Chapter XXIII: Section I: History of the Yellow Fever (4)

“Now every man knows that those who live contiguous to the river at New York, and the Delaware at Philadelphia, mostly sailors, shipwrights, truckmen, labourers, tavernkeepers, &c. seldom trouble themselves about the quantity of their foods and drinks, but indulge copiously in the use of strong liquors, of which an astonishing consumption is made in those parts. They are not in other respects more careful as to cleanliness in their narrow and low houses. There, in a _hole_ called a _bedroom_, and on a feather-bed half rotted, in a heap of rags half devoured by insects still more disgusting, two and sometimes three individuals, covered with sweat, often drunk, sleep, and still increase the filth by their shameful and dirty mode of life. Shall we find it strange that those infected haunts should shed forth in the morning a mephitic air, capable of suffocating the most robust and vigorous men? Shall we wonder that those who breathe this pestilential gaz are suddenly seized with a fever? in itself perhaps not very dangerous, if it were treated in a suitable manner. But what is their method of treating it? They do not even know the name of _ptisan_, still less the use of _anodynes_, nor that of _salt of nitre_, nor of _camphor_, so proper to prevent putridity. Punch, made with rum; water mixed with gin and molasses; a sort of soup made with Madeira wine; fish; raw oysters, &c. these are their first medicines. If their wives or friends go to consult the apothecary, he advises the _castor-oil_, or the famous calomel pills or powders, whose virtues the quacks extol for every disease. Finally, if the fever increases, the doctor is called, who administers a light puke of 12 or 15 grains of tartar emetic, a plenty of laudanum to procure sleep, and who, seeing the case desperate, withdraws, saying that he was called too late![156]

[156] In Dr. Rush’s account of the fever of 1793, we find the
following remarks on the French mode of practice to which it seems
remarkable that our author has given no answer: “I proceed with
reluctance to inquire into the comparative success of the French
practice. It would not be difficult to decide upon it from many
facts that came under my notice in the city; but I shall rest its
merit wholly upon the returns of the number of deaths at Bush-hill.
This hospital, after the 22d of September, was put under the care
of a French physician, who was assisted by one of the physicians of
the city. The hospital was in a pleasant and airy situation; it was
provided with all the necessaries and comforts for sick people that
humanity could invent, or liberality supply. The attendants were
devoted to their duty, and cleanliness and order pervaded every room
in the house. The reputation of this hospital, and of the French
physician, drew patients to it in the early stage of the disorder.
Of this I have been assured in a letter from Dr. Annan, who was
appointed to examine and give orders of admission into the hospital
to such of the poor of the district of Southwark, as could not be
taken care of in their own houses. Mr. Olden has likewise informed
me, that most of the patients who were sent to the hospital by the
city committee (of which he was a member) were in the first stage
of the fever. With all these advantages, the deaths between the 22d
of September and the 6th of November, amounted to 448 out of 807
patients who were admitted into the hospital within that time. Three
fourths of all the blacks (nearly 20) who were patients in this
hospital died. A list of the medicines prescribed there may be seen
in the minutes of the proceedings of the city committee. Calomel and
jalap are not among them. Moderate bleeding and purging with glauber
salts, I have been informed were used in some cases by the physicians
of this hospital. The proportion of deaths to the recoveries, as it
appears in the minutes of the committee from whence the report is
taken, is truly melancholy!”

“Although the inhabitants of the other parts of the city who are in better circumstances follow a mode of life more regular, feed on more wholesome aliment, and are much more cleanly in their houses (except however _feather-beds_ and _lower bedrooms_) it is nevertheless a fact that they are much inclined, the men especially, to eat salt meat, meat half cooked, green fruit, and still more to drink spiritous wines. Several of them allow themselves an immoderate use of the latter between dinner and tea-time, the strength of which, added to that of the high-spiced food, and liquors, must necessarily increase in their blood that fermentation already excited by the heat of the season. Now, shall we not concede that bodies thus predisposed ought to be more susceptible than others of the impression of the corrupted _miasmata_ which are constantly exhaled from every thing that surrounds them; from the common sewers, the wharves or the docks; from the dirt and litter of the alleys and lanes; from the sulphureous bilge-water of ships; from the cellars and from the stores; in short, from those houses which contain sick, dying and dead persons?”

