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UNITED STATES OF AMERICA
MB
FOUNDED 1836
WASHINGTON, D.C.
B19574 
 
 
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            .u-LNiJAL INS. CO.
«  -°> THE
isipaiDSiaiao  ©ip  asa®9


                AS IT PREVAILED

     IX A PART OF THE CITY OF BALTIMORE.


 Comprising an accurate history of its origin, progress and effects,
       as far as they can be ascertained; to which are
                affixed, by way of
APPENDIX,
# •
Some remarks on the medical treatment of the disease, as found

     successful in the hands of the most distinguished
.r S.
C ^BY DAVID M^ltEESE, M D.
Or BALTIMORE.
be valued, "is it is luBuIry-en
*Iife is only to be valued, "ts it U u^Iry-employsaY'
         BALTIMORE:

PUBLISHED BY THE AUTHOR.

        John D. Toy, Printer.

            1819.   .\}X'


               uJ>rl  y>__*_7 J__Le^> <*-t-a 
DISTRICT OF MARYLAND, si.                             i
    BE IT REMEMBERED,  That on  this twenty-fourth day of 1
 2*t*t4M£ December, in the forty-third rear of the Independence of
 2 seal  * tne ^"k^d States of America, David M. Reese, M. D. of
 ********* tne sa"K' ■^'str'ct> natM deposited in this office the Title of
 *      * a Book, the right  whereof he claims  as Author, in the ^
words and figures following,  to wit:
  "Q^seuations on the Epidemic of 1819,  as  it prevailed in a part of
the city or Baltimore—comprising an accurate history of  its origin,
progress and effects, as far as they can be ascertained, to which are af-
fixed by way of Appendix, some remarks on the medical treatment of
the disease, as found  successful in the hands of the most distinguished
members of the  profession.  By David M. Reese,  M. D. of Balti-
more."                                                    _
  in conformity to an act of the Congress of the I'nited States, end-
tied, "An act for the encouragement of Learning, by securing the co*
pies of Maps, Charts and Rooks, to the authors and proprietors of such
copies, during tlie times therein mentioned,''and also the act entitled ,
"An act supplementary to the act entitled, 'An act for the  encour-
agement  of Learning, by securing  the  copies of  Maps, Chajts and
Books, to tlie authors and proprietors of sueh copies  during the times
therein mentioned,'  and extending  tlie benefits thereof to the arts of
Designing, Engraving and Etching, historical and other prints."
                                      PHILIP MOORE,
                              Clerk of the District of .Maryland.
VII  1'-: 
I
                    TO


      EDWARD JOHNSON, Esq.

         MATOH OF THE CITT OF BALTIMORE.
SIR:
   I prefix your name to this production, not in
accordance with the ordeal of custom, nor with
the desire of courting favor by servilcackila-
tion, but thus publicly to testify my esteem
and regard for your  private and  public char-
acter.  Your exertions in the cause of suffer-
ing humanity, during the recent visitation of
our city by an afflictive calamity, have insured
to you the  respect of all good  and virtuous
men, the testimony of an approving conscience,
and the approbation of Almighty God.
   Receive then, this imperfect testimonial of
the respect and esteem of


THE  AUTHOR. 
 
TO
  JOHN HILLEN,       1
  FRED. SCHjEFFER,
  JOHN LEE,
  LAMBERT THOMAS,  lv
  ELY BALDERSTON,   ^ Squires,
  JOSEPH TOWNSEND,
  R. K. HEATH,
  GEORGE  DECKER,   .

        Commissioners of the Poor,

  Acting during the prevalence of  the Epi-
demic in the City of Baltimore, this effort is
also inscribed  as a monument to commemorate
their industry  and fidelity, and as an expres-
sion of the favorable sentiment I entertain of
their individual worth.
                                      **>

                 DAVID M. REESE. 
«
* 
TO
  NATH. HYNSON,
  JOSEPH OWENS,
  JOHN W. BERRY, and
  GEORGE MILLIMAN,

  Members of the Board of Health of the
            City of Baltimore,

  To whose energy and zeal our city owe so
extensive a debt of gratitude, and whose acti-
vity and exertions contributed greatly to meli-
orate the distresses  consequent upon our re-
cent calamity, this book is inscribed as an evi-
dence of the  veneration I  entertain  for their
private virtues and public zeal.
Esquires,
DAVID M.  REESE. 
 
IPBIBffMHBa
  The art of elocution being foreign from the
profession  to  which I am devoted, I at  once
disclaim all  pretensions  to the ornaments of  m
rhetoric. It would illy comport with my qua-
lifications,  and be equally irrelevant to  my
purpose, to attempt a display of fanciful im-
agery  or flowery  declamation.  Mine is  the
task to acquaint the mind with truth without
ornament:  simplicity of fact, without artificial
embellishment.  My design being  merely to
relate historical facts,  some degree of perspi-
cuity,  and correct ratiocination are the only
constituents of elocution  to which I shall as-
pire.
  In preparing this publication I have  been
actuated by an endless variety of considera- 
X
PREFACE.
  tions, the enumeration of which would be but
  an uninteresting detail, and fatigue the reader,
  without a beneficial  result.   I shall however
  point out a few, which I deem the most impor-
  tant.  First, I consider the present, one of the
  most favorable opportunities for establishing
  the non-contagious nature of the disease.  Se-
  condly, I am desirous of defending the  Civil
  Authorities  from any imputations  of  negli-
  gence, or want of energy in the performance of
  their respective duties.  Thirdly, I conceive
  that an accurate history of the manner in which
  the  fever originated and  progressed: of  the
  circumstances which increased or diminished
  its violence, a correct table of the proportionate
  number of Deaths to the number of diseased,*
  and an account of the means  found  necessary
  to relieve the poor, who inhabited the infected
  District, will each furnish a theme  worthy of
^ the contemplation of the citizen,  the philoso-
  pher, and the philanthropist.
     As I wish the publication to stand the test
  of  public scrutiny,  and by its own merits to
  stand  or fall, I send it into the world without
  recommendations of any kind, although these
  have been kindly proffered by men of dignified
  merits and exalted worth.   Conscious that the
  history is given by a careful reference to facts,
  and that however  imperfectly the materials
  are put together, that it  is nevertheless  found-
  ed on  the immutable basis of truth,  the  author
  relies  upon the candor of the ingenuous reader
  for palliation of his  defects.   But although he 
PREFACE.
xi
solicits correction of his errors,  yet he is per-
fectly regardless of the censure of those men
who reject a book as useless,  without giving
themselves  the  trouble to examine it,  or  to
search into the motives of the heart which dic-
tated it.   To  such he would apply the famil-
iar injunction of the celebrated Bacon; "Read
not to contradict  and confute,  nor to believe
and take for granted,  nor to find talk and dis-
course; but to  weigh and consider."  To be fa-
vored with such readers, is the greatest bles-
sing an author can enjoy.  But this book may
possibly fall  into other  and  less ingenuous
hands.   It will be perused by the eye of jea-
lousy, to discover its defects.  The teeth of
malice  will grind each  page, and  mark  its
gritty constituents.   The hand of contemptu-
ous  envy  will hold the  ploughshare of criti-
cism, while it is driven with  violence over  its
surface, turning up in its passage the numerous
irregularities  which  deface  its  appearance.
But in  this the  author will not be disappoint-
ed;  such treatment he anticipated,  and such
enemies he defies; they  are lost in  their own
insignificance, they need  nought to promote
their inevitable downfall.  Just and rational
criticism, founded upon  careful scrutiny, will
be gratefully  accepted,  and  such criticism is
solicited.  Unaccustomed to wield the pen, ex-
cept on ordinary affairs,  the  author  feels that
at his first entrance upou the public stage, he
is obnoxious to egregious errors, and conspicu-
ous  defects.  But relying  upon  that candor, 
xn
PREFACE.
unknown to little minds, but which is the cha-
racteristic of the wise and the learned, he of-
fers his book to the world, and trusts that the
consideration that it is  his first public essay,
will restrain  "the rude hands  that are ever
ready to pluck up the tender plants of hcience,
because they do not bear fruit at a season when
they can only be putting forth blossoms. 
OBSERVATIONS
              ON THE

nsipaiDissa}]© ©if a©a&>
ss
             General Remarks.

     Scarcely had this vast orb been called
 into existence, by the Eternal Fiat, before the
 same power pronounced death  to be the con-
 sequence of sin.   And in  every stage of hu-
 man life, the avenues of death open on either
 hand, and present to man  the earnest of that
 portion, bequeathed to the  posterity of Adam,
 by that fatal act of transgression, which

   "Bro't death into the world with all our woes."

   Various are the means, which in the pre-
 sent  organization  of man, are contributory to
 the production of this effects  Ten thousand
 casualties  open the grave  and hurry millions
 to its dark abode.  Disease in all  its varie-
gated forms, seeks to sacrifice its predestined
victim.  Hydra-like it possesses many heads. 
14         OBSERVATIONS ON THE

and varies its aspect like the cameleon.   No
sooner does man "escape from one of its at-
tacks, than he is obuoxiotrtlto another  of still
greater violence.   If this  also fail to be  effi-
cient, steady to its purpose, it  seizes again
and  again, until   worn  down  by frequent
grasps, man sinks a ready prey.   But  if from
strength of constitution, or  other  causes, he
should withstand all these invaders, the stern
relentless  hand of time will precipitate  him
into  the jaws of death.  Such is  man in his
present conformation, and such  he will  con-
tinue to be, uutil --this mortal shall put on im-
mortality."
  But of all the outlets of human life, none is
more terrific in its  appearance, or  more dire-
ful in its effects, than  the malady  of which I
am  about  to treat.   In every climate, there
are diseases, which may be considered indi-
genous.   Each of the several quarters of the
globe, presents us  with  diseases  peculiar to
itself, although  these  are  susceptible  of  mo-
dification almost in every zone.   The yellow
fever appears to be the disease o§ our coun-
try,  although not peculiar to it;  for  it may
originate in other parts of the temperate and
in the torrid zone, wherever vegetable matter
accumulates, and  is  acted  on  by heat  and
moisture,  sufficiently  to  excite  putrefaction,
and consequent evolution of marsh effluvia.*

  *  Marsh  effluvia is  the name appropriated to the
cause of intermitting and remitting fevers, in  whatever 
EPIDEMIC OF 1819.
15
It is the scourge of America, the bane of our
commercial  intercourse.   It sweeps, as with
the besom  of  destruction,  the  inhabitants of
our large cities, wherever  it   is suffered  to
exist, and  totally exterminates  social  enjoy-
ment, wherever its footsteps are traced.
   It has, however, not prevailed in Baltimore
extensively, since  the year 1800,  at which
time it raged with much violence.   Its long
absence is probably owing to the circumstance
of the summers having been either moderate-
ly warm, or very warm  and  dry,  until the
present season, during which  we have  had
perpetual alternations of heat  and  rain, to-
gether with other causes hereafter to be enu-
merated.
   Let it not be  supposed, however, that our
city has been altogether exempt from the yel-
low fever during that period, since every year
has  afforded sporadic cases.   Nor  let it  be
imagined,   that  our   quarantine regulations
have  at all contributed to the prevention of
the disease; for never have  these regulations
been  more  rigorously enforced, than during
the present  season.  But more of this will  be
said under the proper head.
   It is well known, that during the present
year*1819, the disease has prevailed through-

it consists.  It is  composed most probably of the gases
evolved  during the putrefaction  of vegetable matter.
Its nature, however, has  not  yet been -the subject of
chemical analysis.  It is  sometimes  called  marsh mi-
asma, &c. 
16
OBSERVATIONS, &C.
out the middle and southern states, to the des-
truction  of commercial intercourse to  an al-
most infinite extent, to the great annoyance of
the peace and tranquillity of the infected dis-
tricts, and to  the  sacrifice of many valuable
lives.  Although Baltimore has been largely
interested in this general visitation; yet some
of the  southern cities  have been  still  more
seriously affected.  It becomes then a  desid-
eratum to ascertain the causes of so  distressing
an event.  I  shall confine my observations  to
the origin of  our  own epidemic, and leave it
to others to decide upon the causes  of the ma-
lady in  other cities  of  the Union, although
they are no doubt similar to our own.   And
to be the more systematic, 1 shall appropriate
a section  to each  subject, connected with the
Epidemic, which I deem worthy of attention. 
SECTION I.
,         On the Causes of the Epidemic.

