AN 
.ACCOUNT 
OF 
The Yellow Fever 
AS IT PREVAILED IN PHILADELPHIA 
IN THE AUTUMN OF 1762; 
A PAPER PRESENTED TO THE COLLEGE OF PHYSICIANS OF PHILADEL- 
PHIA .AT ITS STATED MEETING, SEPTEMBER 7, 1793. 
BY 
JOHN REDMAN, M. D., 
FIRST PRESIDENT OF THE COLLEGE. 
NOW FOR THE FIRST TIME PRINTER BY ORDER OF THE COLLEGE. 
PHILADELPHIA: 
1865. INTRODUCTION. 
Of the Yellow Fever of 1762, as it occurred in 
Philadelphia, no account has ever been published. 
Dr. Redman's paper, heretofore existing only in 
manuscript, in the possession of the College of 
Physicians, has been judged worthy of publication, 
partly for this reason, but also for its own merits 
as a contribution to clinical medicine and to med- 
ical history. A sketch of the life of its author* 
may serve as the best introduction to the Letter; 
for the presentation of which a vote of thanks was 
passed by the College, after its reading, September 
7, 1793. 
Dr. John Redman was born in Philadelphia on 
the 27th of February, 1722. He was educated by 
his parents with a view to his entrance into one of 
the liberal professions. After finishing his academ- 
ical course, he entered upon the study of medicine 
with Dr. John Kearsley, then one of the most re- 
spectable physicians of Philadelphia. Upon the 
* The substance of this brief sketch is taken from the Philadel- 
phia Medical Museum for 1808. 4 
INTRODUCTION. 
expiration of his apprenticeship, he went to Ber- 
muda; where he practised for several years, with 
such success as to be able, with the property he 
inherited from his father and a small loan from a 
relation, to go to Europe to complete his studies. 
He spent a year in Edinburgh, while the medical 
school of that city was in the hands of the first 
Monro, Sinclair, Alston, Plummer, and Ruther- 
ford. He also passed a year in attending at Guy's 
Hospital; and some time afterwards in attendance 
upon lectures, dissections, and hospitals in Paris. 
He finally graduated in the University of Leyden, 
in 1748, under Albinus, Gaubius, and Muschen- 
broek, at a time when that institution still retained 
much of the reputation it had derived from the 
name of Boerhaave. 
After thus receiving the highest honors of his 
profession, Dr. Redman returned to his native coun- 
try, and settled in Philadelphia. As a practitioner 
he was very successful. Combining at first surgery 
and obstetrics with general practice, the delicacy of 
his health obliged him afterwards to decline all but 
medical cases. It was observed by his grandson, 
Dr. John Redman Coxe, that, while "his principles 
in medicine were derived from the writings of Dr. 
Boerhaave, his practice was formed by the rules of 
Dr. Sydenham. He early saw that the modes of 
practice recommended by that enlightened physi- INTRODUCTION. 
5 
cian, in the 17th century, in England, were equally 
proper, in the 18th century, in America, from the 
sameness of the manners of the inhabitants of both 
countries, in those different periods of time. He 
saw distinctly the truth of Dr. Sydenham's remarks 
upon the laws of epidemics, and regulated his prac- 
tice by them. He considered a greater force of 
medicine necessary to cure modern American than 
modern British diseases, and hence he was a de- 
cided friend to depletion in all the violent diseases 
of our country. In the diseases of old age, he con- 
sidered small and frequent bleedings as the first of 
remedies; and to them he thought himself indebted 
for much of the ease he enjoyed in his descent down 
the hill of life. Towards the close of his life, he 
read the works of Cullen, Brown, and several other 
physicians, who had called in question the truth of 
Dr. Boerhaave's principles in medicine. He admit- 
ted their objections, and embraced some of the mod- 
ern opinions and modes of practice with the avidity 
of a young man of five and twenty. He published, 
about the year 1759, a defense of inoculation, and 
advised the use of mercury to prepare the body for 
the reception of the small-pox. He entertained a 
high opinion of that heroic medicine in all chronic 
diseases. He introduced the use of turpeth mineral 
as an emetic in the gangrenous sore-throat of 1764; 
and such was its efficacy, that he did not lose a 6 
INTRODUCTION. 
patient who took it in the early stage of that epi- 
demic."* 
Dr. Redman was elected one of the physicians to 
the Pennsylvania Hospital immediately after its 
establishment; and, afterwards, was chosen the first 
President of the College of Physicians of Phila- 
delphia. He discharged the duties of these sta- 
tions faithfully, and reluctantly retired from them, 
only in consequence of the infirmities of age. He 
served also, for many years, as a trustee of the Col- 
leges of Philadelphia and New Jersey. 
He was faithful and punctual in his attendance 
upon his patients. His manner was bland and 
agreeable, and his conversation often facetious and 
full of anecdotes; though also frequently serious 
and instructing. A lady, whom he attended in a 
fatal consumption, said to one of her friends, that 
"death had nothing terrible in it when Dr. Redman 
spoke to her about it." 
Not long after his settlement in practice in Phila- 
delphia, he married a lady of uncommon accom- 
plishments, by whom he had two sons and two 
daughters. To these, and to all the members of 
his family, he was very closely and affectionately 
attached. 
