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NATIONAL LIBRARY OF MEDICINE		
Washington		
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Founded 1836		
U. S. Department of Health, Education, and Welfare		
Public Health Service		
 
 
 
       LETTER


            FROM THE

SECRETARY of the COMMONWEALTH

               of

         $>emtfpftmma,


  BT DIRECTION OF THE GOVERNOR,


  RELATIVE TO THE LATE MALIGNANT FEVER; AND
  REPORT OF THE BOARD OF MANAGERS, OF THE
       MARINE AND CITY HOSPITALS,
             IN REPLY.
         PHILADELPHIA:

PRINTED BY THOMAS AND SAMUEL F. BRADFORD,
      NO. S, SOUTH FRONT STREET.


             1798. 

 
            &ttxttuxv'Q  Letter. !'*;°^
la;     i      ^   'i-'.ii:...    -» -*? £    .:■;•' .jXI ^ov  aiui! .oi
r   GENTLEMEN,   ;rj1. ;rry/nc: 3,; a;„ ai^j., .  t?^,a
     ai.acrn a 3f3iq ^   r     . •■ biii >'  ,Jls>«»»9« >' •■ >livwl> :aaa
       THE Governor ;s defirous of fubmitting to the Legifla-
ture,  a comprehensive view of the  mortality and expenditure,
produced by the calamity, which has  recently afflicled the City
and its Suburbs. ^ He, therefore,  dire&s me to reqaeft, that
you will favour him with a Report,  and the neceflary  docu-
ments, upon thefiabjecl. toThe information contemplated may
be pi operl>y embraced, perhaps, by the following enquiries.

   ill. At what time,  in v/hat place, and in what manner, was
the malignant Fever introduced into th» City and Suburb^?' ^...

  2d.  How long did the Fever continue to rage, ^ad^wj^lt is the
number of its vi&ims ?        ^q loti  / a ~) h n ■:, -,w n ;M

   3d. What was the  general police purfued by the Board,  the
overfeers of the Poor,  and their Agents, to fubdue, or mitigate
the difeafe, to aid the  fick,  to inter the dead, and to maintain
the Poor ?

   4th. What fum has been raifed on this occafion, by taxes, by
voluntary loan, and by gratuitous contributions; what fum has
been expended, and what balance remains on hand ?

   5th. What is  the number and condition of the Citizens who
have been relieved, and will any extraordinary aid be necefTary,
on the part of the Legiflature, for the fupportof the Poor during
the enfuing Winter:

  6th. What precautions ought to be taken to prevent the recur-
rence  of fo dreadful a calamity. 
                         (   4  )
  Permit me to add, that it is the Governor's wifh that the Over-
 feers of the Poor, and, particularly, thofe'a<aive Citizens, who
 fuperintended the bumiefs of the Camps, fhould be confulted in
 forming your Report.  As the Legiflature meets on the 4th of
 December, I hope it will be convenient for you,'to comply with
 the Governor's requeft, in the courfe of the prefent month.

                         t have the honor to be,
 -■:.'J:l:ra.-r    ;  •   ■...■-..     '.    • ■    -'".: "'■
   -nt,                   with fentiments of fincere
      ,,_                     refpeft, andefteem,
     .    .-                       Gentlemen,

    ■ - -   .                 Your molt obedient humble fervant,
     •i-                               A.J.DALLAS.
                                                  Secretary.

Seeretqty's Office, Philadelphia, ?
  %th "November, 1798.      J
To die President and Managers of the
  Marine and City Hofpitals. 
&epi£.
                  Health-Office,  ift. .December,  1798.

    •    SIR,"'                     "  " '  Vp
                       X  H E  Secretary  of the  Common-
wealth,  in a. communication of the  8th. tilt, by! your direction,
having propounded certain queries rejative to tbe late  dreadful
calamity;,' a ,fe«fe" of duty, common  intereft,  and. a poignant
retrpfpeil of the paft fcenes of mifery ar>d  wreufhednefe,  which
came more immediately under our care, have excited an intenfe
folicitude and affiduity,  on our part, to anfwer fatisfaftorily
your inquiries, and devife means for the prevention of ib terrible
a fcourge in,future.     ,           ',,,...

   We regret ^thjat the continuance of the diifcafe to fo late a
period has  delayed the adjuflmentof the accounts of the inlUtu-
tions under our dire&ion, and will  confequently deprive us of
that,  accuracy- which  is, deu>ab!e.   We believe, 'however,
that the report will not ultimately be  found  materially  in-
correct.

