It E PORT 
OF THE 
JOINT COMMITTEE OF COUNCILS, 
RELATIVE TO 
THE MALIGNANT OR PESTILENTIAL DISEASE 
OF 
THE SUMMER AND AUTUMN OF 1820, 
IN 
THE CITY OF PHILADELPHIA. 
PHILADELPHIA •• 
PRINTED BY LYDIA R. BAILEY, 
NO. 10, NORTH STREET. 
1821. REPORT, &c. 
To the Select and Common Councils of the City 
of Philadelphia. 
THE Joint Committee, appointed to "inquire into the 
facts connected 'with the appearance and prevalence of malig- 
nant or pestilential disease, during the past summer and au- 
tumn, and to report those means they may deem best adapted 
to prevent its recurrence or to check its progress," beg leave 
to report:- 
That the best expedient for obtaining the information con- 
templated by the Resolution of Councils, appeared to be that 
of a public invitation to Medical Societies and individuals; 
and the following one accordingly issued from several news- 
papers, viz. 
" The Select and Common Councils, at their last meeting, 
appointed a Committee to inquire into the facts connected 
with the appearance and prevalence of malignant or pestilen- 
tial disease, during the past summer and present autumn, 
and to report those means they may deem best adapted to 
prevent its recurrence or to check its progress. That Com- 
mittee respectfully invites the College of Physicians, the 
Academy of Medicine, the Board of Health, the Lazaretto 
Physician, the Port Physician, and others, to communicate 
answers to the following questions, viz. 
" First. Had you an opportunity of observing any cases 
of malignant fever in Philadelphia, in the months of July, 
August, September, and October, 1820? 
" Second. In those districts which, according to your ex- 
perience, were most affected by disease, what peculiar causes 
were discovered, which did not exist in other parts of the 
city ? 4 
" Third. Did the disease abate in any considerable degree 
before the appearance of frost ? 
" Fourth. What means should be adopted, with a view of 
preventing the recurrence, or of checking the progress, of 
malignant autumnal fever, in this city ?" 
The design of your Committee, in limiting their queries 
to those above written, was to produce information that might 
be relied on as the foundation of an improved police, without 
eliciting those points of discrepance in scientific discussions 
which have frequently arranged the medical faculty into 
parties. 
The College of Physicians were the first to send their an- 
swer, which is annexed, and marked A. 
The Academy of Medicine communicated the paper an-, 
nexed, marked B. 
The Port Physician conceived that his sentiments were 
sufficiently expressed as one of the Committee of the Acade- 
my of Medicine. 
The Lazaretto Physician sent the paper marked C, hereto 
annexed. 
Dr. Currie sent the paper annexed, marked D, and 
Dr. Emlen, the paper annexed, marked E. , 
It will be perceived, that those Societies, and the Lazaretto 
Physician, have formed their opinions and advice on the 
strength of facts which they have not offered in detail, and 
that for these they refer to the Board of Health. The state- 
ment of this Board, then, thus recommended, cannot fail to 
receive the greatest attention. This is annexed, with the 
publication it refers to, and is marked F. 
One of the chief objects of your Committee was to obtain 
statements of facts; and another, to have the benefit of opi- 
nions founded on them. It is well known, that the learned 
Societies who first acceded to the invitation, have heretofore 
differed in their sentiments respecting the origin of malignant 
fevers with which the cities of the United States have been 
afflicted; but your Committee arc now happy to observe an 
unusual degree of coincidence as regards the cause, and en- 
tire consent respecting the means of prevention. This unity 5 
of the medical partied consists in their belief that the city 
may become unhealthy, even to the malign state, from offen- 
sive matters brought in vessels from other ports, and that a 
deleterious atmosphere may arise among us, from accumulated 
filth about the wharves and streets, from the want of cleanli- 
ness in families, and from inadequate ventilation. It is not 
essential for the purpose of effective legislation, that the City 
Councils should seek for nice distinctions in physiological 
points; or that they should inquire, without a prospect of 
attainment, into the degree of concentration of miasm neces- 
sary to produce or disseminate febrile diseases. It is enough 
for them to know, that the summer pestilence of our cities, if 
not exactly the same, is no less terrific in character and ter- 
mination than are intertropieal diseases; and that physicians 
of all parties agree in the important opinion, that neither of 
them will be likely to spread in a pure atmosphere. If then 
the disease in question originate in filth, here or abroad, in 
a cellar, a street, or a ship; or if, being generated by what- 
ever cause, in whatever place, it has the power of propagation 
only in foul air, your Committee would recommend the im- 
mediate adoption of measures calculated to prevent its rege- 
neration from domestic, as well as its retroduction from fo- 
reign sources;-such, too, as will probably check its pro- 
gress, if those precautions should prove unavailing. The 
medical faculty of our City has recommended the revision 
and strict observance of the health laws, and more assiduous 
attention to cleanliness. Your Committee had commenced 
an inquiry with a view to the emendation of the former, 
when they were assured that the Board of Health, assisted 
by eminent physicians, were employed in the work. To 
that Board the subject more properly belongs, and your 
Committee have declined interference. It is understood that 
the contemplated revision will embrace the sections of the 
law relating to Quarantine, as well as to domestic nui- 
sances ; and especially the power of enforcing the former, 
and removing the latter. If the Councils should find them- 
selves called upon to act, your Committee respectfully inti- 
mate that the fit period for interposition will be after the 6 
publication of the projected alterations of the laws, or when 
it shall he ascertained that no progress towards the improve- 
ment of these will be made. 
The existing powers of the Board of Health, and of the 
City Councils, arc limited to the express or implied terms of 
their respective charters. All their powers could not be spe- 
cifically defined ; but the usage of either of those bodies has 
been such as to confer the legislative portion of municipal 
regulation on the Councils, while the Board performed the 
duty of enforcing such of the ordinances of the former as re- 
lated to health. The Councils enjoin their own officers to 
execute the ordinances; and the Board of Health, though 
independent of the Corporation, have been accustomed to 
lend their aid. 
Many nuisances may arise in summer, not to be pre- 
vented by contemplation of law : the Board of Health there- 
fore intend to apply to the State Legislature for additional 
powers, to enable them, as cases arise, not only to judge 
what are public nuisances, but to proceed promptly for the 
suppression of them. As, for example, where a person is 
attacked by any malignant disease that may probably ex- 
tend, it would be proper that the Board should have direct 
powers to remove any local annoyance from houses or vessels 
that may have occasioned it, and that the neighbours should 
be sent away, at their own or public expense, lest they con- 
tract the malady, by their intercourse with the sick, or expo- 
sure to the same atmosphere. The power to do this should 
exist somewhere, if it does not already; and, as the City 
Councils have no wish to increase their own, they could not 
but approve, were the Board of Health to acquire it for them- 
selves and successors, under such regulations as would forbid 
the abuse of it. The suppression of the threatened epidemic 
of last summer, " in more than one position previously to the 
accession of frost," if not attributable to some atmospherical 
vicissitude, may be ascribed to the decisive measures adopted 
by the Board of Health; and the fact, so encouraging, may 
induce the Legislature to strengthen their hands, in antici- 
pation of a similar emergency. But while that Board is dis- 
posed to add to their duties those following the increase of 7 
power, your Committee feel assured that Councils will be no 
less vigilant on their part to enact such ordinances as may 
come in aid of those of the state. 
The cleanliness of a city ought to be a primary object 
with its representatives, especially in our climate, since it is 
agreed on all hands that a pure atmosphere is no less desira- 
ble as a mean of preventing the spread of malignant fevers, 
than as a certain alleviation of them. Various schemes for 
improvement in our Ordinances connected with this subject, 
may be developed occasionally; but your Committee cannot 
forbear to urge a few of the most important, for immediate 
consideration, and with a viewr to the reference of some to 
Select Committees. Those schemes are founded on such 
facts as have been communicated, or are know n; and your 
Committee recommend,- 
First. That alterations in the present mode of contracting 
for cleaning the streets and alleys, be adopted; it appearing 
to your Committee, that while the contractor is entitled to 
the street dirt as part of his emolument, he will gather it 
from places most convenient for himself, before he sends the 
carts to the narrow courts and alleys; though, for the pro- 
motion of general health, the earliest attention should be 
given to these. And your Committee would invite the atten- 
tion of Councils to an Ordinance of New York, prescribing 
the terms of their contract for cleaning. The Ordinance 
divides that city into two districts;-provides for contracting 
with one or more persons in each district, for collecting and 
carrying away all the filth at stated periods;-obliges house- 
keepers to place the offal of their houses in the street on cer- 
tain days and hours, and at no others;-prohibits the keep- 
ing of such offal, or casting it into back yards and alleys;- 
causes the contractors to remove filth from market houses on 
certain days and hours;-and forbids all persons, except 
contractors, from carrying away street dirt. There is an- 
other Ordinance of New York, which appoints an inspector 
of hidden nuisances: this, with some additions to extend his 
duty to the discovery of nuisances in public streets, and to 
making report to the contractors, who may be subjected to 
penalties for neglecting to remove such nuisances upon notice 8 
given by the inspector, your Committee recommend as a 
precedent for one of our own. 
Second. That all alleys, leading into public streets, be 
taken under the public superintendency, if authority from 
the State may be obtained,-the right of the Corporation 
now extending only to such alleys as are twenty feet wide , 
and upwards :-that narrow eralleys be paved by the owners, 
and in default thereof, that they be closed at their intersec- 
tion with the streets, or paved by the public,-the expense 
to be assessed on lots adjoining the alleys. 
Third. That some mode may be adopted for using the 
hydrant water at the same time when the scavengers are at 
work; and that hydrants, for this purpose, be placed on the 
highest situations in the City plot. 
Fourth. That, in future, hewn stone shall be laid for a 
bottom as well as a side of gutters, in order to give a clear 
passage for water and filth, and to prevent damage done by 
brushing or picking, with the broom, the gravel or sand from 
between the pebbles or bricks with which the gutters are now 
paved,-in consequence of which, large holes are made-the 
receptacles of filth. 
Fifth. That no wharf shall be hereafter built, unless the 
dock on either side be so deep as to be covered by water at 
low tide. 
Sixth. That docks now made, and which are not covered 
at low tide, be filled up, or dug deeper, to produce that effect 
at the head of the dock. 
Seventh. That wharves be paved by the owners, and 
cleansed as the streets are or shall be; and that, when paved, 
they shall be raised above the summit of spring-tides. 
Eighth. That privies shall be sunk to gravel, or to the 
depth of feet, where there is none. 
Ninth. That no tavern licence be granted or renewed, in 
any part of the City, unless the lot has sufficient space, out- 
side of the house, for a privy. 
Tenth. That no tavern licence be hereafter granted for 
any houses, except those now licensed, and ferry-houses, 
from the East side of Front street to Delaware river, inclu- 
sive. This recommendation is predicated on the fact, that 9 
our summer pestilence lias generally commenced and raged 
with greatest violence within those limits; where the houses 
are built most closely to each other, where the streets are 
narrowest, where the greatest degree of dampness is uni- 
formly present, where the tortuous direction of streets ob- 
structs perflation; confining heat, moisture, and effluvia from 
filth in conjunction; and where, consequently, the exciting 
causes of fever, arising from intemperate drinking, would 
multiply victims to that disease. This limited prohibition of 
licences would have the further desirable effect of preventing* 
many strangers and others from being exposed, in certain 
seasons, to a morbific atmosphere, during the usual hours of 
repose. 
Eleventh. That inquiry be made respecting the best means 
of regulating the number of inmates or boarders in one house, 
where that number is so great, in proportion to the space for 
accommodation, as to endanger its health or that of the public. 
The annexed communications from Medical Societies, 
the Board of Health, and individuals, as well as the public 
testimony of a late Committee of Citizens, prove the exist- 
ence of nuisances unheard of before the present investigation, 
which obviously require the active interposition of the con- 
stituted authorities. 