Here the author, after stating objections on both sides, seems at last to determine that the disease is produced by putrid effluvia. The dispute on this subject, however, hath continued so long, that we can by no means expect to settle it in this treatise. At first view one would think that nothing could be more easy than to determine whether the disease arose soon after the arrival of foreign vessels, or in places which had no connexion with maritime affairs. But when we come to particulars there is such a strange disagreement and contradiction concerning facts, that we are in every instance driven back into the wide field of theory and argumentation. One instance of this we have already had in the case of the Boullam fever said to be imported by the _Hankey_. Let us now try another. Dr. Currie of Philadelphia, in a letter to Mr. Wynkoop of date October 10th, 1797, says that the fever at New-York, of 1795, was proved “by unquestionable facts,” to have been introduced from Port au Prince by the brig Zephyr; and for a proof of this he refers to a letter of the health committee of New York to the governor, dated September 8th of that year. From this letter it appears that Dr. Treat visited this vessel on the 28th of July, where he found three men ill of what he called a bilious _remitting fever_, and the body of one who died that morning. Two days after, the Doctor was taken ill, and died in eight days, with unequivocal symptoms of yellow fever. On the 25th, four persons from on board the ship William, from Liverpool, which arrived several weeks before (the crew of which till this time had been healthy) were taken ill of fever, and died with similar symptoms in seven days. Nothing can be more direct than this evidence, yet it did not give satisfaction.

The fact was impugned by the late Dr. E. Smith, in a letter to Dr. Buel,[157] who produces such evidence as, in his opinion, “establishes it beyond a contradiction, that neither Dr. Treat nor any other person contracted a fever, such as prevailed in New York in 1795, from any sick or dead man, or any thing else connected with the vessel in question.”

[157] Webster’s Collection, p. 98.

The evidence brought forward is the declaration and deposition of capt. Bird. In a letter to Dr. Dingley, the captain “thinks it his duty to contradict the report” that Dr. Treat “caught the disease of which he died on board the Zephyr.” He contradicts it by a deposition, that “the mate and one mariner had the _fever and ague_ seventeen days on shore, and came on board with the same disease; and the captain himself had a dysentery on his arrival in New York; and John Wheeler, aged 16 years, died on the day of the arrival of the brig in New York, by _worms crawling up into his throat, and choking him_. He was sewed up in a piece of canvass, and ready to be committed to the deep, when Dr. Treat came on board, who desired the captain to have the canvass opened, that he might inspect the body; and he only cut the canvass over the face, but did not make any other examination of the body.”

How far this proves captain Bird’s assertion, that Dr. Treat _did not_ catch the disease on board the Zephyr, the reader will judge. It is, however, inconsistent with the plan of this treatise to enter into an examination of contradictory evidence concerning matters of fact. Accounting as _nothing_, therefore, all that has been said, _by either party_, concerning the brig Zephyr, let us proceed to other testimonies.

In a collection of _facts_ and _observations_ by the College of Physicians, published last year, we find the following remarkable accounts tending to prove that the disease was introduced by the ship Deborah, from Port au Prince and Jeremie in St. Domingo: 1. In a letter from Dr. Stevens to Dr. Griffiths it is stated, that “the yellow fever prevailed in almost all the sea-port towns in the French part of Hispaniola, particularly at Cape Nichola Mole, where it raged so violently that it obliged the British to abandon the post sooner than they intended. About the same time it appeared in the harbour of St. Thomas, and was so destructive to foreigners, that it obtained the name of _the plague_.” The Doctor saw several cases of it in St. Domingo, during the months of August and September, 1798, and “these were entirely confined to _American seamen_, while the native inhabitants of the city were totally exempt from it.” 2. From this very sickly coast arrived the Deborah on the eighth of July. 3. On the 12th of August John Lewis, mate of the Deborah, informed Dr. Currie, that the vessel had lost _seven_ persons with fever on board during her passage, and one by accident; _and that she had been employed as a transport in the British service_ previous _to her taking in her cargo at Jeremie._ 4. Mr. Thomas Town informed Dr. Wistar, that, on the first of August, 1798, he was told by Alexander Philips, of Water-street, that he (Mr. Philips) had brought up two or three sick people from the Deborah, in one or two boats. Some of them he had brought to his own house; and one was dead. Philips himself was sick at the same time, and died a day or two after. 5. Mr. Purdon informed Dr. Currie that he had a similar account from Mr. Philips, whom he saw on the first or second of August in apparent good health, and that he died on the Saturday following.

