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Art. XVI. Obfervations upon the Origin of the Malignant,
Billious, or řellow Fever, in Philadelphia, and upon the means of preventing it. Addressed to the Citizens of Phi. ladelphia. By Benjamin Rush. Dobson. Philadelphia. Pp. 28. 1799
HE ravages which this dreadful disorder has produc d of
but more particularly in Philadelphia, render every attempt to ascertain the causes which produced it, with the means of prevention or cure, extremely interesting. Dr. Rulh thus explians its remote causes.
“ This disease is the offspring of putrid vegetable and animal exhalations in all countries.-It prevails only in hot climates and sea. sons. The sources of it in Philadelphia are chiefly the following
1. The docks ; these contain a large quantity of filthy matters in a high concentrated state. They are first acted upon, by the heat of
the fun, and hence failors and the inhabitants of Water-ftreet, are generally the firft persons who are affected by the yellow fever every year. It is derived so frequently from the docks in New York, that it has obtained there, the name of the dock fever.
2. The foul air of ships.
3. The common fewers. A yellow fever was produced by a large fewer in Calcutta. It was afterwards prevented by closing it up, and removing the filth of the city in another way.
4. The gutters,
5. Dirty cellars and yards.-Foul air is sometimes generated in cellars, which produces sporadic cases of fever in all seasons of the year. Swen Warner died of a yellow fever en the 30th of Januar', 1799, received hy breathing the air of a cellar which had been shut up for several months.
6. Privies. An epidemic fever was once traced to this source, in the city of Frankfort, in Germany.
7. The purifying masses of water which lie in the neighbourhood of the city, and
8. Impure pump-water.
All the physicians in our city agree in deriving the common bilicas fever and dysentery from these fources ; now as these diseases hare, we are told, by the College of Physicians, « lately very much dimin ished, ** and as the putrid exhalations still continue, the presumpuos i s, that they produce our higheft grade of bilious, which is theyelow fever."
The author takes some pains to shew that this fever is not contagious, and though his reasons have failed to produce conviction on our mind, his motives for the attempt merit com. mendation.
" The power, which heavy rains and frost have, of deffroying our fever, clearly prove that it does not spread by contagion. We have feen it checked three times, in three different years by frosty nighus, The cold in these cases cannot act upon the disease in our houses, and of course it does not alter the quality of the matters discharged from the bodies of the sick. It acts only upon the putrid exhalations which float in the atmosphere,
«. The interests of humanity are deeply concerned in the admiffion of the rare and feeble contagion of the yellow fever, Hundreds have perified by being deserted by their friends in situations in which the disease 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 exposed to putrid exhalations, who have believed themselves to be safe, because they kept at a distance from the fick."
* Facts and Observations, P, 24.
He next adduces reasons in support of his position, that the yellow fever cannot be imported, and these appear to be fatistactory; and his means of prevention, whether efficacious or not, are certainly judicious and ought to be tried.
“ Let the docks be immediately cleaned, and let the accumulation of filth in t'en be prevented in future, by conveying water into them by a p.:ffage under the wharves, or by paving them with large flag stones inclining in such a manner towards the channel of the river, as that the filth of the streets Thall descend from them (after it falls into the docks! into the river. This method of paving docks bas been used with success in the city of Brest. The street now known by the name of Dock-street once exposed a large surface of filth to the action of the sun. Its neighbourhood was more fickly at that time, than any o: her part of the city. By means of the prefent arch over that filth, Dock-ftreet has been exempted from an unusual number of fick people, during the summer and autumnal months.
2. Let every ship that belongs to our port be compelled by law to carry a ventilator. Let all such ships as are discovered to con. tain foul air in their holds, be compelled to discharge their cargoes before they reach our city, and let the ships in port be compelled to pump out their bilge water every day,*
3. Let the common sewers be washed frequently with streams of water from our pumps. Perhaps an advantage would arise from opening them and removing such foul matters, as streams of water are unable to wash away.
4. Let the gutters be washed every evening in warm weather, By frequently washing the streets and pavements, the heat of the city would be lessened, and thereby one of the predisposing causes of the fever would, in some measure, be obviated.' The use of water for the above purpoles, has become more necessary since the
* " Many of the citizens of Philadelphia have deserted the College of Physicians, by admitting the foul air of a ship to be the caule of a yellow fever. The College derive it wholly from a Specific contagion formed by a peculiar process in the body, fimilar to that which takes place in the small pox. The foul air produced by putrefation, whether generated in the hold of a ship or in docks, or commun fewers and gutters, is of the same nature, and acts in the same manner in producing the yellow fever.
" A new hypothesis has lately been broached to prove the importation of this dileale. It makes foul air a necessary recipient for ihe contagion, before it can at upon the body. The small pox and mealles require no such recipients to enable them to produce a fewer. The foul air is sufficient to induce all the effects that have been ascribed to it, without calling to its aid a mixture with a lupposed ipecific contagion.”
streets and gutters have been so closely paved; for the filth which formerly loaked into the earth, is now confined, and emits its noxious vapours into the atmosphere.
5. The utmost care should be taken to remove the filth from the yards and cellars of every house in the city. Hog styes hould be forbidden in yards, and the walls of cellars should be white-wahed two or three times a year, and their foors should be conitantly covered with a thin layer of lime.* White-washing the outside of houses in sickly itreets would probably be useful.
6. Let the privies be emptied frequently; and let them be conftructed in such a manner as to prevent their contents from cozing through the earth so as to contaminate the water of the pumps. The famous Ambrose Parey ascribed one of the plagues of Paris wholly to foul air, and impure water. Mr. Latrobe in a note, in his preposal for his prelent important undertaking, has very properly pointed out the impurity of our water as one of the remote cauzes of the yellow sever.-Happy will it be for the citizens of Fhila. delphia if by means of that gentleman's plan for supplying the city with river water, they should be delivered from the neceflity of ma. king use of the water from their pumps for drinking, and culinary purposes.
" Let all the filth be removed from the neighbourhood of the city, and let the brick kiln, and other ponds be filled up, from tine to time, with the earth which is obtained in digging cellars,
8. In the future improvement of our city, let there be no more dwelling houses erected in alleys. They are often the secret recep. tacles of every kind of filth. The pligue always makes its first appearancei
e in the narrow streets, or in the dirty huts of the suburbs of Constantinople.
" I attended two persons in this city last year in one house with the yellow fever, in the yard of which, and directly under the window of the back room was a barrel, filled with cucumber and melon rinds, which had been accumulated there in the summer of 1797. The tiench from them, after a rain, was perceptible all over the house.
“ Some of the best houlekeepers in our city, burn all their offal vegetable and animal matters in their kitchen fires. If this prac. tice were univerial, it would contribute much to the health of our city. Many years ago, housekeepers in Amsterdain were refrained hy law froin throwing the offals of their kitchens into their canals. The late increate of bilious fevers in that city has been afcribed to that lw not being faithfully carried into execution.
“ Tire wood should never be confined in cellars in the warm months, in a green or wet liate. It emits when heated, an unwholefome vapour, which has been known to produce a fever. Log huis and cabiris, the second year they are inhabited, often become un. healthy from the decay of the bark of the logs of which they are compoled,"