A plan for their suppression, and for other purposes, has 
been recently published by a gentleman distinguished for his 
philanthropy and enterprise, commended by many, and urged 
upon the notice of Councils by medical men of all parties. 
Deeply sensible as your Committee are, of the beneficial and 
permanent effects on health to result from its completion, 
there arc considerations attending it which restrain them 
from a full examination of its merits. Nor is the plan so 
well understood by all the advocates for its general tendency, 
as to present distinct parts for deliberation; and if it were, 
the Corporation is not competent alone to accomplish it. 
The Legislature, the Judiciary, the patriotic supporters of 
the scheme, and the individuals to be affected by its adoption, 
the Board of Health, and the Wardens of the Port, should 
he consulted. Moreover, it is acknowledged to be capable 10 
of amendment: it will receive its perfection from the hands 
in which it rests. Time will be necessary to make it worthy 
of the unequivocal patronage of its friends, whose activity 
and zeal might be checked by any interposition of Councils. 
But alterations are now required in the eastern section of 
the City, which Councils should, in the opinion of your Com- 
mittee, attend to without delay,-which pertain to their pro- 
vince, and are within their means: some of those may require 
the aid of a Court of Law, and of the Wardens; as, if a spe- 
cial Committee should deem it expedient (and your Commit- 
tee deem it indispensable) that a new street, fronting the 
stores on the wharf, be laid out, and the wharves extended. 
To effect this, the Court should be applied to for the power; 
the Wardens, for their opinion of its bearing on the river 
channel; and the Councils, for the means of paving it. And 
if the improvement of that section be so important as your 
Committee believe it, they cannot perceive a more suitable 
place for a beginning than the water side; for a new paved 
street there, raised high enough to prevent spring tides from 
extending to the cellars or the ground floors of buildings, 
would be a certain convenience, an additional mean of pro- 
moting health, and a help to more extensive schemes for 
meliorating the climate of that vicinity. The labour of col- 
lecting necessary information previous to the designation of 
the street, the conference with individuals concerned, and 
applications to the Court, would, with other business to be 
presented in that particular district, occupy all the time that 
could be reasonably required of a Committee; and your 
Committee therefore recommend,- 
Twelfth. That a Committee of three from each Council 
be forthwith appointed, to inquire into the most expedient 
measures for improvement in that part of the City eastward 
of Front street, with a view to the preservation of the gene- 
ral health. 
John R. Coates, John M. Scott, 
B. Taylor, J. W. Thompson, 
C. Watson, Elijah Griffiths. 
February Sth, 1821. 11 
A. 
To John R. Coates, Chairman of the Joint Committee of the 
Select and Common Councils, 44 appointed to inquire into 
the facts connected with the appearance and prevalence of 
malignant or pestilential disease, during the past sum- 
mer," &c. &c. 
The College of Physicians of Philadelphia, have delibe- 
rately considered the questions proposed by you on the 29th 
of November last, and have directed the following replies 
thereto to be communicated to you:- 
1st. Most of the members of the College had an opportu- 
nity of observing cases of malignant fever in Philadelphia, 
during the months of July, August, September, and October 
last. The type was as malignant as we have ever known it; 
those persons who remained in the infected districts, after 
having been taken sick, seldom recovered;-remedies did 
not appear to have the usual effects in their cases. 
2nd. The Board of Health, from their more correct know- 
ledge of the facts, are best qualified to give satisfactory an- 
swers to these particulars. 
3rd. The disease, though malignant, was partial. It gave 
way on the appearance of frost, but not in that striking man- 
ner which had occurred in years when it was more widely 
spread. 
4th. During the months of June, July, August, and Sep- 
tember, every vessel from the coast of Africa, the West In- 
dies, and continent of America, to the southward of Cape 
Fear, should undergo a strict search, and perform an effec- 
tual quarantine. This procedure should take place during 
the whole year with respect to vessels from the Mediterra- 
nean. 
To prevent the spreading of malignant fever amongst us, 
the Board of Health should have full power to remove ves- 
sels, and persons, and to prevent communication with infect- 
ed places :-also, to have infected houses, bedding, and cloth- 
ing, thoroughly cleansed. 12 
And lastly, We would recommend a strict attention to die 
means of producing cleanliness, and a free ventilation, espe- 
cially in those parts of the city near the Delaware, where 
the malignant fever has always made its first appearance. 
This cannot be done whilst Water street continues in its 
present confined situation, with the accumulated filth of ma- 
ny years, and for the most part without privies. We there- 
fore strongly recommend the prosecution of the plan now in 
contemplation, of removing the whole of the buildings from 
the east side of Front street inclusive, to the river, begin- 
ning at Vine and ending at South street, according to the 
original plan of William Penn, the wise and intelligent 
founder of our city. 
By order of the College of 
Physicians of Philadelphia. 
THOMAS PARKE, President. 
December 14th, 1820. 
B. 
Dear Sir,- 
Entertaining a conviction, that the disease commonly call- 
ed yellow fever, may originate in foreign as well as domes- 
tic filth, the Academy of Medicine have instructed us to say, 
in reply to the communication which they have had the ho- 
nor to receive through you, from a committee of the City 
Councils, that in their opinion, the most effectual plan, which, 
probably, at present, could be executed, of preventing a re- 
currence of the evil, would consist in a more vigilant exclu- 
sion of foul vessels from hot climates, and in greater atten- 
tion to cleanliness, particularly as regards the eastern front 
of the City. 
It being understood, that the Board of Health will soon 
take up this subject, with a view to an application for some 
further legislative provisions, the Academy hold in reserve 
for a conference with that body, to which they have reason 
to believe they will be invited, the details of these sugges- 
tions. 13 
Deeply impressed, however, with its importance, they can 
not forbear to express to the Councils in the strongest terms, 
their approbation, as an ulterior measure, of the well known 
proposal of Mr. Beck, under an entire persuasion, that it is 
pre-eminently calculated to afford security against the re- 
visitations of the pestilential forms of fever. To such con- 
clusion, they are led by the fact, that whether the yellow fe- 
ver be of local origin, or imported, it has uniformly made 
its appearance on the water side of the City, where it is quite 
certain, that a state of things only exists to generate or nou- 
rish it, and by proof scarcely less indisputable, that the dis- 
ease has never prevailed to any extent, west of Fourth street. 
It remains for us only to add, that several of the mem- 
bers of the Academy had ample opportunities of seeing the 
disease last season j-that it seemed to them to have assumed 
a character of unusual typhoid malignity, and that according 
to their observations, it did cease in more than one position, 
previously to the accession of frost. 
With the highest respect, we are, Dear Sir, 
Your most obedient- servants, 
SAMUEL JACKSON, 
N. CHAPMAN, 
ALEX. KNIGHT. 
JOHN R. COATES, Esq. Chairman, tyc. 
Philad. Dec. 23d, 1820. 
c. 
Philadelphia, Feb. 4, 1821. 
Sir,- 
I observe in the daily papers, that a Committee of the Se- 
lect and Common Councils, of which you are chairman, re- 
quest me to answer certain questions, in reference to the ma- 
lignant fever which prevailed in our City during the past 
summer and autumn. Compelled by the Health Law to re- 
side at the Lazaretto, from the first day of June, to the first 
of October, in every year, I had not an opportunity person- 
ally, of inquiring into the local causes, which it is supposed 14 
gave origin to the fever. I do not think it necessary to com- 
municate to you the information I have received since my 
arrival in the City, as it will be, or has, all been submitted 
to you by the Board of Health, and the respectable societies 
you have called upon, many of whose members have in per- 
son made all the necessary inquiries. Three cases of the 
malignant fever which occurred last summer, came under 
my notice. Two of them were of the first cases in the City, 
near Race street wharf; the third occurred in the brig Mar- 
tha. They were sent to the hospital at the Lazaretto by the 
Board of Health. 
I have but one object in writing this letter, (in addition 
to the respect which I entertain for your Committee,) and 
that is, to call your attention particularly to the eastern front 
of the City. Its confined and filthy condition must be known 
to you. It appears to me that if some plan similar to that 
proposed by Paul Beck, Jr. could be carried into effect, the 
health of the City would be much improved. In the sum- 
mers of 1819-20, the fever originated in that quarter. I 
will not attempt to determine on the practicability of the 
plan, to alter the eastern front of the City. Time, at all 
events,»will be necessary to its accomplishment. In the mean 
while, I strongly recommend the appointment of persons, 
whose sole duty shall be, to superintend the cleanliness of the 
eastern parts of the City. In the month of March or April, 
they should commence, and personally inspect every store, 
warehouse, cellar, dwelling-house, and such other places 
where filth may generate; and have the power to remove all 
offensive or dangerous matter immediately. They should 
also at least twice a month during the summer and autumn, 
closely examine all suspicious places, and suffer nothing cal- 
culated to injure the health of the City, to remain within its 
limits. If such officers should be appointed, the Councils 
will of course, in their wisdom, particularly designate their 
duties. Under such a system of management, and a corre- 
sponding attention to foul and sickly vessels at the Lazaretto, 
with the blessing of Providence, I sincerely believe that ma- 
lignant fever might be banished from our City. 15 
It was my intention to have submitted to you some obser- 
vations, respecting the operations of the Health Law at the 
Lazaretto, but I decline it, on account of the Board of Health 
having presented a memorial to the Legislature to effect cer- 
tain alterations and additions, which, if carried, no doubt 
will have an influence in protecting the City from malignant 
fever. 
With sentiments of respect, 
I remain your obedient servant, 
GEO. F. LEHMAN, 
Lazaretto Physician. 
JOHN R. COATES, Esq. Chairman, #c. 
D. 
To the Joint Committee, " appointed by the Select and Com- 
mon Councils of Philadelphia, to examine into the facts 
connected with the appearance and prevalence of the ma- 
lignant or pestilential disease, during the past summer and 
autumn; and to report those means that they may deem 
best adapted to prevent its recurrence, or to check its pro- 
gress." 
Gentiemex,- 
Though I am convinced from the opportunities which 1 
have had, at different times, of observing the rise and pro- 
gress of the malignant or pestilential fever, in Philadelphia, 
that it has been imported from the West Indies, I am also 
convinced, that it is only propagated, or becomes epidemic, 
in situations where the air is in a great measure confined 
and rendered impure by the putrefaction of vegetables, or 
other putrefiable substances ; of course the most certain me- 
thod of preventing its recurrence, is to subject all vessels ar- 
riving from the West Indies, and other places where the dis- 
ease is prevalent, during the summer and autumnal months, 
to Quarantine at the Lazaretto; and to prevent such as do 
arrive without due performance of Quarantine, from commu- 16 
nicating the disease to the inhabitants of this City; the 
wharves should be improved; the docks kept perfectly free 
from putrefying substances of every description ; and all the 
houses, stores, and materials removed from Water street, and 
the east side of Front street, if practicable, and if not, to 
have all the caverns and cellars filled up ; Water street, as 
well as the docks, raised and firmly paved; and every sub- 
stance liable to putrefaction, prevented from being landed or 
allowed to remain near the wharves or Water street. 
To satisfy you that I am correct in my opinion, I take the 
liberty to refer you to the accompanying manuscript copy of 
the communication of'the College of Physicians of this City, 
to the Legislature of this State, in the year 1806, at which 
time Doctors Kuhn and Wistar were members of the Col- 
lege, and approved of it. 
With sentiments of sincere respect and esteem, 
I am, Gentlemen, your well-wisher and fellow-citizen, 
WM. CURRIE. 
Phil ad. Dec. 6th, 1820. 
.3 copy of the Communication of the College of Physicians of 
Philadelphia, to the State Legislature, in the year 1806. 
" In the year 1793, the latter end of July and beginning 
of August, a fever of a new and very alarming nature made 
its first appearance in Water street, between Mulberry and 
Sassafras streets; and all the cases of that fever were evi- 
dently traced for the first two or three weeks to that particu- 
lar part of the City, or to persons who had intercourse with 
the sick in that neighbourhood; after which, other parts of 
the City, the Northern Liberties, and the District of South- 
wark, became gradually affected with the same disease, and 
it was not until the arrival of hard frost that it subsided, af- 
ter having proved mortal to nearly live thousand persons." 