       In entering upon a field so vast in ex-
:  tent, so unlimited in the considerations which
  it embraces, and so importaut to the interests
>  of our city, 1 am  not a little disconcerted at
i  the undertaking.  Unaccustomed to the cul-
•  tivation of  hypothetical speculation, I feel as
D  though entering upon strange ground.   Op-
i  posed  to that blind  pursuit of theory, which
:  some profess to observe, I have always avoid-
l  ed laboured hypotheses as dangerous in me-
  dicine.   If,  however,  the sentiments  of a
  celebrated writer be correct, that "to think is
  to theorize," then am I a theorist.
    But  not yet having strayed from the secure
  walks  of private life; being without the  com-
  mendation of great names, or the patronage of
  the  learned; unknown, except  in  a very limit-
  ed circle; and but entering on the  threshold
  of science;  it is a task of no small magnitude,
  for me^p attempt to account for the causes of
  a diseift, about which the "literati" have so
  materially differed.   Certain  it  is, however,
  that there are physical causes for every  phy-
  sical effect, and although  these causes pay
  remain for  a time concealed, yet  they  only 
18         OBSERVATIONS ON THE
require industry and research to effect their
discovery.   I have, therefore,  thrown  toge-
ther some  reflections on  this important sub-
ject, and shall give my opinions with all that
diffidence which  becomes me; but i will not
resign those opinions  to  any authority but a
conviction  of their  fallacy.   If I shall not
eause  another ray of light to  penetrate the
cloud, in which this subject is involved, yet
I trust I shall not act the part of an ignis fa.
tuus, by misleading the  votaries of science
from the true path.   If, however, I shall do
no more than point out the  road to the tem-
ple of Truth, I shall consider my part per-
formed, at  least my fondest expectations will
then be realized.
  The city  of Baltimore affords one of the
most  secure  harbours  of  any of the cities of
the United States; but that harbour is of ar-
tificial construction.  It is familiarly denomi-
nated a basin, upon the border of which the
city is built.   Ships of the largest  size come
as far as  Fell's Point, while for vessels of
two  hundred tons, it is navigable to its ex-
tremity.  From  this basin, the  water passes
up  into docks,  which  are  intended for the
convenience  of the bay craft,  and other small
vessels.  These docks are of various dimen-
sions, perhaps from two hundred to fiVhun-
dred  yards in length.  Of this character is
that upon which the disease  first appeared,
or rather to w hicb it was  first attributed, viz:
Smith's Dock.   The  water  in these  docks, 
EPIDEMIC OF 1819.          19
    seldom or never changes, except by a strong
?   south-easterly wind, to blow up the mass of
    water, and a  strong north-westerly wind to
    force it back again, occurring the one soon af-
    ter the other.   A piece of wood or other light
    body, has been observed to float on the water
'   in these  docks  for  weeks together,  without
    any perceptible change in its  position,  until
    an occurrence  like that above  hinted at, pro-
    duced a  circulation in the water.  And, in-
    deed, seeing that they  are situated so far from
    the Patapsco  river, nearly two miles, which
 '   is the  principal  source  from  which  they
f-   derive their contents, it is not at all extraordi-
r   nary, that the ebbing and flowing of the tides
    should only in a very  trivial  degree affect
n   these docks.   And  it  is important to state,
>i   that these docks are resorted to by vessels of
n   small size, many of which contain fruit, grain,
i   and other vegetable substances, the refuse of
1   which is  frequently thrown overboard, in de-
i   fiance of the laws, which adds  to the stock of
i   like substances, necessarily accumulating from
;    unavoidable sources.   These  docks, there-
    fore, generate and evolve the miasma already
    spoken of, in large  quantities  every summer.
      But although the cause exists,  other col-
    lateral circumstances not concurring, the ef-
    fect"%as  not been extensively  produced; yet
    this argues not at all the absence of  the cause,
    even although  no effects were evident.  This,
    however, is not the  fact; for, as has already
    been stated, this same  disease, which this 
20         OBSERVATIONS ON THE
 season  has become epidemic, has  appeared
 sporadically every season for some years; and
 what is very remarkaole, one or more cases
 has been traced to this self same spot, Smith's
 Dock, each season  for  several  years past.
 The condition of the docks then  may be con-
 sidered the cause of the disease, as originat-
 ing west of the Falls.
   Some  peculiarities  in the  structure  of
 Smith's  wharf, as   differing  from   other
 wharves,  have  been supposed to have con-
 tributed to the production of  the malady, by
 a  very worthy and enlightened  professor of
 our city, but not yet having been published,
 they  are  private property; and  I shall not
 trespass upon the rules  of etiquette  by can-
 vassing his opinions.  And, indeed, as  they
 are not yet before the world, they do not ad-
 mit of criticism.  If he  shall hereafter pre-
 sent them  to the  public  from his own pen, they
 will be  clothed in language and  manner,  be-
 fore  which my attempts to  delineate them
 would sink into iusignificance.  1 will, there-
 fore, be excused from thus committing myself,
 since  I am informed that  it is his intention to
publish his  opinions himself.   It is  my duty
to  give  my own sentiments, and  my reasons
for those sentiments, without  having a refer-
ence to the doctrines of any man.  I am  de-
cided  in the belief, that the  condition  of  the
wharves, the construction of the  docks, and
the want of a proper circulation in the water
contained in them, are  the sole causes of  the 
EPIDEMIC OF 1819.
21
disease originating  in  the city, properly  so
called.
   The  next inquiry which  naturally  arises
upon this subject is, to what causes are we to
attribute the appearance  and continuance  of
the fever on the Point?   This is an important
inquiry, and to give it a correct solution, will
require attention commensurate  with  its im-
portance.   I  have  given the subject some
scrutiny, and  will state  the  result of my in-
vestigations,  upon  the merits of which  the
public are  to decide.  "I speak as unto wise
men, judge ye what I say.'*
   It is ascertained  by actual demonstration,
that in filling up the wharves, and making the
streets at  the  east  end of Fell's Point, vast
quantities of wood have been made use of in-
stead of earth.   This may  be  considered td
be one  of  the causes of the  malady; for this
wood is now undergoing putrefactive decom-
position, as may be easily proven  to any one,
who will take the trouble to examine.   He
will find upon digging down two or even three
feet into the earth, at the lower end of Wolf-
street, (in  the vicinity  which  first afforded
evidences of the epidemic,) a mass of chips,
shavings,  &c. which from putrefaction have
become perfectly black and  foetid; and from
this mass may be distinctly seen  bubbles filled
with noxious gas continually evolving.  This
experiment was performed in the  presence of
a  number  of professional  gentlemen,  and
other respectable citizens,  with  the above 
22         OBSERVATIONS ON THE
mentioned  result    This,  however,  in  my
opinion, would not have excited the disease of
itself, although I believe it greatly aggravated
it, and increased its malignancy.  It is cer-
tain that it could not have been the only cause,'
since it raged at the Lazaretto, two miles from
this accumulation of ligneous  matter, as soon
as it prevailed on the Point, and  was equally
malignant and fatal in  proportion to the num.
ber diseased.  Fort McHenry, situate imme-
diately  opposite  the  Lazaretto,  became  so
much affected, that it  was deemed expedient
to remove the troops  stationed  there, which
was  accordingly done. Hence  it is evident,
that the nuisance in Wolf and Pitt-streets, at
Fell's Point,  already spoken of,  could  not
have  been the  sole cause  of our calamity.
We  are, therefore, to look for  some other
source for the poisonous agent; and to those who
are acquainted with the relative situation of
Pitt-street, Fell's  Point, to  the Lazaretto,
and the nuisances existing between them, it is
by no means  difficult  to  see the principal, if
not the whole cause of  our epidemic.
   Several large ponds of water, interspersed
with  the spontaneous growth of dock and
other weeds,  exist in  a direct line  between
the Lazaretto and Pitt-street, Fell's Point.
These ponds are  of  large size, and contain
vegetable matter  sufficient, one  would  sup-
pose, to  poison the atmosphere at any sea-
son.  The water contained  in them, is green;
and from these ponds arises a mist, forming a 
EPIDEMIC OF 1819.          23
cloud of great extent, which may be seen at
any time fr >m May to November, early in the
morning. The smell issuing from these ponds
is foetid beyond description, at  any season of
the year; but in the summer months it is al-
most insupportable.  Now it is known to all
who made  observations on  the  weather, that
for several  days before and after  the com-
mencement  of  the  disease  on Fell's Point,
that the wind  blew from an easterly direc-
tion, which  I conceive was the  manner, by
which the poison was conveyed to the Point.
   The cause existing in a concentrated condi-
tion upon  the surface  of these ponds, was
wafted by  this easterly breeze to the place,
where it first produced its  visible  effects, in
Pitt street, Fell's  Point.   Here  it met  with
an atmosphere nearly allied to its own nature,
from  the causes before mentioned.   These
uniting produced a concentration almost equal
to that existing at the place, where the poison
was generated in such quantities. ,.,
   The  peculiar manner of  its action  on the
system, 1 shall not here examine;  but will
only state,  that although it  is what  is called
by the  profession, the remote  cause, and an
exciting cause, is thought to be necessary to
produce  the disease; yet  if continued it will
produce .the disease, without any other agent,
by acting  both  as  a  remote  and  exciting
cause.   This explanation I  deem  important
to state, to  give the  reader  a  more  explicit
view of the subject, and to enable hfm to un- 
 24        OBSERVATIONS ON THE

 derstand  these  terms, whenever I shall have
 occasim to use them.
   The disease for some time was local, and
 its circuit circumscribed  within very narrow
 limits;  but soon it began  to creep, and pre--
 sently, to use the language of  one of the me.
 dical gentlemen, in  his report,  it commenced
jumping, proceeding along  the course of the
 wharves.    This,  to a  superficial  observer,
 would seem to indicate, that the causes exist-
 ed on the  wharves; but I attribute it to the
 continuance of the easterly wind, which last-
 ed some  days.   The streets  principally af-
 fected,  were  Pitt, Wolf, Ann, George, Fells,
 Thames, Phil pot, Fleet, and Alisanna-streets,
 nearly in  the order iu  which  they  are, men-
 tioned; and  towards  the  conclusion of the
 disease, new cases occurred in Wilk,  Bank,
 Bond,  Carolina,  and Gough-streets,  which
 last  street constituted the boundary line, be-
 yond whiclLit did not pass, as far  as my in-
 formation Intends, so as to become prevalent.
   Having^thus  briefly  enumerated what  I
 conceive to be the causes  of the disease, it is
 distinctly  perceptible, that  1 am decidedly  of
 the opinion, that it is of local origin.
   It  might now be expected,  that  I  should
 point out  some means of prevention of future
 repetitions of this  calamity;  but even if I
 Were competent to this task, it  doos  not  com-
 port with  my design.   I  have stated as my
 belief, that the construction of our docks, and
 the condition of  ou* basin, in relation to the 
             EPIDEMIC OF 1819.       .    £5

Patapsco, from  which  it chiefly derives  its
contents, will always expose our city to dis-
ease, without  active and  energetic exertions
on the part of the Board of Health.  I  have
also pointed  out nuisances in the eastern dis-
trict of our city, which call for speedy  re-
moval.   If it shall be found that my hints are
at all worthy of consideration, prober  mea-
sures will no doubt be taken to remove every
cause of disease, before another  season shall
inflict a similar calamity.  These hints are
the result of much thinking and  careful ob-
servation, they  have  cost  the author  some
pains, and if they shall in any degree be use-
ful, his design will  be accomplished, and  he
will be  fully remunerated  for his  time and
trouble, in making the investigation.
3 
>
I 
SECTION II.
     On the Progress of the Epidemic.

     XJntil the middle of July, our city had
enjoyed  unusual  health; there  had  been  no
appearance of any malignant disease, and the
bilious cases which did occur, had as yet been
mild and manageable.   About the middle of
this  month, however, some  evidences  were
afforded, which induced some of the Faculty
to predict a sickly season.  A number of the
cases of ordinary fever wore an  unfriendly
aspect.   But it was not until the twenty-first
of the  month, that  the first case  occurred,
which  was pronounced  yellow fever, in the
person of Mr. Lark in  Reed,  resident in a
part of the city  distant from any of the re-
mote causes which are ostensible.   The next
day, being the twenty-second, Mr. JohnMott,
living  near the former gentleman, and  under
equally favourable circumstances, was  taken
in a similar manner, but much more violently;
for on  the twenty-sixth he died, while Reed,
although taken before him, did not die until
the twenty-seventh, being the  sixth day of
his disease.   These two cases  occurring al-
most simultaneously, excited much alarm, and 
28         observations on the
various were the speculations relative to their
origin.  The facts, however, are these; Reed
was a  miller, and  daily  employed in  the
steam-mill, owned by Isaac M'Kim, Esq. on
Smith's Dock.  Mott had occasionally visit-
ed this wharf, although his  business was not
located there.   They had both  been on said
wharf the  evening before  Reed was  taken;
went in'o a vessel from the Eastern Shore of
our own State, and there continued some time,
while they  ate freely of pears,  and perhaps
of other  fruit, which  the  vessel  contained.
To this vessel has the disease been attributed}
but I  think  without reason, since no  other
persons, who were afterwards diseased, had
been known to have communicated with said
vessel.
  Some supposed the disease to have origi-
nated from the schoouer Adventure, laden w ith
coffee from  the West Indies, while  others
charged the schooner Proserpine,  laden with
hides and coffee, with containing the poison-
ous agent;  accordingly,  they were  both  or-
dered down to the  quarantine ground, from
which one of them returned the next day, and
the other soon afterwards, having been re-ex-
amined by  the health officer, and their cargoes
being  found in a perfectly sound condition.
These facts I have thought proper  to recite,
although I do not believe they have had any
agency in the production of the malady, since
there are overt causes, more than sufficient to 
            EPIDEMIC OF 1819.          29

excite  yellow fever, without any reference to
such doubtful  sources.
  Soon after these cases, Mr. Wirgman, Mr.
Suhr,  Mr.  Hobin, and Mr. Allen Dorsey,
were severally attacked in rapid succession,
with a disease, which was boldly declared  to
be yellow fever.  These gentlemen, it is very
remarkable, were  all daily engaged in busi-
ness on the east side of  Smith's Dock, and no
other  case having arisen in any other part of
the city,  it may be easily imagined, that the
alarm which had  hitherto been trivial, became
increased and  universal.   From  the time the
first case  occurred, the  Board  of Health,
in conjunction  with the Mayor, had been vigi-
lantly engaged in removing the cause in what-
ever it consisted.   In proof of this, it is only
necessary to remark, that  so early as the fifth
of August, I find  the following document on
the health office books,  viz:
  "In  consequence of  the  numerous reports
and representations made  to the health office,
respecting  the existence  of a  nuisance on
Smith's wharf, the Board, accompanied  by
the Mayor, proceeded to an examination, and
find that  the  cause of alarm exists  in, and
proceeds from the noxious  vapours  issuing
from Gay and  Frederick-street docks, and the
lumber yard of Mr. H. Price, situate between
said docks.''
  The Board  now had recourse to the only
means, which  art  afforded, for  removing the
              3* 
30         OBSERVATIONS ON THE

cause, by passing the following  resolution on
the seventh of August:
  Resolved, that  lime be  scattered over the
alley between  Gay  and  Frederick street
docks, and  that a quantity of tar  be  burned
in the frout and  rear of the warehouses on
Smith's wharf.
  This resolution was faithfully observed and
executed; and  although  some have ridiculed
the burning of tar, and even denounced it as
an useless and injurious  antidote, yet  I bold-
ly assert, without fear of successful  contra-
diction,  that no  better measure could  have
been adopted, which will appear from its
modus operandi.
  The vapour which  is the  product  of the
combustiou  of  tar, is much heavier than at-
mospheric  air.  The poisonous agent  is  also
heavy, and by its gravity always occupies
the  space  next the  surface of the earth; the
vapour of the tar  mixes with the noxious at-
mosphere, (although  it cannot chemically com-
bine.) and  by this mixture, the  poison  is so
diluted  by  its extensive diffusion, that  its
deleterious properties are altogether destroy-
ed.  If this explanation be correct, the board
Could have used no better antidote to the nox-
ious cause.  And  it  is probable, that  it is to
their exertions, together with the co-operation
of the citizens, in speedily removing their
business  from  the infected district, that we
ait  to attribute the  speedy cessation  of the
disease in the city, properly so called. 
EPIDEMIC OP  1819.
21
   On the fourteenth  day of August, it was
 reported to the Board of Health, that the dis-
 ease existed on  the  lower end  of  Fell's
 Point, at least one mile in a direct line from
 Smith's wharf.   This report was made  to
 them by Drs.  Martin  and Murphy, two of
 the  physicians practising in that district of the
 city.  This  of course  augmented  the public
 excitement, and increased the vigilance of the
 Board; for I perceive by their records, that no
 less than twenty-five nuisances had been dis-
 covered, and removed all in a few days.
   It was  now  thought advisable to address
 a circular to each of  the physicians of the
 City and the Point, and to send this regularly
 every day, so that daily reports might be made
 to the public of the  new cases and deaths.
 The following was the form of the circular:

             Health  Office,
              Baltimore,---------,  1819.
   To Doctor---------,
       The  public anxiety appearing  to re-
 quire a daily report of  the health of the city,
 and  the attention of the faculty hitherto paid
 to the communications of this Board, induce
 them respectfully to  request  an answer  to
 the following questions, and such other infor-
mation, as may appear to you appropriate.
   1.  Have you auy cases of fever commenced
within the  last twenty-four  hours, and likely
to prove dangerous?   Or,
  2. Any deaths, or dangerous fever, which 
32        OBSERVATIONS ON THE
commenced previous to the time above men
tioned?
      By Order,      P. REIGART,
                              Secretary.

  Two  active men were appointed to carry
these  circulars daily, to  every  physician  in
the  City and Point; Joseph Legard, to those
west of Jones'  Falls,  and Noah Fowler, to
the  east, a duty, which,  though an arduous
one, was faithfully performed  by  them, and
for  which they merited  and  received much
credit.   This was  the most effectual  means
the  board could  have  adopted, and was met
with promptitude  by the physicians, and was
continued as long as the  disease continued to
prevail.
  About this  time, the.Mayor finding  the
appearances  threatening  in  the   extreme,
thought it expedient to call a  meeting of the
Council, for the purpose of adopting such or-
dinances, as might appear to them necessary.

                        August 27,1819.
   The Council  having convened  in  conse-
quence of a summons from the Mayor, the fol-
lowing communication was received:

    Gentlemen of the City Council,
  The state of the  health of the city  having
devolved new and extraordinary  duties  on  the
Board of Health, and occasioned an expendi-
ture of money not contemplated, will  render 
EPIDEMIC OF  1819.
33
 the appropriation for the health  department,
 wholly insufficient  to  meet  the  expenses,
 which must necessarily be incurred: and un-
 less a favourable change should speedily take
 place, which from present appearances cannot
 reasonably be calculated upon, it is impossi-
 ble to estimate the sum that  may be required
 for this department.  Until within the  last
 week, the fever at the Point was local, being
 confined to Wolf and  Pitt-streets; but from
 the reports of the physicians of the neighbour-
 hood,  herewith handed you,  its range  has
 been  greatly enlarged, and  I  must confess,
 that I entertain  the  most gloomy apprehen-
 sions and  desponding  anticipations, and ear-
 nestly recommend  every precautionary expe-
 dient, the  collected  wisdom of the City Council
 can devise, and a liberal appropriation to ena-
 ble the Board of Health to effect such measures
 as may be deemed necessary or expedient, to
 arrest the progress of disease, and to aid in
 the preservation*  of the future health  of  our
 city.
       Signed,     EDW. JOHNSON,
  August £~, 1819.                Mayor.

