevertheless seems to have a happy effect in  relieving
 the alimentary canal of its morbid accumulations of peccant
 matter, by increasing the peristaltic motion of the bowels ;
 but should all these  remedies fail to have their desired  effect
 —that is, of  relieving the bowels of  their accumulations—■
 and the stage of collapse  is  rapidly approaching, I take of
 podophyline grs. ii,  hyd. chlor. mitis grs. i, lac. sac. 3j„ mix
 and rub for thirty minutes, and divide in powders xx, one to
 be given every four  hours, the large enema to be continued
 as heretofore directed, until the bowels are thoroughly evac-
 uated, bringing away large, black,  consistent discharges.
 This being satisfactorily accomplished, the powders are now
 discontinued,  except  one  at night,  to keep  up  glandular
 action.   But, in the event the necessary evacuations are not
 procured by  these  means, which will  sometimes happen, and 
12
 as  the life of the patient depends upon the  prompt  evacua-
 tion of these accumulated  peccant matters from the alimen-
 tary  canal, then  for this purpose, I  take oleum ricine  fij.
 oleum terubinth 3jt tinct. capsicum 3jj, mix, shake well, and
 give to a male adult two tablespoonfulls, which is to be re-
 peated in  two  hours, if the first does not act within this
 time.   In estimating the  probable  benefits to be  derived
 from this prescription, it will be seen  that they are therapu-
 tically adjuvants of  each other, the turpentine assisting the
 oil  in thoroughly evacuating the bowels, and  arousing the
 secretion,  both of the mucous membranes and  the kidneys,
 whilst the  capsicum, by virtue of its stimulating qualities, not
 only hastens  the action  of  the oil, but  prevents watery dis-
 charges, which would, at this stage of  the disease, be fatal.
 The oil having thus  cleansed the bowels  thoroughly, leaves
 the patient—now in the collapse—in a fainting condition, re-
 quiring  the  prompt  application of cold  water  to  the face
 and chest,  which must be kept up until  reaction takes place.
 In  conjunction  with this  treatment,  brandy and water is
 used in the quantity of one  tablespoonfull of brandy, to three
 of water, a desert spoonfull of this  is given every fifteen or
 twenty minutes, uutil reaction is established; when it is only
 continued  to  meet the  demands of the patient's condition.
 Another symptom, owing to its  important bearing upon the
 fate of the patient, at this stage, requires  a distinct notice—
 this is suppressio'n of urine,  which demands the unremitting
 attention of  the  physician,  insomuch that  he should not fail,
 upon each  visit,  to  institute a  rigid inquiry  as  to  the con-
 dition of the urinary  organs.  By this means he will be pre-
 pared  to meet its  earliest demonstrations ; and for this pur-
 pose  I use the canabis,  and cantharides, first decimal atten-
 uation, ten drops, water %'iv., each  in  alternation, every
 thirty minutes, in the dose of a desert spoonfull.  As  soon  as
 the kidneys  begin to act, the interval of administration  of
 the remedies  is  extended to one, and even two hours.   If
 there be frequent desire to pass  the urine, and the patient be
 only able to pass a few drops at a time, with burning heat
in the parts during its passage, I have recourse frequently to
the pure tincture of  cantharides, three  drops, water to lij., 
13
dose  a desert  spoonfull every hour, and with the happiest
effect.  This state is often a  premonitory symptom of sup-
pression.   But to return, if it proves to be simply a retention*
of urine, a few doses of  apis melo, at the first decimal atten-
uation is given in  the dose of a desert  spoonfull every  thirty
minutes, the sitz bath often aiding very much, if the case
prove obstinate.  The  bowels, in  this condition, are often
constipated, and the oil mixture  heretofore recommended,
will,  as soon as it operates, afford immediate relief.  I have
never known it to  fail.   The  treatment in this fever, up to
the stage of collapse, is simply adjuvant, the  object to be
accomplished  being to keep  the circulation equalized, in
order  to prevent  congestions from  taking  place in any of
the great  vital organs,  also  to protect the mucous  mem-
brances,  by appropriate remedies,  and combat  prominent
symptoms when  they occur, until the disease reaches its crisis,
through  which  every patient must necessarily pass, even in
its slightest form.   In the  more violent forms of the disease,
the prostration in this stage is very great.  This is the stage
in which ignorant  nurses, and  still  more ignorant Doctors,
proclaim the speedy convalescence of the patient, simply be-
cause  the fever  has now disappeared,  and with it,  as they
suppose, all its dangers, whereas, in  fact, he has now reached
the stage in  which the disease only  proves fatal, the febrile
stage  being entirely free  from  any reasonable apprehension
of imminent danger ; or, as has been quaintly  remarked by
a medical iriend, that no patient dies in this stage, if left un-
aided by remedial  treatment.  To meet the crisis or  turning
point  of the disease, the treatment must not only be prompt
but every  remedy  must be administered with  a  specific
object, to evacuate the  bowels thoroughly, is  the leading in-
dication, which can be generally accomplished  without the
hazzard of watery discharges,  by the  means heretofore  re-
commended ;  but  if these should unfortunately occur, they
must be controlled by starch water enemas; and if these fail
then laudanum must be added.  But as we have heretofore'
disposed of the treatment of the more violent  form of  col-
lapse, we have now only to resume that of the milder grades.
In these there  is  little more  to be done, after theToowels 
14
 have been evacuated.  In them 1 generally prescribe arseni-
 ■cum and nux vomica, in alternation, every two hours,  with a
 view to regulate the organs of digestion.  If the coating  on
 the tongue still continues white, after their administration,
 indicating an imperfect action  in the secernent organs, bry-
 onia and ipecac are given  alternately  in  their stead.  If
 there  is still  a failure to correct the chilopoetic organs by
 these  remedies, antimonium  crudum  is substituted for the
 ipic,  and with these  I have invariably succeeded.    The
 patient  is able in  a few days to leave his  room, being re-
 stored immediately to health, without  the formality of a  te-
 dious convalescence, which invariably happens to those who
 have been subjected to the more  onerous  plans of treatment.
   The Homeopathic and Allopathic medication can not  be
 more  beautifully illustrated  than by the contrast shown  in
 the patients  respectively  treated  by  the  two  systems—
 those of  the  one, were for  weeks creeping, sallow, ghosts,
 whilst those of the  other went forth in all the plimitude  of
 health, rejoicing equally at their acclimation, and the  small
 amount of suffering, with which they purchased it.
   At this point, it is necessary to avail  ourselves of   a re-
 sume of  the  symptoms  incidental to the collapse, and its
 sequelas, not only to  recapitulate to some extent  the  treat-
 ment of  this stage, and to extend the list of remedial agents
 to meet  these sequential phenomena, but also to notice the
 modification  of this stage, presented in  a particular  class  of
 patients.
   The most  malignant  form  of  the fever  occurs  among im-
 migrants from cold climates,  with rich blood, in whom the
 synochal  stage  presented a much higher grade of develop-
 ment, whilst the collapse was  more marked  than in others.
 Persons  also  greatly exposed to  insolation, appeared  to be
 peculiarly obnoxious  to the higher grades of the disease, as
 was evinced  by the death of  thirty-five out of thirty-seven,
 carpenters,  who were  thus  exposed in  1848 in  roofing
 houses.  In those also of bilious temperament, of  a plethoric
 habit, the  same exacerbation of  symptoms  was  met  with
 throughout  the fever,  as well  as in those  of intemperate
habits.   Henee, when a practitioner is called  to a patient, hf 
15
should  strictly  scrutinize  him in reference to the  severnl
circumstances above enumerated, as likely to aggravate the
case, as well as  to ascertain  whether belabors under  chronic
disease of any organ, as the fever  will be almost certain to
expend its force upon it, and in the stage of collapse, if such
organ be  not protected by appropriate treatment, the patient
will become the  victim of such neglect.  If the patient has
been accustomed to liquor or opium, be it the one or the other,
he must have his accustomed stimulous. as soon as advisable.
Although opium, and its preparations, are poisonous in this
disease, yet must the patient have it, in the stage of collapse,
or he will sink and die for the want of it.  The physician, if
he expects to treat  the disease successfully, must have a strict
regard to  the idiosyncrasies, habits, constitution and tempera-
ment of his patient.
  In the more violent cases, reaction will be only partial and
the collapse  so  complete—especially if the  patient has been
purged or sweated excessively—that spontaneous  reaction
can not take  place.  It is here that the resources of the phy-
sician is taxed to the uttermost,  in order to bring it'about.
For this  purpose,  our  principal reliance must  be  in cold
water,  freely applied  to the face, chest, and hands, giving
him in the mean time arsenicum and veratrum album, the first
at the sixth attenuation, and the latter at the first, alternated
every every fifteen  or twenty minutes.   If reaction does not
take place under this treatment,  conjoined with the rubbing
of  the  spine, with  the capsicum  liniment of double  the
strength of  the formula heretofore  prescribed,  then strip
the patient, and  pour from five to six  buckets of cold water
over  him, causing the stream to strike him  along  the full
length  of the spinal column ; rub him briskly with crash
towels  until   dry,  then place  him in bed,  under blankets.
Instead of the above method, he may be packed in wet sheets.
Speedy reaction will follow either  plan of applying the
cold water.   Continue  in  the  meantime the  medicine, as
above directed, and after reaction is established, commence
with  the  brandy ;  but  this  must not  be given  before  this
occurs, as it appeared  in this stage  to depress,  instead of
arousing  the vital  forces ;  therefore it will be well for the 
16
 practitioner to observe the above  precaution. As soon as re-
 action is established, it  will be followed by the consecutive
 fever, which always presents itself in a low, typhored form.
   If there be  no disturbance of the urinary organs, the
 patient should again be put on the arsenicum and bryonia,
 alternated  every  half hour, until the patient is brought under
 their influence, which  will be manifested  by a gentle action
 on the surface.  Aconite can not in this form of fever be relied
 on. The cold water here must still be kept up, and freely ap-
 plied to the head, chest and face,  with  wet compresses over
 the stomach, and  bowels.  Should the tongue present a fiery
 red appearance, with much thirst, and painful micturition,
 the pure tinct. of cantharides,  grs. iii., to  water f ii , dose a
 desert spoonfull,  substituted for the bryonia.  If the breath
 becomes offensive, interpose a few doses  of  carbo. lig., at a
 high attenuation. The above remedies must be continued for
 at least twenty-four hours, as they are  our main reliance in
 this  stage of the  disease.  Should  the skin assume a peculiar
 lemon  color, which happens  when the peccant matter, not
 being discharged from the system, becomes absorbed, a few
 doses of mercurios cor. and rhus. tox, will be found highly
 beneficial ;  and  when a strong determination  of  blood to
 the head  exists,  opium and hyoscyamus nig. may  be given
 with advantage.   But these latter remedies—merely inter-
 posed,—must  not interfere  with the general  treatment.
 In this stage of the  disease,  the  hemorrhagic tendency is
 yery apt to show itself in the sponginess of the gums and
 bleeding at the  nose.   In  these cases  the  sulphuric acid
 acts  admirably, administered of the strength  of ten drops, to
 water fiv.,  dose a teaspoonfull, the free acid being preferred.
 The  bowels must  be kept open by enemas, administered every
 night at bed time, in the quantity heretofore recommended.
 After the operation of the enemas, rub the spine  with the
 pepper liniment, which will generally procure the  patient a
 comfortable night's rest, and from this he will  derive more
 benefit  than  from  any medication.  The  patient  should
 never be aroused to give medicine, as upon his procuring re-
 freshing sleep, of some hours' duration, his life depends—he
always  awakes much improved.   Cold water to drink may
             b5 
17
be allowed him, throughout this stage, in quantities sufficient
to quench his thirst, provided it does not  lead him  to swal-
low  enough to load his stomach, giving rise to  nausea and
restlessness—the juice of fresh lemons may be added, if not
contra  indicated by the  remedies  given.  If  the surface
should  become dry, which occasionally happens, rendering
the patient  restless, it  should be  well sponged with  the
tepid alkaline solution, under cover—the friction being very
greatful,  may  be continued for some time.   If great relax-
ation of the surface should take place, giving rise to colliqua-
tive  perspiratioQ, the body should be sponged all over with
good  brandy, or the pepper liniment, to be repeated as often
as the symptoms indicate the necessity for the nse of the one
or the  other.  The patient's room must be  kept clean, and
free from all perfumes, essences, aromatics, or volatile  sub-
stances—they may be grateful at first to the patient, but
ultimately they tend to  produce nausea, or still worse, they
may antidote some of his remedies.   If the surface  becomes
prematurely cool, interpose the veratrum, at  the first attenu-
ation, until  that symptom is controlled.  The  extremities
and spinal column must be rubbed  thoroughly, three or four
times a  day, with the pepper liniment, which is invaluable in
this stage of the disease. It possesses this advantage over all
other counter (irritants, that it does not make the surface
sore so as to interfere with the repetition of  its application.