Having from early life been decidedly religious, 
* Phila. Med. Museum, 1808, p. 51. INTRODUCTION. 
7 
in 1784 he became an elder in the Presbyterian 
Church, and devoted himself assiduously to the 
duties of that office. He was, however, a stranger 
to bigotry, and often worshiped with sects of Chris- 
tians different from that with which he was united. 
He gave secretly and liberally to the poor; and, 
when confined by sickness, would convey his 
bounty to them by the hands of a friend. When 
retired from practice, he visited many of his old 
patients regularly two or three times a year, always 
leaving behind him some pious remarks, or anec- 
dotes, that were not soon forgotten. 
With all these virtues and this piety, he is de- 
scribed as having had, in early and middle life, a 
quick and irritable temper, whose impatience, how- 
ever, was very brief in duration; and he was some- 
times known to make acknowledgments to his 
pupils and servants for even a hasty expression. 
In person, Dr. Redman was rather below the mid- 
dle stature; with dark complexion, and black eyes; 
and a manner, both in speech and gesture, of un- 
common animation. 
At the age of about 86, without previous signs 
of unusual indisposition, he was attacked with apo- 
plexy, and died in a few hours. This took place in 
March, 1807. He was buried, at his own request, 
in the Presbyterian church-yard on Arch Street, in 8 
INTRODUCTION. 
the same spot in which his mother had been interred 
fifty years before him. 
Undoubtedly, Dr. Redman must be regarded as 
having been one of the most eminent physicians of 
his time. He became successful and distinguished, 
by his ability, industry, and character, at a time 
when, the science of the profession being less ad- 
vanced, and less diffused, than now, much more 
depended upon the individual man than upon either 
his training or his opportunities. 
It has been thought proper, in printing the paper 
which follows, to adhere strictly to the letter of the 
original manuscript. If its didactic value be neces- 
sarily diminished by the lapse of time which has 
occurred since its preparation, there is yet so much 
in it of practical observation and excellent sense, 
as to entitle it to rank as something more than a 
merely curious fragment of medical literature. THE YELLOW FEVER 
OF THE 
YEAR 1762. 
Gentlemen :-My memory being much im- 
paired by age and infirmities, and especially by 
a severe and long fit of the rheumatism the win- 
ter before last, affecting at times my head, and 
also from the effects of a former, and more lately 
a second attack of the influenza, I have endeav- 
ored to assist my recollection respecting the yel- 
low fever, which raged among us chiefly in the 
southern parts of the city in the year 1762. By 
recurring to and examining the contents of my 
day-book in the months of August, September, 
and October of that year, and by making some 
enquiries of an ancient woman and others, whom 
I remembered to have attended at that time 10 
YELLOW FEVER. 
under particular circumstances, (being deprived 
of any notes I might have then taken, or at 
least not now to be found,) hoping thereby to 
render such and the best information I can, at 
this distance of time, on the subject to the Col- 
lege of Physicians, respecting our mode of treat- 
ing the disease at that time-and which I 
believe was the most successful-as may be 
agreable (though perhaps not fully satisfying) 
to their wishes, and of some use in their im- 
portant deliberations on the present alarming 
disease among us. 
By the aforesaid retrospection, I find during 
the whole month of August my prescriptions 
were chiefly and almost solely for dysenteries 
and some fevers which appear to be of the re- 
mittent kind and rather slight, by the nature, 
quantity, and continuance of the medicines to 
each patient. 
The 28th of August appears to be the first 
instance of my prescribing directly as to one in 
the yellow fever, according to the medicines and 
mode of practice I pursued therein, as hereafter YELLOW FEVER. 
11 
mentioned; and, as I then had but a small 
share of practice below Pine Street, (just be- 
yond which it began,) comparatively, with Drs. 
Bonds and some others, I have some notion that 
they had patients in it thereabouts a week be- 
fore me. From thence to the 1st of September 
my share of patients with it was small, not 
above four or five; though the others had, I 
think, in that space of time, many more addi- 
tions in that quarter. But from that time they 
daily increased upon me, so that by the 15th, 
or rather from the 20 th to the 25th, (when it 
seems to have been at the height of its prog- 
ress,) as appears by my book, I had daily to 
attend eighteen or twenty patients in the dif- 
ferent stages of it, exclusive of convalescents. 
From the 27th it appears to have gradually 
declined, so that by the 20th of October I had 
but two or three fresh patients in it, and those 
I believe only such persons as had lately come 
to lodge or live in that part of the town. After 
that I had but one new patient that appears to 
have had that fever in its full force, all others 12 
YELLOW FEVER. 
being, according to my prescriptions, either con- 
valescents from it or dysenteries and remitting 
fevers, with some symptoms analogous to the 
precedent fever, but not very dangerous, and, if 
I recollect right, seldom fatall. 