  The following resolution was adopted:
  Resolved by the  Mayor and City Council
 of Baltimore, that a sum not exceeding three
 thousand dollars, be, and the same  is hereby
 appropriated, to  defray such  expenses, as
may be occurred by the Board of Health in the
discharge  of their duties. 
34         OBSERVATIONS ON THE

  It was not until  the twenty-eighth day of
August, that the Board of Health, at the insti-
gation of the mayor,  published an  explicit
statement of the condition of our city.  This
statement was founded upon the reports made
to them  by the medical gentlemen, practising
in the infected district, so that they did  not
proceed without the best  authority, nor until
the most weighty and alarming reasons urged
them to the performance of their duty.  The
following was  the  document  published  by
them, viz:

             Health Office.
   "The cases of fever at the remote part of
Fell's Point, adverted  to  in our last  report,
we  are  sorry  to say,  have  considerably in-
creased  in number, and are  very  decisively
characterized with  the symptoms  of yellow
fever.  They amount in number to about fifty
cases.
  "They are still confined within very narrow
limits, and are chiefly traced to the same source,
but exhibit indications of slowly extending.—
The deaths  have  hitherto been very few, but
most of the  cases  having occurred within  a
few days, their results are not yet ascertain-
ed; but are estimated at the proportion of one*
fifth.
   '•The Board are disposed to hope the dis-
ease may not spread, but have thought it their
duty to give this early notice of its unfavoura-
ble aspect, and earnestly to advise the citizena 
EPIDEMIC OF  1819.          35
of that district, to move away as  speedily as
possible
    "By order of the board of health.
                "P.  RE1GART, Cl'k."
  August 28.

  The Mayor was not ignorant of the ex-
citement whi( h would result, and which ought
to result from a declaration  proceeding from
his office, that within a few days fifty cases
of yellow fever had  originated in our city.
He was aware, that when he should invite  the
citizens to forsake their homes, and fly from
the devastating calamity, that the alarm would
become general,  and our  city would tempo-
rarily suffer.  He was not ignorant of  the
enmity which would be generated against him
in  the breasts of those men, whose  "little
minds" conceive  self-interest to  be justly
the predominant motive  of human actions, and
who would  have approbated  his conduct with
ardour and  zeal, if be had secreted the truth
in  order to further their views, even if hun-
dreds of lives had been the forfeit.  But, as
the safeguard of the people, as the  head of
our civil  affairs,  "standing  upon the  wall,
should  he see the sword coming, and fail to
give warning thereof,"  then indeed would he
have been  unworthy of   his trust;  and  the
blood of those who fell victims to its effects,
would "be  required at his  hands."    Then
would the widow and  the orphan, left deso-
late by the destructive malady, call for yen- 
36         OBSERVATIONS ON THE

geance to rest upon him. since  by neglecting
to give  warning of danger, he  had decoyed
them into an exposure to a disease, by which
all  their earthly hopes  of felicity had  been
torn from their  embrace.  But  by disclosing
the truth, he  no doubt saved many hundreds
of valuable lives.   In a word, Mr. Johnson is
one of the few individuals,  with  whom "when
interest and  duty are in opposite scales, the
latter will ever preponderate."
  It is  true,  some  very sapiently asserted,
when this report was made, that it was the
production of groundless fears, and idle fore-
bodings, and many  who held  this opinion,
have forfeited their lives, as the price of their
temerity.   Now, however,  the public are pre-
pared to do justice to the Mayor and Board of
Health, since the  devastations committed  by
the raging calamity, have left impressions on
the public  mind never  to be  erased.   They
now appreciate  the wisdom  and  forethought
of the civil  authorities, and now consent that
they deserve the warmest gratitude of an en-
lightened people.
  So soon as the report above alluded to was
published, designating  Fell's Point  as the
seat of the prevailing malady, the physicians of
that district formed the opinion,  that the phy-
sicians of the City  concealed their cases, de-
signing  to throw the opprobrium  of local in-
fection  on  Fell's  Point;  they  accordingly
refused  to make any  reports,  which  was  a
matter of considerable regret; for it w as only 
EPIDEMIC OF 1819.
37
by these reports, that the public could be in-
formed  of  the situation of  our city from an
official source.  They, however, being waited
on by the mayor and  several other influential
citizens, consented to renew those  reports af-
ter a suspension of only  a  few days.  This
misunderstanding  occasioned  an  antipathy
between the physicians of the Point and those
of the Ci'y, which was not  easily removed.
Indeed, *o firmly were the former geutlemen
convinced, that the latter concealed cases of
the yellow fever from motives of policy, that
they refused to meet the convention of the fa-
culty: and  some of them  never gave  up this
mistaken idea, through the whole course of the
epidemic.
  On the seventh day of  September, the fol-
low ing communication was sent to the  several
practitioners on Fell's Point, in consequence
of some intimations received from Dr. Owen,
that the disease w as subsiding.

  "The Board of Health  respectfully request
of Dr.---------the  favour of an answer to
the following question, viz:   Whether  the fe-
ver which prevailed  at  the east end of Fell's
Point has not materially  chan.ed its charac-
ter, and  become from a very  fatal  and malig-
nant fever, a very mild, manageable, and rare-
ly fatal disease?"

  In ainwer  to  this question, they  unani-
mously  concurred* iu  the  negative, and gave
             4 
38         OBSERVATIONS ON THE

the most  explicit statement of the increase
of the threatening  calamity, which  could be
made.
  This will appear from one of their commu-
nications, hereunto annexed.

           To the Board of Health.
     Gentlemen,
   In  answer to your  inquiries,  we  are of
opinion, that the fever prevailing  at the  east
end   of  Fell's  Point,   has  not  materially
changed its  character,  and  that  those cases
coming under our  care, are generally in  a
high  degree malignant, and  many  of them
entirely unmanageable;  and we also believe
the disease to be  spreading,  and were the
inhabitants generally remaining, it would be
unusually mortal.
     Yours, &c.
             W. H. &  A. CLENDENIN.

  Nothing  could be more explicit than this
answer, as well  as several  others of similar
p'irport. which I have in my possession. The
board were now well satisfied, that the exer-
tions  used by them should be continued  and
persevered  in without  any diminution;  and
from this time no doubt  was entertained  that
the disease was  spreading, and that the in-
habitants  ought  to  remove.   But such  was
the deficiency of the powers  vested  in the
corporation,  that  no compulsory measures
could  be used, and persuasion was  unavail- 
EPIDEMIC OF 1819.
39
ing w ith one  half of the population  of  the
infected district, until the grim monster Death
seized on  almost every family,  and  roused
them from their lethargy; and even then many
remained resolved to  risk their  lives, rather
than leave their habitations.
   During the time the reports were made with
regularity  by the  physicians,  one thousand
and  sixteen new  cases were  reported, which
comprises those occurring in  the City as well
as the  Point, although only twelve of these
cases are supposed to have originated in the
City, properly so called, all the rest  being
traced to the Point.  And it  is very remarka-
ble, that in almost every instance wherein  any
person visited  the  Point at night, the disease
was contracted, while those  who were only
there in the day time, escaped with impunity.
This may be accounted for consistently with
philosophical  principles.   The  noxious  at-
mosphere, as has already been stated has a
specific gravity,  much  greater  than  atmos-
pheric air,  and occupies the space  next  the
surface of the  earth.  Th«*rays of the  sun
heating the  earth, the poison must of course
rise and  be diffused through the surrounding
air, so as to be rendered inert.   But no soon-
er does  the sun  retire beneath  the horizon,
than  a   concentration  of the  poison  takes
place, which is not again dissipated until  the
rising of  the  sun  on  the  succeeding day.
This change occurred daily,  and may account
for the fact, that so few of the physicians con- 
40         OBSERVATIONS ON THE
tracted the disease, although  every day ex-
posed to the local cause.   It is  farther con-
firmed  by  remarking,  that  those  of  the
medical  geutlemen practising  in Baltimore,
who  became  infected, were taken in conse-
quence of paying a visit by night to the source
of infection, or  the vicinity where the  cause
existed.   Several  physicians who had  been
attending patients through  the whole course
of the fever, in the very  centre  of infection,
in the day time, were exempted from the ma-
lady, but by visiting  once in the night, they
became diseased.
  If  we admit  all  the  cases reported  to be
yellow fever, and  allow for the cases, which
from  the obstinacy of the physicians, were not
reported, or from  the  stubborn disposition of
the families, or  other  causes, were not made
known to  the  faculty,  together  with  other
incidental  circumstances,   we  may  suppose
there were  about   twelve   hundred cases  of
the epidemic.   The  deaths of yellow fever
according to the regular accounts kept by the
health office book*, were about  three hundred,
making a proportion of about one-fourth of the
number diseased; of these, eighty-five occurred
in the Baltimore  hospital,*  in patients who

  * Much censure having  been bestowed upon the
physician  and steward of the hospital, I deem it but
justice to  say a word in their defence-  Standing as I
do aloof from  the interests  of the establishment, it can-
not be imagined that 1 am-actuated by personal or  in-
terested views.   What I shall  say is the  result of 
EPIDEMIC OF 1819.
41
were removed  thither from  Fell's  Point, by
the humane  interference of our worthy May-
or and Board of Health, where they received
constant  attention,  and every  necessary,  to
make their situation comfortable.
   These cases  may be  considered additional

careful  inquiry  and  sober  investigation, undertaken
partly from the anxiety  I felt for the distressing situa-
tion of those who were  sent there by the corporation*
and partly by  way  of contradicting certain  reports,
prejudicial to this useful institution, which were indus-
triously circulated  through all ranks of the people. The
report was, that the poor patients sent thither, were not
faithfully  attended, nor properly nursed, and that  in
consequence of this  neglect, they died  in such  great
proportion.  Although I had been in the habit of c<dl-
mg at the  Hospital occasionally, I again visited  it on
hearing these reports, and without mentioning my bu-
siness, was permitted  as usual to visit the wards occu-
pied by these patients.  Here  I made careful observation,
and found  the patients as comfortable as they could be
in their morbid condition, and nursed  without inter-
mission.   The cleanliness  of the  rooms, and  the neat-
ness of  the  arrangemenl, was  highly creditable to Mr.
Gatchell, the steward, and  to his assistants.  I found
nurses  in  abundance, every article of  nutriment aid
me'licine properly administered, and in short, the whole
arrangement of the house, and attention  to the patients
was indicative of the  most humane and  honourable in-
tentions.  And although the Institution has  been re-
viled  on account  of the number of Deaths occurring
within it»  walls, yet when it is recollected, that many
of the patients were in  the act of dying  when received,
and some  died  in a  few  hours after admission, it will
not be considered wonderful, that  the proportion should
be greater than in the City, where they  were generally
taken  in time.   Thirty-two  cases received into the in-
stitution were hopeless, at the period of their admission.
             4* 
42         OBSERVATIONS ON THE
 to the number reported to the Health Office,
 for  a  great  proportion of  them, at  least,
 were  taken with  the  disease, and conveyed
 to the  Hospital, without being visited by any
 Physician.
   Of the one hundred  and forty-one cases ad-
 mitted into the Hospital, ten died within twen-
 ty-four  hours after their admission,  having
 been prescribed for and retained on the Point
 until theircases were mortal, and then  convey.
 ed thither for the convenience of dying.
   As the disease progressed, the inhabitants
 gradually left their dwellings, and were com-
 pel led  to seek for homes at a distance, for
 every house  was soon filled  in  the  healthy
 part of tlie city.  The incouveuiences to which
 many were thus placed,  were almost incredible.
 Scarcely a mill, bain, or stable, within any
 reasonable distance  from the  city, but was
 occupied by some of these fugitives.   Accus-
 tomed  to comfortable   accommodalions and
 wholesome fare, until  this sad  event, they
 were illy qualified  to bear the privations con-
 sequent upon  their flight. Many became sick,
 and  others died from the hardships to which
 they  were now exposed.  Driven from their
 homes, they were left at the mercy of the in-
 habitants of the surrounding country.   Many
 of these, to their praise be  it spoken, receiv-
 ed them with  that humanity, which their de-
 solate situation required.  Some  there were,
however,  although few  in  number,  who,
finding  that the fugitives were necessitated to 
EPIDEMIC OF 1819.          *3
obtain a residence somewhere, required enor-
mous compensations  for  their houses, thus
making the necessities of the poor, their op-
portunities to add to their coffers.    But to
such individuals, strictures on  their conduct
are  perfectly inert; the  tender  feelings  of
sympathy dwell not  in their  callous  hearts;
they are destitute of that principle, which can
alone exalt or ennoble  the human character:
without it, man  differs in no essential point,
from the beast which perisheth, and is  utterly
unworthy of our  respect or attention.   To
such an one, reason  disdains to speak, and
contempt  silences  censure.  Yet as  a histo-
rian, I must  state  the fact, and having done
so, I have fulfilled my duty.
   The  disease  progressed without much in-
termission, until  towards the  close of Sep-
tember, when the  following very important
and honourable documents were published:

            CLERICAL NOTICE.
   In consequence  of  previous notice, a num-
ber of clergymen  of  different denominations,
met in  the ve»try-room of St. Paul's Church,
on  last  Saturday, the   eighteenth   instant.
The right Rev. J)r. Kemp was called to  the
chair, and the Rev. Mr  Hargrove appointed
secretary.  The object of the meeting  was
stated  by the chairman  to be as follows:—
Inasmuch as it  has pleased  the Almighty to
visit a remote  section  of  our city,  called
Fell's  Point, with a  maliguant  and  mortal 
44         OBSERVATIONS ON THE

fever,  it was deemed highly proper to call
upon the citizens  to  devote a day to fasting,
humiliation,  and  prayer  to  Almighty  God,
that of his infinite mercy  and goodness, he
would be pleased  to  arrest this severe cala-
mity, where it does prevail, and to protect our
city from its  influence, where it has  not yet
appeared.
  On motion, it was  resolved, that the  pious
object  of the meeting meets the unanimous
approbation of this body.
  Resolved,  That next Thursday, the  twen-
ty third of this month, be appointed a day of
fasting, humiliation, and  prayer, that the citi-
zens be requested to suspend, on that  day,
all  worldly  business, to humble themselves
before  tfce Almighty in  deep  contrition for
their sins; to meet in their several  places of
divine  worship, and  to join in  prayer to the
Supreme Being, that in  the midst of  judg-
ment he would  remember mercy, and  avert
those evils, which our sius have most justly
deserved.
  Resolved,  That a committee be appointed
to wait on the Mayor, and solicit his sanction
of and co-operation in this matter.  The com-
mittee  appointed,  were the right Rev. Dr.
Kemp, the  Rev. Mr.  Duncan, and the  Rev.
Dr. Jennings.
                   JAMES  KEMP,
                                Chairman.
  John Hargrove,  Secretary. 
EPIDEMIC OF 1819-          45
            A PROCLAMATION.
  Whereas,  from the pious  usages of our
forefathers, and  the example of holy men in
all ages of the  church, we  are taught to be-
lieve, that in times of great  public  or  pri-
vate calamity, we ought iu a peculiar manner
to humble ourselves before   the Supreme Go-
vernor of the Universe, to  acknowledge our
dependence on  Him, who is the supreme ar-
biter  of events, to confess  our manifold of-
fences, and to supplicate his  tender mercies in
averting  the  manifestations  of his great  dis-
pleasure.    Impressed  with  those  solemn
and  awful truths, the clergy of  the various
denominations of christians  in this city, have
recommended that a day of  humiliation, fast-
ing, and prayer, be set apart, and the several
worshipping assemblies meet on that day, for
the  purpose  of imploring Almighty  God, that
he would be pleased to arrest the progress of
the  malady now prevailing  at  Fell's Point,
and restore our city to its wonted  health.
  Now, therefore, I, Edward Johnson, May-
or of the city of Baltimore, pursuant to the
foregoing  recommendation   of  the  reverend
clergy, do hereby recommend and advise that
Thursday next be set apart  as  a  day of hu-
miliation, prayer, and fasting, and  that all
persons within said city do abstain from their
ordinary occupations on  that  day, and  from
all worldly recreations and amusements.
                 EDW. JOHNSON,
  Sept. 29,1819.                  Mayor. 
 46        OBSERVATIONS ON THE