If the secretions are suppressed, they  must  be restored by an
occasional dose of the powders, heretofore  recommended. If
these means should all  fail, and  the  patient sink into low
muttering delirium, with a  constant  disposition  to get up
and  ramble over the room—and to prevent which often re-
quires force—the lachesis and arsinicum,  both used  at the
sixth attenuation, gtt. x., to water 3iv., in the dose of a desert
spoonfull, alternated every thirty  minutes, should be given,
with  the occasional interposition of a  few doses of stramo-
nium.   The cold wet sheet must be still kept up, the patient
being wrapped in it while the blankets upon which he should
be laid, should be carefully folded over him.  This will in
a short  time, produce a strong determination of blood  to the
surface, and thus relieve  the system  from any internal con- 
18
gestion that may have occurred in any of the vital organs.
As the wet sheet seems to afford much relief, to the restless
patient, its reapplication is indicated as often as it  becomes
dry, not only to allay tbe patient's anxiety, but also it may
be to supply the blood, by absorption, with its proper quan-
tum of aqueous fluid, to compensate for its loss by perspiration
or by other processes of  exhaustation, by  which  an anaemic
state of the vital fluid  is produced.
  This anaemic state of the blood  takes place at the  period
when black vomit is imminent.  My experience teaches  me
that the absorption of the water acts beneficially,  not only
upon that vital fluids, but also  upon the  nervous system.
In case reaction should take place, after this second collapse,
chi  and arsenicum, the first at the first decimal attenuation,
the latter at the sixth, are prescribed in alteruation, every
hour, in the dose of a desert spoonfull, nourishing the patient,
in the meantime, with  beef tea, mutton  broth, and chicken
soup, administered in small quantities ; brandy and  water, or
wine, is given at the  same time, but care must be taken not
to produce over excitement. The lemon juice,  with  a limited
quantity of ice added  to  the  water, allowed the patient  to
quench his  thirst,  makes a  grateful beverage ; but sugar
must not form one of the  ingredients, lest it produce acidity
of tbe stomach.  Beef-steak, rare,  chewed by the patient, the
fibrous  parts  spit out, and the juices  alone  swallowed, is an
improvement on  the tea, as  the salivary glands are excited
by the process of mastication, thereby affording digestion its
natural adjuvant.   But  this  is only  allowed after the sub-
sidence of the  fever now under consideration, and then only
when the bowels  have been  evacuated.   During  the fever
nothing should be allowed but rice-water, or  gruel strained,
with a little salt  in it, given often but in small quantities, to
strengthen the stomach.   While on the  cubject of  diet, as I
have said  nothing in relation  to it  in the  course of the
general treatment, I will remark that the indications of nature
may be relied on—hence in the attacks of women and child-
ren  uncomplicated, in whom they are often very  mild, ap-
petitie  shows  itself  at  a very early period.  Rice  water,
gruel, or any of the farinacia, is ordered for  them, to which 
19
 they are confined during the febrile stage ; but as soon as it
 gives way, a more liberal diet is allowed, such as beef-steak
 squirrel, &c, the fleshy parts being spit out, for the first day
 or two, but after this precautionary  period has elapsed they
 are allowed to make a  general descent upon the culinary de-
 partment, and forage  upon  it ad  libitum.   I  can not leave
 the subject of the treatment  of yeliow lever  without calling
 the attention of  the  inexperienced practitioner  to a few of
 the  most important remedies, fearing that he may not be
 aware of their importance.   The first in point of importance,
 1 suggest, is arsenicum ; this  ought  to be  given as soon  as
 aconite can be dispensed with, and continued through all the
 subsequent stages of the disease.   It is our only  means to
 correct that condition of the blood, in which  corpuscular
 dissolution  and  black vomit  are  imminent.   The mucous
 membranes, and  the glandular  system,  also call constantly
 for the  interposition  of cantharides at the  different at-
 tenuations.  The argentum  nitras, sometimes,  at  this stage,
acts well, if  hemorrhagic tendency is not controlled by the
sulphuric acid.   The action  of the lachises, in my hands, has
not been such as to make me  place  much  reliance  upon it.
 But there is no disease that  calls for  such  vigilance, and
prompt attention, on the part of all concerned, as this.   The
slightest dereliction of duty, in any part of the treatment, in-
volves the life of the patient—he is as it were, vibrating be-
tween  life  and death,  and  the weight of a pin, thrown into
the wrong scale, places him  in the category of cases beyond
the hope of medical redemption—so let the physician govern
himself and others, in  reference to the critical stage of the
disease, otherwise all bis skill in treating of it, will be found
unavailing.
  This epidemic attacked indiscriminately  all  classes  not
sparing even those who had  been raised in New Orleans and
 Charleston,  and attacking  indifferently people of all  color,
 whether acclimated or  not.   Among the negro race the fever
 ran very high at first,  but lasted  a very  short time, termin-
 ating frequently within twenty-four, and rarely exceeding
forty-eight hours in its duration.  The  mulattoes  suffered
 much  more  than their darker cousins of  pure African de- 
20
scent ; and then* attacks were the more severe in proportion
to their approach to the white races in their blood affinities.
The  blacks  recovered rapidly, very few suffering beyond a
few days, whilst the mortality among them was comparatively
insignificant.
   The epidemic which we have just passed through, proved
itself to be highly infectious and malignant.  Every town
along  our railroads, that  placed no restrictions on inter-
course with our infected cities, was  soon  devastated by it.
In fact, refugees from Galveston and Houston  distributed it
in every town and village  wherein they took up their abode,
having left  those cities after they were poisoned by the in-
fection.  It is  even reported that in several  places  it was
spread in the rural districts, to some extent, by  these persons.
Several of our  interior towns—Liberty, on the  Trinity, Rich-
mond and Columbia, on the Brazos, besides several others in
the liue  of its march—escaped by enforcing  rigid  quaran-
tines ; thus showing the  efficiency of this means to  arrest
its spread,  when citizens  chose  to take  the matter in their
own hands, instead of entrusting it to sanitary boards of
squabbling Doctors.
   The rapid spread, by infection, of this epidemic, proves it
to have been yellow fever of a decidedly genuine and  ma-
lignant type, only excelled in this respect by  the great epi-
demic of 1853.   There are no  forurs.  of epidemic fever with
which this is likely to be confounded, except the acclimating
fever of the West Indies ;  and  on the distinction  between
these two, Dr. Copland  is so  clear  that we  shall take  the
liberty of quoting his remarks  upon their peculiar character-
istics.
   Dr.  Copland, of  London, remarks,  in  his  Dictionary of
Practical Medicines, " That the  true, or pestilential yellow
fever,  is different  from  severe remittant and from ardent
fever, neither of which is infectious, while true yellow fever
is eminently infectious.    Ardent  fever occurs only  in Euro-
peans  recently arrived in  hot  climates, and never in the ac-
climated, nor in  aboriginal or native inhabitants—it cannot
attack the dark skinned races and the assimilated  European. 
21
   Tbe true yellow fever attacks the unseasoned, tbe seasoned,
 the constant resident, and the dark skinned raced—the negro
 as well  as the  European—all within the sphere of its  in-
 fection who  have not previously had the disease.  A former
 attack protects  from the yellow fever ;  but  remittants will
 occur again and again in the same person ; and even ardent
 fevers will occur a  second  time, if the person who has once
 been  affected by it, has returned to Europe, resided long in it,
 and afterward gone to a warm country. Ardent fever occurs
 only  among  persons  who  have recently arrived  from cold
 or temperate climates into a very hot country ; and true yel-
 low fever appears  only occasionally, and then  the infection
 may either extend to a few only—the circumstances favoring
 its diffusion  not existing—or to great numbers, the disease
 thereby  becoming  epidemic.   Thus, the first  and second  or
 the ardent and  acclimature  fevers, are always occurring—
 yellow fever seldom, or  only after long intervals.  The  in-
 flammatory fever is described by name as the synochus cau-
 sonides by Gilbert ;  of synocha  causodes, by  Manget,  of
 synocho  ardens,  by Sauvages;  of endemical  causus,   by
 Mosely ;  of inflammatory endemic,  by Dickenson ; of climate
 or seasoning  fever,  by  several writers ; and  of endemic yel-
 low fever,  by others.   This is the disease which  most fre-
 quently  attacks  new  comers into  the  West Indies, more  es-
 pecially sailors and soldiers ; and which has been confounded
by recent writers with the aggravated forms of  bilious fever
on the one hand, and  with epidemic, or pestilential yellow
fever, on  tbe  other."
   Dr. Stevens, of St. Croix, maintains that there  are  three
essential  or idiopathic fevers met with in the West  Indies  :
First, The climate, or seasoning fever,  which  is  not pro-
duced by marsh poison or contagion, but by long  continued
excessive heat, acting, under peculiar circumstances, on tbe
bodies of unseasoned strangers, lately arrived from northern
countries.
  The second is  a swamp or marsh fever ; whilst the third is
the true African typhus or yellow fever, (the pestilential feveir
of Chrisholm, the Bulam fever of Pym,. <fcc.).. 
•
22
   The  two first, Dr. Stevens regards as indigenous to  the
 West Indies, and never communicable from one  person to
 another ;  while the last "is, in every instance, a contagious
 disease."   "At one period," says Dr. Stevens, "there was an
 interval of thirty years during which there was not even one
 case of this fever in the western world ;  and in almost every
 instance where it first commences, when proper inquiry is
 made to ascertain its cause, its  origin can be traced to  the
 traffic with certain countries on the western coast of Africa."
 According to  Dr. Stevens, the climate (or stranger's) fever
 is only  met with as an epidemic during tbe hot  months, when
 the thermometer  is  upwards of 90 degrees during the day,
 and  at least 80 degrees during the night.  It is confined to
 the  whites, and almost entirely  to those  who have lately
 arrived from northern countries.
   The  African  typhus,  or yellow  fever,  according  to  Dr.
 Stevens, prevails in every locality and in every season of the
 year in  the West Indies ;  not confined to the whites or those
 newly arrived ; is as fatal in  the coldest weather as in  the
 hottest  months ; is not produced by any local endemic cause,
 and is always communicated by contagion.
   Dr. Stevens further states: That those who  have had the
 climate  fever are not susceptible of it a  second time, unless
 they leave the West Indies and  return again after a consid-
erable residence in some northern country ; those  who have
 had yellow fever are completely exempt  from any future at-
 tacks of the  disease ; but neither the marsh  fever nor  the
climate  fever  gives any exemption from the yellow fever,
and there is such  a resemblance between  the two latter, that
many suppose they have had two or more attacks of yellow
fever.
   Dr. S. further remarks, in regard to the changes that take
place in the latter stages of this disease:  The saline ingredi-
ents  of  the blood are greatly diminished.   The chief cause
of these alterations is evidently  exhausted  organic, nervous,
or vital power ;  and this is  further evinced by  a loss of  the
tone of the extreme  vessels, and  of the irritability  of  the
moving fibre, always co-ordinately observed in cases present-
ing this change in the blood.   Among the most  striking con 
                           23

sequences of exhaustion of vital power, as thus manifested in
the extreme vessels and blood, are discoloration of the  skin
and passive hemorrhages from mucous surfaces, phenomena
characterizing'the last  stage of  the most unfavorable cases
of the intense disease.
  The gastric disturbance in the early stages generally pro-
ceeds from excited vascular action, and  from the passage of
irritating secretions into the stomach, in  connection with  an
increased susceptibility and irritability of the organ.  In the
latter stages, it more especially results from the morbid secre-
tions poured into the stomach, and the irritated or inflamed
state of its villous surface.
  The source of the black matter passed from  the stomach
and bowels, in  the last stage of this and  of  other severe
fevers of warm countries, has  been variously stated.   Some
consider the black color to  proceed  from tbe exudation of
dark  blood,  which, in  mixing with  the secretions  of the
stomach, liver and  bowels, imparts to them a   still  darker
tint.  Some ascribe it chiefly to the bile  and secretions from
the digestive mucous follicles,  which are often both very dark
and thick in the last  stage of the more malignant kinds of
inter-tropical fevers ; and  others  believe it to  arise  both
ways.   There is no doubt that all  the secretions poured into
the digestive canal are more or less diseased, particularly in
the latter  stages ; but it is as  clear that  the black color
mainly depends upon the state of the blood, and that all the
matter ejected upwards and downwards, presenting this ap-
pearance, does  not consist  of altered  secretions merely, a
great part of it  probably being an exudation of blood from
the mucous surface.
  Dr. Jackson remarks that the secretions from the digestive
mucous surface are ropy and clear during the early periods,
and are brown  or black in  the  latter, sometimes black as
soot, and that the sooty or ink-like color is chiefly observed
where the  head  and  stomach are  simultaneously attacked.
When we consider that the blood becomes darker than natu-
ral, as well as otherwise changed,  early  in the  period of ex-
haustion, and that the liver and mucous follicles of the diges-
tive canal, with  the kidneys, are the  principal organs of de- 
91
puration, or channels by which the elements producing these
changes are eliminated from the exudation, we  need not be
surprised at the secretions which these elements go to form,
and which these organs excrete, presenting somewhat simi-
lar  characters.  It  must,  however, be  admitted that  the
share which the secretions perform in  producing this phe-
nomenon, or that which the exudation of blood has in giving
rise  to it, will vary  much in different varieties of the fever.
