MY original intention, when I began to write the "short account of the malignant fever lately prevalent in Philadelphia," w [...] mere­ly to give a detail of its effects on society, con­sidered in a moral view, and to collect the most striking facts that occurred in the progress of a calamity, that displayed human nature in a point of light new to most of our citizens. I designed to avoid all enquiries that might lead to medical discussions, and therefore not to touch upon the origin, symptoms, or treatment of the disease. This determination I changed on finding how very imperfect the pamphlet would be, without some sketch on those points.

[Page 6] With respect to the origin of the disorder, I was and am in favour of the prevailing opini­on, that it was imported. I gave a statement of such arguments on both sides of the ques­tion, as had made their appearance in the pa­pers. I was very desirous of being able to in­troduce those which dr. Rush had long be­fore declared, he could advance in support of his opinion. But in the three editions of my little work which have appeared, it has been out of my power to gratify this desire; as the doctor's essay on the subject made its first ap­pearance on Wednesday last.

As therefore I had no opportunity of ani­madverting on this essay in the former pam­phlet, it will not, I hope, be judged impro­per to attempt a refutation of the doctor's ar­guments in a separate publication.

My reason for these preliminary observa­tions, is, to apologize for (what might other­wise appear presumption) my interfering in a question which appears out of my sphere, and to belong exclusively to the gentlemen of the faculty.

[Page 7] The first position laid down by dr. Rush, is, ‘that the yellow fever in the West Indies is always generated by vegetable putrefaction.’ This is not well founded. Dr. Hillary makes no mention of vegetable putrefaction produc­ing this disorder. He ascribes it to the peculiar temperament and habits of living of the sub­jects of it. "It is very remarkable," says he, ‘that this fever most commonly seizes stran­gers, especially those who come from a col­der or more temperate climate—and most readily those who use vinous or spiritous liquors too freely; and still more readily those who labour hard, or use too violent exercise, and are at the same time exposed to the scorching rays of the sun in the day time, and soon after expose themselves too suddenly to the cool dews and damp air of the night.’ ^* Dr. Lind gives the same account, and nearly in the same words.

Dr. Mosely, who is the latest and the best writer on this fever, makes no mention, as far [Page 8] as I could discover, and I examined his book with some care, of its arising from vegetable putrefaction in the West Indies, nor of any particular season in which it prevails. He speaks of it as one of the seasoning disorders to which new-comers are subject, especially those of a plethoric habit, and those who live irre­gularly. If it arose from the source to which dr. Rush ascribes it, dr. Mosely would not certainly have neglected to mention the fact.

But even admitting the position, that it arises from vegetable putrefaction, it by no means follows that it was generated here. Indeed, I cannot see that this argument is in any man­ner whatever applicable to the question.

Dr. Rush's second position is, that ‘similar degrees of heat are capable of producing it in every part of the world.’ This is, if possi­ble, more unfounded than the first. Dr. Hillary expressly says: ‘It does not appear, from the most accurate observations of the variations of the weather, or any difference of the sea­sons, which I have been able to make for several years past, that this fever is any way [Page 9] caused, or much influenced by them; for I have seen it at all times, and in all seasons, in the coolest, as well as in the hottest time of the year.’ ^*

To the same purpose, Dr. Lining observes, ‘This fever does not seem to take its origin from any particular constitution of the wea­ther, independent of infectious miasmata, as dr. Warren has formerly well observed; for within these twenty-five years, it has been on­ly four times epidemical in this town, name­ly in the autumns of the years 1732, 39, 45, and 48, though none of those years, (except­ing that of 1739, whose summer and autumn were remarkably rainy) were either warmer or more rainy, (and some of them less so) than the summers and autumns were in seve­ral other years, in which we had not one in­stance of any one seized with this fever; which is contrary to what would have hap­pened, if particular constitutions of the wea­ther, were producttive of it, without infectious miasmata^†’

[Page 10] The doctor's third division of his essay, contains these facts. ‘A quantity of damaged coffee was exposed at a time (July 14th) and in a place (on a wharf, and in a dock) which highly favoured its putrefaction. Its smell was highly putrid and offensive; so that the inhabitants of the houses in Water and Front street, which were near it were obliged to exclude it by shutting their doors and win­dows.’ These circumstances are all true, but they do not answer the purpose intended. Whoever consults the ingenious and interesting experiments made by dr. Alexander, will see that putrid vegetable matters are so far from being the sources of putrid disorders, that they are very powerful antiseptics. As the book is scarce, I shall transcribe his account of one of his curious experiments.