The fever aforesaid was mostly circumscribed 
between Pine Street northerly to three or four 
squares from thence southerly, and extended 
from Front or Water Street to Third or Fourth 
Street westward. Some few had it nearly as 
low as the Swedes' Church, and even to Moya- 
mensing, but not many. I had only one patient 
near the last-mentioned place. A few had it 
also about the bridge and along Dock Street, 
and some higher up in Second and Front Street 
toward Walnut Street; but very few above Wal- 
nut Street were affected with it. Its first and 
greatest ravages were about the new market 
and the square to the eastward of it, in which- 
after some considerable search and tracing it- 
it was found to have originated in a number of 
small, back tenements, forming a kind of court, 
the entrance to which was by two narrow alleys YELLOW FEVER. 
13 
from Front and Pine Streets, and where sailors 
often had their lodgings, to which a sick sailor 
from on board a vessel from the Havannah 
(where it then raged) was brought privately 
after night, before the vessel had come up to 
town, to the house of one Leadbetter, where 
he soon died, and was secretly buried; and I 
believe Leadbetter, with most of his family 
and many others in that court, soon after fell 
a sacrifice to the distemper; and from thence it 
spread rapidly, first affecting the houses nearest 
adjoining in Front and Pine Street. 
The patients were generally seized with a 
sudden and severe pain in the head and eye- 
balls, which were, I think, often though not 
always a little inflamed, or had a reddish cast, 
great prostration, or rather depression of spirits, 
pain in the back and bones, a sick stomach, 
generally attended (but in various degrees of 
violence) with frequent vomiting, more or less 
of green or yellow bile, and was distinguished 
from the cholera morbus by not having a purg- 
ing with it. There was also a kind of cardi- 14 
YELLOW FEVER. 
algia or burning heat about the scrobiculus cor- 
dis with great oppression; but, if I remember 
right, not much pain like a colic. Nor do I 
recollect any chill generally preceding the above 
symptoms, however it might be with some. The 
skin was dry, with a disagreable burning heat 
in it, sensible to the hand of others when ap- 
plyed. The tongue was not peculiarly dry at 
first; in some rather moist, but not covered with 
much mucus, if I remember right. The pulse 
was not generally very full or tense, but very 
quick in the beginning, by which the degree of 
fever was chiefly designated; yet in some per- 
sons previously very plethoric, from high living 
and other circumstances, some fullness, without 
tension, was observed in their pulse in the first 
stage; after which, in many the pulse become 
so moderate in every respect as to be scarcely 
distinguishable from a person in health. Tho' 
very restless, and often tossing about or chang- 
ing position from oppression at the prcecordia, I 
think they were but seldom very delirious; but 
if the disease continued to increase and resist YELLOW FEVER. 
15 
the power of the medicines, they rather grew 
comatous, which was a bad symptom, and gen- 
erally continued till death, unless the black 
vomiting came on and roused them by its fre- 
quent ejection; and even then some appeared 
quite sensible, tho' not capable of preserving 
their thoughts very regular and steady on any 
subject. They soon became yellow in their eyes 
and skin universally, which daily increased, and 
became extreme in some before, and always after 
death; and in those which recovered, it con- 
tinued during the whole convalescent state, and 
in some great part of the whole outward skin 
came off in scales. 
I do not remember to have seen any petechiae, 
but just before or immediately after death there 
appeared many livid spots in several parts. 
Their urine was generally high coloured or yel- 
lowish; and, though sometimes it might have 
some sediment, I do not recollect its being at 
any time so regular as ever to pronounce upon 
it as critical in those who recovered. I rather 
think that we judged more from an abatement 16 
YELLOW FEVER. 
in the high colour and yellowness, of its being a 
favorable and promising symptom. 
They generally died on the fourth, fifth, or 
sixth day, some few later; but after the sev- 
enth day, or even sooner, if the pulse was much 
calmer and slower, without a coma, but in- 
clined to an easy, natural sleep, tho' short, the 
urine nearer to a straw colour, with a moist skin 
and tongue, and the bowells easily kept regular, 
we were encouraged to hope and promise much, 
and generally succeeded in our prognostication. 
Yet some failed us after, if they had only some, 
but not all the above promising symptoms 
clearly. But whether any failed after having 
all of them fully confirmed, by a relapse or 
other ways, I cannot at this distance recollect. 
From former experience on a similar disease 
among us, I believe the practitioners mostly 
avoided venesection and emetics; few persons, 
after the heat of summer, being so plethoric as 
to indicate the former, and which on a former 
occasion they had found ruinous, as sinking the 
patient too low to bear the medicines immediately YELLOW FEVER. 
17 
necessary to succeed, and beyond the power of 
their best invigoratives to support them under 
their operation and the debilitating force of the 
disease. And as to the latter or emetics, they 
had been found often to increase and perpetuate 
the vomiting beyond relief afterwards. As to 
myself, I had early imbibed a prejudice against 
them-and in favour of the saline purgatives- 
in the case, from observing, about the year 1741 
or 1742, when the yellow fever was first intro- 
duced here, while a pupill to Dr. Kearsley, Senr., 
that, by the use of them in the first stage of it, 
he saved most of his patients; while others, by 
emetics, lost many if not most of theirs. I, 
therefore, in pursuit of the same practice, imme- 
diately began with $j of genuine sal Glauberi 
every hour or two, till, by taking four, five, or 
six doses, the bilious matter was turned down- 
wards and plentifully discharged-and I believe 
most of my brethren used the same or some- 
thing similar for the same purpose-assisting 
the operation and supporting the patient with 
wine and vinegar whey, thin gruel, or barley 18 
YELLOW FEVER. 