The rapidity with which a dissolution of the tissues  takes
place after death, in  this fever, deserves  notice, as marking
the rapidity of vital exhaustion, and as  resulting from the
changes of the blood, these  changes commencing with the
stage of exhaustion  and  advancing until this fluid is no
longer capable of influencing the nervous system, and of pre-
serving the irritability of  contractile  parts,  or   until it
poisons instead of  exciting the sensitive and moving tissues.
Dr. T. Y. Simons,  of Charleston, S. C, in a ''Report on the
History and Causes  of Stranger's  or Yellow Fever," in that
city in 1839, (page  23, vol.  8,) has described a disease corres-
ponding in its essential features  with tbe one  we have just
passed through ; and Dr. S. H.  Dickson, of Charleston, has
also given an account of the same malady (the Eclectic Jour-
nal of Medicine, February, 1840),  and remarks that Maxley
has well  denoted this tropical plague by the appellation of
"caususfebris ardens."  The burning heat of the skin, he adds,
was one of the most important features during its prevalence
in former  years (as  was the case  in this present epidemic
here), in 1838.   The surface '"was apt to be moist, and by
no means especially  hot."  The disease  was  marked by a
suffused dark flush upon the visage ; a red and watery  eye ;
great gastric distress  and oppression ;  full, hard pulse, and
pain in the head, back and limbs, there befrig but a single parox-
ysm of long duration, without subsidence, and when subsiding,
returning no more.  There was occasionally a total suppres-
sion of the urinary secretions, and in the latter stages, a fre-
quent discbarge of blood from tbe bowels.  There was, also,
black vomit in many cases.  "In  different  years," says Dr.
D., '"this terrible symptom  shows itself with various degrees
of promptness and certainty, and connects itself, more or less,
         b6 
25
generally, with hemorrhages from the nose, mouth, and other
orifices of the body."  As to its cause, this writer observes,
"I need not tell those who hear me that no palpable cause of
yellow fever has yet  been detected ; nor need I remind you,
that even when we enter, with the most metaphysical  nicety
into the discussion of its probable origin, under varying con-
tingencies, we find ourselves still in the dark. If we  assign
it to the combined operation of heat, malaria,  animal  and
vegetable effluvia, and the effect of personal habits, we  are
totally unable to explain why these causes, acting together,
do not produce it as well in Calcutta as in Vera Cruz, in
Milo as in Havana, in Galveston as in Seville."
  We will illustrate  the reason  why it does not spread in  the
one and  does in tbe  other, by the parable  in the scriptures
which  represents a sower going forth to sow, and most of
his  seed  fell  into localities in which no fructification  fol-
lowed ;  but other portions fell on good ground, and did yield
fruit that sprang  up  and increased  and brought forth, some
thirty, some sixty, and some a hundred fold.
  So it is with yellow fever—if its seeds  are not sown in a
fructifying locality, they perish ; but when sown in a genial
soil, such as Charleston,  Mobile,  New Orleans, Galveston
and HoustOD, and many of their adjacent  towns, not a hun-
dred but a thousand fold of its bitter fruits will be produced.
As spreads cholera so spreads yellow fever, each requiring,
in any locality in which it can be propagated, an element, or
it may be a telluric emination, to which either may communi-
cate its virus,  and by infecting it with its own properties,
soon get up  an  epidemic  constitution of the atmosphere :
we say an epidemic  constitution of the atmosphere, for  the
want of a better term in which to express ourselves. A more
thorough knowledge  of the affinities  between these poisons
and the pre-existing elements which they use as  a nidus, it
may be, for their  own development, would enable us to ex-
press ourselves more in  accordance with a set of facts,  but
indifferently represented by tbe terms "epidemic constitution
of  the atmosphere," since this atmospheric constitution, thus
produced, obeys none of tbe laws appertaining to the atrial
fluids, being neither  retarded, accelerated or delayed by its 
26
currents.  That this virus requires a  local pabulum, a ger-
minating or assimulating principle, to enable it to propagate
itself, is made manifest by its inability  to  spread  in many
places, to which it may be carried, where  it is evident no
such element can be furnished it, such as an elevated, sandy
country, abounding with pine forests,  or  other districts un-
propitious to its reproductive processes, on account, perhaps,
of the absence of miasm.   In this power of self-propagation,
in some localities, and  not in others, we are furnished  with
the clearest evidence of its infectious  character, on  the one
hand, and non-contagious on the other.   What a vast amount
of labor has  been expended in  proving and  disproving its
contagious nature, while tbe disease, before the eyes of the
contestants, without concealment or legerdemain, was demon-
strating that her right of dominion was  everywhere  assert-
ed upon the  simple principle  of infection.  As before sug-
gested, local  miasm may have much to do with the reception
and the  nurishment of the virus into activity, inasmuch as we
find  the disease more  readily propagated  in  localities thus
infected than in others less subject to its evolutions.  When
carried  into any place where the prevailing endemics of mias-
matic character are in an active  state, it is found immediate-
ly to supersede them, thus showing a ready  affinity of the
zymotic poison  for the miasm.  Being produced by a specific
poison,  it assimilates, in one respect, to those  diseases gener-
ated in  the same  way, viz : in conferring perfect immunity
by a single  attack, as  much  so  as measles,  small-pox, &c.
The  results of  my experience, having  treated the disease in
its different epidemic *visitations in  the  same  city for  nine-
teen years, and never having met with a single second attack,
warrant me in saying it never occurs  twice in the same per-
son ; or if it does, it is  so seldom that all apprehension on
the  part of any one who has had the  disease, should belaid
aside.  It may happen that some persons, during an epidemic
yellow fever, may  be taken down and treated  for the prevail-
ing disease, and then they will pass through life asserting and
believing that they have had two attacks of yellow fever ;
whereas, either the first or the last attack was nothing more
than an ordinary miasmatic disease,  leaving the deluded vie- 
tim, nevertheless, a sufficient amount of protection, although
deprived of one of his securities, to insure his passing free
for the future.
   As from  cases like these, a feeling of uneasiness or appre-
hension prompts  the  frequent enquiry  whether a person can
have the disease a second  time.  For  the purpose of giving
confirmation to opinions  heretofore expressed  by me on all
occasions, I shall take the liberty of quoting from the writings
of P. C. H. A. Louis, an eminent French physician, who was
sent by his government, in 1828, to Gibraltar, to make inves-
tigations into the character  of the disease as it prevailed
there during that epidemic.   The quotation  is headed,  as
follows : "Does a first attack of yellow fever preserve from
a second ?"
   "This point of  view in  the history of yellow fever is not
new.   Some of the physicians  who have studied the disease,
and the populations amongst which it  has prevailed  in times
past, have remarked that the same person is rarely attacked
twice by the yellow fever.
   "Sauvage, in his Methodical  Nosology, says positively, that
this  disease attacks  the  same  person once only.   Arejuta
expresses himself to this effect, and it results from inquiries
made by Dr. David Hosack, of physicians who had practiced
at New York and  Philadelphia, that they had never been
called on to treat a patient suffering from a second attack of
yellow fever.  Michael Cabanellis  expressed a similar opin-
ion, in  a work published at Meiri, in 1812, on the laws to be
instituted to prevent  the  reproduction  and  importation of
the yellow  fever.   Valence says the same thing in  his His-
torical and Medical Researches on the  Yellow Fever, pub-
lished iu 1805, for, notwithstanding the  pains he took to  in-
quire and to settle doubts  as to this point, he found no indi-
viduals, French, English or American, who had had the yel-
low fever twice.
   "The subject was further examined, in  1815, by Dr. Pym,
who presented an  important work on  it to the London Col-
lege of Physicians.   A report was made on  this  work, in
which  it was said, amongst other things, that  although,  ac-
cording to the points presented, there was strong ground for 
28
 the belief that a first attack of yellow fever preserves from
 a second, it would be necessary to  collect the opinions of a
 greater number of physicians in  order to come to  any cer-
 tain conclusion ; so that, at the period when this report was
 made, in London  at  least, the  preservative influence of a
 first attack of yellow fever was not looked upon as demon-
 strated.  It was then necessary to collect new facts.   To do
 this, and to comply with the  wishes  of the College of Phy-
 sicians  of  London, Sir William Pym, physician in  chief of
 Gibraltar for the time, recommended to General Don, when
 the epidemic of 1828 had ceased, to appoint  a commission,
 whose duty it should be to collect such facts as might serve
 to settle this point.   Messrs. Chervin, Trouseau, and  Louis,
 had the honor to be of this commission, which  was composed
 of thirteen physicians, the other ten being Dr. Broadfout,
 Dr.  Dorr,  Barry, Dix, Frazer, Arderol,  Bobadilla, Mutras,
 Bonvins, and Thurston.  Louis was the  President, M. Trou-
 seau, Secretary, and Dr. Barry, the Vice President.
  "This commission, as we shall see, neglected nothing which
 could lead  to the knowledge of facts, and the  establishment
 of strict conclusions.  As some  physicians thought that the
 preservative influence of a first attack of yellow fever, real
 for those who did not change their climate, was lost after a
 longer or shorter  residence in a  different climate, the ques-
 tion  to examine becomes two-fold :
  "First: If an individual who has had  the yellow fever in
Europe, was susceptible of a  second attack of the same  di-
 sease in Europe? Second: If an individual who had had the
yellow fever in Europe, could have it a second  time in  Amer-
 ica, and visa versa ?   As simple assertions were inadmissible,
 the commission decided that they  would receive  those cases
 only, in which  the symptoms  of the first and second attacks
 could be given, whether these symptoms had  been noted by
 the physicians  who  communicated  them, or whether they
came through the patient himself,  but were unequivocal.  In
order to learn  the proportion of patients who had  had the
disease  twice,  the commission asked of the  physicians  to
state, and with as much precision as possible, the number of
patients treated by them in  tbe different epidemics. 
29
   "As too many facts relative to the object of inquiry c©uld
 not be collected, all the medical men of Gibraltar, civil and
 military, were invited to come before the commission and to
 communicate the results of their experience.   They all com-
 plied with this invitation, and answered the questions which
 were addressed to them successively by the different members
 of the commission.  Thirty three gentlemen were called upon
 to say, first:  how many  cases of yellow  fever had been ob-
 served by them  in the last, or in anterior epidemics, in Eu-
 rope and America ;  and, secondly : the number of patients,
 in the different epidemics, who had the yellow  fever twice,
 and their symptoms.   Most of these physicians had observed
 the yellow fever in  Spain only : some, however, had seen
 different epidemics in Europe and America, and the number
 of patients seen or treated by  them all,  amounted to some-
 where about twenty-seven thousand.
  "Mr. Amiel, surgeon of the twenty-fifth  regiment, who- had
 observed the  four last epidemics of yellow fever in Gibral-
 tar—those  of 1810, '13, '14, and '28—presented two  cases
 of presumed double attack to the consideration of the com-
mission.
  "The Anglo-French commission (this was the name given
 at Gibraltar to the commission  composed of  the physicians
sent from France and Dr. Barry) had, in  its researches, col-
lected the symptoms manifested  by nine individuals, who had
 been ill during  two epidemics of yellow  fever.   Two other
eases of presumed double attack were communicated to the
commission, who thus had to deliberate on  thirteen  cases,
and each of the  number expressed  his  opinion by a vote,
 writing on a piece of  paper, 'evident/  'probable/ 'doubt-
 ful,' or 'inadmissible,' for each case.
  "In this manner, one of the  cases of double  attack com-
 municated by Mr. Amiel, was  declared  evident, three were
 regarded as probable, the others as doubtful or inadmissible.
 The twenty-seven thousand patients were not all exposed to
 two epidemics of yellow  fever ; but supposing one-half or
 one-third of  them to have  been so (an estimate which very
 probably is below  the truth), we should have, among nine 
30
thousand persons once attacked by the yellow fever, and ex-
posed to it again in a new epidemic, but one well authentica-
ted instance of a second attack of that disease.
   "Undoubtedly, some of the minority <»f the  commission
(those particularly who voted every case to be evident,) will
contest the justice of th?s decision ; and, conceding to these
all that  it seems to rae they  could ask, the admission of the
thirteen facts on  which they  were  called  to deliberate as
cases of second attack, it would result, that among nine thou-
sand persons who had had the yellow fever, and had been
exposed to its causes in a aew epidemic, thirteen only con-
tracted it a seeond time.
   "Another objection  may be made.   Four physicians, who
came before the commission, declared that they had treated
in the  last epidemic (that of 1828),  some patients who had
the yellow fever  in  previous  epidemics.  These  statements
were not considered by the commission—the physicians who
cited them not  being able to  tell  the  symptoms of the sup-
posed double attack ; and some, perhaps, will say that these
were really cases of second attack.  But admitting this sup-
position to be true, and  also  that each  physician had seen
three of these cases, in all, twelve  cases of second attack, it
would  result that among  nine thousand persons who bad
once been attacked by yellow fever,  and who had been  ex-
posed a second time to the influence of all the causes of that
disease,  twenty-five had  it twice.  We must then conclude,
with the commission, that a first attack of yellow fever pre-
serves from a second, as  effectually, and at least m as great
a,  degree, as a first attack of an eruptive  disease, of the
small-pox, for instance,  preserves from a second attack of
the same disease.   There are cases of persons who have had
the small-pox twice ; and, according  to a report made to the
Royal Academy of Medicine, of Marseilles, in 1825, of two
thousand persons who  had had the small-pox once, twenty,
or the  hundredth part, had  had the disease  a second time.
