AN
INAUGURAL DISSERTATION
ON THE
BILIOUS MALIGNANT FEVER.
READ AT A
PUBLIC EXAMINATION,
HELD BY THE MEDICAL PROFESSORS, BEFORE THE
REV. JOSEPH WILLARD, S.T.D. PRESIDENT,
AND THE
GOVERNORS IN THE UNIVERSITY AT CAMBRIDGE,
FOR THE DEGREE OF BACHELOR IN MEDICINE,
July 10, 1797.
BY SAMUEL BROWN, A.M.
"The putrid steams, or some corroding venom, 
In countless pores, o'er all the pervious skin
Imbib'd, soon poison the balsamic blood,
And rouse the heart to every fever's rage."
PRINTED AT BOSTON,
BY MANNING & LORING.
1797. 



AN
INAUGURAL DISSERTATION.
IN August, 1796, the town of Bos-
ton was visited with a contagious
disease of unusual malignancy, the
circumstances and marks of which
were such as threatened great ca-
lamity; and the alarm spread, and became almost 
universal. This still increased, on observing that
in many of its symptoms it bore great resemblance
to the fever which had so recently raged at Phila-
delphia and New-York.
IN the preceding fall and winter, inflammatory
diseases were frequent in Boston, and in many of
the towns in the country, particularly the scarlati-
na, scarlatina anginosa, and measles. And in the
months of June, July and August, or immediately
previous to the disease we have mentioned, a spe-
cies of dysentery was frequent; and now and then
cases 

[ 4 ]
cases of cholera morbus occurred. These were in
some places unusually mortal, and prevailed more
or less in different parts of Boston till the time of
the bilious fever ; after which they were known
no more.
BEFORE entering more particularly on the sub-
ject of the fever, I shall introduce some observa-
tions on the effects of poisons, and their laws of
operation on the human system.
OF POISONS.
THESE are substances which either instantly
destroy the life of a part or parts of the system, or
change the natural functions into morbid actions ;
and thereby, suddenly or by degrees, affect the
whole constitution.
THEY are either mineral, vegetable, or animal.—
The damps or mephitic vapours often met with in
mines and deep wells, are mineral poisons. Of vege-
table poisons we have a remarkable instance in the
Bohan Upas, which grows on the island of Java,
belonging to the Dutch. It is so destructively poi-
sonous, we are told, as that the soil for several
miles in circumference is whitened with the bones
of birds and animals, that have been arrested while
attempting to pass through the atmosphere of this
shrub of death. Animal poisons are of two kinds ; 
original,


[5]
original, as that secreted by the viper ; and such as
are generated by disease. The latter are, by Mr.
Hunter, and afterwards by others, denominated
morbid poisons.
POISONS are communicated either in a gassous
or vaporous state ; or by contact, in the form of
pus, or ulcerous matter. Fevers are an example
of the former, the venerea of the latter.
THE constitution is never affected, or never takes
on the morbid action of the poison, except it be in
a state of predisposition. Thus, at the time of any
raging epidemic, the miasma or putrid effluvia is
generally dispersed, and different ages, sexes and
constitutions are alike exposed ; yet comparatively
but few will be infected, while the others escape.
How the same constitution should possess different
susceptibilities to disease, is best understood from
Dr. Brown and Dr. Darwin.
ANIMAL existence, according to Dr. Brown, is
endowed with a quality which he names excitability,
and Dr. Darwin the spirit of animation, or sensorial
power, on which the phenomena of life depend.
Every thing which supports life, exerts itself on
this principle; and vice versa. It is capable of
different degrees of accumulation and exhaustion:
it is accumulated by the abstraction of stimuli, and
is exhausted by excessive stimuli, or the long appli-
cation of others acting more moderately. A due
proportion between the exciting powers, such as
heat, 
 

[6]
heat, food, air, mental exertion, &c. and the excita-
bility or sensorial power, constitutes health ; and
every variation from either is disease.
"There is, they say, and I believe there is,
A spark within us of th' immortal fire,
That animates and moulds the grosser frame,
And when the body sinks, escapes to heaven,
Its native seat.
Meanwhile this heav'nly particle pervades
The mortal elements,-
And in its secret conclave, as it feels
The body's woes and joys, this ruling pow'r
Wields at its will the dull material world,
And is the body's health or malady."
WITH many diseases of the variolous kind, there
is a certain period between the time the infection
is received, and the appearance of the disease ; and
in this interval scarce any alteration in the actions
of life can be perceived. Thus, in the casual
small pox, we find a space of about twelve days
between the reception of the poisonous effluvia and
the first symptoms of the disease. Travellers fre-
quently leave the country where they received the
miasma of ague, long before any symptoms of it
appear; yet the disposition having been formed,
and the poison received, the disease after a certain
period makes its appearance.
IT sometimes happens, that after the disposition
is given and the poison received into the system,
the period of eruption, or the time when the disease
usually 

[7]
usually appears, is protracted beyond the usual
time, in consequence of the action of other diseases,
as the measles, scrophula, &c. This is confirmed
by various histories of the small pox.
FURTHER — We have great reason to believe,
that not only the morbid action or symptoms of a
disease may be suspended, but also that the suscepti-
bility may be entirely prevented after the poison is
applied. There is a striking proof of this afforded
us in the effect of the Harmattan wind, as recorded
in the Philosophical Transactions of London.- 
Seventy negroes were inoculated for the small pox
three days after the Harmattan set in : none of
them had the symptoms of the disease. In a few
weeks afterwards, fifty of the same were inoculated,
and had the disease ; the rest had taken it in the
natural way. Here, though the infectious matter
was applied to seventy, all of them (as appeared af-
terwards) constitutionally susceptible of the disease,
yet even the local disposition was superceded, and
of course the constitution was not infected.*
THE immediately preceding propositions are in
proof of a medical axiom established by Dr. Hun-
ter, viz. That the constitution never supports the
operation of two distinct diseases at the same time.
IT is a law with most of those poisons which pro-
duce their effects by a critical fever, that a constitu-
tion which has once gone through the action ex-
cited by them, is no longer susceptible of it. This
is
* Adams on the phagedena, &c, 
              

[8]
is accounted for upon the principle, that the poison
is so powerful and active as to destroy the sensibility
or life of the part; or that the constitution becomes
habituated to the particular stimuli of the poison,
and therefore upon a second application to the part
or parts of the system, they are undisturbed by or
are insensible to it. This will account for the sud-
den and seemingly miraculous disappearance of
epidemics, as was the case at Philadelphia and New-
York ; for all those who had a susceptibility to the
disease have taken it and are not liable to be again
affected by it, and those who have not this suscep-
tibility cannot receive it; of course, the prevalence
of the disease must suddenly cease.
POISONS, miasma or morbific effluvia are of too
subtle a nature for chemical analysis ; their constit-
uent materials, and the prevailing or distinguishing
principle of each, whether an acid or an alkali, sep-
ton or nitrous acid gas, or any other gas, is totally
unknown.
VENEREAL and phagedenic poisons, though in
the form of fluid discharge and subject to observa-
tion, and even to be experimented upon ; yet it is
equally unknown what material quality constitutes
their nature, and renders them capable of their spe-
cific effects. Do not most poisons contain a princi-
ple of life, which occasions their activity, and by
means of which their deleterious effects are pro-
duced, when taken into the human system ?
Dr. 