" About the latter end of July, in the year 1797, a fever of 
the same description again occurred in this City. It was ob- 
served first in Penn, below Pine street, from whence it pro- 
gressed gradually to different parts of the City, and District 17 
of Southwark. It ceased on the arrival of hard frost, and 
occurred again at the same season of the year, in 1798, 1799, 
1802, and 1805, and every time in some part of Water street. 
The peculiarity of the symptoms, the remarkable inefficacy 
of the remedies which are usually successful in curing fevers 
which commonly occur in the same season of the year, in low 
wet situations, rendered offensive by putrefying vegetables, 
with somewhat similar symptoms during the early stage, its 
great mortality and contagious nature, convinced us that it 
was a disease essentially different from any fever that ever 
had occurred in this City from domestic causes, and we were 
convinced that the contagion by which it was produced, was 
imported into Philadelphia by some of the vessels which ar- 
rived at this port from the West Indies." 
" The first appearance of the malignant or destructive fe- 
ver, usually called the yellow fever, has never been observ- 
ed among the marshy tracts to the South of Southwark, or 
to the south-west of this City, nor in the confined and filthy 
alleys, or brick ponds, but always in the neighbourhood of 
the wharves, or on the salubrious banks of the Delaware at 
Kensington, and near the places where vessels from the West 
Indies have arrived." " In fact, it was traced every time 
that it occurred in this City, since 1793, to the present year 
1806, to the vicinity of some vessel or vessels from the West 
Indies, or to persons or clothing connected with them." 
" The principal peculiarities of the malignant yellow fe- 
ver, are its contagious nature, the rapid progress of its symp- 
toms, and the mortality consequent on it; but in all our ob- 
servations and practice, we have never known a case, where 
the remittent or bilious fever of this climate have proved con- 
tagious, though we are aware that they arc sometimes at- 
tended with violent and dangerous symptoms ; but this strik- 
ing characteristic of contagion being absent, they have never 
become an ob ject of public dread or concern." 
3 18 
E. 
To the Joint Committee of the Select and Common Coun- 
cils, " appointed to examine into the facts connected with 
the appearance and prevalence of malignant or pestilential 
disease," &c. &c. 
Gentlemen,- 
Although a member of the College of Physicians, who 
have already replied to your communication addressed to 
them on the 29th of November last, I beg your permission 
briefly to state some opinions in reply to your 4th query, 
which have often impressed me as important; and allow7 me 
further to premise that they are the result of considerable 
reading and observation, upon the disease in question; hav- 
ing been much interested in the subject whilst a member of 
the Board of Health, during the years 1817, 18, & 19. 
The query alluded to is, " What means should be adopt- 
ed with a view of preventing the recurrence, or of checking 
the progress, of malignant autumnal fever, in this City ?" 
Whether yellow fever is of domestic or of foreign origin, 
is yet an undecided question. Very able and distinguished 
medical authors still contend that it is an imported disease ; 
whilst many, perhaps the majority of the profession in the 
United States, assert that it arises from causes existing 
among us. In the midst of this uncertainty then it is sure- 
ly the safest plan to guard both supposed avenues to the dis- 
ease ; and the Health Law of our City is intended to an- 
swer these purposes :-that is, to provide means for enforc- 
ing an effectual Quarantine on all vessels from sickly ports, 
and preserving as far as practicable, a pure atmosphere 
throughout our City, by obviating or removing those causes 
which load it with noxious effluvia. To ensure the former, 
however, the Health Law requires improvement, which I 
have no doubt will be very judiciously pointed out by the pre- 
sent Board of Health, to whom one of your communications 
was addressed. To ensure the latter, adequate power is not, 
nor cannot be given to a Board of Health : other municipal 
authorities must come in to their aid. 19 
I will proceed then to state three desiderata which I have 
thought very important, as means of preventing the recur- 
rence, or of checking the progress, of yellow fever in this 
City. 
1st. To remove all the buildings included between Front 
street and the river Delaware. 
Setting aside all dispute about the primary source of yel- 
low fever, the history of the disease, I believe, in all situa- 
tions where it has existed, has placed its first appearance on 
the wharves of sea port towns. And with but very little 
well attested evidence to the contrary, the history of the dis- 
ease also goes to prove that it is not communicable, or does 
not spread itself in a pure atmosphere. 
Whether then the disease be an imported one and spreads 
from vessels on the wharves to the adjacent buildings through 
the medium of a vitiated air, already produced or arising 
from the holds of vessels, infected persons, clothing, or da- 
maged cargoes:-or, whether the disease be induced in the 
first place by the effluvia created by the accumulated filth 
and crowded condition of the buildings and their occupants, 
on the wharves; in either case would not the removal of 
these confined buildings, and the unavoidable filth produced 
by them so long as they remain, ensure a free ventilation, 
and a pure air, and hence promise to be a very important 
preventive measure ? 
If the disease has a local origin in existing causes on the 
wharves, where it has always first appeared, surely the re- 
moval of those causes would give good grounds to believe 
that the alleged effects must cease. On the other hand, if 
an imported disease, the removal of those causes which viti- 
ate the atmosphere, prevent ventilation, and produce a me- 
dium fitted to convey it'from the infected vessels at the 
wharves, would also give us a very reasonable assurance of 
an exemption from that source. I sincerely hope then that 
the proposed plan of Mr. Beck, now so zealously advocated, 
will turn out a practicable one. I have long thought that if 
any price could make it so, it could scarcely be bought at too 
dear a rate. Before any proposition was before the public to 20 
effect this measure, I have repeatedly expressed an opinion 
that it would do more towards securing us from yellow fever 
than the present Quarantine regulations. 
2nd. As a means of preserving a purer atmosphere through- 
out our City, I would propose the necessity of the Councils 
making it obligatory upon all owners of privies to sink them 
to water. The effluvia from ten or fifteen thousand privies, 
during the summer months, must add greatly to the impuri- 
ty of the air we breathe in this City. Any effect such an or- 
dinance might have upon the water in the wells, would be of 
little consequence, as the Schuylkill water is now so univer- 
sally substituted and preferred. Or, if a practicable plan, 
the objection to communicating the privies with the common 
sewers does not now obtain, that did formerly, or will not at 
least when the dam shall be completed across the Schuylkill 
at the Upper Ferry, as there will then be no water introduced 
which will have mixed with that of the Delaware. 
3rd. Another cause contaminating our atmosphere, and a 
subject of perpetual complaint in the summer months, is the 
filthy and offensive condition of our sluggish gutters. The 
Board of Health have no power over the Schuylkill water, 
nor if they had is there water to spare for cleansing the gut- 
ters. But as we are promised a more abundant supply, when 
the plan now in operation for the purpose shall be completed, 
I would propose, as essentially important, that the Councils 
should provide for the erection of perpetual fountains, so situ- 
ated as to ensure the gutters constantly kept clean during 
the hot weather. 
These means, together with a strict attention to general 
cleanliness throughout this well built and well ventilated 
City, would, I humbly think, give us a warranted assurance 
that with the blessing of the beneficent Ruler of events upon 
our endeavours, we should escape the awful disease which is 
the subject of your communication. 
1 am very respectfully, yours, Ac. 
, SAMUEL EMLEN, Jr. 
Jan. 1st, 1821. 21 
F. 
To John R. Coates, Esq. Chairman of Committee of the 
City Councils. 
Sir,- 
The several queries you addressed to the Board of Health, 
on the part of the Committee appointed hy the City Coun- 
cils, were submitted to a Committee, by whom the following 
answers to your respective questions were reported, and 
which wc now have the honour to communicate to you. 
1st. It being the special duty of the Board of Health to 
take cognizance of all cases of malignant fever in the City, 
it is scarcely necessary to say, in answer to your first ques- 
tion, that the Board has a knowledge of all the cases of that 
disease which occurred in this City in the months of July, 
August, September, and October, 1820. 
2nd. As it respects the general and local causes that exist- 
ed in the parts of the City where the disease prevailed, and 
which may be conjectured to have had an agency in its pro- 
duction, wc refer you to the accompanying paper, which is 
about to be published, in which all the facts in relation to 
that subject are detailed. » 
3rd. The disease entirely disappeared at Hodge's dock and 
vicinity, before the occurrence of frost. The last decidedly 
characterized case in that locality was on the 2nd of August. 
Subsequently to that period that portion of the City was as 
healthy and as free from other diseases, as the City general- 
ly. The disease had also very considerably abated at Wal- 
nut street, before the appearance of frost. 
4th. The fourth question, which regards <f the means that 
should be adopted with a view of preventing the recurrence 
or of checking the progress of malignant autumnal fever in 
this City," is one of deep import and interest, and which, it 
is to be regretted, cannot be solved with absolute certainty. 
It is a subject, which, for many years, has engaged the atten- 
tion of our most enlightened and intelligent citizens, the most 
eminent members of the medical profession, and our legisla- 22 
tive bodies ; but no system that has yet been devised, has 
proved effectual in guarding our City from the disease, in 
periods that are propitious to its occurrence. 
Our Quarantine regulations and Health system, are almost 
exclusively based upon the opinion, that the disease is always 
imported, and communicated by personal contagion and fomi- 
tes, and that it cannot be generated from our own soil, and 
exist in our atmosphere. 
While so great a contrariety of sentiment exists with those 
whose means and habits of observation, render them the most 
competent to settle this much controverted subject, it may 
well be considered as imprudent to trust to the accuracy of 
one only of the doctrines. To close up every avenue of dan- 
ger, the possibility, that both may be true, should constitute 
the spirit, and govern the principles of the law. In Gibral- 
tar, this compound system of prevention has been adopted, 
and appears to have been completely successful. A most rigid 
internal police has been established, which has converted that 
port, from being one remarked for its foulness and filthiness, 
into one noted for its cleanliness and propriety:-at the same 
time, a rigid exclusion from infected places, and a strict 
Quarantine have been maintained. Under this twofold and 
combined plan, Gibraltar has been preserved from the rava- 
ges of malignant or yellow fever, although it had been re- 
peatedly desolated with that disease, when protection was 
trusted solely to exclusion and Quarantine, and while Cadiz, 
Xercs, and other neighbouring cities of Spain, which rely 
solely on them for their safety, continue to be afflicted with 
that scourge. 
From these views, it appears to the Board of Health, that 
the best and most probable means to prevent the recurrence 
of malignant fever in our City, will be attained by amend- 
ing the present Health Law, so as to render it more exten- 
sive in its principles, and more efficient in its provisions; at 
the same time a better arrangement of the police of the City, 
as it respects the maintenance of cleanliness, and the esta- 
blishment of some regulations that will early abate existing 
nuisances, seems to be required of the Corporation. 23 
It is considered unnecessary to give a particular detail of 
the amendments deemed requisite in the present Health Law, 
Councils having no jurisdiction in that particular. But we 
beg leave to direct your attention to certain duties, incum- 
bent on Councils to perform, and powers which they can ex- 
ercise, in doing which, they will essentially co-operate with, 
and aid this Board, in their exertions to preserve the health 
of the City. 
1st. It is a common practice for the citizens to throw into 
the streets, in the summer season, the rinds of melons, par- 
ings of vegetables, husks of corn, and other vegetable, and 
refuse matters. The scavengers seldom pass through any 
one street, more than once in two weeks ; and consequently 
those matters accumulate in the streets, render them unsight- 
ly and filthy, become very offensive, and contaminate the air. 
This practice should be prohibited by Ordinance, and carts 
be sent through the streets daily, at convenient hours, to col- 
lect and remove the various kitchen offals. 
2nd. The gutters, especially those in Water and Front 
streets, the alleys running from Water street to the wharves, 
and the steps, communicating to Front street, should be 
washed and thoroughly cleansed, at least once a week, in the 
warm months, with brooms, and by opening the fire-plugs. 
