v*'s -..■•■ .V^*v .-**-; *As ■■-v- UNITED STATES OF AMERICA WASHINGTON, D. C. OPO 16—87244-1 /2 (V. r- >* A - - - • ■ J "A- ' -1 *** , \Z .-■flirfi" Vl lr \ V . .A ^ 1 -ft- - • • t .-N-V A \ k » V i - * 1 v\v. • *e<. ; \"-«. * .- » ■•*■ \ % » - •• 4 f. \ BRIEF HISTORY / r-f £ OF THE INFLUENZA, Which prevailed in New-Tork in 1807. By SHADRACH R|CKETSON, Physician in Neiv-Toth I//*. ADVERTISEMENT. In writing a history of the Influenza, two' plans might haOnbewasrto give a circumstantial account of the disease, with the. a&JL* -r-vS authors. hntK ancient and mo- dem. Another was, to exhibit a summary of it, as it ap- peared in 1807. ,ii The former plan was first contemplated, and some progress made; but it was afterwards relinquished, and the latter adopted for the following reasons: first, it is a popular dis- ease and therefore a description of it may be acceptable to common, as well as to professional readers ; secondly, most medicalpublications are now extended to an enormous size and expense, by which means their diffusion and usefulness are greatly lessened among many, even ^^^ New-York, 4th Month 1808. THISdisease is ranked by Dr. Cullen in the Class of Py- rexia, Order of Profluvia, Genus of Catarrhus, and Species a contagione. ., . The word Influenza, signifying influence, is said to be of Spanish or Italian derivation, and to have been given to A V 2 'History jffthe Influenza in New-York. ^ \ • * -•• ■*- » v *.-. \ \ . X: .; . v this disease fr*"m a general opinion ehtertained b)P anclerik. ^ physicisrn^-and pM|o!j&phe"rs, that disoj-ow\were occasion- ed, and all tnings upon the earth were^flveThed, By the irtflu^'» cnce of the stars or heavenly bodies. ~* *? »•,**. • It was known from the time of Hippocrates to that of Sy- denham, by the name of Febris Catarrhalis Epidemica; but it was called by the latter author, Tussis Epidemica. Since his time, it has mostly been distinguished by the ap- pellation of Influenza. Though the present term is, comparatively speaking, modern, the disease is not so ; for, on recurring to the his- tory of medicine, we shall find it anciently and frequently described under one of the former names. It is mentioned as prevailing often in England, in the course of the last century, particularly in the years 1762, 1775, and 1782; and, in a light degree, in 1795 and 1797 ; and again very generally in 1803. By information lately received from Liverpool, I under- stand it was prevalent in that place last winter. This disease has also prevailed in North America many times prior to 1807: particularly in 1733, 1737, 1747, 1756 & 7, 1761, 1772, 1781, 1789 & 90. It likewise appeared, in a light degree, in the autumn of 1793, in Dutchess county, in this state, where I then prac- tised ; but, at no time, within my recollection, has it pre- vailed so generally and severely as in 1789 and 1807. Before describing the history and symptoms of the disease, it may not be improper to observe the state of the weather during the two last summer months in which it appeared. This cannot be done better than by recurring to the meteoro- logical tables of that time ; from which it will appear that a great deal of rain had fallen ; and that although the wea- ther had been hotter than that of the preceding summer, there have been two remarkable transitions to a cool state of the air, viz. in the evening of the 28th of the second summer month, and on the 22d of the last. Indeed, some judged that the former sudden change was the cause of the complaint; but a few instances were observed nearly two weeks before that time. It might, however, have aggrava- ted it; for it was remarked to increase in severity, and to spread rapidly soon afterwards, so that in 8, 10, or 12 days, it was at its height. It being usual in recording the histories of epidemic diseases, to mention such disorders as immediately pre- -•tde, accompany, or follow them, it may be proper to ob- History of the Influenza in New-Tork. 3 serve, that a violent species of opthalmia prevailed some- what generally before it. This affection of the eyes, though it was sudden and severe, and produced, in some instances, an immediate suffusion of the adnata, yielded mostly to the usual remedies. Some cases of this complaint continued after the appearance of the Influenza, but it did not se- cure the system against the latter, for some had both. I had one patient, whose affection of the eyes terminated in the Fistula Lachrymalis. Some instances of the Influenza occurred as early as the middle of the second summernaonth, but it did not become general till about the first of the next, when it increased so rapidly, that in a few days, it was judged nearly one half of the citizens were affected with it. It spared neither age nor sex, though more children es- caped than adults; and I think fewer women were violent- ly affected than men.