‘I reduced a quantity of cabbage leaves to a pulp in a mortar, and set them in a warm place to putrify. A bowl of strawberries was likewise set along with them. When both the cabbage leaves and strawberries had undergone a fermentation, and were in that state in which vegetables are said to be pu­trid, [Page 11] I put a bit of mutton into each of them, and covered it over with the pulp. Another bit was put into a bowl of water for a stan­dard, and they were all set together in a warm closet. The piece of mutton in the water had evidently turned putrid, and tinged the water red in one night. Both that piece which was in the pulp [...]f the cabbage, and that in the pulp of the strawberries, were kept three weeks, and continued sweet and hard, as if they had been salted. The bowls were then overturned, and their contents lost by acci­dent. From these experiments it appears, that neither the putrid substance, nor the watry infusion of vegetables, is septic^*.’

In this division of his subject, dr. Rush pro­duces several instances of malignant disorders said to have been generated by putrid vegetable substances; and among the rest, quotes Lanci­sis. Of this author's want of penetration, dr. Alexander makes the following very judicious [Page 12] observation; ‘Whoever reads the observa­tions of Lancisis with attention, will see that the greatest part of the putrid epidemics which he mentions, always followed remarkable inundations of the Tyber; and several of them sooner than the water, left by those inundations, could have become putrid; so that all, or the greater part of the pu­trid diseases ascribed by Lancisis to marsh miasmata, may be fairly attributed to the effect of moisture alone, independent of any mixture of putrid effluvia.’

The doctor proceeds: ‘The rapid progress of the fever from Water street, and the courses through which it travelled into other parts of the city, afford a strong evi­dence, that it was at first propagated chiefly by exhalations from the putrid coffee.’

This argument applies with equal force ei­ther to the generation or to the importation of the disorder; for as the vessels by which we have the strongest reason to believe it was in­troduced, were moored near the wharf where the coffee lay, it is obvious, that, whether im­ported [Page 13] or generated, it must have been driven through every adjacent avenue according to the direction in which the wind blew.

The doctor's fifth position is, that ‘many persons who had worked, or even visited in the neighbourhood of the exhalation from the coffee, early in the month of Au­gust, were indisposed afterwards with sick­ness, puking, and yellow sweats, long be­fore the air of Water street was so much impregnated with the contagion, as to pro­duce such effects.’ This argument stands on precisely the same ground as the former one. For the existence of the disorder in that spot, must have produced the same effect in ei­ther case, whether imported or indigenous.

The sixth position is: ‘The strictest en­quiry, accompanied with the greatest solici­tude for proofs, has not been able to disco­ver any other cause of our late epidemic. Every account of the importation of the "disease, has been discovered, upon examina­tion, to be inaccurate, contradictory, and without foundation. The first cases of the [Page 14] yellow fever have been clearly traced to the sailors of the vessel who were first ex­posed to the effluvia of the coffee. Their sickness commenced with the day on which the coffee began to emit its putrid smell. The disease spread with the increase of the poisonous exhalations.’

Amidst the confusion in which this subject is involved—amidst the difficulty of producing positive proof^*—let us enquire into the evi­dence. Let us see whether the opinion of its generation be not much more improbable than that of its importation—let us see whether the presumptions in support of the latter opinion be not so extremely strong, as fully to satisfy every mind open to conviction.

That several persons arrived in this city in the course of the summer, sick with the ma­lignant fever, is beyond question. There were, [Page 15] early in August, several sick people on board the Flora, as appears by the publication of drs▪ Cuthrie and Cathrall. Many persons have been landed out of vessels coming to this port, at different places on the banks of the Delaware, who afterwards died of the yellow fever; and several dead bodies have been buried along the shore.

About the end of July, mr. John Massey of this city, was at Marcus Hook, where a woman from Cape Francois had been landed, and had died of the yellow fever. Some French people who lived near the place of her death, and knew the disorder of which she died, burned a quan­tity of tar at the door, to purify the air.

About the same time in July, as this affair happened at Marcus Hook, captain, Hamilton Sage, from St. Domingo, was landed in a very low state at Chester, in the evening, and died next morning at four o'clock. His sickness was of only five days. His skin had all the yellow­ness, and livid spots that characterised our late epidemic. Information of this latter fact I have had from a letter written by dr. William Mar­tin, [Page 16] to a gentleman of the faculty in this city, who was kind enough to allow me to avail myself of the information it contained.

A single fact, of this kind, would give to the opinion of its importation that high de­gree of probability, which is nearly all the nature of the case allows; for the clothes, or bedding of either of these persons would be sufficient to spread the disorder, if we reason from the experience of 1762.

