EPIDEMIC 
YELLOW FEVER 
IX 
MONTGOMERY, ALA., 
/>< HmUC'C P j 
DURING TIIE 
SUMMER OR1 1873. 
By R, F. MldtlEL. M. T). 
*1 V 0 T* (*• % 
Charlestons S. C. 
The News and Courier Job Presses. 
1874. EPIDEMIC YELLOW FEVER 
IN MONTGOMERY, ALA., 
SUMMER OR1 1873, 
By R. F. MICIIEL, M. D. 
It is eighteen years since the City of Montgomery was visited 
by an epidemic of Yellow Fever; but, in common with several 
sister cities of the South, she has again been compelled to pass 
through the trying ordeal. 
It is not the object of this paper to enter into a learned dis- 
quisition upon the pathology and treatment of this disease, for 
after the labors of LaRoche and the leading medical writers of 
Charleston, New Orleans and Mobile, it would be almost pre- 
sumptuous. But feeling the necessity of a proper medical record 
for our city, and that the historian may hereafter find some mate- 
rial to guide him in his researches, I have determined to give a 
brief, but, I hope, proper account of the epidemic through which 
we have just passed. 
I do not believe that our fair city should be placed in the Yel- 
low Fever Zone; and if by any possible means she can be there 
assigned, I, for one, am determined that her position shall be 
upon its Northern border. 
My opinions with regard to the contagion and importation of 
Yellow Fever aVe well known to all of my medical friends in 
Charleston. A non-contagionist, and one who believes as much 
in its local origin, as in its being an exotic, can with good grace 
take the position, that the disease which proved so fatal this year 
in the City of Montgomery was brought from abroad ; did not 
spring up on its soil; was accidental, and does not properly belong 
to its climate. 
For two months prior to the visit of Yellow Fever we had 
been imminently threatened with Asiatic Cholera. Two of the 
cities of the State, Huntsville and Birmingham, were being then 2 
Michel—Yellow Fever in Montgomery. 
seriously damaged by the havoc of that vapidly fatal disease. 
Indeed, one case absolutely made its way into our capital, but, 
fortunately for us, did not take root. In consequence of this con- 
dition of affairs, our city authorities worked well, and worked 
hard, to fend off the threatened invasion ; and, with credit to 
them, be it said, they were absolutely successful. With lime, 
carbolic acid and coal-refuse scattered freely over the surface of 
the city; with our soil undisturbed, cellars dry, and the offal 
thrown on the banks of the river, we were safe, perfectly safe, 
from the disease. I mention this fact in order to call the atten- 
tion of the profession to the inutility of hunting for a local cause 
upon which to build any theory with regard to the advent of 
Yellow Fever in the year 1873 in the City of Montgomery. 
Whence came it? and,how did it progress? are the questions 
most likely to occur, and to their consideration I now invite your 
attention. 
I propose to show that the Fever was brought from Pensacola, 
Florida, by two persons, viz, Mr. I). II. Cram, President of the 
Pensacola and Louisville Railroad, and Mollie Jackson, a white 
woman. Both of these persons were in Pensacola when the 
Yellow Fever broke out, and had been living near the first re- 
cognized cases. 
Mollie Jackson left Pensacola on the ninth day of August, 
arrived in Montgomery on the 10th, and went to the house 
owned by Mr. Collins, on Clay street, South side, two doors from 
the corner of Wrfkerson, marked M. J. on map. Mr. Cram left 
Pensacola on the 14th day of August, arrived in Montgomery on 
the 15th day of August, and went to his home, at the corner of 
McDonough and Madison streets, owned by Mr. Stubbs, marked 
D. II. C. on map. 
Mollie Jackson was taken sick on Sunday morning, August 
the 17th. I was sent for, and found that she had had a chill in 
the night, and her pulse and general condition indicated fever. 
I visited her four days, and upon the declination of the fever my 
bill was settled, and I informed that if needed I would be sent 
for. 
Upon the morning of the 27th of August I was requested to 
give an interment certificate; and, not knowing at that time 
that she died of Yellow Fever, gave as cause of tleath “ Conges- 
tive Fever,” having seen her only through the febrile paroxysm, 
and not suspecting at the time that she was from Pensacola, or 
that there was an epidemic in that city. 
My friends, Drs. Johnston and Douglass, examined the body 
after death, and I was informed by Dr. Johnston that he looked 
upon the case as one of Yellow Fever, in consequence of the ex- 
treme yellowness of the skin. I immediately determined to ex- 
amine the nurses who waited upon the case; and, after a careful 
cross-examination of each witness, I became perfectly convinced Michel— Yellow Fever in Montgomery. 
3 
that Mollie Jackson died of Yellow Fever, contracted at her 
residence, exactly opposite the hospital in Pensacola. I may, in 
this connection, state that one of her nurses went to West Point, 
Georgia, “ sickened with fever, was very ill, and threw up blood 
from the stomach during the attack,” according to lsef own state- 
ment. 
Now, with this nucleus, what occurred in this neighborhood ? 
Case after case repeated itself, and almost every house in the 
three blocks adjoining became infected. 
Opposite the house of Mollie Jackson are four houses, the 
property of Messrs. Barrett and Collins, and in every one there 
were cases of Yellow Fever, and two or more deaths by this dis- 
ease—the Breshears, Robinsons, Harveys, Alexanders and Geor- 
gie Harris. 
Turning the corner of Dickerson street we find two houses, 
one occupied by the Wilsons, the other by the Mufchays. A 
death in both, preceded by black vomit, determined the char- 
acter of the disease ; while just opposite, on Bell street, Dr. 