All this, and further evidence seemingly equally strong, was set aside with the greatest facility by bringing counter-evidence, particularly that of Mrs. Philips, who denied that there were any sick people in the house; and by bringing instances of the fever existing in town before the vessel arrived. It is needless therefore to trouble the reader with any further discussion of this evidence more than the rest. As the ancient Britons, in their letter to Aetius, lamented that the _barbarians_ drove them to the sea, and the _sea_ drove them back to the barbarians, so may we lament, in the present investigation, that the uncertainty of theory drives us to _facts_, and the uncertainty of supposed facts drives us to _theory_. Still, however, we shall not despair. The introduction of a disease into a large city is much more difficult to be traced than in a smaller one. In the year 1794 the disease appeared in the town of New Haven in Connecticut. Dr. Monson of that place informs us, that it appeared on the 10th of June, when Mrs. Gorham, residing on the _Long wharf_, was visited by Dr. Hotchkiss, who found her affected with symptoms of the yellow fever. In three days her complaints suddenly vanished, and she was supposed to be in a fair way of recovery, but the same evening she vomited matter resembling coffee-grounds, and died next day. On the same day that Mrs. Gorham died, Dr. Monson visited her niece, a girl of eight years of age, who had staid a week with her aunt, and was taken ill three days before. The day after the Doctor saw her she was suddenly relieved as her aunt had been, but in a few hours vomited matter like coffee-grounds, and died next day. These and some other similar cases having alarmed the select men, inquiry was made, when “it appeared, that, in the beginning of June, capt. Truman arrived from Martinico, in a sloop that was infected with the contagion of the yellow fever; that this vessel lay at the _wharf_, within a few rods of Mrs. Gorham’s residence; that she had on board a chest of clothes which had belonged to a mariner who died of the yellow fever in Martinico; and that his chest was carried into Mr. Austin’s store, and opened in presence of Capt. Truman, Mr. Austin, Henry Hubbard, and Polly Gorham: the three last died in a short time after their exposure to the contents of the chest. Hence it is highly probable that Mrs. Gorham caught the disease from the infected sloop or clothing. Mr. Austin’s store stands within three or four rods of Mr. Gorham’s house; and no person in town was known to have the yellow fever previous to capt. Truman’s arrival.”

In his further account of this fever Dr. Monson shows that it was contagious in the highest degree, and that Mr. Gorham’s house proved a kind of seminary from whence the disease spread itself. “June 26 (says he) Isaac Gorham lost an infant child with the yellow fever; and soon after his son and daughter were affected with it: the former died. Solomon Mudge died on the 30th; Jacob Thomson’s negro woman on the 1st of July; Archibald McNeil on the 9th; Polly Brown on the 3d of August; John Storer, jun. and John Hide, on the 8th; and widow Thomson on the 10th. Jacob Thomson’s negro woman, Solomon Mudge, John Storer, jun. and John Hide, had visited Mr. Gorham’s house a few days before their illness; Polly Brown and Mrs. Thomson nursed in Mr. Gorham’s family; and Archibald McNeil nursed Solomon Mudge. Elias Gill died on the 12th of August, and Samuel Griswold’s wife on the 7th: the former visited Mr. Gorham’s house, the latter nursed in his family.

“There were a number of persons who caught the disease at Mr. Gorham’s house, and recovered.

“Mrs. Thomson, on the first day of her illness, was moved half a mile from Mr. Gorham’s, into George-street. Luther Fitch caught the disease from Mrs. Thomson, and communicated it to his servant maid. Both recovered. Mr. Fitch lives in College-street, nearly three quarters of a mile distant from Mr. Gorham’s house. I could trace the disease throughout the town. No person had the yellow fever unless in consequence of attending the sick, or of being exposed by nurses, infected houses, clothing, or furniture.

“I have inquired of several aged persons in this town relative to the yellow fever, whether they knew of its having ever been here previous to June 1794, and there is but a single instance; the facts relating to which are these: In the year 1743 a transient person, by the name of Nevins, who came from the West Indies, lodged at the house of Nathaniel Brown, an inn-keeper in this city. The man was taken very sick in the night, and died shortly afterwards; and his body was very yellow after death. Mr. Brown’s wife sickened in a short time, and died of the same complaint, which was at that time supposed to be the yellow fever.

“I am credibly informed that several persons at Mill-river, in Fairfield county, and also at New London, died with the yellow fever in August and September, 1795. It was propagated there by infected persons from New York.

“Capt. John Smith died in this town, the 20th of August, 1795. He caught the disease in New York, and communicated it to one of his negro servants.”

On the whole, Dr. Monson concludes, “that the yellow fever is seldom or never generated in this country, and that it is always imported from abroad. An objection to the idea of its being generated in this country is, that it was never known in the interior of this state, or of the United States, so far as I can learn. Had it ever appeared in Connecticut before the year 1743, and June 1794, we should undoubtedly have had some record of the fact. There is no such record, and no person remembers to have heard of such a disease, but at these periods, prevailing in any part of the state. There are numbers of aged persons in New Haven who remember the putrid ulcerous sore throat, small pox, measles, dysentery, &c. raging here with great mortality, but have no recollection of any yellow fever. Hence we may rationally conclude that it never did appear in this state but in the years 1743 and 1794.

“It is evident, from facts before mentioned in this letter, that the yellow fever was propagated in no other way than by contagion, and that this is a _specific contagion_, and no more diversified, in its operation on the human system, than that of the small pox and measles.

“If the citizens of large commercial cities were attentive in tracing the origin of the yellow fever, on its first appearing among them, they would often find that the disease was imported. In some instances it would be extremely difficult to discover the origin. But the mischief lies in this; that the inhabitants of such cities, whenever a contagious disease makes its appearance among them, endeavour to suppress all rumour of it, from an apprehension of alarming the country, and injuring their commerce; unwilling to believe that there is evil in the city, till the disease spreads in every direction. Then, indeed, when it is too late, they are solicitous in the use of means to arrest its progress. As it extends itself slowly at first, seasonable exertion might both detect its source, and prevent its increase; but when it is diffused through a city, it spreads with rapidity, and it is no longer possible to discover where it began. But as, whenever the yellow fever has appeared in the United States, it has always been in sea-port towns, and originated near wharves, docks, and warehouses, there seems to be high probability that the disease is imported.”