[ 9 ]
DR. Hunter has long since discovered and dem-
onstrated that the digestive organs have no power
over substances which have within them the princi-
ple of life. There are many circumstances which
render probable this opinion respecting poisons,
contagious ones in particular. In the itch, animal-
culæ are probably the cause of this affection. And
why may not the syphilis be produced in a similar
manner, viz. by an accumulated and mixed quantity
of seminal animalculæ lodged in those reservoirs and
recesses peculiar to the parts concerned ? Lodged
in this abundance, they may by their own activity
insinuate into the system, and form nidi; or they
may become putrid, and thus produce the specific
venom of the syphilitic disease. Thus also with
other animalculæ, introduced by respiration or cu-
ticular absorption.
IN the tropical regions, where death has almost
an undisputed reign, the atmosphere is generally
loaded with myriads of animalculæ ; so much so,
at certain times in the rainy seasons, as nearly to
suffocate the inhabitants. It is then that diseases
mostly prevail. Life is always found where there
is a congeniality of matter for its reception ; and
every object in nature, animate and inanimate,
healthy or diseased, has its particular sphere of ex-
halation. This exhalation always partakes of the
nature and life of its subject,
HOWEVER homogenous poisons are while they
form the atmosphere of the subject from whence
B they 

[ 10 ]
they were exhaled; yet being in contact with other
spheres of exhalation, they are blended with other
substances which form the common atmosphere;
and at length are so equilibriated, by entering into
new forms and states, as to lose their activity and
power to injure.
IT is a universal truth, equally applicable to poi-
sons as to other things, that the more simple and
homogenous a substance is, the more powerful and
active; and vice versa.
THE atmosphere in which we live is made up of
exhalations from every individual substance in all
the three kingdoms of nature-—the animal, vegeta-
ble, and mineral: these substances form a perpet-
ual intermediation of less and more subtle, until they
reach the sun himself, the great sensorium of ma-
terial nature, which by them is nourished and fed,
in return for the activity which it imparts. Our
atmosphere, in all its extent, becomes blended also
with the atmospheres of other planets, and they, in
union, form one common atmosphere of the whole
system. This idea might be extended so far as to
form one general atmosphere for the universe ; but
this would be filling up Newton's VACUUM, which
might expose us to the imputation of philosophical
scepticism.
THIS blending the common atmospheres of each
planet, and giving them reciprocal influence on
each other, may be of use in explaining many of
the diseases and affections of the human body, sub-
ject 

[ 11 ]
ject to periodic returns and regular intervals, viz. in-
termittent fevers, the various species of mænorrhagia,
epistaxis, and hæmorrhois. A late writer has ob-
served, that the paroxysms of fevers shew them-
selves in a greater degree of violence about the full
and change of the moon, that is to say, about
three days and an half before and after, including
at each period a space of about seven days, than
during the interval between these periods. Also—
That the paroxysms of fevers occurring during the
periods described, are constantly more violent about
mid-day and midnight, than during the intervals
between these spaces.—That some remarkable
abatement in the violence of the paroxysm never
fails to take place, upon the expiration of the full
and change of the moon.—That the paroxysms
of fevers, whilst they abate in violence upon
the expiration of the full and change, shift also
their attack to a later hour.—That epilepsy, in-
sanity, paralytic affections, asthmas, phthisical
coughs, with a variety of other complaints, often
assumed an intermittent form, and returned regu-
larly with the full and change of the moon, and
disappeared or diminished during the intervals.
THIS sol-lunar influence has been noticed by the
ingenious author of Zoonomia ; and perhaps better
accounted for than by any predecessor.
MOST of the above observations are capable of
satisfactory proof, and have long been acknowledg-
ed by the best medical writers ; so that they may be
considered 

[ 12 ]
considered as so many medical axioms. They may
be of use in considering our subject—on which I
now enter.
I HAVE observed, that the fever, when it made
its first appearance, shewed strong marks of malig-
nancy. The patient, after some hours of unusual
dullness or dead heavy sensation in the head, and
great reluctance for any voluntary motion, felt
great commotion and uneasiness at the stomach,
which constantly increased till vomiting commenc-
ed. At each of the several vomitings, attend-
ed with severe wretchings, much bilious matter
was thrown up; and there was found, in many
instances, a porraceous substance, resembling the
settlings of coffee. The stomach shewed unusual
symptoms of irritability, it being almost impossi-
ble to keep down for a moment the mildest
medicine that could be administered. In the inter-
vals of vomiting, particularly, a constant and great-
ly exhausting pain was felt; most exquisite at the
small of the back, and extending along the spine
and its connexions quite up to the occiput. Pain
of head continuing, especially over the eyes and un-
der the temporal bones, sometimes with a sensation
as if some instrument had passed the head. Respi-
ration extremely difficult, often with a feel of suf-
focation. Heat very great, especially in the thorax
and region of the liver. Pulse morbidly rapid.
Pores closed. Skin smooth, and apparently distend-
ed 
 

[ 13 ]
ed with the expanded fluids and heat within ; hav-
ing a tinge, somewhat resembling that of chlorotic
patients. The cornea albuginea most resembling,
in colour, that of dusky glass when held up to the
light. The eyes, however, expressed much concern,
and often moved with a furious rapidity in the
early stage of the disease. These all increased, if
possible, in violence till death put an end to the
patient's sufferings; or gradually subsided, when
the fever vanished, and health was restored. 
THOUGH these were the characteristic symptoms
of the disease, yet they were generally variant in their
commencement, progress and termination, accord-
ing to the difference of temperament; and also ac-
cording to the difference in the predisposing causes.
Slight symptoms, scarcely noticed by the patient
or his friends, were sometimes the harbingers of
this fever: Also, languor, yawning, dejection of
spirits, deep disturbed and not refreshing, appetite
impaired, disagreeable taste and smell, and uncom-
mon sensibility to cold, were sometimes among the
early symptoms of the disease. In others the symp-
toms were more rapid and intense ; persons some-
times being roused from deep by a most torturous
sensation in the stomach, near its connextion with
the duodenum, resembling liquid fire spreading
over this viscus and extending, in the direction of
the arteries, quite through both upper and lower
extremities.
SOME 

[ 14 ]
SOME were affected with alternations of heat and
cold; with others, the heat was continual. The
appearance of the tongue was various; sometimes it
was moist, as in catarrhal defluxion ; at other
times was parched and dry. The breath, however,
was invariably disagreeable, and sometimes so of-
fensive as to be almost intolerable to the patient
himself. Pulse often various in the same persons ;
sometimes having the regularity and force of sy-
nocha; at other times weak, fluttering, indistinct
and vibratory; manifesting very great debility.
Costiveness prevailed with the most, especially in
the first stages of the fever ; and all the secretions
and excretions partook of the great disorder of
the system. None were in a healthy date; all
either in a high degree of excess, or greatly dimin-
ished.
OTHER symptoms, more particular, might be
enumerated ; but they would neither direct to a
rational indication, nor assist to form a probable
PROGNOSIS.
THE symptoms which might be considered as
the heralds of approaching death, were excruciating
pain in the loins, through the spine, and in all the
larger or principal muscles. Excessive irritability
of the stomach, so much so as to refuse all access to
medicine. Great pain over the eyes and in the eye-
balls ; this pain increasing to delirium or madness.
The 

[ 15 ]
The pupil of the eye dilated, and the patient stretch-
ed on his back—limbs extended and motionless.
ON the contrary, if these symptoms were neither
excessive nor lasting, the patient's strength retain-
ed, and spirits supported by the exhilarating power
of hope, and a confident expectation of recovery,
and no deficiency of duty in doctor or nurse, he
was seldom disappointed : the termination was fa-
vourable.
PROXIMATE or EXCITING CAUSE.
THIS, in my opinion, is morbid effluvia, first
lodged in the saliva ; thence conveyed and lodged
in the stomach and intestines; here either pervert-
ing or totally destroying the digestive powers of
these viscera: thereby a putrid and highly corro-
sive mass is generated, instead of a mild and bland
substance to give nourishment to animal life. The
surrounding blood vessels feel the change and are
affected. The mysenteric veins, especially, from
contiguity, become loaded with a putrid mass of in-
digested substances, which are conveyed through
the venæ portarum into the liver. This important
viscus becomes disordered ; the bile is thrown into
the intestines and up into the stomach in unusual
quantities and in an acrid date. This still increases
the difficulty ; the stomach and bowels are heated
and inflamed, and puking ensues. The venæ hæpa-
ticæ empty a heterogeneous mass of black damaged
fluid into the right ventricle, which is immediately
thrown 

[ 16 ]
thrown into the lungs. The lungs, in turn, are af-
fected by the disorder ; the patulous mouths of
the absorbing vessels are closed by pressure on the
substance of the lungs from the fluid within.
The blood no longer receives its congenial nourish-
ment; but is conveyed by the veins of the lungs
into the left ventricle of the heart; and, if this Al-
pha and Omega of animal life has not lost its power,
is thence distributed in a highly putrid state into
the several parts of the body. The whole vascular
system is thrown into irritation and commotion by
unusual stimuli ; the mass of blood is destroyed, and
the patient dies : Or, the powers of life, collected as
in a focus act with accumulated force, subdue the
offending causes, separate and discharge the impu-
rities by the several emunctories, and the patient
recovers.
THAT the miasma is first lodged in the saliva,
and thence carried into the stomach and bowels is
probable from this circumstance; we often hear
persons complain, after being over an infected sub-
ject, that they not only smelt the putrid exhalations,
but tasted them for a long time afterwards ; and
that nothing would remove the disagreeable taste.
Probably, however, a part of the contagion finds a
direct way into the mass of blood through the ab-
sorbents of the lungs.
THAT the morbid miasma, when thrown into the
body, in the manner we have mentioned, are capa-
ble of the effects we have ascribed to them, is not
difficult 
 