The seventh position of dr. Rush, is: ‘It has been remarked that this fever did not spread in the country, when carried there by persons who were infected, and who after­wards died with it. This, I conceive, was oc­casioned in part by the contagion being de­prived of the aid of miasmata from the pu­trid matter which first produced it in our city, and in part by its being diluted, and thereby weakened by the pure air of the country. During four times in which it pre­vailed in Charleston, in no one instance, ac­cording to dr. Lining, was it propagated in any other part of the state.’ This argument, [Page 17] by which the doctor doubtless intended to sup­port his hypothesis, if it answers any pupose, militates very strongly against him. The yel­low fever of Charleston did not spread into the country—neither did ours. Yet the former was confessedly imported. If, therefore, any infe­rence is to be drawn from this fact, it undubi­tably is, that ours was likewise imported.

The eighth position of dr. Rush, is: ‘It is very remarkable that in the histories of the disorder, which have been preserved in this country, it has seven times appeared about the first or middle of August, and declined, or ceased about the middle of October—viz. in 1732, 1739, 1745, and 1748 in Charles­ton—in 1791 in New York, and in 1762 and 1793 in Philadelphia. This frequent occurrence of the yellow fever at the usual period of our common bilious remittents, cannot be ascribed to accidental coincidence, but must be resolved, in most cases, into the combination of more active miasmata with the predisposition of a tropical season.’

Of the seven times in which this disorder ap­peared in America, five have been unquestion­ably [Page 18] by importation, viz. four times in Char­leston, and the former time here, to say no­thing of our late misfortune. These instances must have arisen from an ‘accidental coin­cidence;’ and could not possibly have de­pended on "the predisposition of a tropical season." Moreover, the arguments advanced from Hillary and Lining, in page 8 and 9, effectually destroy this position, even if the facts were as stated.

"Several circumstances," continues dr. Rush, ‘attended the late epidemic, which do not occur in the West India yellow fever. It affected children, as well as adults, in common with our annual bilious fevers. Dr. Hume tells us, it never attacked any person under puberty.’

The yellow fever, even in the West Indies, is not always uniform in its symptoms or ef­fects—and on its introduction here, may ve­ry readily be supposed to have changed its ap­pearance. Dr. Lind, who, like dr. Lining, is unexceptionable authority on this subject, after detailing the arguments for and against the [Page 19] contagious nature of the disorder, says: ‘We can only reconcile the facts that may be pro­duced on both sides of the question, by supposing that the yellow fever of the West Indies is sometimes of a mild nature, and al­together free from infection, while at other times it is more violent and highly infecti­ous^*.’

One more observation of dr. Rush's, it may be proper to notice. He says: ‘I am disposed to believe that the instances of the yellow fever being imported, are very few, compar­ed with those of its being generated in our country.’ Five times out of seven, as I have already observed, it was confessedly imported—and in the other two instances of its appear­ance, [Page 20] viz. at New York, 1791, and here this year, its origination in this country is by no means admitted. In New York, it was attri­buted to the exhalations from some putrid mud—although the same kind of mud was at other docks, without producing any effect what­ever. Surely then it is improper to assert that the instances of its importation are few.

I shall now close this subject. The reader has seen that Hillary and Lining declare positively that this disorder does not depend on the wea­ther^*—and Lind and Mosely imply the same thing by their silence—yet that dr. Rush de­clares it arises chiefly, if not wholly from that source—that our disorder assumed the same appearances as in former instances when incontrovertibly imported—that the yellow fever existed in the West Indies for many months before it appeared here—that a very [Page 21] great number of vessels arrived here from that quarter during the summer—that having hard­ly any idea of danger, we used no precautions, so that it would be more astonishing if we es­caped, than it is, that we caught the disease—that many creditable people assure us of sundry sick persons and dead bodies being landed pri­vately from some of those vessels—that people in a very advanced stage of the yellow fever have died at Marcus Hook and Chester, and, for aught we know, at other places—that the ships infected with the effluvia of the sick and dead came freely to our wharves^*—that [Page 22] there is not the smallest probability of their infected beds, bedding, or clothes, being de­stroyed, but on the contrary, that we have every reason to suppose they were brought to the city and sold here.—Let every candid man give these several circumstances a full consider­ation. Let him be actuated solely by a disposi­tion to discover the truth, unbiassed by any consideration of the character of our city—let him allow him reason free scope—and I feel the utmost confidence, that he will pronounce a decided opinion, that the late malignant fever was, in the year 1793, as in 1762, imported from the West Indies.

One word more. Every position the doctor has advanced, might be freely admitted, and still they by no means prove that the disorder was not imported. If it arose from the coffee—and that vegetable was, as it must have been, in a state of putrefaction on its arrival here, the disorder was as effectually imported by the [Page 23] Amelia, in which the coffee came, as if a sick man had arrived in her, and spread it in the city, as was the case in Charleston, or as if a quantity of infected clothes had introduced it, as happened in 1762.