fcUJ *&$ UNITED STATES OF AMERICA WASHINGTON, D. C. GPO 16—67244-1 Presented to the Statistical Division, Surgeon-General's Library, United States Army Washington, D. C. BY The Prudential Insurance Co. of America Newark, New Jeriey / ADDITIONAL FACTS AND OBSERVATIONS RELATIVE TO THE NATURE AND ORIGIN OF THE Pestilential Fever. BY THE COLLEGE OF PHYSICIANS OF PHILADELPHIA. PHILADELPHIA: PRINTED BY A. BARTRAM, FOR THOMAS DOBSON, AT THE STONE HOUSE, NO. 41, SOUTH SECOND STREET. >s°b,L ^ JlfcZSf? CONTENTS. PAGE. I I I Introdudion, Letter from James Pemberton, Esq. to Dodor Cafpar Wistar, junr. Letter from Thomas Willing, Esq. to Dr. Samuel P. Griffitts, Letter from Benjamin Chew, Esq. to Dodor C. Wistar, Communication from Dr. John Charlton, Preft- dent of the Medical Society of the state of New Tork, to Dr. David Hofack, 13 Communication from Dodor Samuel Bard, to Dr. David Hofack, 15 Extrads from Dr. John Redman* s Letter to the College of Phyficians of Philadelphia, on the Tellow Fever of 1762. Read Sept em- ber yth, 1793, !9 Communication from Dr. Jofeph Bay ley, of New Tork, to Dr. David Hofack, 22 Letter from Dr. David Hofack of New Tork, to Dr. William Currie, 31 Cases CONTENTS. Cafes of Tellow Fever which occurred in the Pennfylvania Hofpital, in the year 1798, 33 Statement of fads tending to prove the contagious nature of the Tellow Fever, at German- town, in the year 1798, by Dr. C. Wistar, 36 Letter from Dr. George Bensell to Dr. Cafpar Wistar, 39 Letters from Dr. Charles Meredith to Dr. S. P. Griffitts, 42 Letter from Dodor John Wilson to Dr. C. Wistar, 46 Letter from Dr. Eneas Munfon, to Dr. William Shippen, 48 History of the origin and progrefs of the Tellow Fever in New-Haven, 1794. Extraded from the New Tork Evening Post, of Oc- tober, 1803, 50 Letter from Dr. James Stratton, to Dr. S. P. Griffitts, 72 Letter from Dr. John Stuart, of the IJland of Grenada, to Dr. David Hofack, 77 An account of the rife and progrefs of the Fever, which prevailed in Southwark, during part of the Summer and Autumn of the prefent year, 1805. By Dr. William Currie, 85 ADDITIONAL FACTS, &c. V^/N the re-appearance of the peftilential fever in this city in 1793, after an interval of more than thirty years, we were ftruck with its mortality and contagious nature, as well as with the train of fymp- toms, (o widely different from any thing we had been accuftomed to. Thefe confiderations naturally produced a fuppofition of its foreign origin ; and in the courfe of our inquiries on the fubjeft, we were led to make the following conclufion, in reply to the requifition of the governor of the commonwealth on the origin of the difeafe. " No inftance has ever occurred, of the difeafe " called the Yellow Fever, being generated in this " city, or in any other part of this flate, as far as we B know; C a ) " know; but there have been frequent inftances of " its having been imported, not only into this, but " into other parts of North America, and pre- " vailing there for a certain period of time; and " from the rife, progrefs and nature of the malignant " fever, which began to prevail here about the be- " ginning of laft Auguft, and extended itfelf gradu- tf ally over a great part of the city, we are of opi- " nion, that this difeafe was imported into Philadel- " phia by fome of the veffels which arrived in the " port after the middle of July. This opinion we " are further confirmed in by the various accounts " we have received from the beft authorities we " could procure on the fubjecl." Subfequent events and refearches have confirmed thefe opinions; and in 1798, when the facility of producing fufficient proofs was abundant, we pub- lifhed an account of the nature and origin of the peftilential fever, accompanied with fuch fafts to prove its introduction to this city from the Weft Indies, as to us appeared incontrovertible. The mode of introduction and of the fpreading of this difeafe, beginning as from a point, and gradually extending itfelf more or lefs throughout the city, as well as the daily inftances of its communication which occurred, had alfo, as we fuppofed, afforded evi- dence, ( 3 ) deuce, fufficiently convi&ive, of its contagious nature. In order, however, to throw more light on the fubject, we conceive it may be ufeful to publifh the opinions and obfervations of feveral refpe&able cha- racters, phyficians and others, concerning thefenti- ments long fince prevalent in this country, as well as fome interefting fatts, which had come to their know- ledge refpe&ing the foreign origin of the difeafe. The importation and contagious nature of this Fever appear to be fo clofely connected, that in ad- dition to what has been repeatedly publimed on this head, we have felefted a few cafes, which we fuppofe muft very clearly prove the contagion of the pefli- lential fever, more particularly during the months of July, Auguft, September, and O&ober. A defire to be ufeful to our country by calling the public attention to thefe important points, fo as to prevent any relaxation in quarantine laws, as well as to diffeminate truth generally for the good of others, has been our motive for making a further publica- tion at this time ; for we think there is too much rtafon to fear that the partial exemption from thefe difeafes, of latter years, may have a tendency to pro- duce a dangerous fecurity amongft us. Letter ( 4 ) Letter from James Pemberton, Efq. to Dodor Cafpar Wistar, junr. Esteemed Friend, Being defirous to aid thy inveftigation of the origin, progrefs, &c. of the difeafe which now again afflifts the inhabitants of this city, I hope my recollection of fafts and opinions, may contribute to affift thy endeavours to obviate the impreffions which the fpeculation of fome late writers on the fubjeft may have occafioned; tending to degrade the falu- brity of our climate, both at home, and in foreign parts; the injurious effefts of which are too obvious to enumerate. Since thy inquiries on this fubjecl:, I have been led to recolleft what I have heard and known, of the feveral periods of time wherein a fimilar, if not the fame kind of fever, has, through the permiffion of Divine Providence, pervaded our city. I recoiled to have heard my father often rehearfe what he knew himfelf of the introduction of the dif- temper;* that it was imported in a (hip (or other fea veffel) from the ifland of Barbadoes, whofe cargo confifted partly of cotton in bags, which were land- ed * In 1699. ( 5 ) ed at a wharf between Market-ftreet and the draw- bridge, and there ftored for fale. He mentioned alfo the name of the owner or confignee, (which is loft to my memory). The diforder, however, made its firft appearance in his family, and the neighbourhood, and thence gradually fpread through the city, at- tended with great mortality ; fully equal, or exceed- ing any that has occurred in the fame fpace of time, comparing the then infant ftate of the city, with its population in 1793, or fmce that period. During this calamity my father was about 15 years of age, and apprentice with Samuel Carpenter, one of the principal traders of that day ; he was well capable of making his remarks on occurrences, and afterwards of remembering them, and knew it to be the invariable judgment of the phyficians, and other citizens, that the difeafe was introduced among them in the manner related above, attributing it to no other vifible caufe. From the time of this calamity until after theyear 1740,1 do not recollecT: to have read any account, or heard any talk of an epidemic fever prevailing in our city, and my memory recurs as far back as to fome tranfaftions in the years 1728 and 1729, though not very material; but I well remember the prevalence of the fmall-pox in the years 1730 and 1731, with great virulence, and that about 1733 inoculation ( 6 ) inoculation was introduced, which I think Dr. Chew was earneft to promote, and that it occafioned much converfation, and great oppofition. In the year 1739, a military expedition, which proved unfuccefsful, was promoted by Great Britain againft fome of the Spanifti Weft-India poffeflions, particularly Carthagena; for which troops were raifed in Pennfylvania, and a communication, before utterly reftrained, was opened with our city: and on return of the fliips