The evidence here seems so strong, that no counter-evidence that can be brought appears likely to invalidate it. The coincidence of the commencement of the fever with the arrival of the ship hath not been denied, as in other cases; and, though it has been attempted to prove that a fever might have arisen from the quantity of putrid or putrescent matters at that time in the town, yet the circumstances of those who were present at the opening of the chest of clothes being taken with the fever, and those who were sick of it in so many cases infecting one another, cannot by any means be overthrown. But the fact is, that even those who contend most violently against importation, do yet allow that it may in some cases be so; but they contend that if proper care be taken it will not spread. Dr. Smith in his letter to Dr. Buel says, “that infection may be brought into any place from abroad; that, under certain circumstances of the place where it is introduced, it becomes very destructive; but that, when these circumstances do not exist, however the person immediately affected, if it be introduced by a sick person, may suffer, it is harmless so far as the general health of that place is concerned. If the subject were viewed in this light, as most assuredly it ought to be, the question of importation or non-importation would sink into its merited insignificance.” But, with due respect to the memory of Dr. Smith, this must surely be accounted a very inconsiderate mode of reasoning. In the instance he speaks of, that of the Zephyr lately mentioned, he allows that Dr. Treat _might_ have caught the disease on board the vessel,[158] “but (says he) as _no other_ person is known to have been infected by that vessel, and as the Doctor communicated it to no person, the advocates for importation would not be greatly benefited by the concession.” Surely we must look upon the life of Dr. Treat himself to have been a matter not entirely insignificant, and if he caught the fever by going on board, a number of others who went in full confidence of the _impossibility_ of importation, might have done the same. As far therefore as the prevention of such accidents can be accounted a matter of importance, it is also of importance to believe the doctrine of imported contagion. It is true, Dr. Smith, in the passage just quoted, adds immediately after, that “no such concession (with regard to Dr. Treat) is necessary;” but, in p. 104, he does make an ample concession, as we have seen, viz. that the contagion may not only be imported, but, under certain circumstances, _be very active and destructive_. The question therefore rests here: Can we at all times promise that, with the utmost care that can be taken, the circumstances of a place may not be such as to give activity to an imported contagion? In the nature of things it is impossible that the docks, wharves, streets and alleys of a large town can be absolutely clean. It is equally impossible that _all_ men can be advised to be temperate, cleanly, and neat in their lodgings; and we are unable to determine how far people may deviate from the _rule of right_ in those respects without danger. Before any theory of this kind could be supported, it would be absolutely necessary to bring an unequivocal proof that yellow fever had been in _one_ instance at least produced by local causes; but this cannot be done. Among the Hottentots, the dirtiest people in the world, no such disease exists. Among the peasants of Poland, who likewise live in a very dirty manner, their mode of life is said to produce not a fever, but a disease of the hair, called the _plica Polonica_. In the Medical Repository, vol. i, p. 276, Dr. Mitchill of New York describes a disease called _elephantiasis, liktraa, or scurvy_, occasioned by loathsome, putrefying diet, such as rotten fish, fish-livers and roe, fat and train of whales and sea-dogs, congealed sour milk, with little or no vegetable provisions, and by exposure to wet and cold. This disease prevails in Iceland, in the Ferro islands, in two districts of Sweden, and in _Madeira_; yet this disease is not the yellow fever, though it is said to make the person afflicted with it more like “a putrefying corpse than a living man.” The _cold_ seems to be assigned as a reason why the disease does not assume a febrile form; but, however this may hold with Iceland, it cannot with Sweden, where the summer is so hot, that the sun has been said to set forests on fire. This is probably a fable; but we are assured by Pontoppiddan, in his Natural History of Norway, a country to the full as cold as Sweden, that in summer the heat is very great. His expression is, that it is enough to “make a raven gape.” As to _Madeira_, where the climate is warm, there can be no such objection. But a particularity of this disease is, that it is infectious. Supposing then that by any means it should be exalted into a fever, have we any reason to imagine that in such a case it would lay aside its infectious property? Surely not. If this then is the case with a disease produced by the same causes with the yellow fever, we have the very same reason to suppose that the latter is infectious, as that the former would be so if it could lay aside its present form, and assume that of fever. Another proof that mere dirtiness cannot at all times produce a distemper, or even propagate its infection, may be deduced from the sixth case quoted p. 355 from Dr. Russel, where he says that a poor Jewish family lived in a place such as he had always considered as one of the receptacles of contagion, yet only one in six of those who remained in it was taken with the plague. In all cases of plague, or of violent epidemic disorders, it has indeed been observed that the poor were more subject to an attack than the rich. This was so remarkable in the plague of London in 1665 that Dr. Hodges says it was called the _poor’s plague_; and Dr. Ferriar tells us from Diemerbroeck, that in some parts of Italy it was customary in the beginning of a pestilence to drive out the poor; and likewise that this cruel expedient was used at Marseilles. The bad success of the experiment at this last place, however, shows that people of any description, and in any circumstances, may be attacked. A very probable cause, entirely distinct from any mode of living, may be assigned in this case, viz. that the poor are more exposed to infection than others, both from their circumstances and their rashness; for it will be evident to those who converse with the most uninformed people of any country, that the Turkish notion of predestination is far from being confined to Mahometans. It is not, however, denied, that dirtiness, as well as other local causes, may do much hurt, and occasion the spreading of a disease which otherwise would not spread; because uncleanness of all kinds seems to be the proper vehicle of infection, in which it appears to delight to take up its abode. In the Medical Extracts, vol. ii, p. 174, we have from Goldsmith the following anecdote concerning the concentration of pestilential infection in the plague of London:

