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HISTORY 


OF 


YELLOW  FEVER. 


QUITMAN  KOHNKE,  M.  D. 

BoRX  IX  1857,  AT  Natchez,  IMiss. 
Died  June  26,   1909,  at  Covington,   La. 

Dr.  Kohnke  was  one  of  the  pioneers  and  most  forci- 
ble expounders  of  the  modern  doctrine  of  the  transmission 
of  yellow  fever  by  the  Stegoniyia  Caljpus.  He  com- 
menced teaching  this  do'fi  ne  in  Louisiana  and  illustrated 
his  lectures  by  lantern  slides  immediately  after  the  report 
of  the  Reed  Commission  had  been  given  publicity.  Had 
his  indefatigable  labors  in  this  direction  to  educate  public 
opinion  in  the  South  received  fuller  recognition  at  the 
time,  the  experience  of  1905  would  have  been  an  impos- 
sibility. He  lived  long  enough  to  see  the  universal  ac- 
ceptance of  this  doctrine  and  quarantine  practices  modi- 
fled  in  obedience  to  its  teachings. 
Requiescat  in  Pace. 


HISTORY 

OF 

YELLOW   FEVER 

BY 

GEORGE    AUGUSTIN. 

Assistant  Secretary  Louisiana  State  Medical  Society;  Assistant  Secretary-Librarian  Or- 
leans Parish  Medical  Society,  New  Orleans;  Author  of  "Romances  of  Xew  Orleans" 
and  other  Creole  Stories. 

TO  WHICH  ARK  ADDED  THE  FOLLOWING  ARTICLES: 

MEDICAL. 

KTIOLOCiV — (i.  EARRAR  PATTOX,  Ex-Secretary  Louisiana  State  Board  of  Health. 

I'Rl>:VENTIOX— QVITMAX  KOHXKE,  Ex-President  Xew  Orleans  Board  of  Health. 

P.\THOLOGY— O.  L,  POTHIF;r,  Pathologist  to  Charity  Hospital,  Xew  Orleans. 

DIAOXOSIS— HAMILTOX  P.  JOXES,  Ph.\  sician-in-Chief  Xew  Orleans  Yellow  Pever 
Hospital,  Epidemic  of  1V05. 

TREATMEXT— LVCIEX  F.  SALOMON',    Ex-Secretary   Louisiana  State  Board  of  Health 

PROGNOSIS— CHARLES  CHASS.\IGNAC,  Dean  New  Orleans  Polyclinic. 

THE  LOUISIANA  SYSTEM  OF  HYGIENIC  EDUCATION— FRED.  J.  MAYER,  Secre- 
tary Louisiana  Sanitary  Commission. 

history  .vni)  statistics, 
the  panama  canal  and  yellow  fever- col.  w.  c.  gorgas,  v.  s.  army. 

pu'idemic  of  190.5. 

henry  dickson  bruxs,  m.  d. 
cii.\rlf;s  chass.\ignac,  m.  d. 

LOUIS  G.  LeBEUF,  M.  D. 
JULES  LAZARD,  M.   D. 
SIDNEY  L.  THEARD.   M.  D. 


NEW   ()RLP:.ANS: 

Published  for  the  .\uthor  by 

SEARCY  &  PFAFF  Ltd., 

724-728  Perdido  Street. 

1909. 


A 


Copyright,  1909, 

By  GEORGE  AUGUSTIN, 

New  Orleans,  La. 


Biomedical 
Library 


TO 

THAT  CHIVALROUS  SOUTHERN  GENTLEMAN, 

DR.  CHARLES  CHASSAIGNAC, 

OK 

NEW  ORLEANS, 

THLS  VOLUME  LS  DEDICATED, 

As  a  Testimonial  of  the  high  esteem  in  which   he   is  held  in  ,this   com- 
munity,   and  in   recognition  of   valuable  assistance    rendered 
in    the   compilation    and   classification   of  the 
INIedical   Part   of   this  Work  to 

THE  AUTHOR. 


? 


ACKNOWLEDGEMENTS. 

I  specially  desire  to  thank  Major  Walter  D.  McCaw,  Sur- 
geon, U.  S.  A.,  Librarian  Surgeon-General's  Office,  for  his  un- 
faltering courtesy  in  placing  at  my  disposal  the  works  contained 
in  the  Surgeon-General's  Library.  During  the  long  years  con- 
sumed in  the  compilation  of  this  work,  Dr.  McCaw's  promptness 
in  lending  me  books  necessary  for  research  work  has  greatly 
facilitated  my  labors,  and  I  desire  to  signify  my  heartfelt  appre- 
ciation of  his  kindness. 

I  desire  also  to  thank  Drs.  W.  C.  Gorges,  Henry  Dickson 
Bruns,  Charles  Chassaignac,  Quitman  Kohnke,  Hamilton  P. 
Jones,  Jules  Lazard,  Louis  G.  Le  Beuf,  Fred.  J.  Mayer,  G. 
Farrar  Patton,  Oliver  L.  Pothier,  Lucien  F.  Salomon  and  Sidney 
L.  Theard  for  the  valuable  articles  contributed    to   this   volume. 

THE  AUTHOR. 
June  30,  1909. 


REMARKS  BY  THE  AUTHOR. 

The  original  intention  of  the  writer  was  to  pubhsh  a  bro- 
chure on  "The  History  of  Yellow  Fever  in  Louisiana,"  the  idea 
suggesting  itself  to  him  while  acting  as  special  stenographer  in 
the  olhce  of  the  United  States  Marine  Hospital  Service  at  New 
Orleans  during  the  Yellow  Fever  outbreak  of  1897.  The  duty 
of  copying  the  reports  made  by  the  medical  staff  under  Surgeon 
Carter  devolving  upon  him,  the  thought  occurred  to  him  that  a 
statistical  and  historical  compilation  of  the  many  epidemics  of 
yellow  fever  which  have  afflicted  our  State  would  prove  inter- 
esting. With  this  end  in  view,  the  work  of  collecting  data  was 
begun  shortly  after  the  mild  epidemic  of  1898.  Such  was  the 
nucleus  of  this  work. 

During  the  decade  which  has  elapsed  since  the  collection 
of  data  for  this  volume  was  begun,  the  original  scope  was  en- 
larged, and  as  the  years  rolled  by  and  the  magnitude  of  the  task 
became  more  and  more  evident,  the  author  found  himself  con- 
strained to  dodge  around  corners  whenever  he  spied  a  medical 
friend  who  had  been  assured  that  the  book  would  be  out  "by 
the  end  of  December"  the  year  previous;  and  the  patient,  good- 
natured  people  of  New  Orleans,  who  had  been  told  by  compli- 
mentary articles  in  the  public  press,  from  time  to  time,  that  the 
work  would  "soon  be  issued,"  naturally  reached  the  conclusion 
that  the  end  would  arrive  simultaneously  with  the  Millennium. 


No  apology  is  made  for  the  long-deferred  appearance  of 
this  volume.  A  glance  is  sufficient  to  show  that  it  is  a  work  of 
love,  for  no  amount  of  financial  gain  (should  it  meet  with  public 
favor)  could  be  adequate  compensation  for  the  time  consumed 
in  its  compilation.  Not  being  possessed  of  independent  means, 
the  author  had  to  steal  moments  out  of  the  busy  work-a-day  life 
to  complete  his  task,  aided  by  his  devoted  wife,  to  whose  valu- 
able assistance  is  chiefly  due  the  completion  of  a  work  whi:h, 
until  very  recently,  seemed  unending. 

It  was  the  author's  intentions  also  to  include  within  these 
pages  a  history  of  the  ravages  of  Yellow  Fever  in  the  West 
Indies  and  South  America,  but,  judging  by  the  time  which  has 
been  consumed  in  the  compilation  of  what  is  included  in  this 
volume,  he  has  concluded  that  the  span  of  life  is  too  short  for 
the  accomplishment  of  such  a  task,  and  humbly  submits  the  re- 
sult of  his  labors  to  the  cynical  public  and  to  the  judgment  of 
indulgent  friends. 

GEORGE  AUGUSTIN. 

New  Orleans,  June  30,  1909. 


CONTENTS. 

PART  FIRST. 
GENERAI,   OBSERVATIONS. 

CHAPTER  I. 

THINGS  EVERYBODY  OUGHT  TO  KNOW. 

Definition  of  Teclinical  Terms: 

Epidemic    1 

Endemic    2 

Sporadic   2 

What    Fomites  Are   2 

The  Difference  Between  Infection  and  Contagion   3 

What  a  Pandemic  Is   4 

Brief  Remarl^s  on  Quarantine 6 

CHAPTER  II. 

THE  RAVAGES  OP  PESTILENTIIAL  DISEASE. 

The  Peculiar  Pranlcs  of  Epidemics  7 

Ancient  Notions  About  the  Origin  of  Pestilential  Disease 9 

Odd  Beliefs  and  Practices  of  Superstitious  Ages  10 

An  Extraordinary  Historical  Document  14 

Historic  Mortalities  Caused  by  Pestilences  in  Ancient  and  Medieval 

Times    17 

The  Great  Plagues  of  London  21 

CHAPTER  III. 

THE  GREAT  EPIDEMICS  OF  THE  MIDDLE  AGES. 

The  Inguinal  Pestilence  of  the  Sixth  Century 22 

The  Black  Plague   27 

Le  Mai  des  Ardents   30 

The    Eruptive    Fevers    of    the     Sixt'h     Century — Variola,    Measles, 

Scarlatina    35 

The  Sweating  Sickness  36 

Scurvy     38 

Xicprosy     39 

CHAPTER  'IV. 

INSECTS  AS  PROPAGATORS   OF  DISEASE. 

How  Pestilence  is  Spread  by  Flies,  Mosquitoes,  Fleas  and  Other 
Insects. — Instances  Where  Disease  Was  Conveyed  by  Bed- 
Bugs  and  Ants. — The  Role  Played  by  the  Cattle-Tick  and  the 
Tsetse-Fly. — ^Summary  of  the  Mosquito  Doctrine 44 

IBibliography  of  Transmission  of  Disease  by  Insects 52 


PART  SECOND. 


PRELIMINARY    OBSERVATIONS    ON    YELLOW    FEVER. 
CHAPTER   I. 

PERTINENT  POINTS  ABOUT  YELLOW  FEVER. 

Geographical    Limits    62 

Mortality  in  September,  as  Compared  with  Other  Months 64 

Historic  Mortalities  Caused  by  Yellow  Fever  66 

CHAPTER  II. 

NOMENCLATURE  OF  YELLOW  FEVER. 

Peculiar  Names  Giren  the  Disease  by  Medical  Writers. — A  List  Con- 
taining One  Hundred  and  Fifty-two  Synonyms  70 

CHAPTER  III. 

HISTORICAL  SUMMARY. 

Wiere  was  the  Cradle  of  Yellow  Fever?  85 

Critical  Examinations  of  the  Literature  on  the  Origin  of  Yellow  Fever: 

American  Origin    87 

African  Origin    100 

Asiatic  Origin  105 

The  Gulf  Stream  Theory   10& 

First  Recorded  Outbreaks   Ill 


PART  THIRD. 


HISTORY  OF  YEI/I.OW  F^VBR  BY  I,OCAI,ITI^S. 

ASIA. 

The  Effect  that  the  Completion  of  the  Panama  Canal  will  have  upon 
the  Probable  Extension  of  Yellow  Fever  to  Asia — W.  C. 
Gorgas,  U.  S.  A 135 

Alleged  Yellow  Fever  in  Syria 144 

AFRICA. 

History   cf   Yellow    Fever    in    Africa,    Arranged    Alphabetically,    by 

Localities    150  to  343 

Chronology  of  Yellow  Fever  in  Africa  and  the  Islands  off  the  Coast 

thereof,  from  1494  to  1997   344 

Summary  of  Yellow  Fever  Years  and  Periods  of  Immunity 350 

Chronology,  by  Localities  352 

EUROPE. 

Austria. 
Trieste    356 

Azores. 

Historical  Summary  357 

Ponta  Delgado    358 

France. 

Historical  Summary   359 

Chronology,  1694  to  1908 360 

Aix      363 

Bordeaux    364 

Brest    370 

Dunkirk     372 

Havre    373 

La   Rochelle    375 

Marseilles    375 

Mindin     388 

Montoirde-Bretagne     389 

Montpellier    389 

Nantes 390 

Paris    390 

Rochefort   396 

Saint-Nazaire    400 

Toulon     412 


AIGISTIN   S     HISTORY     UF     YELLOW     KKVER. 


Great  Britain. 

Historical  Summary   415 

Chronology,   1713  to  1878    416 

Cork     430 

Dover     419 

Dublin     430 

Falmouth    419 

Isle  of  Wright    419 

Llanelly     432 

London    420 

Motherbank.  (See  Isle  of  Wight). 

Newcastle-on-Tyne     421 

Portsmouth    422 

Salcombe    423 

Southampton     423 

Swansea   432 

Woolwich   443 

Italy. 

Chronology,  1804  to  1883  447 

Genoa    447 

Leghorn    448 

Naples     452 

Pisa    453 

Torre  Annunziata    454 

Varignana    456 

Portugal. 

Chronology,  1718  to  1880   460 

Belem    460 

Bom    Successo    462 

Ericeira     462 

Lisbon     463 

Olivaes    475 

Oporto   475 

Peniche     480 

Spain. 

Historical  Summary   483 

Geographical    Description    of    Localities    in    Spain    Where    Yellow- 
Fever  has  been  Observed  484 

Chronology,  1649  to  1S90 491 

Summary  of  Yellow  Fever  Epidemics,  by  localities : 

Aguilas    499 


CONTENTS.  5 

Alberca,  Alcala  de  los  Gazules,  Alcala  de  los  Panderos 500 

Alcantarilla,  Algerziras   501 

Alhaurin-el-Grande,  Alicante    502 

Antequera    504 

Arahal,  Arcos  de  la  Frontera   506 

Avriata,  Ayamonte    508 

Badalona     509 

Balearic  Islands   509 

Barcelona     516 

Barcelonette    522 

Barrios,  Benaocaz   523 

Borncs     524 

Cadiz    524 

Caneta-de-Mar     544 

Caneta-la-Real,  Carmona,  Carraca,  Carrana   545- 

Cartagena     54& 

Catalan   Bay    548- 

Chiclana,   Chipiona    549' 

Churriana,  Coin    550 

Conil,  Cordova   , 551 

Coria,  Cortes  de  la  Frontera,  Corunna,  Dos  Hermanos 552 

Ecija    553 

El  Arahal,  El  Borge,  El  Palo,  El  Passajes,  Eprezalena 554 

Espejo     555 

Espera,  Estepa 556 

Ferrol,  Fraga    557 

Gibraltar     557 

Granada,   Guardamar    566 

Huelva,  Isla  de  Leon   567 

Jesus,   Jiimilla    568 

La  Charlotta,  La  Rambla   569 

Las  Cabezas  de  San  Juan,  Las  Palacios,  Lebrixa  571 

Lorca     573 

Loyola     574 

Madrid     574 

Mairena  del  Alcor  576 

Malaga    577 

Malgrat     598 

Mazarron,  Medina-Sidonia 599 

Mequinenza     600 

Mijas,  Monte  Alegre,  Montejague    601 

Montilla    602 

Mora,  Moron  de  la  Frontera,  Murcia    603 

Nonaspe,  Ojos,  Ol'.vera   604 

Olot    605 


AUGUSTIN   S    HISTORY    OF    YELI.OVV    FEVER, 

Palma  (See  Balearic  Islands). 

Palmar,    Pasajes    605 

Paterna  de  la  Ribiera,  Pedrara 607 

Pedroches,  Penacerrada    608 

Port  Mahon.    (See  Balearic  Islands). 

Puerto  de  Santa  Maria  608 

Puerto   Real    609 

Regans,  Ricote   610- 

Ronda    611 

Roquetas,  Rota,  Saint  Eloy  612 

San  Andero,   Salou    613 

San  Gervaiso,  San  Juan  del  Porto,  San  Lucar  de  Baramaeda 614 

San  Roque,  Sans,  Sarria 615 

Seville     618 

Sitges    621 

Tabarca,  Tobarra,  Torre  del  Mar,  Torre  Molino  622 

Tortosa    623 

Totana,    Tribujena    625 

Turriano,  Ubrique,  Utrera    626 

Valencia,  Vejer,  Velez  Malaga   627 

Vera,  Vigo   628 

Villa  Martin    629 

Villanueva  del  Ariscal,  Villaseca  de  la  Sagua  630 

Xeres  de  la  Frontera  630 

Ximena  de  la  Frontera  633 

Yecla,   Zieza    634 

HISTORY   OF  YEI.I.OW   FEVER   IN   NORTH 
AMERICA. 

Proofs  tliat  Yellow  Fever  is  an  American  Product  and  was  Unknown 

to  Europeans  before  the  time  of  Columbus  QZB^ 

CANADA. 

Historical   Resume    650 

Chronology,  1805  to  1880    652 

Summary  of  Yellow  Fever  Outbreaks,  by  Localities: 

Nova  Scotia. 
Halifax    652 

Prince  Edward  Island. 
Charlottetown     656 


Quebec. 
Quebec    656 

Saint  Pierre  and  IVIiquelon. 

Saint-Pierre-deMiquelon     658 

Bibliography  of  Yellow  Fever  in  Canada   659 

CENTRAL  AlVIERICA. 

Historical   Resume    660 

Chronology,  1596  to  1908   661 

Summary   of   Yellow   Fever   Outbreaks,    by   Localities: 

British   Honduras. 
Belize     666 

Costa  Rica. 

Alajuela    668 

Heredia,  Liberia,   Matina   669 

Port  Limon    670 

Punta  Arena.  San  Jose   678 

San  Juan    679 

Zent   680 

Guatemala. 

Champerico,  Chiquimula,  Gualan 681 

Livingston,  Puerto  Barrios    682 

Tucara,  Zucapa    683 

Honduras. 

Ceiba,   Chamelicon    685 

Cholona,  Cienaguita,  El  Pariso,  Nacaome,  Pimenta  686 

Puerto    Cortez    687 

San  Pedro   689 

Nicaragua. 

Bluefields,    Corinto    690 

Granada,  Jucunapa,  Leon   691 

Managua,  San  Francisco    692 

Salvador. 

Acajitla,   La  Libertad    693 

San   Salvador    693 

Santiago  de  Maria   " 696 

Bibliography  of  Yellow  Fever  in  Central  America  696 


O  AUGUSTIN   S     HISTORY    OF    YELLOW     KEVER. 

MEXICO. 