[ 17 ]
difficult to conceive, especially if they contain a
principle of specific life. Life acting against life, is
like the meeting of two opposite powers in nature,
in which case the one will destroy the other ; and
where life is destroyed putrefaction will take place,
whence a contagion may arise too great for the re-
maining power of life to reject or remove, which of
course will in its turn be either impaired or destroy-
ed. Besides, we know that persons are often
thrown into the most distressing disorders by worms
and animalculæ lodged in the stomach and bowels
in an oviform state, in consequence of eating raw
fruit and other uncooked substances. These also
may and often do concur to make human contagion
more fatal.
THAT the stomach and bowels are the first affect-
ed, is evident from the severe pain that is early felt in
the loins, and from the early tendency to puking.
THAT the liver is affected is evident from the
large discharges of bilious matter by the stomach
and stool; and that the lungs are, is plain from
the difficult respiration, which was always an attend-
ant symptom of the disease. In all the subjects dead
of the yellow fever, that have been dissected, the
liver and the lungs had almost universally a morbid
appearance. The lungs were inflamed, and the
liver either greatly swollen or very much shrunk.
THAT the heart is greatly affected, is plainly man-
ifest from the rapidity of the pulse.
C THAT 
 

[ 18 ]
THAT the life of the blood is either greatly im-
paired or totally destroyed, is manifest from the
pains in the muscles and in the head ; from delirium
and coma; from vibices, petechiæ and yellowness of
the skin, &c.
DR. Anthony Fothergill, however, says, in oppo-
sition to Drs. Harvey, Willis, Hunter, and others,
that "the blood is not alive, but is a mere passive
inorganic mass." Thus he proves it: "Life, he
says, is allowed on all hands to be the attribute of
an organized body alone, and if blood be an organ-
ized body, then it is an animal; and if so, here is a
living animal destined to circulate within the vessels
of another living animal!" This is an attempt by
a few words to dissipate a numerous train of facts
and arguments, and to render illegitimate an opin-
ion which I did think was the result of close obser-
vation and skilful experiment.
IF, however, life is the attribute of an organized
body alone; yet this organized body is composed
of parts, of which the blood is one; and therefore
has its share of life. But,
FURTHER on, Dr. Fothergill, in his ingenious
treatise, (for such we esteem it in general) denies
his major proposition. He says, "The nervous in-
fluence, sensibility, or as Dr. Darwin elegantly ex-
presses it, the spirit of animation, cannot be a se-
creted fluid, since the brain is no longer allowed
by anatomists to be a secretory organ. Neither
can 

[ 19 ]
can its origin be proved to be coeval with the un-
formed rudiments of the embryo* when the "dim
speck
* Dr. Darwin is fully of the opinion that the rudiments or living ens
of the future embryo is derived wholly from the male parent; that this
ens or rudiment consists of a living filament or stamen, and that this fil-
ament, of whatever form it may be, is endued with the capability of be-
ing excited into action by certain kinds of stimulus. Roused into ac-
tivity by the stimulus of the nutritive and congenial fluid in which it
is received from the male parent, it receives new adaptations or accre-
tions of substances, and thus becomes organized. With every new
change of organic form or addition of organic parts, a new kind of irri-
tability or of sensibility [which is only a more general sensation] is pro-
duced ; these varieties of irritability or of sensibility exist in our adult
state in the glands ; [perhaps in all the parts of distinct functions] every
one of which is furnished with an irritability, or a taste, or appetency,
and a consequent mode of action peculiar to itself. These changes in-
crease, and additions of parts with their peculiar irritabilities or appe-
tences and consequent modes of action, continue in progressive order
till the embryo is complete in form. The parts most essential to life
are first produced. Thus, the brain to dispense the powers of life, next
the heart, then the lungs, and from these all the parts of the system, ac-
cording to the importance of their functions in the animal economy.
Sec. 39, Vol. I.
THUS then it seems to be the opinion of Dr. Darwin that the esse or es-
sence of the embryo is from the male parent, and that the existere, or
existence, is from the female parent; of this there is no want of proof
convincing. This esse, or as Dr. Darwin names it, living ens, always pos-
sesses the conatus or endeavour to assume a form similar to the male parent
or progenitor, which it always will do when lodged in the proper matrix
or mould, and supplied with the congenial nourishment; this, with ani-
mals, is always from the female. Perhaps Dr. Darwin means the same
thing by " the capability of being excited into action by certain stimuli" This
conatus or endeavour of the seminal germ to produce or assume the
form of its progenitor exists not only with every order, genera, species
and creature of the animal kingdom, but also with every order, genera,
species and thing of the vegetable kingdom. Thus every creature and
thing is preserved in its order and distinction. This preservation by
generation and prolification, production and reproduction, and conse-
quent increase and multiplication, suggests and impresses most strongly
the idea of infinity and eternity, and clearly evinces the wisdom and good-
ness of the "CAUSE OF ALL CAUSES! PARENT OF PARENTS! ENS EN-
TIUM !" 

[ 20 ]
speck of entity" first becomes visible, for then no
vestige of brain or nerves can be discovered."
Nervous influence before any nerves or brain can be
discovered!!— But he asks, Must it not be referred
then to vital air or spirit of the atmosphere, emphat-
ically termed in the sacred page, the breath of life,
and by ancient philosophers, "divinæ particulæ
auræ," drawn into the lungs at the first effort of
respiration?" Here the Doctor takes the life from
the organized body, of which he before asserted it
is the attribute alone, and transfers it to vital air or
spirit of the atmosphere, which is not proved to be
more an organized body than the blood.*
WE might here interrogate the Doctor how it is
that the fœtus moves itself and makes various exer-
tions in utero, if it is without the spirit of animation
before the first effort of respiration ?
SOME medical gentlemen object to our method
of accounting for the introduction of contagious
miasma
* It is not to be denied that the passages in the sacred writings refer-
red to by Dr. Fothergill may indeed admit of the construction he puts
upon them, it being customary in those writings to assume the cause in-
strumental for the cause principal; and the air is the medium by which 
respiration exists, and the active life of the body. But then this cannot
be all that is signified by those words, as is evident from the text being
in the plural number, and hence they have been more properly consid-
ered by divines, as having relation to the life of the soul, from which the
life of the body is derived, and which consists in the perception of what
is good and what is true, or the will of good, and the perception of
truth; thus, a soul of lives. The expression of this soul of lives being
breathed into Adam by the Almighty, seems also fully to denote, that
man is only an organ of life, and not life itself; for life and light are
not creatable, but man was created a form receptive of life, as the eye
is a form receptive of light. 


[ 21 ]
miasmna into the system, and say that it is more
probably applied immediately to the powers of life
or nervous influence. What is the nervous influ-
ence ? whence is it derived ? and through what
medium do we reach it? These are questions I
never have yet seen satisfactorily answered by any
medical writer that has made the attempt.
WE have seen, above, the reasoning of an in-
genious and learned physician on this subject. He
asserts that the nervous influence exists before any
vestige of brain or nerves can be traced, and there-
fore concludes that it must be derived from oxygen,
or spirit of the atmosphere!
DR. CULLEN says, "the nervous power seems dif-
ferent from every thing else in our body, and seems
not peculiar to it, but a general principle in nature
particularly modified in our system." What pro-
duces this particular modification ? the nervous
power ? for he acknowledges none higher ; if so,
nervous power modifies nervous power!
HE again says-—" The vital power is intimately
connected with the sensorium commune, and this with
the soul, which certainly is of use in the medical
system, though by no means a rational conductor."
HERE I cannot comprehend the Doctor's meaning ;
but I suspect his thoughts at this time were electrifi-
ed ; and if by his soul, I agree that it is not always a
rational conductor.
DR. 

[ 22 ]
DR. Cullen thinks also, that "the soul influences
the body not as a prime mover, but as a modifier of
external senses." What higher power than the
modifier of external senses, which all exist from in-
terior life ? But again—
THE Doctor is of opinion that "all our functions
are governed by certain laws, that we may observe
and distinctly mark, so as to know their conse-
quences; so that the consideration of the soul, in a
medical view, is of no weight." And why not ?
By what power are those laws established, which
govern all our functions ?
ONCE more— "Medicamentum non agit in cada-
ver" says the Doctor ; which is, in English phrase-
ology, Medicine operates only on life ; and yet he
agrees with Dr. Boerhaave, that "when a problem
is traced up to the connexion between soul and
body, there we ought to stop, and consider it as re-
solved." Some of the above problems cannot be
either solved or resolved, even by this connexion.
But I think this is the very point from which we
ought to set out, if we ever expect rightly to inves-
tigate the phenomena of life.
WHAT is the soul but life ? and again, what is
life ? " Cogito, ergo sum" said Des Cartes—We can
only know it by its operations, principally within
ourselves. It is the soul or life which sees, feels,
hears, tastes, is sensible of pleasure or pain, deter-
mines our limbs to motion, &c. wills, thinks and
knows.

