PREFACE.
A few words of explanation are necessary to render this
little pamphlet clear and intelligible in ifs aims and purposes, and to explain its extraordinary aggregation of matters,
which mav be considered as almost totally incongruous. In
the first place, its prominent object is to place the Homeopathic treatment of yellow fever before the public in such a
point of view as would render its statements and pretentions
worthy of every confidence. For this purpose, a key is
afforded whereby the modus operandi of their infinitesimal
doses of medicine are made patent, and their power of controlling diseased action rendered evident. This accomplished, the public have no more right to question its own facts in
its favor than they have to question those of the old system.
But still farther, to strengthen its claims upon the consideration of the public, a status has been conferred upon it by a
review of it by Dr. Forbes; and, although that review was
intended to crush It out as a system of therapeutical medicine, yet, as will be seen by our quotation from that performance, he has defined its position before the world with so
much justice and accuracy as will fix its claims to the very character which he labored to deprive it of, and will forever give
it stability and a formal recognition among ftankind, as a
successful means of curing disease. But the Southern mind
has been so little directed to its claims as a system of medication, that incredulity as to its powers, generally prevails;
hence the effort to place it before our communities in its true
character-that is, as a great system of curative medicinestanding, in this respect, side by side with the old.
The two short chapters-one on the non-local origin of yellow fever within our borders, the other on the general principle of treatment of the disease-were intended (the former
by implication and inference) to show the efficiency of quarantine in excluding it from our shores; and the latter, to restrain a meddlesome criminality on the part of doctors,
nurses, and officious intermeddlers, in giving medicine to
cure it.                                     W. R.








PART I.
HOMEOPATHY AND ALLOPATIHY
WRITTEN FOR THE "'SUNDAY TELEGRAPH."
Two systems of treating disease now occupy the attention
of the world, viz: Homeopathy and Allopathy. The latter,
confident in its past history, its great truths being deduced
from the earliest records of medicine, and studiously systematised into a grand whole, imposing both for the symmetry
and solidity of its structure, looks with disdain upon its
parvenu rival, and its efforts to overthrow it. Hence- ridicule and contempt are the only weapons it has deignedito
employ against it; and truly it would merit no other, if
Homeopathy sought to establish itself upon the downfall
of the great principles of Allopathy.  But such is not the
fact. The two systems are so entirely distinct, that the
truths of the one do not inpugn those of the other-Homeopathy may: assert its great formula, " semilia semilibus curanter," without the slightest conflict with a single principle
of Allopathy; and vice versa.  The reason of this want of
conflict between the:principles of the two systems, and the
difference in the relative doses of medicines, will be found to
have its origin in the distinct media, which are employed to
reach the'pathological point intended to be acted upon by
their respective remedies. The Allopathis-t, in order to reach
this point, gives his large doses, which by assimilation arrives
at it through the blood, and asserts its presence by a con2




trolling effect upon the parts to which it is addressed.  But
the Homeopathist reaches the seat of the disease through a
different medium. By the provings of his rewdies, he knows
precisely the nerves or the system of nerves to which they
will address themselves, and these are precisely the ones involved in the disease for which he prescribes.  By adopting
ihe most attenuated form in the administration of his remedies, spiritualizing them as it were into a mere aura, they
reach directly the nerves, which become the media of their
transmission, thus avoiding the transmuting process of assimilation, by which: they would be destroyed.  We have an
illustration of thlis mode of operation in prussic acid, nicotine,
chloroform, ether, &c., which evidently reach the great
central organ of: the nervous system, without traversing the
route of the blood vessels.
But the most vulnierable part of Homeopathy, and that
which exposes its pretensions to ridicule, and calls in question its validity as a system, is its infinitesimal doses of
medicine. The above suggestion as to the medium through
which they operate, ought to remove or greatly lessen the
force of this objection; a fact, however, can not be controverted
by a priori reasoning, and that these doses do cure diseases,
is not furnished by ignorant charlatans but by associations
of the most scientific men of both Europe:and America,
whose testimony stands upon as unimpeachable grounds, as
any presented by Allopathy, in favor of its own results in
the traeatment of disease.   Let those who cavil at Homeopathy, upon this account, be certain, that these cavils have
some other foundation than their own ignorance and prejudice, before they parade them before the world:; and until
they can show that their doubts are based rpon facts and
deductions, they are unworthy of a momeut's consideration.
But as illustrations have more force on some minds than
facts themselves, let me ask one of the objectors if he can
state precisely the amount of miasm requisite to produce an
ordinary chill and fever; whether a smaller or larger dose
of this miasm, or altogether a different one, produces continued or congestive fever; and finally, if he has weighed in
a balance the virus of small pox, measles, scarlatina, the zy



7
motic poison of yellcw fever, etc?  AlthIough these are, the
miost deadly morbific agents'known, yet ard-they so inappreciable in quantity  as to defy us in our attelnpts to place
them in any relation that would. enable us to define thlem'a3
matter?  Yet we cavil at:Homeopatihy, notwithstandingl she.
has not exceeded the limits of appreciable materiality in the
attenuations of her remedies.  Until we ale better informed
upon these and correlative subjects, let us put aside our arrogance: and cease to arraign IHo-neopatlhy -for setting forth
her infinitesimal doses of aedicine, and elaimring for themn
remedial powers.
But again it may be objected, even adnitting, that the reinedy g'oes directly to the n.ierves implicatel:in the disease
for whichl it was p;escribed, how does it cure it. seeing that
it produces effects coincident with the morbid phenomena
previously existing in the parts?  If its remedial powers are
lthus coincidenlt with the morbific foaice,';should it not dyiamically ratlher inclrease than iremove this" force. If a( p'-iori
r'easonilirg was conclusive upon this point arid the inference
deduced from  the hypothesis that the remedy exerted its
powers- in virtue of its dynamical force in' controlling the;morbid action, then rlothing could be clearer thal) t-lie result
-arrived at by this process ot reasoning, viz, that the remedy
would increase and not remove tlhe disease.  Homeopathy
must, therefore, abandon either its theory of dynamic force
for its remedies, or all pretensions to cure disease;s.  But the
latter it cannot abandon. because it stands upon the basis of
fact arnd observation; it must then adopt:saite other theory,
to solve the problem of the modus operandi of its renmedies.
A fact which conflicts with our preconceptions, without a
theory to ext lain it is of doubtful autl enticit -the mind must
generalize it, and refer it to some known phenomena, witr
which it can be assimilated, ere it yields it implicit' credence.
Let us see if this fact caun: be thus generalized and made to
assume a credible place- among the admitted phenomena of
science.
It is well known to pilysiologists that all organized beings
contain within themselves a system of vitai chemistry, under
whose guidance their living economy is regulated, governed




and preserved. It is in short this vital chemistry which was
the architect of their diversifiedl structures, and preserves
them through'the period of their existence from the destruetive powers of the elements which sorround them. It is the
steam engine which propels existence for a time against the
adverse current of the general laws of nature-the heart is
the force-pump which sends the current to supply the material out of which the power is generated for keeping the machinein motion. Every deleterious agent  or miasm which
acts upon  us,, produces a  responsive effect upon this
controlling power of our systems. Every thought, every
pulsation of our hearts, every breath we draw, derive their
dynamitism from it, and tend to disarrange its equilibrium.
Disease, then, may be defined to be nothing more than a disarrangement of the vital chemistry of the parts affected, and
its removal-the restoration of the harmony of its elements,
by countervailing the morbid impress which has disturbed
them. By the Allopathist this is effected by sending his remedies in dynamic force through the sanguiferous system,
either to the part affected or neighboring organ, to arouse
secretion, by which the peceant matter is thrown off. These
views of the Allopathic modus operandi of remedies here
and elsewhere presented, are too general to be strictly true,
perhaps, in all instances, but they conform sufficiently to the
rule of action to serve the purpose of illustrating the difference between the two systems of cure under consideration.
Before we proceed to state our theory of the modus operandi of Homeopathic remedies, it is necessary to recapitulate
to some extent, what has been before said of the media
through which their effects are produced, in order that the
theory may stand in immediate connecion with' that view of
the subject.
Nearly all diseases are produced by miasm, including under this head every species of gaseous poison, whether emanating from the animal,- vegetable or mineral kingdom, but
devoid of any recognized chemical or physical qualities.
These we inhale in the air we breathe, in infinitesimal quantities; therefore these noxious agents do not enter the system
through the digestive and sanguiferous apparatuses, and



9
even if swallowed with our food, it is inconceivable that
they can be. amenable to the laws of assimilation, as gross
inaterialitil ire, since these have, and those have not, properties which fit them for this process. Then they must find
their way through its nervous filaments, to the great central
organ, the brain, and by it are referred to the sensitive extremnities of those nerves which are most appropriate.for
giving expression to the injury done —in other words they
become the seat of disease.  Homeopathy, by attenuating its
remedies until thev become almost infinitesimal in their
quantities, fits them  for taking the same route, and by its
provings of its remedies, it sends them direct to the seat of
disease where they encounter the poisol, to which they present an incompatibility in the chemico-vital relations ot the
parts and neutralize it in situ.
Then let us state in one sentence the differences between
the two systems' of cure: Alloopathy sends its remedies by
the blood vessel systenl to the seat of disease, and stimulates
the parts by their force to secretion, while Homeopathy
reaches the same point by the same channel which was taken
by the poison which produced the disease, and offers its reinedies as clhemico-vital incompabilities to the cause of the
mischief. What conflict, then, is there between them? May
they  not both be equally true, and equally available in the
treatment of disease?
Homeopathy works no miracles-does not even deal in
the  marvelous or ridiculous,  when  she undertakes to
cure, and does cure disease. with her incalculably attenuated
remedies.  On the contrary, her means are in conformity
with the deductions of the strictest rules of phylosophysing
— she encounters an infinitesimal cause of disease with an
infinitesimal antidote.   Her achievements are performed
without a dire stuggle for supremacy, between the dynamic
forces of disease and remedy, as happens in the coarse materiality of Allopathic practice, in which the best that can be
accomplished is a mere substitution  of one malady for another.. The cures of [Homeopathy,,then, have this advantage
over the old practice, that they are, so far as the patient is




10
concerned, accomplished, cito, tuto, et jucande, leaving no
residumn of remedial infliction to be struggled against in a
tedious convalesence.
The foregoing article was written to show that the true
ground of difference between the old and new systems of practice, was simply in the application of their Therapeutics,
and to indicate the cause or reason of that difference. With
this key to the solution of the modus operandi of the infinitesimal doses of the Homeopath, the reader will have no
difficulty in admitting thBir potency in controlling morbid action. But we make a great mistake when we suppose that
the Homeopath is ruled down to the infinitesimal mode of
administering his remedies; on the contrary, as long as they
are given upon the simnilia similibus principle, he is within
the legitimate sphere of his profession, although lie should
adopt Allopathic doses of medicine in his prescriptions.
The enquiry may here be made: " Why does he not, then,
adopt them?" For the simple reason that if he did, the small
number of remedies that possess the similia similibus principle found in that materia medica, when given in bulk,
would leave him almost without the means of combating disease.  Remedies only acquire the property of creating systemic disturbance, by which they produce simulative diseases,
by attenuations, and by these means they are carried directly to the sensitive nervous centres upon which their effects
are produced. Hence the Homeopath, frcm necessity as
well as choice, adopts his infinitesimal doses.
Another great mistake we make in the South is, that a
Homeopath is necessarily ignorant of every qualification
that a physician should possess. In this we are greatly
mistaken. In their numerous schools, both in Europe and
America, the different chairs are filled by- men of great erudition who teach to their classes anatomy, physiology, pathology, therapeutics, chemistr-y, &c., as thoroughly as they are
taught in any Allopathic school.  Hence their writers, p.rticularly in Germany, fiom which country their founder was
driven, have been enabled to triumph so far over their erudite rivals as to have the new system restored to its nation



11
al birth-right, which they could not have done had they not
been able to meet them in every department of medical
science in which they chose to make their attacks.
But to show the true character of the founder, and his followers, and the actual position of the science at that time,
we will here quote an article, contained in the British and
Foreign Medical Review, in the Jan. number of said Review,
1846. The article was written by the Editor, Dr. John.
Forbes, and was occasioned by a publication made by Dr.
Henderson, Professor of Pathology, in the University of
Edinburgh, detailing a number of cases treated by  him
upon the New System. Preliminary to the review of Dr. H.'s
book, a high tribute of respect is paid to the founder of
Homeopathy, whom  he pronounces to have been a man of
great learning, " industry, untiring energy and perseverance,"
who founded a system of medicine as ingenious as many
that preceded, and destined probably to be the remote, if not
the immediate cause of more important fundamental changes
in the practice of the healing art, than any that have been
promulgated since the days of Galen himself. In the history
of medicine, the name of Hahnemann, will appear in the same
list with those of the greatest systematists and theorist, unsurpassed for the ingenuity and originality of his viewssuperior to most in having substantiated and carried out his
doctrines into actual and extensive practice.  By most medical men it was taken for granted that the system was one,
not only visionary in itself, but was the result ot a mere falciful hypothesis, disconnected with facts of any kind, and
supported by no process of ratiocination or logical inference,
whilst the author and his apostles and sucessors wi:re looked
upon either as visionaries or quacks, or both. It is but an
act of simple justice to admit that many of his followers
have been, and are sincere, honest, and learned men.
" On these grounds then it appears to us reasonable that the
claims of Homeopathy, regarded as a system of medical doctrine, ought to be admitted so far as to be entitled to investigatipn at least; and in undertaking such an investigation, we
have no more right to reject the evidence supplied byits professors than we have of rejecting any other evidencein:fa-vor




12
of -,ny other medical doctrine, theoretical or practical." Pages
4 and 5. Again, page 21. " No doctrine, however ingenious,
not based upon positive demonstrable facts, will any more
b- regarded but as a piece of poetical speculation, which indeed may amuse the fancy, but can never influence the conduct of scientific men.  But Homeopathy comes before us
in a much more imposing aspect, and claims our attention on
grounds which can not be gainsaid. It presents itself as a
new art of medicine; as a mode of practice utterly at variance with that long established in the world; and claims
the notice of mankind on the irresistible grounds of its superior power of curing disease and preserving human life. And
it comes before us not in the garb of a suppliant, unknown
and helpless, but as a conqueror, powerful, famous and triumphant. The disciples of Hahncmann are spread over the
whole civilized world. There is not a town of any considerable size in Germany, France, Italy, England, or A merica,
that does not boast of possessing one or more HIomeopathic
physicians, not a few of whom are men of high respectability
and learning, many of them in large practice, and patronised
especially by people of high rank. Numerous hospitals and
dispensaries for the treatment of the poor, on the New System, have been established, many of which publish reports,
blazoning its success not merely in warm phrazes, but also in
harder words, and still more hard figures of statisticals
tables."
In commenting upon those furnished by Dr. Fleishman
Superintendent of the Charity Hospital of Vienna, he remarks, page 26. "' Not merely do we see thus cured all the
slighter diseases, whether acute or chronic, which most men
of experience know to be readily susceptible of cure under
every variety of treatment, and under no treatment at all,
but even the severer and more dangerous diseases, which
most physicians, of whatever school, have been accustomed to
consider, as not only needing the interposition of art to assist
nature in bringing them to a favorable, but speedy termination, but demanding the employment of prompt and.strong
measures to prevent a fatal issue in a considerable proportion
c, cases. And such is the nature of the promises that there




13
can hardly be any mistake as to the justness of the inference.
Dr. Fleishman is a regular, well educated physician, and as
capable of fbrmling a true diagnosis as any other practitioner,
and lihe is considered by those who know  hii, as a man of
honor and respectability.  We can not, tl-herefore, refuse to
adtnit the accuracy of his statements as to matters of fact.
The amount of deaths in the fever and eruptive diseases is
certainly below the ordinary proportion."  On next page, in
continuation of'his remarks on Dr. F.'s report, he says: "But
the results presented to us in the severer internal inflammnations are certainly not such as most physicians would have
expected to be obtained under the exclusive administration
of a thousandth, a millioneth, or billioneth of a grain of
phosphorus, every two, three or four hours.  It would be
verv unreasonable to believe that out of 300 cases of pneumonia, 224 cases of pleurisy, and 105 cases of peritonitis (in
all 629. cases) spread over a period of eight years, all the cases
except the fatal ones (27 in number) were slight, and such   s
would have seemed to us hardly requiring treatment of any
kind. In fact, according to all experience, such could not be
lhe c1ase.   A few of tlese, pneumtonia for instance, we ha ve
reason to know were not of this character.  A few of these
cases are rep-,orted by Dr. F. himself, and w-e hlave ourselves
had. the statemlinent corroborated by the, private testimrony of
a plyvsjcian! ln:ot a H0om':n;opath, wllo attended Dr. F.'s wards
for three nionths.  This gentleman watched tlhe course of,several cases of I)pneumonia, and traced their progress by
phevsical  signs thlrough the different st4ges of collestion,
ltepatizationl and resolution, up to a perfect cure, within ~a
period of' time, which would have appeared short under the
treatlment of Alloclathy."'What further testimony would any one require, not blinded
by prejudices, to convince him of the power of' ornomeopath}ic
doses to cure.diseases?   But what says DLr. F. to these admissions.  "For reasons already stated, no conclusion favorable to 1Homeopathy can be thience adduced."  A volatile
Frenchman would certainly have shru(gged his shloullders, and
elevated his eyebrows up to the very top of his forehead, at
this remarkable announcement, and ejaculated, " Perquoi,
2