Historical  Summary  of  Yellow  Fever  in  Mexico: 

Endemic  Foci   700 

Along  the  Pacific  'Coast   702 

General   Retrospect    705 

The  General  Epidemic  of  1883   707 

Summary  of  Yellow  Fever  Epidemics  in  Mexico,  by  Localities: 

Acapulco,  Acayucan,  Altata,  Altamera  708 

Alvardo,  Amalco,  Atai,  Camarga,  Campeche   709 

Cardenas,    Chilpanzingo    710 

Cilas,  Cinchapa,  Clinidas,  Coatzacoalcos,  Colina    711 

Caraco     712 

Concordia  712 

Cordova  715 

Corrientes    715 

Cosmaloapam,    Cosala,    Culican,    Dofia   Cecilia,   El    Higo,    Equador, 

Frontera 71& 

Gualian,  Guaymas,  Guerrera,  Guietihicori,  Hermosilo   717 

Hidalgo,    Huachinango,    Huimanguillo,    Ixcallan,    Jalapa,   Jicaltepec, 

Jico,   Jiminez    718 

Joltipan,   Juchitan.    Laguna   del    Carmen,   La  Junta,   Lampasas,    La 

Paz   71i> 

Las  Animas,  Linares,  Mazanillo   720 

Matamoras     720 

Mazatlan     721 

Merida    721 

Mexico  City — 

Experiments  Demonstrating  that  the  Yellow  Fever  Mosquito 

can  Breed  in  Mexico  City  723 

Summary  of  Yellow  Fever  Importations  to  Mexico  City 728 

Micaltepec,  Mier   728 

Minatilpan,  Misantla,   Monclava,   Monterey    729 

Motul,   Montzorongo,   Naulta    730 

Nicayuca,  Xeuva  Laredo,  Ocus,  Omealca  731 

Orizaba   731 

Papantla,  Paraje  Nuevo,  Paso  de  Ovijas,  Pinchucalco,  Presidio 734 

Progreso    Peublo  Vejo,  jr^eurto  Angel,  Quantana  Roo,  Reata 735 

Reynosa,  Rosario,  Salina  Cruz,  San  Antonio,  San  Benito,  San  Bias.. 736 
San  Fernando,  San  Geromino,  San  Ignacio,  San  Juan  Batista,  San 

Lorenzo,  San  Luis  Potosi  737 

Santa   Cruz   de   los   Rosales,    Santa   Lucretia.    Santiago   Acapemeta, 

Soconusco    738 

Tampico   738 


CONTENTS.  & 

Tamuin,  Tapachula,  Tepee,  Tehuantep.ee   74L 

Teran,  Texistopec   742 

Tezonapa,    Tierra    Blanca,    Tapona,    Tlacoltipan,    Tpislan,    Tonala, 

Tuxpan    743 

Tuxtepee,   Valladolid    744r 

Vera  Cruz  (1509  to  1909)    744 

Victoria,  Xumpich,  Yuki,  Zonogolica,  Zucatula   750 

Bibliography  of  Yellow  Fever  in  Mex'co,  by  Localities 750 

UNITED   STATES. 

General  Summary 767 

Table  Showing  Years  in  which  Yellow  Fever  has  Invaded  the  Sea 

board  Cities  of  the  United  States.  1668  to  1893 769  to  78(> 

History  of  Yellow  Fever  in  the  United  States,  by  Localities: 

A'abama  781 

Arkansas  792 

California 7E5- 

Connecticut  798 

Delaware   801 

District  of  Columbia   804 

Florida 805- 

Georgia 821 

Illinois    833 

Indiana 838 

Indian  Territory    838^ 

Kentucky   839 

Louisiana   844  to  902 

Maine  915 

Maryland    917 

Massachusetts    5iJ& 

Michigan    936 

Mississippi   937  to  954 

MisEouri   957 

New   Hampshire    962 

New  Jersey    96 J 

New  York  96& 

North   Carolini   982 

Ohio    934 

Pennsylvania  ^^^ 

Rhode  Island   ^^^ 

South  Carolina  ^^^ 


Tennessee 
Texas  .... 


.1001 
.1009 


Virginia    ^"^^ 


Vermont 


.1022 


Washington    1^^"^ 


West  Virginia 


.1024 


10 

PART  FOURTH 


HISTORY  OF  YELLOW    FEVER    EPIDEMIC  OF  1S05. 

I. 

EXPERIENCES  DURING  THE  YELLOW  FEVER  EPIDEMIC  OF 

1905.— HENRY  DICKSON  BRUNS,  M.  D 1027 

II. 
SOME    LESSONS    TAUGHT    BY    THE    EPIDEMIC    OF    1905.— 
CHARLES  CHASSAIGNAC,  M.  D. 

I.     Truth  of  Mosquito  Propagation 1049 

II.     Infection  in  Proportion  to  Number  of  Bites 1052 

III.  Virulence  Diminishes  Pari  Passu  witli  the  Destruction 

of  Mosquitoes 1053 

IV.  Susceptibility   of  Negroes 1054 

V.  Quarantines  Unintelligent  1055 

VI.  Prophylaxis  in  Place 1056 

VII.  Prophylaxis  in  Person 1057 

VIII.     Depopulation  of  Infected  Places 1057 

IX.  Detention  Camps  1058 

X.  The  Great  Lesson 1058 

III. 

THE  WORK  OF  THE  MEDICAL  PROFESSION  OF  NEW  OR- 
LEANS DURING  THE  EPIDEMIC  OF  1905.— LOUIS  G. 
LeBEUF,  M.  D. 

I.     Preliminary  Remarks;  Local  Medical  Organization.  .  .1060 

II.     Appeal   for  Early  Notification 1069 

III.     Appeal  for  Immediate  Screening  of  Suspected  Cases, 

and  Fumigation   1071 

IV.     Appeal  for  an  Educational  Campaign lOTi; 

V.  A  Warning  to  Beware  of  the  Danger  of  Overlooking 
the  Less  Obvious  Breeding  Places  of  the 
Stegomyia   1073 

VI.  Appeal  for  a  More  Skilled  Medical  Body  to  Conduct 

the    Campaign    1074 

VII.  Letter  Warning  Medical  Men  not  to  Overlook  the  Mild 

Type  of  Yellow  Fever  which  may  be  Found  in 
the   Native-Born    lO'^S 

VIII.  Appeal  to  Householders    to    Delay    "Moving    Day"    on 

Account  of  Danger  of  Spreading  Infection 1076 

IX.  Danger  of  Removal  of  Temporary  Cistern  Screens 1076 

X.  Concluding  Remarks    10"7 


CONTENTS,  1  1 

.       .  IV. 

STATISTICAL  REVIEW  OF  THE  YELLOW    FEVER    EPIDEMIC 
OF  1905,  NEW  ORLEANS.— JULES  LAZARD,  M.  D. 

I.     General  Remarks   1078 

II.     "Suspicious"    Deaths,     1905,     Previous     to     Epidemic 

Period   1079 

III.  Daily  Record  nf  Cases  and    Deaths    and    Cases    Under 

Treatment 1081 

IV.  Deaths  Classified  According  to  Age 1083 

V.     Deaths  by  Months 1084 

VI.     Deaths  According  to  Nationality  1084 

VII.     Comparative  Mortality,  1904,  1905,  1906 1085 

V. 

ilEQUIREMENTS     OF      THE      MOSQUITO      DOCTRINE— S.     L. 

THEARD,  M.  D 1086 

VI. 

ISTEW    ORLEANS    YELLOW    FEVER    IN    1905.— S.  L.  THEARD, 

M.  D 1093 

VII. 

AiNTI-MOSQUITO     ORDINANCES     ADOPTED     BY     THE     CITY 

COUNCIL  OF  NEW  ORLEANS  IN  1905 1100 


12 

PART  FIFTH 


THE     ACCEPTED     MODERN     THEORIES     CONCERNING     YELLOW- 
FEVER. 


ETIOLOGY  OF  YELLOW  FEVER— G.  FARRAR  PATTON,  M.  D. 

L     First  Definite  Suggestion  of  the  Truth liOT 

The  Yellow  Fever  Germ 1103 

II.     Views  Formerly  Held 1111 

III.     Tyranny  of  a  False  Doctrine 1116 

IV.     Convincing  Object  Lessons  of  1905 1117 

V.     Etiological  Role  of  the  Mosquito 1118 

VI.     The  Bacillus   Icteroides 1124 

VII.     Dengue  and  Yellow  Fever 112(> 

II. 

THE  SANITARY    PREVENTION    OF    YELLOW    FEVER— QUITMAN 
KOHNKE,  M.   D. 

I.     The  Yellow  Fever  Mosquito 1127 

II.     Moral  Responsibility  for  Epidemics 11 2S 

in.     The  Sanitary  Creed   1125^ 

IV.     Mortality  Statistics    1131 

V.     Destruction  of  Stegomyiae 1133 

VI.     Conditions  Obtaining  in  New  Orleans  in  1905 llo4 

VII.     Conclusions    1136 

Bibliography  of  Transmission  of  Yellow  Fever  by  Mosquitoes 113S 

III. 

PATHOLOGY  OF  YELLOW  FEVER.— O.  L.  POTHIER,  M.  D. 

I.     Difficulty  of  Pathc!ogical  Diagno&Is 1147 

II.     Yellow   Coior    1147 

III.     Hemorrhagic  Spots  1148 

IV.     The   Lungs    1148 

V.     The  Heart   1148' 

VI.     The  Liver   1149 

VII.     The  Spleen    1149 

VIII.     The  Kidneys   1150 

IX.     The  Adrenals,  Thyroids  and  Pancreas 1150- 


CONTENTS.  13 

X.     The   Stomach    125  ) 

XI.     The  Intestines  1151 

XII.     The  Blood   1151 

XIII.  The  Nervous  System 1151 

XIV.  Adults  More  Susceptib'.e 1152 

XV.  General    Steatosis    the    only    Special    Characteristic 

Lesion    1152 

IV. 

DIAGNOSIS   OF  YELLOW  FEVER.— HAMILTON  P.  JONES,   M.  D. 

I.     Preliminary  Remarks    1154 

II.     First  Stage    1156 

III.  Second   Stage    1156 

IV.  The  Blood   1157 

V.     Urine    1157 

VI.     Facial    Expression    •. 1157 

VII.     Jsundice   1158 

VIII.     Circulation   1158 

IX.  Temperature 1158 

X.  Pulse   1158 

XI.  Respiration    1159 

XIL     Blood   Pressure    1159 

XIII.  Differential  Diagnosis   

Malaria   1160 

Hemoglobinuric    Fever    1161 

Dengue   1161 

La  Grippe    1161 

Typhoid  Fever   1161 

Acute  Yellow  Atrophy  of  the  Liver 1162 

Weil's  Disease 1162 

Catarrhal  Jaundice  1162 

Acute  Peritonitis  1162 

XIV.  General    Summary    1162 

V. 

PROGNOSIS  OF  YELLOW  FEVER— CHARLES  CHASSAIGNAC.  M.  D. 

I.     Preliminary  Remarks    1164 

IL     Age    1165 

III.  Condition  of  the  Vital  Organs   1166 

IV.  Habits    1166 

V.  Amount  of  Poison    1166 


14  augustin's  history  of  yellow  fever. 

VI.     Surroundings    1167 

VII.     Race 116? 

VIII.     Treatment   1167 

IX.  Temperature    1165^ 

X.  Icterus 1168 

XI.  Urine   1165^ 

XII.     Hemorrhage    1169 

VI. 

TREATMENT    OF    YELLOW    FEVER— LUCIEX    F.    SOLOMON, 

M.  D 1171 

VIL 

THE  LOUISIANA  SYSTEM  OF  HYGIENIC  EDUCATION— FRED. 

J.  MAYER,  M.  D 1176 


PART    I. 


GENERAL 
OBSERVATIONS. 


PART  FIRST. 


CHAPTER  I. 

THINGS  EVERYBODY  OUGHT  TO  KNOW. 

Definition  of  Technical  Terms.— What  is  Meant  by  Epidemic, 
Endemic  and  Sporadic— What  Fomites  Are.— The  Difference  Between 
Contagion  and  Infection.— What  a  Pandemic  Is.— Brief  Remarlvs  on 
Quarantine. 

As  this  work  is  not  soldy  for  the  use  of  physicians,  but 
also  for  the  information  and  guidance  of  the  public,  we 
wiU  give  a  brief  synopsis  of  the  meaning  of  certain  words 
wluch  have  been  used  quite  freely  by  the  lay  and  medical 
press  recently,  so  that  anyone  who  reads  these  pages  will 
be  perfectly  familiar  Avith  technical  terms  Avhich  might 
otherwise  seem  confusing. 

Epidemic. 

Tlie  term  Epidemic  is  applied  to  any  disease  which  at- 
taclcs  a  great  many  persons  in  a  locality  at  any  particular 
period  and  spreads  rapidly  in  every  direction,  although 
every  conceivable  effort  to  check  it  or  stamp  it  out  is 
resorted  to. 

The  popular  belief  prevails  among  the  laity  that  a 
disease  is  epidemic  when  the  deaths  from  any  cause  exceed 
those  from  all  other  diseases  occurring  simultaneously  in 
any  locality.  Such  is  not  the  case.  A  disease  may  be 
epidemic  Avithout  having  an  unusual  rate  of  mortality. 
This  was  illustrated  by  the  epidemic  of  jaundice  (some 
say  it  was  yellow  fever  in  its  mildest  form)  which  pre- 
vailed in  Ifotherham,  England,  in  1862.  There  were  over 
three  hundred  cases,  with  only  one  death.  And  yet  the 
disease  was  decidedly  epidemic. 


WISTORY     OF     VELLOW     FEVER. 

Endemic. 

A  diseiise  is  said  to  be  Endemic  when  it  is  permanently 
established  or  is  ordinarily  i>revalent  in  a  locality,  and 
dependent  on  local  conditions. 

Sporadic. 

Sporadic  means  that  a  disease  manifests  itself  by  the 
occurence  of  scattered  or  isolated  cases,  cropping-  out  here 
and  there,  at  irregular  intervals,  and  easily  amenable  to 
remedial  measures. 

FOMITES. 

The  word  Fomitcs  has  been  juggled  with  so  much  by 
non-medical  writers  and  by  physicians  who  ought  to  have 
known  better,  but  who  made  use  of  the  expression  in  a 
hap-haxard  way,  that  we  desire  to  call  special  attention 
to  its  true  etymology.  Fomitcs  is  the  plural  of  Fames, 
and  is  derived  fi'om  the  ]>atin  fomes,  meaning  touch-wood 
or  tinder,  or  something  which  spreads  quickly.  It  is  ap- 
plied to  any  substance  capable  of  absorbing,  retaining  and 
transmitting  contagicms  or  infectious  germs.  Such  things 
as  woolen  clotbes,  mos.s,  etc.,  are  decidedly  active  Fomites, 
but  it  is  impossible  for  wood,  stone,  iron,  cork,  books, 
newspapers  or  anything  which  does  not  retain  germs,  to 
propagate  them.  As  yellow  fever  can  only  be  transmitted 
by  a  certain  species  of  mosfpiito,  it  cannot,  under  any  con- 
dition whatsoever,  be  propagated  by  Fomites.  Even  if 
one  wears  the  gannents  of  a  person  who  has  died  of  yellow 
fever,  he  can  never  contract  the  disease  and  will  never  be 
susceptilde  to  it,  uidess  he  is  bitten  by  a  female  Stcgomijia 
Fasciata  which  has  bitten  a  yellow  fever  sufferer  during 
the  first  three  days  of  the  attack. 

Tlie  only  di.sea.ses  believed  to  be  capable  of  l^eing  trans- 
mitte<l  by  Fomltcs  are  cholera,  typhoid  fever,  smallpox, 
scarlatina,  diphtheria,  tuberculosis,  measles  and  eruptive 
and  venereal  affections. 

I'rof.  Beyer  admirably  sums  up  the  question  in  the  New 


THINGS    EVERYBODY    OUGHT    TO    KNOW.  3 

Orleans  Harlequin  as  follows:^  "A  quarantine  against 
any  kind  of  freight  is  stupid.  It  is  as  silly  as  the  disin- 
fecting of  crude  carbolic  acid  and  pig-iron  which  occurre^l 
in  Galveston  during  the  last  fever  panic.  Only  the  house 
mosquito  conveys  the  disease.  You  can  take  a  thousand 
people,  all  ill  of  yellow  fever,  into  the  most  populous  city, 
and  if  there  are  no  mosquitoes  in  that  city  not  one  case 
will  develop.  ^Vith  those  thousand  cases,  the  disease  will 
end.  *  *  *  The  genius  of  the  world  cannot  take  any 
ai'ticle  of  freight  and  make  it  the  transmitting  agent  of 
the  disease." 

Further  comment  is  unnecessary.  In  conclusion,  we 
echo  Prof.  Beyer's  sentiment,  that  this  fact  should  be 
driven  home  to  the  iutelligeuce  of  every  communit}^ 

The  Diffekence  Between   Infection  and  Contagion. 

JnfcctioKs.  The  pathological  definition  of  Infectious  is 
a  disease  capable  of  being  communicated  by  contact,  or 
through  the  medium  of  air,  water  or  fomites. 

Contagious.    Transmissible  b^^  contact. 

Infection  is  frequently  confounded  with  Contagion,  not 
only  by  the  laity,  but  even  by  medical  men.  The  best 
usage  no^^'  limits  Contagion  to  diseases  that  are  trans- 
mitted by  contact  with  the  diseased  person,  either  directly 
by  touch  or  indirectly  by  use  of  the  same  articles,  by 
breath,  or  by  eating  or  drinking  after  a  diseased  person. 
Infection,  is  applied  to  diseases  produced  by  no  known  or 
definite  influence  of  one  person  upon  another,  but  where 
common  climatic,  malarious  or  other  widespread  condi- 
tions are  believed  to  be  chiefly  instrumental  in  their  dis- 
semination. 

Yellow  fever  is  neither  contagious  nor  infectious.  There 
ai'e  only  two  ways  in  which  it  can  be  transmitted : 

1.  By  the  bite  of  the  female  mosquito  of  the  genus 
Stegomgia  Fasciata,  which  has  previously  fed  upon  the 
blood  of  a  person  suffering  from  yellow  fever  during  the 
first  three  days  of  the  attack. 

2.  By  inoculation  with  the  blood    of   a   yellow    fever 

1  August  3,  1905. 


HISTORY    OF    YEI.I-OW    FtVER. 


sufferer  durininj  tlie  first  three  days  of  the  attack;  after  the 
third  day,  the  disease  cannot  possibly  be  conimnnicated. 

Pandemic. 

A  J'andcjnic  is  an  epidemic  which  atta,cks  the  whole  or 
a  greater  part  of  the  population  of  the  world.  ]  t  generally 
follows  the  routes  of  commerce,  but  has  been  known  to 
ignore  the  by-ways  of  travel  and  to  proceed  by  leaps  and 
bounds,  crossing  wastes  of  Avaters  and  covering  miles  and 
miles  of  territory  to  reach  a  certain  fated  spot,  without 
leaving  a  trace  of  its  influence  between  the  ]>oint  of  de- 
pai'ture  and  the  locality  it  was  destined  to  ravage. 