Herreford reports three cases and one death at the Singletarys; 
Dr. Norton two cases in the family of the Campbells. 
We find in the street marked Herron, every house in that 
neighborhood visited, except two. The Hales, Pat. Thorinton, 
O’Brians, Sanderson, Browns, Stewarts and Kelleys, fill up the 
sad history of this memorable block. Dunham’s Row, according 
to the testimony of Drs. Norton, Means, Johnston, Michel, and 
others, suffered in common with the surrounding locality ; while 
to the rear, on Holt street, we find the serious illness of the Rays 
and Wings. The next parallel street, marked Martha, also fur- 
nishes cases of this severe disease, in the persons of the Curans, 
Temples, Stuarts and Ovens; particularly sad and fatal in the 
last family. 
It would be idle to dwell further upon the history of this part 
of the city. The resume of the cases demonstrates how this ward 
suffered, and the dark outline of death marks well the surround- 
ings of Mollie Jackson. 
Mr. D. H. C ram, as already stated, arrived on the 15th day of 
August, was taken sick the night of the 17th or 20th, and had a 
fever, which lasted several days. 
I believe his attack was Yellow Fever, and I will now proceed 
to give my reasons for this statement, although I did not see him 
during his sickness. 
Being President of the Pensacola and Louisville Railroad, Mr. 
Cram was compelled, in the official discharge of his duties, to 
remain in Pensacola as long as possible, and I have no doubt 
that sleeping in the locality in which he did, he was fully ex- 
posed to the poison. 
I here take the liberty of introducing a part of a very valuable 
letter, written me by Dr. R. B. S. Hargis, of Pensacola, upon the 4 
Michel—Yellow Fever in Montgomery. 
epidemic in that city. This letter was written in answer to some 
questions propounded to him by myself. Dr. Hargis is well 
known to the medical public, through his valuable contributions 
to the literature of Yellow Fever: 
“Pensacola, November 6th, 1873. 
Dk. R. F. Michel, Montgomery, Alabama: 
My Dear Doctor : After some days of unavoidable delay, in 
compliance with my promise, I essay to answer your letter dated 
the 20th ult., trusting that I may be able to communicate the 
information which you desire, so as to render it useful to you, in 
some degree, at least: 
1st. Mrs. Nasite arrived in Pensacola, from New Orleans, on 
the 22d of July; got sick on the 7th of August, and died on the 
13th of August. 
2d. Mrs. Pfeiffer was taken sick on the 9th, according to her 
husband’s statement; but from the condition in which I found 
her, I believe she was taken down on the 7th. I saw her for the 
first time on the 10th; she was then “bronzed;” had hemor- 
rhages from the nose, mouth, buccal mucous membrane, fauces, 
and uterus; black vomit on the 11th, 12th and 13th ; died on the 
14th, in the morning. 
3d. Captain Ed. Dunn sickened on the 14th of August; had 
black vomit and recovered slowly. 
4th. The Golden Dream came into port (from Havana) on the 
10th of June, and went immediately into quarantine, detained 
there twenty-four days, and admitted to protigue on the 3d of 
July. 
5th. The sailor from the Revenue Cutter Petrel, eight days on 
board the Golden Dream, sickened on the 2d day of August, and 
died with black vomit on the 5th of August. 
6th. The Golden Dream sailed on the 16th of August, and was 
lost on the 30th of August, just as I predicted, in consequence of 
“ getting short of hands" by the ravages of the monster she fos- 
tered on board. 
Several of the stevedores who worked on board that ill-fated 
vessel, the Golden Dream, contracted Yellow Fever, from sources 
of infection within that very filthy craft itself, at different times 
during the interval between'the 5th and 16th of August. These 
men lived outside the infected district, and communicated the 
disease to the inmates of their houses, and these houses became 
separate and distinct foci which radiated the infectious principle 
in all directions. 
7th. I believe, indeed, I am certain, that the Yellow Fever was 
introduced into Pensacola this Summer (1873) by the Golden 
Dream. 
I predicted that she would introduce it, if allowed to anchor 
within the distance of a thousand yards from the wharves. The Michel—Yellow Fever in Montgomery. 
5 
atmosphere, as I before intimated, was in a favorable condition 
for many days, in July and August, for the propagation of infec- 
tious germs of any kind from a foreign source. 
8th. Mr. 1). II. Cram left Pensacola on the 14th day of Au- 
gust, the same day on which Mrs. Pfeiffer died. The distance 
between his office and the room in which Mrs. Pfeiffer died is 
about eighty to ninety feet, nothing intervening but air and dust, 
and whatever else that may have been invisible. Mr. Cram, 
however, had been inhaling the same deleterious principle that 
poisoned Mrs. Pfeiffer a week at least before the latter was taken 
sick. So was Mrs. Nasite and the rest. 
Mrs. Nasite resided on Intendentia street, that which crosses 
Taragone street at right angles, East and West, one block from 
the Railroad Depot on Taragone street, where Mr. Cram’s office 
is situated. Mrs. Nasite was not removed. 
Now, Mrs. Nasite and Mrs. Pfeiffer were the first two deaths, 
but not the first cases. The first three cases were taken sick at 
the same time, on the 6th of August, in the same house, the 
residence of Mr. W. McKinzie Orthing, Deputy Harbor Master, 
on Romana street, two squares distant, North of Mr. Cram’s 
office. Mr. Orthing, no doubt, carried the germs of the disease 
home in his clothes, as he had been frequently on board of the 
vessel, and stayed there many hours at a time. Rut as nearly all 
the first cases sickened about the same time, on the 7th, I believe 
that the infection was transported from the ship by the winds, 
and leavened the atmosphere in its course. 