[158] Webster’s Collection, p. 98.

“A pious and learned schoolmaster, who ventured to stay in the city during the plague, and took upon himself the humane office of visiting the sick and dying who had been deserted by better physicians, averred, that, being once called to a poor woman, who had buried her children of the plague, he found the room where she lay so little, that it could scarce hold the bed on which she was stretched. However, in this wretched abode, beside her, in an open coffin, her husband lay, who had some time before died of the distemper, and whom she soon followed. What shewed the peculiar _malignity_ of the air, thus suffering from human miasmata or effluvia, was, that the contagious steams had produced spots on the very _wall_ of their wretched apartment. And Mr. Boyle’s own study, which was contiguous to a pest-house, was also spotted in the same frightful manner.” This shows not how infection may be _produced_, but how it may be concentrated in such miserable apartments. The appearance on the walls brings to remembrance what is said in the book of Leviticus concerning the appearance of the leprosy in walls and clothes.

But, supposing we should allow that dirtiness may bring on a yellow fever (and it is plain that this cannot be proved) we have, in the case of the Busbridge Indiaman, a _demonstration_ that cleanliness cannot keep it off.[159] This vessel sailed from England for the East Indies, in the year 1792, much about the same time that the Hankey sailed for the coast of Africa. She had on board 264 people in all, viz. 109 belonging to the ship’s company, 130 recruits, and 25 passengers. She had very boisterous weather at first setting out, but crossed the equator on the 26th of May, where the weather was sultry, with heavy showers of rain. The disease now made its appearance first among the recruits, and in a fortnight spread among the ship’s company. It was common for six or seven to be attacked with it daily from the commencement; “and in the space of twelve weeks almost every person in the ship not only had laboured under it, but many had suffered repeated relapses.” For several weeks the weather was hot and sultry; but, when in the vicinity of the Cape of Good Hope, they experienced a reverse, and were driven by a storm as high as S. lat. 42. Here the thermometer indicated a temperature only 13° above frost, but no material change in the disease took place. Afterwards, when returning into the warm latitudes, they experienced the sultry heats of the Atlantic without any change either for the better or the worse, and this for no less a space than three months.

[159] Annals of Medicine, vol. i, p. 166.

As to the origin of the disease, Mr. Bryce the surgeon, though inclined to ascribe it to contagion, could not trace it to any origin of that kind, as the vessel had been six weeks at sea before it appeared. It “could not be ascribed to want of air or cleanliness, as _every possible_ attention had been used to preserve these: the different apartments were thoroughly cleaned and fumigated with wetted gun-powder; the decks were sprinkled with boiling vinegar; and the windsails were attentively kept in order at each hatchway. Mr. Bryce is inclined to conjecture that a peculiar combination in the circumstances of diet, situation, and state of the atmosphere, may have given rise to this calamity. But the same combination of circumstances so frequently takes place _without any fever_, that it appears much more probable the disease had its origin either from an _imported fomes_, or from a _fomes generated in some individual in_ the ship, from whence it was afterwards propagated to others by _contagion_.” The disease produced on board the ship was not contagious to the people on board another vessel with whom they had communication, nor to the people ashore among whom the convalescents were put, nor to new passengers taken on board the vessel in the East Indies; circumstances certainly not a little surprising.