One  of  the  most  noteworthy  pandemic  waves  of  modern 
times  began  at  the  Cape  of  Good  Hope  in  1822  and  ended 
in  the  frigid  zone  seven  yiars  later,  after  luning  covered 
nearly  the  entire  globe.  Starting  at  the  Cape,  it  traveled 
along  the  southern  coast  of  jMadagascar  and  ]-eached  the 
Island  of  ^Mauritius,  in  the  Indian  Ocean,  in  1823.  It  was 
next  felt  in  Ceylon,  India  and  in  some  parts  of  Eastern 
Asia,  after  which  it  seems  to  have  "doubled  upon  its 
tracks,"  for  it  stopped  when  it  reached  China  and  travelled 
>\x^tward,  skirting  the  southern  coast  of  Asia  and  enter- 
ing tbe  ^Mediterranean  by  Avay  of  Asia  ■Minor,  in  the  fall 
of  1^21.  It  then  successively  invaded  ^Malta,  Cibraltar 
and  some  of  the  islands  off  tlie  west  coast  of  Afri(*a.  It 
next  sojourned  towards  the  north,  reaching  Great  Britain 
the  same  year.  0)»servers  have  recorded  tlu^  fact  that  dur- 
ing the  visitation  of  this  ])aiid(  iiiic,  tlie  admissions  into 
the  fever  hospitals  of  London,  Dublin,  (Jlasgow  and  Edin- 
burg  increased  to  an  abnormal  extent.  Tlie  wave  then 
crossed  the  Atlantic  and  was  felt  in  the  West  Indies  in 
the  Autumn  of  1824,  Avhere  it  caused  a  high  rate  (►f  nnu'tal- 
ity.  Its  influence  seems  to  have  lingwed  in  that  locality, 
for  in  1825,  Jamaica,  in  which  had  taken  place  the  preced- 
ing year  a  slight  advances  in  the  death  rate,  expe^rienced  a 
terrible  epidemic.  By  one  of  those  strange  and  unaccount- 
able vagaries  which  often  chiu-acterize  the  phenomena  of 
Nature,  New  Orleans  was  the  only  locality  in  the  United 
States  ^^I)ich  felt  the  influence  of  the  wave;  the  mortality, 


THINGS    EVERYBODY    OUGHT    TO    KNOW.  5 

hoAve\'ea',  Avas  not  very  great,  the  deaths  from  yellow  fever 
in  1824  aggregatino-  io8,  against  808  in  1822. 

Tlie  pandemic  then  jumped,  as  it  were,  from  the  Gulf 
of  Mexico  to  Canada,  where  it  caused  much  sickness  and 
mortality  in  1825,  especially  in  Nova  Scotia  and  the 
eastern  provinces.  The  wave  seems  tO'  have  been  loth  to 
leave  the  T^ritish  Isles,  for  its  baneful  influence  was  felt 
now  and  then  throughout  the  United  Kingdom  from  1825 
to  1828,  during  which  manifestations  the  death-rate  rose 
to  a  noteworthy  degree. 

This  remarkable  pandemic  finally  spent  itself  on  the 
frozen  shores  of  Iceland  in  1829,  leaving  in  its  wake 
throughout  the  island  a  series  of  epidemic  diseases,  in 
which  typhus  played  a  prominent  role. 

LaAN'son,  anIio  minutely  noted  the  occurrence  and  in- 
fluences of  pandemics,  says:- 

"These  waves  oecupy  about  two  years  in  passing  over 
a  given  station;  the  mortality  froiu  fever,  of  Axhatever  de- 
scription it  ma^^  be,  increases  during  their  passage, 
subsiding  again  as  they  move  onwards.  They  follow  each 
other  at  intervals  of  a  few  years,  and  may  be  traced  from 
the  Cape  of  Good  Hope,  where  tliey  first  iK^conie  sensible, 
to  Iceland.  Some  embrace  Ceyhm,  in  80^  E.  longitude, 
and  New  Orleans,  in  90^  W.  longitude,  or  nearly  half  the 
circumference  of  the  earth.  Were  information  for  other 
places  aA'ailable,  no  doubt  their  passage  might  be  demon- 
strated still  more  extensive]}'." 
xVgain  :^ 

"The  occurrences  in  the  ]Medi terra nean  in  1828  are 
extremely  int/ resting  and  im]iorlaut.  There,  under  the 
same  pandemic  wave,  while  yellow  fever  was  causing  such 
mortality  at  Gibraltar  as  to  induce  many  to  think  it  an 
imported  disease,  the  remittent  fever,  the  undoubted  pro- 
duct of  (he  locality,  was  causing  a  mncli  higlier  one  at 
Santa  ]\faura,  and  other  forms  of  i'ebrib'  disease — petechial 
typhus  at  Naples,  and  plague  in  Albania^ — were  prevailing 
on  either  side  the  latter.    It  must,  therefore,  be  concluded 

-Lawson:    Trans.   Epidemiological   Society  of  London.   Vol   '^. 

1862. 
''  Ibid. 


HISTORY    OF    YELLOW    FEVER. 


that  tlioiijrh  the  pandemic  cause  determines  the  occurrence 
of  febi'ih^  disease  in  places  over  whicli  it  passes,  the 
peculi.'ir  form,  and  even  the  frequency,  of  the  disease  is 
determined  rather  by  the  circumstances,  whether  motfo  u- 
log-ical,  malarial,  livgienic,  or  social,  to  Avhich  each  popula- 
tion is  snhjectetl.  Tlie  same  local  circumstanci  s  may  exis^t 
in  other  years,  and,  so  far  as  can  be  estimated,  to  an  equal 
extent,  but  fevers  do  not  become  rife;  but  no  sooner  is  the 
pandemic  cause  added,  than  these  seem  to  acquire  a 
potency  which  is  almost  inexplicable." 

Quarantine. 

Quarantine  is  derived  from  the  Italian  word  quaruutUui. 
which  means  a  space  of  forty  days,  the  period  (originally 
forty  days)  during  wliicli  a  ship  liavinii'  a  contagious 
disease  on  boar<l,  or  coming  from  a  port  suspected  of 
being  infected  with  pestilential  disease,  is  forbidden  in- 
tercourse with  t.lie  place  at  which  she  arrives.  The  perio<l 
of  (|uarantiiie  in  this  country  is  generally  from  six  to 
twenty  days. 

Quarantine  is  practically  abolished  in  England  and  its 
dependeaicies.  If  there  is  (widence  or  suspicion  of  in- 
fectious disease  on  board  a  vesvsel  arriving  in  a  British 
port,  the  customs  officers  report  the  occurrence  to  the 
sanitary  autlKirities  of  the  port,  whose  decision  in  such 
matters  is  final. 

In  the  United  States,  by  act  of  CongTess  passed  in  1888, 
national  «puuantine  stations  were  establislu d.  This 
statute  makes  it  a  misdemeanor,  i)uuisliab]e  by  fine  or  im- 
prisonment, or  both,  for  the  master,  pilot  or  owner  of  any 
vessel  entering  a  port  of  the  TTnited  States,  without  first 
presenting  a  clean  bill  of  health. 

Pratique  is  pi^rmission  given  to  a  vessel  to  unload  with- 
out hindrance  from  quarantine   laws.      To   do   this,    the  5 
vessel  must  lu-esent  a  cbvin  bill  of  health.                                                h 

A  compi'chensive  history  of  (piai-antine,  from  its  earliest  | 

enforcement  to  the  present  day,  will    be    found    in    the  >% 

medical  part  of  this  volume.  '% 


CHAPTER  II. 

THE  RAVAGES  OF  PESTILENTIAL  DISEASE. 

The  Peculiar  Pranks  of  Epidemics. — Ancient  Notions  about  the 
Origin  of  Pestilences. — Full  Text  of  the  Extraordinary  Document 
Promulgated  by  the  College  of  Physicians  of  Paris  in  1665. — An  Out- 
line of  the  Appalling  Mortality  caused  by  Pandemics  in  Ancient  and 
Medieval  Times. — The  Great  Plagues  of  London. 

The  Peculiar  Pranks  of  Epidemics. 

Fortiinatelj  for  the  human  race,  it  is  seldom  that  two 
diseases  are  epidemic  at  the  same  time  in  the  same  locality. 
"When  yellow  fever  raged  with  such  violence  at  Gibraltar 
in  1S04,  it  was  remarked  that  all  other  diseases  declined ; 
and  ^^'ell  they  might,  for  in  that  great  epidemic,  out  of  a 
civil  population  of  14,000,  only  28  escaped  an  attack. 

A  similar  retreat  of  inferior  diseases  has  been  observed 
to  take  place  dui'ing  the  prevalence  of  the  plague  in 
London,  Holland  and  Germany,  according  to  histories  of 
that  disease  by  Sydenham,  Diemerbrock,  Sennertus  and 
Hildamus. 

A  modern  instance  of  the  malignity  of  yellow  fever  took 
place  at  V»^oodvi]le,  Miss.,  in  1844.  When  the  fever  broke 
out,  all  those  who  could  get  away  fled,  and  out  of  a  total 
remaining  population  of  500  some  495  were  attacked  by 
the  fever. 

There  have  been  notable  exceptions  to  the  rule  that  only 
one  epidemic  can  rage  at  the  same  time. 

In  1830,  both  smallpox  and  measles  were  epidemic  in 
England  and  Wales. 

Smallpox  and  scarlet  fever  were  both  epidemic  in  New 
York  in  1840,  1841,  1842  and  1843;  and  in  1840  and  1841, 
measles  was  also  epidemic,  so  that  the  three  diseases  were 
epidemic  at  the  same  time  in  the  last  mentioned  years. 

In  the  year  1802,  Charleston,  S.  C,  was  affected  with 
four  epidemics — smallpox,  measles^  yellow  fever  and 
influenza. 

It  A^'as  a  common  oecurrence,  during  the  prevalence  of 
cholera  at  "New  Orleans  in  the  autumn    of    1832,    for   a 


O  HISTORY    OF    YKLLOW    FKVER. 

person  to  be  attacked  with  yellow  fever,  and  before,  or  as 
soon  as  the  febrile  excitement  ceased,  for  the  patient  to 
be  destroyed  by  the  cholera  in  its  most  marked  and  malig- 
nant form. 

The  cholera  Avhich  was  imported  to  New  Orleans  in 
186G  maintained  its  existence  throughont  the  yellow  fever 
epidemic  of  1807,  diminishing  in  its  intensity  as  the  fever 
advanced,  and  again  becoming  more  malignant  as  the 
fever  subsided.  Pint  it  was  never  entirely  absent.  In 
Xovemlte]*  of  that  year,  234  deaths  occurred  from  choleja 
and  103  from  yellow  fever;  in  December,  Avhen  the  fever 
had  almost  disappeared  the  mortalitv  from  cholera  was 
210. 

In  1853,  according  to  Fenner,^  there  was  a  remark- 
able series  of  epidemic  disease.  We  call  the  following 
from  his  report,  p.  1 :  "During  the  past  3'ear,-  two  of 
the  most  terrible  epidemic  diseases  that  ever  afflicted  man- 
kind have  prevailed,  to  a  greater  or  less  extent,  in  parts 
of  the  extensive  region  assigned  to  my  notice.^  I  mean 
cholera  and  yellow  fever.  Smallpox  has  also  appeared  in 
several  places;  and  other  epidemics,  such  as  measles, 
scarlatina  and  whooping  cough,  have  made  us  their  cus- 
tomary annual  visitations.'' 

^leasles  and  smallpox  were  also  epidemic  in  Philadel- 
phia in  1823  and  1824,  and  in  1835  and  1845,  smallpox, 
measles  and  scarlet  fever  were  all  epidemic. 

Measles  and  scarlet  fever  were  both  epidemic  in  Balti- 
more in  1837,  and  smallpox  and  scarlet  fever  in  1838,  and 
again  in  1845. 

In  1808,  smallpox,  cholera  and  yellow  fever  prevailed  in 
Cienfuegos,  Cuba. 

Other  instances  could  be  cited,  but  these  suffice  for  the 
purpose  in  view. 

Epidemic  diseases  seem  to  be  more  fatal  among  the  un- 
civilized than  the  civilized.     In  an  epidemic    of    rubeola 

Tenner:  Report  of  the  Epidemics  of  Louisiana,  Mississippi, 
Arkansas  and  Texas  in  the  Year  1853,  by  E.  D.  Fenner, 
1853. 

=  1S53. 

'  The  four  Slates  mentioned  in  above  title. 


THE    RAVAGES    OF    PESTrLKNTIAL    DISEASE.  9 

among  the  Crees  (a  tribe  of  North  American  Indians)  in 
the  summer  of  1846,  as  reported  by  Dr.  Smellie  in  the 
Monthly  Journal  of  Medical  Science  for  December,  1846, 
of  145  cases  treated  in  his  camp,  40  were  fatal. 

Smallpox  has  sometimes  swept  off  an  entire  tribe  of 
Indians,  as  A\'as  the  case  with  the  Mandans  (another  North 
American  tribe),  and  has  generally  proved  abnormally 
fatal  A\'hen  it  attacked  the  Ked  Ilace. 

It  has  been  obseived  by  Oregory*  that  epidemics  are 
usually  severe  when  they  first  appear  in  a  country  or  are 
reneAved  after  any  long  intervals  of  time.  AA'hen  cholera 
first  invaded  India  in  1817,  it  raged  with  an  intensity 
which  may  Imve  been  equalled,  but  never  has  been  sur- 
passed. When  smallpox  first  nmde  its  appearance  in 
America  (Mexico)  in  1518  and  gangrenous  sorethroat 
(diphtheria)  first  visited  Naples  in  1618,  America  in  1735 
and  London  in  1747,  the  ravages  of  each  disorder  were 
terrific.  It  seems,  tlien,  to  be  the  law  of  animal  economy 
that  the  susceptibility  to  any  morbid  poison  is  great  in 
proportion  as  it  has  been  little  accustomed  to  the  impres- 
sion. 

Ancient   Notions  about  the   Origin  of  Pestilential 

Disease. 

The  works  of  Hipocrates  contain  many  interesting  ob- 
servations upon  the  origin  and  nature  of  epidemics.  He 
states  that  disease,  in  general,  nmy  be  said  to  arise  either 
from  the  food  we  oat  or  the  air  we  breathe.  AMien,  tlu^re- 
fore,  a  disease  seizes  upon  a  multitude  of  persons  of  dif- 
ferent sexes,  ages  and  habits,  he  infers  that  it  must  arise 
from  the  latter  cause.''  In  his  first  book,  fourteen 
cases  of  disease  are  related,  and  in  the  beginning  of  the 
third  book,  tAvelve,  and  sixteen  in  the  end,  thus  making 
forty-t\\o  in  all.  It  is  worthy  of  remark  that  in  twenty- 
five  of  these  the  result  was  fatal.  There  is  every  reason 
tlien  to  suppose  that  they  Avere  selected  for  a  pur])ose,  but 
what  that  purpose  was  cannot  now  be  easily  deterndned. 

^Gregory:    A  Treatise  on  Eruptive  Fevers  (1851),  p.  35. 
^Paulus  Egineta  (Adams'  translation).  Vol.  1,  p.  274. 


10  HISTORY    OF    YELLOW    KEVER, 

Tlie  most  natural  result  ^vould  no  doubt  have  bten  to 
illustrate  the  dififerent  pestilential  diseases  which  are 
described  as  oecurriuj::  at  the  tiiue.^ 

(ialeu  also  attiibutes  the  orijiin  of  epidemics  to  the  stiite 
of  the  atmosphere,  but  holds  that  the  nature  of  the  country 
may  contribute.  Lucretius  accounts  for  the  prevalence  of 
epidemics  u[H)n  similar  principles,  and  Silius  Italicus 
refers  au  e])idemical  fever  to  the  same  cause. 

The  purifyiui;-  of  the  atmosi)here  as  a  means  of  prevent- 
inji'  or  limitini*'  the  spread  of  disease,  is  as  old  as  the  world 
itself.  It  is  reported  of  Hipi)Ocrates  that  he  changed  the 
morbific  state  of  the  atmosphere  of  Athens  by  kindlinjr 
fires.  I'lu larch  also  makes  mention  of  one  Acron,  of 
Athens,  a\  hen  the  great  plague  visited  that  city  at  the 
commencement  of  the  PeloponCvsiau  war,  and  attrilmtes  to 
him  the  advice  that  was  given  to  the  Athenians  to  kindle 
large  fires  throughout  the  streets,  Avith  the  view  of  purify- 
ing the  air,  which  is  the  same  plan  as  was  adopted  l)y  the 
priests  of  l"]gyj)t.' 

Pliny  also  speaks  of  fires  as  a  corrective  of  the  state  of 
the  atinos])here,  and  Herodotus  relates  that  fumigation 
with  aromatics  were  recommended  as  a  preventive  of  the 
plague.^ 

Odd  Beliefs  and  Practices  of  Supeustitious  Ages. 

The  ancients  attributed  t/)  their  gods  the  authorship 
of  ejtidemics,  and  under  this  Itclief,  religious  sacrifices 
were  made  to  appease  their  anger.  Terror-stricken  and 
demoralized,  they  abandoned  all  measures  calculated  to 
give  them  ]»r<>te(tion  and  rdicf  and  relied  solely  upon 
their  offerings  and  their  i)rayers  at  the  f(M)t  of  the  altar 
for  presei-vation.  Cai'dan  and  Valesco  de  Tarente  did 
not  fear  to  attribute  the  origin  of  disease  to  the  in- 
fluence of  certain  planets,  while  Xat.  Webster,  an  Ameri- 
can ])hysi(ia.n,  gives  also  iiion*  than  fifty  instances  of  the 
concurrence   of  an  e])idemic   with    some    comnujtion    of 

"Hippocrates   (Adams'  translation).  Vol.  1,  p.  342. 

•  Histoire  de  Medecine  (Leclerc),  Vol.  1,  p.  57. 

*  Paulus  Egineta,  Vol.  1,  p.  174. 


THE    RAVAGES    OF    PESTILENTIAL    DISEASE.  1  1 

nature,  such  as  earthquakes,  volcanic  eruptions  and  the 
appearance  of  comets.  Jackson,  Joubert  and  others,  have 
dwelt  upon  tJie  influence  of  tlie  moon  upon  epidemic 
disease;  and  during  the  plague  that  nearly  depopulated 
Paris  in  1580,  ^^'hen  forty  thousand  people  Avere  swept 
away,  the  sky  was  so  clear  and  serene,  that  the  stars  were 
looked  to  as  the  cause  which  could  no-t  be  found  in  the 
atmosphere.^ 

According  to  researches  made  by  Eager,^"  in  the 
earliest  period,  superstition  and  stellar  influence  took  the 
principal  place  in  the  confused  ideas  of  etiology.  Ill- 
ordei^ed  doctrines  led  to  all  sorts  of  irrational  practices. 
Among  the  Greeks,  in  the  rites  of  Esculapius,  the  sick 
wei'e  not  j)cj'mitted  to  enter  the  temples,  where  they  un- 
derwent tieatment,  without  first  being  purified  by  various 
baths,  frictions,  and  fumigations.  All  this  was  accom- 
panied by  ceremonies  similar  to  those  practiced  within 
the  temples,  namely,  nmgical  perfornmnces  autl  fervent 
prayers  recited  in  a  loud  voice,  often  with  musical  ac- 
companiment. As  an  accessory  to  the  purification  prelim- 
inary to  being  admitted,  the  ])atient  was  required  to  pass 
the  night  sti'etched  on  the  skin  of  a  sheep  that  had  been 
offered  as  a  sacrilice.  Here  he  was  ordered  to  eompose  his 
mind  for  sleep  and  await  the  arrival  of  the  physician. 
Throughout  these  ages  as  we^ll  as  in  more  recent  times  a 
fanciful  association  between  the  phenomena  of  the 
material  world  and  the  destinies  of  mankind  closeh* 
linked  the  doctrine  of  etiology  \\iih  astrology.  Th<i  per- 
sistent belief  of  learned  men  in  tin*  I'elatiou  of  stellai'  con- 
ditions to  epidemics  is  in  part  explained  by  the  fact  that 
astrologers  who  predicted  epidemics  wrought  charms 
against  the  impending  pesti](Mic(\  thus  saA'ing  their  credit, 
in  event  the  disaster  did  not  uiaterialize,  by  claiming  that 
it  had  been  averted  through  their  ettorts. 