The next four cases occurred on Romana street, near the resi- 
dence of Mr. Orthing, on the 7th of August. After this time 
two or three new cases appeared daily, until the 15th, when the 
disease became epidemic. 
The width of the district first infected, measuring from East 
to West, was about one square, a little more perhaps, and did not 
increase for fifteen days ; it extended, however, for a mile, in the 
direction of the winds, Northeast. The disease spread over the 
city from different centres, or foci, created by persons who con- 
tracted the malady, either from the ship itself, or from the atmos- 
phere of the infected part of the city, wherein they exposed 
themselves by visiting at night. 
Now', that there may be no misapprehension in regard to the 
origin and mode of propagation of the epidemic here, 1 shall 
make a few additional observations, and then briefly recapitulate 
what has been already stated, and include in the recapitulation 
other sporadic cases that intercurred at different dates, between 
the. 6th of August and 15th of the same month. 
The atmosphere had been for some time previously to the in- 
troduction of the disease in a favorable condition to foster any 
new morbific principle that might be introduced, and continued 
during the epidemic, with very slight variations, to maintain that 6 
M ichel.— Yellow Fever in Montgomery. 
state. It was humid, negative with respect to electricity, free 
from ozone, and continued at a mean temperature of 80° Fall. 
Our endemic diseases became rife about the middle of July, and 
prevailed until the Yellow Fever made its appearance, and then, 
as always, every other disease either assumed its livery or was 
united with the nature of itself. 
The winds came from the South and Southwest during the 
day, and from about the 28th of July until the epidemic had be- 
come general, about the 20th of August, it swept gently over the 
Golden Dream from the Southwest, and carried with it through 
the “ devoted ” district the infectious matter which that vessel 
brought with her from Havana. 
The Golden Dream laid oft’about five hundred yards from the 
beach. The first case of which we have any certain knowledge 
that occurred on board of this vessel, after she left the Quaran- 
tine Station, was that of the sailor from the cutter Petrel. He 
was taken sick on the 2d of August, and died on the 5th, with 
black vomit. The first cases in the city appeared on the 6th of 
August, at Mr. Orthing’s; next in order were those at Mr. Ka- 
ber’s, Mr. Chandler’s, Mrs. Nasite and Mrs. Pfeiffer’s, on the 7th; 
then the several stevedores, one or two daily, until Pld. Dunn 
fell sick, on the 14th day of August—afterwards epidemic. 
Our population, after the fever made its appearance, was re- 
duced, “by the stampede,” to about three thousand, of whom, in 
round numbers, one thousand were liable to contract the disease. 
It is estimated that of the latter six hundred were attacked; the 
mortality numbered just sixty-one. 
Here, my dear doctor, this communication must terminate. I 
have written necessarily in haste; it is, therefore, very imperfect, 
but you can eliminate the facts it contains, and rest assured that 
they are “facts” 
I am, very respectfully, 
Your obedient servant, 
ROBERT B. S. HARGIS.” 
It may not be irrelevant, just here, to quote from a letter writ- 
ten me by my revered teacher, Professor S. II. Dickson, dated 
Philadelphia, October 20th, 1867, and in answer to the question 
I had propounded : “At what distances have you known Yellow 
Fever to radiate from a centre ?” 
“ My Dear Doctor : As to the Yellow Fever question, the true 
mode of regarding all such particular instances, is fairly this : 
Decide the general question—is the disease portable, communica- 
ble, contagious in any sense? If so, there can be no difficulty as 
to one hundred or two hundred yards of interval, or fomites, or 
currents of air, and the like. 
We cannot trace small-pox always, nor measles, much less 
mumps and whooping cough ; but the obscurity of the links of Michel—Yellow Fever in Montgomery. 
7 
connection does not shake our belief of the dependence of every 
case that we meet with on some preceding case. 
Dr. Thomas Y. Simons, whom yon remember as Quarantine 
Physician, and an obstinate non-contagionist, told me that he had 
known the lapse of twenty-five days between exposure and attack 
in Yrellow Fever. 
I remain, dear doctor, yours, truly, 
SAMUEL H. DICKSON.” 
I think my readers have sufficient evidence for my statement 
that Mr. D. II. Cram and Mollie Jackson Avere exposed, in Pen- 
sacola, to the Yellow Fever poison, and, indeed, did not leave there 
until the epidemic prevalence of the disease. 
In addition, I may mention the fact that Mr. Cram’s physician, 
just returned from a healthy locality in Virginia, became quite 
sick during the month of August, or early in September, and his 
convalescence was so protracted that I incline to the opinion that 
he suffered with the same disease. 
Now for the sequel. With Mr. Cram as a nucleus, let us criti- 
cally observe what took place in this portion of our city— 
Ward 5. 
On Madison street, next door to Mr. Cram, is a house owned 
by Mr. Noble, and occupied by Germans, some of Avhom had 
lately arrived from Illinois. 
The distance from the chamber in which Mr. Cram Avas sick, 
to this house is exactly thirty-two yards. 
On Friday, September 4th, one of the inmates took sick, Mr. 
