regular periods a visitant among the nations of the earth in some and perhaps distant parts of the world. No regular history of fevers since the time of Sydenham has been handed down to us until the yellow fever made its appearance, since which time, until lately, the spotted or petechial fever has never made its appearance. The first cases of it which occurred were in Winchester, Litchfield county, Connecticut, about the 10th April, 1807. It has since prevailed in many places in that state, Massachusetts, and in Vermont, as well as in this part of the state of New-York.

I shall now proceed to describe the symptoms of the disease as it appeared here. The patient is generally seized with a pain in some particular part, most frequently in one of the limbs, the hip or the shoulder, shifting from place to place and often to the head or stomach, with great anxiety and restlessness. These symptoms are accompanied with cold shiverings and other marks of fever, which are soon succeeded by sickness at the stomach, indescribable distress about the precordia, numbness of the extremities, a remarkable and general prostration of strength, and a depraved action of the sensitive organs. In some violent cases the sight is much impaired, and even totally, though temporarily, lost. The pupil of the eyes is for the most part contracted in the beginning of the disease, though after its continuance for some time, it becomes considerably dilated or enlarged. The tongue has been invariably covered with a whitish coat and moist. The pulse is generally low, a little increased in frequency, remarkably intermittent, and unequal both in strength and weakness; but in some few mild cases it is very little altered. Respiration is in all cases much disordered. Pe

techiæ or livid blotches, or a red, fiery eruption in most cases, appear on some part of the body and sometimes they are general; though they are not always a constant attendant. There is in most cases a delirium attending from the attack through the whole course of the disease, though this was not universally the case. The duration of the disease has generally been from twenty-four to forty-eight hours, when the patient has either died or the disorder run into the form of a mild typhus of uncertain duration.

The indications of cure are as various and deceptive as the symptoms which accompany the disease. There is, however, one object to be kept constantly in view, and that is to restore the vital powers by bringing about a reaction of the system, or in other words, to reverse or overcome the prevailing morbid actions, and to force a new train of actions upon the system.

I have generally pursued the following method of cure with those whom I have attended. To an adult, I haye immediately given about twelve grains of calomel and if the vomiting was considerable, a solution of vo latile alkaline salts until the vomiting had in some measure abated; then another dose of calomel according to the age and strength of the patient: this has been followed with an injection. I have next given the compound powder of ipecacuanha which if it did not soon produce a pretty general and copious perspiration, I have made use of blocks boiled in water and applied hot in the bed to the sides and extremities, together with a drink of tea made of the Rad. Serp. Virg. to which if the pulse was low and sunk, I added spirits, diluted alcohol

or brandy. The blocks I have generally used were of hemlock, though I did not believe them better than any others, yet I generally found that my patients had more confidence in them than others, which confidence I was willing to increase by every means in my power, and I have frequently found it to act like a cordial in very low. and debilitated cases.

The stimulants which I have used were mostly of the diffusible kind such as brandy, laudanum, ether, and whiskey, and always proportioned to the violence of the disease. In some cases I have given a quart of brandy in six or eight hours with the happiest effect; though I have not generally used stimulants to so great an extent. But frequently in the latter stages of the disease it has been found necessary to add wine, bark, and other durable stimuli more effectually to invigorate and strengthen the system. Wherever I have found a considerable affection of the brain (which was the case in several instances) I have omitted the stimulants altogether and depended entirely upon calomel together with the employment of the several means which tended most powerfully to the surface of the body. The sweating should always be continued until the disorder gives way, which will frequently take one, two, and sometimes three days. In the hazardous stages of this disease, when an evacuation from the bowels is necessary, it is better promoted by injections than cathartics as the former do not debilitate so much as the latter.

This is the treatment which I have generally pursued and I am happy to add, that in about forty cases which I have attended, only two have proved fatal. I consider its mortality to be ascribed to the general law of epide

mics, that those most susceptible of disease are liable not only to receive it the soonest but with the most severity, and that on its first appearance it is most mortal, when, after a certain period it becomes as much under the controul of medicine and as manageable, as ordinary diseases.

As I know we have generally little time to spare on our anniversary meetings, I have endeavoured to make the history and treatment as concise as possible. I do not believe that this disease is contagious, for I cannot discover a single instance where it appears to have been communicated from one to another; neither have I ever known a single person who has had the cow-pock to have the spotted fever. As preventives, will not emetics be useful? And what will be the effect of mineral acid fumigations, made of oxygenated muriatic gas?

VI.

FACTS and ARGUMENTS in favour of the FOREIGN origin and CONTAGIOUS nature of the PESTILENTIAL or MALIGNANT YELLOW FEVER, which has prevailed in different commercial cities and seaport towns of the United States, more particularly since the summer of 1793. Communicated in a Letter from Dr. WILLIAM CURRIE, Member of the College of Physicians, Phila delphia, Fellow of the American Philosophical Society, &c. to DAVID HOSACK, M. D. Member of the College of Physicians, of Philadelphia, &c.

Philadelphia, September 8th, 1810. If it can be made to appear that the pestilential fever, usually called the yellow fever, occurred with all its complicated horrors in seme of the commercial cities or sea

port towns of this country at an early period after their first settlement, when none, or but few of the causes existed to which the origin of the disease has been imputed by the advocates of its domestic origin; and, if it can also be shewn that this pestilential disease did not makeits appearance for many years previously to the year 1793, in any of those commercial cities or seaport towns, though the enumerated causes existed in much greater abundance during that period than they did at an earlier period, or than they have existed since the year 1793; we are most egregiously deceived if it may not be fairly and satisfactorily concluded, that it does not originate from those sources.

In tracing the malignant yellow fever to its earliest occurrence in this country, we find from the Journal of Thomas Story, Esq. Recorder of the city of Philadelphia, vol. 1st, that a very mortal fever prevailed in Philadelphia, in the autumnal months of 1699, which carried off six or eight persons daily, and some days ten or twelve. Mr. John Gough in his account of this fever, in his History of the Friends, vol. 3d, p. 516, says, that the fever which occurred in Philadelphia in the year 1699, was the same as that which has since been called the yellow fever, and had been prevalent for some time before in several of the West-India islands. This fact is also confirmed by a letter written by Isaac Norris, Esq. who resided in Philadelphia during its prevalence, who also relates that it was very mortal in Charleston at the same time. It also appears from an extract from Hewatt's History of South Carolina, communicated by Dr. Tucker Harris, that a great number of the inhabitants of Charleston were destroyed by it in 1699, that they suffered very much from