m^- -■•'■ Rill rv. ■ Bfc^ r.vrf : p:!p;l>3:;1: -^S^SV •^■r,'" '':■':' ^ ARMY MEDICAL LIBRARY FOUNDED 1B36 WASHINGTON, D.C. _ Ur ^se. OBSERVATIONS UPON THS ORIGIN 07 THE MALIGNANT BILIOUS, OR YELLOW FEVER IN PHILADELPHIA AND UPON THE Means of Preventing it: ADDRESSED TO THJg CITIZENS OF PHILADELPHIA By Benjamin Rujh. PHILADELPHIA; PRINTED BT BUDD AND BARTRAM, FOR THOMAS DOBSON, AT THE STONE HOUSE, N° 41, SOUTH SECOND STREET. ■J 1 ■'..-'i-i/.r: OBSERVATIONS, JL XAVING laboured nearly fix years to no pur- *pofe, to perfuade the citizens of Philadelphia that the yellow fever is of domeftic origin, 1 had con- cluded to dellfl from all further attempts to produce conviction upon this fubjecl:; but a retrofpect of the fcenes of diftrefs which I have witnefTed from that terrible difeafe, and the dread of feeing them fpeedily renewed, with aggravated circumftances, have induced rae to make one more effort to pre? vent them, by pointing out their canfes, and re- medies. I anticipate from it, a renewal of the ca- lumnies to which my opinion of the origin of our annual calamity has expofed me j but thefe will be lefs difficult to bear, than the fuppreflion of truths which involve in their confequences the profperity of our city, and the lives of many thoufand people, whom poverty and defpair will finally compel to become ( 4 ) become the unwilling victims of the fever, fliould it again prevail in our city. Of the Remote Caufes of the Yellow Fever. This difeafe is the offspring of putrid vegetable and animal exhalations in all countries.—It prevails only in hot climates and feafons.—The fources of it in Philadelphia are chiefly the following— 1. The docks; thefe contain a large quantity of filthy matters in a highly concentrated ftate. They are firft acted upon, by the heat of the fun, and hence failors and the inhabitants of Water ftreet, are generally the firfl perfons who are affected by the yellow fever every year. It is derived fo fre- quently from the docks in New York, that it has obtained there, the name of the dock fever. 2. The foul air of fliips. 3. The common fewers. A yellow fever was produced by a large fewer in Calcutta. It was af- terwards prevented by clofing it up, and removing the filth of the city in another way. 4. The gutters* 5» Dirty ( 5 ) 5. Dirty cellars and yards.—Foul air is fometimes generated in cellars which produces fporadic cafes of fever in all feafons of the year. Swen Warner died of a yellow fever on the 30th of January 1799, received by breathing the air of a cellar which had been fhut up for feveral months. 6. Privies. An epidemic fever was once traced to this fource in the city of Frankfort in Germany. * 7. The putrefying maffes of matter which lie in the neighbourhood of the city, and 8. Impure pump-water. All the phyficians in our city agree in deriving the common bilious fever and dyfentery from thefe fources; now as thefe difeafes have, we arc told, by the College of Phyficians, " lately very much diminifhed,"* and as the putrid exhalations ftill continue, the prefumption is, that they pro- duce our higher grade of bilious, which is the yel- low fever. Of * Fadts, and Obfervations, p. 24. ( 6 ) Of the Caufe of the Yellow Fever not occurring more frequently before the Year 1793. It has often been afked, " Why did not the yellow fever prevail in Philadelphia before the year 1793, particularly in the year 1778, when it was left in a more filthy ftate by the Britifh army than it has been at any time fince ?" To this, I anfwer, that for the production of our peftilential difeafe, three things are neceflary, 1. Putrid exhalations, 2. An inflammatory conftitution of the atmofphere" and 3. An exciting caufe, fuch as great heat, cold, fatigue from riding, walking, fvvimming, gun- ning, or unufual labour, intemperance in eating, or drinking, ice creams, indigeftible aliment, or a violent emotion of the mind. The firft caufe acts but feebly without the concurrence of the fecond, producing mild difeafes only, fuch as common re- mitting and intermitting fevers. By the co-opera- tion of an inflammatory conftitution of the air, we obferve not only common bilious fevers, have be- come malignant, but all thofe difeafes which are occafioned by the fenfible qualities of the air, have affumed a more violent character. This has been remarked by moft of the phyficians of Philadel- phia for feveral years paft. The pleurify, rheu- matifm, gout, hives and feveral other difeafes, re- quire remedies of twice as much force to fubdue them. ( 7 ) thenXj as they did ten years ago. On what circum- fiances this change of the atmofphere depends is not known. But the fact is certain. It was taken notice of by Hippocrates two thoufand years ago, and is mentioned over and over in the writings of Dr. Sy- denham. The records of medicine prove, that it has continued from one year, to fifty-two years in different countries. Dr. Sims has given a