   Tt  is certain  that  a very material  change
 occurred  soon after  this period.   The wind
 which  had blown from  the  south-east with
 much violence, in a direction which favoured
 the  progress  of the  disease towards the
 healthy part of  the City, veered  suddenly
 round to the north-west,  and blew with such
 force from  this quarter, that the basin was
 thoroughly washed  out;  a  general cleansing
 of the  filthy situation of the docks,  was the
 result, and the evidences which had been pre-
 viously afforded, that the  disease was pro-
 gressing towards the healthy  districts of the
 City, ceased to be exhibited.   No case, I can
 confidently assert, occurred, originating north
 of Gough-street, from this period, although it
 had reached  this street, at this time, having
 extended several squares in  twenty-four hours
 in several instances  just before.   And, in-
 deed,  had it not  been for this providential
 interference,  there was evident grounds  to
 believe, that  the  malady would  have been
 universally  diffused.   It is  true, the cold-
 hearted infidel may contemn such allusions to
 the Supreme Governor of the Universe: the
 haughty sceptic may  arrogate  to himself the
right  to deny such a  Divine Agency;  but to
the individual,  who  is acquainted with the
 infinite variety of means, by which the Great
Eternal directs the revolutions of  all events;
to that  heart which has been warmed  by the
operations  of Divine grace,  no  arguments
need  be given to establish  the correctness of 
             EPIDEMIC OF 1819.           47

the  above  remark.   "Facts  are  stubborn
things," and  with  such facts, retreating be-
hind  the  impregnable  barrier of Truth,  we
may defy the efforts of sceptics or infidels.
   I would not be  understood to say, that I
impute  altogether  the  favourable  change,
which occurred at this period,  to  this reli-
gious act: for I  have already alluded to the
removal of the inhabitants and other causes,
as contributory to  this  effect:  hut I am de-
cidedly of opinion, and  1 conceive  that opi-
nion to be defen i')le, that  we ought to im-
pute, in a very great degree, the exemption of
the City,  properly  so called, from disease, to
the immediate agency   of  Providence;  and
that  this merciful  interposition  would not
have been made, had it not been for the pray-
ers of our pious  fellow-citizens,  is an  hypo-
thesis  by no  means enthusiastic or supersti-
tions.   Certain it is, that after this period the
malady did not spread, except in a very li-
mited degree, although  the appearances were
threatening  in the  extreme.   The report of
one of the most respectable  physicians of the
Point, made  prior  to this period,  contains a
sentiment of  this  kind.—"Hitherto," said he,
"the disease has been creeping, but it is now
beginning to jump,  for  I find it has traversed
two squares since last night."
  The uncomfortable situation in which many
of our citizens were placed, during their ab-
sence from their  homes, is  one great reason
they were so anxious to return.   Many did 
$8        OBSERVATIONS ON THE

return before  it was  justifiable to do so, and
suffered the ravages of the .llsease, and some
fell victims to Death.  The Board of Health
repeatedly enforced the propriety of  delaying
their return until the fact should justify them
in giving a g'-nenl invitation.   The*e senti-
ments  of  the Board were  repeatedly pub-
lished in the  newspapers of the City, and the
people were earnestly entreated uot  to return
un ila special invitation should be aim unced
officially  from   the   Health  Office,  which
they  promised  should be given  iu  pr-<per
time.   But it is not very surprising, seeing
their uncomfortable situation, living  as some
did  in old  barns, stables, and other wretch-
ed hovel-, that they did return, although dan-
gerous in the  extreme.
   On  the  thiricth day of October, this  in-
vitation was  given,  and   the inhabitants  in-
formed  officially,  that they  might   safely
return, aud thus terminated the career of the
Epidemic.
   Very few cases  occurred  after this period,
and  iu  fact,  the  Point   became  peculiarly
healthy, and  ha- been  so from that time to
the present.   The inhabitants generally re-
turned, aud in a  few days that  part of Balti-
more, which had been the seat  of the epide-
mic, became the theatre  of all  the ordinary
pursiits of life.   Those  streets  which  had
seldom been traversed, except  by the physi-
cians, tlie attendants of the sick, and the slow,
lonely hearse, were crowded with the busy 
EPIDEMIC OF  1819.           19
products of commerce, and frequented by the
votaries of Fashion.   The features  of fear
and dismay wrere exchanged for the smiles of
beauty, and  useful  contentment  supplanted
all alarm.
5
« 
 
SECTION III.
    On the Provision made for the Poor.

    The visitation of our city in the manner
described, by this direful calamity, devolved
new and  extraordinary duties on  the  Board
of Health, and required funds in proportion,
which were at once afforded on application to
the Council.
   The first  and most  important duty which
became requisite,  was to provide for those
who were unable to remove from the infected
District, by reason of their poverty, and who,
if suffered to remain, from their uncomforta-
ble situation and  exposed condition,  would
certainly  become  diseased.    A  Board  of
Commissioners  was  accordingly enlisted, at
first  composed  of six, but afterwards two
more  were added, who were to make every
necessary arrangement, so that all  the poor
might be removed  from the diseased District.
They  were to receive  no compensation, save   x
that which  a conscious  testimony of  their
benevolent intentions would afford  them:  no
recompense,  except  that which  always  ac-
companies the  performance  of virtuous  ac-
tions. 
32         OBSERVATIONS ON THE
   They waited upon  Owen Dorsey, J5sq. a
 gentleman of high respectability, and solicited
 the use of a rope-walk owned by him, for the
 purpose of admitting  the distressed families
 from Fell's Poiut, and affording them  a de-
 fence from the  fate which hovered over  them.
 He at  once consented,  and prepared his  rope-
 walk for  their  reception, nobly  refusing any
 pecuniary recompense.   And now the poorer
 citizens of that part of Fell's Point, affected
 with disease,  were  invited  to come and be
 supported at the expense  of the  Corporation,
 if this  should  be required;  but the warm-
 hearted benevolence of our citizens forbade
 it.  This receptacle was soon  filled, and a
 temporary embarrassment would  have occur-
red, but  for the kindness of Mr. Christopher
 Chapman, the  proprietor of a rope-walk one
 thousand  feet  in length, adjacent to the for-
mer one,  w ho  generously gave it up to  their
 use  without  fee  or reward.  It  was  after-
 wards  found necessary  to  pitch  above one-
 hundred tents and markees, beside the  rope-
 walks,  by which  means  all were accommo-
 dated,  who were  deemed worthy of charity.
 Above  one thousand  persons were  now re-
 ceived, and comfortable apartments appropri-
ated to each family; these were to be supplied
with provisions and  every  other necessary,
for an indefinite period. The Corporation had
previouslv appropriated one thousand dollars
out of  the  funds, towards accomplishing this
object,  but it was afterwards returned, the sup- 
EPIDEMIC OF  1819.          58
 plies from individuals and from other sources
 being amply sufficient to defray every expense.
   No  sooner  was  the  encampment  pre-
 pared,  than subscriptions were opened  for
 its support, and  I  need not  add, were met
 with  energy by the citizens.  Notwithstand-
 ing the pressure of  the times, the stagnation
 of business, the recent failures of our first
 commercial houses, and of one of our banks,
 the total loss  of our autumnal trade, and all
 the threatening calamities which  seemed  to
 hover over  us; yet such was the zeal of our
 citizens, that all these accumulated vVoes were
 forgotten, in the important duties which they
 were  now  called upon  to perform.  But why
 should I consume time,  by attempting to prove
 the generosity of Baltimore?  Has it not always
 been  her characteristic,  to relieve misery and
 distress, wherever it existed within her know-
 ledge?   And who does  not  feel  an honest
 pride in belonging to such a  people?  The
 warm emotions  of my mind are too powerful
 to be  suppressed.  I  glory in being a Balti-
 morean; and 1 sometimes  think I feel similar
 sensations  to those felt  by individuals in for-
 mer times, who  used  to declare, with an air
 of consequence,  "I am  a Roman  Citizen;"
 whose honest pride  induced  them to prize
 their alliance to  a City so  universally feared,
 more  than any  other earthly  consideration.
If, then, a Roman Citizen were proud of that
citizenship,  because of  the power possessed
and abused  by Rome, shall we not be proud
             5* 
54)         OBSERVATIONS ON THE

of our title to  citizenship, when that pride
arises from her being the most generous  and
humane  City in the Union, or perhaps in the
world?   Let  it not be thought  censorious to
assert, that Philadelphia and New-York, with
twice the population, do not possess half the
liberality of Baltimore, since the fact will not
admit  of successful  contradiction.   In proof
of this assertion, let  any  honest man read  the
records  of the  fever  of  1798,  in the city of
Philadelphia, and  he will discover,  that no
sooner did the news arrive in Baltimore,  that
provision was made  for the suffering poor in
that city, during said calamity, than a town-
meeting  was  immediately called.   And  fop
what purpose?  "jVas it to hold a consultation
to determine how we might prevent any "per-
son  or things" from entering our port, w hich
might  have been in the city of Philadelphia,.
and  how  we  might retard the charitable ef-
forts of  our "sister city" for humane  pur-
poses?   No;  on the contrary, it w as for  the
purpose  of raising a sum of money to aid them
in their  attempts  to imitate  our liberality.*
Several  hundreds  of  dollars  were  at  once
collected and  forwaided, and although  their

  *  The liberality of Baltimore has always been pro-
verbial; and although our < ity is not exempt from those
evils with  which  all cities abound, yet this does  not
detract from the  truth of the general observation.
Our citizens may have been wicked, but they are brave
anil  hospitable, liberal  and benevoleut, generous  and
humane. 
            EPIDEMIC OF 1819.  -        55

wants were  not  such as to require our assis-
tance, yet this did not lessen the merit of the
action on our part, nor the debt of gratitude on
theirs.
  But how have they reciprocated?  By pur-
suing exactly  an  opposite  course.   Their
"wise men of the East," were convened, and
passed  a law of strict non-intercourse, to be
binding thirty days, and afterwards extended
fifteen days in addition, under a heavy penal-
ty,  extending to "all persons or things which
may  have been in  the  City  of Baltimore."
But more of this w hen speaking of Quarantine
Regulations in general.
  The  encampment being  established, it was
officially announced,  that  at  certain  ware-
houses  in different parts of the city, donations
would  be  received  for its maintenance, in
goods of any kind, suited for the use of the
poor, either articles of food or raiment.   And
at the office of the Treasurer of  the Commis-
sioners, the public were informed, that  dona-
tions iu cash would be gratefully received for
the  same  purpose.   These several places of
deposit having been selected, the citizens be-
gan to  vie  with each other in the  extent of
their beneficence.   Flour, Bread, Beef, Pork,
Bacon, Fish, Potatoes,  &c. were all  sent in
abundance  to each of the warehouses appoint-
ed  for  the purpose, and  daily  reports were
made to the public of the articles  received,
together with the  names of the donors, when
these were anuexed  to  the donation.   It has 
56        OBSERVATIONS ON THE
been supposed, upon a moderate computation,
that eight  thousand dollars would not have
purchased the articles which were contributed;
and  the  Treasurer of the Commissioners re-
ceived above four  thousand dollars in cash,
amounting in all to upwards of twelve thou-
sand dollars, in addition to the appropriation
of three  thousand  dollars by  the City Coun-
cil, and  the  one thousand advanced  by the
Mayor, which  last was returned,  as  has al-
ready been remarked.
   But to our citizens alone the honour of this
unexampled  scene  of diffusive charity, does
uot solely belong;  for  the farmers iu  the ad-
jacent country, generally  forwarded  straw,
cabbages, apples,  cider, meal, flour, and ve-
getables  of all kinds, besides  many contribu-
tions in cash.   And the conduct of the inha-
bitants of  Tawney Town and Union Town,
Frederick County,  Maryland, ought never to
be forgotten:  these, with the  benevolence of
Georgetown, I). C. in contributing  seven hun-
dred  dollars towards  the  fulfilment  of  this
grand  object, greatly increased  the ambition
of our own citizens, and by the combined ef-
forts of our neighbours, and our own  inhabi-
tants,  the  Encampment was  supplied with
every necessary for its support, and rendered
a peculiar blessing to those who were  the un-
fortunate subjects of its generosity: for with-
out it, several hundreds would have been add-
ed to our  list  of  mortality:  the  number of
wretched widows  and orphans  would have 
EPIDEMIC  OF 1819.
57
been much augmented; and  the  distresses of
the eusuing winter greatly aggravated.  In-
deed, uone can  calculate  the  extent  of the
malady, had  not  the removal  of the  inhabi-
tants been the means used, by which it was
said to the raging calamity, "thus far shalt
thou come, but no farther.**
  The benevolent efforts of the  Commission-
ers were considerably promoted  by the esta-
blishment of a  soup-house  at  the  Encamp-
ment, which was performed by the energetic
activity of Richardson Stewart, James Mo-
sher, and Edward J. Coale, Esqrs. aided by-
some of our  most influential  citizens.  Up-
wards of  one hundred gallons of rich whole-
some soup, were  daily made at this establish-
ment,  and   distributed  to  each  family  in
quantities proportionate to the  number com-
posing said family.  This soup-house was of
large size, and  if built on ordinary princi-
ples,  would  probably have cost  three or four
hundred dollars, but  I  was informed by o:>e
of the gentlemen engaged  in  the Establish-
ment, that ten dollars cjovered  the whole ex-
pense, all else  being obtained  by voluntary
contribution,  both the materials  and  the  la-
bour.
  Such was  the manner  in which  the En-
campment was supported, and on the twenty-
fifth day of October,  it  was broken up, and
the inhabitants returned to their homes, each
being previously furnished  with three  days'
provision.  It was established  on  the third 
58         •BSERVATIONS ON THE

day of September, and continued  in all fifty-
three  days, during which  time above three
hundred families were regularly supplied with
provision, and every other necessary to defend
them from  the calamity.
  The humane interference of Georgetown
has already been noticed; but in order to ex-
hibit it in  its fairest light, the following cor-
respondence will not be thought uninteresting.

            CORRESPONDENCE.
    Mayor's Office, Georgetown, Oct. 8,1819.
To Edward Johnson,  Esq. Mayor of Balti-
                  more.
     Sir,—1 have the  honour herewith to in-
close you a copy of the proceedings of a meet-
ing, held in this town on the  third  instant,
and take great pleasure, in  pursuance of the
tenor of the fourth  resolution of said pro-
ceedings, to transmit to you the sum of seven
hundred  dollars—and, in  the name  of  the
citizens of Georgetown, to solicit  that it may
be accepted as a  small token of their sympa-
thy for that portion of your population, which
has been overtaken by  a calamitous visitation,
and that  it be  applied in meliorating the con-
dition of the sufferers,  under such  regulations
as  may have  been entered  into,  by the  au-
thorities of Baltimore, for their  relief.
  I  avail  myself of this occasion, to assure
you of my individual solicitude for the afflicted 
EPIDEMIC OF  1819.           09
of your city;  and sincerely hope and pray, the
period of their distress is near its close.
     Very respectfully, Sir,
        -I am your obedient servant,
                    HENRY FOXALL,
                     Mayor of Georgetown.

  Here followed the resolutions and proceed-
ings.

           City of Baltimore, Oct. 9,  1819.
Henry Foxall, Esq. Mayor of Georgetown.
     Sik,—With feelings that more easily oc-
cur  to the generous mind, than any language
of mine can describe, I have the honor to ac-
knowledge the receipt of your letter of yes-
terday,-enclosing a  copy of the  proceedings
of the warm-hearted  citizens of Georgetown,
with the result of their efforts to  relieve the
distress occasioned  by the  prevalence  of a
malignant disease  in a  district of this  city,
and  have handed over to the Treasurer of the
Commissioners  appointed for this work, the
seven hundred dollars enclosed.   In the name
of an afflicted people, who know  how to esti-
mate this act, permit me, through you,  to
thank the people of Georgetown for their dis-
tinguished liberality, and  to  offer  up  my
wannest wishes to Him,  "who walketh in the
pestilence," that he will  take them into his
especial  keeping, and protect them from all
evil. 
 60         OBSERVATIONS ON THE

   And for yourself, Sir, be pleased to accept
 our thanks for the very affectionate and feeling
 manner, in which this noble charity has  been
 transmitted by you.
        Very respectfully,
             1 remain, Sir,
                 Your obedient servant,
                     ED W.JOHNSON,
                        Mayor of Baltimore.