and people employed in that bu- finefs, a new fpecies of fever was introduced, but not fo prevalent as to occafion much alarm, nor was the city in that manner remarkably affected until the year 1744, when a difeafe appeared with unufual fymptoms, and proved mortal to a confiderable num- ber of its inhabitants, of whom divers were refpect- able characters, and was diftinguifhed by the, name of Tellow Fever, and known to be imported from fome of the Weft-India iflands. In the autumn of 1747 a malignant fever was in- troduced, and generally believed to be by the means above mentioned, which, although it was moftly confined within the limits of the fouthern parts of the city, below the draw-bridge, and at lodging koufes for failors, and in the neighbourhood of the dock, C 7 ) dock, which was then uncovered, fome refpe&able citizens were feized and carried off by it, of which number was Samuel Powel, an eminent merchant, who resided in that part. A fimilar fever vifited us in the year 1760, which was not long in duration, nor extenfive in its pro- grefs ; but in 1762 the fame kind of difeafe again ap- peared, with a greater degree of malignity, attended with fuch fymptoms as proved fuperior to the Ikill of our moft experienced phyficians; which excited the particular attention and folicitude of my neighbour, Dr. Thomas Bond, to obtain the beft information he could of the nature, origin and progrefs of the difeafe of 1699, by inquiries of the moft ancient inhabitants ; in which he fo far fucceeded to his fa- tisfaclion, as to commit his intelligence to writing, with a view to form a narrative thereof, including the obfervations that had occurred in the courfe of his own practice, on the feveral malignant diforders attending this city fince that period. Having had the opportunity of knowing the ftate of our city in refpect to the prevailing difeafes from the year 1740, I am confirmed in my opinion, that the malignant and infectious fevers afflicting the in- habitants at various times, have been introduced from ( 8 ) from foreign parts, and that this was the invariable judgment of my fellow citizens, phyficians and others, which I never heard called in queftion until fmce the year 1793, when a contrary doctrine was ad- vanced, which I think is as difficult to fupport by facts, as that the plague which diftreffed the citizens of London in the year 1665 was a native of the Britifh climate; or that the fever which raged among the foldiery compofing the flying camp, as it was called, in 1776 and 1777, and carried off near three thou- fand of them after their return to this city, without infecting the inhabitants, originated within its boun- daries. If thefe curfory hints avail in any refpect to pro- mote thy views, they will anfwer my intention of conveying them to thy infpection. I am thy refpectful friend, JAMES PEMBERTON. 12th, lomo. 1802. Letter from Thomas Willing, Esq. to Dodor Samuel P. Griffitts. On my return from England in May 1749, I,of- ten heard converfation on the fubject of the Yellow Fever ( 9 ; Fever which had prevailed in 1747, near the draw- bridge, fo called at that time, in Front-ftreet. My father and mother often lamented the death of their particular friend, Thomas Hatton, bifcuit-baker, who had lived in Front-ftreet, very near the bridge. They told me that the fever had been brought from Barbadoes, in the following manner. Mr. S. Powel who lived on the eaft fide of Plum or Water-ftreet, being part of his wharf eftate, had fent a young man as his fupercargo to Barbadoes, where he died of the Yellow Fever.— that his clothing and bedding had been put in a cheft, and fent back many months afterwards, at the requeft of the lad's friends, who lived at North ■Wales—that the young man's father, mother and aunt came to Mr. Powel's for the cheft one day, whilft Mr. Hatton was drinking a glafs of wine with Mr. Powel; who calling his cooper to come and open the cheft, that the parties might fee what it contained, afked Mr. Hatton to go over the alley with him to the ftore where the cheft lay—that the cheft was opened and the articles looked over, in the prefence of Mr. Powel, Mr. Hatton, the three perfons from North Wales, the cooper and a boy of Mr. Powel's; who all of them fickened and died of C a Yellow ( 10 ) a Yellow Fever, within a few days—that Andrew Hamilton, brother of our late Governor Hamilton, with about forty others of thofe in the neighbour- hood of the bridge, had died of the fame fever, which was confined in its ravages to that part of the city—I think altogether—at leaft I do not recol- lect to have heard otherwife. THOMAS WILLING. Philadelphia, July 21st. 1802. In 1762 a fhip from the Weft Indies came to the Sugar-houfe wharf, below South-ftreet; three men were landed from her, and died of a contagious fever in the neighbourhood, where about fixty others alfo died of the fame fever, as it was believed at the time. T. W. Sir, The foregoing is the memorandum which you afked me this morning to make out for you. I have alfo mentioned the occurrence of malignant fever in Philadelphia, at fuch other periods as my me- mory enables me to recollect. I am, Sir, Your very refpectful friend, THOMAS WILLING. Dr. Samuel Griffitts, Front-street. Letter ( >• ) Letter from Benjamin Chew, Efq. to Dr. Wistar. Dear Sir, All that I can fay with certainty reflecting the prevalence of the Yellow Fever in this city will be comprized within a narrow compafs. I am a native of the prefent ftate of Maryland, and removed with my parents to this city when I was between eight and nine years of age. About the year 1737 I removed into a neighbour- ing ftate with my father and his family, and did not take up my permanent refidence again in this city until the year 1754. The intermediate time was fpent partly in another ftate, and partly in England, whither I went to finifh my ftudies in the profeflion of the law. After my return to America, in the year 1747, bufinefs calling me to Philadelphia, I found the inhabitants greatly alarmed by a conta- gious diforder which raged there, called the Yellow Fever; which was the firft knowledge I had of any fuch difeafe. It had then been fatal to many per- fons, particularly to Andrew Hamilton, Samuel Powel, jun. Thomas Hatton, and others. The r 12 ) The fubjedt then engroffing the converfation in all companies, I well remember it was the univerfal opinion, that the difeafe was imported in a veffel from fome part of the Weft Indies, and was commu- nicated by the clothing contained in the cheft of a perfon who died of the difeafe in the Weft Indies, and that the perfon or perfons who were prefent at the opening of the faid cheft, were the firft who were taken with the Yellow Fever ; and to fome or all of them it had proved fatal. I alfo perfectly remember, that Doctor Thomas Bond and Phineas Bond, Dr. Graham and Dr. Cadwalader, with whom I was particularly acquainted, were all of them of opinion, that it was imported in the manner above ftated: and until the year 1793, I do not recollect to have ever heard it doubted, whether the Yellow Fever, at the different times it had heretofore made its appearance in this city, was imported, or had originated here. I am Sir, with great refpect, Your very humble fervant, BENJAMIN CHEW. Philadelphia, 1 February nth, 1805. J Dr. Wistar. Communication ( '3 ) Communication from Dr. Charlton, Prefident of the Medical Society of the state of New Tork, to Dr. David Hofack. New Tork, September gth, 1803. Dear Sir, In anfwer to your queries: I have practiced phy- fic in this city fmce the year 1762. The fevers that have ufually occurred in fummer and autumn, dur- ing that period, were intermittent, bilious remit- tent, and flow nervous; of late denominated ty- phus fevers. I never faw a cafe of Yellow Fever, in the courfe of my practice, before the year 1793. I refided on Long-Ifland five years of the war, during which lime, I never heard from my medical friends in the city, of any cafe of Yellow Fever having occurred ; nor after my return to it in 1781, did I ever meet with any inftance of it (before the period above- mentioned) although the city was, during the war, more crowded, and far more filthy than ever it was at any other time. I have always confidered the Yellow Fever