PROCEEDINGS OF THE COLLEGE OF PHYSICIANS OF PHILADELPHIA, RELATIVE TO THE PREVENTION OF THE INTRODUCTION AND SPREADING OF CONTAGIOUS DISEASES.
PHILADELPHIA: PRINTED BY THOMAS DOBSON, AT THE STONE-HOUSE N o. 41, SOUTH SECOND STREET.
1798.
COLLEGE OF PHYSICIANS.
Resolved, That the proceedings of the College relative to the prevention of the introduction and spreading of contagious diseases, be published.
PROCEEDINGS, &c.
COLLEGE OF PHYSICIANS.
IN consequence of the prevalence of a fever of a very alarming nature in some parts of this city, the College were called together, in order to consider what steps should be taken by them on the occasion, consistent with their duty, to their fellow citizens.
After a free communication of sentiment, a committee was appointed to consider and report on the means best adapted to prevent the spreading of this disease, and to guard against the contagion of it.
THE committee reported a copy of directions for preventing the further progress of the malignant fever, which, being amended, was agreed upon. It was agreed to have it signed by the Vice-President and Secretary, and to send a copy of it to the Mayor. The directions were as follow, viz.
Directions for preventing the further progress of the Malignant, contagious Fever.
The College of Physicians having taken into consideration the malignant and contagious fever which now prevails in this city, have agreed to recommend to their fellow citizens the following means of preventing its progress.
FIRST.—That all unnecessary intercourse should be avoided with such persons as are infected by it.
SECOND.—To place a mark upon the door or window of such houses as have any infected persons in them.
THIRD.—To place the persons infected in the center of large and airy rooms, in beds without curtains, and to pay the strictest regard to cleanliness, by frequently changing their body and bedlinen; also by removing, as speedily as possible, all offensive matters from their rooms.
FOURTH.—To provide a large and airy hospital in the neighbourhood of the city, for the reception of such poor persons as cannot be accommodated with the above advantages in private houses.
FIFTH.—To put a stop to the tolling of the bells.
[Page 3] SIXTH.—To bury such persons as die of the fever, in carriages, and in as private a manner as possible.
SEVENTH.—To keep the streets and wharves of the city as clean as possible. As the contagion of the disease may be taken into the body and pass out of it without producing the fever, unless it be rendered active by some occasional cause, the following means should be attended to, to prevent the contagion from being excited into action in the body.
EIGHTH.—To avoid all fatigue of body and mind.
NINTH.—To avoid standing or sitting in the sun, also in a current of air, or in the evening air.
TENTH.—To accommodate the dress to the weather, and to exceed rather in warm than in cold cloathing.
ELEVENTH.—To avoid intemperance, but to use fermented liquors, such as wine, beer and cyder with moderation.
The college conceive fires to be very ineffectual, if not dangerous means, of checking the progress of the fever. They have reason to place more dependence upon the burning of gun-powder. The benefits of vinegar and camphire are confined chiefly to infected rooms, and they cannot be used too frequently upon handkerchiefs or in smelling-bottles, by persons whose duty calls them to visit or attend the sick.
- WILLIAM SHIPPEN junr. Vice President.
- Samuel P. Griffitts, Secretary.
A Letter from the Governor of the state was read, requesting information of the origin, state and situation of the disease, and the measures necessary to obviate its future ravages or its removal, as follows, viz.
As I am desirous to lay before the legislature a statement of the circumstances attending the calamity which has recently visited the city of Philadelphia, permit me, through you, to request the aid of the College of Physicians in satisfying the following inquiries.
Was the disorder imported or not? If imported, when, by what means, and from what place? If not imported, what were the probable causes that produced it? What measures ought to be pursued to purify the city from any latent infection; and what precautions are best calculated to guard against the future occurrence of a similar calamity?
I am persuaded that the public spirit and benevolence of the College of Physicians will induce them chearfully to excuse and to comply with this request, which is intended to establish a foundation for regulations, that may co-operate with their professional labours, in preserving to their fellow citizens the invaluable blessing of health.
Answer to the Governor's Letter.
It has not been from a want of respect to yourself nor from an inattention to the subject that your letter of the 30th ult. was not sooner answered—but the importance of the question proposed has made it necessary for us to devote a considerable portion of time and diligence to this business, in order to arrive at a safe and just conclusion.
No instance has ever occurred, of the disease called the Yellow Fever, being generated in this city, or in any other part of this state, as far as we know; but there have been frequent instances of its having been imported, not only into this, but into other parts of North-America, and prevailing there for a certain period of time—and from the rise, progress and nature of the malignant Fever, which began to prevail here about the beginning of last August, and extended itself gradually over a great part of the city, we are of opinion, that this disease was imported into Philadelphia by some of the vessels which arrived in the port after the middle of July. This opinion we are further confirmed in by the various accounts we have received from the best authorities we could procure on the subject.