long and interefting account of thefe inflammatory confti- tutions of the atmofphere from the year 1590 to 1782, in the firft volume of the Manchefter me- moirs, from which it appears that they were fome- times general over Europe, and at other times con- fined to particular countries. The peftilential con- ftitution of the air in the United States began in 1791. This I infer from the yellow fever making its appearance that year in New-York—It pre- vailed in Charlefton in 1792, and it has been epi- demic in one or more of the cities and country towns* of the United States every year fince. We * It has been averted, that this fever is confined exclu- fively to our fea ports. This is an error. It has prevailed fmce the year 1793 in many of the villages of New England, and of the fouthein ftates. On the Genefee river in the date of New York, it has become fo prevalent as to acquire the name of the Genefee fever. The bilious fevers which prevail- ed in all the above places before the year 1793, were of a ( 8 ) We obferve the effects of changes in the qualities of the atmofphere not only upon difeafes, but up- on animal and vegetable life. Infects of different kinds have lately appeared and multiplied in an un- ufual manner, and the fruits of the earth have ri- pened, and decayed in many inftances fooner than in common years. Thefe facts have been noticed by the farmers in every part of the United States. The uncommon mortality in the fummer and autum- nal months, among horfes, cattle and the cats, for feveral years paft, is an additional proof of a change in our atmofphere. It has arifen probably from the fame caufe which has increafed the mortality of our annual epidemic. As a further anfwer to the quef- tion under this head, it might be a/ked, why was not the. fever imported oftener before the year 1791? It is feldom abfent from the Weft-India. iflands. It raged in molt of them during the two wars previous to the prefent, and yet but one in- ftance occurred of it in the United States in thofe two mild nature, and feldom mortal. They have lately difap- peared, or are very much " diminifhed," and have been fucceeded by a fever which frequently terminates in death in five days with a yellow flcin and a black vomiting. Thefe fads have been communicated to me by letters, from phyfi- cians, and by other gentlemen, who have been eye witnefles of them. To doubt of their truth, would lead to a difbe- lief in human teftimony, upon all other fubjects. ( 9 ) two periods of feven years each, and that was in Philadelphia in the year 1762. The intercourfe between our cities and the iflands during that time was extenfive and conftant, particularly in the war between the years 1756 and 1763. Quarantine laws then exifted in but few of our cities, and where they did, they were feebly executed or eluded every day. It has been afked, Why does not the yellow fever prevail every year in cities, where the filth is always the fame in its quantity and quality. To this I anfwer, that filth may be in two ftates in which it will not pro- duce this difeafe, viz. a dry, and a liquid ftate. From exceflive heat or from heavy rains, it is of- ten in one of thofe conditions in our cities. When this is the cafe, they efcape a vifitation from this difeafe. It is only when filth is acted upon by a hot fun in a moist ftate that it produces fevers. The Neck below Philadelphia which has been fub- ject to the bilious fever, time immemorial, was uncommonly healthy in the autumn of 1793 ; ow- ing to the low grounds there being completely dried by the hot weather of that feafon. Fell's Point near Baltimore I have been informed efcaped the yellow fever in 1798 from a fimilar caufe. B I (hall ( «> ) I fhall illuftrate the origin of the yellow fever by a familiar fimile. The foul air of our city may be compared to gunpowder with which the bodies of our citizens are charged from the beginning of fummer. The atmofphere may be compared to fparks of fire. Heat, cold, fatigue, intemperance and the other exciting caufes which have been mentioned, may be compared to a hand, which combines thefe fparks, with the gunpowder ac- cumulated in our bodies. The concurrence of all thefe eaufes is neceflary to produce a yellow fever. Putrid exhalations act but feebly upon the body, unlefs they are aided by the inflammatory activity of the atmofphere. This atmofphere in like manner, acts but feebly upon the body with- out the concurrence of putrid exhalations. Both of them for the moft part, require the hand of an exciting caufe to produce the difeafe. An exciting caufe without them, is harmlefs, or induces only a tranfient indifpofition. If putrid exhalations produce the yellow fever, it has been afked, why are thofe neighbourhoods fome- times healthy that are constantly expofed to their offen- five fmell? This queftion may be anfwered by re- forting to the effects of habit upon the fyftem, which renders