14
Doctor?"  He answers, because the Homeopathic practice
being new, its pretensions to cure diseases by doses such as
above specified, must undergo the experimenturn crusis before they can be received as admitted facts.
I have no doubt any Homeopath would readily join you
in your incredulity, as to the cures effected by the doses
you have specified, any one of which may have been adminiistered indifferently, and selected from your list without any
regard to the inmmneasurable difference in their sizes. You
have assumed a recklessness of statement in regard to doses,
that would mislead your reader and induce him to believe
that the Homeopath was perfectly indifferent to his attenuations, provided they were high enough; or that a mnillioneth, a trillioneth, or a thousandth part of a grain, was regarded by him as mere equivalents in producing results.
It is not surprising that these cures, in order to be believed
as resulting phenomena, from the administrations above cited,
must be subjected to the tests he proposes. Homeopathy
must submit to undergo the humiliation of standing in the
pillory, side by side with Nihilopathy, until Dr. F. can decide upon their respective merits in the cure of disease; but
we fear that the Dr., by no process of calculation devised yet
by naln, can approximate tile period when such a trial could
be brougllt to a close, since the'patients of the former are
likely to have administered to them  the millioneth or billoneth part of a grain of any of these medicines, whilst
those of the latter have even just nothing at all given to
t+hem. Now let any one-be he of the Old, New, or any
other school-state the difference between the patients, as to
treatment, and thence deduce the end of the expeciment if he
c:an —both being negatively treated.
But the Dr. was greatly wanting in courtesy to this new
system of medicine, which I have christened Nihilopathy or
he would have proposed, in all fairness, to subject Allopathy
on one side, and the New systemn on the other of innoxious
N'hilopfathy, to the experimentum crusis, by which means he
could have determined  which of these was the most trustworthy savior of mankind.  This would have been not only
an act of simple justice to the two contestant pathies, but




15
also to Nihiloputhy, which according to his argument deduced
almost ab origine mundi, had had no opportunity to evince
its powers of curing disease, owing to the intermeddlesome
interference of medication in all stages of society.  But if
this experiment'rm  crusis had resulted in favor of Homeopathy, no conclusion thence deduced would have availed
any thing in establishing its claims, to be considered as a
true system of medication, seeing that it is inconceivable
that the infinitesimal doses relied on to produce these results
could have had any such an effect. Ergo, the zymotic poison
of yellow fever, and other reputed contagions, being infinitesimal in their attributes, itlis inconceivable that arJy such
results as have been referred to them, could have been produced by them. But as his favorite auxiliary, in such emergencies, the vis medicatrix, can not be invoked, to account for
these diseased phenomena, there still remained to him the vis
aegrostatrics,* upon which he could have relied to assist him to
a solution of them, and thus have saved himself from the
lhumiliating admission that infinitesimals of any sort can be
operative.
His admissions hevertheless contradict his averments as
to his want of confidence in the operative poaver of their
doses, in contra distinction to his doses, because no (cne
claims that such as he sets down would be operaltivc —silnce
he concedes that Allopathy would have been perfectly satisfied with these results, if they had occurred in that practice.
As curative systems, then, they stand upon the same ground,
and must be regarded as equally available, or equally nugatory, so far as the treatment of disease is concerned. Indeed,
he claims no superiority, in this respect, for the old over the
new system, being satisfied if the former can maintain an
equality with the latter in its achievements.  That we have
not misstated tile purport of his admissions, we quote in
point, page 28.  After reciting a number of cases treated
Homeopathically by Dr. Fleishman, he says: " As we advance to the still more dangerous diseases, we find the loss
proportionally greater.  The only cases in the list, which do
* As there exists a vis medicatrix, I see no reason why its counterpart ought not to have a place, at least in our nomenclature. The above
word is offered to supply this deficiency.




16
not seem, on first sight, to come within the above category,
are the cases of endocarditis and pericarditis (31) which are
all reported cured. These are, no doubt, severe diseases, and
this ~may seem an uncommon amount of success; yet when it
is considered that the number of cases is not great, that the
diagnosis, of end,)carditis, and even pericarditis, is less easy
and certain than that of many other diseases, and that it is
not so much in their primary' condition as in their ultimate
effects, that these diseases are dangerous, we believe that
even the degree of success here recorded can not be admnitted, in fairness, as any ideviation from the ordinary events
in Allopathic medification.
What is this but a studied argument to prove that the
success of Homeopathy, in the treatment of a class of diseases known to be dangerous, may be accounted for under
certain supposed contingencies, whereby Allopathy coulod secure to itself the benefit of a peradventure, by which it
night be enabled to claim  a possible Isuccess equal to that
here detailed.  But is it rational to suppose that all these
cases were treated in their primary condition, in which we
are led to believe that they are easily cured'? Besides, is it
probable that Dr. F. was deficient in medical records and
hospital reporis, tlhat he could not hlave tutred to his authorities and produced ani equal numb'er of cures by Ailopathy,
if such a list had existed, instead of resorting to a dising-enious hypothesis in order to depreciate the success of
EHomieopathy? or that the credit of her cures migh-t be held
at least in abeyance by ingenious interpositions of suppositions, until Allopathy might make its appearance side by side
with her?  His whole object seems to be to deprciate the
cures of the New System, so as if possible to make and keep
honors easy between it and the old.
But his attack upon Homeopathy has resulted much more
disasterously to the old than to the New System.  For the
verification  of this statement, I appeal to any one who
has read his book; and venture to predict that the result
of his reading it, has been to give him a much more exalted idea of the New System, and corresponding depreciated one of the old.  If he were to be indicted for a libel,




17
on account of this attack upon Homeopathy, I opine that it
would puzzle a Philadelphia lawyer to find the flagrant
point in it upon which a prosecution would lie. It must be
admitted nevertheless, that lie expended a certain amount of
innoxious, but " facile ridicule," upon a certain effete part of
Hahnemann's systemn, as delivered to the world in a moment
of excited enthusiasm, when he had made the great discovery
of the dynamitization of his remedies by attenuation, and believed that the process colld be carried almnost ad infinitum;
but whether the learned Editor intended a-yiv thing malicious
or not, is not rendered very clear by any future development
of his purposes. The next averment he made, which might be
construed as intended to be prejudical to the New System,
was that he could not yield his belief in the operative powers
of these doses in the cure of disease. But this want of belief
on his part was so entirely a matter personal to himself,
that no bad effect to Homeopathy could result from it except, by operating upon minds as much overshadowed by
prejudice as his own.  But the learned Editor had informtd
us previously, that the same amount of credibility would be
yielded to the statements made in its favor by its advocates,
as there would.he to the statements made in iavor of any
other systenm; yet in the face of this just and reasonable declaration, he denies that Homeopathic doses are operative,
although  the fhct is attested by thousands, yea clouds of
witnesses, whose respectability, truthfulness, and ability to
make correct observations and note results, he will not venture to question. But why does he thus deny their powers?
I suppose it is because his conclusions are deduced from the
high attenuations of Hahnemann, from which he seems afraid
to separate himself, lest he should surrender the only battery
from which he can thlrow a shot to annoy his adversary.  If
lie had the ingeniousness to disentangle himself friom these
cobwe)bs by -whliclh he permits himself to be enthralled, far
the sake of the supposed advantage ground they afford, perhaps he might change his point of observation, and cease to
struggle against difficulties of his own creation.
But he not only denies their power to cure diseases, but
also that of producing the effects upon the healthy human




18
subject, as announced in the provings of their remedies. Inr
order to show the unreasonableness of this inference, we
must remind the reader that these provings of their almost illimitable materia medica, are and have been, simultaneously conducted, and repeated over and over againi,
in every country embraced within the limits of Christendom,
with such a uniformity of result as to enable practitioners
in every clime in which the New System is represented, to
select the same specifics for the same symtoms.  Could such
a uniformity of result be produced by any system of frauds
and collusions, even the most perfect and extensive that was
ever devised by the combined ingenuity of men, in favor of
this or any other delusion ever practised upon the world?
But as  this denial here given to the operative powers of
Homeopathic doses of substances administered in health, and,
the reasons assigned for that denial, are the most important
of the series of objections made to the New System as a
true one for the cure of disease, it must therefore receive
something more than a mere passing notice.
This denial purports to be based upon the inertness of
some of the most important substances here introduced as
active agents, of which ounces, nay pounds, may be gestated
in the stomach withlout any other effect thlan the mnere inconvenience of bulk.  The Homeopath, without a nmoment's
hesitation, will yield his assent to the truth of this statement but will subjoin  this simple counter statement,
that he never claimed for them. any virtues or potences
until they were confered upon them by attenuations as to their
inertness in bulk; that is entirely an extraneous matter which
has nothing to do with the question of fact long since established by thie above process.  But every body seems to
halt before this appalling solecism, and demands to know:.
Why are substances, naturally inert in bulk, active in a state
of high attenuation?  Causa latet vis est notifimna is true ii}
this as in many other instances.  If the reader will take the
trouble to remember that it has been heretofore explained as
a nervous phenomenon, he need not be startled by its apparent incongruities in its effects in its two states, or its
non-effect in the one and activity in the other. But when a




19
fact is established by numerous and indubitable proofs, all
doubts arising from our inability to account for it should
have their end i'n rational acquiescence. But is this fact thus
established? If any fact in history, science, or any department of human knowledgre was ever so established,' then on
equal grounds has been established, that of attenuations conferring active powers upon substances which had relatively
to the human system  no such powers anterior to its being
subjected to that process, and in developing a new order of
properties in those which, when, administered in bulk, were
known to produce definite effects upon the human organism.
This great and important fact is placed beyond all question
or cavil, by its being made the basis of a grand system of
practical medicine, and the concurrent testimony of thousands
of observers, learned professors many of them, converts from
the old school, men of talent and abilities, who are every
where testing it by repeating experiments either to confirm
what others had stated, or satisfy their own minds, as to
these reputed results; yet these furnish but a tythe of the
proofs going to establish it, that is derived from the thousands
of physicians who practice the New  System as an healing
art, daily and hlourly, among all classes of patients, in all
ranks of life, througrhout the  civilized world.  What a
delusion here startles tile world by the magnitude and
gran deur of its developments —a delusion starting seventy
years ago, froin a given point, spreading thence over half
the habitable globe, overturning  old systems, trampling
under foot dogmias thousands of years old, and now proclaiming itself the champion of the age in the healing art, and
vo one to oppose its triumphant career, except the learned
Editor of the aforesaid Journal.  His courage is certainly
conmmendable, bftt we can no more admire his prudence than
we can that of a certain knight who fell into a serious difficulty with a wind-mill.  But is it to be credited that Dr.
F., by expressing a sneering skepticism as to the value of
these provings of their materia medica, expects to oveithrow,  the peleon-upon-ossa  testimony that has been presented before him, without the aid of Jupiter's thunder?  If
he does, then the only curative measure that is applicable to




20
his case, is to give him over-to the solitude of hiis own meditations, as from these alone we can derive that solace which
wounded vanity ever craves, after being defeated of it!
object.
The last proposal of the experirnentum  crusis to be applied to the provings of the remedies of the New System,
certainly betrays a mind in the last stage of cynicism,
brought on, perhaps, by an agony of fruitless effort to oyerthrow that which it found it could not overcome. Could any
one, unless he were nearly demented by blind rage, have
asked or proposed, as an act precedent to his admissions of
these provings, that his right to denland a parallel number
of healthy persons should be set down to record all their
sensations for several days after taking no medicine, must be
admitted.  This the  tlomeopathist can not give ius. No
man of sane mind could ever have seriously coupled his
assent to a given proposition upon such silly termls as are
here set forth; therefore, unless we are to understand his
last experimentumn crusis to be nothing more nor less than a
contemptuous sneer at the New System and its followers, it
is as meaningless as it is unworthy of the source from whiclh
it erninated.
Yet, to Dr. Forbes, Homeopathy is more indlebted than to
any other writer on his side, for the respectable antagonism
to the old system, which it now presents to the world. In
examining its claims to be considered as a -reat but novel
system of the healing art, in the true spirit of a lofty criticism, he placed her side by side with the old; and in this
position her pretensions were canvassed.  This high position
will ever hereafter screen her from  low cavilings of ignorance, interested scurrility, and blind prejudice;and whoever
approaches her now, with the view of triticism, munst do so
with the becoming dignity of a scholar, duly impressed with
the great importance of his subject.  The reign of taunts.
sueers,5and " facile.ridicule," so far as applying them to
Homeopathy is concerned, is now over, and he who should
hereafter avail himself of these ignoble weapons for such
a purpose, will find that he can harm himself with them, but
can do nothing more.




21
Regarding Dr. F.'s as the text book on his side of the question, we have employed much more time and space upon it than
perhaps, we should have done, had we had a regard simnply to
its isolate merits alone, however great thlesQ tlay have been.
Having now, we think, fairly established the operative
power of Homeopathic doses of medicine, in controlling mol
bid action, and having offered a plausible theory of their nmo
dus operandi, which, when applied to that difficulty, removes
and explains it, with an ease and facility which immediately
obtains the acquiescence, of the reflective reader as to its
truthfulness, we now pass to other subjects, of which we propose to treat in our subsequent remarks, which will have
reference principally to yellow fever, the laws which govern
its propagation, and some general considerations upon its
therapeutical amenibilities.




PREFACE TO PART II.
Having written a succinct account of thle epidemic, as observed by me in both Galveston and Houston, Texas, during
the summer and fall of 1867, my labors here might have
ceased; but finding so little written in medical books that
could be relied' on in practice, especially to meet not only
every stage of the disease, but the ever shifting phases of
this protean monster, and knowing the deep horror, and even
terror, with which it is regarded by the unacclimated, there.
fore I came to the conclusion that my great experience, and
the unparalleled success which attended the Homeopathic
treatment in the various yellow fever epidemics occurling
along our sea coast within the last nineteen years, would
warrant me in tendering these few suggestions in its managemcnt to my professional brethren, thus supplying, in
an humble way, a desideratum in founding a system of therapeutics applicable to the disease, as well as a vade-mecur to
the inexperienced.  Feeling that the first step towards
treating any disease with success, is to systematize the
remedies applicable to it, and thus form for it as it were a
code of practice, 1 have, in accordance with these views, here
contributed to this end my mite, hoping that it may receive a
fair consideration from the profession, and in giving to the
world a practice which I feel sure will be erelong realized,
by which this terrible scourge of the South will have no
more terrors than ordinary chills and fever.
H. C. PARKER.




PART II.
SOME ACCOUNT OF THE YELLOW FEVER
AS IT APPEARED IN
Galveston and Houston, Texas, in 1867,
TOGETHER WITH ITS
SYMPTOMS, TREATMENT, &c.
This Epidemic made its first appearance in the former
city early in July. As usual, much contention arose among
the faculty as to the true character of the disease, nor was
it until about the middle of that month, that it was pronounced yellow fever, in an epidemic form. Great numbers
of unacclimated persons had remained in the city until this
announcement was made, when they took the alarm and fled
in every direction, carry-ing the seeds of the disease in their
person and scattering them  broadcast through the >villages
and towns in which they took refuge, and where a large proportion of them fell ill of the disease.
The writer, having practiced in the epidemic of 1848, and
treated 183 tases with a loss of less than 6 per cent.-the
type being of a mild character-and also in that of 1853. one
of the most malignant forms of the disease, which had, up to
that time, ever visited our cities-having under his charge
during its stay amongus as many as 474 cases, with a loss of
less than 10 per cent.-felt that the triumphs of Homeopathy,
from the success, together with its subsequent employment in
the milder forms of the fever in 1854-'5 and'58, would justify
his trusting to its powers again in the terrible ordeal
through which the above cities were about to pass. Accordingly, after the fever was declared -epidemic, although from




3
impaired health he had retired for several years from practice yet, lie immediately repaired to Galveston, where he
arrived about the first of August, and remained there until
the disease had measurably run its course. By this time it
had fully developed itself in an epidemic form in Houston. to
which city he now catne with the view of encountering the
ravager in one of his stronglholds.  Here he remained until
about the first of November, at which time the epidemic
had measurably subsided.
The following were the symnptoms  of the epidemic under
consideration, as they manifested themselves in most of the
cases seen by the writer, in both Galveston and Houston:
The patients generally complained for several days of fullness in the head, loss of appetite, constipation, and depression
of spirits, together with a tendency to acidity of the stomach.
Pain in the head, back and extremities, next made their appearance, and continued to increase in most instances, with
rigors and chilly sensations, with which they were soon
followed —these last being in a short time superseded by
fever, which gradually reached its climax in from six to ten
hours, at which time the pain in the above parts became very
great, accompanied with strong determination of blood to
the head, and often with delerium, the sclerotic coats of the
eye presenting an injected appearance, and the countenance
becoming much suffused and flushed.
The fever presented great heat of surface, accompanied
with thirst, restlessness and anxiety; the bowels were constipated, urine scanty, high colored, and in many instances
about the third or the fourth day of the attack, entirely suppressed; the tongue was much thickened, and covered with a
slimy coating —its edges and apex presenting a shining,
smooth, red appearance. In many cases there was a great
deal of nausea and vomiting, with much, distress in' the
epigastric region, especially if the stomach was loaded at the
time of the attack, The pain -in the head was mostly confined to the supraorbital and temporal regions, and in many
cases attended by photophobia. As heretofore stated, the
fever reached its achme in from six to ten hours, soon after
which a free perspiration would break out, partial at first,
but in favorable cases it soon became general.