3rd. Provision should be made for the early paving of the 
private streets, lanes, and alleys, of the City, and some plan 
adopted in order to compel the proprietors of property on 
them, to keep them clean. 
4th. The deep docks that now indent the river border, and 
in which there is a constant accumulation of alluvion of the 
worst nature, should, if practicable, be altered, so as to have 
sluices, which might give a current through them; and the 
wharves, as soon as possible, should be paved, and faced with 
stone. To this end, it might be prohibited to construct any 
new wharveS with logs, or to repair old ones with them. By 
this means, the present defective and very objectionable mode, 
in which our wharves are constructed, might, without it be- 
ing felt as burthensome by the owners, be gradually reme- 
died. 24 
5th. Privies and hog pens, especially the first, are a fre- 
quent and common cause of serious nuisances. At nearly 
every meeting of the Board, its attention is occupied with 
complaints preferred to them on this subject. In the warm 
months, the inconveniences arising from them are especial- 
ly felt, and whole neighbourhoods are infected by their noxi- 
ous exhalations. Whether a very great advantage would not 
arise by the general introduction of the improved apparatus, 
proposed by a company in this City, and which has been 
adopted in Paris, London, and other large cities in Europe, 
may be worthy the particular consideration of your Com- 
mittee. Hog pens, if permitted in the City, ought to be 
cleansed at least once a day, in the warm weather. 
6th. There is a species of nuisance of a disgusting cha- 
racter, productive of many evils, for which some remedy 
should be provided. Many houses in this City have no pri- 
vies, nor any proper conveniences of that kind. On the east 
side of Front street, and in Water street, from Vine to Dock 
street, the Board have ascertained from examination, that 
there are about one hundred houses in which common open 
buckets are used, that are often emptied into the streets at 
night or thrown into the docks. The landlords should be 
compelled to have some proper apparatus, where the nature 
of the locality will not permit privies to be constructed, which 
will remedy a custom pregnant with so many evils. 
It is believed that Councils have full powers to carry these 
necessary regulations into effect; but should it be thought 
otherwise, the Legislature would, doubtless, so enlarge the 
City Charter, as to confer the authority to have them put in 
operation. 
The plan for altering the eastern front of the City, as pro- 
posed by Mr. Beck, if it can be made practicable, •appears 
to promise a reasonable expectation, that it would effect an 
exemption from this fatal scourge. It will be equally ope- 
rative on either of the doctrines that are held, with respect to 
the disease. If it be of domestic origin, by removing and 
suppressing the numerous and unavoidable sources of vile 
nuisances, of confined and foul air, which must exist in that 25 
portion of the City as it now is, the disease must be effec- 
tually prevented from occurring. On the other hand, as it is 
very generally considered by those, who believe the disease 
to be contagious, and to be produced by imported contagion, 
that it can only be propagated in confined places, and in an 
impure atmosphere, by procuring a free circulation of air, 
and establishing cleanliness, the disease cannot spread, after 
it is imported. 
Besides, in the West India islands, where yellow fever is 
unquestionably endemic, precisely the same as is noticed in 
this City, New York, Baltimore, &c. it invariably commen- 
ces, and is generally confined to the water border, and does 
not first appear or prevail in those parts of the towns dis- 
tant from the water. By removing the numerous inhabit- 
ants, who now occupy the dwellings in that low, confined, 
and unwholesome situation, where the disease has invariably 
commenced its ravages, and which has always been its cho- 
sen and favourite seat, additional security will be gained 
against the origin or spreading of the disease when intro- 
duced. For it is the result of the most ample experience, 
founded on wide extended and accurate observations in va- 
rious countries, that there is but little comparative danger of 
contracting a disease in an unwholesome or infected place in 
the day-time. The great danger arises from being exposed 
to the cause of the disease in the damp air and dews of the 
night, and from sleeping in the poisoned atmosphere. 
Whether the plan of Mr. Beck is practicable or not, is a 
question, that is not considered necessary for us to examine. 
It is before the public, who are best able to determine the 
merits of the scheme, as well as the propriety of its execu- 
tion. 
When the disease has once made its appearance, the ex- 
perience acquired in this City, during the past summer and 
autumn, and in New York, in the preceding year, furnishes 
the most ample and satisfactory proof, that the immediate 
removal of the inhabitants from the district infected, pre- 
venting access to it by the erection of barriers, and freeing 
it from all nuisances that might occasion noxious cxhala- 
4 26 
tions, are quite adequate to prevent its progress, and even to 
effect its total suppression. 
With sentiments of respect, 
Your obedient servant, 
SAMUEL JACKSON, 
President of the Board of Health. 
Philad. Jan. 29th, 1821. 
Extracts from Dr. Jackson's Pamphlet on Malignant Fever, 
referred to by the Board of Health. 
EXTRACT, No. I. 
The winter of 1819 and 1820 set in severe towards the last 
of December, until which time it had been open and mild. 
From December until March there were but few intermis- 
sions of cold weather, which was rather more severe than 
usual. During most of that time, the surface of the earth 
was covered with snow. Lightning and thunder occurred on 
the 16th February. The northern lights were witnessed re- 
peatedly in the course of the winter. 
Whooping cough had been prevalent during the preceding 
autumn, but had given way, and meazlcs were the mos< com- 
mon disease. The type was considerably inflammatory, and 
required active depletion. 
The spring was very wet and backward. In March con- 
siderable quantities of rain fell. May was also a humid month. 
There was rain either continued or in showers on eighteen 
days of that month. 5.04 inches of rain fell. The mean tem- 
perature was 66.86. 
On the approach of spring the measles disappeared, and 
scarlatina made its appearance, which continued to prevail 
until August, A few cases were of a very malignant cha- 
racter. 
In June warm weather commenced. The coldness and 
moisture of the spring months, had checked the early evolu- 
tion of the vegetable kingdom, which now progressed with 27 
astonishing rapidity. The crops of hay and the harvest were 
more luxuriant and abundant than had been known for many 
years, and this month being dry and warm, were well got 
in. There fell 1.20 inches of rain, and the mean tempera- 
ture was 78.06 degrees. 
July was a humid and warm month. The thermometer in 
a room with a draft throught it, and free from reflected heat, 
stood at eighty-eight and ninety degrees on the fifth and 
sixth, and at eighty-one on the thirteenth. The mean tem- 
perature of the month was 82.01 degrees. It rained on ten 
days, from the fourteenth to the thirty-first. The quantity 
of rain that fell was 4.92 inches. 
August was warm but dry. It rained on seven days, but 
the rain guage marked only 1.98 inches. The mean tem- 
perature was 79.08 degrees. 
September was also warm and dry. There was rain on 
three days only, and the quantity that fell was only 1.56 
inches, of which 1.16 inches fell on the twelfth. The mean 
temperature was seventy-five degrees. There was frost on 
the twenty-fifth. 
October was remarkable for the quantity of rain that fell. 
There was rain on nine days. Four inches fell on the third, 
and 3.60 from the fifteenth to the sixteenth. The whole 
quantity of rain was 11.37 inches. The mean temperature 
was 58.08 degrees. 
In the month of May, a fever of a bilious and remittent 
character, combined with typhoid symptoms, appeared among 
the blacks. It continued to spread during the months of June 
and July ; in the latter part of which month, it obtained its 
height, and was seen in its most aggravated forms. It de- 
clined through the month of August, and terminated as an 
epidemic in September. Between four and five hundred per- 
sons were affected with it. It attacked occasionally a few 
whites of the poorer class, but not more than about twenty 
or thirty on the whole were attacked with it. It was so ge- 
nerally confined to the blacks, that it acquired the name of 
the negro fever. 28 
It was preceded by a chill, and was accompanied with 
pains of the head, hot skin, tenderness of the epigastric re- 
gion, irritability of the stomach, and bilious vomitings. The 
tongue was moist and white at the beginning, but became 
dark, foul and dry in a few days. The adnata was of a 
dusky hue, occasionally yellow, and often blood shot. The 
patients were generally sleepless, and lay with their eyes 
wide open. The pulse was seldom tense, but soft, yielding 
and frequent. In the last stages there was low delirium, 
great insensibility, tremors of the tongue, which was black, 
or loaded with foul sordcs, and a general collapse of the 
system. 
Lenient purgatives, demulcent and sub-acid drinks, and 
mercurial preparations, combined with mild diaphoretics in 
the first stages ; blisters, sudorifics and gentle stimulants, 
with nutritious diet in the second; wine, bark, serpentaria, 
milk punch, toddy, and the like, in the last stage, constituted 
the general treatment. 
The disease was quite manageable, when placed under 
treatment in its commencement, and proper care could be 
taken of the patient. But most of those, who were its sub- 
jects, were in so wretched and miserable a condition, living 
in confined and crowded rooms, amidst every kind of filth 
and vile garbage; were persons generally of vagabond habits 
and lives, and were constantly surrounded by the debauch- 
ed, vicious, and intemperate, that it was impossible to afford 
them proper medical aid, unless removed to the public insti- 
tutions. Few indeed could be induced to persevere in at- 
tendance, amidst scenes of dissoluteness and misery, the 
senses constantly offended with the most nauseous exhala- 
tions and disgusting exhibitions, and finding prescriptions 
and advice almost wholly unattended to. I have often met 
with instances, where it was difficult, sometimes impossible, 
from a want of sympathizing feeling, even amongst the friends 
and relatives of the sick, to induce them to go a few squares 
to obtain proper remedies. In the Alms House establishment 
the deaths were one in six. 29 
The chief theatres of this disease, were the lanes, alleys 
and courts, inhabited by the negroes in the southern and 
western parts of the city. It was also found, though not so 
extensively, in the northern section. These places being 
principally of a less width, than is required by law to con- 
stitute them public lanes and alleys, they are never cleansed 
by the public scavengers, and were in the spring in a most 
abominably filthy condition. Few of them are paved, and 
the offals and accumulated filth of many years, are collected 
in them. The wetness of the spring had kept this heteroge- 
neous mixture of fermentable and putrefying matters, in a 
soft, lutulcnt state, which was soon set in action by the in- 
creasing temperature of the advancing season. The owners 
of property, who have thus cut up and divided their lots in 
the city, in the manner that has, within a few years, been 
done, by which they have formed as it were a number of 
alembics, distilling poisonous exhalations, deserve the most 
serious reprehension, and have created a great and alarming 
evil, which ought to be early corrected by the public authori- 
ties. In the latter part of May, several cases of this disease 
appeared in a court opposite the Alms House, where there 
existed a considerable extent of a half fluid mud, in which 
were decaying the heads and entrails of shad, and other 
kitchen offals, and from which bubbles of gas were seen con- 
stantly disengaging. The city commissioners being inform- 
ed of the circumstance, immediately ordered it to be remov- 
ed. Mr. Stiles informed me, that of seven men who were 
put to work on it early in the morning, three were obliged 
to break off at nine, affected with vomiting and sickness; and 
he himself was affected with nausea and vomiting, brought 
on while giving directions and superintending the work. 
The course of this disease was watched with great solici- 
tude by the Board of Health, who, as far as their powers 
permitted them, endeavoured to remove its obvious causes. 
Its occurrence at so early a period of the year, and the pe- 
culiar features by which it was characterized, were no fa- 
vourable prognostics regarding the health of the city in the 
approaching warm months. so 
While in this state of anxious feeling, the attention of the 
Board was directed by Dr. R. Harlan, on Monday, the twen- 
ty-fourth of July, to John Hays, living at No. 168, North 
Water street, who was ill of a disease of a suspicious nature. 
I visited him the same afternoon in company with Dr. Knight 
the port physician. He was found in a dying state. He had 
served as a sailor on board the ship General Wade Hamp- 
ton, and had arrived about two weeks previous to his illness 
from Charleston, South Carolina. From the period of his 
arrival, he had been daily on the wharves looking for em- 
ployment. His skin and eyes were of a yellow hue, and the 
remains of what he had vomited in a basin, the chief part of 
the contents of which had been thrown out, were of a deep 
brown colour. He died the same night. 