as a fpecies of difeafe not indigenous to our climate, but of ( H ) of imported origin with us: and here it may be neceffary to remark, that in the year 1795, in con- fequence of an application from the mayor of the city to the medical fociety of the ftate of New York, of which I had the honour of being prefident, a com- mittee of that body were directed to confider of, and report upon the nature and origin of that fever, which prevailed at the time. The report of the tommittee was in favour of its domeftic origin, and was adopted by the fociety ; and in my official ca- pacity, I affixed my fignature to it, though con- trary to my own opinion. Among the diftinguifhing characteriftics of this difeafe, I confider the total abfence of remiffion for thefirft two or three days, after which it frequently happens that there will be a regular, flow pulfe, ap- parently free from febrile action, infomuch that the inexperienced are flattered with a profpect of the favourable termination of the difeafe, while the in- fidious foe is feeretly undermining the fabric, as a few hours fatally evince, by an aggravation of all the fymptoms. Another mark of diftinction, is the duf- ky hue the furface acquires, inftead of the bright orange colour it has in the bilious remittent: the appearance of the tongue and fauces, which are fre- quently (^comparatively) clean to the laft, is a pe- culiarity of this fpecies of fever. I alfo think that delirium C 15 ) delirium does not fupervene fo early, as in the jail, hofpital, or fhip-fever.* I never met with a cafe of Yellow Fever in the country, but which could be clearly traced to have been derived by infection from the city. I am, with great regard, Yours, &c. JOHN CHARLTON. Dr. D. Hofack. Communication from Dodor Samuel Bard, to Doc- tor David Hofack. In anfwer to your inquiries: I began to practice me- dicine in New York, in the year 1766.—Remitting fevers have fince that time prevailed more or lefs eve- ry fall. They frequently were attended with bilious difcharges, and a yellow fkin, and in proportion as thefe fymptoms prevailed, were termed bilious remit- tents; in fome inftances thefe fymptoms have run very high, and the accompanying fever in fuch cafes has generally been more ardent and conftant; but never- thelefs * I also consider the black vomit as a symptom peculiar to (his disease, having* never met with it in any other. ( i6 ) thelefs fenfible remiffions fo generally accompanied them, that they were always looked for; and it is now thought the duty of the phyfician to watch for them, and by emetics, other evacuations, and bliftcrs to promote them, fo as to procure an opportunity to adminifter the Peruvian bark, by which the cure was generally completed.—Now and then, and par- ticularly during the war, when the city was much crowded, and little attention was paid to cleanlinefs ; fevers of a more malignant nature have prevailed, in which a foul mouth, haemorrhages, petechial eruptions, and other marks of diffolution have ei- ther characterifed the difeafe from its commencement, or been fuperadded to the bilious fymptoms in the latter ftages; and then the difeafe has been termed malignant, putrid petechial, jail or hofpital fever. In fuch cafes I have now and then feen profufe bloody difcharges and black, or as it is now more ge- nerally named, coffee-ground vomiting ;* but a more frequent fymptom in thefe fevers, and one I do not remember to have feen in Yellow Fever, is the aphthous cruft with which the mouth and throat is often lined.—In thefe fevers death feldom occurs, nor is a crifis often to be expected before the feventh day, and both are frequently protracted to * Is this of the same nature with the black vomiting of Yel- low Fever ? I suspect not. ( i7 ) to the fourteenth or even to the twentieth—fuch were the cafes of my fifter during the war, and of my fon about fix years ago, which you have frequent- ly heard me mention. Juft before, and what gave occafion to the appointment of the health-officer of New York, about the year 1758 or '59, a fhip crowded with Germans arrived there in a very fick- ly ftate, and were put under my father's care. He procured accommodations for the fick at a little dif- tance from town; and I have heard him fay, that out of five or fix pupils and attendants, he was the only perfon who efcaped the difeafe—this difeafe he always called fhip or jail fever, but never Yellow Fever, and it is worthy of obfervation that he had feen the Yellow Fever which prevailed in New York about the year 1744. Another inftance of the fame nature occurred whilft I was health-officer, I mean the (hip in which Mr. M'Clain came from Scotland ; in which out of I think about three hundred paffengers, upwards of feventy died ; but of thofe I faw, no one cafe which in the leaft refembled Yellow Fever. The firft cafe of fever I ever faw with that affem- blage of fymptoms we have fmce denominated Yel- low Fever, was the cafe of Mr. Jenkins.* To this I was called in confultation with my father—I found D Mr. * In the vear \79C-. t 18 ) Mr. Jenkins perfectly in his fenfes, walking about his chamber, and alternately fitting on his bed, with an handkerchief in his hand, continually wiping the blood which oozed from his mouth and gums, and with a very yellow /kin. But what ftruck me moft forcibly was the flownefs and regularity of his pulfe; infomuch that upon retiring to another room, I remarked, that notwithftanding the other threaten- ing fymptoms, I could not help entertaining the moft confident expectation of his recovery: my father, however, immediately checked my hopes by inform- ing me, that this was a cafe of the Tellow Fever of the West Indies, that he confidered the patient in the moft imminent danger, and indeed had little or no hopes of his recovery. You know the event, and how foon we were convinced of the correctnefs of his judgment, both as to the fate of poor Jenkins, and the nature of his complaint. Since this we have too frequently had to lament the occurrence of Yellow Fever, which all the ex- perience I have had, has ftill tended to convince me is a difeafe I never faw before that cafe of Mr. Jen- kins. The rapid courfe of this fever, terminating in death fometimes fo early as the fecond, frequently on the third and fourth, and feldom protracted to the ( 19 ) the feventh day ; the violence and unremitting na- ture of the fymptoms ; the difcoloration of the fkin, which is frequently livid rather than yellow; the haemorrhages, black vomiting, and above all the ceffation of fever, with the regularly flow pulfe, which generally precede death, do in my opinion diftinguifh it from all others. You will perceive that I confider this fever as a diftindt idiopathic difeafe, and not a variety or grade of any other—I likewife believe it to be a ftranger and not a native of our country, and from the beft: information 1 have been able to obtain, in every in- stance of acceflion imported from abroad. I am, &c. S. BARD. December \*]th, 1803. Doctor D. Hosack. Extrads from Dr. John Redman's Letter to the College of Physicians of Philadelphia, on the Tel- low Fever of 1762. Read September yth, 1793. My memory being much impaired by age and in- firmities, I have endeavoured to affift my recollection refpedting the Yellow Fever, which raged amongft us chiefly in the fouthern part of the city in 1762, by recurring to my day-book, in Auguft, Septem- ber, and October of that year, and by making in- quiries ( 20 ) quiries of fome perfons whom I remembered to have attended at that time under particular circum- ftances. By the aforefaid retrofpe&ion, I find I muft have had one patient as early as the 20th of Auguft— whofe cafe I treated at firft as a remittent, from the circumftance of his living above a mile from the ci- ty, to the fouthward, near low and wet grounds ; though he fometimes came to town and tranfacted bufinefs near the place where the Yellow Fever had then juft began to appear, and I had not then feen any of them. I had another patient on the 28th of Auguft—from thence to September ift, four or five —from that time they daily increafed, fo that from the 20th to the 25th of September, (when the dif- eafe appears to have been at its height,) I attended daily 1801-20 patients; though