4
In the more malignant forms of the disease, the perspiroation soon disappeared, and this subsidence was followed by
an increase of restlessness and thirst-at this stage delerium
generally made its appearance.
If the perspiration was continuous for twelve or fourteen
hours, there was an amelioration in all the symptoms-the
fever gradually subsiding until the third or fourth day, when
it completely disappeared, giving place to the stage of collapse, with the cessation of all pain.  IIn the more violent
cases, the fever did not subside until the fifth or sixth day,
the surface remaining dry, and the patient restless, and the
disappearance of these symptoms was follo.wed by thi fatal
collapse-the black vomit and death following close in its
rear. In the stage of collapse, in addition to the prostration
of the vital energies, there was a total relaxation of the surface, over which a yellow hue diffused itself-the features became sharp, the eyes sunken, with a dark'areola under them.
The termination of the collapse, whether' favorable or unfavorable, depended in a great measure upon the violence of
the preceding paroxism  of fever, its duration, and  the
character of treatment received by the patient while passing
through it.
Under favorable circumstances, reaction was fully established in a few hours, followed by free evacuations fiom the
bowels of dark and billionus matter, either spontaneously
taking place, or procured by the syringe; but in speaking of
the stage of collapse, several changes occur; but death is
owing rather to their conjoint influence than to either singly.
1st. Exhaustation of vital power is always present, but not
to an extent sufficient of itself to arrest the organic functions.
2nd. Deteriorations or changes of the blood obviously takes
place, as is shown by the state of this fluid both during life
and after death, but the nature of this change is not fully
sacertained; whatever may be its nature, it is merely consequent upon the altered state of organic nervous influence.
3d. It is is very probable that exhaustation of this influence,
and the resulting changes in the blood, so affect the irritability and tonicity of the fibrous and contractile structures
as to impair these vital manifestations, and thereby to favoror




even to induce the alterations observed toward a fatal close,
particularly those affecting the capillary system and mucous
tissues; for the vital tone of the extreme vessels, and of the
digestive inucrus surface being thus impaired, and the blood
being more fluid and dissolved, as well as otherwise altered,
hemorrhage. readily occurs, with discoloration of the skinand of mermbranous parts, tlhe blotches, &c., observed during
the latter sta es, proceedintg from these pathological states.
That the head should appear to suffer especially, during the
period of excitement, and that the stomlach and digestive
mucous surface should evince predominant disorder, atan advan ced stage, may be ascried to the irruptions of acid or
vitiated secretions, particularly the billiary, to the state of
the organic nervous power, and to the changes induced in the
blood.  Dr. Copland says of the changes that take place in
the advanced period of the disease, the most remarkable are
those affecting the blood and the digestive organs.  As the
stage of excitement merges into that of exhaustion, the
blood changes from a florid to a dark color-loses its property
of separating into crasamentum and serum, and of firmly
coagulating. In unfavorable cases there is only a partial reaction, when a low typhoid type of consecutive fever ensues,
characterized by dryness along the center of the tongue, the
edges and apex of which became extremely red, lips parched,
great thirst, and in many cases distressing nausea and vomiting supervened.  The surface now assumed a yellowish hue,
intermingled with a dark, dingy, dirty appearance, and having a husky dry feel, the eyes were suffused, the intellect began to wander, and finally delirium fully set in —a general
sinking of the vital forces strongly markets this stage. These
symnptorms were aggravated in the evening and the fore part
of the night, but were sensibly ameliorated, in the morning.
During this stage, a total suppression of the secretions existed, especially of urine.  Hemorrhagic tendency was present throughout the collapse, and the patient rapidly sunk.
-Occasionally, before the supervention of this period the hamorrhagic tendency showed itself in passive discharges of
blood from the nose, gums, bowels and lungs. The two last
are of an unfavorable augury after the stage of collapse had




been reached whilst the two former often seemed to be critical and to have exerted a favorable influence upon the course
of the fever. The consecutive fever, or more-properly the
fever of the vital reaction, generally lasted frorn one to four
or even five days, these last cases generally terminating
fatally. Several peculiarities marked the course of this
Epidemic, and prominently among these was a rash, which
was much more generally developed among the patients in
Galveston than in'Houston-in the former of which it ailmost equaled scarlatina. This rash made its appearance (in
the third or fourth day, or about the decline of the fever, at
first partial, but soon spreading all over the body.  Upon
its first appearance, the fever was frequently much increased,
as well as heat of surface, but upon its fulll development the
fever rapidly subsided. In all the cases in which it came
out full and complete, and was not repelled by an imprudent
admission of cold air to the person of the patient, the recovery was considered certain; but in cases in which this
happened, and the rash was repelled, immediately a train of
untoward symptoms followed, such as restlessness, nausea,
and sometimes watery dejections, with great prostration.
The vestiges of the eruption now assumed a dark, purple
color, and death soon followed. Another peculiarity was
the great tendency to form congestions in the large vital organs. Whilst the brain was the organ most frequently
attacked, yet the stomach, bowels, and liver often suffered,
particularly if superpurgation had been induced by the
too free exhibition of cathartics. The catamenia, as the fever
declines, often made its appearance in females of proper age.
This was considered a favorable symptom, but in females
enciente, symptoms of abortion took place, followed by a rapid sinking, restlessness and death. Persons laboring under
pulmonary diseases were generally disposed to congestion
of these organs, and where it occurred, it immediately rendered such cases extremely critical, and often incurable.
They were almost sure td sink when the febrile paroxysm
terminated, in the stage of collapse.




7
TREATMENT OF YELLOW FEVER,
AS IT PREVAILED IN THE CITIES OF GALVESTON AND HOUSTON,
TEXAS, IN'; 1867.
If called to a patient, within a few hours of his attack, and
found any nausea, or disturbanceof the stomach present, I immediately prescribed an emetic of mustard and common salt, a
large sized teaspoonfull of each, to half a pint of tepid water,
being for this purpose administered; the patient was then allowed to remain quiet for ten or fifteen minutes, but if at
the end of this time free emesis did not take place, the
mustard was administered without the salt, less it should
run off by she bowels, by which mischief might be done. If
the action of the emetic was not sufficien tly free, warm water
was given until the stomach was entirely emptied. I then
had his bed adjusted, and hc was covered with what bedclothes would have made him comfortable in health. For
this purpose blankets were preferred, and two generally sufficed,. one to be used during the warm part of the day, and
the other on the approach of night, the object being to keep
up as uniform a temperature of the body as might be found
necessary to avoid a check of perspiration. As regards the
amount of covering, the comfort of the patient was consulted
-to prevent on the one hand restlessness, from the oppression of a superabundance, and on the other to avoid a depression of temperature, below the sweating point. But the
cold air was carefully excluded, and the surface not allowed
to be exposed to its:.:inmediate contact-the patient being
kept for this purpose as quiet as possible. If there was
much determination of blood to the head, recourse was immediately had to aconite and belladonna in alternation, every
fiifteen or twenty minutes, until the patient was discovered
to be under theiri influence, when the alternations were
changed to thirty minutes. If the perspiration now became
profuse, the alternations were again extended to' one, or
even two hours; the object of the remedial administration
being attained, when a uniform, but gentle perspiration was
kept up. As regards the quantities of the remedies, they must
be varied according to the age, temperament, and sex, of the




8
patient: for an adult male of the bilious temperament, ten
drops, each of the first deceinmal aftenuation;, *ere added
to four6 duices'of' water, andj at the "first admininistration, two
teaspoonfulls were givre ih'alte rnation; but after the patient
was fairly impressed, the quantity was diminished to one
teaspoonfell, or'thei peiiod-of alternation wasy extended, as
heretofore- indicated; these two remedies slould be continned, until the deterlmination Of blood to tile head is controlled.'If darting: or shooting pains annoyed the patient,'a
few doses of cimicefuga, at the first:decimal attenuation, were
found highly beneficial in allaying them, and in quieting
the patient, an object of primary impoortance at this stage of
the disease. The room iof the:patient' should be kept' well
ventilated, by allowing a free current 6f air to pass through
it; but'he must be seduously guarded against its passing
immediately over him; and especially must a north wind' be
thus guarded against, as their unfavorable influence ha've
been often remarked. Southern rooms, on this account, were'
found much preferable for patients, especially when alterInations of temperature begin to shlow  themselves, upon the
approach of the fall season of the year.  Nevertheless, in
order to prevent his breathing the same air Qver again, a
plenty that is fresh, is indispensable to the patient, and as
the exhalations from  the lungs and body readily contamiate it, rendering it unfit to supply a: proper quantum of
oxygen to the blood-a deficiency of which is well known to
be the cause of most of the untoward symptoinms that present'themselves in the course, and at the cloje of thei fever. The
importaiice of this injunction can not be tOo forcibly inpressed upon the mind of the inexperienced practitioner.
Should the surface become dry, and the patient restless,
sponging with warm  water, containing in it-saleratus or
some other alkali, may be practiced with great benefit;
and if the heat of'surface be very great, even cold water'may be used in the same way, as a substitute for the warm,
but under the same restrictions as to exposure of the person
of the patient to contact with the air. In this condition of the
patient, cold, and even- ice water, may bet freely applied'to
the face, and even ice itself to'the forehead and temples.
A




9
Great dryness of the, mouth, and fauces, cause intolerable
thirst; but if water be a;lowed in sufficient quantities to
satisfy the thirst, it. is apt, after it becomes Warmnin: the
stomach, to create nausea and vomiting, accpmpanied with
restles3ness, all of which are to be deprecated. JI.therefore
generally administered. a teaspoonfull or two of cold water
every fifteen or twenty minutes, or allowed small lumps of
ice to be dissolved in the mouth, whilst cloths: rung ouZ of ice
water, were at the same time applied to thie head; and the
face was freely bathed in it.
As soon as the determination of, blood to the head was
controlled by these means-which could be easily determined
to have been effected by the eyes becoming clearer, and, the
subsidence of the throbbing pain in the temporal region-the
bryonia, was substituted for belladonna and administered in
the same doses, and at the saine attenuation, alternated
every hour, with the aconite, for the relief of the intolerable
thirst, and drynessof the mouth, and fiery. redness of'the
tongue.  By acting favorably on, the tmucous membranes,
itcnot only carries its benign influence  to that organ, modifying its central coating, but also relieves the fullness, tightness, and dead aching'pain, just above the arch of. the eyebrows. For the purposes above specified, it is indispensable;
and, the two should be given in alternation, until the pulse
is reduced to seventy or eighty per minute. In the meantime, should nausea set in, a few doses of ipecac, five drops
to two ounces of water, in the dose of a teaspoonfull, should
be administered-this is given in the second decimal attenuation, and if it fails, use tartar emetic, at the same strength
and dose. If, in despite of these remedies, the patient still
complains of great burning.in the stomach, and intolerable
thirst, and restlessness, give arsenicum,:at aboutthe sixth
attenuation, same as above remedies.  Patients sometimes
complain of pains in the stomach and bowels, as if produced
by accumulation of gas-that symptom occasionally becoming
distressing. In this case interpose a few doses of nux vomica,
at the first attenuation, five drops to two ounces of water,
dose a teaspoonfull; if still unrelieved, in a reasonable length
oftime, give diascoria same as nux vomica.- But the inter



10
positions of these remedies must not interfere with the general treatment of aconite and bryonia-their influence up;on
the patient being absolutely necessary to conduct him
through the crisis, viz. when the fever merges into collalpise.
In this disease, the great tendency to congestion, Ibefore
adverted to, requires, for its prevention, all the auxili:Iry
means that can be pressed into our service.  In every case,
congestion of the spinal column gives rise to intense suffering in the back, and to great restlessness.  Upon examination of a sulbject after death, it will be found that the blood
has settled along the spine; throughout its whole length, but
m-ore particularly about the inferior aind superior plexus
of nerves.  To relieve the great sufferincg incidental to this
congestion, I have used with great success a liniment, composed of capsicurn and common salt, each iss, and strong
vinegar, a pint, simmered over a slow fire for twenty or
thirty minutes. This is ordered to be kept by the bedside
of the patient, and as often as he complains of pain of the
back, he was thoroughly rubbed with it along the whole
length of the spine. If the feet became cold, and the circulation irregular, the inside of Ithe lower extremities were
well rubbed with it, a woolen cloth being prefered for thiis
purpose, and the friction was kept up for five or ten minutes,
and repeated as often as the symptoms would indicate the
necessity for its repetition.  After collapse has taken place,
this remedy will be found to exert a very beneficial influence in equalizing the circulation, and relieving the great
restlessness of the patient, when all other means have failed
to accomrplish these desirable objects.  Its efficiency  for
these purposes was enhanced by its being used warm.  Independent of its stimulating qualities-the saline ingredients of
the blood, in this disease. being very much impaired-the
absorption of the salt and vinegar seemed to act upon it
favorably, judging from the effects which it produced upon
the whole train of symptoms.  The pain in the back will
continue, more or less violent, until the bowels are freely
moved, and discharges of a consistent character are produced.
Although the fever may be nearly off, yet if the accumWtlatious of this dark peccant matter, is allowed to remain in




11.
the alimentary canal, the pulse will indicate the distress, and
oppression, under which the patient lairs, no doubt caused
by the absorption of a portion of this black, offensive matter,
by which the blood is still further;contaminated, and the
secretions every where vitiated. To obviate all tliis, as soon
as the fever begins perceptibly to decline, I have recourse to
large enemas of cold water, say of the temperature of about
seventy-two or seventy-four, and in quantities of from:one to
two quarts, and repeat them two or three timnes a day-if the
water alone did not answer the purpose, salt was added.
In a large majority of cases these means will be found quite
sufficient, especially if wet compresses be at the same time
applied over the stomach and bowels. This is best accomplished by, folding a towel, several times dipping it in cold
water, and applying it to the parts under cover, where it
must be retained for some time, and renewed as often as
circumstances would seem to require.  When the fever, by
these appliances, has subsided, and the pulse reduced to its
normal standard in frequency, the nux vomica is substituted
for aconite, in mild cases, but in those of a more malignant
character, in which there are great thirst and restlessness,
which at this stage indicate that black vomit is imminent,
arsenicumn, at the sixth attenuation, is now preferred to the
nux vomica.  The nux vomica, in the milder form of the disease, nevertheless seems to have a happy effect in relieving
tlhe alimentary canal of its morbid accumulations of peccant
matter, by increasing the peristaltic motion of the bowels;
but should all these remedies fail to have their desired effect
-that is, of relieving the bowels of their accumulations —
and the stage of collapse is rapidly approaching, I take of
podophyline grs. ii, hyd. chlor. mitis grs. i, lac. sac. 3j,, mix
and rub for thirty minutes, and divide in powders xx, one to,
be given every four hours, the large enema to be continued
as heretofore directed, until the bowels are thoroughly evacuated, bringing away large, black, consistent discharges.
This being satisfactorily accomplished, the powders are now:
discontinued, except one at night, to keep up glandular
action. But, in the event the necessary evacuations are not
procured by these means, which will sometimes happen, and




12
as the life of the patient depends upon the prompt evacuation of these accumulated peccant matters from  the alime-ntary canal, then for this purpose, I take oleum ricine Sij.
oleurn terubinth::j, tinct. capsicum 3jj, mix, shake well, and
give to a male adult two tablespoonfulls, which is to be repeated in two hours, if the first does not act within this
time.  In estimating the probable benefits to be derived
from this prescription, it will be seen tliat they are theraputically adjuvants of each other, the turpentine assisting the
oil in thoroughly evacuating the bowels, and arousing the
secretion, both of the mucous membranes and the kidneys,
whilst the capsicum, by virtue of its stimulating qualities, not
only hastens the action of the oil, but prevents watery discharges, which would. at this stage of the disease, be fatal.
The oil having thus cleansed the bowels thoroughly, leaves
the patient —now in the collapse-in a fainting condition, requiring the prompt application of cold water to the face
and chest, which must be kept up until reaction takes place.
In conjunction with this treatment, brandy and water is
used in the quantity of one tablespoontull of brandy, to three
of water, a desert spoonfull of this is given every fifteen or
twenty minutes, until reaction is established; when it is only
continued to meet the demands of the patient's condition.
Another symptom, owing to its important bearing upon the
fate of the patient, at this stage, requires a distinct noticethis is suppression of urine, which demands the unremitting
attention of the physician, insomnuch that he should not fail,
upon each visit, to institute a rigid inquiry as to the condition of the urinary organs.  By this means he will be prepared to meet its earliest demonstrations; and for this purpose I use the canabis, and cantharides, first decimal attenuation, ten drops, water ziv., each in alternation, every
thirty minutes, in the dose of a desert spoonfull. As soon as
the kidneys begin to act, the interval of administration of
the remedies is extended to one, and even two hours.  If
there be frequent desire to pass the urine, and the patient be
only able to pass a few drops at a time, with burning heat
in the parts during its passage, I have recourse frequently to
the pure tincture of cantharides, three drops, water to 5ijb,




13
dose a desert spoonfull every hour, and! with the happiest
effect.. This state is often a premonitory symptom of suppression.  But to return, if it proves to be simply a retention
of urine, a few doses of apis inelo, at the frst: decinal attenuation is given in the dose of a desert spoonfill every thirty
minutes the sitz bath often aiding very mlch, if the case
prove obstinate.  The bowels, in this condition, are often
counstipated, and the oil mixture heretofore recommendedi,
will, as, soon as it operates, afford immediate relief. I have
never known it to fail. TPte treatment in this fever, up to
the stage of collapse7 is simply adjuvant, the object to be
accomplished being to keep the circulation equalized, in
order to prevent congestions fiom taking place in any of
the great vital organs, also to protect the mucous membrances, by appropriate remedies, and co(mbat prominent
symptoms when they occur, until the disease reaches its crisis,
through which every patient must necessarily pass, even in
its slightest form.  In the more violent forms of the disease,
the prostration in this stage is very great. This is the stage
in which ignorant nurses, and still more ignorant Doctors,
proclaim  the speedy convalescence of the patient, simply because the fever has now disappeared, and with it, as they
suppose, all its dangers, whereas, in fact, he has now reached
the stage in which the disease only proves fatal, the febrile
stage being entirely free from  any reasonable apprehension
of imminent danger; or, as has been quaintly remarked by
a medical friend, that no patient dies in this stage, if left un.
aided by remedial treatment. To nmeet the crisis or turning
point of the disease, the treatment must not only be prompt
but every remedy must be administered with  a specific
object, to evacuate the bowels thoroughly, is the leading indication, which can be generally accomplished without the
hazzard of watery discharges, by the means heretofore recommended; but if these should unfortunately occur, they
must be controlled by starch water enemas; and if these fail
then laudanumn must be added. But as we have heretofore
disposed of the treatment of the more violent form of collapse, we have now only to resume that of the milder grades.
In these there is little more to be done, after the bowels




hlave been evacuated. In themn I generally prescribe arsenicurn and nux vomica, in alternation, every two hours, with a
view to regulate the organs of digestion.  If the coating on
the tongue still continues white, after their administration,
indicating lan imnperfect action in the secernent organs, bryonia and ipecac are given alternately in their stead.  If
there is still a failure to correct the chilopoetic organs by
these remedies, antimonium  crudum is substituted for the
ipic., and with these I have invariably succeeded.  The
patient is able in a. few days to leave his room, being restored immediately to health, without the formality of a tedionus convalescence, which invariably happens to those who
have been subjected to the more onerous plans of treatment.
The Homeopathic and Allopathic medication can not be
more beautifully illustrated than by the contrast shown in
the patients respectively treated by the two systemsthose of the one, were for weeks creeping, sallow, ghosts,
whilst those of the other went forth in all the plimitude of
health, rejoicing equally at their acclimation, and the small
amount of suffering, with which they purchased it.
At this point, it is necessary to avail ourselves of a resurne of the symptoms incidental to'the collapse, and its
sequelse, not only to recapitulate to some extent the treatnient of this stage, and to extend the list of remedial agents
to meet these sequential phenomena, but also to notice the
modification of this stage, presented in a particular class of
patients.
The most malignant form of the fever occurs among immigrants from cold climates, with rich blood, in whom the
synochal stage presented a much higher grade of developtient, whilst the collapse was more marked than in others.
Persons also greatly exposed to insolation, appeared to be
peculiarly obnoxious to the higher grades of the disease, as
was evinced by the death of thirty-five out of thirty-seven,
carpenters, who were thus exposed in 1848 in roofing
houses. In those also of bilious temperament, of a plethoric
habit, the same exacerbation of symptoms was met with
throughout the fever, as well as in those of intemperate
habits.  Hence, when a practitioner is called to a patient, he