* It was most severe with people whose situation or occupation exposed them to the inclemen- cies of the weather. These suffered most frequently from relapses. It continued to prevail till about the 20th of the last sum- mer month ; after which not many recent instances occurr- ed, but some remained long ill who had the disorder se- verely. I myself suffered a severe attack of it after the middle of the first fall month. Ic is estimated that three fourths of the inhabitants had, sooner or later, more or less of the disease ; but although it was so general, it rarely proved mortal, and did not, in every instance, require medical attendance, mostly yielding to regimen and simple domestic remedies. This observation respecting its mildness and mortality, is to be understood in a general sense ; for some cases occur- red that proved very obstinate and almost callous to medi- cine, and a few terminated unfavourably ; though many could not be said to die of the disease alone, most of those instances being sudden hemorrhages occasioned by the vi- * I have been directly informed, that, in the Friends' Boarding-School, in Dutchefs county, containing nearly ioo fcholars, the girls generally paffed through the diseafe, before the boys were affected with it, though all under the fame roof. And a letter from Burlington, New-Jerfey, mentions, that a family in that town, confuting of 13 or i4perfons, allefcaped the complaint, whilll in ma- ny families, every individual was attacked with it, and no other family ef- caped it. N To what caufe can thefe facts be owing ? 4 History of the Influenza in New-York. olence of coughing, or by accelerated pneumonic and other pulmonic complaints. All those cases are, I suppose, included.in the bills of mortality under the name of Influenza ; but these are ad- mitted to be often inaccurate. Perhaps no disease has ever been observed to affect sq many people in so short a time, as the Influenza, almost a whole citv, town, or neighbourhood becoming affected in a few days ; indeed much sooner than could be supposed to spread from contagion. Mercatus relates, that when it prevailed in Spain, in 1557, the greatest part of the people were seized in one day. Dr. Glass says, when it was rife in Exeter, in 1729, two thousand were attacked in one night. Notwithstanding the general opinion-long entertained, and handed down from one physician to another, of the contagious nature of this disorder, it is hoped there are now sufficient observations and incontestable facts to ques- tion, and even to disprove that idea: to adduce all which, would lead beyond the limits of this essay. I have received no authentic information of any neigh- bouring city, town, or part of the country, being affected with it before this city ; but about the same time, or soon afterwards, it extended rapidly in every direction. On revising my notes which I preserved of the Influen- za, in the autumn of 1789, In Dutchess county, I find it re- marked, " that the disease appeared first to the south- ward, and travelled gradually northward and eastward till it pervaded the continent." Dr. Rush, in his account of the disease in that year, re- marks, that he first observed it in Philadelphia, in some members of congress who arrived there from New-York. From which account, and from its appearing here the last time, it is evident, that this city has been twice the origin and centre of the disorder; but to what particular exciting or remote cause, whether to a certain state, modification, or change of the atmosphere, or to some other latent princi- ple we may impute it, is not yet clearly ascertained, and must be left to be determined by accurate observation and future experience. Various conjectures were formed respecting the succeed- ing health of the city ; some predicting, with much cer- tainty, that it was a precursor of the typhus icteroides, or yellow fever, which has so frequently and severely visited this place ; but experience has shown the fallacy of such an History of the Influenza in Nexu York. S opinion, for, in no season for several years past, has that disease been more rarely observed here ; others judging it, with more probability, to be a modification, or a substitute for it. Neither before the appearance of the Influenza, during its prevalence, nor after it, did I know of any epidemic or unusual disease in the city, except the opthalmia already mentioned, scarcely any other disorder of much import- ance or severity appearing in the time of it. The symptoms which characterized the disease, were not much different from those that attend a heavy cold. The severest cases were generally ushered in with an ague, chill, or sensation of cold ; a hoarseness, soreness, and, as some expressed it, a rawness of the throat, lungs, and stomach, accompanied with an urgent cough or hawking. This last symptom was so general and severe, that people were al- most constantly heard coughing or hawking in meetings and along the streets. Pains in the head, chest, back, or limbs, and frequently in all, with a lassitude, restlessness, and great prostration of strength, almost universally attended. The pain in the head was often severe, accompanied in a few in- stances, with a vertigo or slight delirium. In some cases, it centred much in the frontal sinuses ; in others, it affected the jaws, exciting great soreness in the part'.