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Memoirs of the Fever and Occurances in August

Alexander Philips next door neighbor to A. Thompson with attacked with fever accompanied with malignant symptoms on the Last of July or first of August, died under the care of Dr. Griffitts on the 4th inst., being the 4th or 5th day from the Attack.

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Moses Cox at corner of 2d and Spruce, died on the 6th.

John Saunders occupied in the store of Lloyd and Sparks on the wharf a short distance below Walnut St. attacked on the 3d.

Mr. Samuel Russel clerk to Mr. Henderson. Mr. John Lawrence. Mr. Morgan's son. Stephen Davis, who lodged next door to Philips's. Mr. Rudolph. A Tabacconist's boy. Mr. Isaac Lloyd, all in the same neighborhood, with several others whose names I do not recollect, were all taken ill with a fever of a malignant kind within two or three days of each other.

The unusual number of deaths that occured in the first week of August, alarmed the Citizens and became a topic of general conversation.

The case of a man who had worked on board the Ship Deborah, who died of a fever highly malignant the latter end of July, had been reported by Dr. Proudfit, but being a solitary case, had excited by little apprehension.

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On the 5th Achison Thompson's child was attacked with the fever.

The College of Physicians met on the 6th at which time about 26 cases of the fever were all that were known to exist in the city, and after conferring together they unanimously agreed to the following re- [10] solutions which were immediately communicated to the Board of Health of Philadelphia, viz:

"Resolved, that the college inform the Board of Health that a malignant contagious fever has made its appearance in Water Street, between Walnut and Spruce Streets, and in the vicinity thereof: And

That the college recommend to the Board of Health to procure the removal of all the families that are situated between Walnut and Spruce Streets, and the East side of Front and the River, and to have all the shipping lying between Walnut and Spruce Streets removed to a proper distance from the City."

In consequence of the communication of the College, the Board of Managers of the Marine and City Hospitals, published the following recommendations on the 7th.

Health-Office 7th August,1798

"Whereas the Board of Managers of the Marine and City Hospitals of the port of Philadelphia have received information from the College of Physicians "that a malignant contagious fever has made its appearance in Water Street, between Walnut and Spruce Streets, and in the vicinity thereof"; and the reports of Dr. Samuel Duffield and T. Parke, appointed particularly to examine that part of the city, specifying the particular cases found therein. - Therefore, Resolved, that in order too prevent as much as possible all communication with that part of the city, that the Health-officer cause the vessels now lying at the wharves between Tun Alley and Jeffe and Robert Waln's wharf, including the said wharf to be removed, and that no vessel of any description whatever be suffered to come to the said wharf, until the further orders of the Board.

The Board also earnestly recommend to the inhabitants of that part of the city included between [11] Walnut and Spruce streets, and the East side of Front Street and the river, and also those immediately in the vicinity thereof to remove without the boundary of the city and liberties as speedily as possible."

By order of the Board of Managers,

W. Jones, President

Attest

Timothy Paxon, clerk

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The City Hospital was opened today the 7th for the reception of the sick, and Dr. Physic and Cooper appointed to take charge of it.

9th. Boston boasted of its happy state of health the beginning of this month, but it appears from a paragraph in the Gazette of the United States of the 9th inst. that a malignant fever had made its appearance there about the 1st of July, and that 16 persons had died of it from that time to the 4th of August, at which time there were 10 remaining sick; but that no physician, nurse or attendant on the sick had taken the Disease.

Published by order of the Select Men

and signed by Wm. Cooper, T.C.

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Number of deaths in the City and Liberties of Philadelphia from the 1st to the 8th inst. 53.

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A society consisting of 10 or 12 Practitioners called the Academy of Medicine, presented the following address to the Board of Managers on the 8th, which was published in the Philadelphia Gazette of the 9th inst.

"The Academy of Medicine of Philadelphia having taken into consideration the existence of a Malignant Bilious Fever in the city, have conceived [12] it to be their duty to lay before the Managers of the Marine and City Hospitals, the following facts respecting its origins and means of checking its progress.