and raisin drink with a little wine in it, and at 
night some light cordial anodyne. Next day 
repeated two or three doses of the same, if the 
indications made it necessary; or immediately 
began the use of an antiemetic powder, com- 
posed of tartar, vitriolat. gr. x, and a half or 
whole drop of ol. cinnamon every four hours, 
in a spoonfull of simple mint or cinnamon water, 
and two spoonfulls of a strong decoction of snake- 
root every two hours, continuing the foremen- 
tioned drinks warm, in small quantities at a 
time, as often as they could bear it; giving, also, 
instead of one of the above powders, daily a 
dose or two of the sal G., when indicated as 
necessary, by a return of sickness at stomach, 
or the not having two or three stools a day, as 
long as the dejections appeared bilious, and as 
soon as that and the vomiting or sick stomach 
quite ceased, omitting the antiemetic powders, 
but continuing the decoct. Serpentar. Virgin. 
We also gave with it, or between its doses, a 
spoonfull of a vol. neutral mixture, (to be speci- 
fyed hereafter,) and, to aid the design of keeping YELLOW FEVER. 
19 
up a free perspiration or gentle but constant 
moisture on the skin, we added a bolus of five 
or six grains of theriac: venet: with three grains 
of camphire every four or five hours, or a bolus 
of theriaca, consisting of 5ss or 9ij and four or 
five grains of camphire, at bedtime, if the bow- 
ells were inclined to be too loose during the per- 
spirative course. This or the asthmatic elixir 
were the chief anodynes I used in the case, 
liquid laudanum not being then so much in use 
as it has been since, except in cases of extreme 
pain, or those which were spasmodic,-I mean 
in my own practice. Whether others were more 
free in the use of it, I cannot say. Being afraid 
of inducing a stupor, as many were inclined to 
become comatose on the subsiding of the pulse, 
and which always portended a bad issue, I some- 
times added four or five grains of rhubarb to the 
anodyne bolus, if a discharge from the intestines 
was too long protracted. Here I must adjoin 
what should have been mentioned before, but 
escaped my mind at the time, viz., that almost 
from the beginning was applyed to the pit of the 20 
YELLOW FEVER. 
stomach an anodyne stomachic plaister of the- 
riaca, etc., and renewed daily as long as any 
sickness of stomach or oppression of the prm- 
cordia prevailed, and for some time after, though 
not so often renewed. This afforded more re- 
lief than some would expect, and was often 
sensibly usefull as well as comfortable to the 
patients, under the symptoms above mentioned, 
and also in the hickups which sometimes 
affected them. The drinks before mentioned 
were alternated with some pleasant herb tea or 
simple water acidulated with the mineral acids, 
good rich beverage, or lemonade, or even weak 
punch, made with boiling water, and drank 
when cool; also water, well stored with ripe, 
acescent fruits, roasted or raw, and weak wine 
and water, and changed, as most agreable to 
patients, unless where any particular symptom 
required a strict adherence to any one or more 
of them. I think we seldom gave pure wine 
alone; and, if I recollect right, it was not al- 
ways, or rather but seldom, agreable to the 
patients themselves. We seldom used epis- YELLOW FEVER. 
21 
pasties unless they became comatous, and then 
not often with much effect; yet could not avoid 
trying them as a last resort, or to satisfy others 
connected, that every possible effort was made 
to save them, and prevent the painfull feelings 
of those connections if they had been omitted. 
Some patients had bleedings from the mouth 
and nose, and with the intestinal dejections, in 
which cases our chief recourse was to the min- 
eral acids in all their drinks: red wine and 
water cold, and a strong decoction of cort. 
Peruv. two parts, serpentar. Virgin, one part, 
with a little astringent spice, and omitting the 
serpentaria altogether, if the pulse became regu- 
lar and not sunk below the standard natural to 
a debilitated state. The bark in substance was 
not much used, at least, I am sure, not by all 
the physicians or practitioners; and the reasons, 
as near as I can recollect, were, that some at 
that time were not yet got to be clear in their 
judgment, (as has been the case since,) or not 
accustomed to, perhaps prejudiced against, the 
use of it in that form, while the pulse was too 22 
YELLOW FEVER. 
quick and no sediment in the urine. But an 
objection of more moment, with me at least, 
was, that it brought on an oppression or sick- 
ness at stomach, so as often to be rejected, 
whereby the symptom of bleeding aforemen- 
tioned, allready too dangerous, (when that was 
the case,) was considerably increased, and con- 
sequently the injury resulting far exceeded the 
advantage that might otherwise have been ex- 
pected from it. Whether any were so determ- 
ined in their judgment, or so adventurous to 
persist in that mode, I will not say; but if they 
did, I believe the consequences were not such 
as to bragg of, or to encourage an imitation of 
them. 
Some used instead of the plaister a fomenta- 
tion of spices stewed in wine or spirit, and, I 
believe, with advantage; but I had too much 
confidence in and experience of the good effects 
of the plaister to relinquish its use; yet, as I be- 
lieve the fomentation to be a proper and good 
application as far as it went, I had no objection 
to its use, and often ordered it occasionally, pre- YELLOW FEVER. 