Immediately after visiting Hays, Dr. Knight mentioned, 
that he had been called the day previous to attend J. Jack- 
son, a young man residing at Mrs. Williamson's, in Water 
street, a short distance below Race street, of whose disease 
he entertained a strong suspicion, and intended to report the 
case to the Board the next day. He (Jackson) was imme- 
diately visited, and his symptoms were found to have assum- 
ed so decided a complexion, as to leave no doubt with respect 
to the nature of his disease. He died the next night (Tuesday) 
in convulsions, and with black vomit. 
Dr. Knight reported, Wednesday 26th, two women ill with 
fever of a suspicious aspect, on Race street wharf. Being in a 
destitute condition, and having no means to command proper 
attention, they were immediately removed to the Lazaretto. 
One died the next day, the fourth of the disease, with black 
vomit; and the other two days after removal, the fifth of her 
disease, with the same fatal symptom. 
The same day Mrs. Philly, living in a range of buildings 
situated on Hodge's wharf, and adjoining the house in which 
Jackson had died, was taken sick. The disease did not mani- 
fest its character decidedly until Friday evening. She died 
next morning (Saturday) with black vomit. In the room be- 
low that occupied by Mrs. Philly, lived Mrs. Double, who 
was advanced to the eighth month of her pregnancy. She 31 
was attacked by a smart fever on Thursday the 27th, the 
symptoms of which indicated malignancy. Her eyes were 
greatly inflamed, and had a fiery expression. She was de- 
livered on Friday night. After a temporary calm on Satur- 
day, the symptoms became more aggravated, and she expired 
on Sunday morning. 
It was ascertained at this time that a woman of the name 
of McLaughlin, whose husband kept a grog-shop at the end 
of the range of buildings on Hodge's wharf, had died about 
the 17th of July, after an illness of two or three days. No 
medical advice had been called in : but from the history of 
the case, collected from those who had seen her, it is highly 
probable her disease was malignant fever, and the first case 
that had occurred, although at the time it was supposed to 
be cholera morbus. 
On Saturday the 29th, Dr. Knight reported the cases of 
Mrs. Sturgis and daughter, living in Front street, the second 
house north of Race street. Mrs. Sturgis died on Tuesday, 
August 1st; the daughter recovered. 
The same day (Saturday 29th) Mr. Le Compte, who kept 
the New Orleans Hotel, in Water street, and whose back 
buildings open upon Hodge's wharf, was affected with a se- 
vere chill, which was succeeded by fever. He had slept the 
night previous on a table before the back window, with a cur- 
rent of air blowing over him. He conceived his complaint 
to be merely a cold, resulting from that imprudent exposure, 
and could with difficulty be persuaded to take advice. He was 
removed on Monday the 31st to the country, and died on the 
following Wednesday. 
An apprentice lad of George Scott, cooper, in Front street, 
a short distance north of Race street, was reported by Dr. 
Knight, on Tuesday, August 1st, as labouring under fever 
with suspicious symptoms. He had been working on the 
wharf near Race street. He was immediately removed to a 
temporary hospital recently opened, where the disease, yield- 
ing to active purging, assumed a remittent type, from which 
he rapidly recovered. 32 
Two cases of malignant fever were reported by Dr. Knight 
on Wednesday, August 2d, as existing in the persons of the 
daughter and servant girl of Mr. Charles Hill, in Water 
street, the second house south of Le Coinpte's. They were 
removed the next day; the servant girl to the temporary 
hospital, and the daughter into Jersey. The servant girl 
died on Sunday the 6th, with symptoms of great malignancy. 
The daughter recovered. 
Saturday, August 5th, the daughter of Thompson, 
living in Water street above Race, was reported to the 
Board. The symptoms were of a suspicious aspect. She was 
removed on Sunday morning to the temporary hospital; ac- 
tive purgatives and a small bleeding were employed, under 
which treatment her symptoms soon subsided into those of 
remittent fever, and she was dismissed well on the 9th, when 
the temporary hospital was closed. 
The foregoing comprise all the cases of the disease that 
occurred in the vicinity of Race and Water streets. It will 
be seen that twelve of them were decided cases of malignant 
fever, of which nine proved fatal and two recovered ; while 
there were two persons affected with symptoms of doubtful 
character, who both recovered. 
The removal of such of the sick who had not the means 
to procure proper attention, and whose situation would per- 
mit it, was determined on from the recurrence of several 
cases seeming to mark this vicinity as infected ; and the im- 
mediate removal of the inhabitants was deemed a necessary 
measure. As there was a number of families crowded into 
the houses that were the theatre of the disease, whose cir- 
cumstances would not enable them to procure a place of re- 
fuge, the west wing of the City Hospital was appropriated 
for their accommodation ; and a small building near the 
Schuylkill, the eastern wing of the City Hospital being oc- 
cupied by the society for the relief of children affected with 
the summer complaint, was taken and opened as a tempora- 
ry hospital for the reception of the sick. By these means, 
in a few days, most of the houses exposed to the infection S3 
were emptied of their inhabitants. When that measure was 
accomplished, fences were erected (on Monday, 51st July) 
cutting off the approaches to Hodge's wharf and dock, which 
appeared to be the focus of the disease. 
The two cases of malignant fever in the family of Mr.Hill, 
on the 2d of August, were the last that occurred in the vi- 
cinity of Hodge's wharf. The removal of the inhabitants 
from the neighbourhood, the erection of fences preventing 
approach to the source of infection, and clearing away the 
offensive matters, as far as was practicable, appear to have 
completely extinguished the disease, which had appeared 
there with a threatening and alarming aspect. 
For some days a perfect calm ensued ; and a hope was in- 
dulged, that the anxieties and apprehensions which had been 
entertained for the health of the city, would soon be dissi- 
pated, in a general confidence of an exemption from the ca- 
lamities, attending the threatened presence of the formidable 
visiter. But these pleasing anticipations were soon disturb- 
ed. On the 9th of August, Drs. Hartshorne and Moore in- 
vited me to visit with them Mr. Jesse Smith, who had been 
taken ill on Sunday the 6th, and who had strong symptoms 
of malignant fever. He died the next day. The clerk of Mr. 
Smith, Mr. Annesly, was known to be ill at the same time. 
He had also been attacked on Sunday with great violence, 
but was recovering. The counting house of Mr. Smith was 
on the wharf above Walnut street. These gentlemen having 
been engaged on Hodge's wharf, a short time previous to 
their illness, in removing some sugar which had been land- 
ed there, it was supposed they had contracted their disease 
at that place; but as numerous cases immediately succeeded 
theirs, all originating in the vicinity of Walnut street wharf, 
it is more probable they derived the infection from the com- 
mon cause existing in this new seat of the disease, and that 
they were the first on whom it displayed its malignant in- 
fluence. The same day that Mr. Smith's illness was made 
known, it was ascertained that a man of the name of For- 
syth, was ill with a suspicious disease in Water near Walnut 
street. He had been attacked on Sunday, and died on Thurs- 
5 34 
day the 10th. His case could not be traced beyond his im- 
mediate neighbourhood. In these three cases the lancet had 
been freely used. 
On Thursday the 10th, Dr. Wood reported Mr. Ezekiel 
Edwards, a clerk in the counting house of Messrs. T. P.. 
Cope & Son, on Walnut street wharf. He had been taken 
two days previous, and the disease then displayed the most 
marked symptoms of malignancy. He expired on Friday, 
the fourth day of his attack. After strict inquiry it was 
found, that Mr. Edwards could not have contracted the dis- 
ease at any other place, than the one where it was first de- 
veloped, and a suspicion began to be entertained, that there 
was some mischief lurking about Walnut street wharf. 
Dr. Elijah Griffith reported on Saturday the 12th, 
M'Leod, who attended on the store of his brother George 
M»Leod, on the wharf above Walnut street, as ill with ma- 
lignant fever; and on the same day Dr. S. P. Griffitts men- 
tioned the son of Daniel King, who attended a store on the 
wharf below Walnut street, whom he considered as attacked 
with the same disease. 
I visited Mrs. Duffy, in Walnut street below Water, on 
Sunday the 13th. She had eaten heartily of lobsters on Sa- 
turday evening, and was taken in the night with vomiting 
and considerable fever. She complained of violent headache, 
pain in the back and limbs, with great sensibility of the epi- 
gastrium. The skin was hot, face flushed, eyes much in- 
flamed, and tongue furred. 
The night before Mrs. Duffy's attack was known, Mr. 
Abraham Baker was taken very ill. So many cases of dis- 
ease occurring in so short a period, all of which appeared to 
draw their origin from the neighbourhood of Walnut street 
wharf, rendered it no longer to be doubted but that the dis- 
ease had broken out in this situation. 
On Monday morning the 14th, it was ascertained, that 
there were several other persons ill in the same neighbour- 
hood, but as most of those who were then confined with the 
disease, were in the first and second day only, and the symp- 
toms of several of them were but slight, it was thought pro- 35 
per to consult with some of the principal of our physicians 
on the subject. They were accordingly hastily invited to as- 
semble at the Health Office at three o'clock. By that time, 
the number of cases known as existing or having occurred 
near to Walnut street wharf, from the 9th to the 14th, amount- 
ed to seventeen. The result of the conference with the gen- 
tlemen of the faculty, was a unanimous recommendation im- 
mediately to remove the inhabitants residing in the district 
then supposed to be infected, and to prevent all intercourse 
with it, by the erection of barricades. This plan was carried 
into execution without delay, and by Tuesday evening the 
greater part of the people were removed, and the fences were 
erected. New cases were, however, almost hourly reported, 
aud by Tuesday evening, the 15th, amounted to twenty-six. 
From this period to the 26th, sixteen cases occurred. On the 
26th the City Hospital was opened under the care of Drs. 
Hewson and Chapman, who had in a most handsome man- 
ner, and with a generous and disinterested spirit, tendered 
their sen ices to the Board of Health ; and the sick in the 
temporary hospital were transferred to it. The disease at 
this time appeared to be in some degree arrested in its pro- 
gress, and was confined to a very limited extent; for every 
case was satisfactorily traced to a space bounded on the north 
by Tun Alley, on the south by Ross's wharf, and by the east 
line of Water street. 
From the 16th to the 22d, but one case occjirred. On this 
last date, Miss Anderson, living in Water between Market 
and Arch streets, became a subject of this fatal malady, of 
which she died on the third day of her illness. A young man 
who was clerk to Mr. Anderson, left the city the day that 
Miss A. was attacked ; but he was taken ill with the disease 
a day or two after his departure, and died of it. Neither 
of these persons had any communication with the infected 
districts, but appear to have received the disease in their 
place of residence. When I come to point out the different 
supposed causes of the disease, I will treat on these cases 
again. 36 
For a few days no additional cases were reported. On the 
27th, Dr. Wood requested me to visit with him Mr. Whar- 
ton's family, in Front street between Walnut and Chesnut 
streets, in which he and Dr. Parrish were attending the two 
sons and a black servant. The elder son was in the third, 
and the younger in the first day of the disease. The symp- 
toms were unequivocal. The next day (Monday) a daugh- 
ter, who had been in the country a few days, returned, and 
complained of being ill. Iler symptoms rapidly unfolded 
themselves. The two sons died on Wednesday, and the 
daughter on Thursday, all with the black vomit. The ser- 
vant, who was sent to the hospital, recovered rapidly. 
Adjoining to Wharton's lived a person of the name of 
Drinkwater, and his sister. The sister was taken sick on 
the 28th, and died on Friday the 31st of August. Drink- 
water complained of being unwell on Wednesday the 29th, 
but continued about. He was violently attacked in the even- 
ing, became immediately comatose, and died the same night 
in convulsions. This was one of the most violent and rapid 
cases of the disease that occurred. Next to Drinkwater's, 
a lad, apprenticed to M'Intire, was also ill with the disease 
at the same time. He recovered. On the appearance of the 
disease in Front street, it was enclosed with barricades, and 
the inhabitants from Chesnut to Dock streets removed. 