John G. Schan, and died on the 12th day of September. On the 
same day (September 4th) Mr. Ileinecke, of the same family, also 
sickened and died on the 14th day of September. Geo. Fisher, 
another inmate of the house, sickened on the night of the 6th of 
September, and died September 14th ; and, again, another of the 
family, Ed. Ileinecke, took sick on Tuesday, September 16th, and 
died on the 21st. The last remaining male inhabitant of that 
fatal building, Mr. F. Schan, aged twenty-nine years, and the 
proprietor of the establishment, sickened, as reported by his 
physician, Dr. J. M. Williams, and on Thursday, the 25th day 
of September, at half-past eight o’clock A. 31., breathed his last. 
Dr. Williams reported this case as Yellow Fever. I saw Mr. 
Schan, in consultation with the doctor. We examined the black 
vomit carefully, and I reported the result of that examination to 
the Board of Health. 
I believe that every one of these five persons died of YelloAv 
Fever, and I think I am sustained in this opinion by two of the 
attending physicians. 
In Mr. Cram’s kitchen, fifteen yards from this house, Jim Hig- 
gins, husband of Mr. Cram’s nurse, sickened and died Avith Yellow 
Fever. I saw this case at the request of the attending physician. 8 
Michel— Yellow Fever in Montyomery. 
Several persons visited the sick Germans, and many of them 
sickened; among these I may mention Eugenia Harris, McCar- 
thy, and Schnaibel. These three had Yellow Fever, the first two 
dying with black vomit. 
On McDonough street, next to Cram’s, is a row of brick build- 
ings, owned by Mr. Stubbs and the Fountain Estate; not one of 
these residences escaped. The Bealls, the Wa|s, Mrs. Sistrunk 
(and lam here saddened by this last record), sickened, and many 
of them died. The lovely lady named, although removed prompt- 
ly to a different part of our city, in order to escape the terrible 
pestilence, became instantly sick, and died of Yellow Fever. 
In the Inglehart House, on Monroe street, are two deaths by 
the epidemic disease, and on the next block we observe that not 
a house escaped ; each was visited severely; it has been well 
termed t he. fatal point in the city. Harris lost three children ; 
Moncreef, McCarty, Mr. Mathews, the Copets and Caminades, 
all died; and, in my house, on the same block, there occurred 
two very severe cases. My neighbor, Mr. Woolfe, suffered also 
from an attack. In these two blocks we have seventeen houses ; 
three were uninhabited, the Washburns, the Fountains and 
Jannyes; and, at the close of the epidemic, wo see reported eight- 
een deaths in this locality by Yellow Fever. 
I call attention to the fact, that up to a certain date, the rav- 
ages of this disease were confined almost entirely to the two 
•wards, one and Jive. 
But suddenly we are notified of the sickness of Mr. Putnam 
Larkins, who was attacked on Saturday, the 2*7th of September. 
This gentleman died of Yellow Fever, on the 3d of October, in 
the very centre of the city, opposite the Masonic Temple, as 
shown on the map. 
Now, from this point, the disease stealthily crept up Com- 
merce and Court streets, affixing its fatal mark upon many build- 
ings on each side of the way—Halzer, Jim Walker, Yung, Fre- 
mon, Goodwyn, the fatal Begg’s corner, with five deaths in one 
family, Miss Cheney, d&ewys, our distinguished physician, I,)r. 
Jackson, Isaac, and the Spauefburgers, give evidence of the 
regular advancement of this horrible disease. 
From these points it radiated in every direction, and our city 
soon fell a victim to one of the most fatal and extensive epidemics 
of Yellow Fever ever experienced by its inhabitants. 
The extent and severity of the epidemic I propose to prove by 
the fact that no portion of our city escaped, and that of the few, 
very few, white persons who remained, the number not exceeding 
eighteen hundred, between four and five hundred sickened with 
the disease. 
On examining the number of white families who lived, day and 
niyht, on the three most important streets of the city—Court, 
Perry and Madison—I find only seventeen to be recorded. In Michel-—Yellow Fever in Monty ornery. 
9 
fact, on Madison, only the Brittons, Michels and Harmses re- 
mained. 
With regard to the mortality, the Board of Health reports 
eighty cases of deaths by Yellow Fever. To this permit me to 
add the following persons, who, in my opinion, died of the same 
disease, notwithstanding the interment certificate given: Mollie 
Jackson, Mrs. P. W. Wilson, G. Schan, T. Schan, Ileinecke, Sr., 
Ed. Ileinecke, Ji., Fisher, Mrs. E. Holland, Mrs. Sistrunk, Miss 
Spanenburger, Fred. Stewart, Fannie Stewart, Jim Higgins, 
Mrs. Glover, John Pollard, T. Terry, Hannah Mason, Julia 
Ware, McCutchen, B. F. Benton, 1). Packer, 1). S. French— 
twenty-two. 
Of the five hundred cases, we therefore lost at the smallest 
calculation one hundred persons, some of them our most valua- 
ble and prominent citizens. Of the hundred, sixty are accredited 
to ward five, twelve to ward one, and twenty-eight scattered. 
A remarkable feature in the history of this epidemic is the 
number of colored persons who were attacked, it is true, how- 
ever, that very few died. 
In Charleston, although occasionally one of this class fell a 
victim to the disease, they, as a people, were considered almost 
exempt. I do not remember seeing half a dozen black persons 
sick with Yellow Feveir in the many epidemics 1 witnessed dur- 
ing my professional life in Charleston.* 
A few persons, after leaving our city, became subjects of the 
disease ; two dying, and several recovering. The disease how- 
ever did not spread in the localities in which they occurred, viz, 
Mr. Attoway, West Point; John Pollard, Auburn; Mrs. Glover, 
Tuskogee; Mr. Thorgheville, Wetumpka; Mr. F. M. Thouse, 
Talladega; Miss Nellie Woolfe, Greenville; Mrs. F. Woolfe, 
Greenville. 