15
should strictly scrutinize him in reference to the several
circumstances above enumerated, as likely to aggravate the
case, as well as to ascertain whether hlie labors under chronic
disease of any organ, as the fever will be almost certain to
expend its force upon it, and in the stage of collapse, if such
organ be not protected by appropriate treatment, the patient
will become the victim of such neglect. If the patient has
been -accustomed to liquor or opium, be it the one or the other,
he must have his accustomed stimulous. as soon as advisable.
Although opium, and its preparations, are poisonous in this
disease, yet must the patient have it, in the stage of collapse,
or he will sink and die for the want of it. The physician, if
he expects to treat the disease successfully, must have a strict
regard to the idiosyncrasies, habits, constitution and temperament of his patient.
In the more violent cases, reaction will be only partial and
the collapse so complete-especially if the patient has been
purged or sweated excessively-that spontaneous reaction
can not take place. It is here that the-resources of the physician is taxed to the uttermost, in order to bring it about.
For this purpose, our principal reliance must be in cold
water, freely applied to the face, chest, and hands, giving
him in the mean time arsenicurn and veratrum album, the first
at the sixth attenuation, and the latter at the first. alternated
every every fifteen or twenty minutes. If reaction does not
take place under this treatment, conjoined with the rubbing
of the spine, with  the capsicum  liniment of double the
strength of the formula heretofore prescribed, then strip
the patient, and pour from five to six buckets of cold water
over him, causing the stream  to strike him along the full
length of the spinal column; rub- him briskly with crash
towels until dry, then place him in bed, under blankets.
Instead of the above method, he may be packed in wet sheets.
Speedy reaction will follow either plan of applying the
cold water.  Continue in the meantime the medicine, as
above directed, and after reaction is established, commence
with the brandy; but this must not be given before this
occurs, as it appeared in this stage to depress, instead of
arousing the vital forces; therefore it will be well for the




practitioner to o~bserve the above!precantion. As soon as re-:action is established,'it will be followed by the consecutive
fever, which always presents itself in a low, typhored form.
If there be no disturbance of the urinary organs, the
patient should again be put on the arsenicurn and bryonia,
alternated every half hour, until the patient is brought under
their influence, which will be manifested by a gentle action
on the surface. Aconite can not in this form of fever be relied
on.'Te cold water here must still be kept up, and freely applied to tile head, clhest and face, with wet compresses over
the stomach, and bowels. Should the tongue present a fiery
led appearance, with much thirst, and painful micturition,
the pure tinct. of cantharides, grs. iii., to water Sii, dose a
desert spoonfull, substituted for the bryonia.  If the breath
becomes offensive, interpose a few doses of carbo.jg., at a
high attenuation. The above remedies must be continued for
at least twenty-four hours, as they are our main reliance in
this stage of the disease.  Should the skin assume a peculiar
lemon color, which happens when tile peccant matter, not
being discharged from the systern, becomes absorbed, a few
doses of mercurios cor. and rhus. tox, will be found highly
beneficial; and when a stronig determination of blood to
the head exists, opium and hyoscyamus nig. may be given
with advantage.  But these latter remedies-merely interposed,-must not interfere with the general treatment.
In this stage of the, disease, the hemorrhagic tendency is
very apt to show itself in the sponginess of the gums and
bleeding at the nose.   In these cases the sulphuric acid
acts admirably, administered of the strength of ten drops, to
water xiv., dose a teaspoonfull, the free acid being preferred.
The bowels must be kept open. by enemas, administered every
night at bed time, in the quantity heretofore recommended.
After the operation of the enemas, rub the spine with the
pepper liniment, which will generally procure the patient a
comfortable night's rest, and from  this he will derive more
benefit than from any medication. The patient should
never be aroused to give medicine, as upon his procuring refreshing sleep, of some hours' duration, his life depends-he
always awakes much improved. Cold water to drink may
B5




17
be allowed him, throughlout this stage, in quantities sufficient
to quench his thirst, provided it does not lead him to swallow enough to load his stomach, giving rise to nausea and
restlessness-the juice of fresh lemons may be added, if not
contra indicated by the remedies given. If the surface
should become dry, which occasionally happens, rendering
the patient restless, it should be well sponged with the
tepid alkaline solution, under cover-the friction being very
greatful, way be continued for some time. If great relaxation of the surface should take place, giving rise to colliquative perspiration, the body should be sponged all over with
good brandy, or the pepper liniment, to be repeated as often
as the symptoms indicate the necessity for the use of the one
or the other. The patient's room must be kept clean, and
free from all perfumes, essences, aromatics, or volatile substances-they may be grateful at first to the patient, but
ultimately they tend to produce nausea, or still worse, they
may antidote some of his remedies.  If the surface becomes
prematurely cool, interpose the veratrum, at the first attenuation, until that symptom  is controlled. The extremities
and spinal column must be rubbed thoroughly, three or four
times a day, with the pepper liniment, which is invaluable in
this stage of the disease. It possesses this advantage over all
other counter'irritants, that it does not make the surface
sore so as to interfere with the repetition of its application.
If the secretions are suppressed, they must be restored by an
occasional dose of the powders, heretofore recommended. If
these means should all fail, and the patient sink into low
muttering delirium, with a constant disposition to get up
and ramble over the room —and to prevent which often requires force —thelachesis and arsinicum, both used at the
sixth attenuation, gtt. x., to water  iv., in the dose of a desert
spoonfull, alternated every thirty minutes, should be given,
with the occasional interposition of a few doses of stramonium. The cold wet sheet must be still kept up, the patient
being wrapped in it while the blankets upon which he should
be laid, should be carefully folded over him. This will in
a short time, produce a strong determination of blood to the
surface, and thus relieve the system from any internal con



18
gestion that may have occurred in any of the vital organs.
As the wet sheet seems to afford much relief, to the restless
patient, its reapplication is indicated as often as it becomes
dry, not only to allay the patient's anxiety, but also it may
be to supply the blood, by absorption, with its proper quanturn of aqueous fluid, to compensate for its loss by perspiration
or by other processes of exhaustation, by which an anaemic
state of the vital fluid is produced.
This anaemic state of the blood takes place at the period
when black vomit is imminent. My experience teaches mIe
that the absorption of the water acts beneficially, not only
upon that vital fluidk but also upon the nervous system.
In case reaction should take place, after this second collapse,
chic and arsenicum, the first at the first decimal attenuation,
the latter at the sixth, are prescribed in alternation, every
hour, in the dose of a desert spoonfull, nourishing the patient,
in the meantime, with beef tea, mutton broth, and chicken
soup, administered in small quantities; brandy and water, or
wine, is given at the same time, but care must be taken not
to produce over excitement. The lemon juice, with a limited
quantity of ice added to the water, allowed the patient to
quench his thirst, makes a grateful beverage; but sugar
must not form one of the ingredients, lest it produce acidity
of the stomach. Beef-steak, rare, chewed by the patient, the
fibrous parts spit out, and the juices alone swallowed, is an
improvement on the tea, as the salivary glands are excited
by the process of mastication, thereby affording digestion its
natural adjuvant.  But this is only allowed after the subsidence of the fever now under consideration, and then only
when the bowels have been evacuated. During the fever
nothing should be allowed but rice-water, or gruel strained,
with a little salt in it, given often but in small quantities, to
strengthen the stomach. While on the'i'ubject of diet, as I
have said nothing in relation to it in the course of the
general treatment, I will remark that the indications of nature
may be relied on —hence in the attacks of women and children uncomplicated, in whom they are often very mild, appetitie shows itself at a very early period. Rice water,
gruel, or any of the farinacia, is ordered for them, to which




19
they are confined during the febrile stage; but as soon as it,
gives way, as more liberal diet is allowed, such as beef-steak
squirtel, &c., the fleshy parts beingc spit out, for the first day
or two, but after this precautionary period htas elapsed they
are allowed to make a generail descent upon the culinary department, and forage uponl it ad libiturn.  I can not leave
the sutbject of the treatmnent of yellow fever without calling
the attention of the inexpcrieniced practitioner to a few of
the most important remedies, fearing that he may not be
aware of their importance.'rThe first in point of importance,
1 suggest, is arsenicumn; tlils ought to be given as soon as
aconite can be dispensed with, and continued through all the
subsequent stages of the disease.  It is our only means to
correct that condition of tile blood, in which corpuscular
dissolution and black vomit are imrninent.  The mucous
membranes, and the glandular system, also call constantly
fbr tie interposition of canthlarides at the different attenuations. The argentum nitras, sometimes, at this stage,
acts well, if hemorrhagic tendency is not controlled by the
sulphuric acid. The action of the lachises, in my hands, has
not been such as to make me place much reliance upon it.
But there is no disease that calls for such vigilance, and
prompt attention, on the part of all concerned, as this. The
slightest dereliction of duty, in any part of the treatment, involves the life of the patient-he is as it were, vibrating between life and death, and the weight of a pin, thrown into
the wrong scale, places him in the category of cases beyond
the hope of medical redemption-so let the physician govern
himself and others, in reference to the critical stage of the
disease, otherwise all his skill in treating of it, will be found
unavailing.
This epidemic attacked indiscriminately all classes not
sparing even those who had been raised in New Orleans and
Charleston, and attacking indifferently people of all color,
whether acclimated or not. Among the negro race the fever
ran very high at first, but lasted a very short time, terminating frequently within twenty-four, and rarely exceeding
forty-eight hours in its duration.  The mulattoes suffered
much more than their darker cousins of pure African de



20
scent; and their attacks were the more severe in proportion
to their approach to the white races in their blood affinities.
The blacks recovered rapidly, very few suffering beyond a
few days, whilst the mortality among them was comparatively
insignificant.
The epidemic which we have just passed through. proved
itself to be highly infectious and malignant.  Every town
along our railroads, that placed no restrictions on inteicourse with our infected cities, was soon devastated by it.
In fact, refuge's from Galveston and Houston 1 stribnlted it
in every town and village wherein they took up their abode,
having left those cities after they were poisoned by the infection.  It is even reported that in several places it was
spread in the rural districts, to some extent, by thse  persols.
Several of our interior towns-Liberty, on the Trinity, Richmond and Columbia, on the Brazos, besides several others in
the line of its march —escaped by enforcing rigid quarantines; thus showing the efficiency of this means to arrest
its spread, when citizens chose to take the matter in their
own hands, instead of entrustincr it to sanitary boards of
squabbling Doctors.
rIhe rapid spread, by infection, of this epidemic, proves it
to have been yellow fever of a decidedly genuine and malignant type, only excelled in thlis respect by the great epideinic of 1853. There are no forms of epidemic fever with
which this is likely to be confounded, except the acclimating
fever of the West Indies; and on the distinction  between
these two, Dr. Copland is so clear that we shall take the
liberty of quoting his remarks upon their peculiar characteristics.
Dr. Copland, of London, remarks, in his Dictionary of
Practical Medicines, "That the true, or pestilential yellow
fever, is different from severe remnittant and from ardent
fever, neither of which is infectious, while true yellow fever
is eminently infectious.  Ardent fever occurs only in Europeans recently arrived in hot climates, and never in the acclimated, nor in aboriginal or native inhabitants-it cannot
attack the dark skinned races and the assimilated European.




21
The true yellow fever attacks the unseasoned, the seasoned,
the constant resident, and the dark skinned races-the negro
as well as the European-all within the splhere of its infection wlho have not previously had the disease.  A former
attack protects from  the yellow fever; but remittants will
occur again and again in the same person; and even ardent
fevers will occur a second time, if the person who has once
been affected by it, has returned to Europe, resided long in it,
and afterward gone to a warm country. Ardent fever occurs
only among persons who have recently arrived from cold
or temperate climates into a very hot country; and true yellow fever appears only occasionally, and then the infection
may either extend to a few only-the circumstances favoring
its diffusion not existing-or to great numbers, the disease
thereby becoming epidernic.. Thus, the first and second or
the ardent and acclimatire fevers, are always occurringyellow fever seldom, or only after long intervals.  The inflammnatory fever is described by name as the synochus causonides by Gilbert; of synocha causodes, by Manget, of
synocho ardens, by Sauvages; of endemical causus, by
Mosely; of inflammatory endemic, by Dickenson; of climate
or seasoning fever, by several writers; and of endemic yellow fever, by others. This is the disease which most frequently attacks new comers into the West Indies, more especially sailors and soldiers; and which has been confounded
by recent writers with the aggravated forms of bilious fever
on the one hand, and with epidemic, or pestilential yellow
fever, on the other."
Dr. Stevens, of St. Croix, maintains that there are three
essential or idiopathic fevers met with in the West Indies
First, The climate, or seasoning fever, which is not produced by marsh poison or contagion, but by long continued
excessive heat, acting, under peculiar circumstances, on the
bodies of unseasoned strangers, lately arrived from northern
countries.
The second is a swamp or marsh fever; whilst the third is
the true African typhus or yellow fever, (the pestilential fever
of Chrisholm, the Bulam fever of Pym, &c.).




The two first, Dr. Stevens regards as indigenous to the
West Indies, and never communicable from one person to
another; while the last "is, in every insta:nce, a contagious
disease."  "At one period," says Dr. Stevens, "there was an
interval of thirty years during which there was not even one
case of this fever in the western world; and in almost every
instance where it first commences, when proper inquiry is'
made to ascertain its cause, its origin can be traced to the
traffic with certain countries on the western coast of Africa."
According to Dr. Stevens, the climate (or stranger's) fever
is only met with as an epidemic during the hot months, when
the thermometer is upwards of 90 degrees during the day,
and at least 80 degrees during the night. It is confined to
the whites, and almost entirely to those who have lately
arrived from northern countries.
The African typhus, or yellow fever, according to Dr.
Stevens, prevails in every locality and in every season of the
year in the West Indies; not confined to the whites or those
newly arrived; is as fatal in the coldest weather as in the
hottest months; is not produced by any local endemic cause,
and is always communicated by contagion.
Dr. Stevens further states: That those who have had the
climate fever are not, susceptible of it a second time, unless
they leave the West Indies and return again after a considerable residence in some northern country; those who have
had yellow fever are completely exempt from any future attacks of the disease; but neither the marsh fever nor the
climate fever gives any exemption from the yellow fever,
and there is such a resemblance between the two latter, that
many suppose they have had two or more attacks of yellow
fever.
Dr. S. further remarks, in regard to the changes that take
place in the latter stages of this disease: The saline ingredients of the blood are greatly diminished. The chief cause
of these alterations is evidently exhausted organic, nervous,
or vital power; and this is further evinced by a loss of the
tone of the extreme vessels, and of the irritability of the
moving fibre, always co-ordinately observed in cases presenting this change in the blood. Among the most striking con




23
sequences of exhaustion of vital power. as thus manifested in
the extreme vessels and blood, are discoloration of the skin
arid passive hemorrhages from  mucous surfaces, phenomena
characterizing the last stage of the most unfavorable cases
of the intense disease.
The gastric disturbance in the early stages generally proceeds from excited vascular action, and from  the passage of
irritating secretions into the stomach, in connection with an
increased susceptibility and irritability of the organ.  In the
latter stages, it more especially results friom the morbid secretions poured into the stomach, and tile irritated or inflamed
state of its villous surface.
The source of the black matter passed from  the stomach
and bowels, in the last stge of this and of other severe
fevers of warm countries, has been variously stated. Some
consider the black color to proceed from the exudation of
dark blood, which, in mixing with the secretions of the
stomach, liver and bowels, imparts to them a still darker
tint. Some ascribe it chiefly to the bile and secretions from
the digestive mucous follicles, which are often both very dark
and thick in the last stage of the more malignant kinds of
inter-tropical fevers; and others believe it to arise both
ways. There is no doubt that all the secretions poured into
the digestive canal are more or less diseased, particularly in
the latter stages; but it is as clear that the black color
mainly depends upon the state of the blood, and that all the
matter ejected upwards and downwards, presenting this appearance, does not consist of altered secretions merely, a
great part of it probably being an exudation of blood from
the mucous surface.
Dr. Jackson remarks that the secretions from the digestive
mucous surface are ropy and clear during the early periods,
and are brown or black in the latter, sometimes black as
soot, and that the sooty or ink-like color is chiefly observed
where the head and stomach are simultaneously attacked.
When we consider that the'blood becomes darker than natural, as well as otherwise changed, early in the period of exhaustion, and that the liver and mucous follicles of the digestive canal, with the kidneys, are the principal organs of de



