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■(ZuJI J VU--X- /flo) Malignant or Spotted Fever. 
391 
MEDICAL AND PHILOSOPHICAL 
INTELLIGENCE. 
Inform ation relative to the distemper in Worcester Coun* 
ty, (Mass.) called the malignant or spotted fever: 
In communications from Dr. Richard Wait, qJ New- 
London, fC'onn.J to Dr. Miller, dated March 22,1810. 
I INCLOSE you a valuable document, and hope to see 
it embodied in that great national work, the Medical Re- 
pository. Originally appearing in a village gazette, it may 
have a limited circulation; and productions of merit, when 
committed to the light ephemeral sheet of news, hardly 
survive the revolutions of a year. 
That singular and fatal disease, denominated Spotted Fe- 
ver, is making its appearance in every part of our country, 
and it seems as if the prediction of an American poet, when 
describing the precursors of the final judgment day, was 
about to be verified: 
SIR, 
In every blaft the Spotted Plague be driven, 
While angry Meteors fhoot acrofs the heaven. 
From a Worcester, (Mass.) paper of the 14th instant, I 
transcribe the following“ The remote causes of this dis- 
order are said to be improper or putrid diet, corrupted grain, 
a too free use of those salts which dissolve the blood, putrid 
miasmata, &c. It has always raged in the winter, after sea- 
sons which are unfavorable to the productions of the earth. 
The corn was, in many places, killed by the frost last year, 
and of course it cannot be so wholesome as when it arrives 
to maturity. We have lately heard of several animals hav- 
ing been killed by eating mouldy corn; it is also destructive 
to human beings. European writers have given accounts of 
very fatal consequences which have resulted from blasted, 
spurred, or otherwise damaged rye.” 
I remember having read in the newspapers an account of 
a number of horses dying in Newark, (N. J.) a year or two 
ago, in consequence of eating mouldy coin. 392 
Malignant or Spotted Fever. 
MASSACHUSETTS MEDICAL SOCIETY. 
At a meeting of the Counsellors of the Massachusetts Medical 
Society, on the 7th of February, 1810. 
Voted—That a committee be appointed to collect in- 
formation respecting the history and treatment of a malig- 
nant disease, commonly called SPOTTED FEVER; 
which is now prevailing in the county of Worcester, and 
has prevailed, within five years past, in Hartford, Connecti- 
cut, and Providence, Rhode-Island, and report at the next 
meeting of the Society, ox- Counsellors. 
Dr. FISKE, 1 Committee 
Dr. PAINE, ]Lommnee- 
From the Records, 
JOHN C. W ARREN, Sec. Sec. 
N* B. Any communication upon the above subject to the 
committee, or to Dr. Thomas Welch, Corresponding 
Secretary of the Medical Society, at Boston, will be thank- 
fully received. 
March 1,1810. 
Letter from the Rev. Festuu Foster to the Editor of the 
Worcesiler Spy. 
Sir, 
PiiTERSHAM, March 6, 1810. 
I hasten to give you a s ketch of the Spotted Fever in 
this place. It made its first aippearance about the beginning 
of January last, but the instances were few and distant from 
each other, until last week. Although it had proVed fatal 
in most instances, seven only had died, belonging to this 
town, previous to the 25th of February. Since that time, 
the disorder has come upon us like a flood of mighty wa- 
ters. We have buried eight persons within the last eight 
days. About twelve or fifteei a new cases appeared on Thurs- 
day last; many of them very suddenly and violent. This 
was the most melancholy andl alarming day ever witnessed 
in this place. Seven or eight physicians were continually 
engaged in the neighborhoot I north of the meeting-house, 
and I believe not one half hot jr passed in the forenoon with- 
out presenting a new case. ] pale fear and extreme anxiety 
were visible in every countenance. The faculty themselves 
felt their situation in being < :alled to encounter an enemy 
with which they were little acquainted, and before which Malignant or Spotted Fever, 
393 
their late brother in this place had so suddenly fallen.—• 
They, however, manifested great skill and presence of mind, 
and, fortunately for us, adopted and strenuously pursued, 
that mode of treating this disease, which, they since learn, 
has best succeeded in other parts of the country. By these 
means, most of the patients whom they seasonably visited, 
are, by the blessing of a merciful God, yet alive, and hope- 
fully on the recovery. The number of cases which now re- 
quire medical assistance in this town, is about twenty, most 
of which are nigh the centre. I know of no case which is 
considered desperate. It is with pleasure I inform you, 
that we hope, though we dare not believe, that means have 
been, or soon will be discovered, to prevent the mortal ef- 
fects of this malignant and alarming disease. The faculty 
have been so incessantly occupied, and so anxiously watch- 
ing the success of their experiments, that they have not 
found leisure to make any communications to the public. 