   A few preliminary remarks, relative to the precautions which
have been taken in order  to  prevent the  importation of dif-
eafe,  may not be fuperfluous.

   The law, in refpect. to  quarantine, has  been  conftrued and
executed in the ftritteft fenfe.   Every power  and effort which
the Board,  or the officers under their direction, were capable of
exercifmg, has  been employed to cut off all  communication
with the veflels under quarantine.—Every poifible mode of pu-
rification,  which a law fo  manifeflly defective  would permit,
has been adopted,  and the moft rigid  fcrutiny  had, before  the
veflels were permitted to proceed to the city. 
                         (  6  )
   At the Marine Hofpital, the  fences were extended into the
river, the more completely-to enclofe the premiles, and all in-
tercourfe therewith precluded.

   For the fake of perfpicuity we {halFconform, as near as pof-
fible, to the order in which you have prefented the feyeral fubje&s
of enquiry; and

•  ift.  The malignant fever, according to our information, ifixft-
made its appearance in Water ftreet, between Sproce and  Wa4-
tiut ftreets, about the fir ft of Augaft.  Several refpe&able  pfhy-
fxlans declare that it appeared in  the month of Jane J and, that
many unequivocal cafes occurred early in July.  '*■"'"■''

   Unlhackled by  prejudice and diffident of opinidn", we have
endeavoured to trace the  difeafe to its  origin,- but without fac-
cefs.  Thofe  objefts which have  been  pointed  to  with the
greateft confidence as theforeigri fburce of the 'difeafe, on in-
vefiigation, afford  no fuch prodf.                          ;  1

   Thus fituated, it would be indecorous, in an  bffkiar report to
the Chief Magiftrate, to fubftitute-opinion for fact.   We deem  a
 queftion, on which the lives of thoufands and the  profperiry or
 aiiaihilation of our fiourilhing city may depend, of too much im-
 portance to reft upon the exdi/fi-ve'/peiulation of either foreign
 or- domeftic origin.

   In our anfwer to your 6th query, we (hall endeavour to  defig-
 nate fuch generaj  raeafures as,  when properly jdigpftqd by legif-
 lativc  wifdom, are, in our judgment, bell; calc^fqdfcp  guard
 againft the recurrenCe,feif ib fatal a,maauiy from either domeftj?
 or foicign icurces.

   2d.  Th'j difeafe continued to  rage until about the firft of No-
 vember ;  and, partially, until  about the 5th.   The whole num-
 ber of viciiins, exclufive of thofe who died in the country, are
 tLcc thoufand iia hundred  and forty-five. 
(  7   )
   3d.  The  CItyHdbital was evened on the 7th  Augnft.—
all veflels were immediately removed by order of the Board from
all the wharves included between Mr. Levi Hollingfworth's and
Tun Alley.—The Board publicly admonifhed the inhabitants
of the infected  neighbourhood to remove without delay.—A
quantity* of'damaged coffee  and cocoa, imported on  the  30th
July, and Sored in Ro&'s flares,  was reported on the 3d Au»>
guft to the Boaird to be in a  putrid ftate.  It was immediately
put on board the  veffel  in  which  it was imported,  and fenj
down to the Marine Hofpital for purification.

   TVo &itful phyficians and two affiftants were  appointed to
refide at the City Hofpital, wkh a competent number of nurfes
and attendants, and  every thing neceflary for the comfort and
relief of the patients was provided.  All the powers  of reafon-
kig, perfuafion, and authority,  which the  Board poffefled,  fhort
ofabfolute coercion, were afliduoufly employed  to induce the
fick to remove inftantly to the Hofpital; for which purpofe car-
riages corrftantly attended, and litters were conftru&ed as fpeedi-
ly as polfible, to convey them with eafe and convenience.

   All the regular praftifmg phyficians of the City and Liber-
ties were authorized to grant orders for admiflion into the City
Hofpital.—Hearfes and perfons were employed  for the fpeedy
removal and interment of the dead, and the Health-Office kept
open day and night, for the purpofe  of  receiving applications
and executing the ditties of the office with promptitude.

  In order to afcertaintheprogrefs of the difeafe and form fome
criterion by which to judge of its extenfion or decline, as well as
tomark thofe.parfsof the city and. liberties in which it raged with
the greateft violence, a faitable perfon was appointed to obtain
from the phyficians the daily reports x>f new cafes whichoccurred
in their practice feverally, together with the names and refidence
of the patients. 
(  8  )
  Skilful.phyficians were  appointed to attend  the  poor of the
Chy and Liberties, and; medicines provided for their ufe at the
expence of the inftitution.