23 
vious to every renewall of the plaister, provi- 
ded it was not substituted entirely for, or set 
aside the use of the plaister too long at a time. 
After two, three, or more days, continuing 
the perspirative or sudorific course according to 
the indications, if the symptoms appeared quite 
or nearly as promising as mentioned in page 13, 
whether the urine had a sediment or not, but 
especially if it had, I then substituted in the 
room of most or all the other medicines a free 
use of the decoction of the bark and snakeroot, 
equall parts, diminishing the latter and encreas- 
ing the former as the convalescent state ad- 
vanced; allowing whey of wine alone without 
vinegar, and a more free use of wine in their 
gruel or panado, and barley drink, agreable to 
their palate or desires, and leaving them to the 
largest use of any, or sole use of either, as they 
chose themselves, together with sometimes a 
cup of beef tea, or broth made of chicken or any 
of the white meats, or a small portion of those 
meats dressed agreable to their palates, once or 
twice a day, if they desired it, without any 24 
YELLOW FEVER. 
urgency from others, which I rather wished to 
be avoided; ever thinking it best to wait till the 
stomach, that truly vigilant centinel and instru- 
ment of nature, should prejudge without per- 
swasion, and notify the necessity and propriety 
of a new, and more solid and durable supply, 
which it generally did soon after the free use of 
the bark, and then only could we be sure of its 
sitting easy on the stomach or being properly 
digested and diffused. Tea, coffee and choco- 
late, (not too rich,) and toast, were also now 
allowed, as they had been through all the dis- 
ease, under the same proviso of their being 
agreable to and desired by them. As the con- 
valescent state advanced, nothing more was ne- 
cessary than a prudent gradual increase of 
solids in their regimen, with fresh air in proper 
weather, and seasonable moderate exercise, and 
the daily use of a tonic medicine, made by in- 
fusing in wine nearly all the same ingredients 
as are used in making Huxham's Tincture, 
which was not then got into such general use 
as it hath been since, and sometimes a little YELLOW FEVER. 
25 
rhubarb was added thereto. Yet with most the 
recovery was slow and tedious, and often needed 
the addition of chalybeates, with bitters and 
country air, before a perfect and complete re- 
storation of all the natural functions could be 
obtained, especially in the weaker sex. 
Thus, gentlemen, have I endeavoured to give 
you a concise and plain narrative of the disease 
then imported and prevailing among us, and our 
generail mode of treating it, in the best manner 
I could from recollection, without attempting to 
theorize upon it. But a plain inference from 
our manner of encountering it is, that whatever 
might be the specific quality of the morbid 
cause, its effects were a stagnation and corrup- 
tion of the bile and the contents of all the ab- 
dominal glands, dissolving the blood and other 
fluids, and thereby depraving and debilitating 
all the functions of life, and rendering them un- 
fit and unable to preserve it, and that our chief 
curative intentions were to discharge the morbid 
matter as fast as possible, first by the prima 
via, and then by the pores of the skin and uri- 26 
YELLOW FEVER. 
nary passages, at the same time using such 
medicines as tended to correct any acrimony in 
the fluids, resist their effects, and strengthen 
the whole habit for their expulsion, and with 
such kind of nutriment as was adapted to the 
same purpose, or to restore strength to the de- 
bilitated powers after the disease was termin- 
ated. I should now conclude, with only adding 
more particularly some of the prescriptions 
mentioned only generally in the narrative, but 
a few things having occurred while writing 
which were omitted to prevent interruption. I 
shall now add them first, viz.: Tho' an early 
prejudice induced me to prefer the Sal Glaub. 
Ver., yet I believe others used the Tartar. Solu- 
bile and Crem. Tart, with rhubarb or jalap with 
equal advantage, provided the evacuation was 
seasonably and duly obtained. But none that I 
know of used either mercurials or antimonials; 
however, that need not make us suppose that 
they might not have been used had the physi- 
cians then been possessed of that knowledge 
which longer time and experience, and greater Yellow fever. 
27 
enlargement of medical science has afforded us, 
and whereby we now know that they may be 
used with advantage in cases where formerly 
they were thought more likely to do great mis- 
chief. Nevertheless, I hope those of the present 
day will use great precaution and precision in 
their observations before they determine on the 
propriety and safety of them in preference to 
others. Though I said that V. S. was avoid- 
ed, yet there were particular cases and cir- 
cumstances that seemed to require it. Such, 
for instance, as pregnancy with a full pulse, 
rather tense than otherways, with great pains; 
as was the case with the woman mentioned in 
the beginning of this, who was at the end of her 
reckoning, and seized so suddenly and severely 
with pain on the top of her head that-as she 
informed me lately-she verily thought it occa- 
sioned by a clap of thunder that happened at 
the same instant. She was bled moderately; the 
blood was dissolved, and therefore not repeated. 