So soon as their experiments shall be matured, they will, 
we presume, publish the characteristics of the disease, and 
the most effectual method of cure. It seems to be very 
generally agreed, that there ought to be no evacuations, but 
by external applications produce free perspiration, and io 
ternally apply the most powerful stimulants. 
From the same to the same. 
Sir, 
Petersham, March 9, 1810. 
AT the request of a number of persons in this town, 
the gentlemen who have attended as physicians in the epi- 
demic now prevalent among us, have made a general ac- 
count of the symptoms and treatment of that most formi- 
dable disease. The success which has attended their prac- 
tice, clearly evinces the general principles which they have 
embraced, to be correct. Should the disease continue to 
prevail, a further investigation may, probably, much im- 
prove their general system. The internal application of 
powerful stimulants was adopted, not from any previous 
knowledge that they had been tried and found success!ul, 
but because other means which had been employed proved 
ineffectual. We have been happy since to learn, that the 
method here pursued has been found the best remedy to 
this disease in Connecticut, and distant parts of this state. 
Believing that if the epidemic should appear in other parts Malignant or Spotted Fever, 
of the country, a knowledge of the method here pursued, 
and the consequent success, might be satisfactory, and pos- 
sibly of the highest advantage to a distressed and afflicted 
people, you are requested to give publicity to the u Account” 
which I herewith transmit to you. 
Some Account of the Symptoms and Treatment of a singular 
and fatal Disease, commonly called the Spotted I ever, 
:which has made its appearance, and now rages in Pe- 
tersham, in the county of Worcester, and some other ad- 
jacent to-wns, particularly the toxvn of Dana. 
The following are some of its characteristic marks, as it 
has fallen under our observation. It begins with shifting 
pains in different parts of the body, most frequently in some 
of the limbs, often in some of the larger joints, as the knee, 
the hip, or the shoulder, shifting from place to place, and 
frequently to the head or stomach, and often from the one 
to the other of these last-mentioned parts, with a sense of 
universal uneasiness or restlessness. 
These s\ mptoms are accompanied with cold shiverings, 
and other marks of fever, which are soon followed by a re- 
markable and general prostration of strength, and a de- 
praved action of the sensitive organs. In some violent 
cases the sight is much impaired, and even totally, though 
temporarily, lost. 
The eyes appear sometimes dead or glassy; but at other 
times, especially during the progress of the disease, they 
appear red or suffused. The pupil is frequently more or 
less dilated; but sometimes contracted to almost a point; 
and sometimes these states alternate with each other. The 
tongue has been invariably covered with a whitish coat, 
and moist. 
The pulse is generally a little increased in frequency, re- 
markably intermittent, and between the intermissions un- 
equal both in strength and quickness; but in some few 
mild cases it is very little altered. 
There is generally great distress at the stomach, with 
nausea, and for the most part some vomiting. 
Respiration is in all cases much disordered; but the la- 
bour seems to arise rather from the difficulty of inflating, 
than from any infarction of the lungs, as there is no cough. 