-, with tooth- ach ; and in a few, it pervaded the ears, occasioning tinnitus aurium and deafness. The pain in the breast resembled, in some instances, that ofPneumonia, particularly the Peripneumonia notha, or Inter- costal Rheumatism. Those in the back and limbs, were of- ten severe and similar to the pains accompanying the acces- sion of Typhus and some other fevers. When the Trachea and Larynx were much affected, the respiration and cough exhibited that peculiar croaking noise which takes place in the Cynanche Trachealis or Croup. Sometimes a diarrhoea, at others, a nausea, but more frequently a constipation of the bowels, with thirst, a furr- ed tongue, quick pulse, but not very full, high coloured urine, and more or less fever, accompanied the complaint. A deprivation of the smell, taste, and hearing, a sneez- ing and running at the nose, were likewise very general symptoms. No disease, perhaps, bears a greater likeness to it in the accession, than the Measles, which followed not long after, and are still prevalent in the city. Indeed, the similarity or connexion between the two dis- eases is so great, that some writers have remarked, that one 6 Description of the Influenza in New-7 ork. frequently or generally succeeds the other. This was the case in 1789 and 1790, in which years, both these disorders pre- vailed. I had one patient severely attacked with the disease, whose pulse rose and continued several days about double the number of the healthy standard ; but she recovered. The blood let in this epidemic did not generally appear much sizv, except in some cases attended with Pneumonic symptoms ; nor did the crassamentum often exhibit that cup-like shape which is so commonly observed in other dis- eases of the order of Phlegmasia?. The most robust patients very commonly swooned under the operation of venesection. Some who had the complaint severely, with violent coughs, discharged blood from the nose, lungs, or by stool. A few fatal instances occurred of the two last kinds. Uterine hemorrhages and abortions took place in some women, whose coughs were very urgent. Some, after having passed through the height of the dis- ease, being intemperate, or exposed to cold or wet, suffered relapses, which often proved more severe and lingering, than the original complaint. The greatest number of deaths were from this cause, or from consequences of the disor- der. The treatment of this disease was not conducted on the same plan by all physicians, some treating it merely with a dietetic rrgimen and simple domestic remedies, while others used blood-letting and copious evacuations. The middle plan was, I think, attended with the best ef- fects ; for, I generally observed, that bleeding and strongly depleting remedies greatly weakened the constitution, and rendered the convalescence slow and tedious. A large proportion of those affected were so slightly ill as to require little or no medicine, besides the treat- ment usual in cases of common colds ; but when a person was seized with a violent attack of the complaint, I advised to lie in bed, or to keep in a room of moderate temperature, and to promote a gentle perspiration, by bathing the feet and legs in warm water, and by drinking freely of warm infu- sions of sage, catnep, thoroughwort, or snakeroot. Wine-whey and mustard-whey were also used by some, and were very proper in debilitated constitutions, and for an- cient people. If these means were found insufficient to bring on a mo- Description of the Influenza in New-York. 7 derate sweat, it was further encouraged by the addition of spirits of Mindererus, or Dover's sweating powder. When the preceding remedies proved ineffectual in pro- moting a free perspiration, and the pain and other symptoms continued very distressing, the general warm bath, or the semicupium, was found very successful. Rubbing, or bathing the patient in warm vinegar, or en- veloping him in flannel blankets wrung out of it, as hot as could be borne, has succeeded in some cases, after all other means have failed. The utility and success of the last application are not con- fined to the Influenza, but may be extended to various other disorders in which a copious sweat cannot be procured by other means. In cases attended with much nausea, it was advisable to rinse the stomach with warm water, carduus, or chamo- mile tea; and when that symptom was distressing, it often became necessary to administer gentle emetics of ipecacuan- ha, antimonial wine, or white vitriol; which, when a sweat could not be procured in the early part of the disease, by any of the means already mentioned, being given in nauseating doses, often had a good effect in promoting that excretion. After the operation of an emetic, if the sickness continu- ed, the effervescing draught, or the saline anti-emetic mix- ture, was found useful both in removing the nausea, and in promoting a moisture on the surface of the body. The bowels being generally costive, early attention be- came necessary to open them with some purging