On the 29th of August, a boy of the name of Lodor, liv- 
ing in Duke street, in the Northern Liberties, between Front 
and Second streets, became affected with the disease, and 
died on the 2d of September. An examination post mortem 
left no doubt as to the nature of his complaint. It was re- 
ported that he had taken the disease by entering the infected 
district; and it was also reported, that he and his father, 
who was seized with an apoplectic fit the day the son died, 
had been engaged in pilfering the stores on the wharves be- 
low Chesnut street. This story was wholly devoid of founda- 
tion. In the investigation of the origin of the disease, which 
prevailed at a subsequent period in Duke street, the history 
of this case will be stated, and the probable source of the dis- 
ease in that quarter will be pointed out. 37 
From this time, the 30th of August, to the 6th of Septem- 
ber, there were about twelve cases, which were either direct- 
ly ascertained to have had communication with the infected 
district near Walnut street, or in which circumstances ren- 
dered it a probable occurrence. 
On the 6th of September, two cases were reported in Lae- 
titia Court, in the persons of two young women, one of whom 
died the same day, in neither of whom could the disease be 
traced beyond their residence. A man who worked in a hat- 
ter's shop, a short distance below Laetitia Court, in Market 
street, the back buildings of which nearly adjoined the house 
in the court in which the two girls were ill, was also taken 
down on the 6th; and on the 7th, a lad of Mr. Sexton's, two 
houses above the last case, was also attacked. 
From an attentive examination, there is no cause to doubt, 
but that these four cases originated in that place, there being 
no evidence of either of them having approached the barri- 
cades. In a letter I received from Dr. Fithian, of Wood- 
bury, he mentions that he attended a young woman in Jer- 
sey, who died with all the symptoms of malignant fever, and 
who was said to have breakfasted at the tavern in Lietitia 
Court, at which the two girls first affected lived. 
A woman of the name of Cail, was reported on the 6th of 
September, by Dr. H. Klapp, ill with malignant fever, in 
Second street near Shippen. Her disease took place on the 
3d. She had been at Arch street wharf a few days previous 
to her illness, where she had remained but a short time; in 
going and coming she had passed through Second street, and 
consequently had not been in the sphere of the infection in 
its original seat, at Walnut street wharf. She died on the 
7th. On the 5th, Deborah M'Devitt, living next door to 
Mary Cail, was taken with the same disease; she died on 
the 10th. A Mr. Gibson had been attacked on the 2d or 3d, 
in Shippen street, and about the same time several of the 
members of Mr. Gaw's family, in the same neighbourhood, 
were taken ill, but whose disease Dr. Klapp assures me was 
bilious fever. On the 16th, Mr. Joseph Hartley, next house 
to M'Devitt's, was reported a case of yellow fever. In the 38 
family of Mr. Rees, the house next south of M'Devitt's, two 
boys were ill, within a few days of Mr. Hartley's attack, 
but were considered cases of remittent fever. On the 2d of 
October, a recruiting sergeant was attacked by the disease, 
in Shippen street, a few doors below Second street, and died 
on the 5th,-making five decided cases in this neighbour- 
hood, and four others of bilious and remittent fever. 
As the disease was declining in this situation, and in the 
centre of the city, it suddenly broke out in the Northern Li- 
berties, in Duke street, two miles distant from Shippen street, 
and one mile from the other districts where the disease had 
prevailed, where two cases occurred on Monday the 13th. 
There had been a case a few days previous in the neighbour- 
hood, at the corner of Front and Noble streets. Six more 
persons were attacked on Wednesday the 20th, all of them 
in the evening, and two on Thursday the 22d. The disease 
proved fatal in all these instances. A woman who lived in 
Second street below Vine, and who contracted the disease 
whilst nursing her sister, ill at the corner of Front and No- 
ble streets, was the only one that recovered. A man in Green 
street was attacked about the 8th of October, and died on the 
14th, making twelve cases in that location of the disease, of 
which one only recovered. 
After the disappearance of the disease in the vicinity of 
Duke street, eight, cases occurred in different parts of the 
city the last of November, none of which could be traced to 
any particular spot. The heavy rains which fell at that time, 
and the cool temperature of the air, probably terminated the 
disease, which threatened for many weeks to pour on the city 
all the afflictions of a mortal epidemic. 
The preceding narrative contains a general history of the 
cases of the disease, from its commencement to its termina- 
tion. It will be seen, that the whole number was one hun- 
dred and twenty-three, of which eighty-one died and forty- 
two recovered. The following table will exhibit at one view, 
the number of cases in each locality of the disease, and the 
relative mortality in each. 39 
SITUATION. 
Cases 
Died. 
Reco- 
vered. 
Hodge's wharf and vicinity, 
13 
9 
4 
Walnut street wharves, and Water street 
east side from Tun Alley to Ross's wharf, 
about 700 feet, _ . - - 
47 
25 
22 
In Walnut street and west of Water, 
8 
5 
3 
Front street between Walnut and Chesnut, 
and Norris's Alley, - - - 
11 
9 
2 
Front street below Walnut street, 
4 
1 
3 
Water street between Arch and Market 
streets, (Anderson's) - 
2 
2 
Laetitia Court and Market street, 
4 
1 
3 
Second street near Shippen, and Shippen, 
5 
3 
2 
Duke street and vicinity, - - - 
12 
11 
1 
Scattered in various places, and which could 
not be satisfactorily traced, 
19 
17 
2 
.Total, 
125 
83 
1 42 
EXTRACT, No. II. 
Localities and Sources of the Disease. 
The specific causes of general diseases, to which they owe 
their peculiar characters, are confessedly involved in much 
obscurity. Of their nature, the manner of their production, 
the properties they possess, and the laws that govern them, 
we are almost entirely ignorant. Not subjected to the evi- 
dence of our senses, known only by their effects, and those 
effects themselves not rightly understood, it is not surprising 
that great contrariety of opinion and observation, both of 
which to a certain extent must be conjectural, should prevail 
with different physicians. 
On no subject more than this, ought medical men to be 
guarded against an overweening confidence in the correct- 
ness of their own opinions. The sources of error are so nu- 
merous, the probability of deception so great, false observa- 
tions so prevalent, and the chances of accuracy so few, that 
he must be indeed highly gifted or peculiarly favoured, who 40 
can clearly perceive and accurately distinguish, amidst this 
cloud of obscurity, the true from the false. 
With respect to the origin of yellow or malignant fever, in 
the cities of our country, opposite opinions have been and are 
entertained, both among medical men and the public gene- 
rally. Those opinions have been embraced frequently on 
partial views and with limited information; have been sus- 
tained with ardour, zeal, and warmth of feeling, by their re- 
spective partizans. In this conflict of hostile sentiments, 
truth, it is to be feared, has been considered of less impor- 
tance, than the fate of a preconceived doctrine; has been 
overlooked, and either partially or wholly suppressed, when 
its development would tend to shake a favourite hypothesis. 
As to the sources of the disease that prevailed the past 
summer and autumn in our city, I have endeavoured to in- 
vestigate them with as much impartiality as possible, and to 
relate them faithfully. All the circumstances which appeal*, 
or were supposed to have had any agency in occasioning the 
disease, in the different situations in which it existed, will be 
detailed, and the inquiry be pursued in the order in which 
the disease appeared. 
I. Hodge's Wharf. Those persons, who adhere to the doc- 
trine of the exclusive importation of yellow fever, have at- 
tributed the disease at this place to the brig Susan. Nume- 
rous stories respecting that vessel were in circulation during 
the period of alarm, of which few had the slightest founda- 
tion, and most were entire fabrications. 
Having paid particular attention to the investigation of all 
the facts connected with this vessel, so far as she could be 
concerned in the production of the disease, at the time of its 
first appearance, I am able to present them in an authentic 
shape. 
The brig Susan arrived at the Lazaretto July 2d, from St. 
Jago de Cuba, which place she left June 7th, having a pas- 
sage of 26 days. Whilst at St. Jago, two of her crew died, 
one on the 12th, the other on the 20th of May. Both were 
sick and died on shore. The diseases were said to be gravel 
and yellow fever. 41 
On the 15th of June, eight days after the departure of the 
brig from St. Jago, Mr. Geisse, a passenger, died on board, 
from a fever with which he was attacked the day after the 
sailing of the vessel, and which had been excited by violent 
exercise in gunning, whilst the brig lay becalmed. It is very 
certain, his disease was malignant fever. The bed, bedding 
and clothing, that Mr. Geisse had made use of, were thrown 
overboard, the cabin cleansed, and sprinkled with Cologne 
water. 
On the arrival of the brig at the Lazaretto, the quarantine 
master was directed to have her cleansed and purified, which 
order, he reported to the Board of Health, had been com- 
plied with. On the 10th of July, eight days after her arrival 
at the Lazaretto, thirty-five days after leaving St. Jago, and 
twenty-five from the death of Mr. Geisse, permission was 
granted for the brig to proceed to the city, and the next day 
she left the Lazaretto. 
The Lazaretto physician has informed me, that during his 
residence at the Lazaretto, twenty days from the time of a 
death or sickness on board of a vessel, has been considered 
by former Boards of Health, a sufficient time to test the 
healthiness of a crew and vessel. In the instance of the Su- 
san, the time was extended to twenty-five days; a longer pe- 
riod, the Lazaretto physician has stated, than had been deem- 
ed requisite with any vessel under similar circumstances, for 
the last four years. 
The Susan reached the city on the 11th of July, and haul- 
ed to at Pratt's wharf, adjoining to Hodge's dock, where she 
discharged her cargo, consisting of sugar and molasses, and 
left it on the 14th, remaining only three days. She then pro- 
ceeded to the lower part of the city, where she lay during the 
summer. 
The hold of the Susan was represented by Mr. James Bell, 
who assisted to unlade her, as perfectly clean, and the Health 
Officer who examined her made a similar report. 
The crewr of the Susan, on her arrival at the Lazaretto, 
consisted of eight men, none of whom were subsequently sick 
of the fever. 
6 42 
A stevedore and eight men were employed to discharge 
the cargo, none of whom became affected with fever or any 
other disease; and of the owners of the vessel, and some of 
their friends to the number of between twenty and thirty, 
who visited the brig, the custom house officers, and coopers 
employed on board of her, not one was taken sick. The num- 
ber of persons, who had communication with the Susan, and 
consequently were liable to have contracted the disease from 
her, if she had been an infected vessel, must have been be- 
tween forty and fifty, all of whom however remained in health. 
On the other hand, after the most diligent inquiry, it could 
not be ascertained, that a single individual, who was sick in 
this locality of the fever, had been on board the Susan, or had 
directly any communication with her. 
The circumstance which led to a suspicion, that the dis- 
ease had originated with the Susan was, that Jackson, who 
was the second person affected with it, (considering Hays as 
the first,) had worked in the sail loft of Messrs. Keen and 
Drais, in which one of the sails of the brig Susan had been 
placed, in order to be repaired. It was generally reported, 
that Jackson had assisted in taking the sail from on board 
the Susan, and in carrying it to the loft. Mr. Drais, who 
aided in removing the sail, positively contradicts this story; 
and what proves it wholly untrue is, that Jackson was not 
employed by Messrs. Keen and Drais, until the 21st of July, 
whereas the brig left Pratt's wharf on the 14th, and the sail 
was taken into the loft on the 11th. Jackson himself, to my 
repeated inquiries, always assured me, he had not been on 
board any vessel in a short time previous to his illness. It 
was also reported, that Jackson had worked on the sail, and 
had thus contracted the disease. But the fact is otherwise. 
The sail, at the time Jackson was taken sick, lay furled in 
the loft, precisely in the state in which it was, when placed 
there, and had never been touched by him, according to Mr. 
Drais' statement. I examined the sail, and found it perfect- 
ly sweet and clean. Its history will be found in the examina- 
tion of captain Smith, by the Lazaretto physician, which 
shows the improbability of the sails being infected. There 43 
were employed in the sail loft of Messrs. Keen and Drais, 
nine hands including Jackson, of whom Jackson alone was 
sick, and in going and returning to and from the loft, he 
daily passed and repassed by Hodge's dock, where the other 
cases of the disease principally existed. 