other phyficians had more ; and I believe Dr. Bond and others had patients in it about a week before me: from the 27th the difeafe appears to have declined, fo that by the 20th of October I had but two or three frefh pati- ents in it, and thofe I believe only fuch perfons as had lately come to lodge or live in that part of the town ; after this time I had a few more fcattered pati- ents ; and alfo two in the firft week of November, but none afterwards. The ( 21 ) The fever aforefaid was moftly circumfcribed be- tween Pine-ftreet northerly, and three or four fquares from thence foutherly, and extended from Front or Water-ftreet to Third or Fourth ftreets weft ward: ve- ry few had it above Walnut-ftreet. Its nrft and great- eft ravages were about the New Market, and the fquare to the eaftward of it; in which, after fome con- fiderable fearch and tracing it, it was found to have originated in a number of fmall back tenements form- ing a kind of court, the entrance to which was by two narrow alleys from Front and Pine-ftrects, and where failors often had their lodgings; to which a Tick failor from on board a veffel from the Havan- nah, where it then raged, was brought privately after night, before the veffel had come up to town, to the houfe of one Leadbetter, where he foon di- ed, and was fecretly buried. And I believe Lead- better, with moft of his family and many others in that court, foon after fell a facrifice to the diftem- per ; and from thence it fpread rapidly, firft affect- ing the houfes neareft adjoining in Front and Pine- ftreets. In this difeafe, a bowl of vinegar was kept in the chamber of the fick, with an hot iron fometimes put therein, which ferved for the benefit of the pati- ent, the phyfician and the attendants, and indeed was ufeful for dipping the hand therein, and rubbing one's ( ™ ) one's face before approaching the bed and feeling the pulfe. This was the chief preventive or prefer- vativel ufed, befides great temperance, avoiding to vifit patients fafting, if poflible, and keeping tobacco in my mouth while in the fick room ; not from any expectation of benefit from uny quality in the to- bacco, except that of preventing my fwallowing my faliva. This method I found better than a con- stant ufe of prefervatives; which after a little time, I perceived to affect my mind with fuch fears as I thought were likely to render me more fufceptible of infection than the omiffion of them : and fo dis- carded them and went fearlefs, though not thought- lefs, wherever called; and I thank God have been preferved harmlofs from fuch ills to this day. Communication from Dr. Jofeph Bayley, to Dr. David Hofack. Sir, The queries which you were pleafed to addrefs to me require an apology for not attending to them fooner. A change in my fituation in life, prompted me to fet apart, at this feafon of leifure, a little time to vifit my friends in the country. I have C 23 ) I have anfwered the queftions very briefly, but the. fame candidly. I have the honour to be, Your moft obedient, and Very humble fervant. JOSEPH BAYLEY. January, 1804. 1 ft. Quere. Do you confider it Cthe Yellow Fe- ver) as differing from typhus fever, and bilious remitting fever, and in what does it differ from thofe fevers ? A. It differs from typhus in the rapidity of its progrefs through its different ftages, and the irrita- bility of the ftomach. Bilious remitting fever is a milder difeafe of longer duration ; the yellownefs of the body is an invariable attendant, and comes on at the beginning ; but that difcoloration of the fkin which frequently accompanies Yellow Fever comes on later, and is of a du/ky yellow or orange colour, readily diftinguifhed from the yellownefs of bilious fever ; the matter vomited in bilious fever, is al- ways bilious, from a bright yellow to a dark green. 2d. Q^ Have you ever feen the Yellow Fever on board of veffels arriving from our fouthern ftates, or what are the fymptoms which are ufually met with in the fevers on board thofe veffels ? A. ( 24 ) A. When the Yellow Fever rages in any of thofe ftates, perfons ill with this difeafe arrive in veffels. But this is not the cafe when the Yellow Fever is not epidemic ; but bilious remitting fever and intermit- ting fever are the ufual difeafes received at the Ma- rine hofpital from coafting veffels, in the months of July, Auguft, September, and October. 3d. CK Have you ever feen a fever with black vo- mit, orange-coloured fkin, and terminating fatally within feven days, on board the Irifh fhips crowd- ed with paffengers ? is a fever of this fort frequent- ly met with ? or does it ufually affume the charac- ters of the typhus fever, i. e. jail or hofpital fever arifing from confined human effluvia ? A. Among the greater number of fick Irifh emi- grants that arrived here in the year 1801, I have feen four cafes of fever, that terminated in black vomit (of the colour of very weak coffee, with black mucous particles floating in it) on the feventh or eighth day of the difeafe. Their eyes were inflam- ed and protruded ; the fkin began to change after the third or fourth day, and before death was uni- verfally of an orange colour; but there was not that naufea and vomiting at the beginning as in Yellow Fever. 4th. Ch Is the common typhus fever frequently obferved in veffels from the Weft Indies, or from our fouthern ftates ? A ( *5 ) A. I have feen typhus fever in veffels that have had long paffages from the Weft Indies, likewife from the Eaft Indies, but never from the fouthern ftates. 5. Q. Have you ever feen the common autumnal remittent as obferved in this country on board of the Weft India or Irifh veffels ? A. In paffenger veffels from Ireland late in the fall, and beginning of winter, and occafionally on board Weft India veffels, fevers refembling the au- tumnal remittent are met with. 6. Charlton muft be very interefting, and not Iefs fo the communication of Dr. Jofeph Bayley from our qua- rantine ground. It may not be an unimportant fact, that I have been informed by the fame gentleman, that Dr. Ledyard died of the Yellow Fever at the quarantine ground, and not of gout, as reprefented. Dr. Ledyard, when he firft entered upon the du- ties of the Health-office, as he himfelf informed me, went to Staten Ifland with the belief that the Yellow Fever was not an imported difeafe, but generated at home. A few weeks before his death he informed me that he had been compelled to change his belief, and that all his obfervations at the Health-office fa- tisfied him that the Yellow Fever was exclufively de- rived from the Weft-Indies. That he had feen the bilious remittent from our fouthern ftates, and the fhip fever in the crowded fliips from Ireland, but that he had neverfeen the black vomit and the orange- coloured fkin attending either the fever of the Irifh veffels or the bilious remittent from Georgia or the Carolinas. The records of the New York hofpital will alfo teftify, if neceffary, that in no one inftance where the fhip fever of the Irifti veffels proved fatal, it was terminated either by the yellow fkin or black ( 33 ) black vomit. Three or four years fince many of the fick were conveyed to our City Hofpital, and were attended by Dr. Hamerfley and myfelf; and, general- ly, where they proved fatal, it was not in lefs than from fifteen to twenty-five days: not fo, certainly, with Yellow Fever. Yours, truly, D. HOSACK. New Tork, 1 January igth, 1805. \ Cafes of Tellow Fever which occurred in the Pennfyl- vania Hofpital, in the year 1798. BY the minutes of the fitting managers of the Pennfylvania Hofpital it appears, that on the 25th of Auguft, 1798, "no cafe has occurred of Yellow " Fever this month in the hofpital. The patients " have been forbid to go out, and vifitors to come " in, by the fitting managers; on account of the " faid fever prevailing in the city. They alfo by a " minute have excepted againft the admiflion of all " fevers, during the prevalence of the prefent epi- " demic ; and agreed, that the phyficians fhould not " recommend F r 34 ) " recommend any cafes from houfes in which the " diforder is fufpected to be." September iid, 1798. They fay, " Catharine " Shepard, the affiftant nurfe of the men's ward, " took the Yellow Fever the 8 th inft. and remains ill " in the houfe. She