We have upon inquiry discovered that a case of the fever existed in the city on the 6th of June, and that several cases of it existed in July, in parts of the city remote from the river, and wholly unconnected with each other. They appeared to originate from the putrid exhalations of alleys, gutters and docks, and from the stagnating water in the neighborhood of the city. We derive the late rapid increase of the fever from the foul air of several ships lately arrived in the port, and from some damaged coffee which arrived in a brig from Jamaica on the 29 July. In the course of our inquiries into the origin of the fever, we did not meet with a single fact that could support the opinion of contagion being imported in the bodies or cloaths of sick people in the ships and vessels which lie between Walnut and Spruce Streets where the disease has prevailed most. Many respectable modern authorities assert that the yellow fever is not contagious in the West-Indies, and repeated observations satisfy us that it is rarely so, during the warm weather in the United States. None of the cases we have as yet seen have propagated it, and we conceive it to be an error as absurd in its nature as it has been fatal in its operation upon the city of Philadelphia, that the contagion of a disease should adhere to the timber of a ship after a sea voyage, and should spread from the timber of the ship without contact through an extensive neighborhood, and cease to communicate itself afterwards by long and close connection of the sick with their families and attendants. We lament that this fact, together with many others, upon the nature and ori- [13] gin of the yellow fever, which were stated in our letter to the Governor on the 1st of December 1797, and by him laid before the legislature of the state, have been treated with total neglect in the present health law: the distress we felt upon seeing that law is, however, much alleviated by the refection that we have not contributed in any degree, by supporting an erroneous opinion, to reproduce the present alarming calamity of our city.

We beg leave to recommend for the purpose of checking the progress of the fever, an attention to the following directions:

1st. The removal of all the families from those parts of the city where the disease from the contamination of the atmosphere, appears likely to exist, and the preventing those parts being visited by the citizens.

2dly. The removal of all ships and putrid articles of commerce from the wharves and stores of the city.

3dly. The cleaning of the docks, wharves, yards and cellars; also the washing of the gutters every day, and of the streets and alleys three times a week, by means of pumps and fire engines.

4thly. The appointment of a sufficient number of physicians to take care of such of the poor as may be affected with the fever.

5thly. Publicly to advise the citizens to avoid all the usual exciting causes of fever, such as intemperance, fatigue, excessive heat, the night air, all violent and debilitating passions of the mind.

6thly. To advise them, in every case of indisposition, however slight in appearance, to apply immediately for medical aid.

Signed by order of the Acad. Med. of Philadelphia,

Philip Syng Physic, President

Francis Bowes Sayre, Secretary

August 8. [14]

One of the Fellows of the College of Physicians of Philadelphia, asserts, that the College is in possession of unequivocal evidence, that the Malignant Fever, (which is essentially the same as the Yellow Fever of the West Indies) now existing in this city, was brought into it by an infected vessel lately arrived from the West Indies. The writer of this note has already seen it, in more than one instance, communicated by contagion, at a considerable distance from that part of the city where it first made its appearance. The evidence on which this information is founded will be detailed as soon as health and safety shall be restored to the city. In the mean time the writer thought it would be an act of treachery to withhold the above information at a time when attempts are again making to confound and mislead the public mind.

August 10.

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John Saunders and Mrs. McKeever, both treated with occasional bleeding and salivated by the use of mercury externally as well as internally, are now on the recovery.

Mr. Samuel Russel and Mr. Lloyd treated in a similar manner, but not being able to produce a salivation are both dangerously ill.

Lauderburn has been bled repeatedly and takes several mercurial purges, and is recovering.

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Mrs. Wall, an elderly lady, was attacked with fever accompanied with lethargic symptoms. Treated with venesection cathartics and blisters, is recovering.

10th. Elizabeth May, a mantua maker, employed at Achison Thompson's, where some of the first cases occurred this season, was attacked with the fever to day.

A gentleman that had been much in the chamber of Russel, was attacked with the fever to day. [15]

August 11th

Only 7 persons were interred yesterday in all the grave yards of the city and Liberties, a proof that the air of the city cannot be greatly contaminated.

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The New-York papers of yesterday, announce the exemption of the city from the yellow fever, and it asserts its remarkable heathfulness at this time.

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Messrs. Lloyd and Russel both died last night, being the 6th day from the attack with Mr. Lloyd, and the 7th with Mr. Russel.