24
puration, or channels by which the elements producing these
changes are eliminated from  the exudation, we need not be
surprised at the secretions which these elements go to form,
and which these organs excrete, presenting somewhat similar characters.  It must, however, be admitted that the
share which the secretions perform in producing this phenomenon, or that which the exudation of blood has in giving
rise to it, will vary much in different varieties of the fever.
The ripidity with which a dissolution of the tissues takes.
place after death, in this fever, deserves notice, as marking
the rapidity of vital exhaustion,and as resulting from  the
changes of the blood, these changes commencing with the
stage of exhaustion and advancing until this fluid is no
longer capable of influencing the nervous system, and of preserving the irritability of contractile parts, or until it
poisons instead of exciting the sensitive and moving tissues.
Dr. T. Y. Simons, of Charleston, S. C., in a "Report on the
History and Causes of Stranger-'s or Yellow Fever," in that
city in 1839, (page 23, vol. 8,) has described a disease corresponding in its essential features with the one we have just
passed through; and Dr. S. H. Dickson, of Charleston, has
also given an account of the same malady (the Eclectic Journal of Medicine, February, 1840), and remarks that Maxley
has well denoted this tropical plague by the appellation of
"ca ususfebris ardens." The burning heat of the skin, he adds,
was one of the most important features during its prevalence
in former years (as was the case in this present epidemic
here), in 1838. The surface "was apt to be moist, and by
no means especially hot." The disease was marked by a
suffused dark flush upon the visage; a red and watery eye;
great gastric distress and oppression; full, hard pulse, and
pain in the head, back and limbs, there being but a single paroxysm of long duration, without subsidence, and when subsiding,
returning no more. There was occasionally a total suppression of the urinary secretions, and in the latter stages, a frequent discharge of blood from the bowels.  There was, als6,
black vomit in many cases. "In different years," says Dr.
D., "this terrible symptom shows itself with various degrees
of promptness and certainty, and connects itself, more or less,
BG




25
generally, with hemnorrhages from the nose, mouth, and other
orifices of the body." X.s to its cause, this writer observes,
"I need not tell those who hear me that no palpable cause of
yellow fever has yet been detected; nor need I remind you,
that even when we enter, with the most metaphysical nicety
into the discussion of its probable origin, under varying contingencies, we find ourselves still in the dark.  If we assign
it to the.combined operation of heat, malaria. animal and
vegetable effluvia, and the effect of personal hal)its, we are
totally unable to explain why these causes, acting together,
do not produce it as well in Calcutta as in Vera C1uz, ill
Milo as in Havana, in Galveston as in Seville."
We will illustrate the reason why it does not spread in the
one aijd does in the other, by the parable in the scriptures
which represents a sower going forth to sow, and mrost of
his seed fell into localities in which no fructification followed; but other portions fell on good ground, and did yield
fruit that sprang up and increased and brought forth, some
thirty, some sixty, and sorme a hundred fold.
So it is with- yellow fever-if its seeds are not sown in a
fructifying locality, they perish; but when sown in a genial
soil, such as Charleston, Mobile, New Orleans, Galveston
and Houston, and many of their adjacent towns, not a hundred but a thousand fold of its bitter fruits will be produced.
As spreads cholera so spreads yellow fever, each requiring,
in any locality in which it can be propagated, an element, or
it may be a telluric emination, to which either may communicate its virus, and by infecting it with its own properties,
soon get up an epidemic constitution of the atmosphere:
we say an epidemic constitution of the atmosphere, for the
want of a better term in which to express ourselves. A more
thorough knowledge of the affinities between these poisons
and the pre-existing elements which they use as a nidus, it
may be, for their own development, would enable us to express ourselves more in accordance with a set of facts, but
indifferently represented by the terms "epidemic constitution
of the atmosphere," since this atmospheric constitution, thus
produced, obeys none of the laws appertaining to the serial
fluids, being neither retarded, accelerated or delayed by its,




26
currents.  That this virus requires a local pabulum, a germinating or assimulating principle, to enable it to propagate
itself, is made manifest by its inability to spread in many
places, to which it may be carried, where it is evident no
such element can befurnished it, such as an elevated, sandy
country, abounding with pine forests, or other districts inpropitious to its reproductive processes, on account, perhaps,
of the absence of miasm.  In this power of self-propagation,
in some localities, and not in others, -we are furnished with
the clearest evidence of its infectious character, on the one
hand, and non-contagious on the other.  What a vast amount,
of labor has been expended in proving and disproving its
contagious nature, while the disease, before the eyes of the
contestants, without concealment or leger'demainu, was demnstrating that her right of dominion was everywhere asserted upon the simple principle of infection.  As before suggested, local miasm may have much to do with the reception
and the nurishment of the virus into activity, inasmuch as we
find the disease more readily propagated in localities thus
infected than in others less subject to its evolutions.  When
carried into any place where the prevailing endemics of miasmatic character are in an active state, it is found immediately to supersede them, thus showing a ready affinity of the
zymotic poison for the miasm. Being produced by a specific
poison, it assimilates, in one respect, to those diseases generated in the same way, viz: in conferring perfect immunity
by a single attack, as much so as measles, small-pox, &c.
The results of my experience, having treated the disease in
its different epidemic visitations in the same city for nineteen years. and never having met with a single second attack,
warrant me in saying it never occurs twice in the same person; or if it does. it is so seldom that all apprehension on
the part of any one who hat had the disease, should be laid
aside.  It may happen that some persons, during an epidemic
yellow fever, may be taken down and treated for the prevailing disease, and then they will pass through life asserting and
believing that they have had two attacks of yellow fever;
whereas, either the first or the last attack was nothing more
than an ordinary miasmatic disease, leaving the deluded vic



27
tim, nevertheless, a sufficient amount of protection, although
deprived of one of his securities, to insure his passing free
for the future.
As from cases like these, a feeling of uneasiness or apprehension prompts the frequent enquiry whether a person can
have the disease a second time. For the purpose of giving
confirmation to opinions heretofore expressed by Ine on all
occasions, I shall take the liberty of'quoting froim the writings
of P. C. H. A. Louis, an eminent French physician, who was
sent by his government, in 1828, to Gibraltar, to make investigations into the character of the disease as it prevailed
there during that epidemic. The quotation is headed, as
follows: "Does a first attack of yellow fever preserve fron
a second?"
"This point of view  in the history of yellow fever is not
iew. Some of the plhysicians who have studied the disease,
and the populations amongst which it has prevailed in times
past, have remarked that the same person is rarely attacked
twice by the yellow fever.
"Sauvage, in his Methodical Nosology, says positively, that
this disease attacks the same person once only. Arejuta
expresses himself to this effect, and it results from inquiries
made by Dr. David Hosack, of physicians who had practiced
at New  York and Philadelphia, that they lhad never been
called on to treat a patient suffering from a second attack of
yellow fever.  Michael Cabanellis expressed a similar opinion, in a work published at Meiri, in 1812, on the laws to be
instituted to prevent the reproduction and importation of
the yellow fever. Valence says the same thing in his Historical and Medical Researches on the Yellow Fever, published iu 1805, for, notwithstanding the pains he took to-nquire and to settle doubts as to this point, he found no individuals, French, English or American, who had had the yellow fever twice.
"The subject was further examined, in 1815, by Dr. Pyin,
who presented an important work on it to the London College of Plhysiciaus.  A report was made on this work, in
which it was said, amongst other things, that although, according to the points presented, there was strong ground for




the belief that a first attack of yellow fever preserves from
a second, it would be necessary to collect the opinions of a
greater number of physicians in order to come to any certain conclusion; so that, at the period when this report was
made, in London at least, the preservative influence of a
first attack of yellow fever was not looked upon as demonstrated.  It was then necessary to collect new facts. To do
this, and to comply with the wishes of the College of Phlysicians of London, Sir William Pymn, physician in chief of
Gibraltar for the time, recommended to General Don, wlheen
the epidemic of 1828 had ceased, to appoint a commission,
whose duty it should be to collect such facts as might serve
to settle this point.  Messrs. Chervin, Trouseau, and Louis,
had the honor to be of this commission, which was composed
of thirteen physicians, the other ten being Dr. Broadfout,
Dr. Dorr, Barry, Dix, Frazer, Arderol, Bobadilla, Mutras,
Bonvins, and Thurston.  Louis was the President, M. Trouseau, Secretary, and Dr. Barry, the Vice President.'"Tlhis commission, as we shall see, neglected nothing which
could lead to the knowledge of facts, and the establishment
of strict conclusions.  As some physicians thought that the
preservative influence of a first attack of yellow fever, real
for those who did not change their climate, was lost after a
longer or shorter residence in a different climate, the question to examine becomes two-fold:
"First: If an individual who has had the yellow fever in
Europe, was susceptible of a second attack of the same disease in Europe? Second: If an individual who had had the
yellow fever in Europe, could have it a second time in America, and visa versa? As simple assertions were inadmissible,
the commission decided that they would receive those cases
only, in which the symptoms of the first and second attacks
could be given, whether these symptoms had been noted by
the physicians who communicated them, or whether they
came thronugh  the patient himself, but were unequivocal.  In
order to learn the proportion of patients who had had the
disease twice, the commission asked of the physicians to
state, and with as much precision as possible, the number of
patients treated by them in the different epidemics.




2 v
"As too mnany facts relative to the object of inquiry coiuld
not be collected, all the medical men of Gibraltar, civil andc
military, were invited to come before the commnission and to
coimmunicate the results of their experience.  They all complied with this invitation, and answered the questions which
were addressed to them successively by the di fferent emlnbers
of the commission. Thirty three gentlemen were called upon
to say, first: how many cases of yellow  fever had been observed by them  in the last, or in anterior epidemics, in Europe and AXmerica; and, secondly: the number of patients,
in the different epidemics, who bad the yellow  fever twice.
and their symrptoms.  Most of tliese physicians had observed
tile yellow  fever in Spain only; some, however, had seen
different epidemics in Europe and America, and the number
of patients seen or treated by themt  all, amounted to somewhere about twenty-seven thousand.
"Mr. Ainiel, surgreon of the twenty-fifth regiment, who had
observed the four last epidemics of yellow fever in Gibraltar-those of 1810,'13,'14, and'28-presented  two cases
of presumed double attack to the conisideration of the commission.
"The Anglo-French commission (this was the name given
at Gibraltar to the commission composed of the physicians
sent from France and Dr. Barry) had, in its researches, collected the symptoms mnanifested by nine individuals, who had
been ill during  two epidemics of yellow fever.  Two other
cases of presumed double attack were communicated to the
commission,  who thus had to deliberate on thirteen cases,
and each of the number expressed his opinion by a vote,
writing on a piece of paper,'evident,''probable,''doubtful,' or'inadmissible,' for each case.
"In this manner, one of the cases of double attack communicated by Mt. Amiel, was declared evident, three were
regarded as probable, the others as doubtful or inadmissible.
The twenty-seven thousand patients were not all exposed to
two epidemics of yellow  fever; but supposing one-half or
one-third of them to have been so (an estimate which very
probably is below  the truth), we.should have, among nine




3O
thousand persons once attacked by the yellow fever, and exposed to it again in a new epidemic, but one well authenticated instan.ce of a second attack of that disease.
"Undaubtedly, some of thile  inor'ty ef the commission,(those pa.rticlarl]y who voted every case to be evident,) will
conatest the justice of this decision; and, conceding  to these
all that it seenls to me they, could ask, the admission of the
thirteen facts on which they were called to deliberate as
eases of second attack, it would result, that among nine thousand persons who had had the yellow fever, and had been
exposed to its causes in a skew epidemic, thirteen only contractod it a second time.
"A:nother objection may be made. Four physicians, who
came before the comn-mission, declared that they had treated
in the last epidemic (that of 1828), some patients who had
tile yellow fever in previous epidemics.  These statements
were not considered by the cornmmission-the physicians who
cited them not being able to tell the symptonms of the supposed double attack; and some, perhaps, will say that these
were really cases of second attack. But admitting this supposition to be true, and also that each physician had seen
three of these cases, in all, twelve cases of second attack, it
would result that among nine thousand persons who had
once been attacked by yellow fever, and who had been exposed a second time to the influence of all the causes of that
disease, twenty-five had it twice.  We must then conclude,
with the commission, that a first attack of yellow fever preserves from a second, as effectually, and at least in as great
a degree, as a first attack of an eruptive disease, of the
smnall-pox, for instance, preserves from a second attack of
the same disease. There are cases of persons who have had
the small-pox twice; and, according to a report made to the
Royal Academy of Medicine, of Marseilles, in 1825, of two
thousand persons who had had the small-pox once, twenty,
or the hundredth part, had had the disease a second time.
If then, among the patients of whoin we have just spoken,
there had been ninety cases of second attack, the proportion
of second attacks would have been the same as in the smallptox epidemic of 1825.




31
"It will undoubtedly be said that the report, which has just
been admitted, is entirely arbitrary, since the terms of it
were not fixed rigorously, to which it may be answered, that
if the terms of the report were fixed arbitrarily, they were
so in the sense least probable to the conclusions of' the cornmission.  But webcan cite a fact more conclusive than those
which precede. The French commission sent to Gibraltar
have ascertained, in their investigations, that of the persons
who had suffered from the yellow fever in an epidemic anteriot to that of the year 1828, nine only were ill in the course
of this last, and admitting all these to have had a second attack, we ouaht to conclude that cases of second attack are
rare, and adopt the opinion of the commission, which is also,
as we have seen above, that of a great number of physicians,
whose writings are of an earlier period. The conviction of
the truth of' this conclusion is so deep at Gibraltar, where
there haive been four epidemics of vellow fever in so short a
space of time, that in the last, that of 1828, several persons
exposed their children to those influences, which, in their
opinion, would most probably bring in the disease, because
at that time it was milder and less fatal in infancy than at a
later period of life.'"Even physicians did the same thing, and amongst others,
Mr. Amiel, being convinced that their children would have
at that time a light attack of the disease, and that, nevertheless, for the future they would be preserved from it.
"We should remark, also, that those who were ill only
during one or two days in epidemics anterior to that of 1828,
and whose symptoms were very slight, have been equally
well preserved fronom a second attack.
"We cannot doubt of this preservative influence, for it has
bieen noticed in members of a family, all of whom were ill
nearly at the same time, and during an epidemic. In some
of themn the disease was severe and well characterized; others
manifestd but very slight symptoms, such as were by no means
characteristic of the yellow fever.
"From the facts already given, the reader can scarcely have
a doubt of the preservative influence of a first attack of yellow fever. But it may be well to add to them the following,




as very remarkable examples of this truth. The first was
given to the commission by Mr. Amiel. This gentleman visited, professionally, two young men of the name of Ray,
during the Gibraltar epidemic of 1810. These same persons,
in 1821, were on board a vessel anchored in- Barcelona Bay
during the yellow fever epidemic whichl prevailed there.
Several passengers on board the same vessel were ill; the
whole ship's crew (nineteen in number) died, but the two
Rays continued to enjoy perfect health. The second fact was'reported by Mr. Broadfitbt, and relates to civil and military
dolmestics employed in the care of the sick during the last
epidemic. The military domestics, one hundred and sixty
in number, had never had the yellow fever in any anterior
epidemic. The others, sixty-one in number, Spanish or Portuguese, with two exceptions, had already been its subjects.
The two last, and forty of the military domestics, had the
disease at different periods of the epidemic; all those who
had previously had it escaped.
"In the interminable discussions which have taken place
between the contagionists and infectionists, proofs have often
been given of the non-contagious character of the yellow fever, drawn from instances of nurses retaining their
health in the midst of the sick. But, in order to give such
an argument any force, it must be shown that: these nurses
had never had the yellow fever in an anterior epidemic -; and
the necessity of doing this is the greater, for, as the physicians of many of the Spanish cities (men worthy of all confidence) have assued us, it is customary to select the nurses
from among those who have already had tile disease.'As to the question, whether a first attack of yellow fever
preserves from a second, those who go from one climate to
another, as from Europe to America, the facts laid before
the commission by Drs. Ardevol, Cortez, Merry and Dias,
are as follows: Dr. Ardevol knew at Havana many Spaniards who had had the yellow fever in Spain, and who were
not attacked by it in America, living there when epidemic.s
of that disease were prevailing. The same physician had
seen at Barcelona, during the last epidemic of yellow fever
in that place, persons who had had the yellow fever in AmverB7




33
ica, and who enjoyed uninterrupted good health. Dr. Cortez, twenty-five years a practicing physician at Gibraltar,
reported that of twenty-six members of the same family who
had left Gibraltar to reside in Cuba, two only were attacked
there by the yellow fever, and these two were the only ones
who had not had it in Europe. Again, Messrs. Merry and
Diaz spoke of thirteen navy physicians and surgeons, who,
having had the yellow fever in Spain, went afterwards to
Havana and Vera Cruz, without contracting the disease a
second time, though constantly in a flat in which it prevailed.
These facts, though few, are conclusive, and as the commission observed in their report, ought to have a great influence
in the selection of troops by whom the colonies, where the
yellow fever prevails habitually, are garrisoned. In this
point of view, Sir William Pym has rendered a great service
to science and humanity, collecting, as he has done, facts
which show that in an epidemic of yellow fever, the care of
the patients ought, as much as possible, to be confided to
those only who have had the disease at some other period,
and that those who have had the disease may remain with
safety in a city where it is prevailing epidemically, as did the
inhabitants of Gibraltar. We should remark, also, that the
preservative influence of a first attack of yellow Iever is not
destroyed after a considerable lapse of time; twenty-four
years, for example, since the inhabitants of Gibraltar, who had
had the yellow fever in 1804, were preserved from it in 1828
as effectually as those who had been attacked by it in 1815."
We see that it was equally the case here in our own city
of Houston; those who had the disease in 1839, also in 1844
and 1848, and again in 1853, were all equally well protected
from this our last epidemic of 1867; so were others who
had had the disease in other cities and then removed to this.
The following was the result of treatment by the Homeopathic method in my hands. From the first of September to
the last of October, one hundred and twenty cases were
treated, viz:
Adult males,     -       -      -       45
"   females,                      -  39
Children, under 15 years, -    -        36
Total,     -    -                  20




34
Fifteen of the above number were of African descent, the
greater part of whom had a large infusion of white blood
in their veins.
The mortality was 2 adult males,:a females, and 2 children.
Of the above number, two or three were in a hopeless condition when put under treatment.