If then,  among the  patients of whom  we have just spoken,
there had been ninety cases of second attack, the proportion
of second attacks would  have been the same as in the small-
pox epidemic of 1825. 
31
  "It will undoubtedly be said that the report, which has just
been admitted, is  entirely  arbitrary, since the terms  of it
were not fixed rigorously, to which it may be answered, that
if the terms of the report were fixed arbitrarily,  they  were
so in the sense least probable to the conclusions of the com-
mission.  But we can cite a fact more conclusive than those
which precede.  The French  commission sent to Gibraltar
have ascertained, in their investigations, that of the persons
who had suffered from the yellow fever in an  epidemic ante-
rior to that of the year 1828. nine only were ill in the course
of this last, and admitting all these to have had a second at-
tack, we ought to  conclude that cases of second attack are
rare, and adopt the opinion of the commission, which is also,
as we have seen above, that of a great number of physicians,
whose writings are of an earlier period.  The conviction of
the  truth of this conclusion is  so  deep at Gibraltar, where
there have  been four epidemics of yellow fever in so short a
space of time, that in the last, that of 1828, several persons
exposed their  children to  those influences,  which, in  their
opinion, would most probably bring  in the disease, because
at that time it was milder and less  fatal in infancy than at a
later period of life.
  "Even physicians did the same thing, and amongst others,
Mr. Amiel, being convinced that their children would have
at that time a light attack  of tbe  disease,  and that, never-
theless,  for the future they  would be  preserved from  it.
  "We  should remark, also,  that those who  were ill only
during one  or two days in epidemics anterior to that of 1828,
and whose  symptoms  were  very  slight, have oeen  equally
well preserved from a second attack.
  "We cannot doubt of this preservative influence, far it has
been noticed in members of a  family, all of  whom were ill
nearly at the same time, and  during  an epidemic.  In some
of them  the disease was severe and well characterized  ; others
manifestd but very slight  symptoms, such as were by no means
characteristic  of the yellow fever.
  "From the facts already given, the reader can scarcely have
a doubt of  the preservative influence of a first attack of yel-
low fever.   But it may be well to add to them the following, 
32
as very remarkable ex; ;;;ples  of this truth.  The first  was
■given to the commission-' v>y Mr. Amiel.  This gentleman vis-
ited,  professionally, (wo  young men of the name of Ray,
during the Gibraltar 'epidemic of 1810.  These same persons,
in 1821, were on bo?.t r ■> vessel anchored  in Barcelona Bay
during  the  yellow frv-.rr' epidemic which  prevailed  there.
Several passengers on  board  the  same vessel were ill ; the
whole  ship's crew '(nineteen  in  number) died, bat  the  two
Rays continued to enjoy perfect health.  The second fact was
reported by Mr. Bro;-^fout, and relates to civil and  military
domestics employed h  'he care of the sick during  the  last
epidemic.  The military domestics, one hundred and sixty
in number, had never :.id the yellow fever in any  anterior
epidemic.  The other-. *ixty-one in number, Spanish or Por-
tuguese, with two axe-  "vtions, had  already been its subjects.
The two last, and forty of the military domestics, had the
disease at different  pe1'ods of the  epidemic ; all those who
had previously had it e caped.
   "In  the interminable discussions which  have taken place
between the contagio?:'- ts and infectionists, proofs have often
been  given of  the non-contagious character of the  yel-
low fever, drawn from instances  of nurses retaining their
health in the midst oi the sick.  But, in order to give such
an argument any force, it must be  shown that these nurses
had never had the yellow fever in an anterior epidemic ;  and
the necessity of doing this is the greater,  for,  as the  physi-
cians of many of the Spanish  cities (men worthy of all con-
fidence) have assued tss, it is  customary to select the nurses
from among those wh^  have already had the disease.
   "As to the question  whether a first attack of yellow fever
preserves from a  second, those who go  from one  climate to
another, as from  Europe  to America, the  facts laid before
the commission by  Drs.  Ardevol,  Cortez, Merry and Dias,
are as follows : Dr. Ardevol  knew at Havana many  Span-
iards who had had the yellow  fever in Spain, and who were
not attacked by it in America, living there when epidemics
of that disease were prevailing.   The same physician  had
seen at Barcelona, during  the last epidemic of yellow  fever
jn that place, persons who had had theyellow fever in Amer- 
33
ica, and who enjoyed uninterrupted  good health.   Dr. Cor-
tex, twenty-five years a  practicing  physician at Gibraltar,
reported that of twenty-six members of the same family who
had left Gibraltar to reside in Cuba, two only were attacked
there by the yellow fever, and these  two were the only ones
who had not had it  in Europe.   Again, Messrs. Merry and
Diaz spoke of thirteen navy physicians and surgeons, who,
having had the yellow fever iu  Spain, went  afterwards  to
Havana  and  Vera Cruz, without contracting the disease a
second time, though constantly in a flat in which it prevailed.
These facts, though  few, are conclusive, and as the commis-
sion observed in their report, ought to have a great influence
in the selection of troops by whom  the colonies, where tbe
yellow fever  prevails habitually, are garrisoned.  Iu this
point of view, Sir William Pym has rendered a great service
to science and humanity, collecting, as he has done, facts
which show that in an epidemic of yellow  fever, the care of
the patients ought, as much as possible, to  be confided  to
those only who have had the disease at  some other period,
and that those who  have had the disease may remain with
safety in a city where it is prevailing epidemically, as did the
inhabitants of Gibraltar.   We should remark, also, that the
preservative influence of a first attack of yellow fever is not
destroyed after a considerable lapse of time ;  twenty-four
years, for example, since the inhabitants of Gibraltar, who had
had the yellow fever in 1804, were preserved from it in 1828
as effectually as those who had been attacked by it  in 1815."
  We see that it was equally the case here in our  own city
of Houston ;  those who had the disease in 1839, also in 1844
and 1848, and again in 1853, were all equally well protected
from this our last epidemic of  1867 ; so were  others  who
had had the disease  in other cities and then removed to this.
  The following was the  result of treatment by the Homeo-
pathic  method in my hands. From  the first of September to
the last of October, one hundred and  twenty cases were
treated, viz:
       Adult males,       -       -        -       45
         "    females,         -       -       -   39
       Children, under 15 years,   -       -       36
           Total,      -     -     .           120 
34
  Fifteen of the above number were of African descent, the
greater part of whom  had a  large infusion of white blood
in their veins.
  The mortality was 2 adult males, 3 females, and 2 children.
Of the above number, two or three were in a hopeless con
dition when put under treatment.
1 
PART   in
    SOME  GENERAL  CONSIDERATIONS
                         WITH
Regard to the Treatment  of  Yellow Fevei
  No disease, which has obtained froa> its great fatality so
much nctoriety, and called forth in ve -Ligations and researches
so extensive, has ever remained in srsch obscurity, in a thera-
peutical point of view, as this.  Except the facts furnished
by autopsy to guide us in its treatment, its therapeutics ia a
perfect blank ; and even these seen-,  to carry bewilderment
and confusion into every plan of rr/-, lication that human  in-
genuity can  devise.   Such are the  diversities of lesion  by
which life is destroy ed, that to frame a plan of treatment to
meet these in the living subject, would appear to be simply
an impossibility.  Nor is any portion of its history in a much
more satisfactory condition than its, therapeutics.   Whether
its origin is continental, insular, or  indigenous to some limi-
ted locality, is involved in tbe obs 'srity of conjecture.   On
the page of scientific history, yello :* fever stands an unsolved
mystery, without the clue of an Arkdne to guide us throogh
its mazesof incertitude, thus presentk-g itself asthe opprobrium
of the medical profession, and a reproach to it as a practical
art.  It may be likened to the Delphic Sibyl in her dark de-
lubium, giving forth her mythical utterances in such obscure
allusions as to delude the very hope they have  inspired in
those  who have frequented  her lane.  Or  again,  it may
be likened to a sorceress, who stands in defence of her secret
arcana, with the curse of reprobation upon her lips against
those who would introduce light, for the  purpose of  driving- 
2
off the dark shadows of ignorance, stultified prejudice, and
pragmatical self-sufficiency.  A spell of madness seem3 to bt
inflicted upon  all who come within her magic  circle, and
among these, nothing is heard but  incoherent objurgations,
reproaches and recriminations ;  nor do these cease around
her, among sanitary boards in  cities, until she is fairly seated
in her curriculum, whip and reins in hand, ready to run her
destined course.
   The foregoing succinct statement of the  present status of
our knowledge of yellow fever, has  been  made with th«
view of shewing the difficulty of offering any  treatment of the
disease, of any value, derived  either from studying author-
ities, or from personal observation, except entirely of a neg-
ative character.   We shall, therefore, as our  caption  indi-
cates, confine ourselves  to general considerations in  relation
to treatment, hoping  by suggestions to lead  to the adoption
of means more efficient and rational than anv now found in
use, in the pell-mell prescriptions of  daily practice.
   In  order to place yellow fever in its proper category, in
relation to its therapeutical amenabilities, I must fa vail my-
self of  that  trite classification of  diseases which  divides
them into two orders, viz:  The Curable and the Incurable.
   The first, fortunately, comprises a majority of the  diseases
to which humanity is liable, and requires no further notice
from us here.
   The second—the incurable—divide  themselves into two
kinds :  1st, Those whose tendency to the dissolution of the
patient is inevitable, such as Phthisis Pulmonalis, Carcinoma,
<fcc.;  2nd,  Those diseases that run their course in despite of
remedial interpositions, and are therefore  not amenable to
therapeutical agents ; but having a natural tendency  to spon-
taneous cure,  many patients recover from  them.   Of thT«
kind is typhus fever, small pox, measles, yellow fever, <fec.
   It is probable this is the 'first time that yellow fever ever
had a place in the list of  incurable diseases; nevertheless,
it is now in the category to which it belongs, as  well by  ita
affinities as by its  characteristic phenomena ;  1st, By  its
affinities, it belongs to  the zymotic or typhus family of  di-
seases, which are  known to run their course irrespective of 
3
all attempts at medication ; 2nd, Its  characteristic phenom-
ena :  1st, These are, that all attempts at aborting the disease
—that is, of cutting the fever short, and establishing its ces-
sation as the starting point of convalescence—have proved
not only fruitless, but the most disastrous of the many plans
of treatment that have been devised.   A second  character-
istic of its phenomena  is, that no case ever  was reported in
the annals of medicine in which its four stages were not well
marked, viz:  Its cold stage, its synochal, and its stages of
collapse and reaction.  These  four invariable stages stand
as four immovable  comer  stones, to  attest everywhere the
fixedness of its boundaries, in despite of all attempts by vio-
lence to contract the one or move the other.   A third  char-
acteristic of its phenomena, is that no patient was ever so
successfully cured  as  to deprive  him of  the  benefit of
future immunity from a recurrenceof the disease. Hence, that
it has not been regarded as incurable, is one of the chief causes
of its great mortality.   No physician who does not understand
the fixed routine of morbid action in a specific disease, shonld
ever presume to give a  dose of medicine in its  treatment;
and if this be true, or nearly true, with regard to all diseases,
it applies with  ten-fold force to the fever under  considera-
tion.  That it has not been regarded, I repeat, as incurable,
is one of the great causes of its fatality.  If persons, wheth-
er in  or out of the  profession, could  appreciate the delicate
sensitiveness of this fever to the slightest rudeness of medi-
cation, they would instantly accord the full force of truth to
the preceding remark.   Without the knowledge of these two
facts, viz: that it can not be  cured, and that the slightest
mismanagement in the case, or blundering in medication, will
prove fatal, a physician is called to a case, and of course he
thinks it  his business to cure it; and this can only be done
by  the force  of his remedies.  Well,  the  result of such a
physician's, and every other's effort to cure  the disease, is to
add to the mortuary list of the sexton another and another
victim,  until even human vanity, arrogance  and ignorance is
turned into the loathsomeness of disgust—the slaughter ceases
from  satiety, or contrite conviction of blunders,  that moral
turpitude itself would shudder to  repeat.   Let me repeat, 
4
once for all, that it will  never be cured until all attempts to
cure it are put down as impracticable absurdities—then, per-
haps, a mode of treatment will or may be adopted that will
lead to a certain and favorable issue.  To this  point we will
come in due process of time, that is, after we have sufficient-
ly demonstrated its incurability.
