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During the epidemic Rush wrote letters daily to his wife. They afford an extraordinary look at the epidemic and his efforts to control it. These letter begin the second volume of L.H. Butterfield's Letters of Benjamin Rush. In his August 29th letter he described the symptoms of his patients:

The fever's "symptoms are very different in different people. Sometimes it comes on with a chilly fit and a high fever, but more frequently it steals on with headache, langour, and sick stomach. These symptoms are followed by stupor, delirium, vomiting, a dry skin, cool or cold hands and feet, a feeble slow pulse, sometimes below in frequency the pulse of health. The eyes are at first suffused with blood, they afterwards become yellow, and in most cases a yellowness covers the whole skin on the 3rd or 4th days. Few survive the 5th day, but more die on the 2 and 3rd days. In some cases the patients possess their reason to the last and discover much less weakness than in the last stage of common fevers. One of my patients stood up and shaved himself on the morning of the day he died. Livid spots on the body, a bleeding at the nost, from the gums, and from the bowels, and a vomiting of black matter in some instances close the scenes of life. The common remedies for malignant fevers have all failed. Bark, wine, and blisters make no impression upon it. Baths of hot vinegar applied by means of blankets, and the cold bath have relieved and saved some. Mrs. Chaloner owes her life to the former remedy. She caught it from her husband, who caught it in Water Street near the place where it originated. He too is upon recovery. This day I have given mercury, and I think with some advantage. Dr. Wistar and myself consult much together, and I derive great support and assistance from him in all my attempts to stop the progress of this terrible malady.... August 30th. Another night and morning have been added to my life. I am preparing to set off for my daily round of duty, and feel heartily disposed to say with Jabez, "O! that the hand of the Lord may be with me," not only to perserve my life but to heal my poor patients.

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