These  primitive  views  of  the  origin  of  e|)idemics  did  not 
necessarily  place  the  cause  of  the  disease  outside  the  earth 
and  its  immediate  surroundings.      Winds,    thunder    and 

■'Chastant:    Observations  on  Yellow  Fever,  1879,  p.  5. 
'"Eager:      The    Early    History    of    Quarantine    (Yellow    Fever 
Bulletin  No.  12,  U.  S.  Treasury  Dept),  1903,  page  7. 


12  HISTORY    OK     YELLOW     FEVER. 

lightiiiiii>-,  fop;s,  and  even  meteors  were  blamed  for  caus- 
ing pestileuce,  and  the  Hii>ht  of  l)irds  and  injects  were 
supposed  to  be  dependent  plienomena. 

Xanaphanes,  five  hundred  or  six  hundred  years  before 
Clirist,  expounded  an  idea  that  the  sun  was  a  torch  and 
tJie  stars  candles  that  were  put  out  from  time  to  time. 
Accord iufj  to  his  notion,  which  was  seriously  accepted, 
the  stars  were  not  heavenly  l)odies  in  tJie  wider  sense,  but 
meteors  thrown  off  from  the  earth.  So  a  belief  in  stellar 
influence  did  not  carry  the  mind  (;utside  Avorldly  ranjies. 
For  this  reason  other  practices  than  prayc^rs  and  sacrifices 
were  believed  to  be  effective.  They  consisted  cliiefly  in 
efforts  to  dissijiate  the  meteors,  such  as  huiie  and  numer- 
ous fires,  and  to  avoid  meteoric  influence  by  confinement 
in  closed  or  oth.erwise  protected  places. 

"Durinii  the  pe^riod  under  consideration/'  concludes 
Dr.  Ea<ier,  "the  prom]»tiniis  of  superstition  were  para- 
mount and  the  epidemioloiiists  of  the  times  confined  them- 
selves ])rincipally  to  iuterpretini*-  the  sij^ns  of  the  heavens. 
jNIore  advanced  vieAvs  came  as  the  result  of  reasoning]:,  but 
the  path  of  discovery  by  experimental  science  was  not 
enterexl  upon  until  after  many  centuries." 

It  was  a  common  practice  amoni>-  the  Phenicians  to 
immolate  their  children  durini^-  the  ])revalence  of  epi- 
d(  lilies,  ho])infi  tliereby  to  a]>pease  the  anj^er  of  the  gods 
and  put  a  stop  to  the  pestilence. 

Plutarch  relates  the  manneM*  of  Esop's  death.  B.  C.  581. 
The  famous  fabulist  went  to  Delphi  with  a  great  quantity 
of  gold  and  silver  to  offer,  in  the  name  of  Cresus,  a  great 
sacrifice  to  Apollo,  and  to  give  each  inhabitant  a  con- 
siderable sum.  xV  quarrel  arose  l>et.ween  Eso])  and  the 
people  of  Del])hi,  occasioning  him  afterwards  to  send  back 
the  money  to  C'resus.  The  iK'ojjle  of  Del])lii  caused  him 
to  be  condemned  as  guilty  of  sacrilege,  and  to  be  thrown 
froui  the  loj)  of  a  rock.  The  god,  (tft'ended  by  this  action, 
punished  them  with  a  jjlague  and  famine,  so  that,  to  put 
an  end  to  these  e^ils,  the  terrorizeel  Delphians  offered  to 
make  reparation  to  any  of  the  i-elatives  of  Esop.  "At  the 
third  generation,-'  continues  Plutarch,  "a  man  presented 
himself  from  Samos.     The  Delphians  made  this  man  re- 


THE    RAVAGES    OF    PESTILENTIAL    DISEASE.  13 

paration  or  satisfaction,  and  thereby  delivered  themselves 
from  pestilence  and  famine  which  distressed  tliem."^^ 

Epidenjjc  disease  was  frequent  in  Greece  before  the 
Christian  Era,  The  Athenians  were  wont  to  make  annual 
sacrilices  to  Toxaris,  "the  foreign  physician,"  because 
their  city  liad  been  delivered  from  the  plague  by  his  means, 
or  rather  by  a  a\  oman  who  had  dreamed  that  Toxaris,  who 
dwelt  at  Atliens,  had  told  her  that  the  pestilence  would 
cease  if  they  ^^  ashed  the  streets  with  wine,  "which  they 
did,  and  the  plague  ceased  immediately." 

In  the  year  665  B.  C,  T'haletes,  the  Milesian,  is  reputed 
to  have  put  a  stop  to  an  epidemic  which  had  baffled  the 
skill  of  the  most  renowned  physicians  of  the  time,  by  the 
influence  of  music.  Had  Thah  tes  lived  in  the  present  age, 
he  would  uudouI)tedly  have  amassed  a  princely  fortune  by 
stating  what  particular  Diake  of  instrument  he  used.  Un- 
fortunately, history  is  silent  on  this  point. 

Tn  the  year  B.  C.  534,  a  terrible  plague  raged  at  Car- 
thage. The  devastation  was  so  great,  that  the  people  sac- 
rificed their  children  to  appease  the  gods. 

According  to  Xiebuhr,^-  the  eruption  of  Mount  Etna, 
which  took  jdace  in  the  81st.  Olympiad,  coincided  exactly 
with  the  ]iest Hence  which  devastated  Rome  about  that 
period.  The  same  authority  says  that  in  the  year  301, 
the  Northern  Lights  could  be  distinctly  seen  in  Italy  and 
were  •'•'eminently  connected  with  the  ferment  in  the  bowels 
of  the  earth."  in  the  year  2IJ0,  and  also  295,  the  firma- 
ment seemed  to  be  on  fire,  "broken  by  flashes  of  lightning; 
armies  and  tbe  tumults  of  battles  were  seen  in  the  sky  and 
Siounds  A>ere  heard  which  heightened  the  terror  of  this 
phenomenon.'- 

])r.  Howe  (quoting  Nicbuhr)  also  speaks  of  another 
phenomenon  which  is  said  t(^  have  occurred  iu  the  year 
295,  and  observes  that,  however  incredible  it  nmy  seem, 
"it  ought  not  to  be  rejected  as  an  idle  tale."  The  para- 
graph referred  to  reads  as  follows : 

^'irlowe:    Epidemic  Diseases,  186-5,  p.  21. 

'-Niebuhr:     Lectures  on   Roman   Historic    (Howe,   loc.   cit.,   p. 
So). 


!♦  HISTORY    OF    YEI^LOW    FEVER. 

"There  fell,  we  are  told,  a  shower  of  flakes  like  flesh, 
^^ilich  the  birds  devoured.  W'liat  remained  on  the  ground 
did  not  rot." 

No  explanation  is  made  of  this  alleged  phenomenon, 
except  in  meta])lu)r.s,  which,  when  carefully  sifted,  ex- 
plain nothing,  as  is  usually  the  case  with  metaphors. 

In  the  Year  of  Eome  300,  a  ])lan  was  adopted  to  cause 
the  cessation  of  the  plague  which  had  alHicted  Kome  350 
years  from  its  foundation.  The  Romans,  by  the  advice 
of  their  oracle,  sent  ten  deputies  to  Epidaurus,  a  town  in 
ancient  Greece,  in  the  Peloponesus,  celebrated  for  its 
magniflcent  temple  of  Esculapius.  The  delegation  was 
headed  by  (^uinctus  Ogulnius,  and  the  object  was  to  bring 
the  statue  of  Esculapius  to  Kome,  as  a  means  of  stopping 
the  ravages  of  the  pest.  On  tlunr  arrival  at  Ei)idaurus, 
and  A\hi]e  they  ^^'ere  admiring  the  statute  of  Esculapius 
for  its  extraordinary  size,  the  Uomans  perceived,  emerg- 
ing from  the  base  of  the  statue,  a  serpent.  This  unexpect- 
ed {ip])aritioi).  instead  of  causing  dread  and  consternation, 
\\as  regarded  as  a  good  omen  by  those  present  and  im- 
pressed upon  their  minds  feelings  of  awe  and  veneration. 
The  ser[ient  glided  through  the  cix)wd,  sped  swiftly 
through  the  streets  of  the  town — followed  by  the  populace 
— and  betook  itself  to  the  vessels  of  the  Romans  and  went 
straight  to  the.apai'tment  of  Ogulnius.  The  Romans  im- 
mediately erected  a  temple  to  Apollo,  and  the  pestilence 
ceased.^^ 

Ax  ExTItAORDINAKY  IIlSTOKICAL  DOCI'MENT. 

One  of  the  most  remarkable  theories  concerning  the 
origin  of  epidemic  disease  was  solemnly  promulgated  by 
the  Faculty  of  Paris  in  16G5,  to  account  for  the  ravages 
of  the  Black  Plague,  which  was  then  devastating  Europe. 
The  pestilence  commenced  in  December,  1004,  and  ended  in 
January,  1G(>0,  a  period  of  thirteen  months.  The  learned 
medical  men  of  France  assembled  at  Paris  in  June,  1665, 
in  order  to  discover  the  cause  of  the  epidemic  and  devise 

"Leclerc:    Histoire  de  Medecine. 


THE    RAVAGES    OF    PESTILENTIAL    DISEASE.  15 

sanitary  measures  to  arrest  its  progress.  After  much 
deliberation,  the  conchive  tinallj-  evolved  the  extraordin- 
ary document  copied  below,  whicli,  at  this  day,  would  be 
viewed  in  the  light  of  a  burlesque,  but  which  was  looked 
upon  as  an  oracular  pronuuciamento  by  the  superstitious 
people  of  the  time.  We  think  the  document  possesses 
&uch  an  element  of  quaintness  and  absurdity,  that  we  pub- 
lish it  in  full : 

"We,  the  Members  of  the  College  of  Physicians,  of 
Paris,  have,  after  mature  consideration  and  consultation 
on  the  present  mortality,  collected  the  advice  of  our  old 
inasters  in  the  art,  and  intend  to  make  known  the  cause 
of  this  pestilence,  more  clearly  than  could  be  done  ac- 
cording tp  the  rules  and  principles  of  astrology  and 
natural  sciences ;  we,  therefore,  declare  as  follows : 

"It  is  known  that  in  India,  and  the  vicinity  of  the  Great 
Sea^,  the  constellations  wliich  combated  the  rays  of  the  sun, 
and  the  warmth  of  the  heavenly  fire,  exerted  their  power 
especially  against  that  sea,  and  struggled  violently  with 
its  waters.  ( Hence,  vapours  often  originate  which  en- 
velope the  sun,  and  convert  his  light  into  darkness.) 
These  vapours  alternately  rose  and  fell  for  twenty-eight 
days;  but  at  last,  sun  and  fire  acted  so  powerfully  upon 
the  sea,  that  they  attracted  a  great  portion  of  it  to  them- 
selves,  and  the  waters  of  the  ocean  arose  in  the  form  of 
vapour;  thereby  the  waters  were,  in  some  part,  so  cor- 
rupted, that  tlie  fish  which  they  contained,  died.  These 
corrupted  waters,  however,  the  heat  of  the  sun  could  not 
consume;  neither  could  other  wholesome  water,  hail  or 
snow,  and  dew,  originate  therefrom.  On  the  contrary, 
this  vapour  spread  itself  through  the  air  in  many  places 
on  the  eartl),  and  enveloped  them  in  fog. 

"Such  was  the  case  all  over  Arabia ;  in  a  part  of  India ; 
in  Crete;  in  the  plains  and  valleys  of  ]Macedonia ;  in 
Hungary,  Albania  and  Sicily.  Slionld  the  same  thing 
occur  in  Sardinia,  not  a  man  will  be  left  alive;  and  the 
like  will  continue,  so  long  as  the  sun  remains  in  the  sign 
of  Leo,  on  all  the  islands  and  adjoining  countries  to  which 
this  corrupted  sea-wind  extends,  or  has  already  extendi^l 
from  India.     If  the  inhabitants   of   those   parts   do   nor 


16  HISTORY    OF    YELLOW    FEVER. 

employ  and  adhere  to  the  following,  or  similar  means  and 
precej)t«,  we  announce  to  them  inevitable  death,  except  the 
grace  of  Clirist  ])reserve  thc-ir  lives: 

"^\'e  are  of  opinion,  that  the  constellations,  with  the 
aid  of  Nature,  strive,  by  virtue  of  their  divine  might,  to 
protect  and  heal  the  human  race;  and  to  this  end,  in  union 
with  the  rays  of  the  sun,  acting  through  the  power  of 
fire,  endeavor  to  break  through  the  mist.  Accordingly, 
within  tlie  next  ten  days,  and  until  the  17th  of  this  ensuing 
month  of  July,  this  mist  will  be  converted  into  a  stinking 
deleterious  rain,  Avhereby  the  air  will  be  much  purified. 
Xow,  as  soon  as  the  rain  shall  announce  itself,  by  thunder, 
or  hail,  every  one  of  you  should  protect  himself  from  the 
air;  and,  as  well  before  as  after  the  rain,  kindle  a  large 
fire  of  vi]ie-\\-ood,  gTeen  laurel  or  other  gi'een  wood ;  worm- 
wood and  chamomile  should  also  be  burnt  in  great  quanti- 
ty' in  the  market  places,  in  other  densely  inhabited  locali- 
ties, and  in  the  houses.  lentil  the  earth  is  again  com- 
pletely dry,  and  for  three  days  afterwards,  no  one  ought 
Lo  go  abroad  in  the  fields.  During  this  time,  the  diet 
should  be  simple,  and  people  should  be  cautious  in  avoid- 
ing ex])osure  in  the  cool  of  the  evening,  at  night,  and  in 
the  morning.  ]*oultry,  and  water  foAvl,  young  pork,  old 
beef,  and  fat  meat,  in  general,  should  not  be  eaten;  but 
on  the  contrary,  meat  of  a  proper  age,  of  a  warm  and  dry, 
but  on  no  account  of  a  heating  and  exciting  nature.  Broth 
should  be  taken,  seasoned  Avith  ground  pepper,  ginger  and 
cloves,  especially  by  those  who  are  accustomcni  to  live 
temperately,  and  ai'e  yet  choice  in  their  diet.  Sleep  in  the 
day-time  is  detrimental ;  it  should  be  taken  at  night  until 
sunrise,  or  someA\hat  longer.  At  breakfast,  one  should 
drink  little;  supper  should  be  taken  an  hour  before  sun- 
set, when  more  may  be  drunk  than  in  the  morning.  Clear 
light  Avine,  mixed  with  a  fifth  or  a  sixth  part  of  water, 
should  be  used  as  a  l)everage.  Dried  or  fresh  fruits,  with 
wine,  are  not  injurious;  but  highly  so  without  it.  Beet 
root  or  other  vegetables,  whether  eaten  pickled  or  fresh, 
are  hurtful;  on  the  contrary  S]»icy  pot-herbs,  as  sage  and 
rosemary-,  or  wholesome.  Cold,  moist,  watery  food  is  in 
general  prejudicial.     Going  out  at  night,  and  even  until 


THE    RAVAGES    OF    PESTILENTIAL    DISEASE.  17 

three  o'clock  iu  the  moruiug",  is  dangerous,  on  account  of 
tlie  dew.  Only  small  river  fish  should  be  used.  Too  much 
exercise  is  hurtful.  The  body  should  be  kept  warmer 
than  usual,  and  thus  protected  from  moisture  and  cold. 
Bain  water  must  not  be  emplo^-ed  in  cooking,  and  every 
one  should  guard  against  exposure  to  wet  weather.  If  it 
rain,  a  little  fine  treacle  should  be  taken  after  dinner.  Fat 
peO'i)le  should  not  sit  in  the  sunshine.  Good  clear  wine 
should  be  selected  and  drunk  often,  but  in  small  quanti- 
ties, by  day.  Olive  oil  as  an  article  of  food  is  fatal. 
Equally  injurious  are  fasting  and  excessive  abstemious- 
ness, anxiety  of  mind,  anger,  and  immoderate  drinking. 
Young  people,  in  autumn  especially,  must  abstain  from  all 
these  things,  if  the,y  do  not  wish  to  run  a  risk  of  dying  of 
dysentery.  In  order  to  keep  the  body  properly  opened,  an 
enejna,  or  some  other  simple  means,  should  be  employed, 
wlien  necessary.  Bathing  is  injurious.  Men  must  pre- 
serve chastity  as  they  value  their  lives.  Everyone  should 
impress  this  on  his  recollection,  but  especially  those  who 
reside  on  the  coast,  or  upon  an  island  into  which  the 
noxious  wind  has  penetrated." 

Historic  ^Iortalities  Caused  by  Pestilence  in  Ancient 
AND  Medieval  Times. 

If  ^^•e  were  to  compute  the  total  mortality  from  pestilen- 
tial disease  from  the  earlist  times  to  the  present  day,  the 
figure  would  be  appalling  and  almost  beyond  credulity. 
Pandemics  have  played  havoc;  with  the  human  race.  At 
times,  half  the  population  of  the  world  was  swept  a,way 
before  an  epidemic  had  run  its  course;  it  spared  neither 
man  nor  beast,  but  surged  like  an  overcharged  torrent 
o^er  leagues  and  leagues  of  country,  overleaping  the 
highest  mountain  summits,  swirling  over  miles  of  desert 
laud,  crossing  rivers,  lakes  and  i  ven  seas,  and  finally,  like 
a  huge  beast  that  has  gorged  itst^lf  to  suffocation,  ceasing 
its  aA\  ful  carnage  for  want  of  new  material. 

We  shall  cite  only  the  most  notable  examples  of  gi-eat 
mortality. 


18 


HISTORY    OF    VILLOW    FEVER. 


The  greatest  inortalitv  caused  by  a  single  pestilence  took 
place  in  Egyiit  in  1792,  when  800,000  persons  are  reported 
to  liaA'e  perished. 