   The buildings at the City Hofpital being found infuffieieht, a
houfe contiguous thereto was rented ; the fummer houfes were
covered  with canvas, a number of fheds, and a new frame build-
ing 60 by 20 feet, two ftories high, were ere&ed for the better
accommodation of the fick.

   The alarming  progrefs of the difeafe, and frightful increafe
 of mortality ;  the apparent temerity or apathy  of fome, and the
 indigence and diftrefs of others, impelled the Board to reiterate
 in terms the moft impreffive,  their admonitions to the inhabi-
 tants who were in circumftances to abandon their homes ; and,
 in conjunction  with the Guardians of the poor,  to provide a re-
treat for the indigent.

   Tents were accordingly erefted  on the eaft bank of Schuyl-
kill, to which they were invited to refort, and ample provifion
was  there made for their comfort and fupport.  Thefe meafures
being inadequate  to the urgency of the occafion,  temporary
buildings for the accommodation of near two  thoufand per-
fons were erected  on Mailers' Greund, two  miles  above the
city.

  The  regulation and fuperintendance  of each encampment
was confided to a committee of refpeftable and humane citizens,
who voluntarily undertook the arduous tafk.

   By the joint authority  of the Board  of  Managers and the
Board of Guardians of the Poor, a committee bf refpe&able ci-
tizens were appointed for the diftributiori of relief to the poor
of the City and Liberties, whole fituation rendered it improper
to remove to the tents* 
                        (  9  )
  The infe£led houfes and bedding were cleanfedand purified
by order of the Board fo far as was found practicable.  This,
however, was but partial, owing to the inevitable  difficulties
and confufion occafioned by the calamity.

"4th. The~a"fflOant faifid by  taxes and by loan in anticipation
of the taxes to be levied the prefent year for the fupport of the
Marine and City Hofpitals, viz :

  Borrowed on account of  the taxes
for the year 1797,                   D. 7268 09
  A tax of 10,000  Dollars has been
levied for the prefent year ;  the fum
collected on account thereof is,            6'/6 87
  Received of the  Bank of Pennfyl-
vania, on the credit of the taxes of the
prefent year,                        20,000 00
                                  —--------27,944 96
                   Private Loan.
  Borrowed of the  feveral Banks,  on fecurity of
eertain individuals,  for  the relief of the poor, un-
der  the  joint direction  of the Board of Managers
and the Board of Guardians of the Poor, which fum
was  borrowed on the faith  of Legiflative reim-
burfement,                                    29,000 00

  Total raifed by taxes and loans,          Dols. 56,944 96
Gratuitous Contributions Received  For
           The  Use  Of  The Poor.
   By the Board of Managers  of the Marine and
                   City Hofpitals.
  InCafh,                       D. i4°4° 05
  In produce and cloathing valued at     2000
                                   ---------16,040  c^
                          B 
                      (.<  1,9  )
   By the Committee of the Tents ondhe Manksof
                   Schuylkill.

 In Cafh,                         D. 3537  29
 In produce and cloathing valued at       5000
                                 ----~r—T'fa37-*9


By the  Committee  of the Encampment at
              Mafters' place.
  In cafh,                     Dols.  3,254  27
  In produce and cloathing, valued at .   6,568  22
                                   ---------9,822 49
By  the Committee for the relief of the Poor in
           the City and Liberties.
  in cafh,                      Dols.  420 oo;
  In produce and cloathing valued at     1,178 68
                                            1,598 68
Total,         Dols.   35,998; 51
Sums expended by the Several Institutions.
    By  the Board of Managers of the Marine and
                   City  Hofpitals.
 In cafh for the relief of the fick poor,  D. 9,782  56
 In produce and cloathing* valued at       2,000. 00
 Paid the diftributing committee          4,257  49
 Paid on account Marine and City Hofpitals, 20,975  20
                                   -----------37,015 25 
                        f  II  )
    By the Committee of the  Tents, oh the Banks of
                      Schuylkill.
  In cafh^of which 10,000 dollars was
apart  of* the 29,000  dollars  loan, D. 13,537 29
  In produce and cloathing valued at     5,000
                                     ------r— 18,537 *$
By the Committee of the Encampment at
              MaftersK Place.
   In cafh, of which 9000 dollars was  _
 a part of the 29,000 dollars loan,   D.  12,254 27
 In produce  and cloathing valued at      6,568 22
                                      --------  18,822 49
 By the Committee for the relief of the poor