[23]
knows. If it be asked how and whence it is deriv-
ed to the body ? I can at present only reply by
pointing to some of its more interior effects. Ob-
serve, then, the dominion and influence the mind
has over all the most important functions, which
support the economy of life. It actuates the body
in all its parts at pleasure. The mind directs the
ear to hear, disposes the eyes to see, moves the
tongue and lips to speak, and the hands to do what-
ever it pleases. Thus the body is nothing but
obedience to the mind ; but can it be thus unless
there were a most intimate connexion between the
mind and the body ? not such a connexion as is be-
tween what is above and what is below, as oil on
water, but such a connexion as exists between cause
and effect, the one produced from the other. Ev-
ery one, the least drilled in anatomy, must have
learnt how entirely every part and function of the
human system is actuated and lives by the cardiac
and pulmonic motions. But these two motions are
entirely subject to the two constituent principles or
powers of the mind, viz. the will and the under-
standing. The will is immediately operative in all
the series of catenated motions denominated invol-
untary ; but the heart exhibits most distinctly the
will's influence in the system. Its motions are slow
or rapid, calm or tumultuous, according to the va-
rious affections of the will; of this we have sensi-
ble proof by means of the pulse.
EVERY one who has seen the force of love, (which
resides wholly in the will, and, as a general principle
comprehending 


[ 24 ]
comprehending every kind of affection, is in fact
its life) knows how it actuates the body by its pow-
er over the heart's motions ; producing, when in-
tense, delirium, phrenzy, apoplexy, and sometimes
death. When the love glows, the body is warm,
the variations of the heat of the body always, tally-
ing with the variations of love or affection, whatever
be its object, from the freezing point, or the extinc-
tion of love, to any indefinite degree of intenseness.
THE understanding or thinking principle of the
mind influences mainly the pulmonic motions.
Thus, if we think tacitly, we breathe tacitly; if
we think deeply, we breathe deeply ; we draw in
and relax, compress and elevate our lungs either
slowly, eagerly, mildly or attentively, in perfect con-
formity to the different states of the thoughts. Now
it is a maxim of true philosophy, that what is supe-
rior in power is prior in existence, and that the con-
trolling force does not originate from the thing
controlled : This is also agreeable to every rule of
just conclusion. Where the residence of the mind
is fixed, we have no other way of investigating, but
to trace the nerves to where they begin and end;
for all our sensation is transmitted by means of those
nerves called sensory nerves, to the inward sensori-
um, and so to the understanding. Thus the sensations
go by the optic nerves from the eyes and from
the nostrils by the olfactory nerves, or processus ma-
millaris ; from the ears by the auditory nerves, and
so on. Therefore, that the beginning and ending
may be found, we must examine all the brain, and
not

[25]
not desist till we find the ends and beginnings of the
nerves. Having, therefore, dissected the brain, we
meet with little spheres, round, or fully wrapped
inward and outward, commonly called the cortical
glands, where the nerves begin and end, and where
the mind in its principles resides, and acts from the
beginnings of all the nerves; for to these spheres,
as to their ultimate ends, all the nerves are center-
ed. Thence the mind deduces and collects all the
modes of appearance and operation transmitted by
the senses, and thence distributes them round to the
interior perception and understanding. All the
nerves, whatever be their office, are formed and
produced from these glands; wherefore this is our
common sensorium: from hence also proceeds our
intimate sense, or understanding, which perceives by
its senses, thinks on what it perceives ; and judging
on what it thinks, chooses what is judged best;
from what it chooses, desires; and lastly, from the
will of its desire, acts. That the mind or spirit thus
resides in its principles in the brain, and in its prin-
cipiates in the body, is manifest from experience ;
for the glands being affected, the whole appendix of
the brain and body languish in proportion, the
power of imagination is stupefied ; the cogitations
languish ; the memory fails; the determinations of
the will hesitate; the desires fail, and the senses are
dulled. But notwithstanding this defect in the op-
erations of the mind in consequence of defect in the
organization of the brain, it is not to be thence in-
ferred that the mind itself is nothing more than ma-
D terial 

[ 26 ]
terial organization, however highly sublimated; for
we hold the soul or mind, though giving life to the
body, to be perfectly distinct from it in degree,
bearing the same relation to it as what is prior to
what is posterior, or, as cause and effect; so that
one is in the other not in continuous but in discrete
order. Hence it follows, that though the latter can
have no existence without the former, yet the for-
mer can exist without the latter, as is the case when
the body is entirely rejected at death. But till then
the mind is so far dependent on the body, that it
cannot manifest its operation in outward nature, un-
less by rightly disposed organs ; and if there be im-
pediments in the corporeal organs, the perfection of
the mind will also be impeded during its connexion
with them, through a want of afflux and re-agency ;
for it is a received law, that influx is proportioned
to afflux, agency to re-agency, &c.
THE powers of life then which manifest them-
selves in the body, we have just reason to conclude
are derived wholly from the mind, and flow solely
from a spiritual origin, the mind itself or soul
being probably an organized form, but spiritual, per-
fectly distinct from the natural, though in it in ev-
ery part throughout, and communicating life there-
to ; which life the soul itself receives by continual
influx from Deity, "in whom we live and move
and have our being." Thus much on the ques-
tion, What is life, and whence derived ?*
LIFE
* If the above observations be true, how evidently does the fallacy
of that reasoning appear, which, not distinguishing the discrete degrees
of 
 

[ 27 ]
LIFE then is in all and every part of the body; but
some parts are endowed with a much greater share
than others. In the brain it is as it were drawn to
a focus. Indeed it is here, as we have just observ-
ed, that fibre begins and circulation ends ; conse-
quently here also is the connexion between fibre
and blood. No doubt, when the blood arrives at
the brain it becomes highly refined, and imparts a
sublimate matter, which becomes the immediate re-
cipient of life, whence it is distributed by the nerves
to all the parts in the curious mechanism of man
down to the ultimates of life. Now we have al-
ready observed, the less simple and homogeneous
any substance is, the more liable it is to injury and
perversion. Dr. Hunter has shown that the serum
of the blood is a mass of heterogeneous substances,
and is the lowest form of animal life; therefore is
the most liable to be affected by disease. The se-
rum is derived immediately from the alimentary ca-
nal. There it is that contagion first plants itself,
and
of the operation of life, but stopping at proximate causes from the in-
ductions of analysis only, makes no distinction betwixt the life of a man
and that of a brute. For if it be admitted, (and nothing can be more
easily admitted, nor more fully confirmed from the united testimony of
revelation, reason, and experience) that man is distinguished from the
brutes by the faculty of thinking, not only analytically but synthetical-
ly, and thereby of living not only the sensual and natural, but also the
moral and spiritual life, it may be rationally concluded, that the same
distinction prevails in regard to the faculty of living eternally. For it
must, on the same ground, be inferred, that he possesses a superior de-
gree of life or a form receptive of life more immediately from the Deity,
whence he derives the capacity of being conjoined with the Deity by ac-
knowledgment and affection, thus, by re-agency on his part; whence
he consequently also possesses the faculty of retaining the influent life,
and in this retention consists the ground of his eternal existence. 
 