To purify the city from latent infection, we would recommend, that every house, particularly those in which there have been any sick, should be thoroughly cleansed and kept open, so as to admit fresh air through every aperture—the walls should be whitewashed and gunpowder burned in all the apartments—the beds and woollen apparel of the sick should either be destroyed or smoaked with gunpowder in a [Page 6] close room, and exposed to the air and rain—unslaked Lime, should be thrown down the Necessaries, and the streets should be kept clean, especially in the confined parts of the city.
In answer to your last question, permit us to observe, that we trust the early attention of the Legislature will be directed to the safety of the port, with respect to the officers and other arrangements which may be found necessary; and on such an occasion the College will ever cheerfully co-operate with them in their endeavours to prevent, avert, or, remove these dangerous calamities.
- JOHN REDMAN, President.
- SAMUEL P. GRIFFITTS, Secretary.
- THOMAS MIFFLIN, Governor of Pennsylvania,
On motion, ordered, that a Committee be appointed to consider the defects of the health laws, and to point out the proper remedies in a report to the College.
A Committee from the Board of Health, consisting of John Kaighn, Thomas Ewing, Thomas Paul, and Mathew Lawler, attended and laid before [Page 7] the College several plans of the Hospital, intended to be erected for the reception of persons affected with Contagious diseases, in order for their consideration—some time was spent in this business, and a free communication of sentiment took place.—The College gave it as their opinion, generally, that the building ought to consist of one continued range, fronting the south, and should be so constructed as to admit of a free passage for the air through every room.
The Committee on the Health Laws, appointed at the last stated Meeting, made the following Report, viz.
The Committee, appointed by the College of Physicians, to consider the Health Laws, having attended to the subject, report, that the said law appears to them to be inadequate to the purposes intended to be embraced by the Legislature, particularly as it respects the extension of Malignant, Contagious Diseases, when they appear in the city.
The disease which appears to require most attention in this respect is the Yellow Fever; for it is probable, that whenever this complaint is very prevalent in the West-Indies (which is generally the case in time of war) it will find its way to this city, notwithstanding the care of the Health Officers.—Being highly contagious in cities, when it is introduced, the lives of our fellow-citizens will be exposed to extreme danger.—But notwithstanding its contagious nature, the history of the plague and of other Contagious diseases, authorizes the Committee to say, [Page 8] that by proper exertions, it may be prevented from spreading when introduced.
Exertions of this kind can only be made or directed by persons who have some knowledge of the nature and effects of contagion and can judge rightly of suspicious cases when they occur.—The Committee therefore consider the law as defective in this point, because it neither lays down a precise rule of conduct for the consulting physician employed in this business, nor commits the object to his sole discretion; but it associates with him any two members of the Committee of Health, without providing that these Gentlemen should have sufficient information on the general subject; and therefore, the whole object of the law may be lost, by the mistakes which will arise from their want of Medical knowledge.
It is necessary, if a discretionary power be committed to any body of men, that a majority of them should understand the nature of the business entrusted to them; and from this view of the subject, the Committee are induced to propose to the College, to recommend to the Legislature, to commit the powers necessary to prevent the extension of Malignant Contagious Disorders, to the consulting Physician, and a small number of associates of the Medical Profession, a majority of whom shall determine what measures are to be pursued, when occasions of alarm may occur. Of the many advantages which will be derived from this association of professional gentlemen, the Committee will content themselves with enumerating two:
1st. The consulting Physician will derive firmness and resolution in the performance of his duty, from the support of his professional Brethren, and, [Page 9] 2dly. The great object, (the safety of the City,) will be more completely obtained. The most skilful Physicians have been deceived respecting Contagion; but when several are concerned they will most probably judge rightly.
On which it was resolved, that this Committee be directed to draw up a Memorial to the House of Assembly, according to the tenor of the Report, to be laid before the college as soon as they are prepared.
The Committee on the Health Laws reported an Essay of a Memorial to the Senate and House of Representatives of this State, which after some alterations was agreed to, and directed to be signed by the president and secretary, and presented to the assembly by the same committee—The Memorial is as follows viz.
To the Senate and House of Representatives of the Commonwealth of Pennsylvania.
The MEMORIAL of the COLLEGE of PHYSICIANS of PHILADELPHIA,
Respectfully Represents,
That the act for establishing a Health Office &c. appears to them inadequate to some of the purposes for which it was formed, particularly as it respects [Page 10] the communication of malignant contagious Disorders, when they appear in the city.
Amongst those which require most of your Legislative attention, is that fatal disease commonly called the Yellow Fever.—For as that complaint is frequently prevalent in the West-Indies, it may sometimes be brought to this city, notwithstanding the care of the Health Officers.
To prevent its being communicated, when introduced, is therefore an important object; and although, it has been found to be highly contagious in Cities, yet, from the History of the Plague and other Contagious Disorders, there is reason to believe, that, by proper exertions, it may be prevented from spreading when amongst us.