Another important question for our consideration is this—did 
we have any other epidemic disease to treat during the sojourn 
of Yellow Fever in our city ? 
The physicians of Montgomery are well acquainted with the 
fact that, during the months of August, September, and espe- 
cially October, we are generally busily engaged in attending 
malarial diseases. It is remarkable that these milder diseases 
were rarely visible after the appearance of Yellow Fever. They 
moved out of the way, to give precedence to this terrible pesti- 
lence. As the distinguished Dr. Hush, of Philadelphia, well said: 
“ When the giant Yellow Fever makes his entrance into a city, 
all other diseases at once put on his livery.” 
The difficulty with most of the people is to understand the 
fact that, in an epidemic of Yellow Fever, we have a great many 
♦Note.—Oui experience differs from that of Dr. M. We have seen numerous cases 
among the blacks during our epidemics, but these were of light character, and usually 
ended in recovery.—[E»s. 10 
Michel— Yellow Fever in Montgomery. 
mild cases. Some of our patients are only kept in bed forty-eight 
or seventy-two hours, but that fact does not prevent us from 
properly calling these cases Yellow Fever. 
Take an epidemic of Asiatic Cholera, painful, terrific, and 
rapidly fatal. See what Professor Niemeyer says of cases of 
simple diarrhoea occurring during such a period: 
• “ The mildest form is a simple diarrhoea, which is not accom- 
panied by colicky pains or tenesmus, and causes no constitutional 
or other disturbance, except a moderate degree of depression and 
relaxation. The evacuations follow each other more or less 
closely; they are very copious and watery, but have neither lost 
their odor nor color. These cases do not appear on the official 
lists as cholera; but although the police do not consider them as 
such, science should do so.” 
These persons transport Asiatic Cholera by their dejecta. 
Now, it' these simple cases are regarded as mild attacks of Asi- 
atic Cholera, why should we not at once admit the mild cases of 
Yellow Fever, attended simply by a chill, followed by fever, pain 
in the head and back, anclslow convalescence V 
I here quote a part of a letter written me by Professor 11. A. 
Kinloeh, of Charleston, dated November 8th, 1873: 
“ Look almost any where for authority, and you find the fact 
admitted that there is the ‘mild,’ or ‘simple’ form, as well as the 
‘•gravior’ and the ‘malignant’ form of Yelloio Fever. Illair, I think, 
it is, who says, ‘■you may have the disease from a flea-bite to the 
plague.'' That is appearing as a case of the simplest kind of mild 
sickness, or again assuming the form of a terribly malignant 
disease. 
“ In my short reply to Professor Jones, in the October number 
of the Charleston Medical Journal and Review, I refer to the 
several varieties. The thing is to recognize different degrees of 
susceptibility, and of acclimation in the individual; and also 
different doses of the poison, or degrees of its dilution. This wi 11 
explain all. Take, if you please, either Scarlet Fever, or Asiatic 
Cholera, and you see this point equally well exemplified. 
“ Epidemics differ much in this regard, some having a very 
large proportion of grave cases; others the reverse. 
Yours, in haste, K. A. KINLOCII.” 
I have said repeatedly and positively to my professional 
friends that we had no dengue or anything like it in Montgomery 
during the prevalence of Yellow Fever, and I will now give my 
reasons for the faith that is in me. 
Professor Dickson, the most elaborate writer upon Dengue, 
thus describes it: 
“ Dengue usually made its invasion with pain, stiffness, and 
swelling of some of the smaller joints, often of the muscles of a 
limb, rigidity of the neck, aching of the back and loins. These Michel—Yellow Fever in Montgomery. 
11 
pains were followed, after an uncertain, though generally brief 
period, by headache, suffusion of the eyes; abrupt, full, frequent 
pulse; hot, pungent, dry skin, restlessness, thirst, and other 
tokens of febrile excitement. The fever did not remit, but de- 
clined and disappeared in a great majority of cases on the second 
or third day. In this early stage the tongue was generally clean, 
and the stomach quiet; but sometimes there was nausea or even 
vomiting, the determination to the head was occasionally vio- 
lent. Instances occurred in which delirium Avas among the first 
symptoms, coming on at the commencement and enduring until 
the subsidence of the febrile paroxysm. At this time the skin 
lost its heat and dryness, becoming relaxed, with abundant per- 
spiration, and the local pains Avere all lessened in degree. A 
sort of miliary eruption, or rash in some persons, attended this 
sweating stage, and in afeAV others preceded both the local pains 
and the fever. It Avas, however, as connected with this first 
stage of dengue, a very inconstant symptom, seeming rather a 
coincidence than a symptom. The pains of the joints and mus- 
cles which, as has been said, Avere diminished in severity at the 
subsidence of the febrile exacerbation, did not go oft’ entirely; a 
degree of swelling, stiffness, and tenderness of the affected parts 
remaining permanently, though varying much in intensity in dif- 
ferent individuals. This condition of things constituted a sort of 
deceptive interval betAveen what may be described as the first 
and second stages of this strange disease. Many hoav believed 
themselves to have passed through the attack, and attempted to 
resume their ordinary occupations; but soon had occasion to dis- 
cover that their sufferings were by no means at an end. On the 
third or fourth day, there being no fever present, or a very ob- 
scure degree of it, the tongue would begin to be coated with a 
yellowish fur, and the stomach would become distressed, uneasy 
and irritable. The patient Avas now low-spirited, fretful and 
anxious. Vomiting come on in some, with great langour, lassi- 
tude, debility, and restlessness at night. This Avas regarded as 
the most oppressive and insufferable of the stages of the malady. 