it infenfible after a while, of irritat- ing impreffions. The noxious matter which pro- duces ( » ) duces the yellow fever exifts independently of fmell, and is probably not formed till after that procefs of fermentation is ended, which evolves the factor from putrefying animal and vegetable fubftances. This fsetor, like the rattle of the fnake, feems to have been intended to give us no- tice of our danger, and to remove, or fly from the filth which emits it. It is poffible it may in fome cafes predominate fo much in its action upon the fyftem over that matter which produces the fever, as to defend the body from its morbid effects. It is thus, the constant ftimulus of fpirituous liquors has been found effectual in fome inftances in pre- ferving habitual drunkards from the yellow fever.' Is the Yellow Fever a Contagious Difeafe ? To anfwer this queftion, it will be neceflary t© remark, that contagion is of two kinds. i ft. It is fecreted as in the fmall pox and mealies, in which ftate it acts uniformly and without the aid of exciting caufes, upon perfons of all ages and conftitutions who have not been previoufly ex- pofed to it, and is not controuled by the obvious changes in the weather. 2dly. ( I* ) idly. It is derived from certain matters dif- charged from the body which afterwards by ftag- nation, or confinement, undergo fuch a change, as to partake of the fame nature as the putrid ex- halations which produce the fever. If the breath, perfpiration, and other excretions of a perfon in a yellow fever be confined in a fmall clofe room, they may produce a fimilar difeafe, efpecially when they act upon a body previoufly debilitated by grief, or fatigue. But they are generally inoffenfive, where the fick are accommodated in open well ventilated fituations. Out of upwards of one thoufand perfons who have carried this difeafe into the country from our cities, there are not more than three or four inftances to be met with, of its having been propagated by contagion. In the city hofpital of Philadelphia, there was no inftance of this difeafe being contagious in 1793, i797» and 1798. The fever of which Dr. Cooper died in the hofpital laft year, Dr. Phyfick aflures me was derived from the exhalations of Water-ftreet, which place he vifited a few days before he ficken- ed, in order to examine the ftate of the air in that unhealthy part of the city. The difeafe perifhed when carried from Fell's Point to Baltimore in 1794. The fame fate attended it, when it was carried from the places in New York and Bofton in ( '3 ) in which it was generated, to diftant parts of thofe cities. Clothes impregnated with- the effluvia of a perfon who had died of the yellow fever might produce a fimilar difeafe, but it would be only in confequence of thofe effluvia partaking of the nature of putrid matters derived from any other animal fource.* The fame thing may be faid of the efflu- via emitted from a putrefying dead body. In the firft fettlement of the Weft India iflands, pains were taken by feveral phyficians, to prove that the yellow fever was imported from Siam into the Weft Indies. I was educated in the belief of this opinion, but the teftimony of many learned, and eminent modern phyficians, has convinced me that it is a vulgar error, and that the difeafe is generated * In the year 1793 I fuppofed many cafes of the yellow fever to be derived from contagion, which I now believe were produced by noxious exhalations. I did not at that time know, the diftance to which thofe exhalations might be conveyed. From my ignorance of this faft, I was mifled by thofe authors who fuppofe the difeafe to fpread in the Weft Indies by contagion. Many late inquiries have con- vinced me, that this is not the cafe. There is a fmell of a peculiar kind emitted by perfons in a yellow fever which fometimes produces difagreeable fenfations in the attendants, but fimilar effects are produced from a hundred other fmells which do not occafion a fever. ( 14 ) generated there as it is here, by putrid exhalations. To the names of Drs. Huck, Hillary, Hunter, Hec- tor, M'Lean, and Clark, I fhall add thofe of Doc- tors Jackfon, Borland, Pinkard and Scott, phyfi- cians to the Britifh army in the Weft Indies, who lately vifited this city. They all denied the conta- gious nature of the yellow fever in the Weft In- dies.