[ 28 ]
and therefore the alimentary canal may well be
called the store-house of contagion. Here, like the
skilful but cautious enemy, it commences its opera-
tions by progressively invading the weaker parts,
until the inner fortresses of life are endangered.
THERE are many directly and indirectly debili-
tating powers, which prepare the constitution for the
reception of disease, and are therefore called
REMOTE OR PREDISPOSING CAUSES. 
AMONG the directly debilitating powers, we
reckon cold or the absence of heat, the greatest ; its
fects, however, are always proportionate to the de-
gree of intensity, and the date of the constitution on
which it acts. 
A LARGE variety of injecta are of a sedative or
debilitating nature ; plants in particular ; all kinds
of raw sallads, except those of a spicy or aromatic
nature. Vegetable food, when too dilute ; drinks
in large quantities, that are not spirituous; an im-
pure atmosphere ; sloth, ennui, a habit of inactivi-
ty, a mind unemployed, &c. &c.
EVACUATIONS, when immoderate or unnatural,
are greatly debilitating ; such as the various species
of epistaxis, menorrhagia, hemorrhois; also from
the excretory organs and alimentary canal.
SLEEP, that is not forced, is occasioned by the
attraction of stimuli, and therefore, when too
much 


[ 29 ]
much indulged, produces weakness. There are al-
so a variety of mental qualities, which operate as
sedatives on the body. Fear is the greatest : It
has been known totally to unhinge the mind's fab-
ric, suspend all motion, and in fact every animal
faculty, insomuch as to produce syncope or swoons,
and even death ; disappointments, of whatever
kind ; also despondency, with many others. These
are the most common among this class of directly
weakening powers.
THE indirectly debilitating powers are - First, of
the mind. Immoderate desires of whatever kind ;
great mental exertion; a fixed attention to one
train of thought; anger in excess. Unlimited in-
dulgence of sensual appetites is highly pernicious to
the body, and certainly destructive of the mind's
happiness. An excess in eating, or, as it is better
expressed, gormandizing, especially upon food that
is loaded with the richest spices and most powerful
stimulants, is certainly injurious to the constitution,
and prepares it for the invasion of almost every
species of disease.
WHAT a mass of heterogeneous substances are
thrown into the stomach at even a common meal!
The consequences are—Bellum internum ; "the
war of elements and the crush of" life at least.
"For other ills the ambiguous feast pursue,
Besides provoking the lascivious taste.
Such various foods, though harmless each alone,
Each other violate ; and oft we see
What strife is brew'd and what pernicious bane,
From combinations of innoxious things."
THE

[ 30 ]
THE powers of life, by this mode of living, are
strained to the highest pitch, and when exposed to
disease, the constitution has no new or unemployed
force to repel the enemy. The strength collapses,
debility or exhaustion, with all its sad consequences,
ensue. It is to this circumstance, mainly, we are
to ascribe the unusual mortality of contagious dis-
eases which have of late prevailed in several capitals
of the United States.
HEAT, in excess, is the greatest stimulus that
operates on life; indeed it is the most powerful
agent in nature ; by it "rocks fall to dust, and
mountains melt away." When above 80° of
Farenheit, it always injures.
ALL spirituous liquors, if used with frequency ;
also labour, when it induces fatigue ; and indeed
great bodily exertion, of whatever kind, impairs the
strength and gives susceptibility to disease.
BUT we pass to the
TREATMENT, OR METHOD OF CURE,
THE symptoms of the fever which we have de-
scribed certainly manifest a very high degree of vas-
cular irritability and excitement; the first and lead-
ing indication, therefore, is depletion by powerful e-
vacuations, even to bleeding ; and this with all possi-
ble speed. Jalap and calomel were early used for this
purpose by the most celebrated practitioners of Boston,
who 
 

[ 31 ]
who I believe can give fresh testimony of the pro-
priety and benefit of the use of this medicine, first
recommended by Dr. Rush, of Philadelphia. My-
self have witnessed the most happy effects of this
cathartic, when used agreeably to the judicious di-
rections of my preceptor.
IT is now generally thought that mercury, as used
in this disorder, produces its salutary effects chiefly
by operating as a quick and powerful cathartic,
when combined with jalap ; thereby causing a
large and sudden depletion of the intestines and the
excretories that here empty themselves. It is more-
over certain that mercury in all its operations, al-
ways affects the liver more or less. I believe that
in the bilious fever it has almost a specific effect up-
on this viscus by changing its morbid actions and
restoring its healthy functions, which, it cannot be
doubted, are greatly deranged.
DR. Rush enumerates the effects of the use of
jalap and calomel in this fever as follows. 1. It
raised the pulse when low, and reduced it when it
was preternaturally tense or full. 2. It revived
and strengthened the patient. 3. It abated the
paroxysm of the fever. 4. It frequently produced
sweats when given on the first and second day of
the fever. 5. It sometimes checked that vomiting
which occurs in the beginning of the disorder ; and
it always assisted in preventing the more alarming
occurrence of this symptom about the 4th and 5th
day. 6. It removed obstructions in the lymphatic
system. 


[ 32 ]
system. 7. It prevented in most cases a yellowness
of the skin, by discharging the bile through the
bowels as soon and as fast as it was secreted.
THE usual dose, and I believe the best propor-
tioned for an adult, was jalap 25gr. calomel 10gr.
The intention for which this was given was not an-
swered unless it produced four or five discharges.
No other regard is to be paid to time in the ad-
ministration of this medicine than that it be given
as early in the disease as possible. If it should be re-
jected, or is slow in the operation, opening injections
should be administered every one or two hours.
One dose was sometimes sufficient to open the bow-
els ; several, however, were more frequently neces-
sary, as the dose was often thrown up by puking. 
In bilious fevers, there seems to be a constant re-
production of morbid bile; once cleansing the bow-
els, therefore, is not sufficient; it will be proper to
give a purge once a day as long as the fever lasts.
After one or two effectual doses of jalap and calo-
mel, as circumstances require, other cathartics may
be used ; such as Glauber's salt, cremor tartar,
rheubarb, sena, manna, &c. either separate or com-
bined.
To assuage the great heat of this fever, cloths
dipped in cold vinegar, or vinegar and water, ap-
plied to the surface of the body have been found to
do great service.
SOME have recommended flannel shirts wet in
this manner to be kept constantly applied. And
it 


[ 33 ]
it has been practised by many physicians, particu-
larly Dr. Trotter, of England with manifest advan-
tage. It certainly has a tendency to extract the
heat from the body, which always, in proportion
to its intensity, expands the teguments, thereby clo-
ses the pores by increasing the density ; of course
perspiration ceases.
THE pain of the head, very distressing in this com-
plaint, was greatly moderated by similar applications
of cold water, or vinegar and water, to the pained
part, neck and back.
DRINKS should be freely used during the inflam-
matory state of the disorder, to assist the operation
of the physic, and to lessen the heat within. Al-
most any kind of tea is proper, such as marsh mal-
lows, balm, &c. lemonade, tamarind water, toast in
water, apple in water, may be drank with safety
and advantage.
FOOD of all kinds is extremely improper until
the crisis, unless it is unusually protracted ; and
even then it should be of the most innocent kind,
and very cautiously administered.
THE utmost pains should be taken with the pa-
tient in respect to cleanliness. Stools should be im-
mediately removed ; the linen well aired and shift-
ed as often as once a day. The chamber should
be as large as can be had, and constantly ventilated.
BLEEDING in the first stage of the fever is strong-
ly recommended by Dr. Rush and others. It was
E practised 
 

[ 34 ]
practised by them with much apparent success. But
in Boston, the last summer, it was not so much re-
lied on as a necessary part of the cure : I believe be-
cause the fever was less inflammatory. The jalap
and calomel in large doses was found, in most cases,
sufficiently depleting to take off the excitement and
irritability of the vascular system.
DR. Chisholm, in his treatment of the fever at
Grenada, found that bleeding was by no means ad-
missible, and different antiphlogistics were ineffectu-
al. His whole dependence was upon mercury,
which he gave in pills, composed of five grains of
calomel, two of antimonial powder, and one of
opium. This was repeated to the same extent, eight
times in twenty-four hours. The propriety of this
practice was justified by the success, for if salivation
was speedily raised, the danger was removed and
the patient recovered.
NEXT to calomel in this form Dr. C. reckons
vitriolic æther the most beneficial. He gave it in
the following manner : a teaspoonful in half a wine
glass full of cold water. After this the patient was
kept undisturbed for two hours, when the dose was
repeated ; and, in this manner, it was continued
every two or three hours, till the spasm of the
stomach was entirely overcome. Given as above,
he found it extremely grateful to the patient, and
that third, nausea, and oppression often fled be-
fore it.
SHOULD 
 