Exertions of this kind can only be directed, or made by persons, who, having some knowledge of the nature and effects of Contagion, are the best judges in doubtful cases; and therefore, in this respect, the law appears to the College to be defective, as it has committed the business of deciding upon the removal of persons, supposed to be infected, to the consulting Physician and two associates, who are not of the Medical Profession—whereas, in the opinion of the College, it would be most properly entrusted to that Physician and a council of Medical Gentlemen, a majority of whom ought to determine what measures should be pursued, when any cause of alarm may occur.
They believe that the great object, the safety of the city, would be more completely obtained, if the consulting Physician, and this Council, were authorized to direct the removal, not only of such persons as are already diseased, but of such, as from their exposure to the operation of Contagion, [Page 11] are likely to become so; and also if they were consulted respecting the quarantine and purification of vessels, and the construction and regulation of the City Hospital, which is about to be erected.
The College trust that the importance of the subject will be sufficient apology for their address to the Legislature; as from the abstruse nature of Contagion, its effects can only be understood by those who have studied them with attention, and the difficult business of preventing its propagation will be most properly committed to persons of this description.
- JOHN REDMAN, President.
- SAMUEL P. GRIFFITTS, Secretary.
A Letter was read from the Committee of the Board of Health, addressed to the President, requesting the co-operation of the College, in the construction of the intended Hospital over Schuylkill. The letter is as follows:
The Board of Health having appointed a Committee to prepare a plan for an Hospital, for the accommodation of persons afflicted with contagious Diseases; and desirous of obtaining every assistance in this important undertaking, we were directed to [Page 12] advise you thereof, and request your attention thereto.
We have only to add, that we shall esteem every information on this subject, which you may think proper to afford, (leaving the mode in which it shall be conveyed, to your judgment, whether it be communicated by writing, or the joint co-operation of a Committee to be appointed by you to unite with us) as a mark of your desire to alleviate the distresses incident to that afflicting disease.
On which a Committee was appointed, on the part of the College, to join the Committee of the Board of Health in this undertaking, and to give them such assistance as may appear necessary.
The Committee on the address to the Assembly, were particularly requested to continue their attention to that business.
The Committee on the address to the Assembly, reported, that they had attended to the business, by meeting a Committee of the Assembly, and informing them of the opinion of the College on the subject.
The College were informed, that the Committee appointed the tenth of February, to meet the Committee of Health, have performed the business for which they were appointed.
A Letter from the Governor to Dr. Samuel Duffield, was read, in which he requests the College to nominate four persons, Members of the College, for the Governor's appointment, to consult and advise with Dr. Duffield, respecting the removal of persons infected with Contagious Diseases, &c. &c. according to an act of Assembly passed last Session. The Letter is as follows:
By an Act of the General Assembly, passed at the last Session, I am empowered to appoint four persons, Members of the College of Physicians, to advise and consult with you, respecting the removal of persons infected with Contagious Diseases, and respecting the quarantine and purification of vessels.—As the subject is of great importance to the ease and safety of the Citizens, permit me to request, that you will lay it before the College of Physicians, with an expression of my wish, that they would nominate four Members, to whom the trust contemplated by the Legislature, shall be confided.
[Page 14] On which it was resolved, that the President be directed to furnish the Governor with a list of the present Fellows of the College, and to inform him, that the College conceive he will thereby be enabled to make such a selection, as will be most agreeable to him.
The President reported the following answer to the Governor's Letter, according to the direction of the College at their last meeting.
Your Letter of June 19th, to Dr. Samuel Duffield, was by him laid before the College of Physicians, on the seventh instant.—The College would have immediately complied with your request, by nominating four of their Members for your appointment, in order to put into effect the Act of Assembly referred to—but they found several difficulties in the business, and concluded that your views might be fully answered, by sending you a list of their Members, from which the selection may be made.—Agreeably to this conclusion, I inclose you an accurate list of the officers and other Fellows of the College; and at the same time am happy in assuring you, that duty as well as inclination, will ever induce us to use our best endeavours to co-operate with you in this and every other matter which regards the health and happiness, of our Fellow-Citizens.
COLLEGE OF PHYSICIANS,
The President informed the College, that the Meeting was called in consequence of the following letter from the Governor.
The alarm that prevails, respecting the appearance of the Yellow Fever, in the neighbourhood of Penn Street, induces me to request, that you will be so obliging as to obtain, from your Brethren of the College of Physicians, a statement of the facts which have occurred on the subject, in the course of their practice; and an opinion upon the best mode of averting the calamity threatened.
Which being taken into consideration and written or verbal reports being given, by all the Members present, it was agreed, to request the President to inform the Governor, that a Malignant Contagious Fever has lately appeared in Penn Street, and its neighbourhood, of which ten or twelve persons have died; and that the College will as speedily as possible, inform the Governor of what may appear to them the best mode of averting the calamity which threatens us.