Tlie  next  greatest  mortality  on  record  occurred  in 
Naples  and  vicinity  in  1656,  where,  in  six  months,  400,000 
perished,  almost  depopulating  that  section  of  Italy. 

From  December,  1664,  to  January,  1666,  a  period  of 
thirteen  months,  the  "Great  Plague"  of  London  caused  a 
mortality  of  60,000. 

Even  "lionnie  Scotland"  comes  in  for  a  niche  in  the 
iinnals  of  ei)idemiology,  for  it  is  of  record  that  a  pestilence 
carried  off  40,000  of  liei'  sons  in  A.  D.  954. 

Let  us  now  take  a  peep  into  antiquity. 

In  the  1017  B.  C,  "David,  being  elated  with  success, 
God  sends  a  grievous  pestilence,  of  which  70,000  died  in 
less  than  tliree  days." 

In  594  B.  (\  a  third  of  the  inhabitants  of  Jerusalem 
peri  sliced  by  pestilence. 

In  480  B.  C,  while  the  army  of  Xerxes  was  retreating 
into  Asia,  after  the  battle  of  Salamis,  150,000  died  from 
jK'stileutial  disease. 

In  395  B.  C.,  a  terrible  plague  attacked  Ilimilco's  army, 
which  was  on  its  Avav  to  sack  and  destrov  S\Tacuse;  50,000 
died. 

In  878  B.  C,  according  to  Howe,^*  immediately  after 
the  arrival  of  the  troops  from  Italy,  Carthage  had  a  most 
terrible  calamity  to  struggle  with.  "The  plague  broke  out 
afresh  there  and  swept  away  an  infinite  number  of  in- 
habitajits.  1'his  seems  to  have  raged  with  gTeater  violence 
than  any  distemper  the  city  was  ever  visited  with  before, 
for  such  vast  multitudes  were  carried  off  b^-  it,  that  the 
counti'v  A\as,  in  a  manner,  de:i)(ti)ulated." 

In  B.  C.  188,  a  great  plague  raged  in  the  Greek  Islands, 
Egypt  and  Syria,  and  destroyed  2,000  persons  daily. 

In  the  reign  of  the  Echeopean  king,  ^licipsa  (B.  C.  125), 
according  to  Orosius,  a  great  part  of  Africa  was  covered 
with  locusts,  which  died  by  billions,  causing  a  plague, 
which  swej)t  away  an  incredible  number   of   people.      In 

"Howe,  loc.  cit,  p.  57. 


THE    RAVAGES    OF    PESTILENTIAL    DISEASE.  19 

Nuinidia  alone  perished.  800,000  persons,  and  in  Africa 
proper  200,000,  and  also  30,000  Roman  soldiers  quartered 
about  Utica.  x\t  Utica,  particularly,  the  mortality  raged 
to  such  a  degree  that  1500  dead  bodies  were  carried  out  by 
one  gate  in  one  day. 

In  B.  C.  22,  Ivome  was  about  depopulated  by  plague  and 
famine. 

In  A.  D.  77  and  78  a  most  appalling  pestilence  raged  in 
Southern  Europe;  10,000  persos  perished  daily. 

In  A.  I).  717  an  epidemic  carried  off  50,000  of  the 
inhabitants  of  the  then  known  world. 

In  the  Year  of  Eonie  066,  ''all  of  a  sudden  the  plague 
manifested  itself,  but  with  such  violence,  that  in  a  few 
days  it  carried  otf  eleven  thousand  men." 

In  the  year  of  Ivome  510,  during  the  siege  of  Syracuse 
by  Marcellus  (according  to  Catrou  and  Rouille,  Histoire 
Romaine,  vol.  8,  p.  152),  it  appears  that  Heaven  took 
pleasure  to  combine  all  the  scourges  of  its  anger  against 
unfortunate  Syracuse.  In  addition  to  other  calamities, 
a  pestilence  supervened  to  afflict  the  city.  At  first,  the 
contagion  commenced  in  the  country,  The  heat  of  the 
clinmte  and  the  season  had  corrupted  the  air,  and  the  filth 
which  the  sea  ordinarily  leaves  upon  the  shore  when  the 
waters  retire,  had  still  further  deteriorated  it.  The  two 
camps  of  Himilco  and  Crispiuusi  were  first  attacked.  Then 
the  malady  communicated  itself  to  the  army  of  Marcellus, 
from  the  inteixourse  with  that  of  Crispinus.  So(m  after 
Acredina  was  attacked  by  the  pestilence.  Thus  around 
the  city,  and  in  the  interior  of  it,  nothing  was  seen  but 
the  dead  and  dying.  From  the  fear  of  catching  the  infec- 
•  tion  by  approaching  the  dead  bodies,  they  a>  ere  left  with- 
out burial,  to  poison  the  place  where  they  lay  decompos- 
ing.    Hippocrates  and  Himilco  died  of  the  scourge. 

The  plague  which  broke  out  in  the  army  of  Sennacherib 
(B.  C.  709),  is  said  to  have  caused  a  mortality  of  185,- 
000.  This  was  regarded  by  the  Jews  as  a  punishment  of 
Divine  Providence,  meted  out  toi  Sennacherib  for  having 
invaded  Judea. 

During  the  plague  of  Rome  (A.  D.  256),  2,000  persons 
were  buried  daily. 

In  the  year  89  B.  C,  while  Pompeius,  a  Roman  general, 


20 


HISTORY    OF    YELLOW     FEVER. 


was  k'adiii;;  an  army  a<j;aiiist  Mariiis,  the  Carthagenian, 
a  i)la.«»ue  broke  out  among  tlio  soldiers,  which  carried 
away  11,000  men  in  a  few  days. 

J'l-oiii  A.  I>.  74(1  rai»ed  the  great  plagiie  of  Constanti- 
nople, which  destroyed  nt^arly  .*)00,()00  jjcople  in  that 
historic  city.  In  1011,  after  a  period  of  eight  hundred 
and  fifty-two  years,  occurred  the  second  "gTeat  plague" 
of  Constantinople,  when  200,000  persons  are  said  to  haye 
perished. 

In  A.  D.  772,  an  epidemic  carried  off  34,000  of  the  popu- 
lation of  Chichester,  England. 

In  1545,  the  "Trousse  (Talante"'  swept  away  10,000  of 
the  fciieign  population  of  Kcuilogne,  France.  The  fatali- 
ties among  the  uatiyes  could  not  be  ascertained. 

"In  1445,"  says  Sauyel,  "from  the  month  of  August  to 
St.  Andre's  Day    (Xoyember  30),   0,000  infants  died   in, 
Paris  from  smallpox."^"' 

The  "Black  I*lague"  of  the  fourteenth  century  was  one 
of  the  most  appalling  pestilences  which  swept  the  earth. 
In  the  space  of  four  years,  42,83(),48()  persons  died.  Asia, 
exclusiyc  <ff  (Miina,  lost  10,840,000.  China  alone  lost  13,- 
000,000  inhabitants.  In  Europe,  the  mortality  leached 
the  ap])alling  figure  of  18,910,480,  (lermany  alone  losing 
12,000,000  souls.i*^ 

In  1773,  Persia  was  deyastatcd  by  an  awful  ])estilence. 
In  the  City  of  Jiussorah  alone,  SO, 000  ])erislu(l. 

In  170'J,'  the  city  of  Fez,  Africa,  lost  247,000  of  her 
po])ulation  by  pestilence. 

in  17i)0,  3,000  ])crsous  died  daily  in  Pombay,  India. 

Th(*  f(ner  which  swept  oyer  the  Coromandel  Coast, 
In<lia,  in  1801),  1810  and  1811,  caused  the  loss  of  100,789 
out  of  a  j)o]»ulation  of  1,828,()10. 

The  rayag(\s  of  the  glandulas  jdagiie  wei-e  enormous.  In 
London,  in  1025,  it  carried  off  not  less  than  35,417  indi- 
viduals; at  Lyons,  in  ir»28-29,  in  a  i)oi>ulation  of  20(),000, 
it  is  reported' that  50,000  died;  at  :Mai-seilles,  in  1720,  the 
nuH'tiility  was  40,000;  at  Cyprus,  in  17(>0,  the  deaths  were 

"Sauvel:    Histolre  et  Recherches  des  Antiquitees  de  la  Ville 

de  Paris. 
"Ozanam:   Histoire  Medicale,  etc.,  des  Maladies  Epidemiques, 

1883,  vol.  4,  p.  8(;. 


THE     RAVAGES    OF     PESTILENTIAL     D.SEASE.  21 

70,000;  at  Aleppo,  17Gl-()2,  the  plague  carried  off  21,800 
and  in  1790-97,  in  the  same  city,  the  mortality  amounted 
to  00,000. 

In  1720-21,  in  the  space  of  seven  months,  60,000  persons 
died  of  the  plague  at  Marseilles,  France. 

The  Great  Plagues  of  London. 

London  shares  the  palm  with  Konie  for  having  been  the 
nidus  of  the  plague  from  nebulous  times.  As  early  as  207 
A.  D.,  when  Severus  invated  Britian,  50,000  of  his  soldiers 
perished  from  a  pestilence  which  was  then  ravaging  the 
island.  Not  counting  the  lesser  epidemics,  in  which  the 
mortality  amounted  ''only  to  a  few  thousands,"  the  follow- 
ing table  will  show  the  appal ing  havoc  wrought  by  pestil- 
ence in  London,  without  counting  the  balance  of  Britain, 
in  the  short  period  of  forty-four  years : 

Tabic  of  Deaths  from\iU  Diseases;  and  from  Pestilence  in 
London,  EnfjJand,  from  1592  to  1030. 

Year.                              Mortality  from  ^Mortality  from 

All  Diseases.  Plague  Alone. 

1592 25,886  11,503 

1603 37,294  30,561 

1625 51,758  35,403 

1630 10,545  1,317 

1636 23,359  10,400 


Total  mortalitv  during 

forty-four  years.  .  .  .  119,042  89,184 

It  is  thus  seen  that  out  of  a  total  mortality  of  119,042 
from  all  diseases,  the  ])lague  carried  off  89,184. 

In  December,  1664,  twt  nty-eight  years  after  the  terrible 
visitation  of  1636,  began  what  is  known  to  history  as  the 
"(iT-eat  Plague  of  London."  From  its  inception  to 
January,  166(),  a  i)eriod  of  (vuly  thirteen  months,  it  caused 
a  mortality  of  69,000.  Some  historians  place  the  figures 
as  high  as'  100,000. 

In  16(56,  also  occurred  the  "Great  Fire,"  A\hich  spread 
over  396  acres,  destroying  ovei-  13,2000  houses,  ninety 
churches  and  many  public  buildings. 


CHAPTER  III. 

THE  GREAT  EPIDEMICS  OF  THE  MIDDLE  AGES. 

The  Inguinal  Pestilence  of  the  Sixth  Century. — The  Black  Plague  ot 
the  Fourteenth  Century. — Le  Mai  des  Ardents. — The  Eruptive  Fevers 
of  the  Sixth  Century. — The  Sweating  Sickness. — Notable  Epidemics  of 
Scurvy. — Leprosy  and  its  Attendant  Horrors. 

THE  IXGUIXAL  PESTILENCE  OF  THE  SIXTH  CENTURY. 

(Up  to  the  year  1831,  when  the  "Fragments"  of  Ruff  us  were  published, 
the  prevailing  opinion  had  been  that  Procopius,  the  Greek  historian, 
was  the  first  to  give  a  description  of  the  Glandular  Plague  of  the  East. 
Even  after  the  publication  of  this  remarkable  work,  such  distinguished 
historians  as  Hecker,  Rosenbaum,  Fariset  and  Navman  still  gave  the 
honor  to  Procopius,  claiming  that  the  newly-discovered  manuscript 
was  spurious.  The  passage  referred  to  reads  as  follows:  "The 
buboes  called  pestilential  are  most  fatal  and  acute,  especially  those 
which  are  seen  occurring  about  Lybia,  Egypt  and  Syria,  and  which 
are  mentioned  by  Dionysius  Curtus.  Dioscorides  and  Posidonius  make 
much  mention  of  the  plague  which  occurred  in  their  time  in  Lybia; 
they  saw  it  was  accompanied  by  acute  fever,  pain  and  prostration  o£ 
the  whole  body,  delirium,  and  the  appearance  of  large  and  hard 
buboes,  which  did  not  suppurate,  not  only  in  the  accustomed  parts,  but 
also  in  the  groins  and  armpits."  According  to  Adams,  the  only  thing 
which  detracts  from  the  value  of  this  paragraph  is  the  difficulty  of 
determining  exactly  who  the  authorities  are  which  are  referred  to  in 
it.  Of  Dionysius  Surtus  nothing  is  known;  indeed,  it  is  more  than 
probable  that  there  is  some  mistake  in  the  name.  There  are  several 
medical  authors  by  the  name  of  Dioscorides  and  Posidomius,  and  it 
is  difficult  to  determine  to  which  of  them  reference  is  made.  Still, 
Adams  finds  no  reason  lor  questioning  the  authenticity  of  the  passage. 
Ruffus  flourished  in  the  reign  of  Trajan,  in  the  beginning  of  the 
second  Century.  The  graphic  description  of  this  terrible  pestilence 
and  other  epidemics  of  the  Middle  Ages,  has  been  abstracted  from  the 
masterly  translation  of  Dr.  Dupuy's  "Le  Moyen  Age  Medical,"  by  Dr. 
Thomas  C  Minor  of  Cincinnati  These  articles  were  originally  pub- 
lished in  the  Cicinnati  "Lancet  Clinic,"  of  which  Dr.  Minor  is  associate 
editor,  and  an  abstract  is  published  in  this  volume  by  special  permis 
sion. — G.  A.) 

In  the  sixth  centiirT  after  Christ,  occurred  the  terrible 
epidemic  known  by  the  name  of  the  ''Inj>ninal  Pestilence," 


THE    GREAT    EPIDEMICS    OF    THE    MIDDLE    AGES.  SS 

which,  after  ravaging  ^Constantinople  spread  into  Liguria, 
then  into  France  and  Spain. 

According  to  I'rocopius/  it  attacked  the  entire  earth, 
striking  every  race  of  people,  sparing  neither  age  nor  sex ; 
differences  in  habitation,  diet,  temperament  or  occupa- 
tion of  any  nature  did  not  stop  its  ravages;  it  prevailed 
in  summer  and  in  winter — in  fact,  at  every  season  of  the 
yeai'. 

It  commenced  at  the  town  of  Pelusa,  in  Egypt,  whence 
it  spread  by  two  routes,  one  through  Alexandria  and  the 
rest  of  Eg^^pt,  the  other  through  Palestine.  After  this  it 
covered  the  whole  world,  progressing  always  by  regular 
intervals  of  time  and  force.  In  the  springtime  of  543  it 
broke  out  in  Constantinople  and  announced  itself  in  the 
following  manner : 

Many  victims  believed  they  saw  the  spirits  of  the  de- 
parted rehabilitated  in  human  form.  It  appeared  as 
though  these  spirits  appeared  before  the  subject  about  to 
be  attacked  and  struck  him  on  certain  portions  of  the 
body.  These  apparitions  heralded  the  onset  of  the  malady. 
The  commencement  of  the  disease  was  not  the  same  in  all 
cases.  Some  victims  did  not  see  the  apparitions,  but  only 
dreamed  of  them ;  but  all  believed  they  heard  a  ghostly 
voice  announcing  their  inscription  on  the  list  of  those 
who  were  going  to  die. 

The  fever  at  the  onset  of  the  attack  came  on  suddenly, 
— some  while  sleeping,  some  Avhile  waking,  some  while  at 
work.  Their  bodies  exhibited  no  change  of  color,  and  the 
temperature  was  not  very  high.  Some  indications  of  fewer 
were  perceptible,  but  no  signs  of  acute  inflammation.  In 
the  morning  and  at  night  the  fever  was  slight,  and  in- 
.dicated  nothing  severe  either  to  the    patient    or    to    the 

^  Procopius,  the  Greek  Historian,  born  at  Caesarea  in  the  year 
500,  left  behind  him  numerous  works,  among  which  may 
be  enumerated  L'Histoire  de  Son  Temps,  in  eight  volumes 
(Procopii  Caesariensis  .Historian  sui  temporibus).  This 
history  of  the  times  by  Procopius  gives  a  full  description 
of  the  plague,  and  is  one  of  the  chef  d'oeuyres  of  medical 
literature,  one  that  will  never  be  excelled.  In  this  work, 
nothing  being  omitted,  not  even  the  different  clinical 
forms,  it  is  truly  classical. 


24  HISTORY    OF    YELlOW    FEVER. 

])hysiciaii  who  eoiuitcMl  the  ]»nlso.  .Most  of  those  who 
l)reseutiHl  siicli  symptoius  showed  uo  iudicatioiis  of  ap- 
proachiii«»-  dissolution;  but  the  first  day  ainonj'-  some,  the 
second  day  in  others,  and  after  several  days  in  many 
cases,  a  bubo  was  observed  on  the  lower  portion  of  the 
alxlomen,  in  the  groin,  or  in  the  folds  of  the  axilla,  and 
sometimes  back  of  the  ears  or  on  the  thighs. 

Some  ])atients  were  plunged  into  a  condition  of  pro- 
found drowsiness;  others  were  victims  to  furious  delirium. 
Those  who  were  drowsy  remained  in  a.  passive  state,  seem- 
ing to  have  lost  all  memory  of  the  things  of  ordinary  life. 
If  they  had  any  one  to  nurse  them  they  took  food  when 
ottered  from  time  to  time,  and  if  they  had  no  care,  soon 
died  of  inanition.  The  delirious  ])atients,  deprived  of 
sleep,  Avere  eternally  pursued  by  their  hallcinations;  they 
imagined  themselves  haunted  by  men  ready  to  slay  them, 
and  they  sought  flight  from  such  fancied  foes,  uttering 
dreadful  screams. 

A«  nothing  was  known  of  this  strange  disease,  certain 
physicians  tliought  its  origin  was  due  to  some  source  of 
evil  liidden  in  the  buboes,  and  they  accordingly  opened 
these  glandular  bodies.  The  dissection  of  the  bubo 
showed  sub-adjaqent  carbuncles,  whose  rapid  malignity 
brought  on  sudden  death  or  an  illness  of  but  few  days' 
duration.  In  some  instances  the  entire  body  was  covered 
by  black  spots  the  size  of  a  bean.  Such  unfortunates 
rarely  lived  a  day,  and  generally  expired  in  an  houl'. 
many  cases  died  suddenly,  vomiting  blood. 

As  to  treatment,  the  ett'ects  weic  variable,  following 
the  condition  of  the  victim.  Procopius  states  that,  as  a 
fact,  no  etticacious  remedies  were  discovered  that  could 
either  prevent  the  onset  of  the  disease  or  sliorten  its  dura- 
tion. The  victims  could  not  tell  why  they  were  attacked, 
nor  how  they  wei*e  cured. 