   Let any one take up a systematic treaties upon the fever
under consideration, and look at  the list of violent remedios
with which it has been encountered, and he will find that all
that part of our materia medica which had been at any time
tried for its cure, is now  laved aside ; and the world of med-
ical science, as it now stands—not misrepresented by empyre-
cism or conventional modes of  treatment—is without even a
classification of existing remedies for its medication.   What
have our numerous tyroes scattered  throughout the South—
at least tyroes in the treatment of this disease—to say to this
galling  fact?   Are  they prepared  with any  counter-state-
ment of fact  to show why  they dared to improvise a treat-
ment, every article of which any use was made was condemned
as useless or  mischievous ?  If they have, let  them show it
in justification of their  extemporising remedies, at  the ex-
pense of human life, for a disease  that our ablest writers have
abandoned as hopelessly irremediable.  But just at the point
when the systematic writers failed, the professional sciolists,
the Creole or nurses'  practice, made  its appearance, and by
a judicious exchange of scientific  suggestions, for the emper-
icism of old  women's ptisans and  sweating processes, they
have managed  to keep themselves  in countenance, practice
and bread.
   No doubt this practice, at the time of its general adoption,
was very successful, as compared with the harsher remedial
treatment which  preceded  it.  It may readily  be imagined
that any course of treatment, which apparently  preserved the
lives of a few  patients in this terrible scourge,  would be re-
garded with great favor ;  a scourge in which  all were sup-
posed to be mortally afflicted as soon as attacked.  Thus Dr.
Rush's ten and  ten of calomel and jallap took precedence, for
the time being, of every  other remedy or remedies that had
been used heretofore by himself or others.   Throughout the 
5
whole of the western archipelago, bloodletting, calomel and
Other herculian remedies had their day ;  but the results ob-
tained by them, falling Bhort of expectation, owing to the
ever changing phases of the different epidemics, soon brought
them into disuse.   Thus, as soon as a given remedy or course
of treatment ceased to restore as many cases as it had done
in former epidemics, it was supplanted by some new favorite,
which was soon to experience the same fluctuating fortunes.
This unsettled practice is easily explained when we take into
consideration the wide range of symptoms and   the  great
variety of leisons revealed by autopsy, which clearly indicate
the difficulty, nay the  impossibility, of framing any  code of
practice which can  meet the requirements  of this form  of
fever.  In this incertitude as to treatment, either the French
Or Spanish practitioners hit upon what i3 now known as the
Creole,  or more  familiarly,  as the nurses' practice.  This
was a great triumph over the vacillations of  the herculean,
Or perturbing practice, as it  at once give to the world  a sys-
tem of treatment ; and being adopted on  the most northern
border of the great western  archipelago,  it soon  spread  to
all the cities situate around  the Gulf of Mexico.   Its  being
applicable, at that time, to the modified forms of fever which
prevailed in the localities above indicated, gave it unprece-
dented success, and caused  its  adoption to  be regarded  as
the sine qua non in  the recovery of every case—that got tvell.
But now that an enlarged intercourse with the inter-tropical
world has furnished us with epidemics of a much more malig-
nant character than those to which this  treatment was ap-
plicable—epidemics which  have  not  been filtered  slowly
through climates  intermediate  between the point of local
origin and the  south-western shores of the Gulf, by  which
they had been deterged of much of their fatal qualities__it
behooves the profession to reconsider its pretensions, and see
how far it is reliable in the  emergencies  of present circum-
stances.   Indeed, if we regard its modus operandi as afford-
ing the  means of  conducting a  case to.a safe issue, we must
say, never were means  worse adapted to an end—hence the
inference of its success, under any circumstance, has always
been coupled, in my mind, with the fact that remedial pro 
6
 cesses were dispensed with, which gave  nature  a chance to
 throw off the disease, the quietude which was enforced upon
 the patient greatly assisting in producing the result.
   Having  heretofore shown  that all curative means—viz :
 means intended to arrest the course of  the fever—were in-
 applicable  to its treatment, it now becomes necessary to ex-
 plain, that it is not proposed  to abandon the case to nature,
 and expect a cure, but,  on  the contrary, to assist her as far
 as we can in conducting it to a safe issue.  All our remedies
 and means,  (hen,  must  range themselves under  the head of
 adjuvants ; and since we cannot cure yellow fever, let us at
 at least nelp nature, if we can,  to cure it for us. At this point
 it becomes necessary for us to examine the Creole or nurse's
 practice, to see how far it conforms to the above suggested
 adjuvant treatment.   As preliminary to this examination, the
 reader will demand, very justly, to  be informed in what the
 Creole treatment consists.
   To give a full description of the whole affair, would carry
 us a little too far into details ; suffice it to say, that it con-
 sists of a  big, fat old  negress, a  little  mulattoish, and if
 Frenchified, so much  the better, with an awfully important
 air ; next, a very tight room, with a bed in it rendered mon-
 strous by  the  number  of blankets heaped upon it, under
 which lies a poor human being, sweltering in  perspiration,
 extorted from him by constant  appliances of hot bottles of
 water, foot mustard baths,  and orange leaf tea.   In this con-
 dition, this poor  wretch is  held down, if necessary, or  the
 cover is forcibly kept over him ; nor is a breath of air allow-
 ed to visit his burning  temples or his flushed cheeks, until
 the fever spontaneously subsides.  Whether a drop of water
 is allowed to touch the parched tongue of this  modern Dives,
 depends upon the caprice of madam nurse, or it may be of a
 knight of  the pill  box, who, by the way, is a supernumerary
 character in the affair,  seeing that the  aforesaid authorita-
 tive nurse can execute the process without his aid.   In fact,
 as it was originally devised, it was intended, no doubt, to dis-
 pense with the intermeddlings  of doctors and  their drugs,
 thus rendering these  additions  to the treatment an incum-
berance and  a  disfranchisement of its privileges.  But the
         c8 
7
title of doctor seems to confer ubiquity upon  its possessor,
and by some talesmanic  art, is the open-sesame to all sick
chambers ;  therefore, we will be compelled, per force, to re-
cognize him as part and parcel of the paraphernalia of this
extemporized sweat shop ; and as such, he is entitled to his
inevitable bottle of caster oil, and other  insignia of profes-
sional out-fit, for a vigorous rencounter with the enemy.  As
the doctor seems to be a  little at leisure, we will approach
him,  and get him to explain his  views upon  the treatment.
(The interlocutors are the writer, reader,  and the doctor, re-
spectively represented by the abreviations  of W., Doct.,
and R.)
  W. "Well, doctor,give us some account of your treatment.
Where did you learn it, and  what is its object ?"
  Doct. '■Well, sir, I have been a long time in the South, and
found it in full vogue  when I entered the yellow fever re-
gion  ; and having never seen, or indeed heard, of  any other
plan of treatment, I adopted this from convenience, and find-
ing that 1 did as well with it as others, I have been content
t.» confine myself to it.   As to its  object, I suppose it is to
cure  the fever."
  W. "What is  the character of this fever with regard  to
heat of surface ?"
  Doct. "I must say no fever I ever examined is near so hot
as this."
  W. "Do you not think your means of sweating your patient
adds to that heat?"
  Doct. "I do not; because  1 do not know how much hotter
he might have been had I not sweated hiin ;  so you see I can
imagine how much cooler he  is than he would have been
without it, and thus give the treatment and me all  the credit
for breaking the fever."
  W.  "Would  not the fever have broken spontaneously, at
the proper time, without your assistance ?"
  Doct. "I reckon not, stranger, as I have never seen a case
just slough  off the fever,  and get well so, until the pores of
the hide were kept open long enough to draw off the fever."
  W. "Then when you have thus drawn it off, I suppose your
case gets well immediately ?" 
8
   Doct.  "In easy epidemics they do, but in hard ones like '53,
'54, or this of '67, I tell  you, stranger, after the fever was
killed, it took all the rubbing with mustard  and  brandy and
pouring down of the last, to keep  life in any of them, and
even then more than half of them died."
   W. -"Still you think this is the right method of  treating the
disease ?"
   Doct.  'Certainly  I do, and shall continue to  do  so  until
some one can invent  a better one ; and even (hen  I would not
swap it off, until everybody had tried it, and proved the new
to be a better method than  the old."
   W. "Upon what great therapeutical principle  do  you sus-
tain it ?"
   Doct.  "Upon the principle that with the  perspiration the
fever is drawn off, just  as you draw off whisky  from a bar-
rel by inserting a faucet  in it."
   W. "Does not  all this fluid come from the blood?"
   Doct.  "Well, I reckon  it does."
   W. "Then, if it comes from the blood, does it not constitute
one of the elements of the blood ?"
   Doct.  "I think so."
   W. "If you draw off all the serum, how are the liver, kid-
neys, and all  other  secreting organs to be supplied  with
material  to keep up their functions ?"
   Doct.  "Well, stranger, this is rather the business of those
organs than mine ; and when I  apply my remedies and they
cant't stand them, I say, decidedly, let them look to their own
duties, and I'll do the same."
   W. "I perceive to my regret that until a new set of practi-
tioners is introduced, more intelligent and  more amenable
to the  dictates  of common sense, there is little  prospect of
improvement in the therapeutical management of  this disease.
Here ignorance and  prejudice have planted themselves too
firmly upon their own errors, ever to permit reform to visit
them in  their  enchanted  fastness  of self-conceit and  self-
sufficiency."
   Doct.  "Well, stranger, I think you  are about right in your
reflections.  Now, if they all had the schooling in this fever
that I have had—thirty years in  the South, and five years in 
9
a hospital—then there might be some hope of their knowing
something about it."
  R.  "It seems you may still have something valuable to com-
municate, seeing your residence of five years in the hospital
must have added much to your information ; therefore please
continue your instruction.   How many did you nurse during
your abode in the hospital ?"
  Doct.  "In '53 and '54 I nursed more than  a hundred  cases,
nearly every one of whom seemed to die for my special ben-
efit, for as I was studying to be a yellow fever doctor,  I was
allowed to see  them  all opened ; so you see I  had the best
chance in the world to look at the very  inside of yellow
fever."
  R.  "Will you be so kind as to tell us what you saw ?  But
first tell us how your patients were treated."
  Doct.  "They were all treated on the plan of the Creole
practice, and were carried to  the dead-house just in a condi-
tion to look at the mischief done; for they  were all carried
from the sweat-room, hot enough to keep every part in good
order.  I have seen the liver as dry and as brittle as a hoe-
cake ; then again yellow and so full of blood that it would
burst  in handling.  Then as to the kidneys, I have seen them
shriveled away until they were not much larger than a couple
of butter-beans.  The  stomach on  the inside had no lining
on it,  the black vomit having got behind it and pushed it all
off, just as a blister does the cuticle ; and then it was in sepa-
rate bladders, and every time the patient vomited he bursted
one, and  out would come the black stuff."
  W. "That will do, my friend ; your information is so im-
portant and so  pregnant  with  practical facts, that I shall
offer it to the world, that it may profit by it; and as for your-
self, I shall present you to its kind regards, as  a fit repre-
sentative of the Creole practice wherever adopted."
  We have wasted, perhaps, more time upon  this miserable
apology for the treatment of the disease under consideration
than  it in itself deserves ; but  the mischief  which  it  has
done, and may  do, owing  to the tenacity  with which it is
held on to, both by those in as well as out of the profession,
has conferred upon it a factitious importance that will excuse 
10
any amount of labor that may be  bestowed upon it, with a
view to counteract its baleful influence upon the public health
and safety.  Upon what ground it holds even a place among
the plans of treatment now  in use, is difficult to conjecture;
but that it should be  the chief means of combating the di-
sease under consideration, by the only true and exclusive vota-
ries of scientific medicine, is an  anomaly still more perplex-
ing than any other problem  connected  with the subject.   If
it had  even the prestige of empirical success to recommend
it, that success  would  be  sufficient to  enforce  the scientific
world  to hold its peace, and let it still guide the  issues of
life and death; but without this, in the present crisis of malig-
nant epidemics, at which the cycles of  the disease have now
culminated, that a treatment which would almost disgrace the
humblest form of Thompsonian medicine, should constitute
the main resource in the South to  combat the disease by the
most numerous class—and theone, too, which claims superiority
in power, science and art, over all the pathies of the day—is
most wonderful.  If it fs a failure then as an empirical  treat-
ment, and  has neither  the sanction of a scientific deduction in
its favor, nor the authority of a single name derived from books,
worth  quoting, to sanction it, upon what ground is it still kept
among us, to add poignancy, if not death to our mortal scourges?
The world has a right to ask of that numerous branch of the
professson, to show cause why it is retained and relied  upon,
under  existing circumstances ; and if so retained and relied
upon, then to defend it upon some known grounds of rational
hypothesis or scientific deduction.  The sufferings of human-
ity are too manifold from the abuse  of  professional confi-
dence,  in this case,  to permit a combination  of wiseacres
either  openly or covertly to set at naught this demand in the
premises.   Let the public be warned against the imposture
of the  treatment under consideration, for it is nothing less ;
nor is it competent to escape the condemnation of the practice
that drug remedies  have been conjoined with  it,  for  these
only increased its mortality.  What would a patient or his
friends say to a doctor who  should propose to  draw twelve
pounds of  blood from  him daily, as long as the fever lasted ?