Pctechise, or livid blotches, or a red fiery eruption, some- Malignant or Spotted Fever, 
395 
times in clusters, and sometimes in large and distinct pus- 
tules, in most cases, appear on the surface of some parts of 
the body, and sometimes they are general. These pustules 
most commonly break, discharge a little thin watery fluid, 
and then dry up; but sometimes they maturate, forming 
ulcers, which may not heal till after recovering. But nei- 
ther the spots nor the eruptions are inseparably connected 
with this disease. But when the eruptions do appear, they 
are attended with much itching. 
Consciousness, especially in adult males, sometimes re- 
mains to the last unimpaired. But in females violent hys- 
terical symptoms, with high delirium, have, within a few 
hours from the attack, supervened. And in young chil- 
dren a stupor sometimes comes on soon after the vomiting, 
which announces the approach of the disease, and continues 
till death. 
In regard to the prognostics in this disease, our obser- 
vation enables us to state, that from those cases attended 
with petechise, few recover; whilst those accompanied by 
an early eruption, more generally and more safely get 
through the disease. 
The duration of the disease is to us uncertain. Some 
have died within twelve hours, others within twenty-four, 
from the time of the attack j while a large proportion of 
others have had the violence of it broken within forty-eight 
ho rrs, when it run into the form of a mild typhus of un- 
certain duration. 
In the treatment of this most formidable, and too often 
fatal, disease, the experience we have already had, war- 
rants us in stating, that while its rapid progress, especially 
in its most violent forms, deprives us of all hopes of suc- 
cess, from the use of mild alterative medicines; so its pe- 
culiar nature, forcibly interdicts the employment of all 
drastic remedies, which may produce any great degree of 
depletion of the system; and thereby sink the patient irre- 
coverably. An injection of milk and molasses, with a tea- 
spoonful of common salt dissolved in it, has induced strong 
spasms. An emetic of spruce with a grain of tartrite of 
antimony, operating only once upwards, and once down- 
wards ; likewise a dose of sulphate of soda, producing on- 
ly two moderate operations downwards, have each of them, 
in hale young men, reduced the pulse from an hundred, 
down to forty-eight strokes in a minute. From these facts, 
it is easy to conceive how cautious we should be in the use 396 
Malignant or Spotted Fever* 
of emetics and cathartics in this very singular disease. If, 
however, at the beginning of the disease, there be a trou- 
blesome puking, a few grains of Ipecac, or warm water, 
may be drank to clear the stomach, and check that symp- 
tom ; but an opiate should immediately follow the opera- 
tion. 
The only safe and efficacious mode of treatment, which 
has occurred to us, consists in the bold and liberal use of 
the diffusible stimuli, proportioned to the violence of the 
disease, together with the employment of the several means 
of powerfully determining to the surface, and in keeping 
up that determination in proportion to the exigency of the 
case, till relief shall have been obtained •, and at the same 
time exciting the action of the brain, by blisters applied to 
the temples and nape of the neck, and by ether and other 
stimulants, applied to the head. 
The diffusible stimuli employed by us, have consisted 
chiefly of brandy, opium, ether, volatile spirit, and cam- 
phor, and in some hysterical cases the pure oil of amber: 
and the means of determining to the surface, have been 
the employment of warm bath, followed by the assiduous 
application of stupes wrung out of a solution of salt in hot 
vinegar or water, and applied to the extremities and sto- 
mach, and kept warm by hot stones or bricks, or billets of 
wood, taken out of boiling water, and placed round the 
patient; together with a free use of an infusion of snake- 
root and saffron, or pennyroyal, with such of the above 
mentioned diffusible stimuli, as appear best adapted to the 
case, and frequently supped warm. By these means, a 
gentle and universal sweating is induced, and should be 
continued until the disorder gives way. 
To what extent the most powerful of these diffusible 
stimuli may be safely and necessarily employed, the fol- 
lowing facts will shew. A young woman, aged about 20 
years, who recovered from the disorder, being very vio- 
lently attacked, and a high delirium with great distress 
supervening, took more than a quart of brandy, and not 
less than twenty grains of good turkey opium, aided by the 
above means of determining to the surface, in less than 
twelve hours, and before any material mitigation of her 
disorder could be and what is truly wonderful, 
without the least appearance of intoxication. Indeed, we 
have been obliged frequently to exhibit ten grains of opi- 
um for & dose in some of the most violent cases, attended Malignant or Spotted Fever, 
397 
with strong spasms, and have never known it to produce 
stupor in a single instance. 