[Page 16] It was further agreed, that a Committee be appointed to report to the College at their adjourned Meeting to be held on the 17th instant, the measures necessary, to prevent the introduction and extension of contagious Diseases.
The President's answer to the Governor's Letter.
On the Receipt of your letter, I immediately summoned the College of Physicians and laid it before them; and from a full statement of facts which have occured upon the subject in the course of their practice, it is evident, that a Malignant, Contagious Fever, has lately appeared in Penn Street, and its vicinity, of which ten or twelve persons have died.
Our opinions upon the best mode of averting the calamity which threatens us, will be communicated to you as speedily as possible.
The Committee appointed to take into consideration the measures necessary to prevent the introduction and extension of contagious diseases, presented their report; which being read and amended, it was agreed that it should be laid before the Governor in the form of a letter as follows viz.
The College of physicians having attentively considered your request, of giving an opinion upon the best mode of averting the calamity which threatens us, have directed me to communicate to you the following methods; 1st for preventing the spreading of contagious diseases, when introduced among us; and 2dly, for preventing the introduction of such diseases:
1st. To prevent the spreading of contagious diseases when introduced; we recommend the most scrupulous attention to cleaning and watering the streets, particularly washing out the Gutters—Habits of temperance, caution as to cloathing, fatigue of body and exposure to the sun and night air.—When it is ascertained that such diseases exist, let the physicians of the city be enjoined to give information thereof to the Board of Health; to whom they should daily report such cases as may occur—Let all unnecessary intercourse be suspended with that part of the city where the disease first appears—Let such of the sick and their families who reside in any part of the city, where their residence may prove hurtful or dangerous, be immediately removed—When the Disease is ascertained to exist in several Houses, near to each other, in any part of the city, let all the neighbouring families who have escaped infection, be removed, and all communication between the infected families and the city be suspended, by preventing any person, except those whose visits are essentially necessary to the sick, previous to this removal, from entering into that part of the town—for this purpose Mercantile business must, of course, be suspended there, and the vessels removed from the adjoining wharves.
[Page 18] All suspected Wharves and Houses, particularly such as have been occupied by the sick, should be purified by order of the Board of Health, in the manner formerly recommended by the College.
2d. To prevent the introduction of Contagious Diseases; we recommend that a new Law on the subject be made, constituting a Board of Health, consisting of five persons, including two Physicians; of whom three shall be Citizens of Philadelphia, one an inhabitant of the Northern Liberties, and one an inhabitant of Southwark; who shall meet daily during the months of June, July, August, and September: they shall have full power to do every thing necessary respecting the quarantine to be performed by vessels arriving in this port, as well as to direct the removal of any vessels, after their arrival at the city, which may be found or suspected to be unhealthy—a consulting, and a residing Physician should be appointed—the former to dwell in the city, and the latter to be generally at the Health Office, on State Island; from which he is never to be absent during the abovementioned months.—Every vessel which arrives, from the West-Indies, from the American Main to the Southward of Florida, or from the Mediterranean, during these months, should perform a quarantine of not less than thirty days—and all suspected vessels, should have every article wrought or unwrought, which is used for cloathing, or bedding, or which may be supposed to contain infection, particularly those which may be composed [Page 19] of Cotton, Wool, or Silk, unladen and purified at the Island.
The following extract from the minutes of the Board of Health was read, viz.
Resolved, that the inspectors of the Health Office request the College of Physicians to meet daily, or as often as they can with convenience, to adopt and publish such information and advice to the citizens of Philadelphia, as they may judge will tend to check the progress of contagion. That they be also requested to communicate to this board, from time to time, such information as they may deem necessary.
In pursuance of the above, it was resolved that a committee be appointed, to report to the college, at their next meeting, the particular method to be pursued in purifying houses, in regulating funerals, in restricting intercourse with houses where the contagious disease prevails, and in checking the progress and extension of contagion.
The committe appointed yesterday, to propose the methods of putting a stop to the progress of contagion, presented their report, which was read, but the meeting not being sufficiently numerous to enter into the full consideration thereof, it was agreed to postpone it until tomorrow.
The report of the committee appointed to propose a plan to prevent the extension of contagion, was again read and deliberately considered, and, after some amendment, it was agreed that it should be laid before the inspectors of the Health Office as soon as possible; it is as follows, viz.
The College of Physicians having taken into consideration the request of the inspectors of the Health Office, to propose the methods necessary to be adopted for preventing the extension of contagion, recommend the following plan.
FIRST.—Let a person, appointed for that purpose, call every morning upon each of the physicians in the city and suburbs, and procure information of all the cases of malignant contagious fever that have come to their knowledge.
SECOND.—Let those who are affected with the aforesaid disease, be removed from town, in all cases where they are willing, and also all those who by living in the same family or visiting the sick are liable to an attack of the same disease.