Would they not indignantly tell him  to hunt some  other 
11
patient to try his experiments upon ? yet his proposition is
not so irrational as the practice which  takes at least that
much perspiration from him, because the former leaves tbe
blood in an integral condition as to its  elements;  whereas,
the other mode of depletion carries off  one of its main in-
gredients—the serum—and thereby unfits it for circulation
and secretion.  But  let us waive this advantage of blood-
letting over sweating as a depleting process, and say, once
for all, let no one deplete a yellow fever  patient by any pro-
cess whatever, and expect  that he has not thereby greatly
diminished his chances  of recovery.   This adherence to this
practice, is greatly to be regretted by all who feel  an inter-
est in Allopathy—that adherence being  principally confined
to its advocates and votaries—thus bringing into its congre-
gation an  empirical heresy with which  its  scientific creeds
have been contaminated and corrupted.  It can now have no
sanctuary  freed from  the  lowest intrusions of empiricism,
since they have recognized the Thompsonian  principle  in
practice in the most important diseases we are called upon to
treat.  Furthermore, in this adherence, they have abandoned
the richest field of glory that ever awaited her triumphs in
science.  Now, a  rival  has entered that field iu triumph, and
will soon master it, while Allopathy will be driven in shame
from it, or be dragged at the  car  of Homeopathy  in dis-
grace.  There is no  exaggeration in this.   The world of re-
nown can  only be reached by toil, vigilance, and well direct-
ed effort.   Let Allopathy  assert its dignity, put  forth  its
powers in the right direction, and not begin to fold its arms
at a  first difficulty or two, or to allow old women or empir-
ics to direct  her steps  in  her march to  the  goal  of proud
achievement; if she does, she will fall by the wayside.  In
her present humbled condition, I know not how she  can  re-
fuse  to fraternize with any  low charlatanism  that  comes
along ; she may  next  be  expected to clip quack advertise-
ments from the  newspapers, with the view of giving these
mixtures  a place in  some  future edition  of new remedies.
Nothing can be more humiliating than to see our old Alma
Mater  brought so low as to render,  instead  of receiving
at her shrine, homage of all the pathies. 
12
   We will now lake leave of the Creole practice ;  but before
we do so, must bequeath it our parting blessing, which is,
that it may very soon find a resting place in the tomb of all
the Capulets.
   It still remains  for us to  explain the  adjuvant practice,
mention  of which  has  been heretofore made, in connection
with  the statement, that  all remedies  which do  not come
under this head, are inapplicable to the treatment of yellow
fever.  These are very mild means to keep down  the fever,
such as ice or ice water to the head and face, gentle diapho-
retics for keeping the skin moist, enema of cold water for the
bowels ;  and if anything is given with the view of control-
ling the action of the heart  and  arteries, it should be the bi-
sulphite of soda, 20 grs. dissolved in  8 ounces of water, to
which is  added sulphurous acid enough to acidulate the  mix-
ture, which is given every two hours.   When the fever  sub-
sides, adjuvants now take the form of gentle stimuli, moder-
ately administered  as to time and quantity   But I will not
detain the reader any further, but will refer him directly to
the excellent article upon the treatment of the disease by our
co laborer in this little treaties.
THE NON-LOCAL  ORIGIN OF  YELLOW FEVER
        UPON THE WESTERN  CONTINENT.
  This declaration will no doubt startle many, if not all my
readers, and is so contrary to all the teachings of the numer-
ous faculty of the South, that  I fear that I  will hardly be
able to get a candid hearing in the  premises from those who
ought to feel so deep an interest in the subject.   Be this as
it may, the views I entertain are so important, not only in
themselves, but also in their bearings on other collateral
questions of great moment, that I shall devote as much time
and space to their consideration as  the nature of my under-
taking will permit.  This importance will be readily appre-
ciated, when the reader is informed that the question of quar-
antine, as an efficient means of protection against  the ravages
of this terrible scourge of the South, is  involved in its issues. 
13
 I am fully  aware of the darkening  hosts of prejudice, con-
 ceited  egotism and  ptupid dogmatism which will spring from
 their lairs, and turn loose their fury upon any one who ven-
 tures to mention  this ominous term in connection with the
 sanitary measures for the protection of our cities along  our
 seaboard.  This formidable array of opposition  to the view
 announced in the caption of this article, precluding all hope
 of making converts to it, we will nevertheless present it, with
 the sole  object of calling  attention to it, as an  elementary
 fact, which may lead to its examination, whereby its  truths
 may be not only  established, but all the  sequences flowing
 from it become the fixed record of its history.
  The   great  point is the  autocthonic  origin  of yellow-
 fever.  It  is now  a  well  established fact,  that all  the
 periodic recurring epidemics, which now and  then have for
 centuries devastated the world, had such an origin.  It will
not be gainsayd by the most fastidious, that yellow  fever comes
within  the category of a periodically recurring epidemic, and
to this  extent acknowledges its affinity  to these great families
of disease.  A close affinity observed in any instance of a
uniform character, between the leading phenomena of two
distinct objects, is apt to conduct to the inference that other
analogies exist;  and the question is immediately propounded
by the  investigating mind,  "Why may  not yellow fever have
 the same kind of origin as that which  has been  assigned to
the other epidemics of  the  same genera ?"  To establish this
fact, in reference to yellow fever, we shall present some con-
siderations to the  reader, which,  we  think, will go  far  to-
 wards a  conviction  of his mind of its truth.  The point of
 origin of Asiatic  cholera is too well known to require any
 thing more than reference  to it, and this we do for the pur-
 pose of the analogy existing in the spread of the two diseases.
 Asiatic cholera takes up its march along the lines of human
 intercourse, and intimately connects itself with this, as to its
 tardiness or rapidity of spread.   This fact would seem clear-
ly to indicate its power of  self-propagation in all the locali-
 ties in  which it establishes itself, as a temporary  inhabitant.
Whence does it derive  this power ?  Clearly not from con-
tagion.   It must then possess it from some contingent condi- 
14
 tion of local causes, wherein  it makes its lodgment.   What,
 then, is the relation of this local  condition to the virus, thus
 furnished by the disease?  To answer this  question, we must
 admit that  there is either a chemical relation, by which the
 virus converts the local element into a poison identical  with
 itself, upon the principle of fermentation  ; or, that it  puts
 forth a something  to  which this  local  element administers
 sustenance.   Now, as the fermentative hypothesis  is, for
 very obvious reasons, untenable—one of which is, that strong
 currents of air would constantly  free any  locality from any
 such epidemical cause, owing to  the gaseous nature of the
 supposed compound—we must, therefore, adopt the  latter,
 and maintain the  doctrine of local  sustentation.  But this
 sustentation cannot be afforded to a virus or fomitisas inan-
 imate entities, unless upon the principle of chemical assimi-
 lation,  which, as above  stated,  is  inadmissible.  We are,
 therefore, forced upon the recognition of the principle  of
 its animal origin.   There are no  other grounds upon which
 its spread  and local habitat  can  be explained. Upon this
 hypothesis,  its  phenomena,  in this respect, are of easy  solu-
 tion.  A patient, for instance, is carried into any locality  in
 which the animalculas, discharged from his  body, are furnish-
 ed with a suitable  pabulum, in sufficient quantities, and in-
 stantly  reproduction commences, and  rapid generation
 spreads them in every direction, so that in  a short time they
 have poisoned a large city.
   This process, no  doubt, is greatly hastened, as the number
 of persons attacked increases, each affording an additional
 focus for their reproduction.  These, being infinitesimal or
 metascopic, can easily penetrate the human skin through its
 pores, and,  guided  by the laws  of instinct, we can readily
 imagine they select man's blood, as affording the  nidus in
 which the species are  propagated ; just  as a certain  fly de-
 posits its egg  upon the  hair  of the  horse, that it may per-
 chance reach his stomach, and thereby reproduce its species.
 The animalculas theory, applied to yellow  fever, renders all
 its phenomena of prevalence, distribution, and mode of  pro-
Vocation, equally amenable to a rational solution.  If it were
 possible for us  to follow  its line of march,  as easily as that
 y        c9 
15
of cholera, no doubt we would find it having a specific local-
ity for its origin, just as that great migratory epidemic has.
But two difficulties present themselves in our search for its
locality of origin ;' 1st, The Asiatic cholera does not confer
immunity upon those who have had it—hence it holds  to its
point of origin, and exhibits  itself annually as the endemic
of that particular locality, whilst it prevails at none other,
unless when it assumes the  malignant form of  an epidemic,
when its inarch becomes too well  marked not to  attract at-
tention ; 2nd, Yellow fever, on the  contrary, by  conferring
immunity on those who have had it, refuses to reveal its point
of origin, by this means—except by  the importation of fresh
subjects to the given point suspected,  and kept up  for a series
of years, and always uniformly producing the disease; without
such importations, we have  no mode of definitely identifying
it.   .As this will never occur, in all probability, we shall for-
ever remain in ignorance of  the fact sought to be established.
Another difficulty in our way in search for its local origin
is, that it takes up its habitat in many  localities in the trop-
ics, which become the focus  of the disease, from which it may
be distributed  annually for years to  other places, thus as-
suming the  semblance of the home of its origin.   But ob-
servers, everywhere distributed on the islands of the western*
archipelago, accuse every other place, except the one on which
they are established, as being the unfortunate locality of its
origin.   If introduced  into any one  of them, it is likely to
remain  there for several years, as the  amount of  cold in the
climate does not exterminate it, as it does with  us.  Thus,
great confusion, upon this  point, prevails throughout that
wide range of its  almost  ceaseless  migrations.  But one
prominent fact  remains to be noticed, which will  ever  stand
as  a clear index  as  to  the  direction  from   which  the
fever comes, and  indicate the country of  its origin, and this
is, that  the most  malignant form of the  disease  claims the
western coast  of Africa as its point of origin ; and  the
nearer our epidemics are derived from this coast, the more
  *This word is applied in an analogical, and not in its literal sense—a western
and eastern archipelago both being applied to islands instead of the seas in which
they are situate. 
16
malignant they appear to be.  Witness the epidemic  of '93
in Philadelphia,  which, in despite of Dr. Rush's rotten cof-
fee, no doubt, according to Dr. Pym, was carried to that city
almost directly from that coast, or  at  second hand at least.
Witness, also, the epidemic on our Southern  border in 1853,
which was imported directly  from  Rio ; and to that place
from  Africa.  The  most sensible opinion I have ever heard
from  Dr.  S., of  New  Orleans, was  that that epidemic  was
the true African type of the fever,  and truly it was so ; and
the same may be said of that which prevailed this year, both
being distinguished by the petechial eruption, which charac-
terize the fevers having this origin and malignancy.
   But, as  heretofore remarked, the point to be established as
indigenous, is so much obscured by its migrations among the
islands of the West Indies—many of which get  the credit  of
its local origin—that a  sweeping  credulity prevails on  this
subject, which not only embraces all these iu that category,
but with a facile deduction, which disdains investigation, in-
cludes within the range  all our cities  along our  Southern
seaboard ; hence many physicians, even among those deemed
most  intelligent, put in the claims  respectively of New Or-
leans, Mobile, Charleston and Galveston to  this distinction.
Yet this is done in  the face  of the fact that  they all pass
years of exemption with a climatology not variant from that
of the epidemic  years,  so far at  least as observation can
establish  their respective uniformity.   Furthermore, in the
face of another historical fact of much more significance,  as
regards the  erroneous character  of these conclusions, viz:
that  a  period  of  thirty years*  occurred,  between  17b'3,
of the last century, and  1793, during which not  a single case
of yellow  fever, either of domestic or exotic  origin, took
place on the western continent.   Is it  possible that such an
interregnum could have taken place in  any  indigenous pro-
duction, whether animal, vegetable or  zymotic in its charac-
ter ?  Such  a fact is conclusive  against  any  such  a  sup-
position.
  *At one period, says Dr. Stevens, of St. Croix, there was an  interval of thirty
     duiiug which there was not even one case of yellow fever in the western
ye 1(|'.  anci  almost in every instance,  where it first continences, when propel
W° uirV is made to ascertain its causes, its origin can be traced to traffic with oer"
tain countries on the western coast of Africa. 
17
   But again. Although a sweeping deduction may place these
respective cities in the same category in  this  respect, yet 1
so happened that in Galveston,in every epidemic since 1839,
inclusive, has been coincident with the introduction of the
fever from abroad ;  and if any exceptions exist, they can be
easily shown to be mere revivals from the preceding year—
the amount of cold of the intervening winter not being suffi-
cient to exterminate the dormant germs of the disease,  rhus
were kept alive the great epidemics of '53, '54  and '55, the
remarkably severe winters of  '55-6 arresting the revival of
the fever, and  putting an end to its career ;  and unless the
present winter shall be of sufficient intensity to render us  a
similar grace, we may confidently  expect  the revival of our
late epidemic the  ensuing summer,  with all its characteristic
symptoms of malignancy, viz : its great mortality and rapid
spread along the lines of human intercourse.  If such should
be the fact, those  who contend for its  local  origin here  and
elsewhere, along  our  extended seaboard, will claim it as a
confirmation of their favorite hypothesis ; and instead of at-
tributing  it to the cause just stated, will make it  the basis
of  another  tirade against the inutility   and  barbarism of
quarantine.  In this revival  of our epidemics, and  the non-
observance of the cause of that  revival,  lies the principal
difficulty in discriminating between its local  and  exotic or-
igin.  The cotton worm, which devastates our fields, affords
an apt exemplification, in this respect, of the resuscitation of
our epidemics, when the freezes of our winters are  not  suffi-
ciently severe to destroy the one or the other ; "and so strong
is the analogy between  them, as  to local origin, that there
are quite as many planters who attribute  the annual recur-
rence of these pestiferous insects to climacterical coinciden-
ces, as there are doctors who contend that yellow fever springs
from  the same causes.   Yet, destroy the one or the other,
in their germinal  state, and neither will re-appear until they
are wafted to our shores from foreign  lands—neither of them
being indigenous to our climate.   To argue against a propo-
sition so self-evident as  this, is to revive the exploded  doc-
trine of equivocal generation, or  to assume the existence  of
an  effect without a cause. 