On the fifth or sixth day from the invasion, the period varying 
someAvhat in different individuals, the annoying symptoms just 
described Avere relieved by the coming out of an abundant erup- 
tion, met Avith so constantly and in so very great proportion of 
the cases, that it clearly demands to be considered a character- 
istic and essential circumstance in the history of the disease. It 
consisted of minute papulse, someAvhat elevated, of a florid red, 
and distributed in irregularly shaped patches; the feet and hands 
being somewhat swollen, with a sense of numbness and thicken- 
ing. It appeared first on the face, then on the trunk and thighs, 
gradually spreading to the extremities. It resembled scarlatina 
more than measles, in the hue and aspect of the skin, but avus 
less diffused or confluent than either. When fully developed, it 12 
Michel-— Yellow Fever in Montgomery. 
was attended with some itching and burning of the surface, and 
at this time a second febrile paroxysm came on, with return or 
aggravation of the muscular and arthritic pains. Inflammation 
and enlargement of the lymphatic glands in the neck, axilla and 
groin, attended in a good many cases; these parts being apt to 
continue swollen and painful for some time after convalescence 
was finally established. In a few instances suppuration of these 
tumors took place. The eruption disappeared after two or three 
days’ duration, becoming gradually paler, with some desquama- 
tion of the cuticle. Of all the symptoms of dengue the affection 
of the joints was the most tenacious and troublesome, adhering 
for weeks to some patients, and constitut ing a sort of permanent 
lameness or loss of mobility. Nay, even so late as 1835, some of 
the population of cities visited by this plague persisted in speak- 
ing of the rheumatic or quasi-rheumatic decrepitude and pain 
under which they labored as the effects of dengue. 
“ Pregnant women, Avhen attacked, were very liable to abor- 
tion, and a remarkable number of miscarriages and premature 
labors occurred. A sore mouth was among the frequent symp- 
toms ; ulcers formed in the mouth. Dengue is to be classed 
properly among the exanthemata. It is an eruptive fever of 
distinct and specific character. Its essential symptoms are, in the 
first stage, a painful affection of the joints and muscles; and, in 
the second, divided by an interval obvious and sufficiently regu- 
lar, a cutaneous eruption. The arthritic inflammation of the 
first stage was attended by fever of the ordinary inflammatory 
type, of twenty-four to forty-eight hours’ duration. The erup- 
tion was preceded, as is usual in the exanthemata, by considera- 
ble gastric oppression, Avith nausea, and sometimes vomiting.” 
We must insist upon the fact that mild cases of Yellow Fever 
be not confounded with this painful, very painful, but perfectly 
harmless affection, Avell known to the profession as free entirely 
from danger to life, which it may annoy, but never destroys. 
Look carefully at the premonitory symptoms ; watch well the 
kind and sev erity of the pains, which mark the onset, continuance 
and termination of dengue. No chill—mark that; no mention of 
even a rigor. Observe the intermission, not accidental, not oc- 
curring by chance, but regular, never deviating, always coming 
to the relief of the sufferer, and to be counted with certainty by 
the hands of the clock. Then examine the secondary fever, ac- 
companied always by an eruption that Dr. Dickson says, “clearly 
demands to be considered a characteristic and essential circum- 
stance in the history of the disease.” Look at the prompt conva- 
lescence of dengue, with the deformed and enlarged joints; the 
patient, staggering about, bald-headed, with stick in one hand, 
or crutch in both. Observe the common accident of abortions 
and premature labors, and then say if this condition of things 
resembles, however remotely, not the violent cases of Yellow Michel—Yellow Fever in Montgomery. 
13 
Fever, with black vomit, discoloration and bleeding from gums, 
lips and nose, but the milder and more numerous cases of Yellow 
Fever frequently met with during an epidemic, easy of control, 
but very tardy in convalescence. 
Pathologically considered, dengue is one of the exanthemata, 
and I challenge the proof that it has ever been regarded as “a 
hemorrhagic disease,” by any standard authority. No one values 
authority more than I do, but I must insist (not in a name) that 
the authority carry with it force and character upon the subject 
matter under consideration. I repeat, that I do not believe there 
was any dengue in our city during the Yellow Fever epidemic, 
and the profession bears me out in this statement. At a meeting 
of the members of the Montgomery Medical and Surgical Socie- 
ty, for the purpose of discussing the epidemic of Yellow Fever, 
it was unanimously decided, by the physicians Avho were in Mont- 
gomery during the epidemic, that no such disease as dengue had 
been observed. 
With reference to the pathology of Yellow Fever, I have 
hardly anything to say. We made no post mortem examina- 
tions, and very few chemical investigations; consequently the 
researches of Blair, Lewis, and Joseph Jones, were not again re- 
peated and confirmed. I examined the urine and the black vomit 
of several cases; found albumen as stated by Blair in the one, 
and the characterist ic features of the others, as first insisted upon 
by Dr. Middleton Michel, in the Charleston Medical Journal, 
May, 1853, and by Dr. Hassell, of London, for February, of the 
same year. 