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James Wright, treated with mercury and moderate bleeding, is on the recovery.

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August 13th

Mrs. Rains and her little daughter, have recovered from the fever, by the use of simple laxatives and bleeding. Their symptoms were neither highly inflammatory nor accompanied with great debility and nervous affections.

Abraham Douglas, a young athletic lad, has recovered after repeated blood-letting and the use of an amazing quantity of mercury, both externally and internally.

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Captain Hollingquist, sent from a vessel at Market Street wharf to the Marine hospital, died there.

A little girl daughter to John Aitkin, in Second near Pine Street, died to day on the 4th of her illness, had taken no medicines but castor oil and simple teas, appears to have caught the disease from an apprentice who had left the house much indisposed a few days before (The apprentice recovered.) [16]

Address of the Board of Health

Health Office, 13 August, 1798

The Board of the Managers of the Marine and City Hospitals have observed with great regret the fatal consequences of the delay for the applications for medical aid to persons afflicted with the prevailing malignant fever, and that the removal of patients to the City Hospital, in many case, is procrastinated until they are literally sent there to die.

They recommend, in the most earnest manner, the early removal of patients to the City Hospital, where the public may be assured, that every possible comfort and accommodation will be afforded. - The public are informed that the care of patients and the management of the City Hospital, is committed to Doctor Physic and Doctor Cooper, who reside constantly there, and whose professional eminence, it is presumed, will secure a just confidence.

An Apothecary also resides at the Hospital, with an ample store of the best medicines.

The Board consider this recommendation as of the highest importance, and entreat the attention of their fellow citizens.

By order of the Board of Managers

Wm. Jones, President

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Richard Allen's Advertisement

Whereas numbers of the citizens of Philadelphia have left the city and shut up in their houses their dogs and cats, whose howlings and cries are so frequent and loud as to disturb the neighborhood in which they are confined. The subscriber takes [17] the liberty of hinting to the owners of such animals as remain in this state of confinement and starvation, the propriety of empowering some friend in town to liberate them as speedily as possible.

RICHARD ALLEN

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Achison Thompson's child, when apparently in a convelescent state, was taken to Germantown, treated there for worms, and died.

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Miss M. G. and E. May have both recovered. They were both bled twice, took two mercurial cathartics, and calomel in small doses, for two days, and had no return of fever after the 5th. (note: Miss M. G. left town on Sunday, returned the Friday following, and was attacked with fever immediately, and after died, being the 6th day from the time that she had been exposed to the contagion from Jas. Wright.)

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Polly Wood sent to the Hospital. (note: died the 6th day from the attack)

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A boy of the name of Bennet, whom I reported as a Yellow Fever case turns out to be a case of the Small-pox, the pustles numerous, but distinct.

He was twice blooded, and purged with calomel and jalap before the eruptions appeared.

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Miss Wharton and her mother, who were much with Mrs. Allen, in Front near Walnut Street, during her illness, are now both ill with the fever.

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Mr. Myers, in Front-street, sick today.

First case in Chancery Lane.

First case in Race Street above Seventh-Street.

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Received information from Dr. Keimly today that he had attended one of the crew of the Deborah who died under his care about the 1st or 2d of August. [18]

A young man of Mr. Dunaut's, under the care of Dr. Griffitts, is now on the recovery.

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Mr. F. Hamilton not expected to live; had been employed in Mr. Yard's store near Walnut street wharf (note: died a few days after)

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August 14

The College of Physicians had a special meeting today - only 12 members present.

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Mrs. Roberts and two daughters are sick in Christian Street; they know of no way they could have taken the disease, as they had been in no house where there was any person sick, nor in any part of the city where the disease was prevalent; and no person from any sick house, excepting Wm. Douglas's nurse had been at their house.

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The Mayor of Baltimore boasts of the health of the inhabitants of that city on the 10th inst., and recommends watering the streets.