The  epidemic  at  C(mstantinople    lasted    four    months,  I 

three  months  of  which  time  it  raged  with  gTcat  violence.  * 

As  the  epidemic  progrosed   th(^  mortality  rate  increased  ( 

from  day  to  day,  until  it  reached  tlve  ])oint  of  5,(MK)  deaths  ? 

per  day,  and  on  several  occasions  ran  up  to  as  high  an  ^ 

10,000  deaths  in  the  twenty- four  hours.  ] 

Evagre,  the  scholastic,  ancither  (Ji'cek  historian  of  the  .    < 


THE    GREAT    El'IDEMICS    OF    THE    MIDDLE    AGES.  25 

sixth  centni\v,  recounts  in  lis  works  the  story  of  the 
phijiiie  at  Constantinople.  He  states  that  he  frecinently 
observed  that  persons  recoverin,ii  from  a  tirst  and  second 
attaek  subse<iuently  died  of  a  third  attack;  also  that 
persons  fiyin^i*  from  an  infected  locality  were  often  taken 
sick  after  many  days  of  an  incubating-  period,  fallinj;-  ill 
in  their  places  of  rcfu,i2,('  in  the  midst  of  populations,  free, 
up  to  that  time,  from  the  pestilence. 

In  following:  the  projiress  of  this  epidemic  from  the 
Orient  to  the  Occident,  it  was  noticed  that  it  always  com- 
menced at  the  sea-ports,  and  then  traveled  inland.  The 
disease  was  carried  much  more  easily  by  ships  than  it 
could  be  at  the  present  time,  inasmuch  as  there  were  no 
quarantines  and  no  pest  houses  for  isolatini*'  patients. 
It  entered  France  by  the  Mediterranean  Sea.  It  was  in 
549  that  the  plaj^ue  struck  Oaul.  ''During  this  time," 
says  (iregory  of  Tours,  "the  malady  known  as  the 
inguinal  disease  ravaged  many  sections;  the  province  of 
Artcs  was  cruelly  depctpulated."- 

This  illustrious  historian  wrote,  in  another  passage: 
"We  learned  this  year  that  the  town  of  Xarbonn(^  was 
devasted  by  the  groin  disease,  of  so  deadly  a  tyi)c  that 
when  one  was  atacked  he  generally  succumbed.  Felix, 
the  Bishop  of  Nantes,  was  stricken  down  and  ajipeared  to 
be  desperately  ill.  The  fever  having  ceased,  the  humor 
broke  out  on  his  limbs,  which  were  covered  with  ])ustulcs. 
It  was  after  the  application  of  a  plaster  covered  ^^•ith 
cantharides  that  his  limbs  rotted  off,  and  he  ceased  to  live 
in  the  seventieth  year  of  his  age. 

"Before  the  plague  reached  Auvergne  it  had  involved 
most  all  the  rest  of  the  country.  Here  the  epidemic  at- 
tacked the  people  in  5(;7,  and  so  great  was  the  mortality 
that  it  is  utterly  impossible  to  give  even  the  approximate 
number  of  deaths.  Po])ulations  perished  <ii  iiinssc.  On 
a  single  Sunday  morning  three  hundred  bodies  were 
counted  in  St.  Beter's  (Miapel,  at  Clermont,  awaiting 
funeral  service.  Death  came  sinhh^dy;  it  struck  the 
axilla  or  the  groin,  forming  a  sore  like  a  serpent  that  bit 


-Georgius  Florentinus  Gregorlus,  Historia  Franeorum,  de  417 
a  591  A.  D 


26  HISTORY    OK    YELLOW    FLYER. 

SO  cruelly  that  men  rendered  up  their  souls  to  God  on  the 
second  or  third  day  of  the  attack,  many  being-  so  violent 
as  to  lose  their  senses.  At  this  time  Lyons,  Bourges, 
Chalons,  and  Dijon  were  almost  depopulated  by  the 
pestilence." 

In  590,  the  towns  of  Avignon  and  Viviers  were  cruelly 
ravaged  by  the  Inguinal  Disease. 

The  i)lague  reached  Marseilles,  however,  in  587,  being 
carried  there  by  a  merchant  vessel  from  Spain,  which 
entered  the  port  as  a  center  of  infection.  Eight  persons 
who  bought  goods  from  this  trading  vessel,  and  who  all 
lived  in  the  same  house,  were  carried  off  by  this  i)lague. 
The  spark  of  the  epidemic  did  not  burn  very  rapidly  at 
first,  but  after  a  certain  time  the  smouldering  fire  of  the 
pest  burst  out  in  a  l)laze  that  almost  consumed  Marseilles. 

Bishop  Theodorus  isolated  himself  in  a  wing  of  the 
cloister  of  Saint  Victor,  with  a  small  number  of  persons, 
who  remained  with  him  during  the  plague,  and  in  the 
midst  of  their  general  desolation  'continued  to  implore 
Almighty  God  for  mercy,  with  fasting  until  the  end  of 
the  epidemic.  After  two  months  of  calm,  the  population 
of  the  city  commenced  to  drift  back,  but  the  plague  reap- 
peared anew  and  most  of  those  who  returned  died. 

Anglada,-^  who  derives  most  of  his  citations  from 
Gregory  of  Tours,  thinks  that  the  i)lague  that  devasted 
Strasbourg  in  51)1  was  only  the  same  inguinal  disease  that 
ravaged  Christendom.  He  cites,  in  suj^port  of  his  asser- 
tion, that  passage  from  the  historian-poet  Kleinlande, 
translated  by  Dr.  Boersch : 

"In  51)1  there  was  a  gi'eat  mortality  throughout  our 
'.MMiuti-y,  so  that  men  fell  down  dying  in  the  streets,  ex- 
l>iring  suddenly  in  their  houses,  or  even  at  business. 
When  a  person  sneezed  his  soul  was  apt  to  fly  the  body; 
hence  the  exi)rcssion  on  sneezing,  'Y/or/  hlrss  j/oh.'  And 
wh(^n  a  ])('rson  yawned  tliey  made  the  sign  of  the  cross  be- 
fore their  mouths.'' 

Such  are  the  documents  we  possess  on  the  great 
epidemic  of  Inguinal  Plague  of  the  fourth  century,  docu- 
ments furnished  l»y  historians,  to  whom  nu'dical  history 

'Anglada:   Etude  sur  les  Maladies  Eteintes    et    les    Maladies 
NouYelles. 


THE    GRKAT    EPIDEMICS    OF    THE    MIDDLE    AGES.  S7 

is  indebted,  and  not  from  medical  authors,  who  left  no 
records  of  the  pestilences  of  that  period. 

The  Black  Plague. 

The  Black  Plague  of  the  fourteenth  century  was  more 
destructive  even  than  the  bubonic  pest  of  the  sixth 
century,  and  all  other  epidemics  observed  up  to  the 
present  day.  In  the  space  of  four  years,  more  than 
twenty-five  millions  of  human  beings  perished — one-half 
the  population  of  the  Avorld. 

Like  all  other  pestilences,  the  Black  Plague  came  from 
the  Orient — from  India,  and,  perhaps,  from  China. 
Europe  was  invaded  from  East  to  West,  from  South  to 
North. 

After  Constantinople,  all  the  islands  and  shores  of  the 
Mediterranean  were  attacked,  and  successively  became  so 
many  foci  of  disease,  from  which  the  pestilence  radiated 
inland.  Constantinople  lost  two-thirds  of  its  population. 
Cyprus  and  Cairo  counted  15,000  deaths.  Florence  paid 
an  awful  tribute  to  the  disease,  so  great  being  the  mor- 
tality, that  the  epidemic  has  often  been  called  Peste  de 
Florence.  According  to  Boccacio,  100,000  persons  per- 
ished. Venice  lost  20,000  victims,  Naples  60,000,  Sicily 
53,000  and  Genoa  40,000.  In  Eome,  the  dead  were  innu- 
merable. 

In  Spain,  German}^,  England,  Poland  and  Russia,  the 
malady  was  as  fatal  as  in  Italy.  In  London  they  buried 
100,000  persons.  It  was  the  same  in  I'rance.  Avignon 
lost  150,000  citizens  in  seven  months,  among  whom 
(1318)  was  the  beautiful  Laura  de  Noves,  immortalized 
by  Petrarch.  At  Marseilles,  56,000  people  died  in  one 
month;  at  Montpellier,  three-quarters  of  the  population, 
including  all  the  physicians,  went  dcAvn  in  the  epidemic. 
Narbonne  had  30,000  deaths  and  Strasbourg  16,000  in  the 
first  year  of  the  outbreak. 

Paris  was  not  spared.  The  Chronique  de  *S'f.  Dviti.s  in- 
forms us  that,  "in  the  year  of  Grace  1318,  commenced  the 
aforesaid  mortality  in  the  Kealms  of  France,  the  same 
lasting  about  a  year  and  a  half,  increasing  more  and  more, 
until  Paris  lost  each  day  800    inhabitants ;    so   that   the 


28 


HISTORY    OF    YELLOW    FEVER. 


imiuber  who  died  there  amounted  to  more  thau  500,000, 
while  ill  the  town  of  St.  Denis  the  niiiiiher  readied  1(5,000." 

Aiuonu  the  victims  were  Jeanne  de  Konruojiiie,  wife  of 
rhilii>  VI;  Jeanne  II,  (jneeii  of  Navarre  and  lirandchild 
of  IMiilip  the  Beautiful.  In  Spain,  died  Alphonso  XL, 
of  (^astille. 

IIai)]»i]\'  for  tlie  human  race,  diirinji*  the  years  which 
followed  the  jihii-ue,  the  births  werc^  lireatly  in  excess  of 
the  deaths,  as  though  Nature  desired  to  repair  the  ravages 
wrought  by  the  pestilence. 

According  to  the  records  of  that  time,  many  i>ersons 
died  the  first  da^^  of  their  illness.  These  bad  cases  were 
announced  by  a  violent  fever,  with  headaehe,  vertigo, 
drowsiness,  incoherency  in  ideas,  and  loss  of  memory; 
the  tongue  aiul  palate  were  l>lack  and  browned,  exhaling 
an  almost  insupportable  fetidity.  Others  were  attacked 
by  violent  iiitiammation  of  the  lungs,  with  hemorrhage; 
also  gangrene,  which  manifested  itself  in  blaek  spots  all 
over  the  body;  if,  to  the  contrary,  the  Ixtdy  was  covered 
by  abscesses,  the  patients  seemed  to  have  some  ehance  for 
recovery. 

^Medicines  were  powerless,  all  r(Miiedies  seeming  to  be 
useless.  The  disease  attacked  rich  and  ]»<)or  indiscrimin- 
ately; it  overpowered  the  robust  .and  (l('l)ilitated ;  the 
young  and  the  old  were  its  victims.  On  the  tirst  symptom 
the  jiatients  fell  into  a  prof((und  melancholy  and  seemed 
to  abandon  all  hope  of  recovery.  Ths  moral  prostration 
aggravated  th(ir  i)hysical  condition,  and  mental  <lei>res- 
si<ui  hast(^ned  the  time  of  death.  The  f(^ar  of  contagion 
was  so  gTeat  tliat  but  few  ]iers(>ns  attended  the  sick. 

The  clei-gy,  eii<-<)Uraged  l>y  the  T*(»pe,  visited  the  bed- 
sides of  tlie  dying  who  b(M|ueathe(l  all  their  wealth  to  the 
Church.  The  ])lague  was  considered  on  all  sides  as  a  pun- 
ishment intlicted  by  (lod,  and  it  was  this  idea  that  in- 
duced armies  of  penitents  to  assemble  on  the  i)ublic  streets 
to  do  jtenance  for  their  sins.  Men  and  women  \\(  nt  half 
naked  along  the  highways,  tlagellatiiig  each  other  with 
whips,  and,  growing  desperate  with  the  fall  of  night,  they 
committed  scandalous  crimes.  In  certain  ])laces  the  Jews 
were  accused  of  l)eing  the  authors  of  the  plague  by  pois- 
oning the  wells;  hence    the    Hebrews     were     prosecuted. 


THE    GREAT    EIMDKMICS    OF    THE    MinDLK    AGES.  29 

sometimes  burned  alive  by  the  fanatical  seets  known  as 
Flaj»ellants,  Bej;ardes  and  Turlnpius,  who  Avere  eneonr- 
a<.;ed  in  their  acts  of  vioh'nce  by  the  priests,  notwithstand- 
ini^'  the  intervention  of  Clement  VI. 

riiysicians  were  not  only  convinced  of  the  cantagious 
nature  of  the  disease,  but  also  believed  that  it  could  be 
transmitted  by  look  and  word  of  mouth.  Sucli  doctors 
oblij^ed  their  patients  to  cover  their  eyes  and  mouth  with 
a  piece  of  cloth  whenever  the  priest  or  physician  visited 
the  bedside. 

Guillaume  de  ^lacliant,  ])oet  and  ralct  dc  cJuunhrc  of 
Philip  the  Beautiful,  mentions  this  fact  in  one  of  his 
poems : 

"They  did  not.  dare,  in  open  air 
To  even  speak  by  stealth, 
Lest  each  one's  breath  might  carry  death 
Bv  poisoning  the  other's  health." 

And,  in  the  preface  of  the  ''Decameron,"  Boccacio  re- 
umrks  in  his  turn  :  "Tlie  plajiue  communicated  direct,  as 
fire  to  cond)Ustible  matter.  Tliey  were  often  attacked 
from  simply  touching  the  sick;  indeed  it  was  not  even 
necessary  to  touch  them.  The  danjicr  was  the  same  when 
you  listened  to  their  words  (»r  even  if  they  ^azed  at  you." 

One  thinji;  is  certain — those  who  nursed  tlie  patients 
surely  contracted  the  disease. 

Ali  the  authcuities  of  the  Middle  Ai>es  concur  in  their 
statements  as  to  the  coutaiiious  nature  of  the  ])hiiiue. 
The  rules  and  rei>idati()us  enforced  ai^aiiist  the  alllicted 
were  barbarous  and  inhunuin.  "Persons  sick  and  well,  of 
one  family,  when  the  pest  developed,"  says  Black"*,  were 
held,  without  distinction,  in  close  confinement  in  their 
home,  while  on  the  house-door,  a  red  cross  was  traced, 
bearing  the  sad  and  desperate  epitaph: 

Dien,  aijez  pitic  iic  nous!* 

"No  one  was  permitted  to  leave  or  enter  the  pla.niie- 
stricken  house,  save  the  physician  and  nurse,  or  other 
persons  who  might  be  authorized  by  the  Gavernnuuit." 

'Black:     Histoiie  de  la  Medecine  et  da  la  Chirurgie. 
*  Lord,  have  mercy  on  us! 


30  HISTORY    OF    VEIXOW    FEVER. 

We  can  well  judge  of  the  terror  inspired  bv  the  pestil- 
ence by  the  precautions  which  the  physicians  who  attend- 
ed the  sick  took.  In  his  treatise  on  the  plajiue,  Mau«;et 
describes  the  costumes  worn  h\  those  who  approached  the 
bedsides  of  patients : 

"The  costumes  worn  Avere  of  Levant  morocco,  the  mask 
haviuii  ci-ystal  eyes  and  a  long-  nose  filled  with  subtle  per- 
fumes. The  nose  was  in  the  form  of  a  snout,  with  an 
openinij;'  on  each  side.  These  openings  served  as  respira- 
tory passages  and  were  well-filled  at  the  anterior  portion 
with  drugs,  so  that  at  each  breath  they  contained  a  medi- 
cated air.  Under  a  cloak,  the  doctor  also  wore  buskin 
made  of  morocco ;  closely-sewed  breeches  were  attached  to 
the  bottines  above  the  ankles;  the  shirt,  the  hat  and  the 
gloves  were  also  of  soft  morocco." 

Thus  accountered,  the  doctor  resembled  a  modern  diver 
clad  in  a  suit  of  leather. 

All  this  sounds  ridiculous  at  the  present  age,  but  it 
must  be  understood  that  the  great  epidemics  of  plague 
Avere  of  a  nature  to  terrify  ignorant  poi)ulati()us.  The  nar- 
ratives of  historians  (►f  that  epoch  show  them  to  be  im- 
bued with  the  superstitious  ideas  of  antiquity.  This  at- 
tack of  an  invisible  enemy,  whose  blows  fell  right  and  left, 
paralyzed  and  terrified  every  one.  "In  the  midst  of  this 
orgy  of  death,"  remarks  Anglada,  "the  thought  of  self- 
preservation  absorbed  every  other  sentiment.  Dominated 
l>y  this  selfish  instinct  the  human  mind  shamelessly  dis- 
played its  cowardice,  egotism  and  superstition.  Social 
ties  were  rudely  sundered,  the  att'ections  of  the  heart  laid 
aside.  The  sick  were  deserted  by  their  relatives;  all  flew 
with  horror  from  the  plague-breathing  air  and  contact 
with  the  dreadful  disease.  The  corpses  of  the  A'ictims  of 
the  epidemic,  abandoned  without  sepulture,  exhaled  a  hor- 
ribly putrid  odor,  and  became  the  starting  point  of  new 
infectious  centres.  The  worse  disorder  overthrew  all  con- 
ditions of  existence.  Human  passions  raged  uncontrolled ; 
the  voice  of  authority  Avas  no  longer  respected;  the  Avheels 
of  civilization  ceased  to  revohe.'' 

LE  MAL  DES  ARDENTS. 

Towards  the  end  of  the  tenth  century  a  ncAv  epidemic 
appeared  in  Europe,  the  ravages  of  which  spread  terror 


I 


THE    GREAT    EPIDEMICS    OK    THE    MIDDLE    AGES.  31 

among  the  people  of  the  Occident ;  this  disease  was  known 
by  the  name  of  Alal  des  Ardent s,  Sacred  Fire,  St.  An- 
thony's Fire,  St.  MarcelPs  Fire,  and  Hell  Fire. 

This  great  epidemic  of  the  Middle  Ages  is  considered 
by  many  modern  writers  as  one  of  the  forms  of  ergotism, 
notwithstanding  the  contrary  conclusions  arrived  at  by 
the  Commission  of  ITTO,  composed  of  such  men  as  Jussieu, 
Paulet,  Saillant,  and  Teissier,  who  were  ordered  to  report 
as  to  the  nature  of  the  disease  by  the  Ko^al  Societ3\  Ac- 
cording to  the  work  of  this  Commission  the  Mai  des  Ar- 
dent s  was  a  variety  of  plague,  Avith  buboes,  carbuncles 
and  ]3etechial  spots,  while  St.  Anthony's  lire  was  only 
gangrenous  ergotism.  This  is  a  remarkable  example  of 
the  confusion  into  which  scientific  facts  were  allowed  to 
fall  through  the  fault  of  careless  authors.  It  is  in  such 
instances  that  we  may  estimate  the  importance  of  history. 