In one instance only have we employed the lancet. A 
man about twenty-eight years of age, having been violently 
attacked, and attended by strong spasms ; on the third day, 
his spasms having been subdued, was exercised with ex- 
treme difficulty of breathing, and great oppression at the 
breast, and exhibiting at the same a strangulated counte- 
nance, which symptoms appearing to arise from a sur- 
charge of the vessels of the lungs, owing to their inaction, 
rather than their inflammation; sixteen ounces of blood 
were taken away, merely to restore the equilibrium. This 
had the happiest effect in relieving those distressing symp- 
toms. But these symptoms returning on the fourth day, 
the operation was repeated, and with the same salutary ef- 
fects. The blood did not exhibit the usual marks of an 
inflammatory diathesis, but on standing, remained destitute 
of the inflammatory buff, and its coagulum was of a loose 
texture and tender. 
Out of twenty-five cases, which have been subjected to 
the above mode of treatment, only three have as yet proved 
fatal, and those were patients under four years of age. The 
others are in a hopeful way of recovery. 
Great alarm has been excited on account of the supposed 
infectious nature of this disease. But for the consolation 
of the people we can say, that from the most careful ob- 
servation we have been able to make, we cannot discover a 
single instance, in which it clearly appears, that the disease 
has been communicated from one to another by contagion. 
And as we are of the opinion, that none can be affected 
by this disease but those in whom a certain change in 
the state of the body, commonly called the state of pre- 
disposition, has been affected by the influence of a cer- 
tain morbid quality in the atmosphere, which state of pre- 
disposition disposes the moving powers, upon the appli- 
cation of any exciting morbid cause, to produce those spe- 
cific morbid affections which characterize this particular 
disease ; and as we are furthermore of the opinion, that the 
only rational means of checking the progress of this, or any 
other epidemic, consists in removing the state of predis- 
position ; and as the strong impression made on the system 
by the application of cold water suddenly applied to the sur- 
face, appears to be one of the most probable means of de- 
stroying this state of predisposition, by dissevering the chain. Malignant or Spotted Fever. 
connecting those morbid affections; we cannot but strongly 
recommend the adoption of the practice of the cold bath, 
cither by plunging, showering, or affusion, which may be 
employed three successive mornings, (the weather being 
fair) then omitting it three, and thus proceeding to the third 
time, as a most probable mean of arresting the progress of 
this malignant disease, and of preventing its extending its 
ravages. 
ABRAHAM HASKELL, 
MASON SPOONER, 
JACOB HOLMES. 
Petersham, March 9, 3810. 
THE “SPOTTED FEVER.” 
[The following Circular has been addressed to Medical and 
other gentlemen, near the places where this epidemic has 
lately prevailed: But, as there may be others who may be 
able to afford information on the subject, to whom it has 
not been sent, we readily comply with the desire of the 
committee of the Counsellors of the Massachusetts Med- 
ical Society, to insert it in the Chronicle ; with the request 
that gentlemen, either of the profession, or others, who 
may have it in their power, will attend to the questions, 
and transmit their replies to Dr. Thomas Welsh, Cor- 
responding Secretary of the Massachusetts Medical So- 
ciety, without paying postage—and we are authorized to 
say, that the committee are happy in being able to state, 
from the communications they have already received, 
that the disease is, at this time, far from being a mortal 
one; and that it is considered by their correspondents, as 
being under the controul of medicine as much as ordina- 
ry diseases.] 
Sir, 
Boston, March 30,1810. 
In consequence of the alarming extension of the very 
fatal disease, which is commonly called the Spotted Fever, 
the Counsellors of the Massachusetts Medical Society, have 
considered it their duty to investigate with peculiar care, 
every thing relative to the causes, history, and modes of 
treatment of that disease. They have, therefore, at their Malignant or Spotted Fever, 
399 
meeting on the 27th inst. appointed the subscribers a com- 
mittee to correspond with, and collect materials from the 
fellows of the Society, and other gentlemen of character, in 
whose vicinity the disease has prevailed. 