*—In thofe cafes where a fever appeared to fpread * The following extract from Dr. James Clark's hi/lory of the yellow fever in the ifland of Dominica, in the years 1793, 4, 5, 6, contains an epitome of the opinions of all the medical gentlemen whofe names are mentioned with his, up- on the origin and noncontagious quality of this difeafe. " According to Dr. Lining's account of this fever in Charlefton, South Carolina, communicated in the EfTays Phyfical and Literary, Vol. 2, it appears to have broken out there in the years 1732, 1739, 1745 and J748 "> he tllinks ic was always imported from the Weft Indies ; but gives no proof, nor even reafon, in fupport of this opinion, which doei not feem to be well founded. " At Fort Royal, in Martinique, where there is a great pre- valence of mephitic effluvia, arifing from the marfhy ground at the back of the town, it generally broke out in the fummer or autumnal feafon, on the arrival of troops from France, or of a number of feamen, who had never been in the Weft In- dies before; and the fame thing happened at Point a Petre, Jn Grand Terre, Gaudaloupe, almoft annually, and from the fame caufe ; but it was never looked upon as an inftSllout ( '5 ) fpread by contagion in vefTels at a diftance from the (hore, Dr. Scott informed me that there was al- ways difeafe ; nor did it ever fpread among the natives of the towns nor among thofe who were feafoned to the climate ; nor was it ever carried from thence to the other iflands. In this ifland few cafes have occurred for thefe laft twenty years ; and thefe have chiefly been at Prince Rupert's Head, where from the Jlagnated water in a large morafs near the town and fort, the marfh miafma prevails in a high degree. Since the fwampy places which were in the town Roufeau have been filled up, this fever has been feldom obferved; but previous to the year 1792, we had generally violent thunder ftorms—heavy rains—or fevere gales of wind, during the autumnal feafon. " M. Defportes, in his Hiftoire des Maladies de St. Domin- gue, during the fourteen years that he kept a journal of the difeafes at Cape Francois and Fort Dauphin, found that this fever broke out conftantly in thofe towns upon the arrival of new-comers from France, and among thefe, only fuch as had not been formerly in that climate. In and about thefe towns, during thefe fourteen years, viz. from the year 1732 till 1746, there were a great many inlets of the fea, where the water continued long in a Jlagnated Jlate, which in fo hot a place produced very ojftnfive exhalations ; to thefe he attributes this fever, and the bilious and other difeafes that prevailed at the fame time. " From a firm belief that this difeafe is by no means contagious in our ifland, the fick are not abandoned by their friends, nor neglccled by their attendants, which contributes much to the recovery ef many, who would otherwife have been ( i<5 ) ways reafon to believe it to be the common fhip fever which is every where admitted to be of con- tagious nature.—The fhip, goal, and hofpital fever mean one and the fame difeafe. It is produced by exhalations from living bodies in a crouded, filthy, or debilitated ftate. The fevers which have been imported into Philadelphia from Holland and Ire- land in paflenger fliips, were of this nature. It is fometimes confounded with the yellow fever by writers, but it is materially different from it. The power which heavy rains, and froft have of destroying our fever, clearly prove that it does not fpread by contagion. We have feen it check- ed three times, in three different years by frofty nights. The cold in thefe cafes cannot act upon the difeafe in our houfes, and of courfe it does not alter the quality of the matters difcharged from the bodies of the fick. It acts only upon the putrid exhalations which float in the atmofphere. The loft for want of care." In Dr. Jackfon's treatife upon the fevers of Jamaica, he fuppofes the bilious and yellow fever to be different difeafes. Since his late return from the Weft Indies, and this country, he has publifhed the refult of his obfervations upon the yellow fever, in which he retraces the opinion of its being a fpecific difeafe, and proves it to be a high grade of bilious fever. ( >7 ) The interefts of humanity are deeply concerned in the admiflion of the rare and feeble contagion of the yellow fever. Hundreds have perifhed by be- ing deferted by their friends in fituations in which the difeafe could not have been taken by contagion, and where there was no danger to the attendants from putrid exhalations, either from the fick, or the adjacent neighbourhood. Many people have perifhed likewife in places expofed to putrid exha- lations, who have believed themfelves to be fafe, becaufe they kept at a diftance from the fick. Can the Yellow Fever be Imported? I once thought it might, but the foregoing facts authorife me to aflert, that it cannot, fo as to become epidemic in any city or country. There are but two authorities on which the belief of this difeafe being imported, refts. Thefe arc Dr. Lining's and Dr. Lind's. The former fays it was imported into Charlefton in 1732, 1739, 1745 and 1748. The latter fays it was con- veyed into Philadelphia where it afterwards be- came epidemic, by means of the clothes of a young man who died in Barbadocs. No circum- ftances of fhips, or names are mentioned with thefe aflertions to entitle them to credit, and. from the facility with which vague reports of the foreign ori- gin of this difeafe have been admitted and propa- C gated ( i8 ^ gated by phyficians in other countries, there is rea- fon to believe the aflertions of thofe two phyfici- ans are altogether without foundation.