THIRD.—Where it is not practicable to remove the sick, the families who inhabit the adjoining houses should be directed to remove.
[Page 21] FOURTH.—After the sick have recovered, so that they may be removed, or have died, all the family should be removed from town. The bedding, cloathing, and other articles that have been used about the sick, and the furniture of the rooms occupied by the sick, should be collected in the rooms which are to be closed, and during two days kept filled with a smoke to be made in the following manner, viz. Fill a small pan with alternate layers of charcoal and brimstone, kindle a slow fire on the top of these combustibles, with a few small pieces of bark, and they will burn a long time—When they are consumed renew them during the aforesaid space of two days—After this, the walls are to be whitewashed and the floors scrubbed—These services should be performed by Africans, under the inspection of persons appointed for the purpose.
FIFTH.—The bodies of those who are supposed to have died of the aforesaid fever, should be interred as soon as possible after death—They should be carried in hearses, and the whole business relating to interments should be performed by native Africans, if possible; if this cannot be done the descendants of Africans who have lately arrived from the West Indies, should be preferred. No person, who by living in the family, or visiting the deceased may be supposed capable of communicating infection ought to attend the funeral.
SIXTH.—It cannot be repeated too often, that the sick should be placed in large airy apartments, which should be constantly ventilated: Their cloathing and bed linen changed daily and washed in cold water. Half an ounce of strong oil of vitriol poured upon an equal quantity of powdered salt-petre, in China or glass vessels, produces a vapour that has [Page 22] been found very beneficial in destroying contagion in sick rooms.
- JOHN REDMAN, President.
- Thomas C. James, Secretary,
The following Letter from the Secretary of the Commonwealth was read.
As the legislature meets on Monday next, the governor is anxious at that time, and as frequently as it is convenient during the session, to lay before the members a correct statement of the information, which the College of physicians may receive, on the subject of the existing malignant and contagious fever. He directs me therefore to request that they will be good enough to furnish him with the most satisfactory reports, that the nature of the case admits.
The President was requested to acknowledge the receipt of the above letter as soon as possible.
Answer to the Letter of the Secretary of the Commonwealth.
I laid your letter of August the 26th, before the College of Physicians, who have requested me to acknowledge the receipt thereof, and to assure you of their readiness at all times to assist the Governor's endeavours for the public good. The adjournment of the Assembly, they presume, renders it unnecessary to make any further reply at present.
The following Letter from the Governor of the State was read.
As I am desirous to lay before the legislature a statement of the circumstances attending the calamity which has recently visited the city of Philadelphia, permit me, through you, to request the aid of the College of Physicians, in satisfying the following enquiry:
What measures ought to be pursued to purify the City from any latent infection? And what precautions are best calculated to guard against the future occurrence of a similar calamity?
[Page 24] I am persuaded that the public spirit and benevolence of the college of Physicians, will induce them chearfully to excuse and to comply with this request, which is intended to establish a foundation for regulations, that may co-operate with their professional labours in preserving to their fellow-citizens, the invaluable blessings of health.
A committee was appointed to take into consideration and report on the above enquiry.
The report of the Committee on the Governor's letter was read, and adopted unanimously as an answer to the same, and is as follows,
We have duly considered your letter of the 24th ult. and shall chearfully comply with the requisitions contained therein.
The measures to be pursued for purifying the city from any latent infection, are such as we have heretofore recommended, viz.—A strict attention to cleanliness, washing, white-washing, and ventilating the infected houses, bedding and cloathing; and fumigating them with charcoal and sulphur, or [Page 25] a mixture of oil of vitriol and salt-petre. These, with the frost, we believe, will be found sufficient entirely to destroy any latent contagion.
But the latter part of your enquiry, viz. What precautions are best calculated to guard against the future occurrence of a similar calamity, is an object of such magnitude, as to demand a more [...] reply.
We have, on former occasions, communicated our sentiments on this head; but as you now inform us, that it is intended to establish a foundation for future regulations, we willingly enter into the detail; and though this will principally consist of repetition, yet it may be useful to have our ideas presented in one view for your consideration. And as these sentiments have been more fully confirmed by recent events, we are again induced earnestly to recommend a strict adoption of the measures we advised in our communication of August 18th, 1797, as being the best calculated to guard against the future introduction of contagious diseases. We now recapitulate those advices with some additions.
Let an entire new health-law, be made, constituting a Board of Health, to consist of five persons, two of whom to be practitioners of physic. The smallness of the number will ensure responsibility, and a constant residence in the city; and the professional knowledge of the medical characters will be necessary to assist in directing the measures of the Board. Let no person whose private interest may be affected by quarantine laws, be a member of this Board.