is fuppofed to have taken the " fever, by going for clothes into the city. The " fitting managers, at the requeft of Wm. Annefly " and James Brown, (two of the journeymen car- " penters employed in the building) admitted them " to fleep in the garret of the weftern apartment, " on their promifing not to enter the city; and " agreeing, if taken ill of the fever, to be removed, " if required, to the City Hofpital. William An- " nefly is now unwell, and fuppofed to be in the " fever, but not afcertained. He has been feveral " times in town, which may account for his taking c< the diforder." Oftober 2jth, 1798. The managers fay, " Our " pupil, G. Lee, took the Yellow Fever the 7th " inft. he fuppofes in the city. Patrick Savage " the cell-keeper got drunk on receiving his wages, " and lay all night in a houfe where the fever was; " and in the morning of the 8th, he took it very " badly. Elizabeth M'Gregor took the fever the " 14th. ( 35 ) " 14th. She had not been in the city at all, fincc " it broke out. Mordecai Ackly took it the fame " day, and died on the 19th. He had not been out " of the hofpital for four months paft. On the 14th, " Caleb Parr took it alfo, and died the next day, " he had not been in town for years. Barbara Place, " the cook, juft employed as fuch from Paffyunk, " took it the 20th, and died the 25th ; fhe might " have brought it with her : and Elizabeth Robe- " fon, nurfe of the New Houfe, took it the 27th." N. B. She died in November. From the foregoing records it appears, Catharine Shepard, William Annefly, Dr. Lee and Patrick Savage caught the fever by vifiting infected houfes in the city; and that Elizabeth M'Gregor, Mor- decai Ackly, Caleb Parr and Elizabeth Robefon af- terwards took the difeafe, probably from the first mentioned cafes having brought the fever into the houfe. Doctor Lee afterwards obferved, that fome more of the patients were indifpofed, but foon recovered. All fufpicious cafes were kept apart from the well, and every unneceffary intercourfe forbid; which prevented the difeafe from fpreading any further in the hofpital. THOMAS PARKE, One of the Phyftcians of the Pennsylvania Hofpital. July 1805. r 3^ ) Statement of fads tending to prove the contagious na- ture of the Tellow Fever, at Germantown, in the year 1798, by C. Wistar, M. D. THE difeafe which produced the fatal effects now to be related, commenced in the family of Elizabeth Johnfon, a widow who lived in the main ftreet of the village of Germantown, about fix and an half miles from Philadelphia. The perfon firft affected was her child, Betfey Johnfon, who had been in Philadelphia from the third to the feventh of Auguft, in a neighbourhood where feveral cafes of the fever had already appear- ed. She returned home the feventh, and on the ninth of the fame month was attacked with the Yel- low Fever, which terminated fatally in four days. Fourteen days after her death, viz. Auguft 27th, Mrs. Duy, the next neighbour of Mrs. Johnfon, who had vifited Betfey feveral times during her ill— nefs, was attacked with a fever fuppofed to be of the fame kind, and died at the end of four days. On the thirtieth of Auguft, the wife of Charles Hubbs, who alfo lived near to Mrs. Johnfon, and had vifited both Betfey and Mrs. Duy, once at leaft during their refpective indifpofitions, but had not been in Philadelphia for many months, was attacked with unequivocal fymptoms of the Yellow Fever, ( 37 ) Fever, in its moft malignant form, and died the 2d of September. Mr. Duy, hufband of the above-mentioned Mrs. Duy, was attacked eighteen days after the death of his wife, viz. September 18, and died alfo, after an illnefs of fix days. A few days after the death o^ Mrs. Duy, an En- glifh gentleman and his wife, of the name of Fifher, who had fled from Philadelphia on account of the fever, went to board with Mr. Duy, and were pla- ced in the chamber occupied by his late wife during her illnefs: they were alfo attacked with fever. Mrs. Fifher was taken, September 19th, and recovered in a few days, but Mr. Fifher, who was attacked four days after his wife, died with the black vomit, the 27th of September. At the fame time, the difeafe re-appeared in Mrs. Johnfon's family, in a young female fervant, who was very ill, but recovered,—foon after the attack of this girl, Mrs. Johnfon herfelf was taken ill with the fame difeafe : fhe had vifited both of her neigh- bours, Mrs. Duy and Mrs. Hubbs, while they were fick, fhe alfo had afforted the clothes of her deceafed daughter, four or five days before her own attack commenced, but had not been in Philadelphia for a month. Her diforder continued eight days, and terminated the 28th of September, with convulfions and the black vomit. A ( 38 ^ A few days before the death of Mrs. Johnfon, Elizabeth Stern, a woman who lived in the family, was attacked with fever, and became very yellow. Her fymptoms appeared moderate at firft, but after lingering a fortnight fhe died alfo.—The wife of a tenant of Mrs. Johnfon, who lived in a feparate part of the houfe, but ufed the fame yard, was at- tacked before the death of Elizabeth Stern, and re- covered with great difficulty. The laft victim to be mentioned, was one Stephen Poft, an old man, who lived at a diftance, but worked in Mr. Duy's barn, while the bed was there on which Mrs. Duy died. He alfo was attacked with fever, and died in a few days. * Thefe melancholy circumftances occurred in a village which has long been remarkable for its falu- brity, at a time when the other inhabitants enjoy- ed their ufual health. In moft of the cafes, the dif- eafe appears to have been contracted at the houfe of Mrs. Johnfon, which, before this diftrefling period, had been eminently diftinguifhed by the health and longevity of its inhabitants. The family were ex- tremely neat, and it may be afferted with confidence, that the premifes were never more clean, than they were at the time of this truly affecting cataftrophe. What caufe but contagion is adequate to the pro- duction of fuch a difeafe among perfons fo fituated ? Philadelphia, Dec. 15, 1805. Germantown C 39 ) Letter from Dr. George Bensell to Dr. Caspar Wistar. Germantown, May 4th, 1805. Dear Sir, THE events that took- place in Germantown in the fummer of 1798, have excited much attention and difcuffion ; tending to eftablifh the belief of the cxiftence of contagion in Yellow Fever, even out of the city of Philadelphia. Some of the cafes brought forward for this purpofe having come under my obfervation, I fhall ftate them, as they occurred, agreeably to your defire, leaving to your judgment, to draw the proper inference therefrom. On the 10th Auguft, 1798, I was called to the daughter of Mrs. Johnfon, whom I found labouring under fever, with fymptoms of the moft alarming nature : I immediately fuggefted to a friend of the family, that it was probable it would terminate fatally, and at the fame time intimated, that fhe had the Yellow Fever. She died on the 13th. On the 30th Auguft, I was requeftedto fee Mrs. Hubbs, who lived immediately oppofite to Mrs. Johnfon's: fhe was feized with a violent vomiting, which had continued feveral hours, and was ac- companied with ardent and inceffant fever ; bearing ftrong ( 40 ) ftrong marks of malignancy, on the fecond day from the attack. She died on the 2d September, hav- ing previoufly vomited the brownifh fluid fo fre- quently defcribed. Her fkin was a deep orange co- lour ; and various livid fpots were to be feen on her neck, breaft, and arms.