It doth not therefore appear, that, without the intervention of some other cause, mere dirtiness can produce the yellow fever. Let us next see what can be done by confinement, want of air, or, as it has been lately called, abstraction of oxygen. On this, however, we must observe, that in all cases where people are allowed to breathe, their lungs must be filled with the due quantity of _some_ elastic fluid. If the fluid they breathe contains a smaller quantity of oxygen, it must contain a greater quantity of something else. If a disease therefore is produced, it must be occasioned by the _presence_ of that other fluid, as well as by the absence of oxygen. Now, in confined air, we know that not only the oxygen is diminished, and consequently a larger proportion of azote or septon mixed with it, but in addition to this increased proportion of azote, there is also a positive augmentation of the deleterious part of the atmosphere by the effluvia from the bodies of those who are confined. These effluvia, as we have seen, p. 90, contain a great quantity of fixed air. Others have shown that they contain also azote; and it may be so; but still we are sure that the fixed air predominates. Besides this, from the breath we know that a great quantity of aqueous moisture proceeds. Experiments on the action of these different kinds of fluids are yet in an imperfect state, yet some important facts relating to them are known. 1. Oxygen breathed in great proportion produces an augmentation of heat, and proves an universal stimulant. See p. 118. By itself it quickens the pulse.[160] 2. Pure fixed air breathed by itself destroys life with the circumstances of increased heat, rarefaction of the blood, and rupture of the vessels. See p. 206. 3. The circumstances attending death by breathing azote are not particularly recorded; but we know that by breathing an atmosphere lowered by it the consumptive fever is not increased, but diminished; and there is an account in the Medical Annals of a person who was perfectly cured of a consumption by the smell of the bilge-water of a ship. 4. It has formerly been shown, from Dr. Black’s experiments, that, when the vapour of water is condensed in the body, a great quantity of heat must be thus communicated to it. In confined air therefore there is a diminution of the oxygen which produces heat; but there is an augmentation of the fixed air and of the aqueous moisture which increases it; so that, on the whole, the balance must be considered as in favour of the augmentation of heat in the human body; not to mention the quantity of sensible heat continually added to the atmosphere by that which evaporates from the body. This position, however, doth not stand upon the uncertain ground of theory; it is confirmed by the following remarkable fact: Commodore Billings, who commanded a Russian expedition fitted out by the late empress, found, in his travels through the northeastern part of Asia, that the cold of the atmosphere exceeded not only what was known in other climates, but even what most people had been able to produce by freezing mixtures. Dr. Guthrie informs us that he was unable to produce a greater degree of cold than 36 below 0 of _Reaumur_, though assisted by 20 below 0 of natural cold, and the power of all the freezing mixtures he knew. “How much then (says he) was I surprised to hear Mr. Billings assert, that some spirit thermometers which he had with him, graduated according to _Reaumur’s_ scale, were often as low as 40° below the freezing point of water, that is, 8 deg. below the freezing point of mercury. And once or twice he observed them at 42 deg. below the _freezing point of quicksilver_.[161]

[160] In the Medical Extracts we find it recorded, that a young
gentleman having breathed pure oxygen for several minutes, his pulse,
which was before 64, soon beat 120, in a minute.

[161] This account is taken from the Annals of Medicine for 1798,
and appears in a letter from Dr. Guthrie at Petersburg to Dr. Duncan
at Edinburgh. It is drawn up with such _astonishing_ inaccuracy,
that we may well be surprised how the one physician should write,
and the other print it. There seems in the first place to have been
a mistake of Reaumur’s thermometer for Fahrenheit’s. But even this
will not rectify the account. The _zero_ or (0) on Reaumur’s scale
is the freezing point of water; on Fahrenheit’s it is the cold
produced by a mixture of salt and snow, 32 degrees below the freezing
point of water. The freezing point of quicksilver has been fixed at
39, 39-1/2 or 40 degrees below the cold produced by salt and snow.
When the thermometer therefore fell to 40 deg. below the freezing
point of water, it was only eight degrees below the cold of salt
and snow, and not equal to the congelation of mercury by more than
thirty degrees. The difference between this and _forty-two_ degrees
below the freezing point of quicksilver is enormous and incredible.
It indicates a degree of cold hitherto unobserved on the face of
the earth, and scarcely equalled by the latest experiments made
at Hudson’s bay, where, by means of vitriolic acid and snow, the
thermometer was made to indicate a degree of cold 40 degrees below
the freezing point of quicksilver. The inaccuracy and confusion of
this account, however, does not affect the subsequent part relative
to Mr. Billings’s journey.

“During this severe cold (probably 42 below 0 of Fahrenheit) the Nomade Tchutski (a wandering nation on the northeastern extremity of the Asiatic continent) who were conducting him along the coast of the Frozen ocean, in sledges drawn by rein-deer, encamped every night on the frozen snow in low tents, which they quickly formed with the skins of rein-deer, spreading some of them on the surface of the snow, on which they all slept; and he assured me, that, so far from suffering from cold during the night, the heat was so excessive in these fur tents, where from ten to fifteen slept together, according to its dimensions, that no one could bear even a shirt; but all lay in a violent perspiration, naked as they were born, till dawn of day, without the aid of fire, excepting a train-oil lamp, which lighted each tent.”