—The Col- lege of Phyficians of Philadelphia after two weeks inveftigation, were unable to difcover any fhips, clothes, or fick perfon, that could have introduced the difeafe into Philadelphia in the year 1793. The Academy of Medicine have clearly proved, by many documents, that the difeafe was not imported in the years 1797 and 1798. The origin of a few cafes, reported by Dr. Griffitts and other members of the College of Phyficians, which have lately ap- peared in our city, has in vain been fought for from a prize floop of the Ganges. Two affidavits of Meflieurs Hill and Ingerfol, prove that file had been healthy in the Weft Indies, and that no per- fon had been fick on board of her during her voy- age, nor after her arrival in our port. Equally unfuccefsful have been the attempts to derive thofe cafes, from beds, and blankets infected by the fe- ver of laft year. In Bofton, Connecticut, New York, Baltimore, Norfolk and Charlefton, both phyficians and citizens have long ago rejected the opinion of the importation of the fever. Some phy- ficians fuppofe it poflible for the contagion of this fever to adhere to the timbers of fhips that have failed from Weft India ports, and that it may be propagated from them to a whole neighbourhood, although ( 19 ) although houfes, and even ftreets, interpofe be- tween them. This opinion is too abfurd to ftand in need of refutation. Indeed every thing that re- lates to the importation of this fever is contrary to reafon and facts.—It is an error, fubftituted in the room of a belief that all peftilential difeafes were derived from the planets.—The exiftence of a health-law founded upon this error, in the clofe of the eighteenth century, and in a city abounding with literary inftitutions, will appear incredible to pofterity. Thinking men alone will difcover its poflibility, in their knowledge of the nature of the human mind. It is poflible this law may in the courfe of many years be the means of preventing the difeafe being received, in a folitary inftance.— To enforce it under this circumftance, at the ex- penfe of our commerce, is to imitate the conduct of the man, who in attempting to kill a fly upon his child's forehead with a hammer, knocked out its brains. // has been faid, if we admit the yellow fever to be of domestic origin, it will ruin the credit and com- merce of our city. The reverfe of this opinion is true; for by admitting that it is generated among ourfelves, we fliall foon remove its caufes, where- as, by fuppofing that it may be imported, and act- ing accordingly, we fliall naturally be led to ne- glect ( 2° ) gleet the removal of the fources of putrid exhala- tion, and thus after driving our commerce to other ports, we fhall entail the difeafe upon future generations. Many of the cities of Europe, and of the Weft-Indies, that once generated pefti- lential difeafes, now enjoy an exemption from them by adopting meafures for removing their cauf- es. The hereditary cleanlinefs of the Hollanders was impofed upon them by the difeafes to which their country was formerly fubject from putrid ex- halations.—The town of Harrifburgh in Pennfylva- nia, loft more of its inhabitants in proportion to their number, than the city of Philadelphia by the yellow fever in 1793. The caufe of this great mortality was traced to a mill dam. It was foon afterwards removed, and the town has ever fince been healthy. It is of the utmoft confequence for the cities of the middle and northern ftates of America to adopt meafures of ftrict and univerfal cleanlinefs, inafmuch as the difeafe may be taken as often as our inhabitants are expofed to its fourc- es. In the Weft-Indies, the conftant action of the fun and of putrid exhalations upon the bodies of the natives and old fettlcrs, render them for the nioft part, infenfible to any morbid impreflions from them j hence the difeafe is never taken a fe- cond time except by perfons who have left the iflands, and after fpending two or three years in a cold C 21 ) a cold climate, have returned to them. New comers are the principal victims of the higheft grade of their bilious fever. The winters 'in North America, by deftroying the habit of infenfibility to heat, and putrid exhalation induced by the previ- ous fummers, place our citizens every year in the condition of new comers in the Weft-Indies, or of perfons who have fpent two or three years in a cold climate. This circumftance increafes the dan- ger of depopulation to our city from our annual epidemic, and ftiould produce correfponding exer- tions to prevent it. Of the Means of Preventing the Yellow Fever. i. Let the docks be immediately cleaned, and let the accumulation of filth in them, be prevent- ed in future, by conveying water into them by a paflage under the wharves, or by paving them with large flag ftones inclining in fuch a manner towards the channel of the river, as that the filth of the ftreets fhall defcend from them (after it falls into the docks) into the river. This method of paving docks has been ufed with fuccefs in the city of Breft. The ftreet now known by the name of Dock-ftreet once expofed a large furface of filth to the action of the fun. Its neighbourhood was more ( 22 ) more fickly at that time, than any other part of the city. By means of the prefent arch over that filth, Dock-ftreet has been exempted from an un- ufual number of fick people during the fummer and autumnal months. 