Dr. Joseph Jones has stated that the lesions of tlie heart are 
characteristic in this disease ; that the heart is structurally alter- 
ed and enfeebled ; oil and granular albuminoid or fibroid matter, 
is deposited within and around the muscular fibrillai, and the 
organ after death presents a yellow, flabby appearance. He says 
we must keep our patients quiet, in order that the heart may be 
restored to its free and vigorous action. The profession owe Dr. 
Jones a debt of gratitude for his very practical pathological 
demonstrations. 
This feeble condition of heart was frequently observed. In the 
case of my son, Middleton Michel, I found his heart at forty for 
three days and nights, and for several hours during that time 
only beating thirty-eight per minute. 
It is well known that this peculiar disease, in its initial stage, 
may be characterized by individual idiosyncracy. I know of five 
cases in which the disease was ushered in. with convulsions, and 
most of these were in persons of intemperate habits. 
Some of the cases were prolonged for fifteen or twenty days 
before they terminated fatally, while others were rapid in their 
results. Mrs. Shields died with black vomit, exactly eighty-five 
hours after the initiatory chill. Most of the fatal cases, however, 14 
Michel—Yellow Fever in Montgomery. 
are recorded as dying on the fifth or ninth day. Abortions oc- 
curring during the febrile attack, as a general rule, proved fatal. 
This was not the case when the product of conception was carried 
to its full term. Mrs. 1). and Airs. B., subjects of the disease, 
recovered promptly, and the children are doing well. Almost 
all of the cases occurring among females were accompanied by 
hemorrhage from the uterus. This bloody sweat from the mu- 
cous membrane of the vagina and uterus was first described as a 
symptom of Yellow Fever, by Dr. Middleton Michel, in the 
eighth volume of the Charleston Medical Journal. I was present 
and assisted my brother in these pathological investigations, and 
can now further confirm his statements from observations dur- 
ing this epidemic. 
TREATM EXT. 
With regard to treatment, the profession here generally believ- 
ing the disease self-limiting, seldom resorted to medicine. 
When called to see a case, the patient was placed in allot mus- 
tard bath; castor oil or seidlitz powders were resorted to as 
aperient; very few, if any, administered mercurials. Mild dia- 
phoretics and diuretics were used, as orange-leaf tea, black tea, 
or sage tea. After the full effect of the bath was realized, the 
action on the skin was kept up by warm mustard pediluvia ad- 
ministered under the covering, without exposure of the person. 
In the stage of restlessness, chloral was given generally by the 
rectum, rarely by the mouth, with good effect. Narcotics were 
regarded as unsafe remedies. For myself, as soon as I found 
sighing, respiration, and frequent eructation, I generally placed 
a large blister on the epigastric region. Tn the case of my 
son, who had black vomit, I feel assured that it controlled the 
nausea. 
Stimulants, as a general rule, were avoided, except during con- 
valescence, when they were used in order to assist the heart in 
its propulsive efforts. Brandy and Champagne were those most 
frequently given. In cases attended with great prostration they 
were very cautiously administered during the febrile stage. 
Solid food was strenuously avoided; but beef tea, milk and 
lime water, gruel, chicken broth, and arrow root, permitted. 
Rest, absolute rest, was insisted upon ; and hence very few 
cases of sudden death during convalescence are reported. An 
equable temperature in the sick room was constantly main- 
tained. 
Quinine was only used as a prophylactic, and in some cases 
with apparent success. 
It will be observed, on examining the tables of Mr. G. A. Clum,* 
to whose kindness I am indebted for the valuable meteorological 
records, kept carefully by him during the epidemic, that the fever 
♦These tables, for want of space, we have to exclude.—[Eds. M ichEL'—Yellow Fever in Montgomery. 
15 
travelled with, and against the wind; and that rain, or clear 
weather, made no material difference in its severity. But when 
we come to the consideration of the effect of cold, we find again 
the old established and well understood principle earned out : 
Frost destroyed the Yellow Fever poison in Montgomery, just 
as it does in every locality. 
The first frost occurred on the twenty-first morning of Octo- 
ber. This was so slight as not even to kill tender garden plants, 
and many persons in the city denied its existence. On the morn- 
ing of the 29th of October we Avere favored Avith a “ black frost,” 
frost with ice. The same thing occurred on the following morn- 
ing, and on the morning of the 31st of October avo had a Avhite 
frost. 
Now, taking nine days for the full period of incubation, and 
nine days for disease and death, Ave should not have a death by 
Yellow Fever recorded after the sixteenth day of November. 
And this calculation is correct, for Ave observe that the last death 
by Yellow Fever (subject Mr. Leroy Taylor) occurred on the 
tenth day of November, at 12 M. 
Previous to this epidemic, Montgomery had been visited three 
years consecutively by YcIIoav Fever—1853, 1854, 1855. 
II aving no medical record to guide us in drawing a compari- 
son betAveen these visitations, and the one through which Ave have 
just passed, I have selected a most reliable account, carefully pre- 
pared by an old citizen. This record has been kept Avith zealous 
care, in the Supreme Court Library of the State. 
In comparing these three epidemics Avith that of 1873, it is 
very observable that the disease this year has been more grave, 
more extensive, and remained with us longer than it ever did 
before: 
“The YcIIoav Fever was first declared to exist in this city the 
latter part of September, 1853. The first interment from the dis- 
ease was on the 22d of that month. The total interments for 
that month were twenty-eight Avhites and eight colored; of the 
Avhites, nine Avere YcIIoav Fever. In October, 1853, of the fifty- 
three Avhites interred, twenty-two Avere from the fever. In No- 
vember, 1853, there Avere four interments from the fever. 