As one comprehended in this description, we take the 
liberty to address you; and, in behalf of the Massachusetts 
Medical Society, we beg leave to request you to answer all 
or any of the subjoined queries. We beg leave, at the same 
time, to request, that if in any instance your replies are not 
founded on your own personal observation, but on informa- 
tion from others, you would do us the favour to notice from 
what sources such Information has been derived. 
It is the wish of the Counsellors that we should make a 
report to them on this subject, so interesting to every mem- 
ber of the community, as soon as the circumstances can pos- 
sibly admit. We shall therefore be peculiarly obliged to 
you, if you will seize the first moment of your leisure to 
prepare your answer. We are aware, that your important 
engagements at this time, must render a compliance with 
our request very inconvenient to you; and, did we not con- 
sider ourselves as acting in behalf of the whole community, 
we should not feel at liberty to make our call upon you so 
urgent. Should you be able at present to give very concise 
answers to a part only of the queries proposed, at a future 
day you might add whatever else shall have been furnished 
by subsequent experience and inquiry. 
It will be most convenient both to yourselves and to us, 
if you will refer to the number of each question, without 
recapitulating it, and reply to each distinctly, in the order in 
which they are placed. 
1. At what time, and at what place, did the first case of 
this disease occur under your observation ? 
2. What are the symptoms of this disease, the order of 
their occurrence, and the most usual duration of each ? 
3. Have you noticed any precursory symptoms by which 
the approach of the disease can with tolerable certainty be 
ascertained ? 
4. Is the disease to be distinguished only by attending to 
the combination and course of the symptoms, or by any one 
or more peculiar symptoms ? 
5. Have any persons previous to the attack of this disease 
been subjected to any extraordinary fatigue, or exposure to 
irregularities or peculiarities of diet, or to any other circum- 
stances which can be considered as exciting causes; and if 400 
Malignant or Spotted Fever. 
any, in what proportion of cases have such circumstances 
been noticed ? 
6. Have you noticed any circumstances which lead you 
to consider the disease contagious or infectious: or have you 
noticed circumstances which lead to the opposite opin- 
ion? 
7. Are persons of any particular class or profession, age, 
sex, or temperament, peculiarly subject to this disease ; or 
have persons of any particular description been peculiarly 
exempt from its attacks ? 
8. Have any particular evacuations, or other symptoms, 
marked the crisis of this disease ; and has it, in any cases un- 
der your observation, been followed by affections of the 
joints or glands, by erysipelas or any other local affetion ; 
and what has been the termination of such cases? 
9. Are there any symptoms in the early stages, or in the 
course of the disease, on which a prognosis of the event 
may be founded; and with what degree of assurance may 
such prognosis be formed ? 
10- Are relapses frequent; and do the symptoms differ 
from those of the original attack, either in kind or degree? 
11. Do those who survive the disease recover speedily; 
or is there noticed any remarkable change in their state of 
health ? 
12. What mode of treatment have you tried or seen tried; 
and what has been the success of each mode ? 
13. What have been the external appearances on exami- 
nation of the body after death; and at what distance of time 
after death have your examinations been made ? ' 
14. What have been the internal appearances ascertained 
after death by dissection, and at what period ? 
15. Have you, at any former period, seen the same dis- 
ease, or any nearly resembling it ? 
16. Have there been any unusual diseases, or any unusual 
mortality among brute animals in your neighborhood ? 
17. Are there any other points on which you can give in- 
formation, which appears to you to be material at the pre- 
sent moment ? 
In reference to the second and fourth queries, we beg to 
call your attention particularly to the following objects :■—!• 
Svmptoms denoting local affection of the brain, such as de- 
lirium, or any peculiar affection of the mind, spasms and 
convulsions, remarkable insensibility, deafness, unusual di- 
latation or contraction of the pupils, paralysis of any part of Malignant or Spotted Fever. 