She had the symptoms as usual with others, 
and was delivered early on the fifth day, (a few 28 
YELLOW FEVER. 
hours after which her husband died, on the 
fourth of his illness, having been comatose very 
early,) and tho' under these deplorable cir- 
cumstances, with a free discharge of the lochia, 
great paleness and coldness of the skin in her 
face and arms, and a pulse scarce perceptable 
the whole night, she gradually recovered from 
them next day under the use of the medicines 
aforesaid, rendered somewhat more cordial by a 
larger proportion of Tinct. Croci and spt. lavand. 
to the Vol. neut. mixture. The child was alive 
and well, and next day appeared yellow all 
over; was weakly for three weeks, and then 
grew healthy and hearty, and lived to be the 
mother of children. 
And here, for the encouragement of those 
who may be engaged in obstetric cases under 
such circumstances, I choose to mention that 
the midwife, tho' much terrified, so as scarce 
to be retained till it was over, and must, from 
her office and situation, for some hours have re- 
ceived much of the effluvia that came from her 
patient, yet she escaped the infection entirely. YELLOW FEVER. 
29 
Whether this be from a kind, superintending 
Providence over us, exercised peculiarly in our 
favour in the execution of duty on such occa- 
sions, let every one judge, and practice accord- 
ingly. 
Pediluvia, on account of the pain in the head 
and also for cleanliness, were used at first, and 
then bathing the feet and legs with vinegar, 
also the hands and face with the same, and con- 
tinued to the forehead by a cloth wet therewith, 
and a bowl of vinegar in the chamber with a 
hot iron sometimes put therein, which served 
for the benefit of both patient and physician, 
and attendants; and indeed was usefull for dip- 
ping the hand therein and rubbing one's face 
before approaching the bed and feeling the 
pulse. This was the chief preventative or pre- 
servative I used, besides great temperance, 
avoiding to visit patients fasting if possible, and 
keeping tobacco in my mouth while in the sick- 
room, not from any expectation of benefit from 
any quality in the tobacco, except that of 
preventing my swallowing my saliva. This 30 
YELLOW FEVER. 
method I found better than a constant use of 
preservatives, which after a little time I per- 
ceived to affect my mind with such fears as I 
thought were likely to render me more suscep- 
table of infection than the omission of them, 
and so discarded them and went fearless tho' 
not thoughtless wherever called, and I thank 
God have been preserved harmless from such 
ills to this day; whether that fearlessness was 
well founded, or only arose from that presump- 
tive illy founded confidence and insensibility 
that too many I suspect have, not much for 
their own good, I will not say, but it had its 
use, at least for the good of others. And here, 
my brethren, I beg leave to add one more 
thought not quite forreign to the subject, that 
with all my apparent courage something would 
and often did obtrude to raise my fears, and a 
sense of danger frequently affected me, but how 
far effectually must be left to Him who knoweth 
all things, and searcheth the hearts and tryeth 
the reins of the children of men. But thus 
much I know, that when that Light which YELLOW FEVER. 
31 
shineth in darkness led me to the exercise of 
piety and virtue, it made me happy even in the 
midst of danger or troubles, and when slighted 
or neglected it rendered me miserable, tho' sur- 
rounded with every other circumstance capa- 
ble of giving pleasure to the senses. But to 
proceed. I observe further, that I was often 
astonished to see how well the stomach would 
bear the small doses of sal Glauber, when every- 
thing else, even the simplest and pleasantest 
drinks, were almost immediately rejected. A 
spontaneous discharge in the beginning, espe- 
cially if bilious-but which seldom attended- 
always abated the sickness and vomiting, and 
rendered relief easier and more speedy. Yea, 
and if in the midst of the sweating course the 
oppression of the prmcordia returned, or any 
other symptom denoting or indicating a fresh 
accumulation of corrupted bile or lymph, or the 
previous discharge of them had not been suffi- 
cient or complete, a few spontaneous intestinal 
dejections, whether bilious or not, gave a speedy 
relief, and therefore a common laxative clyster, 32 
YELLOW FEVER. 
in order to produce such dejections while other 
medicines were preparing, sometimes almost 
precluded the necessity of using them. But I 
generally gave three or four drams of the saline 
purgative to make sure of a more complete dis- 
charge, and so prevent a recurrence of those 
symptoms in future.* And it was remark- 
able that they sweat more easily and freely 
after well emptying the bowells than before. 
And here I must not omit, what should have 
been mentioned before, (and for-which I am in- 
debted to the recollection of Dr. Rush, who was 
then my pupill,) viz., that a peculiar diagnostic 
* Here I think it right to add, in confirmation of the 
benefit of keeping up a discharge from the bowells, that 
the woman before mentioned lately informed me that 
though pregnant and expecting her labour every day, I 
kept her intestines daily in a lax state more or less till the 
symptoms of parturition commenced, which was on the 
fourth or fifth day of her disease. Yet she and the child 
were preserved, and she recovered as fast as most of the 
others. I find also that I often enjoined a few grains of 
rhubarb with the bolusses, especially the large one at night, 
which I suppose was intended to obviate its binding quality. YELLOW FEVER. 
33 
symptom attending it, and by which the doctor 
remembers my having distinguished it from the 
autumnal remittent that also had been prevail- 
ing, while other symptoms were too obscure to 
determine upon, and that was a very great sen- 
sibility about the\scrobiculum cordis, so that a 
slight pressure thereon would occasion a pain- 
full or very uneasy sensation, which in some in- 
creased so much as not to be able to bear even 
the bedcloaths without pain and restlessness. 