We  find  in  the  ''Chronicles  of  Frodoard,''  in  the  year 
945^  the  following : 

"The  year  945,  in  the  history  of  Paris  and  its  numerous 
suburban  villages,  a  disease  called  Ignis  Phiya  attacked 
the  limbs  of  many  persons,  and  consumed  them  entirely, 
so  that  death  soon  finished  their  sufferings.  Some  few 
survived,  thanks  be  to  the  intercession  of  the  Saints;  and 
even  a  considerable  nund)er  were  cured  in  the  Church  of 
Notre  Dame  de  Paris.  Some  of  these,  believing  them- 
selves out  of  danger,  left  the  church;  but  the  fires  of  the 
plague  Avere  soon  relighted,  and  they  were  only  saved  by 
returning  to  Notre  Dame.^' 

Sauvel,  the  translator  of  Frodoard,  remarks  that  at  this 
epoch  the  Church  of  Notre  Dame  served  as  a  hospital  for 
the  sick  attacked  by  the  epidemic,  and  sometimes  con- 
tained as  high  as  six  hundred  patients. 

Another  historian  of  the  time  was  liaoul  Glaber,^  who 
mentions  that  "in  993  a  murderous  malady  ])revailed 
among  men.  This  was  a  sort  of  hidden  fire,  l<jnii^  Oc- 
cult us,  which  attacked  the  limbs  Jind  detached  them 
from  the  trunk  after    having    consumed     the     members. 

'The  "Chroniciue  de  Raoul  Glaber,"  Benedictine  of  Cluny. 
covers  the  period  between  the  year  900  and  1046.  It 
may  be  found  translated  in  the  collection  of  memoirs  on 
the  History  of  France  by  Guizot. 


32 


HISTORY    OF    YELLOW    FEVER. 


Amoiiii'  soino  the  devonriiic,'  eftVct  of  this  fire  took  place  in 
a  single  iiiiilit." 

"In  103J),"  coiitiinu's  (uiv  author,  "divine  Yenjieance 
aj^aiu  descended  on  the  hnnian  race  with  fearful  etfect 
and  destroyed  many  inhabitants  of  the  ^^'orld,  striking 
alike  the  ri<h  and  the  ])oor,  the  aristocrat  and  the  peasant. 
.Many  persons  lost  their  limbs  and  draiiged  themselves 
around  as  an  example  to  those  who  came  after  them." 

In  the  Clironicle  of  France,  from  the" commencement  of 
the  ^lonarch}^  up  to  102!),'^  the  monk  Adhenmr  speaks  of 
the  epidemic  in  the  foUowinj;-  terms:  "In  these  times  a 
pestilential  tire  {pcstilciitidi  i(/iii.s\  attacked  the  popula- 
tion of  Limousin;  an  infinite  number  of  persons  of  both 
sexes  were  consumed  by  an  invisible  fire."' 

^Michael  Felibien,  a  Benedictinee  friar  of  Saint  Maur, 
also  left  notes  on  the  epidemic  of  jianiirene.  He  states 
in  his  Hiatorjj  of  Furis:  "In  the  same  year,  1129,  Paris, 
as  the  rest  of  France,  was  afflicted  by  the  nialadie  des 
(irdciiis.  This  disease,  altliou,u,h  known  from  the  morality 
it  caused  in  the  years  1)45  and  lOll,  was  all  the  more  ter- 
rible inasmuch  as  it  ai)peared  to  have  no  remedy.  The 
mass  of  blood,  already  corrupted  by  internal  heat  which 
devoured  the  entire  body,  pushed  its  fluids  outwards  into 
tumors,  which  deucncM-ated  into  incurable  ulcers  and  thus 
killed  ofl"  thousands  of  i)eople." 

We  could  nmke  many  more  citations,  derived  from 
ancient  writers,  but  we  think  Ave  have  (pioted  enougjh  to 
prove  that  the  Mai  dr.s  Ardcnts  was  only  the  ])laiiue  con- 
founded with  the  sym])toms  known  as  iianiirenous  ergot- 
ism. Could  it  not  have  been  a  plague  of  a  gangrenous 
ty])v'f  We  cannot  positively  aifirm,  however,  that  it  had 
no  connection  with  poisoning  by  the  sidiacclia  developed 
in  grain,  pai-ticularly  on  rye.  Its  onset  was  smlden  and 
often  very  ra])idly  followed  by  a  fatal  termination. 

The  Eruptive  Fevers  of  the  Sixth  Century — Variola, 
Measles,  SeARL.rriNA. 


Before  the  sixth  century,    the   terrible   period     of    the 
plague,  one  never  heard    of   the   eruptive   fevers.      Small- 

"  Nouvelle  Bibliotheque  des  Manuscripts. 


THE    GREAT    EPiDKMICS    OF    THE    MIDDLE    AGES.  33 

pox,  measles  and  scarlet  fever  were  unknown  to  the  an- 
cients. Neither  Hippocrates  nor  Galen  nor  any  of  the 
Greek  physicians  who  practiced  in  Rome  make  mention 
of  these  diseases.  The  historians  and  poets  of  Greece  and 
Italy  who  have  written  largely  on  medical  subjects  remain 
mute  on  these  three  great  (piestious  in  pathology.  Some 
authors  have  endeavored  to  torture  texts  for  the  purpose 
of  throwing-  light  on  the  contagious  exanthemata,  but 
they  have  not  been  repaid  for  their  fresh  imagination.^ 
It  is  admitted  to-da^'  that  the  eruptive  fevers  are  compara- 
tively new  diseases,  which  made  their  appearance  in  the 
Middle  Ages. 

The  first  document  that  the  history  of  medicine  pos- 
sesses on  this  point  is  that  left  by  Marius,  Bishop  of 
Aventicum,  in  Switzerland,  who  says,  in  his  chronicle, 
''Ainio  570,  inorhus  validus  cum  profluvio  vciitris  ct  vari- 
ola, ItaJiam,  GaUkunque  cahle  affecit.''^ 

Ten  years  later,  Gregory  of  Tours  described  the  symp- 
toms of  the  new  disease  in  the  following  terms  :^ 

"The  fifth  year  of  the  reign  of  Childcbert,  580,  the  re- 
gion of  Auvergne  was  inundated  l)y  a  fiood  and  numerous 
weather  disasters,  which  were  followed  l)y  a  terrible  epi- 
demic that  invaded  the  whole  of  Gaul.  Those  attacked 
had  violent  fevers,  accompanied  by  vomiting,  great  pain 
in  the  neighborhood  of  the  kidneys,  and  a  heaviness  in 
the  head  and  neck,  flatter  rejected  by  tlie  stomach  looked 
yellowish  and  even  green,  many  deeming  this  to  be  some 
secret  poison.  The  peasants  called  the  pustules  corals.^*^ 
Sometimes,  after  the  application  of  cups  to  the  shoulders 

'  Satirical  writers  would  not  have  failed  to  have  spoken  of  the 
marlts  left  by  small-pox.  Such  authors  as  Martial,  who 
frequented  the  public  baths  in  order  to  write  up  the 
phs  sical  infirmities  of  his  fellow-townsmen,  to  the  end  of 
divulging  their  deformities  in  biting  epigram,  would  only 
have  been  too  happy  to  have  mocked  the  faces  of  con- 
temporaries marked  by  the  cicatrices  of  small-pox. 

'In  the  year  570,  a  violent  disease,  with  running  of  the  belly 
and  variola,  cruelly  afflicted  Italy  and  France. 

°  Gregorii  Turonensis,  Opera  Omnia,  Liber  V. 

"Latin  corallum,  which  signifies  heart,  lung,  intestines,  and  by 
extension  of  meaning,  the  interior  of  the  body. 


Si  HISTORY    OF     YKLIOW     FEVER. 

or  limbs,  blisters  were  raised,  wliieb,  when  br()keii,  gave 
issue  to  sanioiis  matter,  wliich  oftentimes  saved  tlie  pa- 
tient. DrinlvS  composed  of  simples  to  combat  the  effects 
of  the  poison  were  also  very  efilcacioiis. 

"This  disease,  wliich  commenced  in  the  month  of  Au- 
gust, attacked  .all  the  very  young  children  and  carried 
them  otf. 

''In  those  days  Chilperic  was  also  seriously  afllicted, 
and  as  the  King  commenced  to  convalesce  his  youngest 
sou  was  taken  with  the  malady,  and  when  his  extremity 
was  perceived  he  was  given  baptism.  Shortly  afterwards 
he  was  better,  and  his  eldest  })rother,  named  Chlodobert, 
was  attacked  in  his  turn.  They  ])laced  the  prince  in  a  lit- 
ter and  carried  him  to  Soissons,  in  the  chapel  of  Saint 
^fedard ;  there  he  was  placed  in  contact  Avith  the  good 
Saint's  tomb,  and  made  v(;ws  to  him  for  recovery,  but, 
very  weak  and  almost  without  breath,  he  rendered  his 
soul  to  God  in  the  middle  of  the  night. 

"•In  those  days,  Austi'echilde,  wife  of  King  Gontra,  also 
died  of  the  disease;  while  Xantin,  Count  of  Angouleme, 
succum1)ed  to  the  same  malady,  his  Iwdj  beconung  so 
black  that  it  appeared  as  though  calcined  charcoal." 

It  will  thus  be  seen  that  smallpox  came  from  the  Orient 
— tliat  etei'iial  centre  of  pestilence  and  curses.  From  the 
seventh  century,  the  Saracen  armies  spread  the  malady 
wherever  they  passed — in  Syria,  Egypt  and  Spain;  in 
th(  ir  turn,  the  ('rusriders,  in  returning  from  the  Holy 
Land,  bronght  the  disease  into  France,  England  and  Ger- 
many; from  these  foci  spread  the  great  epidemics  of  the 
twelfth  and  thirteenth  centuries,  after  which  smallpox  be- 
canu^  periodically  epidemic,  ajjpearing  and  disa])pearing 
withcut  causation,  but  always  destroying  myriads  of  vic- 
tims. 

"In  1445,"  says  Sauvel,  "from  the  month  of  August  to 
St.  Andre's  Day  ( November  .'*())  over  (5,000  infants  died 
in  I'aris  from  smallpox.""  The  ])hysi('ians  knew  neither 
tlie  nature  nor  the  ticatnient  of  the  disease. 

The  measles  was  tirst  noted  at  the    same    time   as    the 

='  Sauvel :     Histoire  et  Recherches  des  Antiquites  de  la  Vill^ 
de  Paris. 


THE    GREAT    EPIDEMICS    OF    THE    MIDDLE    AGES.  35 

small-pox,  niakiug-  its  first  appt^arauee  as  au  epidemic  in 
the  sixth  century. 

It  is  more  than  probable  that  the  measles  originated  in 
Eiiypt,  and,  accordini^-  to  Rorsieri,  it  had  snch  an  extension 
throughout  Western  Europe  that  there  were  but  few  per- 
sons who  had  not  suffered  attacks.  The  history  of 
measles,  however,  is  less  clearly  defined  than  that  of 
small-pox,  although  Anglada  says  that  it  figured  among 
the  spotted  diseases,  of  which  (Iregory  of  Tours  speaks. 
But  it  was  only  in  the  sixteenth  century  that  Prosper 
Martian  exactly  describes  the  disease. 

Says  jMartian,  "It  is  a  disease  of  a  special  type,  peculiar 
to  children.  It  commences  with  a  violent  fever,  folloAved, 
towards  the  third  day,  by  an  eruption  of  small  red  spots, 
which  become  elevated  by  degrees,  making  the  skin  feel 
rough  to  the  touch.  The  fever  lasts  until  the  fifth  day, 
and  when  it  has  ceased,  the  papules  commence  to  disap- 
pear." 

Measles  was  designated  in  the  ndddle  ages  under  the 
name  MorJtilli,  which  signified  a  petty  plague,  the  same 
that  Morbus  meant  a  special  ])lague.  It  is  then  fair  to 
l)resume  that  the  type  of  disease  was  no  more  sej-icus  than 
it  is  at  the  present  day. 

It  is  probable  that  the  measles  of  the  sixth  century  in- 
cluded at  the  same  time  small-pox,  measles  and  scarlet 
fever,  of  which  the  ancients  made  no  differential  diag- 
nosis. Anglada  affirms  the  co-existence  of  all  forms  of 
eruptiv6  fevers  and  gives  the  following  reasons : 

''The  contempoj-aneous  appeaiance  of  variola  and  rube- 
ola represents  the  first  manifestation  of  an  epidemic  con- 
stitution, resulting  from  a  collection  of  unknown  infiu- 
ences  as  to  their  nature,  but  manifest  by  their  effects. 
The  earth  was  thence  prepared  to  receive  scarlatina, 
and  it  soon  came  to  bear  its  baleful  fruits.  We  do  meet 
some  mention  of  scarlet  fever  in  the  writings  of  the  Ara- 
bian School,  but  it  is  merely  suspected  and  only  vaguely 
indicated.  But  when  we  remember  how  ditlicult  it  often 
is  to  diagnose  at  first  between  variola  and  measles,  we  are 
not  astonished  at  the  indecision  manifested  in  adding  an- 
other exanthematous  arCection  to  the  medical  incognito. 
It  was  only  after  innumerable   observations   and    the   ex- 


36  HISTORY    OF    VELI  OW    FEVER. 

perience  of  several  centuries  that  tlie  third  new  disease 
received  its  nosological  l)a})tisni.  There  is  nothing"  to 
prove  that  it  did  not  co-operate  Nvith  earlier  ei)ideinics  of 
variola  and  niheola,  remaining  undistinguished  as  to 
type,  however." 

What  clearly  proves  that  there  was  confusion  hetween 
the  various  fevers  of  exanthemata  is  that  Ingrassias  de- 
scribes scarlatina  in  1510,  under  the  name  of  rosallia,  add- 
ing, "Some  think  the  measles  and  rosaUia  are  the  same 
malady;  as  for  me,  I  have  "determined  their  ditferences  on 
many  occasions." 

These  facts  ajjpear  conclusive  enough  to  admit  that 
measles  and  scarlet  fever  are„  like  variola,  the  products 
of  the  epidemic  constitution  developed  during  the  sixth 
century,  as  contemporaries  of  the  bubonic  i)lague,  all  these 
maladies  representing,  the  medical  constitution  of  the 
first  centuries  of  the  Middle  Ages. 

The  Sweating  Sickness. 

The  name  of  l^iccdting  ^Sickness  was  given  to  the  great 
epidemic  of  fever  that  appeared  in  England  in  the 
fifteenth  century,  and  thence  extended  over  Continental 
Europe.  This  epidemic  broke  out  in  the  month  of  Septem- 
ber, 148(),  in  the  army  of  Henry  VII.,  encamped  in  Wales, 
and  soon  reached  London,  extending  over  the  liritish  Isles 
with  fi'ightful  ra])idity.  Its  a])])carance  was  alarming 
and  while  it  lasted,  which  was  only  a  month,  it  made 
a  considerable  number  of  victims.  "It  was  so  terrible 
and  so  acute  that  within  the  memory  of  man  none  had 
seen  its  like." 

This  ei)i<h'mic  ]ea])i)eared  in  England  in  1518,  1517,  and 
1551.  It  was  i)recede(l  by  very  moist  weather  and  violent 
winds.  The  mortality  was  great,  patients  often  dying  in 
the  s])ace  of  two  hours;  in  some  instances  half  the  ]»opula- 
tion  of  a  town  being  carried  off.  The  epidemic  of  1529 
was  surely  murderous;  King  Henry  VIII  was  attacked 
and  narrowly  escaped  death.  Although  flying  from  vil- 
lage to  village  the  nobility  of  England  i)aid  an  enornnms 
tribute  to  the  King  of  Terrors.  The  Ambassador  from 
France  to  London,  L.  du  Bellay,  writing  on  the  21st  of 


THE     GREAT    EPIDEMICS    OF    THE    MIDDLE     AGES.  37 

July,  1529,  remarks:  "The  day  I  visited  the  Bishop  of 
Canterbury  eiiihteen  of  the  household  died  in  a  few 
hours.  I  was  about  the  only  one  left  to  tell  the  tale,  and 
am  far  from  recovered  yet." 

This  same  year  the  sweatino-  sickness  spread  all  over 
Europe.  It  made  terrible  ravages  in  Holland,  (Termany, 
and  INslaud.  At  the  famous  synod  of  Luther  and 
Zwiugie,  held  at  Marburg,  the  Keformed  ministers  seized 
by  fear  of  death  prayed  for  relief  from  the  pestilence.  At 
Angusl)urg  in  three  months  eighteen  thousand  people  were 
attacked  and  fourteen  hundred  died. 

This  epidemic  did  not  extend  as  far  as  Paris,  but  it  de- 
veloped in  the  north  of  France  and  Belgium. 

Kernel,  physician  to  Henry  II.,  who  practiced  in  Paris, 
likewise  speaks  of  this  sudorific  sickness  in  one  of  his 
works. ^- 

It  prevailed  generally  in  summer  and  autumn,  especial- 
ly when  the  weather  was  moist  and  foggy.  Contrary  to 
what  is  seen  in  other  epidemics,  it  was  observed  that  the 
weak  and  poor  and  the  old  and  infants  were  not  attacked 
as  often  as  robust  persons  and  those  in  affluent  circum- 
stances. 

The  symptoms  noted  by  physicians,  such  as  Kaye  and 
Bacon,  may  be  classed  into  three  distinct  periods: 

1.  The  period  of  chill,  characterized  by  pains  and 
itching  in  the  limbs,  an  extraordinary  prostration  of  the 
physical  forces — a  tremulous,  shaky  period. 

2.  The  period  of  sweat,  pre<-e<led  by  a  burning  heat  all 
over  the  body  and  an  unciuenchable  feverish  thirst.  The 
patient  was  agitated,  dis<iuieted  by  terror  and  despair. 
]\[any  comidained  of  spasms  in  the  stouuich,  followed 
sometimes  by  nausea  and  vomiting,  suttocation  and  lum- 
bar pains,  headache,  with  palpitation  of  the  heart  and 
proecardial  anxiety.  This  period  was  announced  by  a 
high  delirium,  sometimes  muttering,  sometimes  bxpia- 
cious;  a  fetid  sweaty  odor,  irregular  ]>ulse,  coma,  and,  in 
the  last  named  condition,  death  always  occured. 

3.  The  duration  of  the  disease  was  most  frequently  but 
a  few  hours,  rarely  exceedingly  a  day,  whether  the  termin- 
ation was  favorable  or  fatal. 

'-  Ferneli :     Universa  Medico 


38  HISTORY    OF    YEI,I.OVV    FEVER. 

Convalescence  was  always  lonjj;-,  often  bcinii"  complicated 
by  diarrhoea  or  dropsy.  It  lias  been  remarked  in  this  con- 
nection that  the  malady  mioht  be  confounded  with  the 
miliary  sweat  observed  in  Picardy  and  central  France, 
but  in  the  lirst  named  disease  no  cutaneous  eruption  was 
observed.  Kernel  clearly  affirms  this  statement,  as  he 
says:  "In  this  affection  there  is  no  carbuncle,  bubo,  ex- 
anthema or  eczema,  Init  simply  a  hypersecretion  of 
sweat." 