18
   Our maritime cities become, then, the gates through which
 all our epidemics enter, and  unless  these are closed against
 their admittance, it is in vain that  we  can expect to be ex
 empt from their visitations.  That they should not shut them,
 offers a  curious problem to  the  casuist for solution, seeing
 the untold miseries which are inflicted upon their own citizens,
 as well as upon the inhabitants of the  towns and villages in
 the interior of our country.   But when we come to analyze
 this criminal  indifference to the  ravages of the  disease, we
 shall ascertain that its solution is to be found in  the predom-
 inant selfishness of  our nature.  If  we examine  the number
 of acclimated citizens in any one  of these cities, wre shall
 find that they greatly exceed those who  are  unacclimated.
 To the former belong, not only from numerical strength, but
 from longer citizenship,  the government of such  cities ;  and
 these systematically and  persistently endeavor to discourage
 and put down all  attempts at quarantine, owing to the em-
 barrassments which  it  may inflict upon commerce.  This
 spirit is manifested in the unequivocal manner in which they
 denounce every physician who dares pronounce a first case
 of fever, of a suspicious  character,, to be of the  type of yel-
 low fever.  Hence quarantine, is declared to bea barbarism,
 unworthy of  an enlightened age, and its advocates as  fit sub-
 jects for an asylum.  These  views are carried into city coun-
 cils, and their actions are framed in accordance with them ;
 and as their governments are in the hands of those who consti-
 tute, through their influence  and  power over  the business
 avocations of others, the overruling  party, they can carry
 out their narrow and  selfish purposes, in despite of all oppo-
 sition.  Thus, I repeat,  a large  majority of acclimated citi-
 zens, in each  of such  cities, are  found violently opposed  to
 quarantine ;  whilst the  unacclimated  have  to  remain the
 passive  victims of such  selfish policy,  without the power  of
 adopting any measures of self-protection, or of  escape from
, its dire ravages, except by flight when  the dread  destroyer
 enters their gates.
    The argument of those who represent the commercial in-
 terest  of such cities, seems to  be, that they  had to  pass
 through the ordeal, and  having  done so, they feel  under no 
19
moral obligation to endeavor, at any sacrifice  of their own
interest, or that of commerce, to shield others from under-
going the same hazard that they had incurred, in procuring
their immunity from the fever; that the  unacclimated had
come to these respective cities with  the view  of settling in
them ;  and, as a preliminary to their business pursuits, to pass
through the yellow fever was a  matter of first importance to
them, and the  sooner this ordeal was passed through the bet-
ter for them.  According to these views, to have the  fever
was part and parcel of the  contract of the unacclimated in
settling in the localities of its known invasions ;  and no one
was to blame for his having to  comply with its conditions.
The morale, as to  quarantine, being thus settled, its  avail
ability or non-availability, as a means of protection, becomes
a question of secondary importance, and can offer no imped-
iment to the adoption of such measures, in reference to it, as
the commercial interest may deem most advisable for itself.
This interest being dominant, all others must become subser-
vient and yield obedience to its behests.   Unfortunately for
the interest of medical science, its votaries must  yield to the
pressure of the overruling power, and either yield the hom-
age of obedience to the powers that be, or turn a deaf ear
to the  suggestions  of self-interest.   Few  men  in the profes-
sion have the moral courage to brave the epithets of old-
fogy, alarmists, &c, especially when applied by men in pow-
er, or by those in high social positions, and whose frown or
scorn can blast their professional prospects.  The city gov-
ernments, when they refer questions to the faculty, touching
the efficiency or the inefficiency of quarantine, know full well
that decision  before  it is rendered.  Physicians are  men,
and are as subject to the bias of self-interest as other people
are.   To ask them to decide a question, on one side of which
is their bread and butter, and  on the other just nothing at
all, is simply to forestall that decision.   The common pru-»
dence  of men, in  every department of human  affairs, has
long since taught them to  guard against our  natural pro-
clivities to selfishness.  Hence, men are not permitted  to
preside as judges  in our courts, or sit as jurors in any case
involving their own interest ; yet physicians are called, upon 
20
to decide upon questions in direct violation of a principle so
seduously  guarded  against  by society,  in  every instance
where its operation might prove prejudicial to the well-being
of its members.  Are communities so blind that they do not
perceive that doctors are almost exclusively the beneficiaries
of these incursive epidemics ;  and seeing it, yet  persist in
placing them in positions which render  their dictum poten-
tial in keeping open our ports, through which our epidemics
make their incursions ?   This could not be, unless there was
a secret sentiment in such communities opposed to the policy
of closing them.
  The confidence reposed in high-minded  and  honorable
members  of the profession,  can never be misplaced—men
who pursue science for  its own  sake, and who cannot be
turned aside from the pursuit  of  its dictates by  the pitiful
considerations of selfishness ;  but  it is to be feared that they
are too much in a minority to  avert  the  evils of which we
complain  ; at least, quarantines in our seaboard cities are at
a great discount, which could not  be the case unless a major-
ity cf the medical faculty were under  the influences above
alluded to.  It must be admitted, nevertheless, that there are
numbers of  high-minded physicians, who are  sincerely con-
vinced of the  local  origin of  the fever, who maintain that
opinion from the convictions of their own minds, and inde-
pendently of any  extraneous  considerations.   Begging sim-
ply to  differ from these in opinion, far be it from our pur-
pose to  implicate them in  any  selfish  scheme  of  policy,
in acting in  the premises in accordance with  their own
views.
  That the  writer has not  mis-stated  the ground upon which
is  founded  the  opposition to  quarantine in our maritime
cities, viz : the preponderance in point of numbers of accli-
mated persons found in  such  cities, he will cite, in favor of
his views, what happened in reference to this matter in our
rural towns and villages.   In these, nearly the whole popu-
lation being unacclimated,  quarantine, as a means of protec-
tion  found no  opposition, when all were equally interested
in keeping off the epidemic ;  and when it was adopted, and
efficiently maintained, their exemption from the fever amply 
21
repaid them for their persistency  in  maintaining it-—thus
setting an example worthy of being imitated by their broth-
ers of the seaboard.   If the interior towns can protect them-
solves from the fever by  cutting off all communication with
the infected seaboard  cities, why may not these protect them-
selves from it by the same means, when menaced by an at-
tack from abroad ?   But whether  they  do or apt, the  late
experience in Texas, in the efficiency of quarantine, has been
demonstrated in too  many instances in our own  towns, for
the lesson ever to be lost  in the future ; and hereafter, when
our seaboard cities, from negligence or indifference, are rav-
aged by  the epidemic, their unacclimated  citizens will be
compelled to abide their  fate at home,  instead  of being  per-
mitted  to destribute the disease by  taking  refuge  in  the
country.
  But I  would  by  no means do the  city governments the
injustice to say, that they were so indifferent to the approach
of yellow fever, as not to adopt sanitary regulations, at least
in reference to internal precautions.   On the contrary, noth-
ing can exceed the industry  and vigilance of health officers
in the removal of filth of  every description from the streets,
alleys, back premises, &c.   If the city  was about to undergo
a strict review, as to cleanliness, by  some authority compe-
tent to impose a heavy fine upon it  for the slightest devia-
tion from the strictest requirements of mundification, no more
pains could be  taken to  escape  such a fine.  In  truth,  one
would suppose, from the  industrial efforts and vigilance of
execution, that yellow fever was some distinguished guest, to
whom it would render honor, and whose delicate olfactories
might be  offended by the slightest reeking of stench,  and
whose smiles or frowns—potent for good or evil—were to be
won or  averted, accordingly as  they succeeded or failed in
this cleansing process. But, unfortunately, this distinguished
guest is not to be thus propitiated—bis  attention is not to
be diverted from his purpose, or balked in it, by any  such
paltry consideration as the condition of a city in  respect to
its cleanliness or want of it.   When he has once effected a
lodgment in a place, he has  accomplished all he asks of the
city authorities ; and immediately proceeds to his legitimate 
22
business of victimizing those who are strangers to him.  His
mission is blood, and blood he will have, in despite of all the
arts of  the therapeut, surrounded though he  be  by  all the
insignia of his cabalistic science—"A' kind of boxes,.mugs,
an  bottles"—but still he reigns, unchecked or  unintimidated,
until the  blood of the  last  victim  has smeared  his chops.
No, city fathers, the fight against this  monster must be oh
the outside and not on the  inside of your wall-!, if you ex-
pect to  repel his invasion.   Those  who expect to struggle
successfully against  him after he is master  of the citadel,
have lost  all  the advantages of defence, and yielded the vic-
tory without an effort worthy of the name.
  To confirm the views here presented, we quote  from Dr.
Copeland's Medical Dictionary, a standard  work of the very
highest authority, the following :
  "It cannot be denied by any one who has attended to the
subject  of quarantine, especially as it  has been agitated in
recent  times, and with a due  knowledge  of the  influence
which the ruling passion—the desire of amassing  wealth;—
exerts upon all the more generous and social emotions of the
mind, that the  restrictions imposed  upon trade, arising out
of  precautions against the introduction of pestilential infec-
tions, have been the chief  cause, directly  or indirectly, cf
producing opposition to the  doctrine of the  infectious pro-
perties  of pestilence ; and all  that  has been  written to dis-
prove the doctrine—and written with no small virulence by
some—has not  proceeded from a firm conviction of the jus-
tice of  the cause espoused, but are  either special pleadings,
subservient to sordid purposes  and  the  gratification of dis-
appointed feelings, or of private resentments,  or outpouring
of minds  teeming with mistaken views, arising out  of imper-
fect observations and hastily formed opinions, and excited
by  a desire of  acquiring notoriety iri a  contest involving the
interest of the whole community.
  "Dr.  Gordon, of St.  Croix, government  physician to the
Danish West India Islands, concludes  his remarks  on the
malignant pestilential fever prevalent  in these islands and
North America, near the close of the last century, by  stating
his belief in  the  importation  and  diffusion of infection, by
          clO 
23
 ignorance, perversity and selfishness, or by  the abstraction
 of the sentiment of public good, by  the  abuse of all  pre-
 ventative measures, in  the  promotion of the speculations of
 cupidity, and the calculations of venal men : by tue prostra-
 tion of truth  and  humanity, and  by  eluding  the laws of
 quarantine."
  After quoting many instances, and numerous authorities.
 illustrative  of the efficiency of quarantine in averting  the
 spread of the epidemic, he adds  the  following  comment,
 page 179:
  "In  whatever  light this fact  may  be viewed—exemp-
 tion procured in the midst of  the pestilence by  non-inter-
 course with the sick—it suggests  a  most requisite precau-
 tion ; and that such a precaution should have  been neglect-
 ed,  may be viewed as one of the «, vils arising out. of the doc-
 trine so assiduously inculcated by the heads of the medical
 staff on the outbreak of the pestilence.  The non-infection-
 ists argue that  the malady  is not propagated by eraina-
 tions  of  the sick, either  direct or by fomites, and hence no
 such precaution as the  one  now stated is requisite.   That it
 was most requisite—that the  neglect of  it  in this, and on
 numerous occasions in America,  the West Indies, Africa,
 and in Southern Europe, was  most calamitous, even  most
 murderous, is apparent to any reflecting mind.   Ten times as
 many lives have been sacrificed during  the last sixty years,
 by the abettors of a most erroneous doctrine—by following
 the  false glare of what has been ignorautly deemed the lights
 of science, instead of adopting the suggestions of common
 sense—than have been lost on the field of  battle."
  Dr. Currie, in his work on Bilious  Fever, states that a
 contagious fever, "called  the yellow fever," has occurred six
 times at Philadelphia since the first settlement, viz : in 1639,
 1741, 1747, 1762, 1793, and 1797.   Dr. Lend states that in
 in the year 1741, "the disease was introduced by means of a
 trunk of wearing apparel, which had belonged  to a gentle-
 man who died  of the disease  in  Barbadoes, and that the
 disease spread from the family who had received the trunk
 into the town, and  destroyed about  two hundred of the in-
habitants." 
24
   In an account of the prevalence of this pestilence in 1762,
communicated to the College of Physicians by Dr. Redman,
it is stated that the disease was introduced  about the end of
August, by a  mariner, who arrived from Havana  ill of it,
who took lodgings near the New Market, below  Pine street.