—The mortality which foon afterwards happened in the neighbourhood, 1 had not an opportunity of making remarks on ; but it is certain, that no fever had hitherto exifted in Ger- mantown, within the limits of my knowledge, whofe tendency and termination poffeffed fuch powerful to- kens of contagion. In the cafe of Mrs. Hubbs, I had the moft folemn affurances, that fhe had not been in the city during the fummer; and thefe were made by her hufband, a man eminent for the moral rectitude of his conduct, and a diftinguiflied preacher, among the fociety of Duncards. How then fhall we account for the rapid violence of her death, the prefence of fymptoms fo unufual and deftructive, as well as the fubfequent figns of malignancy after difeafe ? This woman's fate has al- ways been to me completely inexplicable. In the courfe of 19 years, I have never feen any thing like it in Germantown, or in the furrounding country, where my practice has extended. The ( 4i ) The village itfelf is fcarcely fufceptible of the au- tumnal difeafes, that are to be found every year on higher and lower ground, above, below, and around it: the proper line of demarcation might commence from the height as you enter it, and end at Cliveden, the fummer refidence of Mr. Chew ; immediately above which, is Beggarftown, where the dyfentery began in 1803, and extended itfelf to Chefnut-hill, wearing the appearance of an epidemic: its progrefs was marked with unufual fatality, to adults as well as children. In 1802, I do not recollect in my practice a cafe of fcarlet-fever in the village—but it was to be met with in fhort, and remote diftances from it j and feemed to traverfe every poffible variety of fitua- tion. I found it along the margins of the Schuyl- kill and Wiffahiccon, as well as on the high and rocky grounds above. This fingular exclufion from epidemics, it would perhaps be difficult to affign any good reafon for : but facts of this kind may be traced, as far back as 1787, when the cynanche maligna fwept away a great proportion of many families, on the ele- vated fituations of the Ridge and Chefnut-hill, as well G ( 42 ) well as in the low lands of the neighbouring town fhips. With the greateft efteem and friendfhip, I am, dear fir, Your moft obedient fervant. GEORGE BENSELL. Dr. Caspar Wistar. Letters from Dr. Charles Meredith to Dr. S. P. Griffitts. Philadelphia, May $d91805. My Dear Sir, I am extremely forry it is not in my power to fur- nifh you with a very circumftantial account of the difeafes of Robert Kirkbride and his daughter. I was not engaged in attendance on either of them, and I believe faw them but once. The circumftances, in both cafes, were however too irapreffive to be ea- fily forgotten. During the prevalence of the Yellow Fever, in the autumn of 1798, Mr. Kirkbride made a vifit to Philadelphia. Very foon after his departure from thence, he was attacked with fymptoms of fever, and immediately on his arrival at home, about 26 miles from the city, my father was called in, who attended him during the remainder of his illnefs. I faw ( 43 ) few him on the following day; he appeared much affected with languor and debility, and prefented the ufual appearances of a perfon ftruggling with the firft fymptoms of a highly malignant difeafe. His eyes were much fuffufed with blood, and his pulfe did not exceed forty pulfations in a minute. I fully concurred with my father in opinion, that his dif- eafe was entirely fimilar to that which prevailed at the fame time in this city, to fuch an alarming de- gree. Not having an opportunity of feeing him af- terwards, I am unable to detail the fymptoms as they occurred; but the event fully juftified the opinion we had formed : an intenfe yellownefs of the fkin took place early, and he died, I believe, on the ninth day. His daughter, a young woman, of about 18 years of age, attended him as nurfe during his illnefs, and at the time of his death, was feized with fymptoms of fever, which exhibited from the firft ftill greater marks of malignity; but as I did not fee her till the day fhe died, it is not in my power to give you a hiftory of her cafe ; the appearances then, how- ever, left me no room to doubt of the nature of her difeafe. There was an univerfal fuffufion of bile over the whole furface of her body, which, I was in- formed, had taken place on the third day; and fhe had vomited much dark-coloured matter, refembling coffee- C 44 ) coffee-grounds, the morning I faw her; from that time till her death, fhe continued in a ftate of ftupor, from which fhe could with difficulty be awakened, her countenance exhibiting, at the fame time, the moft ftriking indications of the ravages of Yellow Fever. She died on the fifth day. From all the fymp- toms that I faw, and learned from her attendants, I could not hefitate to believe her difeafe was, in its nature, precifely fimilar to her father's ; but owing, perhaps, to her time of life, and greater degree of predifpofition, ftill more malignant, and fpeedy in its termination. I regret much, that my informa- tion on this fubjectis fo limited, but think it proba- ble I can procure a more particular account of both cafes; if fo, I will take an early opportunity to com- municate it. I am, with much refpect, Yours, &c. CHARLES MEREDITH. Dr. Griffitts. Philadelphia, May 30th, 1805. My Dear Sir, I have been difappointed in my expectation of re- ceiving further information rcfpecting the cafes of Mr. Kirkbride and his daughter. It appears, there have ( 45 ) have been no regular ftatements preferved; but am happy to fay, that my father's account, although not more minute, correfponds entirely with that I had the pleafure to communicate fome time ago. As the daughter of Mr. Kirkbride had not been in Philadelphia, previoufly to her illnefs, the circum- ftances of her difeafe were calculated to excite con- fiderable alarm, and more efpecially fo, as no per- fon appeared to entertain a doubt of the fource whence it proceeded : every one feemed ready to at- tribute it to contagion received from the father, and indeed her conftant attendance, together with the folicitude and fear with which fhe regarded the fitua- tion of a beloved parent, muft have rendered her fyftem extremely favourable to the reception of dif- eafe. But what principally favoured the opinion of the daughter's illnefs depending on the contagious nature of her father's, was the general ftate of health that prevailed in the place. Few local fixa- tions are perhaps entirely exempted from the occa- fional vifits of autumnal fever; but in this particular neighbourhood there exift few of its remote caufes, and confequently its appearance is by no means fre- quent, and its fymptoms feldom marked by any pe- culiar malignity. Although Mr. Kirkbride's family was numerous, I do not recollect a cafe of autumnaj remittent to have happened in it before or after the fatal ( 46 ) fatal period in 1798. There were, however, a few cafes in the vicinity, about the time of Mr. Kirk- bride's death, the only one of which I recollect to have terminated fatally, was protracted until the twentieth day. I have, fir, ftated fuch facts as have recurred to my recollection, and cannot conclude without regret- ting my inability to give a more minute account of a cafe, which might perhaps have fome tendency to elucidate a fubject, that has called forth different opinions from men of the higheft perfonal merit, and profeffional refpectability. With fincere efteem, Yours, &c. CHARLES MEREDITH. Dr. Samuel P. Griffitts. Dodor John Wilson's Letter to Dr. Wistar. Dear Sir., I received your requeft of July 2d, refpecting the cafe of R. Kirkbride's daughter; but perhaps I am not fufficiently able to fatjsfy you on the fubject, as I was not called upon in the primary ftage of her complaint. I was called to vifit R. Kirkbride's daughter, October 3d, 1798, and on the third day of ( 47 ) her difeafe. She was labouring under all the fymp- toms of Yellow Fever as dcfcribed by authors, and fimilar to thofe I had before feen, only attended with more yellownefs of the fkin : I vifited her twice on the 4th, and once on the 5th of October, upon which day fhe died. I was informed, that fhe had not been to the city, or even from home, for fome time. She nurfed her father with great diligence, during his illnefs, who was kept pretty much confin- ed in a fmall room, and was once very much over- come with fear, on account of his fainting. The neighbourhood of R. Kirkbride, as well as my own, was very healthy, as far as my obfervation and practice extended, during the prevalence of Yellow Fever in your city, and not one cafe of our common bilious fever occurred during that time, as far as I can recollect. Dr. Meredith, fenr. attended R. Kirkbride during his illnefs, and alfo his daughter in the primary part of her difeafe. From him fome light, poffibly, may be obtained on this fubject. With fentiments of efteem, I remain, Your friend and well wifher, JOHN WILSON. July 10th, 1805. Dr. Caspar Wistar. ( 48 ) Letter from Dr. Eneas Mitnfon, to