   This  noble  charity was also suitably ac
 knowiedged by  the  Commissioners  in  their
 official capacity, and the sum appropriated ac-
 cording to the intention of the donors.
   The health of the inhabitants of the  En-
 campment, was  truly  remarkable;  for during
 the  whole  time  of their coutinuance in the
 rope walks, only six persons  died there; five
 others  who  contracted  the  disease  at  the
 Point, but became affected  after their removal
 to the  Encampment, were carried to the Hos-
 pital,  and died  there,  making  iu all  only
 eleven Deaths in the whole number who were
 collected  from  the  Diseased  District.   The
 Whooping  Cough  which was • prevalent and
 unusually fatal in tlie City and surrounding
 country,  made its appearance among the child-
 ren in  the  rope-walks, and, as 1 am inform-
 ed, above fifty cases existed there at once; and
yet no death occurred from this very trouble-
some, and sometimes very fatal disease. This
is very remarkable, since  at  this very junc- 
EPIDEMIC OF  1819.
61
ture, one or more children daily fell victims
to Whooping Cough in the City.
   The Board were  not unmindful  of the
condition  of  the  Poor, who  were already
diseased;   they  provided  that  those  who
were so situated as  to  be deprived of pro-
per care aud attention, should be removed to
the Hospital, where they would be well taken
care of at the expense of the City; they em-
ployed one of the Physicians  of  the Point,
to attend  to the poor in general,  and pro-
vided  at the house of Captain  Murphy, arti-
cles of nutriment, such  as flour,  rice, sago,
wine, brandy, sugar, tea,  and sundry other
useful medicaments,  for the use of conva-
lescents; these were  subject to the order of
any practising physician, to be delivered to
the poor in suitable proportions; from  which
arrangement great benefit resulted.  Prior to
this period,  many who  were  safely  carried
through the disease, by the humane attention
of the several Physicians, afterwards died for
want  of proper  nutriment  and suitable  ma-
nagement.   By  this  measure, therefore, no
doubt many were saved from dissolution.
6 
-(I

,'t->  -
 1. v  ■ 
             SECTION IV,


              On Contagion.

     Sue 11 is the proneness to error, evinced
by all  the performances  of'man, that it may
well be supposed to be inseparable from his
character.  No sooner does he embark on-the
sea of life, than he meets with rolling waves
and  tempestuous billows, which convince him
that  his  calculations  of  peace  and calmness
on his voyage, have been marked  with glar-
ing errors and formidable absurdities.  If he
launch  his bark  iu scientific researches, ex-
pecting applause aud  veneration from those
who  behold  him,  calculating  on  immortal
honours  from bis fellow men; surges of per-
secution, storms of  ridicule, and hurricanes of
malicious envy, soon  destroy all  his  hopes,
anil  he is wrecked on thoste quicksands of er-
ror, which are inherent in his nature.
  In no Science  has this sentiment been more
evidently exhibited, than in  that of Medical
Theory.  At one  period, a doctrine is an-
nounced by  a  man of superior talents, and
adopted with universal consent;  but no sooner
has  it appeared, than another of  equal  rank
comes forward with the  ploughshare of criti- 
64         OBSERVATIONS ON THE
cism, drives it through the  masses of error,
which he, with eagle eyes, sees at a glance;
he  soon  overturns  the  visionary delusions of
his predecessor, and his doctrine becomes the
phantom  of the age.   Scarcely is  this hero
inscribed on  the scroll of  Fame,  before  a
writer appears, fulminating  against absurdi-
ties and  false  doctrines, which he beholds in
all who have preceded him, denouncing  them
all  as mistaken enthusiasts,  or  ignorant pre-
tenders.   He  also establishes another theory,
in which he  sees  excellencies innumerable,
and which he  fondly hopes  will endow hira
with immortal  honour;  this  soon falls before
another  champion of  criticism, and his also
shares a similar fate.  Thus, in  rapid suc-
cession,  theory succeeds to  theory, hypothe-
sis to hypothesis, until the world is filled with
idle speculations, which only tend to  delude
the minds which they design to instruct, and
contribute to the  obscurity of those subjects)
which they are intended to explain.
  Every  age supposes itself to be the emporinm
of scientific truth, and  every succeeding age
looks on  the former  one as having arrived at
the very climax of superstition  and  folly.
We wonder at the silly throng, wiio listened
to the  absurdities of former years, with ad-
miration  and delight; wTe view with pity and
indignation  the  enthusiastic  votaries of Sci-
ence, who swallowed  the crude and  undi-
gested doctrine  of the Humoral  Pathology,
and it is  more than  probable that future ages 
            EPIDEMIC OF 1819-          65

may laugh  at  our superstitious  follies, and
view  us in the same light, as we now view
the alchemists, or those who  searched after
the philosopher's stone. Nay, the very truth*
and propositions which  wre uow view as self-
evident and incontrovertible, may after a short
lapse of years, be deemed the products of a
distempered imagination, and a deluded brain;
and the authors of our most distinguished
theories, be consigned to the pages of infamy
and disgrace, if  they are  suffered to escape
the gloom of oblivion.
  But  although  hypothetical  speculation is
thus deceitful in  its result, yet the doctrine of
contagion is certainly  at present on a  much
more permanent basis,  than it has  ever been
heretofore, since it has  never beeu rendered
in any  degree intelligible, until  the present.
Solar and Lunar influence; the agency  of co-
mets; the vapors evolved from the bowels of
the earth,  by the concussion of earthquakes;
and the  doctrine  of aniraalculse; have  each
been severally resorted  to,  as  explanations of
contagion.   Some have attributed all conta-
gious diseases  to visitations  from Heavenr
while others open the abyss of Hell, and call
for Infernal agency to  account for their phe-
nomena.  While our doctrine, at present re-
ceived, seeks not for foreign aid,  but from ra-
tional and correct premises, deduces undenia-
ble conclusions.  My remarks, however, be-
ing intended  to  apply to  the Yellow Fever
alone, I shall not consider the doctrine of con- 
66         OBSERVATIONS ON THE

tagion in its more extensive application, but
shall restrict my reflections  to the subject in
hand.
  It is certain that the Yellow Fever only ex-
ists in those Districts of country where Bilious
Intermittent  and Remittent Fevers  prevail,
nor was it ever known to exist further than
50° N. Latitude, although  opportunities for
the transmission of contagion are  equal  in
every place, and the possibility of the impor-
tation of contagions virus every where simi-
lar.   From these facts I deduce the inference
that the same  cause which  produces Bilious
Intermittent and Remittent Fevers, also pro-
duces the Yellow Fever; and that the one is as
contagious as the other.   But the advocates of
contagion will repeat what has been often said,
that a disease mayT be strictlyr*contagious and
yet originate from marsh effluvia, and although
it does originate from this cause still however
its becoming epidemic proves that it is conta-
gious.  This is in effect to say, that two dis-
tinct causes produce the same  definite effect,
which is by no means  admissible.   If marsh
effluvia will excite  yellow fever,  to-day, the
same cause will re-excite it to-morrow, and
thus it w ill extend, without receiving assistance
•from any other agent.   Moreover to ad mit this
kind of causation, would be to depart from
that rulo  which  enjoins " not to admit more
causes than are true, and absolutely necessa-
ry for the  solution of any phenomenon."
  Dr. Davidge, the learned Professor of Ana- 
EPIDEMIC OF 1819.
67
 tomy in the University of Maryland appears
 to be the first gentleman in America who pub-
 licly defended the non-contagious nature of
 Yellow Fever, which he did in 1798; although
 some  other professional  gentlemen profess to
 have adopted similar opinions about the same
 time.   But as these opinions were not made
 public, being known only to  their possessors,
 they are not at all to be taken into the account.
 Dr.  Davidge  therefore,  may be justly consi-
 dered  the author of the  opinion that the dis-
 ease is not contagious.
    The great  source of  error  in  the  public
 mind,  has  arisen from a want of the proper
 distinction being preserved between the terms
 infection and  contagion, which distinction be-
 ing maintained will overturn many of the ob-
 stacles to a union of sentiment between the
 members of the profession, and the public at
 large.   This  union of sentiment  is what all
 our arguments are intended to effect, but what
 they have hitherto failed to accomplish.  Their
 failure in my  opinion however, arises from ob-
 vious sources.  The publications  which have
 appeared  for  the ostensible purpose of con-
 vincing  the public of the non-contagious na-
 ture of the disease,  have been  written in a
 style of mystery, and clothed  in such a profes-
r sional garb, that they are only intelligible to
 minds  accustomed to technical phraseology.
 In truth, the common  people have been invi-
 ted to participate in the delights  afforded by
 speculative ingenuity, when those  delights 
 68         OBSERVATIONS ON THE

 were kept beyond  their reach, by the dogma-
 tism of  their authors, or  their fondness for
 pompous  bombast.  An essay written on a
 professional subject, may be rendered equally
 intelligible to the citizen as to the philosopher,
 by  being  arrayed in a garb consistent with
 the  acquirements and habits of each.  To de-
 scribe the constituent properties of a ray of the
 sun, by  speaking of its  analysis produced by
 the  aid  of a prism to au ordinary citizen, in
 professional terms, would be illy calculated
 to please or profit;  while  to tell him that by
 the  aid  of a triangular glass a single solar
 beam may be so  divided as to exhibit the va-
 riegated colours  of the rainbow, would be in-
 telligible  at least,  if it did not  amuse  or
 instruct.
   This  apparent  digression is  intended to
 show, that if the arguments which have been
 used, and the labours  that  have been perform-
 ed, for the purpose  of convincing the profes-
 sional world that the disease is  not a conta-
 gious one, had been  employed to satisfy the
 common people of  the impossibility of a dis-
 eased body communicating Yellow Fever to a
 healthy one; long  since it would  have been
 considered presumptuous to hold an opposite
 opiuion.   But  the  great mass of  the people
 are without those reasons furnished  by philo-
 sophy, and which would at once settle the dis-
putation  on  this point; and they are without
them because the writers ou  the subject have
in general clothed their ideas and arguments 
            EPIDEMIC OF 1819.           69

in so  technical a style, that to them they are
dark  and incomprehensible.  I shall endea-
vour  to  satisfy  every impartial  and candid
man,  that  the disease is  not contagious, by
arguments  and  facts, which  however  little
merit they may intrinsically possess, will still
have the advantage of being written in a plain
and compreheusible language.
  I shall be as brief, as is consistent with per-
spicuity.
  1.  No disease which is contagious, can ori-
ginate from any other cause beside  contagion;
the Yellow fever has originated in the centre
of cities thicjdy populated, and but one single
case  has occurred, of course could not have
been caused  by contagion; therefore the Yel-
low Fever cannot be contagious.
   2.  All diseases arising from the same cause
partake of the same  specific nature, differing
only   in  grade;  the Remittent  fever,  the
Fever and Ague, Dysentery, Cholera Morbus,
and Summer complaint  of children, all  arise
from the same cause as Yellow Fever;  there-
fore the one  is as contagious as the other.
   3.  If the  disease were contagious,  there
would be no  instances of its  occurring in  the
country, remote from those associations which
tend  to favor  contagious maladies; yet  the
 Yellow Fever has been known to occur  spon-
 taneously in  isolated districts of country, and
 no person contract the disease, although con-
 stant intercourse had been preserved with  the
 sick by the  rest of  the family;  therelore  the
Yellow Fever is not contagious. 
70         OBSERVATIONS ON THE
  4. Diseases which are strictly contagious in
their character, are always propagated by the
secretions from the skin, and other parts of
the diseased body, being applied to  a healthy
body under circumstances favorable to its ab-
sorption; but  the secretions of patients in the
Yellow Fever, have been used by way of ex-
periment under the most favorable circumstan-
ces for the  propagation of the disease.   The
blood taken from patients dying w ith the Fe-
ver, has been inserted by  inoculation under
the skin of a healthy body; the sweat has  been
used in like manner with  entire exemption
from the disease.  The secretions- of the sto-
mach have been used in a similar manner, and
so  certain was one member of our profession
that the disease could not be communicated,
and so anxious was he to convince the public
of the fact, that being blessed with a stomach
of firmer texture than his fellows, he boldly
swallowed  a  considerable  quantity of the
black vomit from a dying patient, aud permit-
ted it to remain until  conveyed away by the
natural process.   Thus he  placed  the  most
putrid discharge from a patient in this disease
in the most suitable  place to  favor its absorp-
tion, with total impunity.
  5. The fact, that when a district is affected
with  the  cause of  the disease,  and persons
seized with the fever are conveyed out of the
spot locally  infected to a healthy  situation, in
no individual case was the malady contracted
from such persons, ought forever to  establish 
            EPIDEMIC OF 1819.          71

its non-contagious nature.  In the recent ca-
lamity on Fell's Point this truth was  most
completely elucidated.   It  was as easy to se-
parate the healthy from the diseased portion
of the Point, as it would be to stretch a line
across a  room, so circumscribed  was the ex-
tent of the noxious poison.  Aud although a
continual  intercourse  was kept open between
the City and Point, and diseased persons con-
stantly carried up to the centre of the  City and
dying there, yet iu no instance was the disease
thus  communicated.  And  a  fact still  more
remarkable  is,  that in the Hospital  where
there was an accumulation of the  worst cases,
yet in no  instance was a Physician, nurse, at-
tendant or visitor diseased.  This however is
a familiar fact to professional men.  It is a
fact  which  has induced many of our citizens
to renounce iheir preconceived  opinions on
this subject.   For in the height of the preva-
lence of the malady, the Hospital was visited
by our civil authorities, and  several gentle-
men who had previously been contagionists.
When it  was known that  the mayor of our
city  had  been in the  room of the Hospital,
where the patients in the fever were  confined,
many  accused him with  presumption,  and
predicted that he  would soon fall a victim.
He however was not to be impeded from the
performance of his duty  by such phantoms;
he frequently repeated his visits, and now is
more than ever confirmed in his opinion of its
non-contagious nature; and many others were
convinced by similar occurrences. 
 
SECTION V.
  Continuation of the subject of Contagion.

