9. That yellow fever is a peculiar disease; a fever of only one paroxysm, varying from one to three days before the remission and collapse; and that it is radically different in its character from the whole family of remittent and intermittent fevers. YELLOW FEVER HAS BEEN EPIDEMIC IN THE FOLLOWING TOWNS AND PORTS OF THE UNITED STATES 1. CHARLESTON, S. C. This is one of the oldest commercial ports in the United States, and has at all times had an extensive commercial intercourse with the West Indies; and it has likewise been subject to epidemic yellow fever repeatedly during its commercial prosperity. The first epidemic was in the year 1700, again in the years 1703, 1728, 1745, 1748, 1753, 1755. The next was in 1793. From the year 1793 to that of 1807 inclusive, this disease prevailed in Charleston almost every alternate year, either severely or partially.* From that time until the restoration of commerce, after the peace of 1815, this city, as well as all other ports of the United States, was exempt from this disease. In 1817 the city was severely visited again; and from that time up to the year 1839, a period of 22 years of active and uninterrupted commerce, it has been epidemic in Charleston nine times, or nearly every alternate year. In this city the disease, always appearing among the vessels in port, and in unacclimated persons, is known chiefly by the name of the stranger's fever. 2. PHILADELPHIA. This is one of the oldest commercial ports in the Union, but being in a more northern latitude was less liable to epidemic yellow fever than Charleston; yet it was occasionally visited by this disease up to the year 1762. From that time, during all the difficulties and interruptions of foreign commerce, until the close of the war of independence, *See Med. Repos., old series, vol. ii, pp. 234, 235, and vol. iv, p. 100. See Dr. Simonds on Yellow Fever of Charleston. the city was free from this disease. After the peace of 1783 the foreign commerce gradually revived, and having increased rapidly, Philadelphia became an important port, as the seat of the Federal Government. The consequence was, that yellow fever was introduced every alternate year, until the year 1808, when commerce was again interrupted by new difficulties with England and other European belligerants. This interruption, with the war which followed, gave Philadelphia another exemption for ten years. Since the year 1822, the city, having adopted the policy of New York in prohibiting infected vessels from the port, has enjoyed an exemption from these epidemics, and her commercial interests have been benefited rather than injured. We may remark, that during the revolutionary war, the autumn of 1778 was unusually sickly along the whole Atlantic seaboard, the summer "being unusually hot and sultry”: but there was no yellow fever, for the want of foreign infection, the general character of the diseases being of the "intermit tent" type.* Yet so soon as commerce with the West Indies was fully revived, the diseases in the seaports dropped the "intermittent" character, and assumed that of epidemic yellow fever. During this time the British army and navy in the West Indies were annually ravaged by this pestilence which prevailed in nearly all the West India ports;† while the inhabitants of the interior were exempt. 3. NEW YORK, lat. 40° 43′ north. This city has been gradually increasing in point of population and commerce for the last fifty years, during which it has more than doubled its commerce and population. In a latitude almost too far north for epidemic yellow fever, the city has never been so extensively ravaged by this disease as the more southern ports. Yet it has suffered to a considerable extent, several times previous to the year 1808. After the great expansion of commerce after the late war, yellow fever was occasionally intro * See Med. Repos., old series, vol. ii, p. 364. duced by vessels from the West Indies. But it did not spread epidemically except in 1819 and 1822, the latter being much the most fatal of any previous year.* Since the year 1822, a period of nearly twenty years, a judicious quarantine has protected the city from epidemic yellow fever, although the commerce of the city during that time has been more extensive than it ever was previously; while Charleston, Savannah, Mobile, and New Orleans, without any quarantine restrictions, have suffered severely. 