medicine, particularly with those of the saline kind, such as Glauber's salt, soluble tartar, or crystals of tartar; some preferred jalap and calomel; others used castor oil; and with ma- ny, Lee's pills were a popular remedy; but I know of no cathartic better adapted generally in the complaint than ja- lap or rhubarb and vitriolated tartar, thoroughly rubbed together, particularly for those whose stomachs rejected the other kinds. Calomel was occasionally added to the last, when it did not prove sufficiently powerful. Those who had long ne- glected to take physic, and whose bowels were not readily moved, were much relieved by the seasonable use of purga- tive injections. The cough and soreness of the throat and breast, being early and urgent symptoms, required particular attention.— They were kept moderate, and were relieved by the liberal use of mucilaginous drinks, such as infusions of wheat bran, 3 Description of the Influenza in Ntw-York. pearl barley, quince seeds, marshmallows, red-elm bark, flax- seed, or liquorice, or of some of the demulcent gums, with thv. occasional interposition of oily medicines and opiates ; the last of which were found frequently and indispensably ne- cessary to appease the cough, and to procure sleep. Opium, however, was rarely observed to give that ease in the earl} part of the disease, before a perspiration took place, which it did afterwards. Soothing and instantaneous relief was obtained in some cases attended with incessant coughing, great soreness, and difficult respiration, by inhaling the vapours of the decoctions of mucilaginous or demulcent herbs ; or, when these were not accessible, those of warm water only, through some suitable apparatus. Mudge's Inhaler is well adapted for this purpose, and may be easily fitted and kept in every family ; or, when that cannot be obtained, a coffee-pot, or a common funnel, may be substituted, and used to considerable advantage. The receiving of the vapours of the infusions or decoc- tions of emollient vegetables, or even of simple warm water into the lungs by inhalation, is a sovereign remedy, too little. known, and too much neglected, not only in the Influenza, but in various other catarrhal, pulmonic, and anginose affec- tions. I omitted to mention blood-letting as an early remedy in this disease, judging it not generally necessary in the treat- ment of it; in which, I am sensible, I diilc-r from many prac- titioners. I have already remarked, that the pulse was rare- ly full or hard, that the blood was not, except in some parti- cular cases, much sizy—that a languor and prostration of strength universally accompanied—and that the most robust patients generally swooned under the operation : for which reasons, I rarely bled in any considerable quantity, except in plethoric strong constitutions, attended with a full hard pulse, and severe pain in the head or chest, threatening phrenitic or pneumonic affections, when I did not hesitate to practise and repeat it, if necessary, according to the nature and ur- gency of the symptoms, with the occasional use of blistering and other remedies usual in such cases. Topical bleeding, either by cupping, or by the application of leeches, to some part of the chest, I considered as more admissible and better adaptt d than free blood-letting from the arm. Blisters were useful, not only in relieving the pains in the chest, but in abatii g the soreness of the throat and the dis- tressing sickness and vomiting which attended some severe Description of the Influenza in New-York. 9 cases of the complaint, and which did not yield to other re- medies. Strong sinapisms applied to the feet, had a good effect in relieving the head, throat, and chest. These with stimula- ting and rubefacient liniments, with a portion of laudanum, were also useful applications to the chest, when blisters were omitted. After the crisis of the disease, and after the abatement of the catarrhal symptoms, the consequent fever in some cases, put on an intermittent or remittent form, when the bark, bit- ters, and other usual remedies in fevers of that kind, became indicated. The same treatment, with chalybeates and the vitriolic acid, was necessary, when the disorder was suc- ceeded by great debility, or profuse night sweats. A few instances were said to put on a typhoid character, or to degenerate into a fever of that type; when they were to be treated accordingly; but I did not meet with many of this kind. Before closing this account of the Influenza, it may not be improper to mention that soon after the disease became general in this city, I published a letter, containing a short description of it, with the nlode of treatment, designed and adapted principally for popular use ; and that, after the dis- order had nearly disappeared, I issued a circular letter ;* directed to the physicians throughout the United States, re- questing their attention and assistance in transmitting to me accounts of it in the several places where they resided, in or- der to write a circumstantial history of it. In consequence, and in compliance with which, I received