     The  doctrine of contagion is fraught
with consequences so deleterious  to that har-
mony and tranquility which is essential to our
happiness, in our mutual  relations  to each
other as members of the community;  that it
ought not for a moment to be indulged or coun-
tenanced, unless where the most indubitable
evidences are afforded that the nature  of the
malady  is strictly  and unequivocally  conta-
gious.
  As has  already  been remarked, it  is im-
portant that the  distinction between the terms
infection and contagion be acknowledged and
maintained.  Although lexicographers  gene-
rally  consider these words  as  synonymous,
yet each  has  a definition appropriated to it at
this  day  by  universal  consent.  Many dis-
eases are infectious which are not contagious,
and  the  Yellow Fever is one  of those dis-
eases.  I would define these words  as fol-
lows, viz.
  Infection.  When  by being exposed to a
noxious  atmosphere,  or the effluvia  arising
from  putrefaction, whereby the " pabulum of
                     7 
74         OBSERVATIONS ON THE
 life," the air, is rendered impure, or so min-
 gled with gases, that the system  does not re-
 ceive the necessary nutriment from its inhala-
 tion, disease  is produced; we say the disease
 is excited by infection.  These diseases may
 be contracted any number of times  by the
 same individual.
   Contagion.  This term implies  a  specific
 quality of a malady by which it may be com-
 municated from  a sick to a healthy body, by
 the  latter inhaling the breath of the former, or
 by  actual contact, and  by its rendering the
 subject of it forever after unsusceptible of the
 disease *
   From  these  definitions it will appear that
 the  mass of mankind use these words without
 reference  to the appropriate meaning of each,
 considering them both  as conveying a similar
 idea,  for this is  the general  understanding
 among the common people.   It is also a mor-
 tifying reflection that  some of  those  whose
 professional rank  and  literary  attainments
 render them conspicuous, do not acknowledge
 this  distinction, plausible as  it may appear;
 or if they do acknow ledge it, exhibit by their
 modes of expression when on the subject of
 Yellow Fever, that they  disbelieve  what they
 acknowledge.  And while  this  continues to

  * I allude to contagious fevers, for there are some lo-
cal disease^ which are contagious, which may be taken
moje  than once; this however docs not detract from the
truth  of the  above assertion in a general way. 
EPIDEMIC OF 1819.          79
be the case, we need not expect the errors we
deprecate to be removed.   When members of
our own profession, instead  of propagating
truth, contribute to the distribution of super-
stitious  error, we  are not to  expect but  that
those errors  will  reflect  light  and  borrow
strength  from those professional meu.  Aud
were professional  men unanimously to agree
in the suppression of this fiction of the ima-
gination, and unite  their efforts to  dissipate
the fogs of contagion from the eyes of the pub-
lic, we might probably have some prospect of
success in our efforts thus united.  But while
medical men  of high standing, whose age and
experience ought  to have taught them better
things, continue to uphold the doctrine of con-
tagion, because they learned it when young,
from men who were elevated in the profes-
sion, and from whom nothing  but pure  light
and truth ought to have emanated,  it will al-
ways find advocates enough  from  the vulgar
and thus he  perpetuated.  Great names sel-
dom fail to commit great errors.  And when
a doctrine, however absurd,  proceeds from a
source highly respectable, there are hundreds,
whose  vision is  so eclipsed by the lustre of
great names, that they  receive it at once as
evangelical truth.   Hence it is, that great men
are dangerous to literature,  and their great-
ness is frequently ruinous to their own intel-
lectual faculties.  When  men become  well
acquainted with  any branch of Science, and
their superiority  becomes notorious, they be- 
 76         OBSERVATIONS ON THE

 come too conscious of that superiority; and in-
 stead of persevering in the pursuit of Science,
 they become engrossed in the contemplation
 of their own intrinsic excellence.  Their ab-
 errations  from  orthodox  sentiments is not
 then to be wondered at, since  they depend
 upon  their own merits for success, and not
 upon  the  excellence  of their performance.
 Their names, not their  ideas, render  them
 popular.   That  deference for authority, that
 respect for great names  which is inherent in
 man, and  which renders him susceptible of
 the grossest errors, and exposes him to the ad-
 mission of folly, and absurdity, is justly to be
 reprehended.   It has  caused the  wheels of
 Science  to be retarded in their  progress to
 literary truth.  Many  a bright   luminary in
 the scientific world, for fear of the persecution
consequent upon  an opposition   to received
 opinions,  has withheld the most important
 facts and doctrines, and they have beeu totally
 lost.  Men have such  unlimited partiality to
 the doctrines  which they  first imbibed, to the
 theories  which  they first adopted, that they
 will never renounce them  until  driven by
 compulsory efforts from their delusive infatu-
 ation.  Thus  error and absurdity will adhere
 to our nature; folly will  disenthrone reason;
 and ignorance will revel on the altar where wis-
 dom should hold unrivalled sway; until we
shall shake oft* the shackles wiiich enchain our
noble powers, and destroy those cords which
bind us fast to received  opinions.   Never will 
EPIDEMIC OF 1819.          77
truth prevail in  scientific  pursuits, uutil rea-
son shall assume her sovereignty, aud  pros-
trate titles  and names into eternal oblivion.
Then  shall  the  sons of  science increase  in
number and exertion,  uutil truth  jfttd light
shall be universally diffused.
  The .contagious nature of Yellow Fever is
one of the superstitions of darker ages, which
still is wont to adhere to modern philosophy.
It is a doctrine  sauctioned universally  until
within a  few years,  by the wise and learned
of the profession in every  country, aud admit-
ted as irrefragable  truth.  To  our country
was reserved the  honor of first attempting  its
overthrow.   But this  attempt  was not made
until we  had partook of the deleterious effects
which its  admission  has produced in  every
clime.   Our establishment of Lazarettoes and
quarantine  laws evidenced that the Sun  of
Science  was  still obscured  by fogs of error
and inconsistency, and that  its genial rays
had not yet dissipated those mists  which co-
vered  the  habitable  globe.  The  Genius of
Philosophy wept at the contemplation of such
gross absurdity, and refused to enter the  Tem-
ple dedicated to  her, while darkness veiled
her altar in obscurity,   Such was the perver-
sion of her  sacred abode, that  even the ora-
cles which  were appealed to for truth,  only
emitted light sufficient to make "darkness vis-
ible.''  But  this only lasted for a time; the
rays of Science soon scattered those clouds  by
commissioning her sons to protest against such
                    7* 
78          OBSERVATIONS ON THE
 sacrilegious errors.  Their efforts as yet have
 not been so successful as was desirable.  Still
 some  are found who in defiance of the light
 which now has spread abroad, refuse to yield
 their fjtforite hypotheses  to practical  troth.
 Having proclaimed their sentiments in favour
 of contagion they are not  willing to abandon
 those  sentiments  lest it should detract from
 that infallibility  which  they claim as a con-
 stituent  of their character.  And although the
 happiness and interests of their fellow-citizens
 call for  the surrender of their sentiments, and
 although  facts occurring  daily before their
 eyes prove the  folly of the doctrine,  and  the
 mischievous consequences  which result from
 its belief, still they cleave to  their  opinions at
 the expense of the interests of the whole com-
 munity;  and exclaim  "what 1 have  written,
 I have written."
   The  truth however has  not  been  without
 able and ingenious advocates, aud it must and
 will prevail  in  defiance of the efforts of con-
 tagiouists  or the  exertious  of empiricism.
 "Facts are stubborn things,*' and when these
 facts are so easy  of  access to an enlightened
 community, their decision must  be in accord-
 ance with these facts.
   I cannot dismiss this subject without glan-
 cing at  the remains  of this doctrine which
 were  evinced during the existence  of the late
 Epidemic in Baltimore, by the  civil authori-
ties ot  the city of Philadelphia, a city which
should last of all  inculcate  such absurdity, 
EPIDEMIC OF 1819*
79
since that city produced but a few years since
a luminary of Science, whose bright lustre of
character has  not been extinguished with the
lamp of his  life,  but which will shine with
splendour  and grandeur when  his persecu-
tors  shall sink beneath  the surges  of  a dark
oblivion.  Yes, the spirit of Rush looks down
with grief to see Science prostrated, and truth
sacrificed at the shrine of ignorance and su-
perstition.  His  name  and  merits are dis-
honoured by his successors, and even by those
who were his contemporaries; for he challen-
ged  the  opposition  of a congregated world,
by renouncing the  doctrine of contagion, so
soon as his reason  was convinced of its ab-
surdity,  and   by  defying the censure  of his
brethren iu the profession when literary truth
was  his object, while they yielded  to popular
prejudices  and  preconceived opinions,  and
thus perpetuated the existence of those opin-
ions.
  Their act   of non-intercourse  with Balti-
more in the year 1819, will be  an eternal blot
upon the pages of  their History,  and future
generations will laugh at their  idle fears and
groundless apprehensions, and place  Phila-
delphian Philosophers with all  their self-con-
sequence on  a level  with  those  whose peace
has  been  paralyzed  by  apprehensions  of
witches or ghosts, in the dark ages of former
superstition.
  Some  have  been disposed to  deny that such
ignorance can exist in that standard of Medi- 
80
OBSERVATIONS ON THE
 eal information, (as they  have been pleased
 to denominate  Philadelphia,)  and  attribute
 her ordinance of non-intercourse to motives of
 commercial policy.  This opinion  may not be
 altogether without  foundation,  yet  I am not
 inclined  to  receive it as orthodox,  but am
 willing to let them give us the motives which
 prompted them to action.   Their own declara-
 tions announce the prevalence of a  contagious
 disease in Baltimore,  proving that they con-
 ceive the Yellow Fever to belong  to this or-
 der.   Now  it is a gross and palpable false-
 hood that a contagious disease prevailed here,
 for the fact  of its  being confined  to one dis-
 trict of the city and other circumstances alrea-
 dy related,  prove its  non-contagious  nature
 beyond contradiction.   It is however, certain,
 that let either or both of the motives be ad-
 mitted, the conduct of Philadelphia is marked
 with  evidences  of ignorance, hypocrisy, and
 inconsistency; and  had  Rush ou quitting the
 combat let fall  his mantle  on one  who could
 inherit his integrity,  these strictures  would
 have  been anticipated by a champion of her
 own,  and  would  not  have  called forth the
 feelings  and  emotions  of an individual at a
 distance.   His anathemas  would  have been
 hurled at the principle which was the  origin of
 sucli proceedure; he would have  declaimed as
with a voice of thunder against such i,ross ab-
surdity regardless  of  the patronage  vi  the
w ise,  or the  applause of the great.   Truth
would govern,  philosophy  would  sustain, 
             EPIDEMIC OF 1819.          81

 and science  would  defend  him.  And  al-
 though the contempt of the vulgar might be
 hurled at him with violence, yet it should be
 remembered that the opinions of some men nei-
 ther benefit nor injure; neither honor nor dis-
 grace.
  The Corporation of Alexandria, from that
 propensity to imitation, natural to animals of
 every class, stimulated by the example of the
great city, passed a similar law, requiring all
 vessels  arriving from  Baltimore, to perform
 quarantine, to  the  great  annoyance of com-
 mercial  interest, and  to  the  great  inconve-
 nience of the success of those connected with
 such arrivals.
  A fact occurred, among many others, which
 I deem proper  to record.   During the exist-
 ence of the Fever  at the Point, a vessel was
 dispatched by one of our commercial houses,
 with a  cargo divided  into parcels,  destined
for  Alexandria,  Georgetown, and Washing-
 ton; this vessel  sailed up the Potomac  (di-
rectly  passing  Alexandria)  to Washington
 and Georgetown, discharged the parts of her
 cargo designed for each place; after laying at
 the  wharf some days,  she passed down to
 Alexandria, and was there  compelled to re-
 main twelve  days  to perform  quarantine, al-
 though no person was sick on  board, and the
part of  the cargo remaining  was  made  up
 of ordinary articles of  merchandize, and in a
 perfectly  sound condition.  No person  was
 diseased in either of the places to which she 
82          OBSERVATIONS, &C,
had previously touched,  and yet this tedious
quarantine was sanctioned and enforced.
   The  Governor  of Virginia proclaimed an
embargo, extending  throughout  the  state,
which was attended with like inconveniences.
And what is  truly laughable, the little bo-
rough of Wilmington,  Delaware,  followed
the  sapient  example, although it must have
been known to their  wise  men, that a mau
who would  send a vessel to their town  for
commercial  purposes, would be  worthy of a
lunatic  cell.  I deprecate  ridicule,  in  any
shape, yet  I  cannot  but indulge my risible
faculties, when  I contemplate  this  great
"city,"  striving  to emulate, her "sister  city"
Philadelphia,  by following her brilliant ex-
ample.   It produces an  association of ideas,
which is truly laughable.   It  can only be
equalled by the attempt  of the frog to swell
to the size of  the ox, and is viewed by every
man of  ordinary  intelligence, as equally ri-
diculous. 
SECTION VI.
        On  Quarantine Regulations.

     The prejudicial tendency which the sup-
posed contagion of Yellow Fever exerts upon
our commercial prosperity, has already  been
hinted at.   Idle  as  is the opinion, its advo-
cates are able  and ingenious in this  and in
other countries.  In  England,  where a case
of Yellow  Fever never occurred, the Faculty
boldly assert, and attempt to defend its  con-
tagious nature.  Men who never saw the dis-
ease, actuated  by idle and  imaginary fears,
are the loudest declaiiners in defence of the
position.   The British  Physicians, without
exception,  agree  that it  is highly contagious,
and  this belief has established the institution
which  we  now deprecate.  Quarantine  laws
have been  enacted, and  the eHdless train of
evils, consequent upon the existence of  laza-
rettoes, as  penalties, fines,  forfeitures,  fees,
and  ruinous delays, have been transmitted to
posterity with their being.  We have inherit-
ed, with the virtues of our "mother country,'
many of her follies and  errors, and it is only
by progressive gradation,  we  can ever re- 
 84         OBSERVATIONS ON THE

 move these hereditary evils.  This gradual
 work has been  commenced, and  is partially
 effected.  Our quarantines are so  meliorated
 by the  humane and  honest exertions of our
 civil authorities, that in this country we do
 not suffer half the inconveniences or  delays,
 required in other countries. But the practice,
 although  gradually declining, is   so  grossly
 absurd, and so inconsistent with truth, that it
 ought for ever to be discontinued.   This ob-
 servation, however, is not  intended to imply
 that  the access  to  a city  should be free and
 uninterrupted;  on  the contrary, I  would in-
 sist  on  the  propriety  and necessity of the
 erection of a barrier;  but let  that  barrier be
 consistent with justice  and truth,  and in ac-
 cordance with the fact.
   If a vessel arrive from a foreign port, where
 it is  known that at the time of her  departure,
 the  disease raged with  unimpeded violence,
 let this vessel be examined by the Health Offi-
 cer, the sick, if any,  removed, and if neces-
 sary, the vessel be cleansed, and then suffered
 to proceed to her destination.  This could all
 be done in forty-eight hours.  If, on the  con-
 trary, the vessel  should be found  to contain
 any vegetables in a  state of putrefaction,  or if
 persous  have  been diseased and dead  on the
 passage, after the vessel was out at  sea, then
 some detection should  take place; but the
 healthy individuals  on board ought  to be per-
mitted to proceed to their  place of destiny.
This kind of Quarantine would be  consistent 
EPIDEMIC OF 1819.          85
with the  fact, would prevent the importation
of any contagious disease, more effectually
than the one at present in vogue.
  But for the neighbouring cities and  states
to pass an act of non-intercourse extending to
Baltimore, because the Yellow Fever prevail-
ed  here, is  indecorous and unjustifiable, for
the reasons before specified.  It is a species
of  quarantine, which  must meet with  the
unanimous contempt of the world.
  But I protest against quarantine regulations
for another reason.   I conceive that the prac-
tice of detaiHiug vessels at  a lazaretto, twelve
to forty days in the  heat of summer, without
any cleansing or ventilation, is calculated to
effect, what it is intended to prevent.  If these
vessels,  thus  proscribed, contain coffee and
other substances  liable to undergo putrefac-
tion, they must receive injury at least by this
detention; and if  they are at all damaged,
the mischievous effects of  their  want of ven-
tilation,  must be an  iucrease of the damage.
The vessel is then permitted to proceed to the
centre of our cities, the hatches are removed,
and the  gas evolved from the hold, is so foetid
and poisonous, that whole cities have been
thus infected, by the noxious vapor generated
during the detention of the vessel; and if she
had been suffered to come up  to unload at
once, upon  her arrival,  no mischief would
have resulted, but much evil would have been
avoided.  This is no  imaginary delusion, or
idle fanaticism, not  the production  of  a dis-
              8 
 86         OBSERVATIONS ON THE