        in the City  and Liberties.......     bi;, y
 , Ins cafh;. of which .10,000   1 -
dol-lars was a  part of the ■
2^,000 dollar loan,      D.  14,677  49
  Deduft . fo much charged-     •.  :.  1'-:  ~
in the expenditures  of the              -
Board  of Managers, of the
Marine arid City Hofpitals,
paid to this committee for
distribution,               4**5T 49
                         ------—- 10,420,
   In produce and cloathing
-.-. -.1 si-3 *o
valuedat  '  ;  r:i  ;                  V7g &
11,598 68
Total,  Dollars,        85,973 7' 
                        (   12  )

       Recapitulation of the preceding ftatement.
  Total-amount of taxes and loans ^ ■   56,944 96
  Total amount of gratuitous con-     35.998 51
tributions                  ir U..    —L/a" ■", 'cg:2.g^j  ^y

  Total amount expended by the                    v  u
feveral inftitutions,  '                            85,973  71

  Balance in the hands of  the Treafurer of the
Marine and City Hofpitals *              Dollars  6,969  76
  Note, the above balance is  on account, of'the  Marine and
City Hofpitals.  This fum, however, will be inadequate to the
discharge of the debts now due by the faid  inftitutions.
           Number of Perfcns relieved, viz.

  At the City Hofpital,                               g™
  By the Phyficians appointed by the Board of Managers
of the Marine and City Hofpitals to attend the  poor of
the City and  Liberties about,'        .   ,  .   ,  .   .    3000
  At the tents on Schuylkill and the:vicihhy thereof, .....1950
  At the  encampment on Mailers' Place  and  its vi-      >■>
cinity,                ; .;  -;.a;;                      2024.
  By the Committee for diftributirigrelief in the City
and Liberties about,               ...           j  ._.    3500
Total  11,353
  Exclufive of the above expenditures and number of perfons
                                       '.  ,";',Jw;:j
relieved, the  guardians of  the poor have  incurred a  very
great and  extraordinary expence for the relief of orphans and
perfons  diftrefled by the calamity. 
                         (  i3   )
 - 5th. The  poor will, douhtlefs, require extraordinary aid
from the legiflature the enfuing winter, in confequence of the
fufpenfion of labour during the prevalence of the difeafe, the
extraordinary expenfes incurred by ficknefs, or removal  from
the city, and, in all  probability, a fhort interval from the re-
turn of the citizens to the clofin-g of the navigation for the ex-
ercife of induftry.

  6th.  No queftion can be more  interefting, none more en-
titled to ferious confideration, than that which fhall determine
the precautions to be adopted, in order to prevent the recur-
rence off,a calamity  fo destructive.  Accordingly, we find our
fellow citizens generally engaged in the contemplation and
difcuffion of the  fubjecl:.

  Whatever difference of opinion may exift as  to its origin,
ALL appear to agree in the general fyftem of police neceflary        f
to'guard againft its introduftion in future.

   THe idea of refbrting to the legiflature of the union, for an
aftc to interdict the commerce  from  the Mediterranean-and
Weft-Indies, during the Summer months, appears to be gene-*
ral, and if attainable, would certainly be  moft defirable, at
lea ft until fame effectual fyftem fhall be devifed and completely
ready fa* execution.

   The great diverfity ofjfentiment which appears to prevail in
the different ftates, relative to the origin of the difeafe, together
with the powerful influence of commeicial iritereft and;rivalfhip,
may create infurmosntabie obftacles to the attainment of an effi-
cient law from the general government.

   Under the'fe circumftances, we think it will be prudent to per-
fevere with energy in an application  to the flate legiflature, for
effect.ua! quarantine and Health laws,  with liberal endowments
for t,he fupport of the feveral inftitutions.  It may here be pro-
per .to obferve that a w^l digefted quarantine law of this flate 
                          (   14  )
will be-neceflary (even in the event of a law of the general go-
vernment) to provide for the eafe Of  veflels which  may  enter
tWr-potb  from ftrefs of weather, or other cafualty duririg the pe-
riod of interdiction.
   '' ■ Ti P. *'"'...
  We take the liberty of fuggeftingthe propriety ofati'a'pp'licafiori
to the governments of the ftates of Delaware and New-J erfey for
their co-operation.   The principles of common intereft and felf-
prefervation, 'and their participation  in the late calariiity, muft
dictate to them the necefiity of fuch a coalition.