401 
the body, &c. &c.—2. Symptoms denoting affection of the 
stomach, or any of the abdominal viscera, such as increased 
tenderness, fulness or tension of the abdomen or any region 
of it; vomiting or purging, the nature of the matters dis- 
charged either from the stomach or the bowels, &c. &c. In 
reference also to the 14th query, we wish to learn especially 
the appearances in the head and stomach. 
It is unnecessary to suggest to you as being likewise ob- 
jects of attention under the second query, the state of the 
skin as to temperature, dryness or moisture, and as to spots 
of different descriptions which may be remarked on it; the 
countenance, and especially the eyes; the respiration; the 
pulse, whether dissimilar in different parts of the body; the 
urine, &c. Nor can it be necessary to state the importance 
of noting the stages, or periods of the disease at which any 
observations are made, or any remedies are tried. We may, 
however, remark, that as violent diseases have sometimes 
grown more mild in the latter part of an epidemic season 
than in the beginning, it will be useful to note at what part 
of the season your various remedies have been employed. 
There are some other questions which might be added to 
those above, particularly respecting the soil and other cir- 
cumstances of the districts in which your observations have 
been made ; respecting the state of weather before and dur- 
ing the prevalence of the present epidemic; the diseases 
which have prevailed during the year past, the direction in 
which the disease now prevailing has been extended, wheth- 
er this has or has not corresponded with the prevailing 
course of the winds, or with the ordinary lines of intercourse ; 
respecting any thing peculiar in the grain raised last year, 
&c. But probably your time is now too much occupied to 
attend fully to questions on these subjects; and with your 
permission we may perhaps address you respecting them 
at a future time. 
Shall we, in addition to other requests, beg you to inform 
us, if possible, once a week, or as often as you can, what may 
be the progress of this lamentable disease, within the circle 
of your observation. Your letters may be addressed and 
sent to Dr. Thomas Welsh, in Boston, whenever a direct 
. conveyance by mail or otherwise can be procured; in other 
cases they will reach us less directly, but very safely, if in- 
closed to Dr. Oliver Fisk, at Worcester. 402 
Stoddard’s Sketches of Louisiana and Florida. 
With the most sincere sympathy for the sufferings to 
which you, and your neighborhood are exposed; and with 
great respect, we are. Sir, your obedient servants. 
THOMAS WELSH, 
JAMES JACKSON, 
JOHN C. WARREN, 
Committee. 
Major AMOS STODDARD, of the United States’ 
Artillerists, who has been stationed several years on the 
Mississippi and Red River, is about publishing Sketches, 
Historical and Descriptive, of Louisiana. This work will 
contain about five hundred pages, and embrace a concise 
history of Louisiana, from its first discovery to the cession ; 
the boundaries and extent of it—some account of the Flori- 
das—a description of what is called the Delta, including the 
City of New-Orleans—of the country between the Delta 
and the Arkansas—of the territory about Red River and to 
the westward of it—of Upper Louisiana, or all that tract, 
particularlv the settled parts of it, to the north of the Arkan- 
sas, and also some sketches of the interior regions—an ac- 
count of the population, climate, diseases, soil, productions, 
natural growth, &c. &c. of the country—the nature of the 
Spanish government and laws, and the mode of administer- 
ing justice—of the lands and land titles—of trade, com- 
merce, and manufactures—of learning and religion, and the 
manners and customs of the creole inhabitants—of the ex- 
traordinary appearances of salt, mines, and minerals—of the 
antiquities—ol the aborigines in general, and of the proba- 
bility of one or more Welsh tribes in America—a descrip- 
tion of the large rivers, and some observations on the state 
of slavery in that country. 
Stoddard’s Sketches of Louisiana and Florida, 
History of New Netherland. 
AMONG the early historians of the country, called, at 
the time of its settlement, New Netherlands and since com- 
prehending parts of New-York, New-Jersey, and Pennsyl- 
vania, Adrian Van Der Donk, has acquired a large share