[ 35 ]
SHOULD the fever change, in consequence of the
excessive stimulus of the morbid miasma, from the
inflammatory or synochus type, and become typhoid,
then the tonic and stimulating plan must be pur-
sued. The signs of this change are the loss of
voice; tremulous motion of the tongue, or putting
it out; the patient muttering to himself; catching
at the bed-clothes, sighing, weeping, and sometimes
laughing ; difficult deglutition ; paralysis of the
sphincter muscles ; tremors ; convulsions; syncope
on being raised upright ; gangrene of blistered
parts ; profuse diarrhœa ; dark coloured urine;
eye-balls fixed and sunk; the countenance shrunk,
lengthened, ghastly, and discoloured; inside of the
mouth and tongue black and parched; deafness,
or hearing very acute ; the jaw fallen ; immobility
of the joints ; watchfulness or constant sleep ; heav-
ing of the bread ; rattling of the throat ; pulse felt
only at intervals.
I WOULD, however, interpose a caution against
the use of the diffusible stimuli, unless an immedi-
ately favourable turn of the disease can be gained
by them.
THIS subduing one stimulus, (especially if it has
gained ascendency even over life, which is always
the case when an inflammatory fever changes to a
typhus) by the superior force of another stimulus,
is like placing a person in time of battle between
the two fires. It is much safer to let the powers
of the constitution become quiescent for a time, un-
til 


[ 36 ]
til they recover force to withstand the disease: Or,
let the stimulus of the disease act till the constitu-
tion, from the power of habit, can adapt itself to the
peculiar nature of the stimulus, and thereby escape
destruction.
BRANDY and water, or porter and water, when
agreeable to the stomach, snake-root tea, now and
then a cup of chicken, veal, or mutton broth, may
be used in restoring the tone of the system.
IN most cases of debility it is proper to wrap the
limbs in flannel dipped in warm spirits ; also to ap-
ply cataplasms of bruised garlick or onion with mus-
tard seed to the feet. But the principal depen-
dence, next to the use of mercurial medicines, for
exciting a healthy action in the arterial system,
should be on mild and gently stimulating food.
"- While the vital fire
Burns feebly, heap not the green fuel on ;
But prudently foment the wand'ring spark
With what the soonest feeds its kindred touch :
Be frugal even of that; a little give
At first ; that kindled, add a little more ;
Till, by delib'rate nourishing, the flame
Reviv'd with all its wonted vigor, glows."
To allay the puking, always greatly exhausting
to the patient in the bilious fever, a blister applied
to the pit of the stomach often had the desired
effect. Liquid laudanum with sweet oil applied to
the


[ 37 ]
the same place, gives relief where the stomach is
affected by pain only.
THAT I may be sure of something valuable on
the disease of which I am treating, I insert the fol-
lowing cases taken from Medical Observations by
DR. JOHN WARREN, my preceptor, whose medical
abilities are deservedly in high public estimation ;
communicated first to the American Academy of
Arts and Sciences, and by their order to the pub-
lic. July 1st, 1797.
CASE I.
The first appearance of the disease was on the
25th of August, 1796, in a family at the easterly
part of the town of Boston, near a considerable ex-
tent of flats, which are daily exposed for some hours
to the action of the sun.
A LADY of this family was the first victim to
the disease. She was seized with rigors, a general
distress throughout the whole system, with a white
and moist tongue, dry skin, frequent and weak
pulse ; but without any very alarming appearance
until the third day, when the pains, which now
became more severe, with laborious respiration, a
slight redness of the eyes, a sleepiness and insensi-
bility, followed at night by a sudden sinking, and
intermission of the pulse, announced the extreme
hazard of her situation. Active cathartics were
prescribed


[ 38 ]
prescribed in the beginning, and a blister was ap-
plied over the whole anterior part of the thorax,
but no benefit was derived from either, and she
died at the end of the fourth day.
CASE II.
THE next person attacked was a female of the
same family. She was taken sick within twelve
hours of the first, with pains in the head, back, and
lower extremities ; a vomiting, which continued in-
cessant through every stage of her illness, great op-
pression at the breast, a weak and quick pulse, moist
skin, and yellow tongue. Opium and calomel, with
other purgative medicines, were administered, with-
out having been a moment retained in the stomach.
Her pulse became intermittent on the third day ;
and on the fourth, a fatal termination ensued.
VARIOUS CASES.
On the 2d September a son-in-law of the above
mentioned lady, was seized with a fever of the
same kind ; and within three days from that time,
his wife, and her two brothers, all of whom had
been closely attentive on their deceased mother.
Three of these were treated with large and repeat-
ed doses of jalap and calomel; two of the three
took emetics; one of them was bathed with cold
water, dashed over the whole body on the third
day from the attack, and having been kept cool,
they


[ 39 ]
they all recovered. The fourth was in a situation
peculiarly unfavourable when attacked ; she took
such doses of jalap and calomel, as were thought
belt adapted to her date; and on the fourth day
she died.
THE case of Mr. Newell, who was taken with the
disease, 18th September excited much aprehensions
in town. On the fourth day the skin became yel-
low; on the sixth petechiæ were discovered over
all parts of his body; and a most obstinate dysente-
ry followed by colliquative diarrhœa proved fatal on
the 8th day.
WITH many patients, after slight rigors, and ob-
tuse pain in the head, for the first twenty-four
hours, together with a sense of heat or burning at
the stomach—a hæmorrhage from the nose often
took place, and continued to be a troublesome
circumstance for several days, without any remarka-
ble mitigation of the symptoms. In these cases,
spontaneous vomitings rarely occurred—but when
they did, large quantities of bile were thrown up
from the stomach. In two cases only, what is call-
ed the black vomit, took place.
PROPHYLAXIS.
TO prevent infection, all those things which are
reckoned predisposing should be carefully avoided.
Some of these I have enumerated, under the head
of predisposing causes.
DIET. 
 

[ 40 ]
DIET.-All gross food, especially meats, when
prepared with spices and pepper stimuli, which
greatly inflame the blood, and fit it for disease, are
to be avoided. Food should be chiefly vegetables,
cooked in a simple manner.
DRINKS should be mostly of the acid kind.
Porter is good ; tamarind water ; cream of tartar
in water ; apple in water, &c. But the drink
which most effectually allays thirst, and perhaps is
as safe and healthful as any, because both nutritive
and diluting, is simply milk and water, equal parts.
These drinks will serve to keep the body in a
regular order, neither too lax, nor too costive, a
point which should be closely attended to. Should
either of these states of the body prevail, it must
be remedied by the proper medicines.
THE exhalations of putrid or putrifying matter,
also pools and puddles of stagnant water, must be
carefully shunned.
ALL possible attention must be paid to cleanli-
ness of body, by frequently shifting the linen, and
washing off perspiration by frequent bathings in
water of a middle temperature, or the temperature
of the surrounding air.
THE purity of the common atmosphere should
be preserved with all possible diligence, by emptying
and cleansing the cellars, streets, drains, ditches,
vaults, &c. &c.
THE
 

[ 41 ]
THE chambers of the sick must be visited as
much as humanity and the convenience of the sick
require, and no more. When the sick are visited,
all the windows and doors should be opened.
DR. Chisholm, who has written a treatise on
the yellow fever, as it appeared in the island of
Grenada, 1795, thinks that the effluvia of infec-
tious diseases do not extend themselves beyond a
limited distance from the person or thing from
which they are emitted, so as to produce disease :
This distance he thinks may be fixed at the utmost
from six to ten feet.
HE observed, 1stly, That when the disease had
entered a dwelling, avoiding the chamber of the
sick, prevented the infection. 2dly, That merely
entering the chamber of the sick, without approach-
ing near to the diseased person, never communica-
ted infection. 3dly, that approaching so near the
diseased person as to be sensible of the fœtor of his
breath, or of the peculiar smell which is always
emitted from the bodies of the sick, or touching
the bed clothes on which he lays, generally occa-
sioned nausea, slight rigors, and often head-ach, at
the moment, and some hours afterwards, produced
the disease itself. 4thly, That actual contact, so
that the perspired fluid of the sick person might
adhere to the hands, &c. of the healthy person,
more certainly produced the disease. 5thly, That
touching the wearing apparel of a person actually
diseased, or who had just recovered from the disease,
F communicated 
 

[ 42 ]
communicated infection as certainly as actual con-
tact of the skin. 6thly, That the merely passing an
infected person, or one who wore the clothes he
had on, when labouring under the disease, if the
effluvia proceeding from them were blown upon
him, produced the disease.
FROM the united testimony of Dr. Warren, Dr.
Rush, and Dr. Chisholm, it appears, that the con-
tagion always acts within four days after its appli-
cation to the body.
WHETHER the MIASMA or CONTAGIOUS
MATTER of the BILIOUS MALIGNANT
FEVER, OF WHICH WE HAVE TREATED, IS
AN IMPORTED OR A HOME PRODUCTION ?
A NEW doctrine has lately been broached by
Dr. Mitchel, of New-York, respecting the cause of
malignant diseases, making it septon, or septous
acid.*
AN inaugural dissertation by Dr. William Bay,
citizen of New-York, has just come to band, and is
declaredly a branch of this doctrine. His subject
is the Dysentery. The work is worthy attentive pe-
rusal. But we are not convinced, as the author
seems
* In DR. Mitchel's nomenclature, we find septon substituted for azote
osr nitrogene ; septous gas for azotic gaz or atmospherical mephitis ; gazcous
oxyd of septon, for dephlogisticated nitrous air ; septic gas, for nitrous gas ;
septous acid for nitrous acid; septic acid, for nitric acid; septate, septite, for
nitrate, nitrite, &C. 