Let a sufficient sum of money, per annum, be subject to the draughts of the Board, who shall render to [Page 26] the Assembly a yearly account of their expenditures. Let this Board sit daily during the months of July, August, September and October; and, during these months let every vessel from the Mediterranean, Coast of Africa, West-Indies, and Continent of America, to the southward of Florida, perform an effectual quarantine. Let the cargoes of suspicious vessels be unloaded, and, with the vessels, be purified at the Island.
Let a resident physician, or health-officer be appointed, who shall never be absent from the Island during the above mentioned months, and a consulting physician, who shall reside at Philadelphia.
Let the punishment of a master of a vessel, who evades the law, by landing cargo, crew or passengers, contrary to the intent and meaning of it, be the same as for murder of the second degree. Let no vessel of war ever to be allowed to come above the Fort.
Let co-operative laws be procured from the neighbouring legislatures or from Congress.
Let the Board of Health have power, with the concurrence of the Governor, to cut off the intercourse with infected persons and places. Let the long projected Hospital be erected.
Let the most diligent and scrupulous attention be given to cleaning and watering the streets, gutters and wharves, throughout the City and Liberties.
Such are the precautions which we believe best calculated to guard against the future occurrence of calamities similar to those we have experienced. If further discoveries shall happily add to our knowledge on this important subject, we shall not fail to [Page 27] make such communications to the governor, without delay.
- JOHN REDMAN, President
- Thomas C. James, Secretary.
The same committee were appointed to draught a memorial to the legislature of this state, to carry into effect the propositions contained in the above letter.
The committee appointed for that purpose reported the draught of a memorial to the legislature, which was read and adopted. The same committee was desired to present the memorial and procure the documents therein referred to.
To the Senate and House of Representatives of the Commonwealth of Pennsylvania, the Memorial of the College of Physicians of Philadelphia respectfully represents:
That your Memorialists, deeply affected with the calamities produced by the disease which has recently occurred amongst us, are impelled by a sense of duty to their fellow-citizens and themselves, to inform you, that they consider the laws which were enacted for the purpose of preserving this city [Page 28] from Malignant, Contagious, Disorders, as very imperfect.
The subject being of immense importance, they hope to be excused for stating their sentiments with respect to it, at large.
They are of opinion, that the disease which produced so much mortality and distress in the year 1793, was imported into this city from the West-Indies; and they are confirmed in this sentiment, by the circumstances attending the disease of this year, which they consider as of the same nature, and derived from the same source.
Some of their most important reasons for this opinion, are as follow:—The disease in question is essentially different from the fevers that occur in this climate, and which originate from domestic causes. This difference particularly regards the general progress of the symptoms, and the mortality, as is evident upon a comparison of its history with that of the ordinary diseases of this city.
A disease which resembles the fever of 1793 and of this year, in many important points, has long been known in the West-Indies, and those parts of America situated between the tropics; and in seven or eight different instances in which a similar disease has occurred in the United States, in the course of this century, there is good reason to believe that it was derived from those countries. In most of the instances, the original history of the disease contains the information that it was imported. In some cases, the infection can be traced to the imported clothing of persons who died in the West-Indies. In most of the cases where the importation cannot be ascertained, the first appearance of the disease has been, as in the other instances, [Page 29] in the neighbourhood of the shipping, or among persons connected with vessels.
The circumstances attending the fever of this year are extremely in point; and the narrative which accompanies this, will, we trust, satisfy you that it was imported.
The disease in question, commences invariably in our sea-ports, while inland towns, equally exposed to the ordinary causes of fever, escape; and in the two last instances of its occurrence in Philadelphia, the suburbs and the country adjacent, were more healthy than usual at the same season; and at the commencement of the disease, all the parts of the city, excepting the small spaces to which it was confined, were remarkably healthy.
It exists in the West-Indies, particularly in time of war, when great numbers of strangers are to be found there; and reference to dates will shew, that in most of the instances of the occurrence of the disease in the United States, there has been war in the West-Indies.
Your Memorialists are aware, that cases may be adduced where the disease has occurred in persons, who were not known to have been exposed to imported contagion: but such is the subtile nature of this power, that it often exists unsuspected and similar difficulties occur respecting the small-pox, and other contagion, allowed by all to be of foreign origin. There also occur, although very rarely, solitary cases of malignant remitting fevers, the symptoms of which resemble so much the disease in question, that they are often supposed to be the same; but there is this essential difference, that a malignant remittent fever has never been to our knowledge contagious in this climate.
The difference of sentiments among physicians, now so much regretted, resembles that which almost [Page 30] always takes place, when the plague is introduced into any of the civilized parts of Europe, where it is not well known. The identity of the disease, its origin and its contagious nature have been often the subject of controversy. Some physicians have considered it as of domestic origin; but proper health laws, strictly enforced, have latterly protected the commercial parts of Europe from its ravages.