“ In September, 1854, there were twelve whites interred, of 
which six were from Yellow Fever. In October, 1854, of the 
fifty-tAvo Avhites interred, thirty-seven Avere of persons dying from 
that fever. The largest number buried in one day, Avas on Sun- 
day, the 22d of October, 1854, which Avas the following named 
seven: Joseph Knox, James Narramore, Mrs. Clara Connally, 
Oliver Reed, Miss Francis McGuire, Mary Binnard, and Isidore 
Binnard. In November, 1854, there were two interments from 
the fever. 
“In September, 1855, of the seventeen whites interred, seven 
Avere from YcIIoav Fever, and, in October, twenty-one of the 16 
Michel— Yellow Fever in Montgomery. 
thirty-four were from the same disease. In November, 1855, 
there were two Yellow Fever interments, among the whites.” 
The Board of Health of Montgomery declared the disease epi- 
demic on the sixteenth day of October, in accordance with the 
well known rule governing the Boards of Mobile and New Or- 
leans, viz: “ That 'the deaths by the epidemic disease shoiild 
exceed the deaths by all other causes”—a rule as arbitrary as 
unscientific; one to be honored more in the breach than the ob- 
servance. 
My only object in referring to this matter is to enter again 
my protest. I earnestly hope that the Boards of Health may be 
governed hereafter by a different rule. 
I beg to introduce to the readers of the Journal, two intelli- 
gent and authoritative letters, written me during the late epi- 
demic, upon the subject of JJpulendeity. One from Professor 
Bemiss, of the University of Louisiana; the other from Professor 
Kinloch, of the Medical College of the State of South Carolina: 
“New Orleans, October 18, 1873. 
To Dk. K. F. Michel: 
Dear Doctor: Undoubtedly, in :i purely professional sense, 
the term epidemic is applied to diseases with very different 
degrees of prevalence, so that it becomes difficult to decide when, 
as physicians, we should pronounce a malady “epidemic.” I 
should say, that in a professional use of the term, we ought to 
regard any disease as epidemic which has become so prevalent 
in a population, that we meet examples of it more frequently 
than we meet with cases of any other one form of disease. In 
respect to all those diseases which are admitted to be in any 
manner communicable, it is quite usual to declare them epidemic 
before they have reached this degree of prevalence; and we are 
certainly right in doing so, when, by any kind of sanitary meas- 
ures, we may be able to diminish the number of attacks. 
The difficulty in answering your question has presented itself 
time and time again to the Boards of Health of this city, until 
they at last adopted an arbitrary rule for obtaining it. This is, 
to declare a disease to be epidemic when the deaths due to it, 
exceed in number those from all other causes combined. 
I write with very great haste, but have given you as frank an 
answer as I am capable of making. 
Very respectfully, 
L. M. BEMISS.” 
“Charleston, S. C., October 18, L873. 
My Dear Doctor: In answer to your card, I can only say 
that you put a difficult question, and one that can only be arbi- 
trarily answered. An epidemic disease in a city is, of course, as 
the derivation of the word implies, a disease that is upon the Michel— Yellow Fever in Montgomery. 
17 
people, or, as I understand it, one that affects so many persons 
as to attract marked attention, and lead to apprehension of a 
greater spread of said disease, depending, as is believed, upon an 
unusual prevailing influence. 
When the disease is a well recognized one, and one known as a 
rule to prevail epidemically, as does Cholera and Yellow Fever, 
the fact of the existence of almost any unusual number of cases, 
not confined to a limited section, but scattered, and leading to 
the inference that any of the people may be the next victims, I 
think entitles the disease to be called epidemic. As I intimated 
before, it would be simply arbitrary to limit the name epidemic 
to a definite number of cases. If you fixed upon fifty cases as the 
number necessary to constitute an epidemic, I might with equal 
propriety insist that twenty cases were sufficient. 
It occurs to me, that the proper ground to take is that founded 
upon the reasonable probability of the disease spreading. In 
other words, if the cases are so numerous, occur in such quick 
succession, and are so scattered as to locality, as to render ques- 
tionable the idea of their being simply sporadic, I would con- 
sider the disease epidemic. 
Under such circumstances I should say that twenty or thirty 
well marked cases of the disease would warrant any one in con- 
sidering the disease epidemic. 
I don’t know whether this answer will satisfy you. It is the 
best I can give. 
Truly yours, R. A. KINLOCH. 
Dr. R. F. Michel, Montgomery, Ala.” 
In conclusion, permit me to say that it is a fact, remarkable in 
the history of this epidemic, that so many of our profession 
should have been attacked. While it serves to illustrate the 
zeal and devotion which characterize the profession to which we 
belong, it also most significantly demonstrates the highly infec- 
tious nature of the terrible disease with which we have had to 
contend. I take great pleasure in recording the names of the 
gentlemen who, while disinterestedly laboring for the preserva- 
tion of human life, suffered with the disease: I)rs. E. A. Semple, 
S. D. Seelye, F. Lynch, W. 0. Jackson, J. B. Gaston, F. Persall, 
J. A. Fremon, and James Douglass. E ll K A T A 
Page 3, line 5 : for “her” read ‘‘his.” 
Page 8, line 7: for “ the Bealls, the Wans,” read “ the Bealls, the Wares.” 
Page 8, line 33: for “ Ilalzer” read “ Holzer.” 
Page 8, line 35 : for “ Sewys” read “ Lewys.” 
Page 15, line 18: insert after Yellow Fever, “reported by the Board of 
Health.” 
Note.—The Map referred to was lost by Post Office Department, while 
on its way to publishers.