On further recollection I find that flor, camomeli 
were added to the decoction of serpentaria, espe- 
cially toward the latter end of the perspirative 
or sudorific course. 
With respect to acids in use as medicine, they 
were chiefly of the vitriolic kind, both the spt. 
vitrioli dulcis and that denominated elixr. vi- 
trioli. But from a considerable experience I 
have had since of the special good effects of the 
spirit, salis marini, internally used in a very 
putrid kind of small-pox which at one time pre- 
vailed among us, attended with livid spots on 
the arms and legs in great numbers, and in some 34 
YELLOW FEVER. 
with mortifications, and also in speedily remov- 
ing an indurated tumour on the lips of children 
in the same disease, which otherwise soon term- 
inated in a gangrene, which destroyed the whole 
cheek of one side before the patient died, which 
they always then did after languishing very mis- 
erably for many days; in which last case the 
early and constant application of a piece of lin- 
nen, two or three double, wet with three parts 
vinegar and one of spt. salis, and frequently 
renewed to the part while only indurated or 
but little discoloured, were peculiarly and often 
speedily efficacious to prevent a gangrene, and 
in the former cases the frequent application of 
vinegar, with a little spirit and some strong, 
bitter decoction, such as wormwood, rue, camo- 
mile, and dittany to the legs, where generally 
the livid spots appeared in greatest numbers, 
and indeed in a few cases wholly livid from the 
knee to the toes (some of which they lost) was 
peculiarly beneficial, and especially as they were 
much disposed to breed maggots if omitted some 
hours, as was too often the case during the YELLOW FEVER. 
35 
night by the inattention of nurses. In these 
cases were also used plenty of acidulated decoc- 
tion of bark with a little snakeroot and camo- 
mile flowers in it, and a plentiful use of wine 
and water was allowed, or sometimes pure wine 
if agreable to the patient, which it generally 
was in these cases more than in the yellow 
fever. Nay, I knew a negro man who recov- 
ered beyond all expectation (being all over cor- 
rupted) upon the use of near a pint of rum 
every day, to which he had been long accus- 
tomed and craved much, but to which his phy- 
sician only consented on supposition that no- 
thing could save him, and thought it a pity to 
debar him from what he so earnestly desired. 
I say from these considerations I have been led 
to imagine that the marine acid might be pre- 
ferable to the vitriolic in the fever which is the 
subject of this narrative, and Dr. Rush says he 
remembers to have heard Dr. P. Bond speak 
favorably of it at that time, but I had not then 
got into the use of it. 
As to emetics, I have only further to add that 36 
YELLOW FEVER. 
the husband of the pregnant woman aforesaid, 
having had an attack of a remittent, as appears 
by my book, two or three weeks before his 
seizure with the other, I imagine his first symp- 
toms must have led me to suppose it was only a 
return of his remittent, as it was not my usual 
practice to give an emetic in the other, for he 
had a vomit and dyed on the end of the fourth 
day, very yellow, having been very comatose for 
two days before, as I have already mentioned. 
From a further inspection of my day-book 
and recollection of circumstances, I find I must 
have had one patient as early as the twentieth 
of August, but was overlooked, from his fever at 
first appearing to be only of the remittent kind, 
according to the medicines prescribed, to the 
end of the third day, when, a considerable remis- 
sion or intermission appearing, he commenced 
the use of the bark, which judgment of his case 
I was the more readily induced to form from 
the circumstance of his living above a mile from 
and to the southward of the city, near low and 
wet grounds, where remittents and intermittents YELLOW FEVER. 
37 
then prevailed, tho' he sometimes came into 
town and transacted business near the place 
where the yellow fever had then just began to 
appear, and I had not then seen any of them. 
But as I now recollect that he grew wrorse on 
the end of the fourth day, so as to discontinue 
the bark, became gradually comatose on the 
fifth, when on the sixth four blysters were ap- 
plyed, besides other medicines administered, and 
dyed on the seventh day, some yellowness ap- 
pearing the day before, and much increasing 
near the time of and after his death, we have 
no doubt of his having received the infection 
of the yellow fever, though probably somehow 
commixt with a remittent from his having 
been previously affected with the seeds thereof, 
and by giving that cast to the symptoms at the 
beginning disguised it for awhile.* 
* Upon a more close inspection and recollection, I also 
find that I had a few more scattered patients after the 20th 
of October up to the end of that month, particularly one 
Mr. Ab. Judan, whom I attended in consultation with Dr. 
Cadwalader, and who dyed on the 30th with a black vomit- 38 
YELLOW FEVER. 
As to the use of the bark in substance, I have 
only to add that a sensible man, of a corpulent 
but vigorous habit of body, informed me that, 
under the yellow fever in 1748, when it was 
very fatall here-his physicians having pre- 
scribed it in that form to him,-(on what day 
of the disease I cannot say,) he became so op- 
presst and restless that they were obliged to 
desist and return to other medicines, which car- 
ryed him safely through without the renewall 
of that or any other bad symptoms. 