With these sentiments of the nature of the disease, your memorialists cannot but regard a proper law respecting the subject, as a matter of the greatest importance, and although they are perfectly sensible of the imperfection of the science of medicine, yet from a conviction that physicians are the best informed, as well as the most interested in the subject, they approach you with that respect which is due to your legislative authority, and declare their belief, that the existing health laws of this commonwealth are not such as are best calculated to obtain the desired end, and that they ought to be improved.
Having lately communicated in writing to the governor their ideas respecting the best methods of preventing the introduction of contagious diseases, they beg leave to refer you to that communication. At the same time they tender you their professional assistance in framing an efficient law for this purpose; and thus having performed their duty, they hold themselves discharged from [...]ll responsibility, on account of the evils which may arise from the present imperfect state of the legislative arrangements respecting this important subject.
- JOHN REDMAN, President.
- Thomas C. James, Secretary.
Narrative of Facts relative to the probable Origin, and Progress, of the Malignant Contagious Fever which lately appeared at the junction of Penn and Pine Streets.
THE ship Arethusa, Captain Keith, sailed about June 1, 1797, from Port Royal in Jamaica for the Havannah, with slaves; during the passage two men died with a fever, which Mr. Stephen Kingston, a gentleman of this city, who was a passenger on board, and has frequently seen the disease, believes to have been the Yellow Fever, one having the black vomit. After remaining some days at the Havannah, the vessel proceeded for Philadelphia, and arrived in the stream opposite to Pine Street, July 23, 1797. At the capes of Delaware she took on board a Pilot, and performed a quarantine of five days at State Island. The Pilot was attacked with a fever the day of their arrival at the city, and went on shore the same day, when he was visited by Dr. Currie, who has been much conversant with the Yellow Fever, and was so sensible of the resemblance of his symptoms to those of that disease, that he mentioned the case as suspicious to one of his friends.
The Arethusa was moored at Mr. Joseph Russell's wharf, outside of two vessels which lay there when she arrived, her crew left her immediately after she was moored, and the next day, returned for their cloathing, &c. when they crossed and recrossed the above mentioned ships. Two boys only and the captain (who was on board occasionally) composed the crew of the outermost ship, or that immediately [Page 32] contiguous to the Arethusa; but the innermost vessel, the Brig Iris from Oporto, had a crew of the usual number. On the twenty ninth day of July, five men of this crew were taken ill with fever, and attended by Dr. J. Stuart, who states, in his report to the College of Physicians, that the symptoms were similar in all, tho' varying in the degree of violence; four of these recovered, but one died with unequivocal marks of the malignant yellow fever. A servant of George Latimer, Esq. who lived about 100 yards to the north of this vessel, and was frequently on the wharves, was attacked, July 30, with a fever which was highly contagious and malignant, of which he died in five days.
Mr. N. Lewis, who kept a compting room about the same distance from the Arethusa, was attacked about the same time, and died also in five days, of a fever which was supposed to be of the same nature.
Mr. Dominick Joyce, who was much engaged on board a ship near the Arethusa, was attacked, August 3d, with a fever of the same kind, but recovered. A man who lived in a store on the South side of Pine Street, about 150 yards from the river, was attacked with a malignant fever about this time, and died in a few days.
About the sixth of August, Mr. Ferguson, whose yard adjoined the wharf where the Arethusa and Iris lay, was attacked with a malignant fever, and the same day Mr. John Plankinhorn's girl, who lived nearly opposite to Mr. Ferguson's across Penn Street, and worked in a yard which was situated very near to the above mentioned store in Pine street, was also attacked with fever, they both died on the fifth or sixth day after the attack, Mrs. Ferguson with very suspicious, and Mr. Plankinhorn's girl, with [Page 33] compleat and unequivocal symptoms of the yellow fever. In this manner the disease continued to spread, so that by the middle of August, or within three weeks from the arrival of the Arethusa, above ten persons had died, who either lived or were engaged in business within 300 yards of the Arethusa, and this at a time when the other parts of the city were so healthy, that it is probable all the other deaths which occurred in it [...] were not [...] equal in number to those which occurred in this small district. After this the disease gradually extended itself to Southwark, and at the same time became thinly scattered through the city, where its destructive effects are but too well known.
Facts relative to the sickly state of the Ship Hind.
IT appears from the depositions of Francis Tow, Nicholas Benson, and William Cooper, seamen on board the armed Ship Hind, taken before Chief Justice M'Kean, that about the beginning of July 1797, the Hind sailed from Port an Prince, bound to Philadelphia, with a cargo of sugar and coffee, and with 43 passengers; of which number 23 were whites and twenty coloured persons, that they touched at Cape Nichola Mole, where they remained eight days and discharged a part of their cargo, in lieu thereof taking in a quantity of stone ballast: during the time they lay at the Mole, the passengers were occasionally on shore. It would appear that they le [...]t the Mole between the 12th, and 15th, of July, and arrived at this port, after a passage of twenty or twenty one days. About three or four [Page 34] days after their departure from the Mole, five or six white persons and one negro of the passengers were attacked with fever, the white persons so attacked were observed to become very yellow. During the passage four other coloured persons and five of the crew fell ill of fever: one or two of the latter number, after the vessel entered the capes of Delaware, but only a coloured boy and child died during the passage, and were thrown overboard after the vessel entered the river. Upon the arrival of the vessel opposite the Marine Hospital, in consequence of orders from the captain, four sick persons were secreted and did not come under the inspection of the Physician of the Port; exclusive of these, two women were sick in the cabin. After passing the Fort one of the seamen was taken ill, went on shore, and was afterwards carried to the marine Hospital; and two other persons were taken on shore sick. So far go the depositions.