   A quarantine law  to  be effectual  fhould make provision for1
t?*e following objefts. '

   An infular fituation, remote from the City,fhouU befelefted,
if practicable,  for the place,of quarantine ; if  none  fuch can ba
obtained, forty or fifty acres on fame convenient part of the De-
laware fhore fhould be fecured by a high and ftro^g enclofure—
Wharves, .Ware houfes, .and  other fiatable bui-dings fhould be
<i e«Tted for the reception and purification of cargoes and accom-
modation of perfons.  >.'■

   All veflels from.the. Mediterranean arid Weflalndies, fromihe'
firft of June  to the firft OSiober, fhould there discharge their car- .'
goes, which,  together with the veflels,  fhould be thoroughly
purified, and perform a quarantine of at leaft* 20  days.  Guards
fhould be conftantiy pofted;at all the avenues,  and guard  boats*
ftationed afound the fleet,    ,joa jo       .'      '•"",'    ■•   '

   The law fhould provide for  the prohibition of 'mtercQurfe. by
land or  water with fuch of our fifter ftates as may not adopt
efiicifnt quarantine laws;  and^interdift all communication with
infe&ed places.    ;'•'-'.    :               ..,■■■••
                                                            j
   Having defignated thofe general regulations,  which we con-
cieve are: heft - adapted to guard againft the'importation of difeafe,' 
                          (  '5   )
fre fhall take the liberty of adverting to meafures, which ap-
pear to us no lefs neceffary to the health and profperity  of our
city.

   If the domeftic origin of the difeafe is denied, yet it muft be
allowed that local caufes have a potent effect, in its diffufion, and
encreafing its malignity ;  of this, fatal experience has furnifhed
an irrefragable proof in  the exceffive mortality, and numher
of the difeafed, in particular parts of  the City and  Libcuiei.

   We believe that thefe dreadful confluences would be great-
ly mitigated, if not wholly averted, by a judicious  reformation
in the police of the city and liberties.

  The introduction of wholefome running water for domeftic
purpofes, and for wafhing the ftreets, and common fewers, is
in our judgment, an  object, of primary importance ; the clean-
fing of all the docks to a depth  below the  level of low water
mark, a ftrift attention to the removal of all filth and putrify-
ing fubftances, and correcting the  noxious effluvia  from the
privies  in  the  commencement of the  hot  feafon, would, we
conceive, be productive of the happieft effects.

   The great attention which has been paid  to the cleanfing of
the beft improved parts of our city, and the obvious neglect of
remote and confined fituations, has long been  a fubject of fe-
rious  complaint.

   Any work, however great,  will be but partial whilft the
ftagnant pools, and filth of the narrow lanes, alleys and yards,
in the extremities of the city, and  particularly in  the diftrids
of  Southwark and  the  Northern Liberties, are  fuftered to
exift.

   We beg leave to call your attention to a fubieft wLich  we
•onfider as deeply interefting. 
                          (   16   )
  The eftablifhment of a City Hofpital upon an enlarged plan,
permanently provided with every thing neceflary for the conrfort
and relief of the  fick, and fkillful profcflbrs, nurfes,  &c.  pro-
vifionally  engaged in  the  event of a  recurrence of the difeafe,
would excite  public confidence,  and greatly diminifh the  evils
of the calamity.   The fituation of the prefent City Hofpital, we
confider as highly improper for the purpofe, from its contiguity to
the marines of the Schuylkill.  The lots and improvements there-
on, if fold,  would, probably produce a fum equivalent to the
purchafe of an  elevated fituation, and the completion  of build-
ings  better adapted to  tke purpofe.

  We have been led into unavoidable prolixity from  the mag-
nitude of the fubjeel,  and a wifh to contribute the refult of our
experience and  obfervations.   Should they  produce,  in  any
degree, the defired effeft, it will alleviate the recollection of thofe
painful  fcenes which it was our lot to witnefs, and  our duty to
relieve.
            By order of the Board of Managers of the Marine
            and City Hofpitals,
                             WILLIAM JONES, Pxefident.

Atteft,
        TIMOTHY  PAXSON, Clerk,
Thomas  Mifflin Efq.  Governor of the
Commonwealth of Pen,ijyi*vania. 
 
Mittm