[ 43 ]
seems to be, that the diseases arising from the ex-
halations of dead animal and some vegetable sub-
stances are not putrid; nor that the principle of pu-
trefaction is not putrefactive ; nor again, that septon
is antiseptic. See pages 9 and 10 of the introduc-
tion.
THESE notions, however, Professor Mitchill him-
self advances and endeavours to support, as may be
seen from the following paragraph, taken from the
above treatise, page 99. appendix, A.
He says,—" I reject altogether the notion of pu-
tridity, as it is very generally supposed to be going on
in the blood vessels ; I have no faith in the intro-
duction of putrid ferments into the mass of fluids.
A putrefactive process taking place in the contained
parts of the living body except among the contents
of the alimentary canal, is incompatible with life
more than a few minutes. Putrefaction is a resolu-
tion of an organic body into its elementary atoms
or into new compounds. Now many of these are
gasses whose extrication in the blood-vessels would
extinguish life in a very short time. Besides, the
fluids produced by putrefaction having already un-
dergone that operation, cannot be any more suscep-
tible of it. They not only do not putrefy the mus-
cles, but, in the common acceptation of the term,
they retard putrefaction in other substances. Thus,
fixed air, nitrous acid, and volatile alkali, which are
reckoned among the most active products of putre-
faction, are known to be the most powerful opposers
of


[ 44 ]
of it. And it may be laid down as a pretty broad
fact, that such substances as are septic in their origin,
are antiseptic in their effects ; and this from the na-
ture of things."
I AM not satisfied with this reasoning, neither do
I think it conclusive. "A putreactive process tak-
ing place in the contained parts of the living body
is incompatible with life for more than a few min-
utes." The duration of life, while the putrefactive
process is going on in the body, is wholly according
to the violence or rapidity of the process. But if
the putrefactive process is so incompatible with life,
why reject the idea of putrid ferments in the mass of
fluids ? and why not call those diseases so suddenly
destructive to life, putrid ? and why say, that the
very principle or cause of these diseases, which,
from its supposed effects, is called septon, is anti-
septic ?
WE grant that putrefaction is incompatible with
life; and if it becomes general, the whole life is
extinguished. But it may exist in a part of the bo-
dy without a total and immediate extinction of the
whole life. If this were not the case, how came the
idea of ulcerous putrefaction ? It is allowed by all,
that putrefaction may exist in the alimentary canal;
perhaps always, in some degree. It is here, howev-
er, that those substances are selected and taken up,
which afterwards receive and retain life, and be-
come a part of the body. This lacteal fluid, when
there is a high degree of putrefaction in the prima
via, 
 

[ 45 ]
via, may in all probability become putrid, as it
comes from the source of putrefaction : next the se-
rum ; and so on, till the whole mass of fluids be-
comes corrupted, and life escapes. Or, in the Doc-
tor's own words, "Can it possibly happen that pes-
tilential fluids shall come in contact with the lungs,
skin and intestines, whose surfaces are thickly beset
with absorbent vessels ; and that their noxious mat-
ters shall remain around the orifices of those inhal-
ing tubes for a very long time, and yet no atom or
particle of them be taken in ? Will not a portion
of them be sucked up by the lacteals from the in-
testines, and by the lymphatics from the other ex-
posed surfaces of the body, and through their chan-
nels be conveyed into the mass of blood? will not
the blood, on receiving these foreign materials, assume
new qualities, and, as it travels the round of cir-
culation, carry with it mischief and venom to the
nervous system." p. 92. More than this I con-
ceive was never understood by putrid ferments in
the mass of fluids.
IN page 98, the Doctor seems to admit the same
idea (if possible more fully, perhaps too much so)
for he there gives it as his opinion that "the septic
gas does not produce death by its inflammatory ac-
tion on the superficial muscles, but by its being mix-
ed in a certain quantity with the blood; and after
conversion to septous or septic acid, by conjunction 
with oxygen in circulating through the lungs, STIM-
ULATING THE HEART TO DEATH, and utterly
destroying all the irritability of that muscle." Great-
er 


[ 46 ]
er phenomena were never expected or known from
the most rapid putrefaction in its most violent stage ; 
and all this the Doctor allows is done within the
vessels of the circulating fluid. First the septic gas
is converted into septous or septic acid, and then
the deletereous effect is not by an inflammatory ac-
tion on the superficial muscles, but by STIMULAT-
ING THE HEART'S MUSCLES TO DEATH! This,
it is observed in the same page, can be done in the
course of half a minute !
HE observes further, "that it must not be im-
agined, that, after pestilential venom is inhaled into
the blood-vessels, death will in all cases be the conse-
quence. The offending matter may be carried from
the body through the excretory outlets ; or it may
circulate a long time with the other fluids, and so
season both the vessels and the heart to its action, that
after a while, they, like the external parts, will grow
insensible to its stimulus, and no longer have their mo-
tions disturbed by it." — How can Dr. Mitchill deny
the existence of putrid ferments in the mass of flu-
ids, after saying all this ?
BUT I do not fully understand, how it is that the
offending matter seasons both the vessels and the
heart to its actions, when just before it killed them
both!
WE grant that the life of a part, which has been
destroyed by deleterious stimuli or putrefaction, may
be restored or renewed by the application of conge-
nial matter, and abstracting the offending cause ;
but 
 

[ 47 ]
but otherwise the interior organization will be de-
ranged, and the whole life destroyed.
I HOLD it as a truth that there is no life but in
some form ; and the animal life of man has its pe-
culiar
* AN eminent Swedish author, to whose writings I acknowledge my-
self indebted for the ground of some other observations made in this
work, reasons thus: Not only animal and vegetable life have their pe-
culiar forms, but also spiritual existences ; even thoughts and affections
have their appropriate and distinctive forms. These latter, viz. thoughts
and affections, are commonly but unintelligibly denominated abstract
things, when in fact they are no more abstracted from their appropri-
ate, spiritual, or substantial forms, than vision is abstractcd from its or-
gan the eye, or hearing from its organ the ear. But these forms, how-
ever, have nothing of gross materiality in them, therefore are not dis-
cerned by bodily fight. But it may be asked, what is affection and
what is thought, in their substantiate forms or subjects. A satisfactory
answer may be deduced from all and every thing in the body, where
there are many viscera, each fixed in its particular situation, and which
operate their functions by changes and variations of their state and
form. That the viscera are severally employed in their respective op-
erations, is well known; the stomach in operating its functions, and so
the intestines, the kidneys, the liver, the pancreas, and spleen in theirs;
and likewise the heart and lungs, each in its respective office: and all
these motions are operated only intrinsically or within themselves, and
to be moved intrinsically is to operate by variations of state and form.
Hence it may appear, that the purely organic forms or substances of the
mind are of a similar nature, only with this difference, that the opera-
tions of the organic substances of the body are natural, and those of the
organic forms of the mind spiritual, and that both of these act as one by
correspondences. There can be no ocular demonstration of the changes
and variations of state and form in the organic substances of the
mind, which are affections, but yet they may be seen as it were in a glass,
by the changes and variations of the state of the lungs in speaking and
singing, there being a correspondence, inasmuch as the sound of the
voice in speaking and singing, and also the articulations of sound, which
are words in speech, and the modulations of the voice in singing, are
effected by the lungs; sound corresponds to affection, and speech to
thought ; they are also produced thereby, and this is done by changes
and variations of the state and form of the organic substances of the
lungs, 
 