   Dr. Lining, of  Charleston, says, "The fever does not seem
to take its origin from any particular condition of the atmos-
phere, independent of  infectious miasmata ; for within twen-
ty-five years, it lias been only four times epidemical in  this
town, viz: in the years  1832, '39, '45, and '48, though none
of those years, except one, were either warmer or more rainy
than the  summers and  autumns  were in  several years in
which we had  not one  instance of any person being  seized
with this  fever."
   Having said as much as our space will allow upon the non-
local origin of the fever upon any portion of sea-coast—At-
lantic or Gulf—and upon its portability from place  to place,
either as fomites,  or in the  persons of  the infected, we  will
now direct our investigations to the West India Islands, in
order to establish our  declaration that its permanent local
habitat is not to be found on the western continent.
   Dr. Fosse makes no mention of its occurrence in St.  Do-
mingo between the yeers 1775 and '93, and Dr.  Gilpin,  who
resided many  years in  the  Island previous to '93,  confirms
this  statement.  Dr. Davidson states that in the more healthy
islands of St.  Kitts,  St. Vincent, and Barbadoes,  soldiers
have arrived from Europe, and  remained there for years in
the enjoyment-of good health, notwithstanding their debauche-
ries.   Dr. Weir,  director general of army hospitals,  states
that he arrived in  Jamaica  in  1785, from which time till
1782, only one officer died  out of four  regiments quartered
there, and that no fever of bad  type  occurred  during these
years, until 1793, when the pestilence appeared.  Dr. Theo-
dore  Gordon  served  in Barbadoes, Dominica and  Jamaica
during five years  preceding the occurrence of this malady in
1793, and considered  the health of  the .troops  remarkably
good, &c.   That this malady is not a constant resident in the
West Indies, (and therefore not  indigenous in  them) is fur-
ther shown by Dr. J.  Hunter, Dr. Franklin,  Dr. Gordon, 
25
and others who have found  troops  remain during several
years  perfectly  healthy.  Its outbreak  occurred  in these
islands, after many years of immunity from  it, in February,
1793, in Grenada, at a  time  when bilious  remittent fever
does not prevail.   It did not reach Dominica until the end
of July ;  Barbadoes was unaffected  until the beginning  of
1794. and  St. Domingo did not suffer until late  this year,
and then  in consequence of the introduction of the  conta-
gion by a detachment of troops from Gaudaloupe, where it
was  raging.   This  pestilence appeared  in  Philadelphia in
the month of July, 1793, and during the latter part of  that
year and 1794, it reached most of the West India Islands.
  Dr.  Dancer, of Jamaica, after a close  examination  of the
opinion emitted respecting the malignant pestilence of 1793
and  1796,  states most  decidedly, "that it  is an  imported
disease, and communicable by  contagion."   Dr.  Charlton,
president  of the Medical  Society  of N")w  York,  since the
year 1762, in that city, declared that he never saw a case of
yellow fever before 1T93, and that he always considered it
a disease of foreign origin."
  It is evident that if this fever only occurs in the West In-
dia Islands at long intervals, as shown  above, and  then in
consequence of its introduction  from  abroad, most  assuredly
it shows none of the laws of  an  indigenous origin, but is
clearly an exotic.  Now, if this be true  of all these islands
which lie within the range of latitudes propitious to its local
origin, and yet it is not produced, how much less likely  is it
to be indigenous to the coast of the United States, north of
the tropics, where the thermal  range  of annual tempera-
ture is greatly below that said to be necessary to its produc-
tion ?.  If it be indigenous to our  seaboard', and not  to the
islands within the tropics, then  has the world greatly erred
in considering it a disease of hot  instead of cold  climates.
Yet from  the facts adduced  from the records of  its history
to this absurd position the  advocates  of  its  local  origin
are driven ; nor can they escape from  it, except  by either
abandoning a  phantom hypothesis, or by overthrowing the
whole records of the disease, as it has been  developed  and
spread throughout these islands, as shown by numerous ob-
servers stationed upon them for more than a century. 
26
   As furnishing still  further evidence in favor of quaran-
 tine, we give place, by  permission, to the following letter,
 written by a distinguished physician, recently  of Philadel-
 phia, now  of this city, whose experience in the late epidemic
 was of too painful a character not to have awakened in him
 regrets most poignant, that his views in relation to this sub-
ject had not been acted upon here, and thus  have saved him
 from the sorrows of family bereavements :

                           Galveston, Dec. 27th,  1867.
 Dr. Richardson :

   Dear Sir—To your views, expressed  to  me in  a recent
 conversation upon the disease which  has, during the past
 summer, decimated this city, I  desire to add a few words.
 The paper you  propose  to publish, as  a monograph of yel-
 low fever,  will doubtless be an important acquisition to medi-
 cal science, and calculated to  enlighten the profession in
 reference to many ot its phenomena, so  rarely noticed by the
 most elaborate writers upon the subject.  I  have, for many
 years,  held my own theory of this pestilence.   Its visitations
 and virulence have been alike predicted and dreaded.
   When New Orleans was taken possession of by Maj. Gen.
 Butler, on the 1st of May, 1862, I then being the 'Senior
 Medical  Officer, acting upon  my  theory, addressed him an
 urgent letter, requesting  the establishment of a strict  quar-
 antine,  to  prevent the  possibility  of its admission  from
abroad.   In that letter it was stated that yellow fever was
 not a disease indigenous to the soil or  climate of Louisiana,
 and never  of home production ;  that in this  respect, it was
 like their  great staple, the sugar cane, which,  when intro-
 duced  into the  State, would both  grow  and find  soil and
 climate suited to its  most productive  and prolific results ;
 but that it was not native, or indigenous, nor generated either
 by latitude, climate or locality,  and was never to be found,
except  as  the direct  result of importation.  Upon  these
 views Gen. Butler acted, and guarded, even at the cannon's
 mouth, every avenue  to the city, being firmly convinced of
 their truth.  Acting,  as he did, upon  the true  theory—its
 portability and contagiousness—his measures were promptly
 taken, and his orders being strictly obeyed, he excluded from
 the city every case, for the whole season, and thus preserved
 the health  of twenty  thousand  unacclimated  persons.  The
epidemic of the present year  in Galveston,  I have passed
 through ;  was the quarantine  physician of the city, and, al- 
27
 though it was not in my  power to prevent its appearance,
 or restrain its course, I am by this experience the more con-
 vinced of the truth of my  original theory.
   When the quarantine  was inaugurated  in Galveston, on
 the first day of June, 1867, by  Mayor Haviland, to whom
 this duty was committed by Gen. Griffin, the city was entire-
 ly healthy.   The first  case of yellow fever appeared at In
 dianola in that month, and I had an interview at the earliest
 moment with the Mayor, for the purpose of having all ves-
 sels quarantined, and the  trains from  the interior placed
 under the same regulations. This was refused, ou the ground
 alleged by the Mayor, that it was not yellow fever atlndian-
 ola ; that Texas ports  were, under his proclamation, exempt
 from quarantine, and that no disease could be  brought into
 Galveston from another of our ports.  I then went to Gen.
 Griffin with a protest—I declared to him  that  yellow  fever
 was at Indianola, and  that unless he would interpose his
 authority to prevent it, we would  have it here.  The Gen-
 eral declined to  take from the  Mayor duties already com-
 mitted to him, and directed me to go  again to  him and try
 to convince him  of the  necessity of  his yielding to  my ad-
 vice.  My errand was fruitless.  The Mayor was  an old
 gentleman, of antiquated views  and  ideas—did not  believe
 in quarantine, no  how ; that it was a useless expense to
 the  city, and a great drawback to commerce, and  that he
 should do nothing more than had already been done.   Thus,
 through the  inefficiency, imbecility, or criminal negligeuce
 of the city executive, has this disease  invaded every house-
 hold—hearts have been  broken, hearthstones desolated, and
 happiness forever wrecked.
   But, sir, I sat down to give you my theory of the disease,
 and  somewhat of my experience.
   That yellow fever  is a disease of foreign origin, no man
 of observation can doubt.   That it never did originate with-
 in the boundaries of  the United  States, is just as certain as
 the truth of history.   These two propositions are as clearly
 demonstrable as is  the evidence  of its existence.  So far as
the late epidemic will go in sustaining them, let us at once
go into the  evidence thus  furnished, and  trace it from its
Texas beginning.   A schooner from Vera Cruz, Mexico,  with
vomita on board, arrived at Indianola, Texas.  There was
no quarantine at that port.   The blankets  upon which yel-
low fever patients had lain, were carried  from the schooner
to an auction room and  sold. The person  who carried the
blankets was  the first to take the  fever and die.  The auc-
tioneer who sold  them took the  fever, also, and died.  The
persons who  purchased  them took the fever, and several
died.  Through these cases, the disease became  epidemic. 
28
  The first case that occurred in Galveston was brought from
Indianola on board the steamship W. H. Hewes.   The gen-
tleman's  name  was Moller, from Baltimore, an agent of a
tobacconist, who  had been at  Indianola  on business.  He
was  in  apparent health  upon his arrival, but in less than
forty-eight hours thereafter he was  buried, from the fatal
effects of that disease, clearly  and unequivocally  marked.
  From  the house where this  patient died, the disease com-
menced to spread.  The next  case was  at the opposite cor-
ner ;  then the  next  was a few  doors  above ; and  thus it
gradually but quietly spread by  progressive steps, until al-
most every unacclimated person in the city had been attacked.
Its ravages  were fearful.   The fatality was so great  that al-
most every individual who could  get  away, left for the inte-
rior.   By these the disease spread throughout the State in
all parts not above the sea-level of 500 feet ;  above which it
cannot be propagated.  These are  the  simple truths of its
history ; and is there any man, do you believe, of one par-
ticle of experience  and observation, who would dare  to deny
the fact of its  contagiousness  ?   Who would  dare  deny, at
this late day, in defiance of the lights of science,  of  natural
law, and of observation, that for virulence and specific conta-
giousness, there is any other disease, in the whole category
of human affliction, so certainly reproductive of itself?
  1 am satisfied I can trace my own case to its origin :  that
I can  show where  every  case that occurred in my family
sprang from, and go to the burial place of my fiiends direct-
ly from my own house, witnessing all the varied  phases and
symptoms of the there acquired disease.   That yellow fever
is an exotic is evident from its entire dissimilarity to any of
our  domestic diseases.   The  difference  is so essential and
distinct  as to impress medical gentlemen of the  largest ex-
perience, that he  has  been  brought into contact with a
stranger'.  No  foreigner  ever landed in  tbe United States
possessing more  marked  habits,  characteristics and  distinc-
tions, to indicate him as among and not of us, than does this
disease when it makes its appearance.   An  evidence, gath-
ered from inductive reasoning—that reasoning upon which
medical  science is alone founded and supported—is its non-
recurrence in the same individual.  Every one knows this to
be  a  characteristic  of other  contagious  diseases,  such  as
measles, small-pox,  scarlatina,  &c, and of this disease also.
In no case have I ever discovered where a second attack has
recurred in the same individual, where the recovery has been

  The proximate cause of this fever I hold to be  a blood
poison, which peison is  doubtless an animalcule.  These an- 
29
imulcnlae are so infinitesimally  small as not yet to have been
discovered by the microscope, but capable of being absorbed,
and of penetrating every tissue of the human body.
  To elaborate from the system ibis  poison, without exhaust-
ing the vital energies of the patient, is to effect a cure ;  and
if your paper will effect  such  a change  in the treatment as
to prevent the complete exhaustion  produced by the Creole
system of sweating  patients to death, or medicating them
into the grave,  you  will be a benefactor to the  human race.
If you convince the public mind that the curative process of
nature is often  disturbed by the doctor and the  nurse, by a
system unfounded in either reason  or  in philosophy,  and
that all experience  proves, that  in this fever, when nature
has been permitted to  wrestle  with this pestilence, without
these extraneous  interferences, we  always have the largest
number of recoveries ;  when, I repeat, you can convince the
public mind of these facts, then the  thought and labor  you
have bestowed upon your  work  will have  produced  their
legitimate fruits.  I  am a physician of the old school, with-
out one single sympathy  for any  of the pathics which have
been  engrafted as fungi upon my  profession—endeavoring
still, as I was taught, to seek from  the great storehouse of
nature for all my remedial agencies, and  to apply them ac-
cording to the  lights of reason and experience, so that no
laws of her's shall be violated, no curative process retarded
—but that everything useful,  everything  developed by  new
scientific discoveries, and  all  else that improves  our noble
profession, belong of right to  us alone.   That no sectarian-
ism is known in medicine—that quackery is a crime, and that
honest men  will  always abhor both  its practice  and its
author, whose  purpose is  (under the  cloak of science) to
hoodwink or humbug a confiding people, are my sincere con-
victions.               Very truly yours,
                                  ROB'T. K. SMITH.

  The importance of the subjects passed in review in this
little essay, when contrasted with its paucity of detail, can-
not fail to call forth the criticism of the reader.   In exten-
uation of this fault,  we can only  plead the  limited  time to
which we were restricted in the execution of our task. Hence,
condensation may have been  carried to obscurity in many
places ; but be this as  it may, no  labor was spared to render
every sentence, in the  more important parts, the representa-
tive of a suggestive  idea—this extent  our  labors had, and
no more.                                        W. R. 
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