various communi- cations from different parts of the Union. This information I intended to incorporate with my re- marks, or to add by way of supplement to them ; but, on reviewing those several communications, and on summing them together, I find very little important matter to record in addition to my own observations on the subject, or differ- ent from them. I shall, however, note a few particulars. Most of the accounts mention its appearance not until a considerable time after its prevalence in this city. It evi- dently first appeared here, and spread gradually and rapidly in every direction, its progress being clearly traced from one town and country to another. Letters from Pittstown in Rensselaer county, and from Whitehall, in Washington county, in this state, say, thnt u * This letter will be annexed to this History. R 10 Description of the Influenza in New-York. appeared in those places about the middle of the last sum- mer month. A person informed me he was attacked with it on Lake Champlain, on his passage from Canada to this city, in the fore part of the first Fall month. Another letter from Ovid, near the Seneca lake, states, that the disease was not frequent there till the latter part of the last Summer, and the beginning of the first Fall month ; and that the latter may be considered the month in which it pre- vailed in that part of the country; and that it was about two weeks earlier at the Seneca river, and gradually progressed between the lakes to the southward. By a letter from the Bay of Quinti, in Upper Canada, it appears not to have passed through that country till the two last Fall months. In most of the communications received, in answer to my Circular Letter, the symptoms of the disease are descri- bed as being more inflammatory, and denoting a greater phlogistic diathesis in the system, than were observed in this city. This may account for the more liberal use of the lancet, which appears to have been used in many places as a general remedy ; but it is no new thing that other diseases are attended with different symptoms at different seasons, and even in different places at the same season ; and that they consequently require different modes of treatment. During the prevalence of the disease in this city, I observ- ed no unusual sickness among domestic animals; but seve- ral of the accounts received, mention, that horses and dogs were disordered; one saying, that " many died:" another, that " a singular and unusual affection prevailed amon g horses during the month of August, and fore part of Sep- tember, viz. an extraordinary discharge of saliva (not the ordinary frothing from fresh grass but a constant and exces- sive flow of pure saliva from the mouth, without any morbid appearance of the parts of the mouth itself, or any other of the animal, except that the beast, in some instances appeared at times a little hollow ; but otherwise in ordinary health and spirits. A young mare of about five years old, having her head confined over a trough, discharged two quarts in about an hour and an half, yet she kept her flesh and worked well. This appearance, for it can scarcely be called a dis- ease, prevailed, and was remarked by many all over the country for many miles around, and lasted, like the Influ- enza, about 18 or 20 days." The same account says further, that the Influenza was then called the " Horse distemper, by which name, it has ! \ '•> ■'. • " v J)eeri;alm -v ■, ■« «JJ-, %""*V'-M-». ^ , . "tjfn.- • # * * \"- -CIRCULAR. " " ■• *l\ v T$^e P/ty^c/a-i^^/ic ^ The recording of epidemic diseases hayin*^|peen long- ob- .. . * » «\ Served>by ph^sMahs to b*e %s^fuMn cteV^t&ping^t'heir hfotWy^V . *... v v prevention, and cure, q inquest is hereby made of the physici- ans throilgWitthe-fcJhion, t©*colle,ct from actual observation, *,' •. and to transmit to me in New-York, an accounl of me * '•. v- " Influtjj'e.a^ which i%no-|r rapidly j^reaHing in different parts of the cbntinent. * *' .".•*. . % The particulars, on which information is more particular- ly ; ' ly requested, are the following: & % . «. # 1. The.time of the first appearance of the'cllseSse. * 2. The symptoms that characterized it. 4 .** *■ 3. The remedies that were found most successful in alle- * * yiating and curing it. 4. What proportion of the inhabitants we"t*eaffected with it: whether it proved mortal: and in what number of cases. ' \ 5. What diseases immediately preceded, accompanied, or followed it, 6. Whether any unusual sickness was observed to pre-» vail about the time among domestic animals, such as horses, » cattle, sheep, dogs, and cats. Though obtaining an accurate history of the Influenza, in different places, was the particular object of this address, yet information of,any other late epidemic, or uncommon . sickness, deserving notice or recoi/a in the annals of Medi- cine,^yttl also^be acoep^able. * m 9 ^^ It is desired, that "communications may be made M soon as convenient, post paid, or by pr^ate eonve^aafes^ if such , present. '**** SHADRACH RICKETSON. 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