Dr. William Shippen. New-Haven, May 3^, 1805. Sir, Yours of the 27th ult. in due time came to hand; but my ill health prevented that immediate attention to the fubject which it merited, and might have been expected. In the year 1794, we were vifited with the Yel- low Fever in this town : I then took much pains to find out and afcertain the origin of it, by collecting facts. My fcrutiny in the affair excited others to the fame inquiry. We found the facts to be fuch, as foon convinced the more thinking part of the town, that it was introduced by the floop Iris, and fpread by contagion, from one to another, in almoft every inftance, as far as it prevailed. The facts were at that time fo recent and obvious, and the public mind was fo fully convinced, that I neglect- ed the neceffary fteps to authenticate my communica- tions to Mr. Webfter, which he publifhed, not ap- prehending the importance and confequence of it; but as thofe facts were, in the public prints, faid to be ftated from popular tales and idle reports, I was under the neceffity, about two years fince, of going over the ground again, in vindication of my charac- ter, ( 49 ) ter, in regard to my communications, as in Mr. W.'s publication ; and although at fuch a diftance of time, when many witneffes were not to be pro- cured, yet the more fubftantial facts were fupported by the depofitions of a number of our moft refpec- table citizens, which are now in the hands of either Doctor David Hofack, or the Editor of the Evening Poft, New York. An inftance of importation at Chatham, on Connecticut river, might have been as clearly evinced as that in New-Haven : but I have too many matters at this time of life to attend to, befide hunting up evidence to eftablifh a fact fo abundantly evinced already. I could mention a number of folitary cafes of its introduction fincc, and thofe decided and clearly - marked ; but what fhall 1 fay more ? Through all my pilgrimage in life, which is upwards of feventy years, I have never met with any of the human race ' more blind than tjiofe who were determined they would not fee. Such vouchers as I have procured, I wifh may be lodged in fome public records, for the benefit of thofe who may come after us; though I do not think it will remain long a fubject of difpute Your moft obedient fervant, ENEAS MUNSON. Dr. William Shippen. H History ( 5° ) History of the origin and progrefs of the Tellow Fever in New-Haven, 1794. Extradedfrom the New- Ttrk Evening Post, ofOdober, 1803. " The hiftory of the origin and progrefs of the Tellow Fever at New-Haven, has been compiled by gentlemen on the fpot, fully competent to the talk, and unincumbered with the bias of diftorting theo- ries. They have prefented us with a minute and well connected feries of facts, which, having been re- corded while of recent occurrence, are calculated to make an impreffion too deep and lafting, to give way to difingenuous cavils, or filly fophiftries." The following ftatements are made by Dr. Mun- fon, jun. and his father, and publifhed by Mr. Webfter, in 1796. " On the 10th of June 1794, (fays Dr. Munfon) the peftilential, or Yellow Fever, appeared here. Dr. Hotchkifs vifited Ifaac Gorham's wife, on the Long-Wharf. She complained of a violent pain in her head, back and limbs; her eyes were dull and flightly inflamed; fhe had naufea at her ftomach, was obftinately coftive, with a moderate degree of fever. No marks of inflammation were difcoverable by infpection in the throat. The diftrefsful fymp- toms ( s> ) tonus, above mentioned, continued till the four- teenth ; when her pain and diftrefs fuddenly fub- fided, and fhe was elated with the profpect of a fpeedy recovery. In the evening fhe vomited mat- ter refembling coffee-grounds; and died on the fif- teenth. The phyfician who attended her, was ig- norant of her complaint till he faw what fhe had vomited. He then declared her difeafe to be the Tellow Fever. On the 15th of June, I vifited Elias Gorham's daughter, a child of eight years of age, in Chapel- Street, three-quarters of a mile from Ifaac Gor- ham's houfe. She had been fick three days ; her countenance was flufhed with a deep red colour; her eyes were dull, and highly inflamed ; fhe had violent pain in her head, back, and Hmbs; naufea, and frequent vomiting; obftinate coftivenefs; a quick, full, hard, throbbing pulfe; her fkin was hot and dry ; and her tongue covered with a thick white fur. On the 16th, her pain and diftrefs fud- denly abated; in a few hours, fhe vomited up mat- ter refembling coffee-grounds; and died the next day. I iufpefted her throat, during her illnefs, and could difcover no marks of inflammation. I was furprifed at the Angular appearance of the difeafe, and hearing of the death of Mrs. Gorham, ;Ifaac Gorham's wife) inquired of the mother if her daughter ( 52 ) daughter had been on the wharf She informed me that the child had lived with her aunt (Ifaac Gorham's wife) nearly a week. The 23d of June, I vifited the child's mother. She complained of violent pain in her head, back, and limbs; naufea; frequent vomiting; obftinatc coftivenefs ; with a confidcrable degree of fever. Thefe fymptoms continued five or fix days; then gradually abated; and foon after fhe recovered her ufual health. On the 20th of June, Mr. Elijah Auftin died in New-York; and his clerk, Henry Hubbard, died in Derby. They complained within three or four hours of each other; and Mr. Hubbard vomited matter refembling coffee-grounds. The inhabitants of this town were alarmed at thefe hidden deaths, and requefted the feled-men to make diligent inquiry into the origin of this difeafe. On examination, it appeared, that in the beginning of June, captain Truman arrived from Martinico, in a floop that was infected with the contagion of the Yellow Fever; that this veffel lay at the wharf, within a few rods of Ifaac Gorham's houfe; that fhe had on board a chest of clothes, which had belong- ed to a mariner who died of the Yellow Fever in Martinico; and that his cheft was carried into Mr. Auftin's ( 53 ) Auftin's ftore, and opened in the prefence of cap- tain Truman, Mr. Auftin, Henry Hubbard, and Polly Gorham; the three laft mentioned of whom died in a fhort time after their expofure to the con- tents of the cheft :—hence it is highly probable, that Mrs. Gorham caught the difeafe from the infected floop, or clothing. Mr. Auftin's ftore ftands with- in three or four rods of Ifaac Gorham's houfe; and no perfon in town was known to have the Yellow Fever previous to captain Truman's arrival. June 26th, Ifaac Gorham loft an infant child with the Yellow Fever; and foon after his fon and daughter were affected with it. The former died. Solomon Mudge died on the 30th; Jacob Thom- fon's negro woman, on the ift of July; Archibald M'Niel on the 9th ; Polly Brown on the 3d of Au- guft; John Storer, jun. and John Hide, on the 8th; and widow Thomfon, on the 10th.—Jacob Thomforis negro woman, Solomon Mudge, John Storer, jun. and John Hide, had vifited Mr. Gorham's houfe a few days before their illnefs; Polly Brown and Mrs. Thomfon, nursed in Mr. Gorham's family ; and Archibald McNeil nursed Solomon Mudge.— Elias Gill died on the 12th of Auguft ; and Samuel Grifwold's wife on the 7 th : the former vifited Mr. Gorham's houfe; the latter nurfed in his family. ( 54 ) There were a number of perfons who caught the difeafe at Mr. Gorham's houfe, and recovered. Mrs. Thomfon, on the firft day of her illnefs, was moved half a mile from Mr. Gorham's into George-ftreet. Luther Fitch caught the difeafe from Mrs. Thomfon, and communicated it to his fervant maid. Both recovered.—Mr. Fitch lives in College-ftreet, nearly three-quarters of a mile diftant from Mr. Gorham's houfe. 