From information obtained from the Health Office, it appears, that the Hind was examined at the Fort on the second, and arrived at Philadelphia on the fourth of August; and that Mr. Doughty, one of the Inspectors of the Health Office, sent to the marine Hospital on the 13th of August, Peter Malosio, one of the crew of the Hind then residing in Love Lane, and on the 14th, a Portuguese from near the junction of Penn and South Streets, who had been landed there; and that another person was sick of a suspicious fever at Mrs. O'Connors in Almond near Front Street. Both these were from on board the Hind, and the Portuguese abovementioned had been visited by Dr. Currie, who declares his disease to have been Yellow Fever.
Letter from Dr. James Stuart, to the College of Physicians of Philadelphia.
When you consider the welfare of the citizens of this city, and the danger attendant on the concealment of the appearance of contagious diseases, I trust any apology for the following communication will be considered superfluous and unnecessary.
On the 29th of July last, I was called upon to visit James Hood mariner, belonging to the Brig Iris, Captain Rhodes, lately from Oporto, then lying at Nixon's Wharf (occupied by Messrs. Wharton and Palmer.) He was taken in the forenoon of the same day, on board with drowsiness, some stupor, sighing, light but frequent chills, and pain in his loins and head. The pain in his loins he represented as though he felt something tearing from his back; to these symptoms succeeded a violent attack of Fever, in which state I found him about four o'clock in the afternoon of the same day; still complaining of the most excruciating pain in the head and back, with a burning sensation in the stomach; inflamed eyes, flushed face, his tongue white on the fore part, but more dark towards the pharynx, and very dry, a little incoherent at times in conversation, his pulse very strong and tense—he lost by my direction sixteen ounces of blood from the arm with evident relief. I prescribed a scruple of jalap with ten grains of calomel. On the 30th I found the powder had produced several stools exhibiting a very dark colour, but in no way particularly foetid—his pains had [Page 36] much abated, but the fever continued, with strength and tension of the arteries; he lost twelve ounces of blood, and the purge was repeated. 31st, He had a very restless night, had not taken the powder; symptoms much the same as the day before; directed the same purge to be given in my presence. August 1st, the powder, as I was informed, was ejected by vomiting—the pupils were considerably dilated; he had a slight delirium with great restlessness, oppression, and pain in the breast, with still a tense pulse. A blister was applied to his breast and stomach—I ordered an injection to be thrown up, and after a stool should have been procured, to give five grains of calomel every third hour; he took two doses without effect, and refused to repeat them. On the morning of the 2d, I found the difficulty of breathing much relieved, and the other violent symptoms in some measure abated; but a small diarrhoea attended, with dark stools, insomuch that he and the attendants supposed it to be blood, but upon examination it was discovered to be of a very dark green colour, exhibiting the appearance of viscid bile—I directed a continuation of the powders—about six o'clock in the evening he had not taken any of the powders, had been attacked with a chill, was very yellow, (which was taken notice of by his attendants) his fever had become more violent, accompanied with an increase of delirium, his pulse still tense. Whilst sitting by his bed he vomited up a small quantity of black bile—took ten ounces more of blood from the arm, which appeared different from what had been taken at the first bleedings, in being bu [...]y, whereas that taken before had appeared dark without a disposition to separate, streaked with red— [Page 37] prescribed a repetition of the injections—August 3d, about nine o'clock the vomiting had in some measure ceased and appeared only when he was moved, comatous, increase of delirium, (when roused said he was well); Symptoms of effussion in the breast, his skin and eyes very yellow with livid spots on the former, especially on several parts of his arms. I ordered blisters to his wrists, legs, and breast, and to take five grains of volatile alkali every hour—Cold clammy sweats now came on with singultus, and he expired at twelve o'clock this day, being the fifth from that on which he was taken.
It is a circumstance worthy of remark, that four of the same crew were taken on the same day with similar symptoms, (except in degree and one nearly in the same degree at the first aggress) all of whom, being more conformable in taking medicines as directed, recovered on the third and fourth day; and another who was taken on the first of August, recovered on the seventh—a particular detail of each case, with the particular remedies employed, if required, will be given, when time and opportunity will permit, by Gentlemen,