PART III.
SOME GENERAL CONSIDERATIONS
WITH
Regard to the  Treatment of Yellow  Fever.
No disease, which has obtained from its great fatality so
much nGtoriety, and called forth investigations and researches
so extensive, has ever remained in such obscurity, in a therapeutical point of view, as this. Except the facts furnished
by autopsy to guide us in its treatment, its therapeutics is a
perfect blank; and even these seem to carry bewilderment
and confusion into every plan of medication that human ingenuity can devise. Such are the diversities of lesion by
which life is destroyed, that to frame a plan of treatment to
meet these in the living subject, would appear to be simply
an impossibility.  Nor is any portion of its history in a much
more satisfactory condition than its therapeutics.  Whether
its origin is continental, insular, or indigenous to some limited locality, is involved in the obscurity of conjecture. On
the page of scientific history, yellow fever stands an unsolved
mystery, without the clue of an Ariadne to guide us through
its mazesof incertitude, thus presenting itself as the opprobrium
of the medical profession, and a reproach to it as a practical
art. It may be likened to the Delphic Sibyl in her dark delubium, giving forth her mythical utterances in such obscure
allusions as to delude the very hope they have inspired in
those who have frequented her fane. Or again, it may
be likened to a sorceress, who stands in defence of her secret
arcana, with the curse of reprobation upon her lips against
those who would introduce light, for the purpose of driving




off the dark shadows of ignorance, stultified prejudice, and
pragmatical self-stfficieucy.  A spell of madness seems to b'i
inflicted upon all who come within her magic circle, anlt
among these, nothing is heard but incoherent objurgations,
reproaches and recriminations; nor do these cease around
her, among sanitary boards in cities, until she is fairly seatcd-4
in her curriculum, whip and reins in hand, ready to run hier
destined course.
The foregoing succinct statement of the present status of
our knowledge of yellow  fever, has been made with the
view of showing the difficulty of offering any treatment of the
disease, of any value, derived either from  studying authlirities. or from personal observation, except entirely of a negative character.  We shall, therefore, as our caption indicates, confine ourselves to general considerations in relationu
to treatment, hoping by suggestions to lead to the adoption
of means more efficient and rational than any now found in
use, in the pell-mell prescriptions of daily practice.
In order to place SYellow fever in its proper category, in
relation to its therapeutical alnenabilities, I must avail mnyself of that trite classification of diseases which divides
them into two orders, viz: The Curable and the Incurahie.
The first, fortunately, comprises a majority of the disease
to which humanity is liable, and requires no further notice
from us here.
The second-the incurable-divide themselves into two
kinds: 1st, Those whose tendency to the dissolution of the
patient is inevitable, such as Phthisis Pulmonalis, Care inoma,
&-c.; 2nd, Those diseases that run their course in desp ite of
remedial inlterpositions. and are therefore not amena.ll t,),
therapeutical agents; but having a natural tendency to spontaneous cure, many patients recover from them.  Of t!lih
kind is typhus fever, small pox, measles, yellow fever, &c.
It is probable this is the first time that yellow fever eerr
had a place in the list of incurable diseases; nevertIleiecs,
it is now in the category to which it belongs, as well by i s
affinities as h~ its characteristic phenomena; 1st, By its
affinities, it belongs to the zymotic or typhus family o'f MHseases, which are known to run their course irrespeiibve ef




3
all attempts at medication; 2ud, Its characteristic phenomena: 1st, These are, that all attempts at aborting the disease
-tliat is, of cutting the fever short, and establishing its cessation as the starting point of convalescence-have proved
not only fruitless, but the most disastrous of the many plans
of treatment that have been devised. A second characteristic of its phenomena is, that no case ever was reported in
the annals of medicine in which its four stages were not well
marked, viz: Its cold stage, its synochal, and its stages of
collapse and reaction.  These four invariable stages stand
as four immovable corner stones, to attest everywlecre the
fixedness of its boundaries, in despite of all attempts by violence to contract the one or move the other. A third characteristic of its phenomena, is that no patient was ever so
successfully cured as to deprive him of the benefit of
future immunity from a recurrenlce of the disease. Hence, that
it has not been regarded as incurable, is one of the chief causes
of its great mortality. No physician who does not understand
the fixed routine of morbid action in a specific disease, should
ever presume to give a dose of medicine in its treatment r
and if this be true, or nearly true, with regard to all diseases,.
it applies with ten-fold force to the fever under consideration. That it has not been regarded, I repeat, as incurable,
is one of the great causes of its fatality.  If persons, whether in or out of the profession, could appreciate the delicate
sensitiveness of this fever to the slightest rudeness of medication, they would instantly accord the full force of truth to
the preceding remark. Without the knowledge of these two
facts, viz: that it can not be cured, and that the slightest
mismanagement in the case, or blundering in rmedication, will
prove fatal, a physician is called tot a case, and of course he
thinks it his business to cafe it - and this can only be done
by the force of his remedies.  Well, the result of such a
physician's, and every other's effort to cure the disease, is to
add to the mortuary list of the sexton another and another
victim, until even human vanity, arrogance and ignorance is
turned into the loathsomeness of disgust-the slaughter ceases
from satiety, or contrite conviction of blunders, that moral
turpitude itself would shudder to repeat. Let me repeat,




4
once for all, that it will never be cured until all attempts to
cure it are put down as impracticable absurdities-then, perhaps, a mode of treatment will or'may be adopted that will
lead to a certain and favorable issue. To this point we will
come in due process of time, that is, after we have sufficiently demonstrated its incurability.
Let any one take up a systematic treaties upon the fever
under consideration, and look at the list of violent remedies
with which it has been encountered, and he will find that all
that part of our materia medica which had been at any timle
tried for its cure, is now layed aside; and the world of medical science, as it now stands-not misrepresented by empyrecism or conventioqal modes of treatment-is without even a
classification of existing remedies for its medication. What
have our numerous tyroes scattered throughout the Southat least tyroes in the treatment of this disease-to say to this
galling fact? Are they prepared with any counter-statement of fact to show why they dared to improvise a treatment, every article of which any use was made was condemned
as useless or mischievous?. If they have, let them show it
in justification of their extemporising remedies, at the expense of human life, for a disease that our ablest writers have
abandoned as hopelessly irremediable.  But just at the point
when the systematic writers failed, the professional sciolists,
the Creole or nurses' practice, made its appearance, and by
a judicious exchange of scientific suggestions, for the empericism  of old women's ptisans and sweating processes, they
have managed to keep themselves in countenance, practice
and bread.
No doubt this practice, at the time of its general adoption,
was very successful, as compared with the harsher remedial
treatment which preceded it. It may readily be imagined
that any course of treatment, which apparently preserved the
lives of a few patients in this terrible scourge, would be regarded with great favor; a scourge in which all were supposed to be mortally afflicted as soon as attacked. Thus Dr.
Rush's ten and ten of calomel and jallap took precedence, for
the time being, of every other remedy or remedies that had
been used heretofore by himself or others; Throughout the




whole of the western archipelago, blood-letting, calomel and
other herculian remedies had their day; but the results obtained by them, falling short of expectation, owing to the
ever changing phases of the different epidemics, soon brought
them into disuse. Thus, as soon as a given remedy or course
of treatment ceased to restore as many cases as it had done
in former epidemics, it was supplanted by some new favorite,
which was soon to experience the same fluctuating fortunes.
This unsettled practice is easily explained when we take into
consideration the wide range of symptoms and  the great
variety of leisons revealed by autopsy, which clearly indicate
the ditficulty, nay the impossibility, of framing any code of
practice which can meet the requirements of this form of
fever. In this incertitude as to treatment, either the French
or Spanish practitioners hit upon what is now known as the
Creole, or more familiarly, as the nurses' practice. This
was a great triumph over the vacillations of the herculean,
Wr perturbing practice, as it at once give to the world a system of treatment; and being adopted on the most northern
border of the great western archipelago, it soon spread to
all the cities situate around the Gulf of Mexico. Its being
applicable, at that time, to the modified forms of fever which
prevailed in the localities above indicated, gave it unprecedented success, and caused its adoption to be regarded as
the sine qua non in the recovery of every case-that got well.
But now that an enlarged intercourse with the inter-tropical
world has furnished us with epidemics of a much more malignant character than those to which this treatment was applicable-epidemics which have not' been filtered slowly
through  climates intermediate between the point of local
origin and the south-western shores of the Gulf, by which
they had been deterged of much of their fatal qualities-it
behooves the profession to reconsider its pretensions, and see
how far it is reliable in the emergencies of present circum-stances. Indeed, if we regard its modus operandi as affording the means of conducting a case to a safe issue, we must
say, never were means worse adapted to an end —hence the
inference of its success, under any circumstance, has always
been coupled, in my mind, with the fact that remedial pro



6
cesses were dispensed with, which gave nature a chance to
throw off the disease, the quietude which was enforced upon
the patient greatly assisting in producing the result.
Having heretofore shown that -all curative means-viz:
means intended to arrest the course of the fever-were inapplicable to its treatment, it now becomes necessary to explain, that it is not proposed to abandon the case to nature,
and expect a cure, but, on the contrary, to assist her as far
as we can in conducting it to a safe issue. All our remedies
and means, then, must range themselves under the head of
adjuvants; and since we cannot cure yellow fever, let us at
at least help nature, if we can, to cure it for us. At this point
it becomes necessary for us to examine the Creole or nurse's
practice, to see how far it conforms to the above suggested
adjuvant treatment. As preliminary to this examination, the
reader will demand, very justly, to be informed in what the
Creole treatment consists.
To give a full description of the whole affair, would carry
us a little too far into details; suffice it to say, that it consists of a big, fat old negress, a little mulattoish, and if
Frenchified, so much the better, with an awfully important
air; next, a very tight room, with a bed in it rendered monstrous by the number of blankets heaped upon it, under
which lies a poor human being, sweltering. in perspiration,
extorted from him by constant appliances of hot bottles of
water, foot mustard baths, and orange leaf tea. In this condition, this poor wretch is held down, if necessary, or the
cover is forcibly kept over him; nor is a breath of air allowed to visit his burning temples or his flushed cheeks, until
the fever spontaneously subsides. Whether a drop of water
is allowed Ato touch the parched tongue of this modern Dives,
depends upon the caprice of madam nurse, or it may be of a
knight of the pill box, who, by the way, is a supernumerary
character in the affair, seeing that the aforesaid authoritative nurse carl execute the process without his aid. In fact,
as it was originally devised, it was intended, no doubt, to dispense with the intermeddlings of doctors and their drugs,
thus rendering these additions to the treatment an incumberance and a disfranchisement of its privileges. But the
c8




title of doctor seems to confer ubiquity upon its possessor,
and by some talesmanic art, is the open-sesame to all sick
chambers; therefore, we will be compelled, per force, to recognize him as part and parcel of the paraphernalia of this
extemporized sweat shop; and as such, he is entitled to his
inevitable bottle of caster oil, and other insignia of professional out-fit, for a vigorous rencounter with the enemy. As
the doctor seems to be a little at leisure, we will approach
him, and get him to explain his views upon the treatment.
(The interlocutors are the writer, reader, and the doctor, respectively represented by the abreviations of W., Doct.,
and R.)
W. "Well, doctor, give us some account of your treatment.
Where did you learn it, and what is its object?"
Doct. "Well, sir, I have been a long time in the South, and
found it in full vogue when I entered the yellow fever region; and having never seen, or indeed heard, of any other
plan of treatment, I adopted this from convenience, and finding that 1 did as well with it as others, I have been content
t( confine myself to it. As to its object, I suppose it is to
cure the fever."
W. "What is the character of this fever with regard to
heat of surface?"
Doct. "I must say no fever I ever examined is near so hot
as this."
W. "Do you not think your means of sweating your patient
adds to that heat?"
Doct. "I do not; because 1 do not know how much hotter
he might have been had I not sweated him; so you see I can
imagine how much cooler he is than he would have been
without it, and thus give the treatment and me all the credit
for breaking the fever."
W. "Would not the fever have broken spontaneously, at
the proper time, without your assistance?"
Doct. "I reckon not, stranger, as I have never seen a case
just slough off the fever, and get well so, until the pores of
the hide were kept open long enough to draw off the fever."
W. "Then when you have thus drawn it off, I suppose your
case gets well immediately?"




8
Doct. "In easy epidemics they do, but in hard ones like'53,'54, or this of'67, I tell you, stranger, after the fever was
killed, it took all the rubbing with mustard and brandy and
pouring down of the last, to keep life in any of them, and
even then more than half of then died."'
W.'"Still you think this is the right method of treating the
disease?"
Doct. "Certainly I do, and shall continue to do so until
some one can invent a better one; and even then I would not
swap it off, until everybody had tried it, and proved the new
to be a better method than the old."
W. "Upon what great therapeutical principle do you sustain it?"
Doct. "Upon the principle that with the perspiration the
fever is drawn off, just as you draw off whisky from a barrel by inserting a faucet in it."
W. "Does not all this fluid come from the blood?"
Doct. "Well, I reckon it does."
W. "Then, if it comes from the blood, does it not constitute
one of the elements of the blood?"
Doct. "I think so."
W. "If you draw off all the serum,. how are the liver, kidneys, and all other secreting organs to be supplied with
material to keep up their functions?"
Doct. "Well, stranger, this is rather the business of those
organs than mine; and when I apply my remedies and they
cant't stand them, I say, decidedly, let them look to their own
duties, and I'll do the same."
W. "I perceive to my regret that until a new set of practitioners is introduced, more intelligent and more amenable
to the dictates of common sense, there is little prospect of
improvement in the therapeutical management of this disease.
Here ignorance and prejudice have planted themselves too
firmly upon their own errors, ever to permit reform to visit
them in their enchanted fastness of self-conceit and selfsufficiency."
Doct. "Well, stranger, I think you are about right in your
reflections. Now, if they all had the schooling in this fever
that I have had-thirty years in the South, and five years in




9
a hospital-then there might be some hope of their knowing
something about it."
R. "It seems you may still have something valuable to communicate, seeing your residence of five years in the hospital
must have added much to your information; therefore please
continue your instruction.  How many did you nurse during
your abode in the hospital?"
Doct. "In'53 and'54 I nursed more than a hundred cases,
nearly every one of whom seemed to die for my special benefit, for as I was studying to be a yellow fever doctor, I was
allowed to see them all opened; so you see I had the best
chance in the world to look at the very inside of yellow
fever."
R. "Will you be so kind as to tell us what you saw? But
first tell us how your patients were treated. 
Doct. "They were all treated on the plan of the'Creole
practice, and were carried to the dead-house just in a condition to look at the mischief done; for they were all carried
from the sweat-room, hot enough to keep every part in good
order. I have seen the liver as drv and as brittle as a lloecake; then again yellow and so full of blood that it would
burst in handling. Then as to the kidneys, I have seen tiemn
shriveled away until they were not much larger than a couple
of butter-beans. The stomach on the inside had no lining
on it, the black vomit having got behind it and pushed it all
off, just as a blister does the cuticle; and then it was in separate bladders, and every time the patient vomited he bursted
one, and out would come the black stuff."
W. "That will do, my friend; your information is so important and so pregnant with practical facts, that I shall
offer it to the world, that it may profit by it; and as for yourself, I shall present you to its kind regards, as a fit representative of the Creole practice wherever adopted."
We have wasted, perhaps, more time upon this miserable
apology for the treatment of the disease under consideration
than it in itself deserves; but the mischief which it has
done, and may do, owing to the tenacity with which it is
held on to, both by those in as well as out of the profession,
has conferred upon it a factitious importance that will excuse




any amount of labor that may be bestowed upon it, with a
view to counteract its baleful influence upon the public health
and safety. Upon what ground it holds even a place among
the plans of treatment now in use, is difficult tQ conjecture.;
but that it should be the chief means ofecombating the disease under consideration, by the only true and exlusive votaries of scientific medicine, is an anomnaly still more perplex.
ing than ally other problem connected with the subject.,: If
it had even the prestige of empirical success to recommend
it, that success would be sufficient to enforce the scientific
world to hold its peace, and let it still guide the issue of,
life and death; but without this, in the present crisis of walignant epidemics, at which the cycles of the disease have now
culminated, that a treatment which would almost disgrace the
humblest form of Thomnpsonian medicine, should constitute
the main resource in the South to combat the disease by the
most numerous class-and the one, too, which claims superiori ty
in power, science and art, over all the pathies of the day-is
most wonderful. If it is a failure then as an empirical treatmnent, and hias neither the sanction of a scientific deduction in
its favor, nor theauthority of a single name derived from books,
worth quoting, to sanction it, upon what ground is it still kept
among us, to add poignancy,ifnot death to our mortal scourges?
The world has a right to ask of that numerous branch of the
professson, to show cause why it is retained and relied upon,
under existing circumstances; and if so retained and relied
upon, then to defend it upon some known grounds of rational
hypothesis or scientific deduction. The sufferings of humanity are too manifold from the abuse of professional confidence, in this case, to permit a combination of wiseacres
either openly or covertly to set at naught this demand in the
premises. Let the public be warned against the imposture
of the treatment under consideration, for it is nothing less;
nor is it competent to escape the condemnation of the practice
that drug remedies have been conjoined with it, for these
only increased its mortality. What would a patient or his
friends say to a doctor who should propose to draw twelve
pounds of blood from him daily, as long as the fever lasted?
Would they not indignantly tell him  to hunt some other




patient to try his experiments upon? yet his proposition is
not so irrational as the practice which takes at least that
much perspiration fiotn hirn, because the former leaves tlhe
blood in an integral condition as to its elements; whereas,
the other mode of depletion carries off one of its main ingredients-the serum-and thereby unfits it for circulation
and secretion.  But let us waive this advantage of bloodletting over sweating as a depleting process, and say, once
for all, let no one deplete a yellow Pever patient by any process whatever, and expect that he has not thereby greatly
diminished his chances of recovery. This adherence to this
practice, is greatly to be regretted by all who feel an interest in Allopathy —that adherence being principally confined
to its advocates and votaries —;thus bringing into its congregation an empiricalheresy with whlich its scientific creeds
have been contaminated and corrupted. It can now have no
sanctuary freed from  the lowest intrusions of empiricism,
since they have reco)gnized the Thompsonian principle in
practice in the most important diseases we are called upon to
treat.  Furthermore, in this adherence, they have abandoned
the richest field of glory that ever awaited her triumphs in
science. Now, a rival has entered that field in triumph, and
will soon master it, while Allopathy will be driven in shame
from it, or be dragged at the car of Homeopathy in disgrace. There is no exaggeration in this. The world of renown can only be reached by toil, vigilance, and well directed effort. Let Allopathy assert its dignity, put forth its
powers in the right direction, and not begin to fold its arms
at a first difficulty or two, or to allow old women or empirics to direct her steps in her march to the goal of proud
achievement; if she does, she will fall by the wayside. In
her present humbled condition, I know not how she can refuse to fraternize with any low charlatanism that comes
along; she may next be expected to clip quack advertisements from the newspapers, with the view of giving these
mixtures a place in some future edition of new remedies.
Nothing can be more humiliating than to see our old Alma
Mater brought so low as to render, instead of receiving
at her shrine, homage of all the pathies.