4. SAVANNAH. This also is one of the oldest ports of entry. From a very early period it has been occasionally visited by epidemic yellow fever, when it had been prevailing extensively in the West Indies. From the year 1808 to 1817, during the interruption of commerce, it was exempt. Since that time it rarely escapes when Charleston, Mobile and New Orleans are visited. No quarantine regulations have been adopted in this city. 5. ST. AUGUSTINE & PENSACOLA, under the Spanish occupancy, were proverbial for their salubrity, and yellow fever was unknown in them as an epidemic until the Floridas fell under the jurisdiction of the United States on the 17th of June, 1821. As the treaty of cession had been made several months previously, the emigrants from the United States were pouring into St. Augustine early in the summer of 1821, while the Spaniards were departing as fast as possible for Cuba. Thus a constant intercourse was kept up between Cuba and St. Augustine, by numerous vessels which were transporting the Spaniards and their effects to Havana. These vessels on their return were chiefly freighted with tropical fruits, which were the means, no doubt, of producing an epidemic bilious fever, while some persons contracted yellow fever in the vessels direct from Havana. The following year, 1822, the American emigrants began to crowd into Pensacola; while transports were constantly passing and repassing to Havana, in removing the *See Townsend on Yellow Fever of New York, passim A. D. 1822also N. Y. Med. Repos., vol. ii, pp. 315 and 316. + William's Florida, p. 207, &c. persons and effects of the loyal Spaniards. The result was the introduction of a malignant epidemic, which spread rapidly among the unacclimated and promiscuous population who remained in the place. Again, in the autumn of 1825, the population was composed chiefly of recent northern emigrants, who were pouring in daily; and a brisk trade having sprung up with the port of Havana, the yellow fever was again introduced with great mortality. Since that period Mobile and other ports in the Territory of Florida, having withdrawn the trade from Pensacola, have likewise taken away the liability to frequent yellow fever epidemics; and for many years past, Pen-sacola has rarely suffered from yellow fever, although caseshave been occasionally introduced in the national vessels of the United States and other powers. 6. NEW ORLEANS. Site on adhesive alluvial earth, or mud, 10 feet above tide level, in lat. 29° 57′ north. This city has carried on a constant commercial intercourse with Havana and other West India ports, for more than seventy-five years, including the Spanish régime previous to 1803. During this long period, we are not able to ascertain that it has been vis ited by any malignant epidemic, until it came under the jurisdiction of the United States. Since that time, and especially since the revival of commerce, after the peace of 1815, its population and commerce have increased more rapidly than those of any city in the United States; and the frequency and mortality of yellow fever epidemics have been pari passu. In the period of twenty years from 1817 to 1837, the yellow fever has prevailed as an epidemic about nine times; and to such a degree of virulence that in 1819, when the resident summer population was only thirty-three thousand souls, the deaths in August were 560 souls, and in September 594. The yellow fever generally, if not invariably, begins its ravages among the shipping and in the population near the wharves. We infer that any interruption to the commerce of NewOrleans and other Atlantic ports, such as that preceding and during the last war with Great Britain, would again suspend the prevalence of yellow fever in our ports. For man ow fev of le introd Eliza abern necti hese Bost cted lai G yello yea For many years after the close of the war of independence, yellow fever was introduced occasionally into some other ports of less note than those we have already named. Thus it was introduced into Baltimore, into Wilmington, Delaware; Port Elizabeth, New Jersey; Norfolk, Virginia; Wilmington, Newbern, and Washington, North Carolina; New London, Connecticut, and Portsmouth, New Hampshire. Yet in most of these places, which were then important ports of entry, the disease manifested itself by only a few cases; and in those only, in most instances, who had had direct communication with infected ships, then lying in port,* which were charged with "foul air," as it was termed. 7. GIBRALTER and CADIZ, ports of Spain, have been visited by yellow fever. It prevailed in Gibralter in the summer of the years 1804, 1810, and 1813, and at Cadiz in the autumn of the year 1814. In each of these places it was introduced by vessels from the Spanish Main and the West Indies; and especially by the arrival of large fleets and armaments during the prevalence of the European wars against the power of Napoleon. It has also occasionally appeared in other ports of southern Europe at divers times between the years 1800 and 1815; but there are the strongest reasons to convince us that the disease was introduced by vessels and transports from the West Indies, during the wars which devastated Europe and the West Indies within that period. The troops and marines were those who suffered first and most severely. ART. II.-Facts and Conjectures on the Trembles and Milksickness. In a letter from Dr. G. B. TAYLOR of Morganfield, Kentucky, to Dr. W. L. SUTTON, of Georgetown in this State; communicated by the latter with some remarks. * * * The subject of your letter is one on which I have made many inquiries, and in every neighborhood within *Med. Repos., vol. ii, p. 117. |