1 could trace the difeafe throughout the town. No perfon had the Tellow Fever, unlefs in confequence of attending the fick, or of being expofed by nurfes, infeded houfes, clothing, or furniture. I have inquired of feveral aged perfons in this town, relative to the Yellow Fever, whether they knew of its having ever been here previous to June 1794; and there is but a fingle inftance, the facts relating to which are thefe:—In the year 1743, a tranfient perfon, by the name of Nevins, who came from the Weft-Indies, lodged at the houfe of Na- thaniel Brown, an inn-keeper, in this city. The man was taken very fick in the night; and died fhortly afterwards ; and his body was very yellow, after death. Mr. Brown's wife fickened in a ftiort time, and died of the fame complaint; which was at that time fuppofed to be the Yellow Fever. The ( 55 ) The following is an account of the number who died, with the Yellow Fever, in New-Haven, in the different months of the year 1794: June, 6 Jll,y» 3 Auguft, 16 September, 26 October, 12 November, 1 Total 64 Of this number, forty-eight vomited matter re- fembling coffee-grounds, or port wine. There were about a hundred and fixty perfons who had the Yellow Fever. Three perfons recovered who vomited matter like coffee-grounds; but none re- covered, that I remember, who vomited matter re- fembling port wine. Some vomited a vifcid, tough mucus, fimilar to the white of an egg; others, matter like chocolate, which were as fatal as the black vomit. " In refpect to the origin and nature of the difeafe under confideration, I efteem it jufti- fiable to reafon from facts alone. I am fully of opinion that the Yellow Fever is feldom or never generated in this country, [but] that it is always r 56 ) always imported from abroad." " Had it ever ap- peared in Connecticut, before the year 1743* a°d June, 1794, we fhould, undoubtedly, have had fome record of the fact. There is no fuch record, and no perfon remembers to have heard of fuch a difeafe, but at thefe periods, prevailing in any part of the ftate. There are numbers of aged perfons in New-Haven, who remember the putrid ulcerous fore throat, fmall-pox, meafles, dyfentery, &c. rag- ing here, with great mortality ; but have no recol- lection of any Yellow Fever. Hence we may ra- tionally conclude that it never did appear, in this ftate, but in the years 1743, and 1794. " If the citizens of large commercial cities were attentive in tracing the origin of the Yellow Fever, on its first appearing among them, they would often find that the difeafe was imported. In fome inftan- ces it would be extremely difficult to difcover the origin. But the mifchief lies in this—that the inha- bitants of fuch cities, whenever a contagious difeafe makes its appearance among them, endeavour to fup- prefs all rumor of it, from an apprehenfion of alarm- ing the country and injuring their commerce; un- willing to believe that there is evil in the city till the difeafe fpreads in every direction. Then, indeed, when it is too late, they are folicitous in the ufe of means ( 57 ) means to arreft its progrefs. As it extends itfek flowly, at firft, feafonable exertion might both detect its fource and prevent its increafe; but when it is dif- fufed through a city, it fpreads with rapidity, and it is no longer poffible to difcover where it began. But as, whenever the Yellow Fever has appeared in the United States, it has always been in fea-port towns, and originated near wharves, docks and ware- houfes, there feems to be high probability that the difeafe is imported. ELIJAH MUNSON. New Haven, April 24, 1796. Extrad from the Letter of Dr. Munfon,fen. " We have never, in this part of the country, (except in a fingle inftance in the year 1743, been acquainted with a fever altogether fimilar to the one in queftion. True, fome chronic complaints in the vifcera, as well as acute fporadic fevers, ending in fphacelation, have been attended with the vomiting of a fluid, putting on the appearance of coffee- grounds, and terminated in a black vomit. We have often feen continual endemical fevers, inter- mittent, and remittent bilious fevers, originating I from ( 58 ) from the putrid gafes of animals and vegetables com- mixed, as from draining of ponds and ftagnant wa- ters—but no difeafe from thefe fources, or any in our climate, I conceive, ever compared with what is generally known by the name of Yellow Fever; no difeafe attended with fo great rapidity, or charac- terifed by that deep-fhaded, univerfal yellownefs, and vomiting of black-coloured matter, oozing from the furface of the ftomach. Dr. Ferriar obferves, that peftilential diforders are not to be afcribed to animal putridity. Inftances have been adduced in which thoufands of dead bo- dies have been left to putrify on fields of battle, without producing peftilential fever; nor have fe- vers been obferved to originate, or to rage more fe- vcrely, in houfes furrounding church-yards, though the flench is often infufferably offenfive. ENEAS MUNSON." New Haven, April, 1796. Mr. Webfter, in his " Concluding Obfervations," admits the force of the above facts to be fuch as to make out one cafe of importation. " It feems to be proved, (fuch are his words') that in New-Haven the difeafe was introduced and propagated by infedbn.'' The ( 59 ) The year fubfequent to the above publication, Dr. Munfon fenior, in anfwer to a letter from Dr. Ho- fack of New-York, inquiring if any additional facts had come to his knowledge, gives him the following information which is tranferibed from the original. " It was evident in almoft every inftance that the fick had been expofed. We were a long time, how- ever, in the dark, refpecting a fmall child about two years old, as the parents were confident it had never been abroad to be expofed. This was at length ex- plained by one of the nurfes, who had been long in the infedion, who informed, that as he was paffing the houfe, he faw the child endangered by a carriage, he caught it up in his arms and fet it into the houfe, unknown to the parents. Another [youth] which died with the black vomit, the phyfician confidently aflerted died of worms and not of the fever, which the inhabitants had conceived fuch apprehenfions of at this time. The neighbourhood entertained an high opinion of the phyfician, and from unbounded confidence in him, friends and neighbours went in, as ufual, to perform their kind offices to the fick. After death, the difeafed was permitted the cuftom- ary ceremonies of burial, which before this time had been laid afide in this fever. The corpfe was expofed to view as is common, and borne of eight bearers, attended by a large proceffion. The con- fequence was a more extenfive fpread of the fever than ( 6o ) than was known during the whole ficknefs from any one individual. Six out of the eight bearers werefeized with the fever within a week, and many who attended at the houfe." Notwithftanding Mr. Webfter, after publifhing the communication of Doctors Munfon, acknow- ledged, that " in New-Haven, the difeafe was intro- duced and propagated by infection, yet he afterwards publifhed in the Commercial Advertifer, a laboured refutation of every important circumftance, and at- tempted to produce a conclufion diametrically op- pofite, without the Ieaft apology for his change of opinion. This occafioned Doctor Munfon, fen. to be again applied to for information on the fubject; and in a letter, in anfwer, dated New Haven, September, 1803, he confirms his former ftatements, and af- ferts that he has never feen reafon to alter his opi- nion with refpect to the introduction of the Yel- low Fever into New Haven, in 1794. From Mr. Webfter's account, it would appear, that the floop Iris, Capt. Trueman, from Martinico, arrived [not firft at New Haven, but] at New-York the latter part of May, 1794. Her crew and paf- fengers being in health, fhe was admitted as a clean veffel, ( 61 ) veffel, and hauled up at or near a wharf. Here fhe lay wind-bound, from eight to twelve days ; during which time, no perfon on board was ill. Early in June, the floop arrived at New Haven, as has been related by Dr. Munfon. Mr. Webfter does not deny, that the cafes of Yellow Fever, mentioned by Dr. Munfon, occurred at New Haven, foon after the arrival of the floop at that place; but does not allow, that they origina- ted from any contagion or infection imported in the floop, although he acknowledges in one of his laft publications on this fubject, that " from the floop " was landed a cheft of clothes, which belonged to " a feaman who died with Fever in Martinico; " which cheft was opened and the contents invento- " ried by Mr. Auftin in his ftore, in prefence of " capt. Truman, of Henry Hubbard, and of Polly " Gorham, a niece of Ifaac Gorham; Mr. Auftin " and his clerk, continues he, were feized a few \