From this account it seems pretty evident, that, by the accumulation of animal effluvia, a heat may be communicated to the atmosphere greater than that of the human body. We cannot suppose the heat of the tent which put the people in a violent perspiration to have been less than 90° of Fahrenheit; and, supposing the temperature of the external atmosphere to have been at a medium 30° below 0, there must have been a generation of 120 degrees of heat; but the heat of the human body does not exceed 97 degrees, and it cannot communicate more heat than it has. But we must suppose the tents to have been capable, had they been filled to the top, of containing twice the number who did sleep in them. They could communicate to the air therefore only one half of 97 degrees, or 48-1/2°; the remaining 71-1/2° therefore must been derived from the breath and perspiration of the body.[162]

[162] Here no account is made of the heat that the very cold snow
upon which they lay must have absorbed, which we know must have been
very considerable, though it cannot be calculated.

Let us now attend to the consequences which must naturally and undeniably follow from this fact. If, in such a violently cold climate, the effluvia of fifteen human bodies could produce a heat sufficient to induce a violent perspiration, what would they not have done had they been in a climate where the heat of the atmosphere was upwards of an hundred degrees greater, or between 70 and 80 above 0 of Fahrenheit? Perhaps this was never thoroughly tried except in the black hole at Calcutta. Here an hundred and forty-six men and one woman were enclosed in a dungeon only 18 feet square, and consequently affording scarce eighteen inches square to each. This happened in a very hot climate, in the month of June; so that we cannot suppose the temperature to have been less than 80° of Fahrenheit.

On being confined in this manner, the vital powers endeavoured, by a most profuse perspiration, to send off the superfluous quantity of heat thrown into the body. This was exactly what took place with Dr. Guthrie; but, in the case of the black hole, there was, besides the quantity of heat produced by the warmth and perspiration of the body, _an hundred and ten_ degrees more to be added, on account of the natural heat of the atmosphere. For we cannot suppose the heat at Calcutta, in a sultry evening in the month of June, to have been less than 80, which added to –30, supposed to be the temperature among the Tchutski, makes 110°. The perspiration was extremely profuse, and was soon accompanied with excessive thirst; nature being unable to supply such a quantity of liquid, or this liquid to carry off the heat from the body. The want of pure air began then to be felt by a difficulty of breathing; and Mr. Holwell, having in despair retired from the window, found the difficulty of breathing increase, attended by a palpitation of the heart. Aroused by his sufferings, he returned and was relieved by drinking some water, and having air at the window. The difficulty of breathing diminished, and the palpitation ceased; but, finding the thirst not to be quenched by water, he sucked his shirt-sleeves, which were wet with sweat, and endeavoured as much as possible to catch all of it that he could. The taste was soft and agreeable. A pungent steam was now felt like spirit of hartshorn. A number had died, and Mr. Holwell, once more rendered desperate, retired from the window, and lay down upon a bench, where he soon lost all sense. Next morning only 23 survived, of whom Mr. Holwell was one. He revived on being brought out to the fresh air, but was instantly seized with a putrid fever, as well as all the rest of the survivors. In this situation they were obliged to walk, loaded with fetters, to the Indian camp; at night they were exposed to a severe rain, and the day following to a sultry sun; yet, notwithstanding this ill treatment, they all recovered; having an eruption of large and painful _boils_ all over the body. Mr. Holwell, however, said that he never afterwards enjoyed good health.

Another melancholy proof of the bad consequences resulting from a want of fresh air we have in the evidence given by Dr. Trotter, when the question concerning the slave trade was agitated before the British House of Commons. He deposed that the slaves were confined 16 hours out of 24, and permitted no exercise while on deck. They were kept in rooms from 5 to 6 feet high, imperfectly aired by gratings above, and small scuttles in the sides of the ship, which could be of no use at sea. The temperature of these rooms was often above 96 of Fahrenheit, and the Doctor says that he never could breathe in them, unless just under the hatch-way. “I have often (says he) observed the slaves drawing their breath with all the laborious and anxious efforts for life which are observed in expiring animals subjected by experiment to foul air, or in the exhausted receiver of an air-pump. I have often seen them, when the tarpaulings have been inadvertently thrown over the gratings, attempting to heave them up, crying out, in their own language, ‘We are suffocated!’ Many I have seen dead, who, the night before, had shown no signs of indisposition; some also in a dying state, and, if not brought up quickly on the deck, irrecoverably lost. Hence, in one ship, before her arrival in the West Indies, out of 650 slaves, more than 50 had died, and about 300 were tainted with the sea scurvy.”

A third example of the effects of want of air, though conjoined with other causes, may be reckoned the case of the Hankey, formerly related. The people there were not indeed confined as much as in the black hole, but it is impossible to suppose that there could be a proper circulation of air, and the length of time the passengers were confined might be equivalent to the violence of the cause in the case of the black hole. In the latter, however, the disease produced was not the yellow fever, but seems to have been a kind of non-descript eruptive one, more resembling the small pox, or rather _Job’s disease_, than any other. From Dr. Chisholm’s account of the Boullam fever also, it seems to have been more of an eruptive nature than the common yellow fever; so much, that Dr. Chisholm is of opinion that it partook “in no small degree of the nature of the true plague.” He says that in it he “did not observe _carbuncles_ on any who died; but that in many who recovered they were numerous, large, and very troublesome.” He considered them also as a critical discharge, and the only one in this fever; but in the plague they certainly are not; neither is it at all probable that they were of the same nature with the pestilential carbuncles.