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Orders of the Baltimore Board of Health

The Board of Health taking into consideration the danger that may arise from cargoes of coffee, hides, & c. being discharged within the limits of the city, at this season of the year-

Therefore resolved, That all vessels arriving from any of the West Indian islands laden with aforesaid articles, or other produce that may be liable to damage or putrefaction, be prohibited by the health officer from coming up into port; but that the cargo thereof be discharged into another vessel, while it remains in the river, and the necessary care extended to purify the same, before it be admitted into the city [19]

Also resolved, That it be recommended to custom-house officers not to enter any vessel at the custom-house without a certificate being first produced from the health-officer, expressive of his approbtion of the same, until the Board may advise to the contrary,

Commissioners of Health

William Winchester

Joseph Townsend

Michael Diffendorffer

John E. Reese

William C. Goldsmith

John Dalrymple

Levin Hall

James Biays

Benjamin Thomas

Baltimore, August 10th, 1798

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The City Hospital is situated on a low flat piece of ground, on the east side of Schuylkill, with a tract of marshy ground in front.

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Of 22 patients admitted into this Hospital, during the first three days, 12 died in the course of a week, and only two have yet been discharged. Doctors Physick and Cooper, the resident physicians, astonished at this unparalleled mortality, addressed the following letter to Dr. Rush.

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From the American Daily Advertiser

City Hospital, August 12th, 1798

Dear Doctor,

Our want of success in treating the prevailing disease, makes us anxious to hear from you, in hopes that you may have added some new and useful remedy to those heretofore in use. It is true all our [20] patients have been sick at least two, and some of them nine days previously to their admission. Is there any mode of relieving these unfortunate people which you can suppose we are unacquainted with? We recollect your observing that an emetic had been useful after the disease appeared to be mitigated by bleeding. If you can spare a few minutes to us on these subjects, you will much oblige your sincere friends, &c.

PHILIP SYNG PHYSICK

SAMUEL COOPER

Dr. Benjamin Rush

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THE ANSWER

My Dear and Worthy Friends,

I am sorry to discover by your letter, your want of success in the treatment of our malignant fever at the City Hospital. I do not wonder at it. You seldom see the disease in its first stage, and when you do, you meet it in an aggreavated state by the motion your patients undergo in being conveyed to the Hospital.

In answer to your request, I have sat down to inform you of the practice which I have adopted in our present epidemic. In the treatment of the yellow fever of last year, I have occasionally lamented the loss of patients after reducing the pulse by bleeding, and by the liberal use of purging medicines. I have suspected that death occurred in those cases, from the stagnation of the acrid bile in the gall bladder, or its close adherence to the upper bowels in the manner described by Doctor Mitchell in his account of the yellow fever in Virginia, in the year 1741. The slow pulse which occurs about the 4th day, I suspect further to be the effect of this bile. Its effects in a much more morbid state in the Jaundice, [21] in reducing the pulse, is well known. Mr. John Hunter says he once met with an instance in which it fell to 32 strokes in a minute in that disease. Revolving these facts in my mind, I resolved to try to remove this bile by exciting an artificial cholera morbus, about the 4th day of the fever. I was the more disposed to attempt this method of cure, from believing, as I have done for several years, that a cholera morbus is nothing bu the first grade of bilious fever thrown in upon the bowels, just as the Dysentery and Diarrhoea are the internal forms of a common bilious or intermitting fever.

I began this mode of treating the fever eight days ago. My solicitude for the issue of it was very great. Thank God it has succeeded to my wishes, and therby lessened in a great degree, the anxiety and distress which accompany our attendance upon this ferocious disease. The medicines I use for shaking the gall-bladder and bowels and discharging the contents are tartar emetic, gamboge, jalap and calomel, combined or given separately, and in small or large doses, according to circumstances. Perhaps Turpeth Mineral might be added to this list of vomiting and purging medicines with advantage. In one case I gave four grains of tartar emetic, and twenty of calomel. It operated freely upwards and downwards, and brought away a large quantity of green and black bile, but without exciting the least cramp or pain in the stomach or bowels. At the time I gave it, death appeared to be creeping upon my patient. The next day he was out of danger. The person thus rescued from the grave, was a son of Mr. Richard Renshaw. Indeed I have not, as yet, lost a single patient to whom I have given this powerful remedy. In one instance I fear it will fail. It is in a boy of 16 years of age to whom I have given near thirty grains of tartar emetic in the course [22]