12
We will now take leave of the Creole practice; but before
we do so, mnustbequeath it our parting blessing, which is,
that it may very soon find a resting place in the tomb of all
the Capulets.
It still remains for us to explain the adjuvant practice,
mention of which has been heretofore made, in connection
with tVie statement, that all remedies which do not come
under this head, are inapplicable to the treatment of yellow
fever. These are very mild means to keep down the fever,
such as ice or ice-water to the head and face, gentle diaphoretics for keeping the skin moist, enema of cold water for the
bowels; and if anything is given with the view of controlling the action of the heart and arteries, it should be the bisuiphite of soda, 20 grs. dissolved in 8 ounces of water, to
wliich is added sulphurous acid enough to acidulate the mixture, which is given every two hours.  When the fever subsides, adjuvants now take the forln of gentle stimuli, moderately administered as to time and quantity   But I will not
detain the reader any further, but will refer him directly to
the excellent article upon the treatment of the disease by our
co laborer in this little treaties.
THE NON-LOCAL ORIGIN OF YELLOW FEVER
UPON TIHE WESTERN CONTINENT.
This declaration will no doubt startle many, if not all my
readers, and is so contrary to all the teachings of the numerous faculty of the South, that I fear that I will hardly be
able to get a candid hearing in the premises from those who
ought to feel so deep an interest in the subject. Be this as
it may, the views I entertain are so important, not only in
themselves, but also in their bearings on other collateral
questions of great moment, that I shall devote as much time
and space to their consideration as the nature of my undertaking will permit. This importance will be readily appreciated, when the reader is informed that the question of quarantine, as an efficient means of protection against the ravages
of this terrible scourge of the South, is involved in its issues.




I am fully aware of the darkening hosts of prejudice, conceited egotism and stupid dogmatism which will spring from
their lairs, and turn'loose their fury upon any one who ventures to mention this ominous term in connection with the
sanitary measures for the protection of our cities along our
seaboard. This formidable array of opposition to the view
announced in the caption of this article, precluding all hope
of making converts to it, we will nevertheless present it, with
the sole object of calling attention to it, as an elementary
fact, which Inav lead to its examination, whereby its truths
may be not only established, but all the sequences flowing
from it become the fixed record of its history.
-The great point is the autocthonie origin of yellow
fever. It is now  a  well established  fact, that all the
periodic recurring epidemics, which now  and then have for
centuries devastated the world, had such an origin.  It will
not be gainsayd by the most fastidious, that yellow fever comes
within the category of a periodically recurring epidemic, and
to this extent acknowledges its affinity to these great families
of disease.  A close affinity observed in any instance of a
uniform character, between the leading phenomena of two
distinct objects, is apt to conduct to the inference that other
analogies exist; and the question is immediately propounded
by the investigating mind, "Why may not yellow fever have
the same kind of origin as that which has been assigned to
the other epidemics of the same genera?"  To establish this
fact, in reference to yellow fever, we shall present some considerations  to the reader, which, we think, will go far to.
wards a conviction of his mind of its truth.  The point of
origin of Asiatic cholera is too well known to require an'y
thing more than reference to it, and this we do for the purpose of the analogy existing in the spread of the two diseases..
Asiatic cholera takes up its march along the lines of human
intercourse, and intimately connects itself with this, as to its
tardiness or rapidity of spread. This fact would seem clearly to indicate its power of self-propagation in all the localities in which it establishes itself, as a temporary inhabitant.
Whence does it derive this power?  Clearly not fi'om contagion. It must then possess it from some contingent condi



14
tion of local causes, wherein it makes its lodgment. What,
then, is the relation of this local condition to the virus, thus
furnished by the disease?  Io answer this question, we must
admit that there is either a chemical relation, by which the
virus converts the local element into a poison identical with
itself, upon the principle of fermentation; or, that it puts
forth a something to which this local element administers
sustenance.  Now, as the fermentative hypothesis is, for
very obvious reasons, untenable-one of which is, that strong
currents of air would constantly free any locality from any
such epidemical cause, owing to the gaseous nature of the
supposed compound-we must, therefore, adopt the latter,
and maintain the doctrine of local sustentation. But this
sustentation cannot be afforded to a virus or fomitis as inanimate entities, unless upon the principle of chemical assimilation, which, as above stated, is inadmissible. We are,
therefore, forced upon the recognition of the principle of
its animal origin. There are no other grounds upon which
its spread and local habitat can be explained. Upon this
hypothesis, its phenomena, in this respect, are of easy solution. A patient, for instance, is carried into any locality in
which the animalculoe, discharged from his body, are furnished with a suitable pabulum, in sufficient quantities, and in:
stantly reproduction commences, and rapid generation,
spreads them in every direction, so that in a short time they
have poisoned a large city.
This process, no doubt, is greatly hastened, as the number
of persons attacked increases, each affording an additional
focus for their reproduction. These, being infinitesimal or
metascopic, can easily penetrate the human skin through its
pores, and, guided by the laws of instinct, we can readily
imagine they select man's blood, as affording: the nidus in
which the species are propagated; just as a certain fly deposits its ego upon the hair of the horse, that it may perchance reach his stomach, and thereby reproduce its species.
The animalculae theory, applied to yellow fever, renders all
its phenomena of prevalence, distribution, and mode of propagation, equally amenable to a rational solution. If it were
possible for us to follow its line of march, as easily as that
c9




15
of cholera, no doubt we would find it having a specific locality for its origin, just as that great Inigratory epidemic has.
But two difficulties present themselves in our search for its
locality of origin; 1st, Thee Asiatic cholera does not confer
immunity upon those who leave had it-hence it holds to its
point of origin, and exhibits itself annually as the endemic
of that particular locality, whilst it prevails at none other,
unless when it assumes the malignant form of an epidemic,
when its march becomes too well marked not to attract attention; 2nd, Yellow fever, on the contrary, by conferring
immunity on those who have had it, refuses to reveal its point
of origin, by this means-except by the importation of fresh
subjects to the given point suspected, and kept up for a series
of years, and always uniformly producing the disease; without
such importations, w.e have no mode of definitely identifying
it. His this will never occur, in all probability, we shall forever remain in ignorance of the fact sought to be established.
Another difficulty in our way in search for its local origin
is, that it takes up its habitat in many localities in the tropics, which become the focus of the disease, firom which it may
be distributed annually for years to other places, thus assuming the semblance of the home of its origin. But observers, everywhere distributed on the islands of the western*
archipelago, accuse every other place, except the one on which
they are established, as being the unfortunate locality of its
origin. If introduced into any one of them, it is likely to
remain there for several years, as the amount of cold in the
climate does not exterminate it, as it does with us. Thus,
great confusion, upon this point, prevails throughout that
wide range of its almost ceaseless migrations. But one
prominent fact remains to be noticed, which will ever stand
as a clear inldex as to the direction from which the
fever comes, and indicate the country of its origin, and this
is, that the most malignant form of the disease claims the
western coast of Africa as its point of origin; and the
nearer our epidemics are derived from this coast, the more
-*This word is applied in an analogical, and not in its literal sense-a western
and eastern archipelago both being applied to islands instead of the seas in which
they are situate.




16
malignant they appear to be.  Witness the epidemic of'93
in Philadelphia, which, iri despite of Dr. Rush's rotten coffee, ino doubt, according to Dr. Pyrn, was carried to that city
almost directly front that coast, or at second hand at least.
Witness, also. the epidemic on our Southern border in 1853,
which was imported directly from  Rio; and to that place
from Africa.'l'he Inost sensible opinion I have ever heard
from  Dr. S., of New  Orleans, was tlat that epidemic was
the true African type of the fever, and truly it was so; and
the same may be said of that whiclh prevailed this year, both
being distinguished by the petechial eruption, which characterize the fevers having this origin and malignancy.
But, as heretofore remarked, the point to be established as
indigenous, is so much obscured by its migrations among the
islands of the West Indies-many of which get the credit of
its local origin-that a sweeping credulity prevails oun this
subject, which not only embraces all these in that category,
but with a facile deduction, which disdains investigation, includes within the range all our cities along our Southern
seaboard; hence ma:ly physicians, even among those deemed
most intelligent, put in the claims respectively of New Orleans, Mobile, Charleston and Galveston to this distinction.
Yet this is done in the face of' the fact that they all pass
years of exemption with a climatology not variant from that
of the epidemic years, so far at least as observation can
establish their respective uniformity.  Furthermore, in the
face of another historical fact of tnuch more significance, as
regards the erroneous character of these conclusions, viz:
that a period of thirty years* occurred, between 1763,
of the last century, and 1793, during which not a single case
of yellow  fever, either of domestic or exotic origin, took
place on the western continent.  Is it possible that such an
interregnilum could have taken place in any indigenous production, whether animal, vegetable or zymotic in its character?  Such a fact is conclusive  against any such a supposition.
*At one period, says Dr. Stevens, of St. Croix, there was an interval of thirty
years, during which there wvas not even one case of yellow fever in the western
world; and almost in every instance, where it first commences, when proper
enquiry is muade to ascert;ain its causes, its origin casn be traced to traffic with oretain countries on the western coast of Africa.




17
But again. Although a sweeping deduction may place these
respective cities in the same category in this respect, yet it
so happened that in Galveston,in every epidemic since 1539,
inclusive, has been coincident with the introduction of the
fever from abroad; and if any exceptions exist, they can be
easily shown to be mere revivals from the preceding yearthe amount of cold of the intervening winter not being sufficient to exterminate tAle dormant germs of the disease. Thus
were kept alive the great epidemics of'53,'54 and'55, the
remarkably severe winters of'55-6 arresting the revival of
the fever, and putting an end to its career; and unless the
present winter shall be of sufficient intensity to render us a
similar grace, we may confidently expect the revival of our
late epidemic the ensuing summer, with all its characteristic
symptoms of malignancy, viz: its great mortality and rapid
spread along the lines of human intercourse.  If such should
be the fact, those who contend for its local origin here and
elsewhere, along our extended seaboard, will claim it as a
confirmation of their favorite hypothesis; and instead of attributing it to the cause just stated, will make it the basis
of another tirade against the inutility and barbarism of
quarantine. In this revival of our epidemics, and the nonobservance of the cause of that revival, lies the principal
difficulty in discriminating between its local and exotic origin. The cotton worm. which devastates our fields, affords
an apt exemplification, in this respect, of the resuscitation of
our epidemics, when the freezes of our winters are not sufficiently severe to destroy the one or the other; and so strong
is the analogy between them, as to local origin, that there
are quite as many planters who attribute the annual recurrence of these pestiferous insects to climacterical coincidences, as there are doctors who contend that yellow fever springs
from the same causes. Yet, destroy' the one or the other,
in their germinal state, and neither will re-appear until they
are wafted to our shores from foreign lands-neither of them
being indigenous to our climate.  To argue against a proposition so self-evident as this, is to revive the exploded doc-:trine of equivocal generation, or to assume the existence of
an effect without a cause.




18
Our nmaritilne cities become, tlen, the gates through which
all our epidemics enter, and unless these are closed against
their admnittance, it is in vain that we can expect to be e.x
empt from their visitations.  That they should not shut thelm,
offers a curious problem to the casuist for solution, seeing
the untold miseries which are inflicted upon their own citizens,
as well as upon the inhabitants of the towns and villages in
the interior of our counltry.  But when we come to analyze
this criminal indifference to the ravages of the disease, we
shall ascertain that its solution is to be found in the predolninant selfishness of our nature.  If we examine the number
of acclimated citizens in any one of these cities, we shall
find that they greatly exceed those who are unacclimated.
To the former belong, not only from numerical strength. but
from longer citizenship, the government of such cities; and
these systematically and persistently endeavor to discourage
and put down all attempts at quarantine, owing to the emnbarrassments which it tmay inflict upon commerce. This
spirit is manifested in the unequivocal manner in which they
denounce every physician who dares pronounce a first case
of fever, of a suspicious character, to be of the type of yellow fever.  Hence quarantine is declared to( bea barbarism,
unworthy of an enlightened age, and its advocates as fit subjects for an asylum.  These views are carried into city conmcils, and their actions are fra.ned in accordance with them;
and as their governments are in the hands of those who constitute, through their influence and power over the business
avocations of others, the overruling party, they can carry
out their narrow and selfish purposes, in despite of all opposition. Thus, I repeat, a large majority of acclimated citizens, in each of such cities, are found violently opposed to
quarantine; whilst the unacclimated have to remain the
passive victims of such selfish policy, without the power of
adopting any measures of self-protection, or of escape from
its dire ravages, except by flight when the dread destroyer
enters their gates.
The argument of those who represent the commercial interest of such cities, seems to be, that they had to pass
through the ordeal, and having dne so, they feel under no




19
moral obligation to endeavor, at any sacrifice of their own
interest, or that of commerce, to shield others from undergoing the same hazard that they had incurred, in procuring
their immunity from the fever; that the unacclimated had
come to these respective cities with the view of settling in
them; and, as a preliminary to their business pursuits, to pass
through the yellow fever was a matter of first importance to
them, and the sooner this ordeal was passed through the better for them.  According to these views, to have the fever
was part and parcel of the contract of the unacclimated in
settling in the localities of its known invasions; and no one
was to blame for his having to comply with its conditioins.
The morale, as to quarantine, being thus settled, its avail
ability or non-availability, as a means of protection, becomes
a question of secondary importance, and can offel- no impediment to the adoption of such measures, in reference to it, as
the commercial interest may deem most advisable for itself.
This interest being dominant, all others must become subservient and yield obedience to its behests. Unfortunately for
the interest of medical science, its votaries must yield to the
pressure of the overruling power, and either yield the homage of obedience to the powers that be, or turn a deaf ear
to the suggestions of self-interest. Few men in the profession have the moral courage to brave the epithets of oldfogy, alarmists, &c., especially when applied by men in power, or by those in high social positions. and whose frown or
scorn can blast their professional prospects. The city governments, when they refer questions to the faculty, touching
the efficiency or the inefficiency of quarantine, know full well
that decision before it is rendered. Physicians are men,
and are as subject to the bias of self-interest as other people
are. To ask them to decide a question, on one side of which
is their bread and butter, and on the other just nothing at
all, is simply to forestall that decision. The common prudence of men, in every department of human affairs, has
long since taught them  to guard against our natural proclivities to selfishness.  Hence, men are not permitted to
preside as judges in our courts, or sit as jurors in any case
involving their own interest; yet physicians are called upon




20
to decide upon questions in direct violation of a principle so
seduously guarded against by society, in every instance
where its operation might prove prejudicial to the well-being
of its members. Are communities so blind that they do not
perceive that doctors are almost exclusively the beneficiaries
of these incursive epidemics; and seeing it, yet persist in
placing them in positions which render their dictum potential in keeping open our ports, through which our epidemics
make their incursions? This could not be, unless there was
a secret sentiment in such communities opposed to the policy
of closing them.
The confidence reposed in high-minded and honorable
members of the profession, can never be misplaced-men
who pursue science for its own sake, and who cannot be
turned aside from the pursuit of its dictates by the pitiful
considerations of selfishness; but it is to be feared that they
are too much in a minority to avert the evils of which we
complain; at least, quarantines in our seaboard cities are at
a great discount, which could not be the case unless a majority of the medical faculty were under the influences above
alluded to. It must be admitted, nevertheless, that there are
numbers of high-minded physicians, who are sincerely convinced of the local origin of the fever, who maintain that
opinion from the convictions of their own minds, and independently of any extraneous considerations. Begging simply to differ from these in opinion, far be it from our purpose to implicate them in any selfish scheme of policy,
in acting in the premises in accordance with their own
views.
That the writer has not mis-stated the ground upon which
is founded the opposition to quarantine in our maritime
cities, viz: the preponderance in point of numbers of acclimated persons found in such cities, he will cite, in favor of
his views, what happened in reference to this matter in our
rural towns and villages. In these, nearly the whole population being unacclimated, quarantine, as a means of protection, found no opposition, when all were equally interested
in keeping off the epidemic; and when it was adopted,'and
efficiently maintained, their exemption from the fever amply