Thus it appears, that none of those, who are known to have 
worked on board or visited the Susan, amounting to between 
forty and fifty, were subsequently ill with the fever; and none 
of those, who had the fever, arc known to have been on board 
of her. 
I shall now proceed to point out the local causes, which 
may be supposed likely to have produced the fever in this 
situation. 
1. Hodge's Wharf and Dock. The wharf on the north side 
is bounded by a range of frame buildings, which were crowd- 
ed with inhabitants, and in front of which runs a gallery. It 
extends westward to the buildings on Water street, which 
are occupied as stores, and there is a passage to it from 
Water street, by an arched way. The wharf forms a square, 
closed on the north and west by lofty buildings, and is open 
to the east and south. It is consequently exposed to the di- 
rect and reflected rays of the sun, from an early hour in the 
morning until late in the afternoon. The wharf near to the 
dock is higher, than where distant from it, so that the water 
cannot drain from the wharf, but stagnates and evaporates 
on it. The people residing in the frame buildings which have 
been mentioned, some of whom were washer-women, were in 
the habit of throwing all their kitchen water, offal matters, 
and soap suds from the gallery on the wharf, and on a pile 
of plaster of paris, that had lain there for two or three years. 
The pile of plaster had in this manner become a receptacle 
of filth, which filled up its interstices, and the wharf was kept 
in a foul and offensive condition. 
2. Hodge's Dock. This dock has been neglected for some 
years, and has gradually been filling up. At low water, it 
is at present uncovered nearly its whole extent, and a large 
mass of mud, of animal and vegetable remains, are thus ex- 
posed to the action of the sun and air. Two culverts, or 44 
tunnels, into which empty the privies of the range of frame 
buildings on the north of the wharf, and those of some of 
the houses in Water street to the south of it, discharge their 
contents into the dock ; and the inhabitants of that part of 
Water street, few of whose dwellings had privies, are ac- 
customed to throw into it, the contents of the buckets, &c. 
which arc employed as substitutes for those indispensable 
conveniences. 
On the wharf south of the dock, there formerly stood a 
large frame building, which had been used for packing and 
storing hay, of which considerable quantities had fallen into 
the dock at different times, and when the store was burnt 
down about two years since, some hundred weight were 
thrown into the dock. This statement was made to me by 
Dr. Kughler and Messrs. Pratt and William Montgomery, 
whose counting-houses are in the vicinity. 
3. In the month of May, a quantity of potatoes were land- 
ed on the wharf north of the dock, which were in a damaged 
state, and were extremely offensive. They were stored in 
the neighbourhood, where they were picked, and the worst 
of them thrown into the river, a few feet above the dock, in- 
to which a large portion was carried by the current, to add 
to the mass of decaying and putrescent matter already de- 
posited there. 
How long the potatoes remained stored in this neighbour- 
hood has not been ascertained, but Mr. Joseph Lefevre, of 
the Union Line of Packets, has furnished me with some me- 
moranda he made last summer, in which he remarks, that 
in « the latter part of June the smell from potatoes on Rae® 
" street wharf, was so offensive, that people in Race, above 
" Front street, could not stand at their doors.*' 
I have thus detailed in an impartial manner, and I believe 
with correctness, all the facts that have a connexion with 
the appearance of the disease in this situation, both as it 
respects its foreign importation or its domestic origin. I 
shall now proceed to investigate, in the same manner, its 
causes at, 45 
II. Walnut Street Wharf. The disease has been attributed 
in this situation to infected vessels and to local causes. There 
appeared for some time to be a difficulty in selecting the ves- 
sel, which had occasioned the mischief. At one time the 
sloop Isabella was accused of having introduced the disease. 
She is the vessel that was put under quarantine at New York 
the last of June, in consequence of having come from Balti- 
more, where it was falsely reported that the fever had broken 
out. But as no fever prevailed in Baltimore, and as none of 
the crew of the Isabella had been sick, the supposition was 
abandoned. She arrived at this port June 28th. 
When three of the sailors of the brig Martha were sent to 
the hospital, the rumour ran, that she had brought the fever 
to Walnut street. But on investigation, it was found she had 
not been higher up the city than Pine street wharf, where 
she had lain between two and three weeks, and had then been 
removed to Queen street wharf, in Southwark. It was ascer- 
tained subsequently at the hospital by Dr. Rhees, that the 
sailors of the Martha, had been at Walnut street wharf about 
the time the fever commenced there, and had slept a night 
in one of the taverns in that neighbourhood. 
The sloop Hector, as far as I have been able to learn, is 
now the only vessel to which suspicion of introducing the 
disease is attached. It was reported very generally, that the 
greater part of the crew of that vessel, had died in the West 
Indies, or on her passage home, and that she had put into 
Wilmington, Delaware, to avoid quarantine. Mr. Henry 
Cope, of the house of T. P. Cope & Son, who took great in- 
terest in the investigation of the causes of the disease, has 
favoured me with the facts concerning this vessel, which he 
obtained from Mr. John Hemphill, to whom the Hector was 
consigned, in order to be sold. From this statement it ap- 
pears, that the Hector arrived at Wilmington, Delaware, 
where she was owned by Mr. Baily, the latter end of June, 
from Cape Henry, and discharged her cargo. She was wash- 
ed out and cleansed, and after remaining twelve or fifteen 
days, took ou board a quantity of corn meal, which was con 
signed to Messrs. Masden & Buncker, and which was dis- 46 
charged at their wharf. She then fell down to the first wharf 
below Walnut street. None of her crew were sick at Cape 
Henry, on her voyage home, or afterwards, and her original 
crew all returned in her. 
I have not heard any other than the above vessels, accused 
of having introduced the disease, and the relation of the facts 
respecting them, will, I am confident, be found accurate. 
The local causes to which the disease has been attributed 
in this situation are as follows : 
1st. A quantity of damaged vegetables, which were stored 
below Walnut street wharf, especially beans and potatoes. 
In consequence of the failure of the potatoe crop, the pre- 
ceding year, in this part of the country, the importation of 
that vegetable had been unusually great. Such quantities, it 
is believed, never were before brought to this port. A very 
considerable part of what was imported, were on their ar- 
rival, in a very bad state, and some cargoes completely da- 
maged. The greater part were landed and stored at Walnut 
street wharf. Mr. Lefevre, in his memoranda, made last 
summer, states, that " it is a well known fact, that large 
quantities of potatoes have been stored in the neighbourhood 
of Walnut street wharf, w here they have been kept in a very 
confined state, and also kept in several dwelling houses, 
whose occupiers are, or have been in the practice of keep- 
ing on hand all kinds of vegetables, for the purpose of sup- 
plying shipping, and have dealt largely in potatoes, particu- 
larly in the early part of the summer, at a time when they 
were landed from vessels in a damaged state." In the same 
memoranda, it is stated, « that the schooner Alert, captain 
Cobb, arrived and hauled to at Beck's wharf, in July, w ith 
six or seven hundred bushels of potatoes, which were in a 
damaged condition. When the hatches were taken off, a 
thick and offensive vapour issued from the hold, and so un- 
pleasant was the smell, that it caused several counting-houses 
in the vicinity to be shut. Those potatoes were stored in the 
neighbourhood of Walnut street wharf. Two negroes were 
employed in the hold of the schooner, to shovel the potatoes 
into barrels, to be hoisted on deck and delivered to carters. 47 
One of the negroes has not since been seen, and it is sup- 
posed he must have taken sick and died. The other was at- 
tacked with fever immediately after the completion of the 
work, from which he recovered with difficulty ; Capt. Cobb 
sickened from the effluvia from the hold, and one of the sail- 
ors was also ill, but both recovered after seven or eight days 
illness." On the 29th of July those potatoes were hauled to 
the commons and thrown away. 
It has been supposed, from the great quantities of damaged 
potatoes, that arrived in the spring and the commencement 
of the summer, and which were purchased by the blacks foi* 
a trifle, or were given away to them to feed their hogs, that 
the fever which afflicted those people, must have been pro- 
duced from that cause. Certain it is, that in many of the 
places where that disease was prevalent, considerable quan- 
tities of damaged potatoes had been kept by them. 
In the store immediately in the rear of Messrs. T. & C. 
King's counting-house, one of whom was the gentleman who 
was taken sick in New York, and removed by the order of 
Dr. Hosack, at noon, in a boat across the bay, without a 
covering to defend him from the rays of the sun, were stored 
in the month of June, twenty-five hundred bushels of pota- 
toes, which were in a damaged state. They became so very 
disagreeable to the neighbours, that they wrere removed in 
the course of that month. Mr. King and Mr. Duffy have 
both informed me, that when the store was opened, a dense, 
offensive vapour rushed out; it seemed, they stated, as if the 
store was on fire. The store was washed out after the re- 
moval of the potatoes; but the offensive smell still con- 
tinued. 
The winds at this time, were almost constantly from the 
southward. The store adjoining that in which the potatoes 
were, and the house in Water street, on the same line with 
it, wrere the south limit of the disease in this situation. It 
extended north from this position to Tun Alley, less than a 
square, or about seven hundred feet. From the Messrs. 
King's store to Walnut street, and the same distance along 
Water from Walnut street, forms a square of about one bun 48 
drcd and fifty feet. Within fifteen days from the removal of 
the potatoes brought by the Alert, and ten from the com- 
mencement of the disease, between twenty and thirty cases 
of the fever occurred in, or were traced to that square. 
2. The dirty and foul condition of the wharves in this 
situation. Immediately above Walnut street large quantities 
of molasses had been landed, the hogsheads of which were in 
a very bad condition, and in consequence had leaked con- 
siderably. From the frequent showers that fell, the wharves 
were moist and soft, and the molasses became worked up by 
the constant passing and repassing of carts, drays, and peo- 
ple, with the mud, which is a compost of various putrefiable 
and fermentable matters. In this moist and lutulent state 
the wharves remained for some time, exposed to the fervid 
beams of a July sun. The putrefactive fermentation was thus 
occasioned, and a most noisome effluvia was perceptible in 
this situation. 
3d. The pavement of an alley immediately above Walnut 
street, leading from Water street to the wharf, was taken 
up for the purpose of repairing, and the old earth, which is 
altogether in this situation made ground, was turned up, and 
left exposed some weeks to the action of the intense heat of 
July. 
The above comprise the local causes, that were conjec- 
tured to have an agency in the production of the disease in 
this quarter. How far they were adequate to occasion it, and 
the probability that they were the agents in accomplishing 
the evil, those accustomed to investigations of this nature 
will be able to determine. 
III. I know not whether the two cases which occurred at 
Mr. Anderson's, in Water street between Market and Arch 
streets, are to be considered as sporadic cases, similar to a 
number of others which afterwards appeared in various parts 
of the city, and which could not be traced to any of the 
original seats of the infection, or to any communication with 
the sick, or that the disease was produced by the cause I am 
about to state. 49 
The schooner Lydia and Mary, Capt. Shippen, from Port 
an Prince, lay at the wharf directly in the rear of Mr. An- 
derson's house. She arrived at the Lazaretto from Port an 
Prince, after a passage of eleven days. The crew being in 
health, and having continued so during the voyage, the port 
from which she arrived being also healthy, she was permitted 
to proceed to the city. Her bilge water was pumped out after 
she was moored to the wharf, and was very offensive. Being 
sick at the time of the occurrence of these cases, I was not 
able to ascertain whether any other local causes of disease 
existed in the vicinity. No other persons were affected with 
the disease, which seems to cast a doubt over the production 
of these cases from any extensive local cause. Neither Miss 
Anderson nor the clerk had been where there were any per- 
sons sick. 
