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

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

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

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

The firſt poſition laid down by dr. Ruſh, is, that the yellow fever in the Weſt Indies is always generated by vegetable putrefaction. This is not well founded. Dr. Hillary makes no mention of vegetable putrefaction producing this diſorder. He aſcribes it to the peculiar temperament and habits of living of the ſubjects of it. "It is very remarkable," ſays he, that this fever moſt commonly ſeizes ſtrangers, eſpecially thoſe who come from a colder or more temperate climate—and moſt readily thoſe who uſe vinous or ſpiritous liquors too freely; and ſtill more readily thoſe who labour hard, or uſe too violent exerciſe, and are at the ſame time expoſed to the ſcorching rays of the ſun in the day time, and ſoon after expoſe themſelves too ſuddenly to the cool dews and damp air of the night. Hillary on diſeaſes of Barbadoes, page 146. Dr. Lind gives the ſame account, and nearly in the ſame words.

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

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

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

To the ſame purpoſe, Dr. Lining obſerves, This fever does not ſeem to take its origin from any particular conſtitution of the weather, independent of infectious miaſmata, as dr. Warren has formerly well obſerved; for within theſe twenty-five years, it has been only four times epidemical in this town, namely in the autumns of the years 1732, 39, 45, and 48, though none of thoſe years, (excepting that of 1739, whoſe ſummer and autumn were remarkably rainy) were either warmer or more rainy, (and ſome of them leſs ſo) than the ſummers and autumns were in ſeveral other years, in which we had not one inſtance of any one ſeized with this fever; which is contrary to what would have happened, if particular conſtitutions of the weather, were producttive of it, without infectious miaſmataEſſays and obſervations, political and literary, vol. II. page 406, 407.

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

I reduced a quantity of cabbage leaves to a pulp in a mortar, and ſet them in a warm place to putrify. A bowl of ſtrawberries was likewiſe ſet along with them. When both the cabbage leaves and ſtrawberries had undergone a fermentation, and were in that ſtate in which vegetables are ſaid to be putrid, I put a bit of mutton into each of them, and covered it over with the pulp. Another bit was put into a bowl of water for a ſtandard, and they were all ſet together in a warm cloſet. The piece of mutton in the water had evidently turned putrid, and tinged the water red in one night. Both that piece which was in the pulp • f the cabbage, and that in the pulp of the ſtrawberries, were kept three weeks, and continued ſweet and hard, as if they had been ſalted. The bowls were then overturned, and their contents loſt by accident. From theſe experiments it appears, that neither the putrid ſubſtance, nor the watry infuſion of vegetables, is ſepticAlexander's experimental enquiry, 53—4..

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

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

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

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

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

Amidſt the confuſion in which this ſubject is involved—amidſt the difficulty of producing poſitive proofSome of the perſons who could throw full light on this ſubject, are dead—others removed away—and there are ſome who would not chooſe to reveal the truth from an unwillingneſs to engage in any controverſy.—let us enquire into the evidence. Let us ſee whether the opinion of its generation be not much more improbable than that of its importation—let us ſee whether the preſumptions in ſupport of the latter opinion be not ſo extremely ſtrong, as fully to ſatisfy every mind open to conviction.

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

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

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

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

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

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

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

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

The yellow fever, even in the Weſt Indies, is not always uniform in its ſymptoms or effects—and on its introduction here, may very readily be ſuppoſed to have changed its appearance. Dr. Lind, who, like dr. Lining, is unexceptionable authority on this ſubject, after detailing the arguments for and againſt the contagious nature of the diſorder, ſays: We can only reconcile the facts that may be produced on both ſides of the queſtion, by ſuppoſing that the yellow fever of the Weſt Indies is ſometimes of a mild nature, and altogether free from infection, while at other times it is more violent and highly infectiousThe different appearance of the ſame diſorder, in different perſons and places, is noted by Lind: From one cauſe, from the ſame infection, I have frequently known to proceed what may be termed, from outward appearances, the yellow, petechial, and miliary fevers; and while in a few the contagion aſſumed an intermitting form, and was mild, in others it raged with a conſtant fever. Lind on the health of ſeamen, page 265..

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

I ſhall now cloſe this ſubject. The reader has ſeen that Hillary and Lining declare poſitively that this diſorder does not depend on the weatherDr. Bruce, an eminent phyſician of Barbadoes, quoted by •• nd is o • the ſame opinion: In omni anni tempeſtate 〈◊〉 e ••• rt hic morbus▪ ſymptomata autem graviera obſerv • ntur, ubi calor magnus cum multa humidi • ate conjungitur. Lind on hot climates, 2 • 7.—and Lind and Moſely imply the ſame thing by their ſilence—yet that dr. Ruſh declares it ariſes chiefly, if not wholly from that ſource—that our diſorder aſſumed the ſame appearances as in former inſtances when incontrovertibly imported—that the yellow fever exiſted in the Weſt Indies for many months before it appeared here—that a very great number of veſſels arrived here from that quarter during the ſummer—that having hardly any idea of danger, we uſed no precautions, ſo that it would be more aſtoniſhing if we eſcaped, than it is, that we caught the diſeaſe—that many creditable people aſſure us of ſundry ſick perſons and dead bodies being landed privately from ſome of thoſe veſſels—that people in a very advanced ſtage of the yellow fever have died at Marcus Hook and Cheſter, and, for aught we know, at other places—that the ſhips infected with the effluvia of the ſick and dead came freely to our wharvesLind has ſome remarkable inſtances of the yellow fever being communicated by infected veſſels, even after the removal of the ſick. When the men from the Cambridge (one of the healthieſt ſhips then in the fleet) became infected, their infection did not proceed from any perſon being ſick on board the Neptune; for upon the firſt complaint, or the appearance of any man being there taken ill, he was immediately taken to the hoſpital. And the ſame is to be obſerved, with reſpect to the numerous infected patients, who were daily ſent for five or ſix weeks from the North American ſhips; that is, from their arrival at Spithead till their purification in the dock. During this period, no ſick man was kept for an hour on board any of them, if the weather permitted to ſend him aſhore. —that there is not the ſmalleſt probability of their infected beds, bedding, or clothes, being deſtroyed, but on the contrary, that we have every reaſon to ſuppoſe they were brought to the city and ſold here.—Let every candid man give theſe ſeveral circumſtances a full conſideration. Let him be actuated ſolely by a diſpoſition to diſcover the truth, unbiaſſed by any conſideration of the character of our city—let him allow him reaſon free ſcope—and I feel the utmoſt confidence, that he will pronounce a decided opinion, that the late malignant fever was, in the year 1793, as in 1762, imported from the Weſt Indies.

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