2. Let every fhip that belongs to our port be compelled by law to carry a ventilator. Let all fuch fhips as are difcovered to contain foul air in their holds, be compelled to difcharge their cargoes before they reach our city, and let the fhips in port, be compelled to pump out their bilge water every day.* 3. Let * Many of the citizens of Philadelphia have deferted the College of Phyficians, by admitting the foul air of a fhip to be the caufe of a yellow fever. The College derive it wholly from a fpecific contagion formed by a peculiar pro- cefs in the body fimilar to that which takes place in the fmall pox. The foul air produced by putrefaction, whether generated in the hold of a fhip, or in docks, or common fewers and gutters, is of the fame nature, and acts in the fame manner in producing the yellow fever. A new hypothefis has lately been broached to prove the importation of this difeafe. It makes foul air a neceffary recipient for the contagion, before it can act upon the body. The fmall pox and meafles require no fuch recipients to ena- ble them to produce a fever. The foul air is fufHcicnt to induce all the effects that have been afcribed to it, without calling to its aid a mixture with a fuppofed fpecific conta- gion. ( 23 ) 3. Let the common fewers be wafhed frequent- ly with ftreams of water from our pumps. Per- haps an advantage would arife from opening them and removing fuch foul matters, as ftreams of wa- ter are unable to wafh away. 4. Let the gutters be wafhed every evening in warm weather. By frequently wafhing the ftreets and pavements the heat of the city would be lef- fened, and thereby one of the predifpofing caufes of the fever would in fome meafure be obviated. The ufe of water for the above purpofes, has be- come more neceflary fmce the ftreets and gutters have been fo clofely paved; for the filth which formerly foaked into the earth, is now confined, and emits its noxious vapors into the atmofphere. 5. The utmoft care fliould be taken to remove the filth from the yards and cellars of every houfe in the city. Hog-ftyes fliould be forbidden in yards, and the walls of cellars fhould be white- wafhed two or three times a year, and their floors fliould be conftantly covered with a thin layer of lime.* White wafhing the outfide of houfes in fickly ftreets, would probably be ufeful. Let * 1 attended two perfons in this city laft year in one houfe with the yellow fever, in the yard of which, and di- rectly under the window of the back room was a barrel fill- ( 24 ) 6. Let the privies be emptied frequently ; and let them be conftrudted in fuch a manner as to prevent their contents from oozing through the earth fo as to contaminate the water of the pumps. The fa- mous Ambrofe Parey afcribed one of the plagues of Paris wholly to foul air, and impure water. Mr. Latrobe in a note, in his propofal for his prefent important undertaking, has very properly pointed out the impurity of our water as one of the remote caufes of the yellow fever.—Happy will it be for the citizens of Philadelphia if by means of that gentleman's plan for fupplying the city with liver water, ed with cucumber and melon rinds, which had been accu- mulated there in the fummer of 1797. The ftench from them after a rain, was perceptible all over the houfe. Some of the beft houfekeepers in our city, burn all their offal vegetable and animal matters in their kitchen fires. If this practice were univerfal, it would contribute much to the health of our city. Many years ago, houfekeepers in Amfterdam were reftrained by law from throwing the offals of their kitchens into their canals. The late increafe of bi- lious fevers in that city has been afcribed to that law not being faithfully carried into execution. Fire wood fliould never be confined in cellars in the warm months, in a. green, or wet ftate. It emits when heated, an unwholefome vapor which has been known to produce a fever. Log huts and cabins, the fecond year they are inhabited, often become unhealthy from the decay of the bark of the logs of which they are compofed. ( *5 ) water, they fhould be delivered from the neceflity of making ufe of the water from their pumps for drinking, and culinary purpofes. 