 tempered brain, but the effusions of sober rea-
 son, unbiassed by prejudice.  The plausibili-
 ty of the  statement must  be  evident  at the
 first glance, to  the most  superficial observer.
 And 1 think it highly probable, however no-
 vel the idea, that the regulations  under con-
 sideration,  have been productive of  the  very
 effects, which they were  intended to  prevent;
 that they have done injury, will not  be deni-
 ed, that they have  ever  been  useful,  is ex-
 ceedingly doubtful.  In  this state of things,
 therefore, ought not some change to be  effect-
 ed in the laws of Quarantines, so as to remove
 the objectionable  features  of  those  laws?
 Surely, if they were ever worthy of attention,
 they demand it now; the injured community
 call for the administration  of equity  and jus-
 tice, the  Genius of Liberty frowns with in-
 dignation on such  perversion of her rights,
 ami the fair daughters  of Columbia lament
 the inhumanity, which continues a loug  pro-
 tracted  separation  from their  dearest rela-
 tives.   Learning droops iu  despondency, and
 Philosophy weeps in silence, at such prostra-
 tion of her  corollaries.  Let America then
 first step forward  the champion of humanity,
 honour and  truth, and  by abolishing the ex-
 ceptionable  features of the quarantine law,
 prove that her  character has not been misre-
 presented by those, w ho declare her to be the
 sworn  enemy of ignorance,  error,  and  delu-
sion.
  Such arguments as have been giveu, the au- 
EPIDEMIC OF 1819.          87
thor  is well aware, will  meet with persecu-
tion and censure; but in  the investigation of
the subject, he considers it perfectly unim-
portant what will meet with popular applause.
Truth is his object,  and in its pursuit,  he
views with perfect indifference the censure or
applause of those,  who  condemu or approve
without examination.
  European authority has been too long  res-
pected  in  this country, as being the criterion
of truth.   We have  been too much incliued
to admit doctrines and opinions, because they
proceeded from certain authorities, whom  we
had  been  taught to respect; rather  than  be-
cause of  any intrinsic  merit or  excellence
contained  in them.  This has been the great
cause of the perpetuation of error among us,
We  have adopted in Politics as in  Science,
many of  the  absurdities of  Great Britain;
some we have discovered and removed, others
still  adhere to our government, notwithstand-
ing the exertions  made  to eradicate them.
We  have not  sufficiently maintained our in-
dependence, which is equally important as its
Declaration.  We look to them for precedents
in law and gospel, instead of endeavouring to
cultivate inquiry and investigation iu our  own
citizens; and I may add,  we hajre encouraged
artists, manufacturers, aud authors of foreign
kingdoms, while men of equal talents have
been  suffered  to remain  unnoticed  and  un-
known, because they  are of domestic growth.
Our own  writers of  merit arc neglected and 
88         OBSERVATIONS ON THE
forgotten, while British authors are read with
avidity,  and  French scribblers  sought af-
ter with ardour and  zeal.   Foreign writers
have not been idle spectators of this thirst for
foreign productions, and they have not forgot-
ten to sow the seeds of discord and confusion
among our political ranks, and have even at-
tacked  with unhallowed hands, the sacred
system  of Christianity itself.
   We should  be exceedingly sceptical in
matters of opinion, and  admit the sentiments
of  no writer,  whether  foreign or domestic,
without strict scrutiny and cautious examina-
tion; and on the other hand, we should con-
demn no  production,  until we search into its
merits, and  examine  its claims  to respect,
whether it  be of British, French, or Ameri-
can origin.   So far as the author proceeds on
firm ground, we may venture to follow  him
with safety, but when he steps on  tottering
and unstable earth, we should suffer him to
walk alone, and refuse him our confidence and
support.  Such only is  the respect I besto\v;
and such alone I solicit.
   In my strictures on Quarantine regulations,
I wish  to be distinctly  understood,  as being
decidedly favourable to their existence, with
certain  modifications.   While we are careful
to avoid the  extreme of extending free inter-
course  and  dangerous licentiousness,  let us
also guard  against unnecessary  barriers to
that intercourse.  We should steer  between
the Scylla of  licentiousness,  and  the  Cha- 
EPIDEMIC  OF 1819.          89
rybdis of despotism, retaining the beneficial
parts of  the law on this subject, while we re-
ject such as are useless and hurtful.
   That the present mode of quarantine in the
port of Baltimore, is a peculiar grievance, 1
am not prepared  to assert; for in  our city the
light of  science  has, by its  radiant beams,
illumined the dark abodes of legal supersti-
tion, and the result has been, that vessels are
only  detained a  few hours at the lazaretto,
unless there be evidently some noxious cause
on board, such as putrid hides, coffee, or other
substances  in  a state of decomposition.  But
in some  of the other cities of the Union, the
commercial interests are  seriously  injured;
for the law extends in many cases to thirty or
forty days.   Instance  the  act  of non-inter-
course, passed by  Philadelphia,  during the
late  visitation of Baltimore by  a distressing
calamity, and the proclamation of the gover-
nor of Virginia, the mayor  of Alexandria,
and the authorities of Wilmington, &c. during
the same period.   These are facts to which
frequent  reference  has  been made  in this
work, because they are facts which cannot  be
too severely  censured,  nor  too  energetically
deprecated.  They go to show the irremedia-
ble injury  to social enjoyment  and  familiar
intercourse, which  the  same principle would
effect if pursued and practised.  It is a cause,
therefore, in which no  tongue should be si-
lent, no pen  idle, nor  no individual uncon-
cerned.   The cause of  science, of  philoso-
                     8* 
90
OBSERVATIONS ON THE
 phy, of humanity, of truth, all are interest-
 ed in the extermination*of  this relic of igno-
 rance and  superstition.    I  call  upon  all
 governors and legislators, all teachers of phi-
 losophy, all votaries of Science, all  friends
 of truth, to unite  in the destruction of this
 bane of commercial  prosperity,  this common
 enemy of liberty and philosophy.
   Life  is  «nly to be valued, as it  is useful-
 ly employed; let  us, therefore, contribute  to
 the  advancement  of  the interests and  happi-
 ness of our country, by declaiming  against
 the  remains of folly, which adhere  to  our
 civil policy, and uniting  in the work of sac-
 rificing  prejudice  and  superstition,  at  the
 shrine of  philosophical truth.   Then shall
 we  have lived to purpose,  and when we die,
 the  world will be the better  of us, that  we
 have lived in  it;  a termination  which every
 honest man must ardently desire.  Then shall
 we  be at  least useful, if not honoured; and
 have our own conscious approbation, although
 we may  receive the censure of a  cruel world.
   These then are the considerations  which
 urge me  to the reflections I have thrown out
 on this  subject, aud although  they may be
 thought  censorious  at this period, yet  the
 time will  come,   when Quarantine Regula-
 tions will be meliorated  and modified, until
 scarcely a trace of their former lineaments will
 be  perceptible.   Yes, without professing to
be endowed  with a  prophetic spirit, I may
assert, that the time is at band, when  the 
EPIDEMIC OF 1819.
91
host of sequela consequent upon those regu-
lations, as lazarettos, fines, forfeitures, fees,
and  ruinous delays, will  be so totally  des-
troyed, that not a vestige will be left behind.
Liberty  will  supplant tyranny  and  oppres-
sion,  light shall disperse darkness,  Science
shall  dissipate  the  mists  of error,  and Phi-
losophy shall exterminate ignorance and su-
perstition for ever.   This country, yet in its
infancy, will be the criterion of philosophical
truth, and the theatre of  successful scientific
research.  Europe  shall lose the epithet of
being the  "mother  of Philosophy,"  Science
shall  flourish  under the wings of our Eagle
with  unsullied  splendor,  and  we  shall  yet
soar  above all French, above all British fame. 
 
         APPENDIX,

             COMPRISING

   AN ACCOUNT OF THE SYMPTOMS AND TREATMENT

               OF THE


 iLix^iE is ip a id ie am®;,

           AS rOCTTD SUCCESSFUL

    IN THE HANDS OF THE MOST DISTINGUISHED


 MEMBERS OF  THE PROFESSION,

               AXSO,

     SOME REMARKS ON THE TREATMENT

            PURSUED IN THE

        BALTIMORE HOSPITAL,

          DUBIITG ITS PREVALENCE,

AS CONTRASTED WIT'I THE MODE ADOPTED IN Till
              CITY. 
 
&!?I?ISM!M2&3
    That  the  Epidemic  under considera-
tion, is definitely the Yellow Fever, will not
be doubted, when I shall have described the
symptoms as  they  appeared in the generality
of cases.  Although some  persons  have as-
serted, that the only sure mark of distinction
between  Bilious Remittent Fever, and  the
Yellow Fever, is the fatal termination  of the
latter;  yet the most superficial observer must
protest against such sentiments, when he shall
have  been informed, that  cases  of Bilious
Fever frequently  prove fatal,  without  any
symptoms of Yellow Fever  whatever,  and,
vice versa, many cases  pronounced by these
same individuals  to be genuine  cases,  and
irrecoverable, were by the  providential inter- 
96              APPENDIX.
ference  of  other  physicians, and different
treatment, perfectly cured.   Certain it is, that
when men assume the prerogative of being the
sole individuals capable of deciding on the na-
ture of  diseases,  and bring themselves tho-
roughly  to believe this  enthusiastic delusion,
that they presumptuously assert, whatever they
imagine to be correct, because they conceive
their judgment, and their decision to be infal-
lible.  Hence, during the prevalence of the re-
cent Epidemic, men were found, who verily
believed that  they alone were capable of de-
signating the line of demarkation between
whai they were pleased to term, high  Bilious
Fever and  Yellow Fever,  and therefore as-
serted that not one fourth of the cases of Yel-
low Fever reported as such, were deserving
of that appellation, although they were report-
ing them by dozens.  Some had the temerity
to inform the Health Office and the  public,
that no  case of Yellow Fever existed in the
City at a period  when  8 to 10  Deaths were
daily reported as resulting from its  agency.
Some even  surpassed this  extreme, and de-
clared in offit ial communications that intempe-
rate men, and persons of  peculiar habits of
body were obnoxious to a disease  exactly re-
sembling Yellow  Vecer, in  all its  symptoms,
and hence argued the probability  of errors.
They however do not inform  us by  what
meaus they were  enabled to make the disco-
very, nor what difference can be delineated be-
tween two diseases which  are exactly  alike. 
APPENDIX.
97
Their powers of vision are so peculiarly sen-
sible, that they behold with precision and ac-
curacy,  what persons of  ordinary optics can-
not see even with artificial aid.  Hence they
come not under the consideration of those who
inhabit this inferior clod;  we shall therefore
resign these sentiments with  their authors to
the public, without further remark.
  To attempt an account of the symptoms and
treatment of this calamity is a task of no ordi-
nary magnitude, seeiug that it is a subject
upon which there are a variety of opinions, and
     "When Doctors differ,  who shall decide."
  Waiving these apparent obstacles, I shall
proceed to the description of the symptoms, as
they generally  appeared, noticing  however
those peculiarities with which I am acquaint-
ed, which are of peculiar import.           .'

               i. Symptoms.

  The manner of attack varied in different in-
dividuals, although in general they were seiz-
ed with a chill, of more  or less violence, ac-
companied by  a pain in the head, back and
limbs.   1 am inclined to  believe that the chill
was a more universal symptom in this, than in
any similar Epidemic, from the written infor-
mation which has been given to the world, al-
though it was not always an  attendant.  This
state of things continuing for an hour or more,
the pulse being all this time slow, and retiring
              9 
98              APPENDIX.
  From pressure, it was usually followed by a
  generally diffused heat, as in other fevers, but
  the temperature was excessive; the eyes  now
  became red and fiery, the countenance fierce
  and tumid, the  skin  dry and parched, the
  pulse tense and quick, but not much increased
  in frequency,  (in the general not more  than
  eighty in  ♦be  minute,  during the first pa-
  roxysm,)  the secretion from the kidneys was
  usually thick, brown aud deposited sediment,
  if indeed any secretion took place, for in many
  cases there was a total suppression of all the
  secretions, from the first moment of disease.
  The tongue did not give  so distinct marks of
  disease as might be  expected, although the
  stomach and primse vise were sometimes very
  much interested.  An obstinate constipation of
  the bowels was the most uniform  symptom,
  a»d in some instances this could not be remov-
  ed by any means, and the patients fell victims
  in consequence.  In  this as  in other similar
  Epidemics, it was found  exceedingly difficult
  to produce any moisture on the surface, which
  could at all indicate, the termination of the pa-
  roxysm, the vessels of the skin appearing to
  be  constricted  so violently, that  no perspira-
  tion could be  excited.  The  pain in the sto-
  mach was in  some cases excessive from the
  first, but in general it  was not  much complain-
  ed of, until the third day; and the same ob-
 servation  will apply to the pain in the back.
 If the remedies which had been applied, had
'not been successful in producing alvine evacu- 
APPENDIX.
99
ations, the pain in the back was the most un-
pleasant symptom.   If, however,  the bowels
were  rendered soluble, the pain in the back
was at ouce alleviated or removed.  The sto-
mach  was not  so much affected in this as in
former Epidemics;  with this  solitary  excep-
tion, it exactly resembled the fever of 1793—
98, &c. as described by Rush  and  others, and
was characterized by symptoms equally ma-
lignant.  The symptoms as described  having
appeared on the first day, were usually melio-
rated on the second day, but the third day all
the symptoms returned with redoubled vio-
lence,  and  many died on  this day who had
been pronounced convalescent on the day pre-
ceding.  In most cases the black vomit made
its appearance  on  the  third day, and many
died with this  evacuation  with only fifty or
sixty  hours illness.   But although it has been
thougU by some that  when  this evacuation
took place, recovery was impossible, yet I am
happy to have it in ray power to say, from the
information given me by several medical gen-
tlemen and from my own observation,  that not
more than oue  out of five died who had the
black  vomit.  This  should teach  us  the  im-
propriety of deserting a patient in any disease,
while  life  remains.  Indeed,  it is a doctrine
fraught with dangerous consequences, to pro-
nounce any  disease incurable, or any patient
irrecoverable,  because of any  peculiar symp-
tom or appearance, however malignant or se-
vere.   The black vomit in Yellow Fever is a 
100
APPENDIX.
symptom which  is peculiarly alarming, yet so
many instances have occurred of recovery, af-
ter it had appeared in its  most violent condi-
tion, that we should hence learn not to be too
hasty in our decision upon the mortality of the
disease,  even after this evacuation.  But to
proceed,  the alvine evacuations  were black
and foetid in every case, resembling tar in ap-
pearance  and consistence.  This  symptom,
however, attended all the ordinary bilious re-
mittent fevers of  the season, although they had
no symptom of  malignancy  whatever.  The
skin was  hot and dry, tongue black or brown,
breath  fcetid, and a peculiar frantic appear-
ance of the eye was generally attendant.  De-
lirium but seldom occurred until the third day,
and it usually was the forerunner of death. In
a few instances,  however, the delirium came
on with the disease in the first paroxysm, and
these cases proved fatal from inflammation of
the brain.
  The apparent cessation of the symptoms on
the second day above alluded  to, was a cir-
cumstance which caused much mischief. Many
persons, when taken with the pain in the head,
back, limbs, &c.  declined applying for medical
aid at once; and on the second day,  finding
themselves somewhat better,  imputed the ap-
parent change to their domestic remedies, and
resolved  to continue them.  The  third day,
however, would unfold the mystery, the phy-
sician would be called, and in many instances,
only called to witness the departure of their 
APPENDIX.              101
 lives.  But in every instance, when the phy-
 sician was called early in the first paroxysm,
 and  no peculiar want of firmness of original
 stamina in the constitution, the chance of re-
 covery was great, insomuch that at a meeting
 of the physicians of the City and Point, held
 in the midst of the prevalence of the fever, it
 was  given as  an unanimous opinion, and pub-
 licly announced, that the Epidemic was per-
 fectly under the dominion of Medicine, if taken
 in its commencement.   It is therefore import-
 ant to inquire what was the successful mode of
 treatment, which I shall notice  as briefly as is
 consistent with perspicuity.