In p. 207 of this treatise it is inferred, from some experiments of Dr. Davidson and Dr. Chisholm, that the fevers in warm climates _are not_ owing to a deficiency of oxygen in the atmosphere; but in a treatise on the yellow fever in Dominica by Dr. Clarke, we have other experiments, which, if they can be depended upon, certainly overthrow that doctrine, or at least render it very dubious. Dr. Clarke endeavoured to ascertain the purity of the air by Mr. Scheele’s apparatus, and which was likewise used by Dr. Davidson, viz. filling gallipots with flowers of sulphur and iron filings well mixed and moistened, and putting these upon a stand under a glass vessel, which was placed on a stool in a pail of water. The glass vessel was marked and divided on the outside, and, allowance being made for the space occupied by the gallipot, the water rose only one fifth in the glass vessel, after standing 24 hours. When the disease abated, it rose near one fourth; and upon many trials afterwards it never rose above one fourth. When the emigrants fled towards the mountains, where the air is very pure, they always avoided an attack of fever, or soon recovered if in a convalescent state. This is similar to what is stated by Van Swieten concerning the plague at Oczakow, viz. that the atmosphere was so loaded with some kind of vapour, that in certain parts of the town polished sword-blades were turned black. This seems to have indicated a great prevalence of inflammable or hepatic air, or both, in the atmosphere; but it is extremely doubtful whether this could produce a _fever_, much less the true _plague_. In Dr. Clarke’s experiments it were to be wished that he had examined the nature of that part of the atmosphere which was left after the absorption of the oxygen. It is by no means probable that at any rate the addition of a fifth part of azote could have rendered the air so unwholesome; and besides, we are entirely at a loss whence to derive such an immense quantity; for certainly the quantity of air which surrounds us, even for a few miles extent, is so great, that any considerable alteration in its composition could not take place without a very evident cause. The probability therefore is, that the experiments did not give an accurate statement of the quantity of oxygen contained in the atmosphere. Experiments on this subject must always be uncertain; and of all the modes of trying the qualities of the air, perhaps that with sulphur and iron filings is most liable to variation. It may vary, from the nature of the sulphur,[163] from the cleanness or the impurity of the iron filings, or lastly from the accuracy of the mixture. It is also a misfortune in this case, that though a great absorption proves the existence of a large quantity of oxygen in the atmosphere, yet a small one does not prove the contrary; for it is more reasonable to suppose that we have failed in our experiment, than that the constitution of the atmosphere has changed. Dr. Clarke’s experiments therefore cannot prove any thing, until more accurate methods of investigating these things be found out.

[163] If sulphur be a _simple_ substance, as the new chemists
pretend, there ought never to be any variation in its properties,
except what arises from mere impurity; but the following is a
remarkable instance to the contrary: Dr. Crawford (brother to the
celebrated Adair Crawford) informed me, that for his oil of vitriol
works at Lisburn, in Ireland, he had purchased _five tons_ of
sulphur produced from copper mines in the island of Anglesey. The
sulphur looked well, and was not more impure than what he commonly
used; but, on trial, the produce of acid fell so much short of
what he had been accustomed to receive, that it would not afford
the expense of manufacturing. An experiment on such a large scale
could not be erroneous. If sulphur is a simple substance, the fact
is unaccountable: if it is composed of phlogiston and acid, an over
proportion of the former will easily account for it.

We must now proceed to investigate a third cause assigned for the production of fever, and that is the putrefaction of animal and vegetable substances. This hath been very much insisted on. Dr. Rush ascribes the fever of 1793 to the exhalations of putrid coffee, but allows also the distemper to have been contagious, and says, that “for several weeks there were two sources of infection, viz. exhalation and contagion. The exhalation infected at the distance of three or four hundred yards, while the contagion infected only across the streets. The more narrow the street, the more certainly the contagion infected. Few escaped it in alleys. After the 15th of September the atmosphere of every street was loaded with contagion; and there were few citizens in apparent good health, who did not exhibit one or more of the following marks of it in their bodies: 1. Yellowness in the eyes, and sallow colour on the skin. 2. Preternatural quickness in the pulse. 3. Frequent and copious discharges by the skin of yellow sweats. 4. A scanty discharge of high-coloured or turbid urine. 5. A deficiency of appetite, or a preternatural increase of it. 6. Costiveness. 7. Wakefulness. 8, Head-Ach. 9. A preternatural dilatation of the pupils.... Many country people who spent but a few hours in the streets in the day, in attending the markets, caught the disease, and sickened and died after they returned home; and many others, whom business compelled to spend a day or two in the city during the prevalence of the fever, but who escaped an attack of it, declared that they were indisposed during the whole time with languor or head-ach.”