I do not wish to trouble my brethren, or 
spend their precious time in recounting appar- 
ent trifles, but, as in such important matters as 
malignant and dangerous diseases as well as on 
some other subjects, a minute circumstance that 
may at first be deemed but of little worth, may 
prove of great moment on some future occasion, 
I shall conclude my narrative with observing 
that I do not remember that Dr. K., Sen. ever 
ing; and also two in the first week of November, but none 
afterwards. YELLOW FEVER. 
39 
gave me any other particular reason for his 
using, so early as he did, the saline purgatives 
upon the first appearance of the yellow fever 
here, but that, in the course of his medical 
studies and reading, he had met with the fol- 
lowing practical observation in an old author: 
"That in all fevers of the putrid, bilious, and 
malignant kind, accompanied with a moist 
tongue, he had always found the saline purges 
far more proper, safe, and efficacious than emet- 
ics"-which he carefully treasured up in his 
mind for future use; and, perhaps, as he spent 
some months in Barbadoes (where it often pre- 
vailed) before he came to this city, he might 
have had an opportunity there of confirming 
the sentiment. And may not this be a hint 
also to us not to slight or neglect the practical 
observations of even antiquated authors, because 
they do not quadrate with the more enlighten- 
ed theories of the present day? Yea, tho' we 
may with some reason, from the enlargement 
of medical science since, smile at their mode of 
theorizing upon them. Let us rather pay all 40 
YELLOW FEVER. 
due respect to their memory, and give them all 
the credit we can, for their great and often pain- 
full attention to what might conduce to the 
progress of the healing art and the benefit of 
mankind; and but for which possibly we might 
not have yet been so far advanced in successfull 
practice as we now are, whatever we might 
have been in diversity of theories. Is not old 
Sydenham an eminent instance of the truth of 
the above observation? whose theory is often 
such as almost to disgust a modern theorist, 
and yet whose practical observations are such 
(at least in the principal matters of them) as 
that he who attends to them most seriously, 
and follows them the most closely, will be most 
abundantly compensated, with satisfaction to 
himself in practice and benefit to his patients. 
Perhaps few of us, with only the same oppor- 
tunities and degrees of knowledge which the 
ancients had, would have advanced so far, or 
done as much or as well as they did; and, 
therefore, in a comparative view, all circum- 
stances considered, they may possibly far ex- YELLOW FEVER. 
41 
ceed the most of us in the degree of credit they 
deserve, especially when it is considered that 
some of them were chiefly if not solely indebted 
for their knowledge and success to their own 
assiduity, industry, and attentive observation. 
But, least I become tedious, I shall now con- 
clude with hoping, yea, assuring myself of the 
candid reception and construction of this small 
attempt to evidence my respects to the College of 
Physicians, and hearty concurrence with them 
in their important deliberations on so critical an 
occasion, and thereby yet contribute, as well as 
I can, (though not largely or actively,) through 
them, to the publick utility, which, if in the 
smallest degree should be the case, it would 
answer my highest wishes. Not doubting also 
their kindly overlooking any defects arising 
from not having time to correct and transcribe 
what I have written, or from impaired faculties. 
I am, gentlemen, 
Your respectfull fellow-servant, 
JOHN REDMAN. 
Philadelphia, September 3, IT93. 42 
YELLOW FEVER. 
From further consideration on the experience 
and numerous instances we have had in later 
years of the good and sometimes surprising 
effects attending the use of calomell and other 
mercurial preparations, in resolving and remov- 
ing obstructions of the liver, with incipient drop- 
sies, as well as those of the other viscera, par- 
ticularly infarctions of the mesaraic glands, and 
also in some autumnal bilious fevers, by pro- 
curing large discharges not only of scybala and 
fluid bile, but also such as was very tenacious, 
as if it had been impacted in some of the biliary 
ducts, to the great and immediate relief of the 
patient-of which Dr. Carson gives a remark- 
able instance in himself-I have no doubt, but 
had we then been in the use of it, and given 
a dose of it immediately preceding the saline 
purgatives, it might have produced a more 
speedy and copious discharge of the bilious mor- 
bid matter, and perhaps more complete in the 
first instance, besides probably anticipating or 
preventing the necessity of repeating so often YELLOW FEVER. 
43 
the saline doses, to the no small comfort of the 
sick, to whom so many and frequent repetitions 
were very irksome. I therefore most heartily con- 
curr with those who are in the use of calomell 
and jalap for the purpose of evacuating the bil- 
iary and other contents of the stomach and 
intestines in the beginning of the disease. But 
as the first and even the second dose of those 
dry and indissoluble powders sometimes fail of 
producing the desired effects, to the loss of too 
much precious time in the cases, and consider- 
ing, as I do, the neutral saline purgatives as 
more apt to pervade and scour the biliary ducts 
and intestinal glands, and probably with less 
stimulus than jalap or other such substances, 
and possibly acting as much or more by their 
solvent than stimulant qualities, which is of no 
small moment if the bile or lymph to be dis- 
charged be very tenacious, as Dr. Mitchell some- 
times found it on dissection-I am apt to think 
that three or four drachms of the salts, given 
in due time after the dose of calomell, might 44 
YELLOW FEVER. 
more speedily and efficaciously produce the 
effect, and save much of the time necessary to 
wait before they dare venture to give a second 
dose of calomel and jalap; and therefore wish 
and recommend, on some proper opportunity, 
to make the try all.