[ 48 ]
culiar form; this form consists of almost an infini-
tude of parts, all possessing a vita propria, or a life
peculiar to their functions, which is derived from the
common life which resides in the sensorium or brain ;
for the life of all the parts is one, as much as all the
parts are one body. Now let any venomous sub-
stance be applied to any one of these parts, and the
whole life is affected from the injury done to the part;
and this, because the whole is connected with every
part,
lungs, and from the lungs by the trachea or wind-pipe in the larynx
and glottis, and afterwards in the tongue, and lastly in the mouth and
lips. The first changes and variations of the state and form of sound
are produced in the lungs, the second in the trachea and larynx, the
third in the glottis by various openings of its orifice, the fourth in the
tongue by its various applications to the palate and teeth, the fifth in
the lips by disposing them in various forms: Hence it may appear, that
the mere changes and variations of the state of organic forms, successive-
ly continued, produce sounds and the articulations thereof, which are
speech and singing. Now, forasmuch as sound and speech are produced
from no other source than from the affections and thoughts of the mind
(for from the latter the former exist, and never without them) it is evi-
dent that the affections of the will are changes and variations of the
purely organic substances of the mind, and that the thoughts of the un-
derstanding are changes and variations of the form of their substances;
similar to what hath just been instanced in the lungs.
FORASMUCH as affections and thoughts are mere changes of the state
of the forms of the mind, it follows, that the memory is nothing else but
the permanent state thereof; for all changes and variations of state in
organic substances are of such a nature, that when once they become
habitual they are permanent; thus the lungs are habituated to produce
various sounds in the trachea and to vary them in the glottis, to articu-
late them in the tongue, and to modify them in the mouth, and when
those organs are once habituated to them, they are in them and can be
reproduced. See treatise on Divine Providence, No. 279. Published by
Thomas and Andrews at Boston, 1796.
To me the above reasoning is satisfactory. Something, in a degree
similar, may be seen in Dr. Darwin's Zoonomia, vol. 1st. sect. 4 to 12.
His ideas, however, are not new; but his experiments are original and
ngenious, and his proofs more in detail. 


[ 49 ]
part, and every part with the whole. This, howev-
er, is greater or less in proportion as the part is con-
nected either remotely or nearly with interior or
central life. Thus, poisons applied directly to the
heart, soon destroy its motions, and produce death ;
applied to the brain, the effect is still more sudden.
But poisons, however active, never can affect these
organs, except through fluid media: I doubt wheth-
er there is any perception by the nerves, but in this
way. Now,
DEATH never happens, or in other words animal
life never leaves its material form, until this form
is impaired by having its more subtle and animate
principles or materials perverted or corrupted; es-
pecially those which reside in the brain and are de-
rived from the blood or through this medium.
This certainly is the case with all malignant dis-
eases. Nor does this idea differ widely from Dr.
Mitchill's notion of putrid ferments or putrefaction,
which he defines, "a resolution of an organic body
into its elementary atoms."
WHETHER septon or septic acid really is the cause
of malignant diseases, is problematical; experiments
and future observations have yet to decide. Neith-
er the affirmative nor negative is yet clearly or sat-
isfactorily proved.
I SUSPECT Dr. Mitchill has been led to adopt his
opinion of the cause of pestilential diseases mostly
from appearances: Thus it is found that all those
G spots 
 

[ 50 ]
spots and soils, where nitre is produced in greatest
abundance, are unhealthy, viz. Egypt, Persia, and
the East-Indies. But it does not follow, that be-
cause diseases are connected with the soil in which
nitre is found, that it is, in any shape or form, the
cause of these diseases. Nitre is commonly thought
to be the result or residuum of putrefactions, and is
very seldom found in a vaporous or unsaturated
state, in which it must be when taken into the sys-
tem by cuticular absorbents, or inhaled by the lungs
in respiration. But I shall be answered, that septon
or the radical of nitre is saturated by oxygen or vital
air, which is taken from the atmosphere, and there-
by made unhealthy. But this would make hydro-
gen (inflammable air) the cause of these diseases ; for
then this gas would be in undue proportion.
SOME probable reason might be brought in sup-
port of the opinion that oxygen or vital air, what-
ever be the substance with which it is combined,
may be highly injurious, if not the cause proximate
of many diseases, when in over proportion ;
although it is in other circumstances undeniably
the great supporter of life and health. It is certain
that it gives causticity to every preparation that
acts as such on the human system. Without oxy-
gen there is no putrefaction, no change or waste of
substance; no corrosion, rust, or decay of metals
or minerals.
GREEN peas, green corn, &c. when gluttonously
eaten, have been known to produce a most distress-
ing 
 

[ 51 ]
ing diarrhœa ; and not unfrequently a cholera mor-
bus. These substances are said to contain much
oxygen.
WHICH, therefore, of the above principles has
the greatest share in the production of diseases, will
not be decided, until some standard, or Gasmetre,
shall be invented, by which it can be known what
is the peculiar date of the atmosphere when they
prevail.
IT is somewhat singular that the same principles,
which by physicians in America is considered as
the cause of pestilential diseases, in Europe is ex-
tolled as a sovereign remedy for their cure and
prevention.
BUT more directly to the point in question.—
By some physicians it has been strenuously contend-
ed, and with much ingenuity of reasoning, that the
fever of Philadelphia, New-York and Boston had
its origin in those places. Others say that it origi-
nated from fomes of foreign import.
THE same causes must every where produce the
same effects ; and the same noxious substances in
one place will produce the same disorders as in an-
other, all other circumstances being the same.
THAT there may be, in either of the above men-
tioned capitals, such a peculiar state of the atmos-
phere, or such a combination of noxious substances
as will give rise to contagious diseases, cannot be
disputed. 
 

[ 52 ]
disputed. But it is within the southern or middle
latitudes that these diseases mod commonly have
their origin. It is here that we find material quali-
ties in a more naked and uncombined state, conse-
quently more powerfully active. Here putrefaction
is sudden, and vegetation rapid. Here also is the
region of elementary contention and violence ; hur-
ricanes, tornadoes, sulphureous explosions, volca-
noes, and earthquakes. Every species of tropical
wind has its peculiar diseases, the Monsoons, Har-
mattan, Samiel, &c. The winds of these regions va-
ry their terrors ; sometimes involving all things in
a suffocating heat ; sometimes mixing all the ele-
ments of fire, air, water, earth together; sometimes
with a momentary swiftness passing over the face of
the country, and destroying all things in their pas-
sage,
AT Minorca and Gibraltar the winds which at
times blow there from the interior of the country
are very destructive, and at the Falkland Islands an
extraordinary wind is felt, occasionally, so blasting
as to cut the herbage down, equal to the raging of
fire; the leaves are parched and crumbled to dust.
So at Goree, on the river Senegal, there is an east-
erly wind from the inland parts, with which those
who are suddenly met by it in the face are scorched,
as by a blast from a furnace.
BUT beyond all others in its dreadful effects, is
the Samiel, or mortifying wind, of the deserts near
Bagdad. The camels, either by instinct or experi-
ence,

[ 53 ]
ence, have notice of its approach, and are so well
aware of it, that they are said to make an unusual
noise and cover up their noses in the sand. To escape
its effects, travellers throw themselves as close as
possible to the ground, and wait till it has passed by,
which is commonly in a few minutes. As soon as
they, who have life, dare to rise again, they exam-
ine how it fares with their companions, by pluck-
ing at their arms or legs ; for if they are destroyed
by the wind, their limbs are absolutely mortified,
and will come asunder. See Adams's Philosophi-
cal Lectures.
IN northern latitudes the atmosphere is uniform-
ly temperate and neutral; and if there are malig-
nant diseases, here originated, it must be more in
consequence of idleness, neglect of cleanliness, in-
ternal and external, or some moral default, than of
situation.
ALL this being agreeable to fact, the opinion that
the miasma of malignant diseases, more especially the
one of which we have treated, is imported from some
sultry climate, seems most probable.
FEW capitals, perhaps none, are more heathfully
situated than Boston. It is on a peninsula, and con-
stantly ventilated on all sides by water breezes.
THE streets almost all are so much inclined as to be
washed and cleansed by every shower. None—or
very few places where filth can collect and stagnate
without great neglect of scavenger duty. On the 
west
 

[ 54 ]
west side is a large common of 20 acres or more
extent covered with verdure, with a mall adjoining:
A spot more beautiful and recreative is not found in
any country. A walk here may well be called a
healthful luxury.
AN elegant State-house, and other rich buildings;
the surrounding back country, with its hills and
vales; the intervening waters, and other agreeable
objects which diversify the prospect, all unite to ren-
der this place extremely delightful.
THUS favourably circumstanced, to what must it
be owing, should Boston be again visited with con-
tagious malady ? No doubt to street filth and other
impurities which adulterate and destroy the healthy
qualities of the air, and render it a fit vehicle for
the circulation and extension of the pests of dis-
eases, here originated, or, introduced from south-
ern climates.
FINIS.