7. Let all the filth be removed from the neigh- bourhood of the city, and let the brick kiln, and other ponds be filled up, from time to time with the earth which is obtained in digging cellars. 8. In the future improvements of our city, let there be no more dwelling houfes erected in alleys. They are often the fecret receptacles of every kind of filth. The plague always makes its firft appear- ance in the narrow ftreets, or in the dirty huts of the fuburbs of Conftantinople. 9. The predifpofition of our citizens to be affect- ed by the remote and exciting caufes of the yellow fever, would be very much leflTened by their living fparingly upon frefh animal food and chiefly upon broths and frefh vegetables rendered favoury by fpic- es, and a fmall quantity of faked meat, during the fummer and autumnal months. A conftant attenti- on fhould be paid at the fame time to bodily cleanli- nefs. The expenfes of removing all the fources of putrid exhalations which have been mentioned, fhould not be weighed for a moment with the lofs of three or D four ( 26 ) four thoufand lives every year, with the diminution of our commerce by the fever, nor the delays and charges of our prefent oppreflive quarantine law. Let us not be alarmed, nor difcouraged for the fate of our city. To every natural evil, Heaven has provided an antidote, and it is not more certain, that houfes are preferved from the deftruc- tive effects of lightning by metal conductors, than that our cities might be preferved, under the ufual operation of the laws of nature, from the yellow fever by cleanlinefs. It would feem as if the neglect of it, was neceflarily connected with fuffering. We obferve it in the human body, as well as in our cities. The fufpenfion of ficknefs from filth, no more proves it to be inofFenfive, than the temporary abfence of remorfe for wicked actions, proves them to be innocent. A regard to cleanlinefs was en- joined upon the Jews by divine authority.* To prevent * " For the Lord thy God walketh in the midft of thy camp to deliver thee—therefore fhall he fee no unclean thing in thee, and turn away from thee1." Deut. xxiii. ver. 14, fee alfo the 12th and 13th verfes of the fame chapter. The connection between filth, and peftilence, feems to be pointed out in the following words in the Old Teftament. " I have fent among you, the peftilence after the manner of Egypt, and I have made the ftink of your camp to come up to your noftrils, yet have ye not returned unto me faid the Lord." Amos, iv. ver. ic. ( *7 ) prevent difeafes among them, was one of the de- figns of their frequent ablutions, and of many other of their ceremonial inftitutions. The fame reafons exift for removing the filth from large cities, as from a camp, and the fame advantages of health, and order have attended it in all warm countries, in every age of the world. Reafon was given to man chiefly to promote his physical happinefs. We expect a miracle, in wait- ing to be delivered from our epidemic, by the wrong application of the reafoning faculties of our minds. In their proper ufe, we may humbly hope for a bleffing upon our endeavours, to avert our calamity, from that Being, who loves truth in every thing, and who afflicts not willingly the children of men. Citizens of Philadelphia, bear with this attempt to perfuade you to reconfider the facts and reafonings that have from time to time been laid before you upon this important fubject. Think of the unfuc- cefsful iflue of all your efforts for five years paft, to guard againft the prevalence of our fummer and autumnal peftilence, by adhering to the popular hypothefis of its origin. The meafures that have been recommended are cheap, compared with the coftly apparatus for preventing its fuppofed impor- tation. The adoption of them will render our city agreeable to ourfelves, and inviting to ftrangers, at the ( 28 ) the fame time ^that it will defend it Trcnn .the yellowfeveno '*" ' Philadelphia was once preeminent over all the cfties in North America, in p'larte of public urfHty and happinefs—fhe must admit the unwelcome truth fooner, or later, that the yellow fever is engender- ed in her own bowels, or fhe mult renounce her character for knowledge and policy, *nd perfiaps with itj hfer esTiftefide as a commercial city J ' -.'..' * • , • ..... *' May heaven forbid this cataftrophe to the prefent Capital of the United* States I and in mercy command the deftrdyln|* angel 'of "peftilence to fheath his up- lifted fword! In fpite of the numerous execrations that have been heaped upon me for my opinions and conduct upon the fubject, of this addrefs^ by the citizens' of •Ph'Ha'delphia, her ^rrofptrity is" ftill the object of my conftant'folrcitude:-------Yes— Dear afylum of my anceftors! Beloved nurfe and protectrefs of my infant and youthful years ! May thy health, thy commerce, thy freedom and thy happinefs exift, till time fliall be no morel 16th, July 1^99. THE END. Mti. H'st wz zn o ) 7 93 C ^