               2. Treatments

   On this head  of my subject,  it behoves me
 to speak  with modest diffidence, as it is  no
 easy  task to decide on a subject about which
 "doctors differ."  I have, however,  obtained
 from  a number of the most distinguished prac-
 titioners,  the mode of practice  used  by them
 with success. Two of these gentlemen attend*
 ed above  150 patients each;  of course, their
 opportunities of information were considerable.
 Their mode of treatment having been similar
 to that adopted by myself,  I shall not make
reference  to my  own, since  the limited num-
ber* of which  I had the management, and avy
obscure standing in the profession, would not

                * About fort v.
                    9* 
10£             APPENDIX.
warrant a comparison between my observation
and theirs.  I shall therefore state the amount
of the information communicated to me by their
polite attention.
  The  method of treatment, varied according
to the period at which the physician was call-
ed.  The  remedies which  were appropriate
and successful in the first paroxysm, if not ap-
plied during its continuance, would be hurtful,
or even fatal, at a later period of the disease.
  1. Bleeding. This was one of the most  im-
portant remedies in  almost every case,  al-
though  there are solitary exceptions, in which
it was  inadmissible,  arising  generally from
some peculiarity in  the  constitution,  rather
than from  any v ariation in  the disease.  To-
wards the middle and close of the progress of
the Epidemic,  the lancet was more indispen-
sable than in  the former part of its progress,
although in most cases from the first, it was an
important remedy.  If called during the first
paroxysm, it was the invariable practice to ab-
stract blood without regard to quantity; only
having  reference to the state of the arterial ac-
tion, and the effect produced while the blood
was flowing.  From  two  to four pounds  has
been the amount of  the first bleeding in the
generality of cases;  but  it has been customary
to repeat the evacuation  in a few hours, when-
ever relief was not obtained by the first bleed-
ing.  In many instances,  where  the patient,
on  first feeling the  approaching symptoms of
disease, called on the physician, while it was 
APPENDIX.
103
 only in a forming state  this remedy has been
 instantaneous in  its  effect.  From  a  state of
 suffering the most excruciating, the patient has
 been brought into a calm and tranquil condi-
 tion, the skin has become moist, and he has, in
 many cases, sunk into a placid sleep, imme-
 diately after a large  bleeding,  and from this
 period been perfectly convalescent.  When,
 however, the disease was established, this re-
 medy was not so successful, but required fre-
 quent repetition, and the co-operation of other
 means, hereafter to be enumerated.
   The modus operandi of Bleeding, admits of
 a variety of conjectures; but that which 1  con-
 ceive to be the most plausible is, that it acts by
 reducing the system from  a state of indirect
 debility (which is the first effect of the cause)
 to a state of direct debility, and retaining the
 system in this  debilitated  condition until the
 expulsion of the morbid agent can  be effect-
 ed by the other  collateral adjuvants which re-
 main to be detailed.  For, as long as the  sys-
 tem  is retained in this state of direct debility,
 so long it will not admit of a fever being ex-
cited, and no mischief can  result  from weak-
 ening our patient, since we need not fear  that
 he will die from  direct debility..  But although
 bleeding has been stated as a primary, yet it
 is not the only remedy, for the patient, although
 always  benefited, yet he is not altogether re-
lieved by this evacuation in every  case.  The
 skin continues  parched and  collapsed;  the
 tongue and primse viae exhibit threatening ap- 
104             APPENDIX.
pearances; the bowels are still obstinately con-
stipated; and in short, the whole system evi-
dences the presence of some morbid agent.—
It was therefore found necessary to combine
with these means, some others which  would
be  contributory to the same effect.   And  for
this purpose, almost every physician possess-
ed and used prescriptions of his own, differing
in most cases only in quantity and  degree of
activity.
   Calomel.   This, as  an internal  remedy,
was found of infinite importance in every case,
and indeed may be considered as indispensa-
ble, especially in  the more violent cases.   It
is the remedy which was principally relied on
after  vensesection, and in almost every case
successful, where it was given in proper doses,
and under suitable circumstances.  The doses
of Calomel  were generally  of extraordinary
extent, and indeed the reason this remedy has
sometimes fallen into disrespute,  is most pro-
bably, because  it  is  not  generally  given  in
quantities sufficiently  large,  I mean  in  the
treatment of disease in general. The evil ten-
dency which it has been supposed large doses
of Calomel would  excite, is altogether  imagi-
nary, as has been  proved  in the treatment  of
this Epidemic.   The dose adopted by most of
the practitioners, was ten  grains every  two or
four hours,  as the urgency of the symptoms
required, and this continued without intermis-
sion, until the patient was relieved, or ptyalism
was effected. And although many were cured 
APPENDIX.
105
before the gums were affected, yet in those in-
stances  which required the continued exhibi-
tion of the medicine until this effect was pro-
duced, the ptyalism  and the convalescence
were frequently, and I may say generally sim-
ultaneous; for few,  very few indeed, died af-
ter the salivation was  established.  These few
fell victims to hemowhage from  the gums,  a
termination which only proves that the prima-
ry remedy, bleeding,  had been neglected, for
when the lancet was used freely in the first in-
stance, and repeated according to circumstan-
ces, no case was afterwards  affected  with he-
morrhage.  And indeed, it may be laid down
as an incontrovertible position, that when a pa-
tient is  sufficiently bled in the commencement
of the disease, neither hemorrhage nor morti-
fication  ever did,  or ever can occur in its con-
clusion.  But when  we are deficient in the
operations of art, nature  sometimes sponta-
neously resorts to this mode of relieving her-
self, of what  we should have relieved her by
artificial means, thus attempting to compensate
for our mismanagement.
  A case in proof of these observations  occur-
red during our  Epidemic, which is too re-
markable to  be overlooked.  A  man named
Kensler, was attacked with the disease, and
his family, finding so many dying under me-
dical treatment, and not contrasting these with
the number cured, refused to call iu a physi-
cian at first.  But from the violence of the dis-
ease on the third day, his friends  sent for a 
106             APPENDIX.
practitioner, who, finding that the bleeding
point had passed by unimproved, very correct
ly concluded,  that the  mercurial  treatment
must be his chief resource. This was pursued
by the dose of Calomel above mentioned regu-
larly repeated, and in a short time, the Pty-
alism was produced.  But no sooner had the
salivation become free, than a hemorrhage of
great violence ensued, which occasioned very
great alarm, and threatened to terminate his
life; but by very active and energetic practice,
he was saved.  This case is related, not from
any intrinsic peculiarity  it possesses,  but as
proof in  favor of the declaration that hemorr-
hage is the consequence of neglect of the lan-
cet, and not of the violence of the Ptyalism.
This, therefore, can be no objection to the mer-
curial  practice, although it has been used as
such, since when bleeding is premised, no uu-
pleasant effect is the consequence  of  the ad-
ministration of the mercury.
   It has been contended  that the salivation is
not essential to the cure, and 1 shall not assert
that the  discharge of saliva is by any  means
important, abstractly;  but 1 hold it to be  the
only evidence that the medicine has produced
its  full effect on  the system, and therefore I
should not be satisfied  without this evidence,
when  the salvation of my patient is suspended
on  a diaVs point, as in violent  cases of this
Epidemic.
  In the use of  Calomel, some have  far  ex-
ceeded the dose  I have mentioned; instead of 
APPENDIX.
107
 10 grains they haw doubled the quantity, and
 given this extensive dose every two hours, for
 a day or more, without any unpleasant conse-
 quences, and with a beneficial result.   And I
 have known three physicians, who extended
 the  dose to a drachm,  as a desperate effort,
 and succeeded  in  curing their patients.  I
 would by no means,  however, insinuate that
 this precedent  should  be followed,  except
 when in the judgment of a skilful practitioner
 it might be considered safe; but I relate these
 facts to annul the idea, that large doses of mer-
 cury are dangerous in  their effects.   There
 are numbers who have survived attacks of this
 Epidemic, who are now iu a state of  uncon-
 taminated health, who in a few days took 300
 grains of Calomel, besides having externally
 applied the  strongest mercurial ointment  all
 over the surface  of their bodies.
   In the use of  Calomel, no definite limits
 ought to be fixed  to the quantity which may be
 necessary, for in this as in  the quantum of
 blood to be drawn, every practitioner must be
 guided by his own judgment,  the  peculiarity
 of the constitution and the violence of the dis-
 ease.  But let him remember always, that vio-
 lent, diseases require violent remedies;  and al-
 though  it would be  absurd to expend the
 "strength of a Sampson in the  destruction of
 a fly," yet when great morbid efforts are evolv-
 ed, he should meet  them with proportionate
energy and effect; an injunction, which how- 
 *08              APPENDIX.

 ever plausible  and self-evident,  is not suffi-
 ciently attended to in the treatment of disease.
   From what has been said,  it is plain that
 Bleeding and Calomel are the principal reme-
 dies  which have  been  successfully  adopted.
 But they are  not the only means used, but are
 aided by Emetics and Aperients, as Magnesia,
 Oleum Ricini, Sulphas Sodae, Enemas, &c. as
 well  as Blisters, which last remedies w ere in
 many cases of infinite  importance.  All these
 will be considered  in proper order.
   Emetics.   These were only useful in the
 incipient stage of the  disease.  A very com-
 mon prescription during the first few  hours of
 the disease, was the following:
       JR. Submur. Hydrarg. grs. 20.
            Tart. Antim.  grs. 3.
 dissolved in  warm water,  and taken all at
 once, followed by 10 grain doses of Calomel,
 repeated at intervals of four hours.   This may
 be said to have been the first prescription most
 generally in use,  after  copious vensesection.
 After the operation of the Emetic,  which took
 place generally  in a few minutes after its ad-
 ministration, it  was common to observe the
 skin to become moist, and a termination of the
 paroxysm usually  succeeded, provided  the
 Calomel was successful in rendering the bow-
els soluble.   A  period was put to the  disease,
in some mild cases,  by this course of proce-
dure, without  any farther remedy.   But even
when the paroxysm returned, it was much di-
minished in violence, and the disease rendered 
APPENDIX.            109
 manageable.  Indeed, an  Emetic sometimes
 established a crisis at once, when given in the
 incipient state of the disease, but it was  not
 found useful in any other stage.
   Cathartics.  As has already been hinted,
 the constipation of the bowels was the most
 uniform and the most troublesome symptom of
 the disease.  In  some few instances  it could
 not be removed by any means whatever, and
 the patients speedily fell  victims  in conse-
 quence.  "When the Calomel  failed to  operate,
 which it sometimes did, even when given iu
 large doses; it was customary to assist it by
 the frequent exhibition of Calcined Magnesia,
 Castor Oil, the Neutral Salts, and the admin-
 istration of Enemas, composed of some active
 aperient ingredients.  But these remedies were
 only used as accessory to the Calomel, not re-
 lying by any means on their efficacy in curing
 the disease.  In an eastern city,  an account of
 the treatment there pursued was published by
 a learned  professor, and this  account was  re-
 published in Baltimore during the prevalence
 of the Epidemic.   But I believe no one was
 found, possessing sufficient  temerity to depend
 upon the same remedies in  our calamity.  He
 recommended Magnesia, Neutral Salts,  &c.
 as primary remedies, and 1 am bold in the as-
 sertion, that if these remedies were successful
in that  city, their  Epidemic and  ours must
have been essentially,  and diametrically dif-
ferent; for had we attempted to rely upon such
inefficient practice here, our cases would have
                    10 
110
APPENDIX.
been universally  cured  by being delivered
from a world of trouble, and that in many in-
stances with only a few hours illness.—And
from the statements published in said  city,  it
would appear that this was the mode by which
every patient  was  cured, for there were but
few, very few cases of Yellow Fever there re-
ported, but were announced in a few days af-
terwards as interred.  But to return, in addi-
tion to these remedies already detailed,  ano-
ther class now to be noticed have been found
exceedingly useful.
  Blisters. After  sufficient  depletion  had
been effected,  by  the  prescriptions already
enumerated, if pain in the head, back,  or epi-
gastric region  continued, it was  found  neces-
sary to use blisters of considerable  extent.
These were applied to the  stomach, back of
the neck or extremities,  according to the ca-
price of the practitioner, although it was a mat-
ter  of perfect indifference as to the locality of
the application, so that the effect was produc-
ed.  They were also eminently useful in those
cases where the disease assumed a low ty-
phoid character, and stimulation was requisite,
an occurrence  by no means unfrequent.
  Diet.  With respect to Diet,  more caution
was requisite in this disease than perhaps  in
any other,  for it was necessary in most cases
to forbid any kind of food whatever, at  least
until the depletion  was pursued  to sufficient
extent; and indeed until the disease was to-
tally conquered, no kind of food could be ta- 
APPENDIX.
Ill
ken without danger.   Many who were advis-
ed of the danger of taking food,  even when
convalescent,  violated their  directions,  and
were  thrown into tedious and dangerous re-
lapses by this imprudent act, while others for-
feited their lives from the same cause.
  Drinks.  These were usually administered
cold, and in truth, all warm drinks were found
hurtful.  All kinds of spirituous liquors, wine,
beer,  and other stimulating drinks were for-
bidden, except in the  typhoid condition  into
which the disease sometimes sunk, and even
here they required great caution in their  use.
A single glass of wine was found to produce
delirium and death, when given improperly by
the advice of an empiric.   Molasses and wa-
ter  was the drink most in use, although every
physician prescribed drinks according  to his
own discretion.
  It remains now to draw a comparison be-
tween the treatment pursued in the  Baltimore
Hospital  during  the  same  period,  and  our
treatment in the City; as this has been  used
by  way of argument against the course of de-
pletion  pursued  successfully in the city,  and
has prejudiced the minds of some against the
latter mode of management.   It was found ne-
cessary in the Hospital to prescribe stimuli  of
the  most powerful  character.   Wine   and
Brandy were constantly in use,  and where
success  was obtained, it was, with few excep-
tions,  under this course of treatment.  This
fact to a superficial observer might be deemed 
US
APPENDIX.
 paradoxical, but upon careful examination, the
 reasons why their treatment was so different
from that laid down in this work, will become
 apparent.  The patients were seldom received
into the Institution until the third day;  many
not until the 5th, 7tb, and even 9th day of the
 disease;  of course they were in a very diffe-
rent condition from those to  whom immediate
attention was administered,  after their attack.
In  several instances  wherein the patient was
received at an early period,  the same practice
was pursued in  the  Hospital as in the  City,
and with the same result.
  Having briefly comprised in*this Appendix,
all that I deem important in the treatment of
the Epidemic, I will now only add, that there
is no credit of originality in the mode adopted
belonging to us.   This treatment was pursued
with equal  effect in Philadelphia  in former
Epidemics,  by a gentleman  of high standiug,
to whom some are of opinion the credit of ori-
ginality properly belongs.   He used his lan-
cet with equal decision, and  administered Ca-
lomel  with  equal effect.  But whether this
mode of treatment was first adopted and pur-
sued by him, is a question somewiiat dubious,
since  Dr. Potter,  the ingenious professor  of
the Theory and  Practice of medicine in  the
University of Maryland,  certainly has, in a
recent  publication,* given some reasons  to be-
lieve that he is the author of this plan of inan-
" Memoir on Contagion. 
APPENDIX.
113
agement,  and indeed that he also was one of
-the first individuals, who protested against the
contagion of  Yellow  Fever.   But  whether
Rush is really the sole author of this plan of
treatment or not, is unimportant, if decided. It
is certain, that from his superior opportunities,
he tested the success of the plan more effec-
tually than has been or could be done by any
other member of the profession.  And although
his name has  been the theme of slander  and
abuse,  from those very men who owe to him
every medical idea they possess, yet it shall
shine with unsullied lustre and  brilliancy on
the page of Time.  The scroll of Fame shall
transmit the name of RUSH to after ages in
imperishable  characters,  while his  revilers
shall be  entombed  in  the shades  of night.
Their names and writings shall cease to exist,
except on the dark book of oblivion, while the
name of Rush shall be proclaimed from gene-
ration to generation as another name for Sci-
ence itself.   He was the common  enemy of
error and of vice.  Regardless of the opinions
of a censorious world, he pursued an uudevi-
atiug course of moral rectitude, and  although
the shafts of envy, the teeth of malice, and the
jaws of hatred, were all conspired  for his de-
struction, yet like the American Eagle soaring
above the roaring Lion, and the crowing Cock,
he soars above their malicious conspiracy, and
sits upon the imperishable  monument of his
country's praise.   He  did honor to his  pro-
fession; to philosophy; to Science; to his coun- 
114
APPENDIX.
try; to humanity; and to God. His name shall
live in the recollection of the profession, while
stars their courses move; and when earth shall
expire amidst surrounding flames, he shall
rise triumphant above the fiery void, and reap
an eternal reward.
THE END. 
(D®S^I£M^0
General Remarks,...........'fj
                 SECTION I.
On the Causes of the Epidemic,......]7
                 SECTION II.
On the Progress of the Epidemic,......27
                SECTION III.
On the Provision made for the Poor,.....51
                SECTION IV.
On Contagion, ---......---63
                 SECTION V.
Continuation of  the subject of Contagion,  -  -  -  73
                SECTION VI.
On Quarantine Regulations,.......83
APPENDIX,............93 
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