21
repaid them for their persistency in maintaining it-thu,
setting an example worthy of leing imitated by their brothers of the seaboard.  If the interior towns can protect themsolves from the fever by cutting off all communication with
the infected seaboard cities, why may not these protect themselves from it by the same means, when menaced by an attack from abroad?  But whether they do or not, the late
experience in Texas, in the efficiency of quarantine, has been
demonstrated in too many instances in our own towns, for
the lesson ever to be lost in the future; and hereafter, when
our seaboard cities, from negligence or indifference, are ravaged by the epidemic, their unacclimated citizens will be
compelled to abide their fate at hotnq, instead of being permitted to destribute the disease by taking refuge in the
country.
But I would by no means do the city governments the
injustice to say, that they were so indifferent to the approach
of yellow fever, as not to adopt sanitary regulations, at least
in reference to internal precautions.  On the contrary, nothing can exceed the industry and vigilance of health officers
in the removal of filth of every description from the streets,
alleys, back premises, &c. If the city was about to undergo
a strict review, as to cleanliness, by some authority competent to impose a heavy fine upon it for the slightest deviation from the strictest requirements of mundification, no more
pains could be taken to escape such a fine. In truth, one
would suppose, from the industrial efforts and vigilance of
execution, that yellow fever was some distinguished guest, to
whom it would render honor, and whose delicate olfactories
might be offended by the slightest reeking of stench, and
whose smiles or frowns-potent for good or evil-were to be
won or averted, accordingly as they succeeded or failed in
this cleansing process. But, unfortunately, this distinguished
guest is not to be thus propitiated-his attention is not to
be diverted from his purpose, or balked in it, by any such
paltry consideration as the condition of a city in respect to
its cleanliness or want of it. When he has once effected a
lodgment in a place, he has accomplished all he asks of the
city authorities; and immediately proceeds to his legitimate




22
business of victimizing those who are strangers to him. His
mission is blood, and blood he will:have, in despite. of all the
arts of the therapeut, surrounded thougl. ho be by all the
insignia of his cabalistic sciencQ-'A' kind. of boxes, mugs,
an' bottles"-but still he reigns, unchecked or unintimidated,
until the blood of the last victim  has smeared his chopst,
No, city fatheras tbe fight against this. monster nmust be on
the outside and not on the inside of your wall., if you expect to repel this invasion.  Those who expect to struggle
successfully against him  after he is master of thq citadel,
have lost all the advantages -of defence, and yielded theivictory without an effort worthy of the name.
To confirm the views here presented, we quote from Dr.
Copeland's Medical Dictionary, a standard work of the very
highest authority, the following:
"It cannot be denied by any: one who has attended to the
subject of quarantine, especially as it has. been agitated in
recent times, and with a due knowledge of the influence
which the ruling passion-the desire of amassing wealthexerts upon all the more generous and social emotions of the
mind, that the restrictions imposed upon trade, arising out
of precautions against the introduction of pestilential infections, have been the chief cause, directly or indirectly, ~cf
producing opposition to the doctrine of the infectious properties of pestilence; and all that has been written to disprove the doctrine-and written with no small virulence by
some-tias not proceeded from a firm conviction of the justice of the cause espoused, but are either special pleadings,
subservient to sordid purposes and the gratification of disappointed feelings, or of private resentments, or outpouring
of minds teeming with mistaken views, arising out of imperfect observations and -hastily formed opinions, and excited
by a desire of acquiring notoriety in a contest involving the
interest of the whole community.
"Dr. Gordon, of St. Croix, government physician to the
Danish West India Islands, concludes his remarks on the
malignant pestilential fever prevalent in these -islands and
North America, near the close of the last century, by stating
his belief in the importation and diffusion of infection, by
c10




23
ignorance, perversity arrd selfi,;4lvneoss or by the abstractiorn
of the sentiment of pn-bli; zonod, by the abise of all preventative Mneasure, in the prol Yncion of the speculations.of
cupidity, and the: calulations ofi venal men M; by tie prostration of truth and hnnmanity, and. by elading —the laws of
qua-rantine."
After quoting rnahy instances, abid numerous authorities,
iflustrative'of the efficiency of quafrantine in averting the
spread; of the epidemic, he adds the following commcnt,
page 179:
"In. whatever light this' fact may- be  viewed —exemp,
tion procured in the midst of the pestilence by; non-inter.
course with the sick-it suggests a most -reqnisite precaution; and that such a precaution'shoulcd have been neglectr
ed, may be viewed as one of the, vils arising out of the doctrine so assiduously inculcated by the b heads of the medical
staff on the outbreak of the pestilence. The non-infectionists argue that the malady is not prdpagated by eminations of the sick,: either direct or by:fomites, and hence no
such precaution as the one now stated is requisite.  That it
was most requisite that the neglect of it in this, and on
numerous occasions in America, the; West Indies, Africa.
and in Southern Eit'ope, was most calamitous, even mnost
murderous, is apparen t to any reflecting mind.  Ten times; as
many lives have been sacrificed during the last sixty years,
by the abettors of a most erroneous doctrine-by following
the false glare of what has been ignorantly deemed the lights
of science,-Instead of adopting the suggestions of common
sense- -than have been lost on'the field of battle."
Dr. Currie, in his work on Bilious Fever, states that a
contagious fever, "called the yellow.fever," has occurred six
times at Philadelphia since the first settlement, viz: in 1639,
1741, 1747, 1762, 1793, and 1797.  Dr. L[end states that in
in the year 1741, "the disease was introduced by means of a
trunk of wearing apparel., which had belonged to a gentleman who died; of the disease in Barbadots, and that the
disease spread from the family whoi had received the trunk
into the town, and destroyed about two hundred of the inhabitants."




24
It an account of the prevalence of this pestilence in 1762.
communicated to the College of Physicians by Dr. Redman,
it is stated that tile disease was introduced about the end of
August, by. marliner, wiho arrived from  Havana ill of it,
who took ledgings nea' the New Market, below Pine street.
Dr. Lining,. of Charleston, says, ",The fever does not seem
to take its origin from any particular condition of the atmosphere, independent of infcctious iniasrmata; for within twentyv-five years, it has been only four titmes epidemical in this
town, viz: in thle years 1832,'39,'45, and'48, though none
of those years, except one, were either warmer or more rainy
than tLhe summers and autumns were in several years in
which we had not one instance of any person being seized
with this fever."
Having said as much as our space will allow upon the nonlocal origin of the fever upon any portion of sea-coast-Atlanltic or Gulf-and upon its portability from place to place,
either as fomuites, or in the persons of the infected, we will
now direct our investigations to the West India Islands, in
order to establish our declaration that its permanent local
habitat is not to be found on the western continent.
Dr. Fosse makes no mention of its occurrence in St. Domingo between the yeers 1775 and'93, and Dr. Gilpin, who
resided many years in the Island previous to'93, confirms
thlis statement.  Dr. Davidson states that in the mnore healthy
islands of St. Kitts, St. Vincent, and Barbadoes, soldiers
have arrived from Europe, and remained there for years in
the enjoyment of good health, notwithstanding their debaucheries.  Dr. Weir, director general of army hospitals, states
that he arrived in Jamaica in 1785, from  which time till
1782, only one officer died out of four regiments quartered
there, and that no fever of bad type occurred during these
years, until 1793, when the pestilence appeared.  Dr. Theodore Gordon served in Barbadoes, -Dorminica and Jamaica
during five years preceding the occurrence of this malady in
1793, and considered the health of the troops remarkably
good, &c. That this malady is not a constant resident in the
West Indies, (and therefore not indigenous in them) is further shown by Dr. J. Hunter, Dr. Franklin, Dr. Gordon,




25
and others who have found troops remain during several
years perfectly healthyi. Its outbreak occurred in these
islands, after many years of immunity from it, in February,
1793, in Grenada, at a time when bilious remittent fever
does not prevail: It did -not reach Dominica until the end
of July; Barbadoes was unaffected' until the beginning of
1794. and St. Domingo did not suffer until late this year,
and then:in consequence of the introduction of the contagion by a detachment of troops from Gaudaloupe, where it
was raging. This pestilence appeared in Philadelphia in
the month of July, 1793, and during the latter part of that
year and 1794, it reached most of the West India Islands.
Dr. Dancer, of Jamaica, after a close examination of the
opinion emitted respecting the malignant pestilence of 1793
and 1796, states:most decidedly, "that it is an imported
disease, and communicable by contagion." Dr. - Charlton,
president of the Medical Society of N-w York, since the
year 1762, in that city, declared that he never saw a case of
yellow fever before 1793, and that he always considered it
a disease of foreign origin."
It is evident that if this fever only occurs in the West India Islands at long intervals, as shown above, and then in
consequence of its introduction from abroad, most assuredly
it shows none of the laws of an indigenous origin, but is
clearly an exotic. Now, if this be true of all these islands
which lie within the range of latitudes propitious to its local
origin, and yet it is not produced, how much less likely is it
to be indigenous to the coast of the United States, north of
the tropics, where the thermal range of annual tempera.
ture is greatly below that said to be necessary to its production? If it be indigenous to our seaboard, and not to the
islands within the tropics, then has the world greatly erred
in considering it: disease of hot instead of cold climates.
Yet from the facts adduced from the records of its history,
to this absurd position the advocates of its local origin
are driven; nor can they escape from  it, except by either
abandoning a phantom: hypothesis, or by overthrowing the
whole records of the disease, as it has been developed, and
spread throughout these islands, as shown by numerous observers stationed upon them for more than a century.




26
As furnishing still further evidence in favor of quarantine, we give place, by;permnission, to the following letter,
written by a distinrguished physician, recently, of Philadelphia, now of this city, whose experience in the late epidemic
was of too painful a character not to have awakened in him
regrets most poignant, that his views in relation to this subject had not been acted upon here, and thus have saved him
from the sorrows of fainily bereavements:
GALVESTON, Dec. 27th, 1867.
DR. 1I.{CHARDSON:
Dear bSir-To your views, expressed to me in a recent
conversLation upon the disease which has, durhig thle past
summer, decimated this city, I desire to add a few words.
Thle paper you propose to publish, as a monograph of yellow fever, will doubtless be an important acquisition to medical science. lnd calculated to enlighten the profession in
reference to Iailly of its phenomnea, so rarely noticed by the
most elaborate writers upon the subject.  I have, for many
years, held my own theory of this pestilence.  Its visitations
and virulence have been alike predicted and dreaded.
When New Orleans wvas taken possession of by Maj. Gen.
Butler, on the 1st of May, 1862, I then being the Senior.
Medical Officer, acting upon my theory, addressed him an
urgenxt letter, requesting the establishment of a strict quarantine, to prevent the possibility of its admission from
abroad. In that letter it was stated that yellow fever was
not a disease indigenous to the soil or climate of Louisiana,
and never of home production; that in this respect, it was
like their great staple, the sugar cane, which, when introduced into the State, would both grow  and find soil and
climate suited to its most productive and prolific results;
but that it was not native, or indigenous, nor generated either
by latitude, climate or locality, and was never to be found,
except as the direct result of importation.  Upon these
views Gen. Butler acted, and guarded, even at the cannon's
mouth, every avenue to the city, being firmly convinced of
their truth. Acting, as he'did, upon the true theory-its
portability and contagiousness-his measures were promptly
taken, and his orders being strictly obeyed, he excluded from
the city every case, for the whole season, and thus preserved
the health of twenty thousand unacclimated persons.  The
epidemic of the present year in Galveston, I have passed
through; was the quarantine physician of the city, and, al



though it was not in my power to prevent its appearance,
or restrain its course, I am by this experience the more convinced Of the truth of my original theory.
When the quarantine was inaugurated in Galveston, on
the frst day of June, 1867, by Mayor Elaviland, to whom
this duty was comnmitted by Gen. Griffin, the city was entirely healthy. The first case of yellow fever appeared at Indianola in that month, and I had an interview at the earliest
moment with the Mayor, for the purpose of having all vessels quarantined, and the trains from the interior placed
under tlhe same regulations. This was refused, on the ground
alleged by the Mayor, that it was not yellow fever at Indianola; that Texas ports were, under his proclanmation, exempt
from quarantine, and that ino disease could be brought into
Galveston from another of our ports. I then went to Gen.
Griffin with a, protest-I declared to him that yellow fever
was at Indianola, and that unless he would interpose his
authority to prevent it, we would have it here. The General declined to take from the Mayor duties already committed to him, and directed me to go again to him and try
to convince him of the necessity of his yielding to my advice. My errand was fruitless. The Mayor was an old
gentleman, of antiquated views and ideas-did not believe
in quarantine, no how; that it was a useless expense to
the city, and a great drawback to commerce, and that he
should do nothing more than had already been done. Thus,
through the inefficiency, imbecility, or criminal negligence
of the city executive, has this disease invaded every household-hearts have been broken, hearthstones desolated, and
happiness forever wrecked.
But, sir, I sat down to give you my theory of the disease,
and somewhat of my experience.
That yellow fever is a disease of foreign origin, no man
of observation can doubt. That it never did originate within the boundaries of. the United Sta'es, is just as certain as
the truth of history. These two propositions are as clearly
demonstrable as is the evidence of its existence. So far as
the late epidemic will go in sustaining them, let us at once
go into the evidence thus furnished, and trace it'from its
Texas beginning. A schooner from Vera Cruz, Mexico, with
vomita on board, arrived at Indianola, Texas. There was
no quarantine at that port. The blankets upon which yellow fever patients had lain, were carried from the schooner
to an auction room and sold. The person who carried the
blankets was the first to take the fever and die. The auctioneer who sold them took the fever, also, and died. The
persons who purchased them took the fever, and several
die.. Thrcuglh these cases, the disease became epidemic.




28
The first, case that occurred in Galveston was brought from
Indianola on board the steamship W. H. Eiewes. The gentleman's name was Moller, from Baltimore, an agent of a
tobacconist, who had been at Indianola on business. He
was in apparent health upon his arrival, but in less than
forty-eicght hlours thereafter he was buried, from the fatal
effects: of that disease, clearly and. nequivocally marked.
From the house where this patient died, the disease commenced to spread. The next case was at the opposite corner; then the next was a few doors above; and thus it
gradually but quietly spread by progressive steps, until almost every unacclimated person in the city had been attacked.
Its ravages were fearful. The fatality was so great that almost every individual who could get away, left for the interior.  By these the disease spread throughout the State in
all parts not above the sea-level of 500 feet,; above which it
cannot be propagated. These are the simple truths of its
history; and is there any man, do you believe, of one particle of experience and observation, who would dare to deny
the fact of its contagiousness?  Who would dare deny, at
this late day, in defiance of the lights of science, of natural
law, and of observation, that for virulence and specific contagiousness. there is any other disease, in the whole category
of human affliction, so certainly reproductive of itself?
1 am satisfied I can trace my own case to its origin; that
I can show where every case that occurred in my family
sprang from, and go to the burial place of my friends directly from my own house, witnessing all the varied pha.ses and
symptoms of the there acquired disease. That yellow fever
is an exotic is evident from its entire dissimilarity to any of
our domestic diseases. The difference is so essential and
distinct as to impress medical gentlemen of the largest experience, that he has been brought into contact with a
stranger. No foreigner ever landed in the United States
possessing more marked habits, characteristics and distinctions, to indicate him as among and not of us, than does this
disease when it makes its appearance. An evidence, gathered from inductive reasoning-that reasoning upon which
medical science is alone founded and supported-is its nonrecurrence in the same individual. Every one knows this to
be a characteristic of other contagious diseases, such as
measles, small-pox, scarlatina, &c., and, of this disease also.
In no case have I ever discovered where a second attack has
recurred in the same individual, where the recovery has been
complete.
The proximate cause of this fever I hold to be a blood
poison, which poison is doubtless an animalcule. These an



29
imialcula are so iniinitesimally small as not yet to have been
discovered by the microscope, but capable of being absorbed,
and of penetrating every tissue of the human body.
To elaborate from the system ihis poison, without exhausting the vital energies of the patient, is to effect a cure; and
if your paper will effect such a change in the treatment as
to prevent the complete exhaustion produced by the Creole
system of sweating patients to death, or medicating them
into the grave, you will be a benefactor to the human race.
If you convince the public mind that the curative process of
nature is often disturbed by the doctor and the nurse, by a
system  unfounded in either reason or in philosophy, and
that all experience proves, that in this fever, when nature
has been permitted to wrestle with this pestilence, without
these extraneous interferences, we always have the largest
number of recoveries; when, I repeat, you can convince the
public mind of these facts, then the thought and labor you
have bestowed upon your work will have produced their
legitimate fruits.  I am a physician of the old school, without one single sympathy for any of the pathics which have
been engrafted as fungi upon my profession-endeavoring
still, as I was taught, to seek from the great storehouse of
nature for all my remedial agencies, and to apply them according to the lights of reason and experience, so that no
laws of her's shall be violated, no curative process retarded
-but that everything useful, everything developed by new
scientific discoveries, and all else that improves our noble
profession, belong of right to us alone. That no sectarianism is known in medicine-that quackery is a crime, and that
honest men will always abhor both its practice and its
author, whose purpose is (under the cloak of science) to
hoodwink or humbug a confiding people, are my sincere convictions.             Very truly yours,
ROB'T. K. SMITH.
The importance of the subjects passed in review in this
little essay, when contrasted with its paucity of detail, cannot fail to call forth the criticism of the reader.:In extenuation of this fault, we can only plead the limited time to
which we were restricted in the execution of our task. Hence,
condensation may have been carried to obscurity in many
places; but be this as it may, no labor was spared to render
every sentence, in the more important parts, the representative of a suggestive idea-this extent our labors had, and
no more.                                       W. R.