IV. The Families of Wharton and Drinkwater. It was at 
first supposed, that the disease which proved so very destruc- 
tive to these families, was derived from the same sources that 
gave rise to it at Walnut street wharf, as their houses open- 
ed on Water street. Mr. Wharton, a short time after the 
mournful event in his family, informed me that Drinkwater 
had in his cellar and vault, which opened into the street by a 
grate, a quantity of damaged potatoes and putrid fish. Whar- 
ton's children frequently complained of the noxious effluvia 
emitted by them. When the disease at Walnut street wharf 
began to attract attention, Miss Drinkwater requested Mr. 
Wharton's family to join with her in remonstrating to her 
brother against keeping these articles any longer, as the fe- 
ver was attributed at Walnut street to damaged vegetables. 
In consequence Drinkwater had them removed. In less than* 
a week afterwards all the members of those unfortunate fami- 
lies that perished, were ill with the disease. The grate of 
Drinkwatcr's vault is directly opposite Norris's Alley, in 
which about the same time several cases of the fever occurred. 
V. Lcetitia Court. It has been con jectured, that the disease 
was brought to this situation, by a female, who took the dis- 
ease at James Forsyth's, in Water street near Walnut. The 
facts are as follow. Mrs. Townly attended on Forsyth, the 
r 50 
night of the 9th August. She was taken sick on the 13th, 
and died on the 17th. By a mistake, ten grains of corrosive 
sublimate were administered to her instead of calomel. The 
stomach was very irritable and instantly rejected the dose. 
It is now impossible to decide, whether the symptoms and 
fatal termination of this case, was produced by the powerful 
poison she had taken, or whether it was tridy a case of ma- 
lignant fever. The symptoms that result from poisons of this 
nature, are scarcely to be distinguished from those of malig- 
nant fever. The case, however, was considered as one of 
malignant fever, and treated as such. The night on which 
Mrs. T. died, the bed, bedding, &c., were sent to the Laza- 
retto, the room was fumigated, white-washed and scrubbed, 
as was done in all similar cases. On the 2d of September, 
Martha Pritchett and Eliza Curtis were taken sick. They 
lived at Basett Baker's tavern in the court, about one hun- 
dred feet distant from the building in which Mrs. Townly 
died, but several houses intervened between Baker's and Mrs. 
Townly's. About the same time a young man who worked 
as a journeyman in a hatter's shop, in Market street, five 
houses below the corner of Laetitia Court, was attacked, and 
on the 7th, Robert Bancroft, an apprentice to Mr. Sexton, 
the next house to the corner of the court, was also taken ill. 
The room in which Mrs. Townly was sick, has a dead wall, 
without an opening towards the houses below it. Neither of 
the young women, the journeyman hatter, nor Mr. Sexton's 
lad, had any intercourse or communication with Mrs. Town- 
ly or her family. 
There were no local causes, that could be particularly de- 
signated, as having given rise to these four cases. Several 
of the cellars of the houses in the court, and Baker's was 
one of them, were used by the country people and hucksters 
who attend the market, to keep their vegetables, cheese, &c. 
in, from one market day to another; but I could not learn 
that there had been any in a damaged or putrefactive state. 
VI. Second street near Shippen. It is difficult to account 
satisfactorily for the appearance of the disease in this quar- 
ter. So far as I could ascertain, there were no obvious local 51 
causes, no accumulation of filth, no collection of fermentable 
and putrefiable matters, whose decomposition might have en- 
gendered poisonous effluvia. 
VII. Duke street or Artillery lane, and vicinity. .The in- 
vestigation and correct determination of the cause of the 
disease in this location, and which bore the character of un- 
mitigated malignancy, becomes highly interesting and im- 
portant. Remote from the commercial part of the city, and 
removed from the bank of the river-inhabited by persons 
not connected with shipping-the disease could not have been 
directly produced by fomites imported from abroad, or the 
infected timbers, sails, or air of ships. At the same time, 
being so far distant from those places where the disease had 
been or was then partially existing, it could not be derived 
from them, except by personal contagion. The disease in this 
quarter, therefore, must either have originated there, and 
consequently local causes sufficient to have produced it, can 
be pointed out as existing; or it can in the first cases, be dis- 
tinctly and unequivocally traced to communication with the 
sick, in the districts where the disease was known to prevail. 
Isolated in this manner, and disembarrassed from those 
conflicting circumstances, which have so frequently been con- 
current, and which could be cited by the parties holding op- 
posite sentiments, as equally bearing on and sustaining their 
particular views, the decision in this instance will mainly 
tend to settle the most contested and important points of this 
" dcbateable ground." 
For this reason, the facts have been examined into with 
close attention, and will be detailed with considerable minute- 
ness. 
It has been already mentioned that a boy of the name of 
Lodor was the first person attacked in this situation. He was 
taken sick on the 29th of August. It was reported, that he 
had been in one of the infected districts, where he had taken 
the disease. This report originated from a loose statement 
that he had made, of his having a short time previous to his 
illness been at, and looked through a fence, erected by the 
Board of Health. From his mother, sister, and a boy, who 52 
was the companion of Lodor, I collected the following par- 
ticulars of the case. 
About a week prior to his attack, he had been sent to 
Camden in Jersey. In proceeding thither, in company with 
the lad who related the facts, they had stopped at the fence 
put up at the avenue leading to Hodge's dock, to prevent ac- 
cess to it, and had looked through the apertures between the 
boards. Their stay was but for a few minutes, when they 
proceeded on their way. This was about the 22d or 23d of 
August. It must be recollected, that the last case of fever in 
this situation, was on the 2d of August, from which time, the 
most perfect health was enjoyed by the inhabitants of the 
neighbourhood in Water street, adjoining the fences; and the 
wharves contiguous to Hodge's dock, were frequented as usual 
by people, whose stores were on them, with impunity. There 
was in the remainder of the summer and autumn, but a sin- 
gle case of fever, which was a simple remittent, in Water 
street, extending from Arch to Vine street. It is scarcely 
possible, therefore, that Lodor could have contracted this dis- 
ease from looking for a few minutes through the openings in 
the fence. From the weight of testimony, it is demonstra- 
ble, that the disease had totally subsided before he was in the 
vicinity. 
The next object of inquiry is to ascertain, whether any 
communication direct or indirect, occurred between young 
Lodor and any of the persons subsequently taken sick, or 
between any of those individuals after the disease began its 
ravages among them. Dr. Knight, the Port Physician, ex- 
amined very strictly the different persons who were connect- 
ed with the sick, and reported to the Board of Health, " that 
there was no reason to believe, that any of the persons af- 
fected with the disease in Duke street and vicinity, had any 
intercourse with Lodor." The same point was investigated 
by myself, entirely separate from Dr. Knight, and the in- 
formation I received from the sick themselves, and their 
friends, was precisely the same as he had obtained. On the 
death of Lodor, when the corpse w as taken aw ay, particular 
attention was paid to remove his bed and bedding, which 53 
were destroyed; and the house was washed and fumigated 
the same morning. 
The second case that occurred was Mrs. Brewer, who liv- 
ed in a different street, and distant from Lodor in a straight 
line, between three and four hundred feet, and with a num- 
ber of houses intervening. The times and manner in which 
the other cases occurred, are conclusive, that the disease 
could not have been communicated from one to another. Two 
persons, on the night of the 18th of September, were attack- 
ed, living about two hundred feet distant from each other. 
On the 19th, the weather became cool and wet, and continued 
so during the 20th ; and on the night of that day, five cases 
occurred, scattered over a space, the two extreme points of 
which, north and south, were distant about three hundred 
yards, and which extended from cast to west about one hun- 
dred feet; and on the night of the 22d, two more were at- 
tacked in the same limits, living about one hundred and fifty 
feet from each other. Thus in the space of four days, a spell 
of cool weather developed the disease in nine individuals, 
most of them living apart at considerable distances from, and 
only two of whom had communication with, each other, or 
with any sick person previous to their illness. The cases of 
Mrs. Hand and Miss Keen, are particularly striking. They 
resided in Green street, the most remote point to which the 
disease extended north, removed from the nearest person 
sick to them when first tafcJen, about two hundred feet, and 
had lived for several weeks very retired. Captain Hand in- 
formed me, they had not been out of the house, except to 
church, for two or three weeks prior to their illness. 
The circumstances attending these cases, most decidedly 
prove, that the disease was not and could not have been car- 
ried into that quarter by young Lodor; and could not and 
did not spread from one to another, by personal contagion. 
The only inferences that are authorized by the facts, are, 
that the disease was caused in those who were attacked with 
it, by a poison floating in the atmosphere, which, unhappily, 
they inhaled to such an extent, as to suffer from its delete- 54 
lious operation, or had systems peculiarly susceptible to its 
effects. 
I will now proceed to show what were the local causes, 
which may be conceived to have been sufficiently extensive 
and fully competent to the generation of a subtle poison, 
which disengaged into the air, was capable of producing the 
fatal and terrible disease, that ravaged this neighbourhood, 
when introduced into the human system. 
In the first week of September, a memorial dated August 
29th, (the day Lodor was taken sick, but which was then un- 
known to the neighbours,) signed by eighteen respectable 
citizens, residing near Pegg's Run, was sent to the Board of 
Health, directing its attention to, and requesting its inter- 
ference for, the suppression of " the greatest nuisance in Phi- 
ladelphia." That nuisance was Pegg's Run, which had been 
dammed up at New Market street, by the erection of a bridge. 
The memorialists in describing the evils that were then ex- 
perienced, predicted that disease must be the consequence of 
its continuance, little expecting that their fears were so soon 
to be verified. 
Pegg's Run is to be considered as an open culvert or com- 
mon sewer, passing through the closely built parts of Penn 
Township, Spring Garden, and the Northern Liberties, to 
the river Delaware. In its course it receives the contents of 
the gutters of the numerous populous streets and alleys it 
crosses, and two culverts from the city also open into it. 
Along its borders are situated a number of manufactories of 
glue, starch, dressed skins, and soap ; about fifty slaughter- 
houses, and the privies of most of the adjoining dwellings, 
the refuse, fermentable and putrescent matters of which are 
all emptied into its stream. Except during heavy rains, or 
immediately after them, the stream is barely sufficient to car- 
ry along, with a sluggish current, the mass of decomposing 
offensive substances that compose it, for in fact it seems more 
like liquid mud than water. 
By the erection of a bridge across Pegg's Run at New 
Market street, last spring, a stagnating pool of the feculent 55 
stream just described, was formed west of the bridge, from 
two to three hundred feet in length, from twelve to fifteen in 
width, and about three deep. In the months of July and Au- 
gust, this pool was exposed to the action of the sun and air, 
while the thermometer in the shade was daily above eighty 
degrees at three o'clock, and sometimes as high as ninety de- 
grees ; circumstances in the highest degree favourable to the 
production of the most noxious exhalations. 
From Pegg's Run, on the north, the ground rises with a 
gentle ascent, on the crown of which is Duke street, distant 
between three and four hundred yards from the run. New 
Market street crosses Pegg's Run at the bridge, and termi- 
nates at the rear of the lots on Duke street, making a large 
avenue leading from the creek to Duke street. In the inter- 
mediate space there are but few dw ellings. The w inds, at the 
period abovementioned, were generally from the south or 
southwest, and an inspection of the w'hole ground will show 
that Duke street/ east of New Market, is in a direct line in 
the course of the prevailing winds from the pool west of the 
bridge, and is the first place that would arrest the exhala- 
tions from it, when wafted by the currents of the air usual at 
that time. It was precisely at this place that six of the twelve 
cases occurred, all of them in the space of about one hundred 
and fifty or two hundred feet. The three cases in Green street 
were on an open lot, which communicated with Duke street 
at this point, about one hundred feet distant, and the other 
three cases wrere nearer to Pegg's Run. 
As the disease in Duke street and vicinity, must be refer- 
red either to young Lodor having carried it thither, and com- 
municated it to the others w ho were affected with it, or to 
Pegg's Run, in the peculiar state in which it was, exposed to, 
and operated upon, by an atmosphere heated to a tropical 
temperature, the facts which are now detailed will enable 
those who are interested in this subject to decide for them- 
selves the more probable source by which it was produced.