Such  was  the  sweating  sickness  of  the  sixteenth  cen- 
tury, which  made  so  few  victims  in  France,  but  which  de- 
stroyed so  many  people  in  Enjjland  and  Germany.^^  The 
orijiin  of  this  disease  has  been  often  discussed,  and  also 
its  nature;  l)ut  all  theories  expounded  by  various  authors 
partake  of  the  doctrines  of  other  days  and  are  too  anti- 
quated to  be  revamped. 

The  Scurvy. 

It  has  been  supposed  by  many  that  Hippocrates  de- 
scribed scurvy  under  the  name  of  Enlarged  ^Splcvii,  an  af- 
fection attributed  to  the  use  of  sta<inaut  water  and  char- 
acterized by  tumefaction  of  the  j»ums,  foul  breath,  pale 
face,  and  ulceration  of  the  lower  limbs.  But  the  study  of 
the  Ilippocratic  passage  leads  us  to  think  that  these  symp- 
toms were  more  of  the  character  of  scrofula  than  of 
scurvy.  The  recital  by  Pliny  of  the  disease  of  the  Koman 
soldiers  while  on  an  expedition  to  Germany  seems  to  in- 
dicate scurvy,  which  Coelius  Aurelianus,  and  after  him 
tlie  Arabian  ]»hysicians,  claims  presented  only  a  slight 
analogy  to  that  atfecTion. 

Springer  thinks  that  we  maj'  find  the  first  traces  of 
scurvy  iu  tlu^  expedition  of  the  Normans  to  Wineland,  in 

'^According  to  the  Climatologist,  vol.  1,  p.  63,  1888,  the  "Sweat- 
ing Sickness"  appeared  in  epidemic  form  in  1887.  It 
broke  out  in  the  Department  of  Vienne,  Haute  Vienne, 
iu  March  of  that  year.  The  French  Government  prompt- 
ly sent  a  commission  of  prominent  sanitarions,  with  Prof. 
Brouardel  at  their  head,  into  the  infected  districts,  with 
power  to  take  measures  for  the  restriction  of  the  disease. 
Strict  isolation  and  disinfection  soon  brought  the  out- 
break to  an  end. — G.  A. 


THE    GREAT    EPIDEMICS     OK     THE     MIDDLE     AGES.  39 

the  first  years  of  the  eleventh  century.  In  admitting  that 
the  men  commanded  by  Eric  Thoisteiu  were  obliged  to 
winter  on  the  western  shores  of  Wineland  and  almost  all 
succombed  to  an  epidemic  malady  of  that  country,  proves 
that  it  was  nothini^  but  scurvy,  althoui>h  the  word's  only 
signification,  in  Danish,  is  ulceration  of  the  mouth. 

We  have,  besides,  another  document,  which  has  great 
authentic  value,  a  proof  transmitted  to  us  bv  our  earliest 
and  best  chronicler  of  the  Middle  Ages,  Joinville,  the 
friend  and  companion  of  Saint  Louis  in  liis  Crusade  into 
Palestine.  In  liis  memoirs  he  gives  a  very  succinct  re- 
cital of  the  epidemic  of  famine  and  scurvy  whicli  attacked 
the  French  ami}-  on  the  banks  of  the  Nile  in  1248,  just 
after  the  battles  of  Mausourah.^'^ 

The  relation  of  Joinville  leaves  no  doubt  as  to  the  na- 
ture of  the  epidemic  that  attacked  the  Crusaders.  He 
gives  a  minute  pen  picture  of  the  debility,  and  hem- 
orrhages, the  livid  ecchymosis  of  the  skin,  the  fungous 
tunu'faction  and  bleeding  of  the  gums,  which  character- 
ize the  disease  known  as  scurvy. 

According  to  the  writings  of  some  German  physicians 
of  the  fifteenth  century,  this  malady  was  endemic  in  the 
septentrional  portions  of  Europe  upon  the  shores  of  the 
Baltic  Sea.  In  Holland  numerous  ei)idemics  of  scurvy 
were  observed  among  the  lower  classes  of  the  population, 
coinciding  Avith  bad  conditions  of  public  hygiene,  such  as 
food  consisting  of  salt  and  smoked  meats,  dwellings  lo- 
cated on  marshy  ground,  cold  atmosi)heres  charged  with 
fogs,  etc. 

This  was  the  same  infection  that  attacked  our  colonies 
in  Canada,  but  at  that  time  we  had  no  knowledge  of  the 
therapeutic  indications  in  such  emei-gencies.  A  proof  of 
this  remarkable  observation  is  inscribed  on  the  registers 
of  Cartier  on  his  vessels  during  his  sojourn  in  Canada. ^^ 

Lkprosv. 

Leprosy  is  a  disease  originating  in  the  Orient;  Egypt 
and  Judea  were  formerly  the  principal  infected  centres. 

"Joinville:     Histoire  de  Saint  Louis. 

''Cartier.     Bref  Recit  et  Siiccincte  Narration  de  la  Navigation 
Faite  aux  Ysles  de  Canada.     Paris,  1545. 


40  HISTORY     OK     YELLOW     FEVER. 

It  was  tlie  ri'tiiin  of  an  expedition  to  Palestine,  under 
I'onipcy,  that  imported  tlie  malady  to  Italy.  In  tlie  first 
years  of  the  Christian  Era  it  is  mentioned  by  Celsns,  who 
advised  that  it  should  be  treated  by  sweating,  aided  by 
vapor  baths.  Some  years  later  Areteus  used  hellebore, 
snlidmr  baths,  and  the  flesh  of  vipers  taken  as  food,  a 
triatment  adopted  by  others,  as,  for  instance,  ^Musa  and 
Arthiiienes. 

In  the  second  century  tlie  disease  was  in  Gaul ;  Soranus 
treated   the   lepers  of   Acpiitaine,    who   were   numerous.^^ 

According  to  Velley,  lci)rosy  was  common  in  France  in 
the  middle  of  the  eighth  century,  when  Nicholas,  Abbot 
of  Corbeil,  constructed  a  leper  hospital,  which  was  never 
much  frecpiented  until  after  the  Crusades  of  the  eleventh 
and  fourteenth  centuries.  At  this  jjeriod  the  number  of 
lepers,  or  ladrcs,  a  name  given  to  the  unfortunates  in  re- 
membrance of  their  patron  saint,  St.  Lazarus,  became  so 
great  that  every  town  and  village  was  obliged  to  build  a 
le])er  h(»use  in  order  to  isolate  the  altiicted.  Under  Louis 
VIII.  there  were  2,000  of  these  hospitals;  later  the  num- 
ber of  such  asylums  reached  19,000. 

According  to  the  historians  of  this  time,  when  a  man 
was  suspected  to  be  a  leper  he  could  have  no  social  rela- 
tions without  making  full  declaration  as  to  what  the  real 
nature  of  his  complaint  might  be.  Without  this  precau- 
tion his  acts  were  void,  from  the  cai)itulary  of  Pepin, 
which  dissolved  all  marriage  contracts  with  lepers,  to  the 
law  of  Charlemagne,  that  forbade  their  associating  with 
healthy  persons.  The  fear  of  contagion  was  such  that  in 
places  where  no  leprosy  existed  they  built  small  houses 
for  any  one  who  might  be  attacked;  these  houses  were 
called  hordrs}''     A  gray  numtle,  a  hat   and    wallet,    were 

"Gregory  of  Tours  says  that  in  Paris  they  had  a  place  ol 
reluge,  where  they  cleaned  their  bodies  and  dressed 
their  sores 

"  They  designated  by  the  name  of  horde,  bordeau,  bordell, 
bordette,  bourde,  or  bourdeau,  a  small  house  or  cabin 
built  on  the  edge  of  town;  a  cabin  intended  to  contain 
lepers.  The  word  bordell,  a  house  of  ill-fame,  as  used 
even  in  modern  days,  takes  its  origin  from  horde,  an 
asyium  for  lepers 


1 


THE    GREAT    EPIDEMICS    OF    THE    MIDDLE    AGES.  41 

also  supplied  the  yictiiiis,  also  a  tartareUe,  a  species  of 
rattle,  or  a  small  bell,  with  wliieh  they  warned  all  passers 
near  not  to  approach.  The^-  also  had  a  cup  placed  on  the 
far  side  of  the  road,  in  which  all  persons  might  drop  alms 
without  iioing  near  the  lei)er. 

Leper  houses  were  enriched,  little  by  little,  by  the  liber- 
ality of  kings  and  nobles  and  the  people,  and  to  be  a 
leper  became  less  inhuman  and  horrible  than  at  the  be- 
ginning. 

After  entering  a  leper  house  the  victim  was  considered 
as  dead  under  the  civil  law,  and  in  order  to  make  the  pa- 
tients better  understand  their  position  the  clergy  accom- 
panied them  to  their  asylum,  the  same  as  to  their  funeral, 
throwing  the  cemetery  dust  on  them  while  saying:  "En- 
ter no  house  save  your  asylum.  AVhen  you  speak  to  an 
outsider,  stand  to  the  windward.  When  you  ask  alms, 
sound  your  rattle.  You  must  not  go  far  from  the  asylum 
without  your  leper's  robe.  You  must  drink  from  no  Avell 
or  spring  save  on  your  own  grounds.  You  must  pass  no 
I)lates  or  cups  without  first  putting  on  your  gloves.  You 
must  not  go  barefotted,  nor  walk  in  narrow  streets,  nor 
lean  against  walls,  trees,  or  doors,  nor  sleep  on  the  edge 
of  the  road,"  etc. 

When  dead  they  were  interred  in  the  lepers'  cemetery 
by  their  fellow-sulferers. 

It  is  true  that  each  time  that  sanitary  measures  were 
relaxed  by  the  authorities — such,  for  instance,  as  the  per- 
fect isolation  of  the  patients — an  increase  in  the  number 
of  lepers  was  noticeable,  AYhen  this  was  observed  the 
old-time  ordinances  were  enforced  again  with  vigor.  It 
was  thus  in  1371  the  Provost  of  Paris  issued  an  <'dict 
enjoining  the  lepers  to  leave  the  Capital  within  fifteen 
days,  under  heavy  corporal  and  pecuniary  jx-ualties;  and 
in  138.S,  all  lejjcrs  were  forbidden  to  enter  Paris  without 
special  permission;  in  1102  this  restriction  was  renewed, 
"under  penalty  of  being  taken  by  the  executioner  and  his 
deputies  and  d(  tained  for  a  month  on  a  diet  of  bread  and 
water,  and  afterwards  perjjetual  banisliment  from  the 
kingdom."  Finally,  in  Ai>ril,  1188,  it  was  announced  "all 
persons  attacked  by  tliat  abominable,  very  dangerous  and 
contagious  malady  known  as  leprosy,  must    leave    Paris 


42  HISTORY    OF    YELLOW    FEVER. 

before  Easter  and  retire  to  tlieir  li()si)itals  from  the  date 
of  issuance  of  this  edict,  under  penalty  of  imprisonment 
for  a  month  on  bread  and  water ;  and,  where  they  had 
]>i()pei-tv,  the  se(iuestrati(>n  of  tlieir  houses  and  jewels  and 
arbitrary  corporal  punishment;  it  was  permitted  them, 
however,  to  send  things  to  them  by  servants,  the  latter 
being'  in  health." 

AVe  can  understand  from  this  how  these  poor  wretches, 
at  different  epochs,  were  accused  of  horrible  criuies,  among 
other  things,  poisoning  rivers,  wells,  and  fountains.  As 
regards  this  accusation,  says  the  author  of  the  D'lsUon- 
tiairc  dcs  Mociirs  dcfs  Franaiis,  Philip  le  Long  burned  a 
certain  nund»er  of  these  poor  wretches  at  the  stake  aud 
confiscated  their  wealth,  giving  it  to  tlie  Oi-der  of  Malta 
and  St.  Lazare. 

A  minute  description  of  this  disease  will  be  found  in  the 
works  of  Barbarin.^^ 

The  i)hysicians  of  leper  hospitals  have  left  hebind  a 
great  number  of  medical  documents  bearing  on  the  char- 
acteristics of  the  disease,  but  their  observations  are  so 
confused  that  we  can  only  c(tnclude  that  they  considered 
all  cutaneous  maladies  as  belonging  to  the  same  constitu- 
tional vice. 

In  1543,  leprosy  was  so  widespread  in  France,  as  to  be 
beyond  sanitary  contnd,  and  th(»  edict  of  Francois  I.,  re- 
establisliing  leper  hospitals,  auiountcd  to  nothing.  There 
were  too  nuiny  affected  people.  The  Hospital  of  Lour- 
cine,  which  was  si)ecially  devoted  to  these  cases  at  Paris, 
contained  000  patients  in  1540,  and  in  the  wards  of 
Trinity  Hospital  and  the  Hotel  Dieu  there  were  many 
more.  H  was  Ihe  sauie  iu  the  Pi-ovinces,  notably  at  Tou- 
louse, which  had  the  merit  of  creating  the  first  hosjiital 
of  its  kind  ever  instituted.  IMnally,  fifty  years  later,  in 
1000,  for  want  of  lepers,  the  leper  asylums  were  otficially 

'•^Etienne  Barbazin,  erudite  and  historian,  born  iu  1696,  author 
of  a  number  of  works  on  the  History  of  France:  "Recueil 
Alphabetique  de  Pieces  Historiques";  "Tableaux  et 
Contes  Francais,  des  XII.,  XIII.,  XIV.,  et  XV.,  Siecles"; 
"The  Orders  of  Chivalry,  etc."  He  also  left  numerous 
manuscripts  on  the  origin  of  the  French  language.  See 
"Bibliotheque  de  I'Arsenal." 


THE    GREAT    EPIDEMICS    OF    THE    MIDDLE    AGES.  4S 

closed.    Henry  IV.,  in  a  proclamation,  gave  those  remain- 
ing "to  poor  gentlemen  and  crippled  soldiers." 

Thus  ended  the  epidemic  of  leprosy  in  France,  which 
had  prevailed  from  the  second  century,  observing  the 
same  progress  in  other  countries  of  Western  Europe  dur- 
ing the  same  period  of  time. 


CIIAPTEJ{  IV. 

INSECTS  AS  PROPAGATORS  OF  DISEASE. 

How  Pestilence  is  Spread  by  Flies,  Mosquitoes,  Fleas  and  Other 
Insects. — Instances  Where  Disease  Was  Conveyed  by  Bed-Bugs  and 
Ants. — The  Role  played  by  the  Cattle-Tick  and  the  Tsetse-Fly. — Sum- 
mary of  the  Mosquito  Doctrine. — Bibliography. 

In  the  niedieal  part  of  this  vchiiuc  will  lie  found  a  de- 
taih^d  scientific  account  of  the  mosquito  tlieory.  For  the 
heneflt  of  the  lay  reader,  h(jwever,  who  is  either  too  busy 
to  digest  the  views  expressed  in  these  instructive  observa- 
tions, or  who  does  not  care  to  tussle  with  medical  phrase- 
ology, we  will  give  a  short  talk  regarding  the  role  played 
by  insects  in  the  propagation  of  disease. 

There  is  no  novelty  in  the  doctrine  of  insect  or  animal- 
cular  origin  of  disease.  Many  of  the  older  writers,  most 
cons])icuous  amongst  whom  are  Linnaeus,  Kircln^r  and 
Lyander,  have  pr(;mulgated  such  an  oijinion,  and  it  has 
been  vaguely  presented  to  the  notice  of  the  medical  pro- 
fession in  the  past;  but  it  was  not  until  after  the  publica- 
tion of  Ebrenberg's  great  work  on  Infusoria  (1S38)  that 
its  bearings  were  fully  appreciated. 

It  will  no  doubt  be  news  to  many  to  learn  that  the  mos- 
quito theory  of  the  transmission  of  yellow  fever  came 
very  nearly  being  expounded  over  half  a  century  ago.  Dr. 
Nctt,  of  .Mobile,  in  a  paper  published  in  1848,^  reviews  the 
situation  in  a  scholarly  manner  and  attributes  the  speci- 
fic cause  of  yellow  fever  to  "some  form  of  insect  life."  He 
does  not  mention  the  mos(|uito  as  the  active  agent  of 
transmission,  l»ut,  in  a  long  and  caiTfully-prei)ared  paper, 
dwells  upon  the  fact  that  "certain  insects"  are  capable  of 
transmitting  the  disease. 

Anwnig  other  things.  Dr.  Nott  makes  the  following  as- 
sertion ( loc.  cit.  p.  40),  which  certainly  is  prophetic  of 
the  theory  fathered  by  Dr.   I'inlay: 

"It  would  certainly  be  (juite  as  philosoi)hical  (as  the 
nmlarial  tlieory)  to  suppose  that  some  insect  or  an  animal- 
cule, hatched  in  the  lowlands,  like  the  mosquito,-  after 

*Nott:   New  Orleans  Medical  and  Surgical  Journal.  1848,  vol. 

4,  p.  563. 
-  The  emphasy  is  ours.     G.  A. 


INSECTS    AS    PROPAGATORS    OF    DISEAj^E.  45 

passing'  through  its  iiietainorphoses,  takes  tlight,  aud 
either  by  preference  for  a  different  atmosphere,  or  im- 
pelled b}^  one  of  those  extraordinary  instincts  which  many 
are  known  to  possess,  wings  its  way  to  the  hill  top  to  ful- 
fil its  appointed  destiny." 

Twenty-two  years  later  (1870),  Dr.  Nott  was  commis- 
sioned by  the  Board  of  Health  of  the  City  of  New  York  to 
prepare  and  present  to  the  Board  a  report  upon  the  out- 
break of  yellow  fever  at  Governor's  Island  that  year.  In 
an  elaborate  paper,  in  which  the  Doctor  touches  upon  the 
causes  of  the  outbreak  and  its  progress,  he  comments  at 
length  upon  the  insect  hypothesis.  The  following  extract 
from  Dr.  Nott's  paper  is  the  nearest  approach  to  the  pres- 
ent accepted  doctrine  of  transmission  we  have  yet  seen 
in  opinions  of  the  past:'^ 

"It  is  possible/'  ol)serves  Dr.  Nott,  "that  even  insects 
uia}'  exist  a  million  times  smaller  than  any  the  microscope 
has  yet  reached.  While  the  slow  and  steady  progression 
of  yellow  fever  from  a  point,  as  I  have  described  it,  should 
be  received  as  an  indisputable  fact,  on  the  other  hand  we 
confess  that  the  fact  is  at  present  inexplicable ;  it  must  be 
some  form  of  living  organism,  which  multiplies  and  ex- 
tends by  organic  laws.  If  in  insects  form,  it  is  easy  to 
understand  its  progress,  and,  if  a  fungus,  we  are  not  with- 
out examples  in  the  larger  fungi,  of  a  manner  of  progres- 
sion from  a  given  spot  more  rapid  than  that  of  yellow 
fever.  Moreover,  it  is  the  business  of  some  insects  to  dis- 
tribute certain  seeds  of  plants  far  and  wide;  to  carry  the 
pollen  of  one  plant  to  another  to  fructify  it;  and  it  may 
be  the  duty  of  others  to  disseminate  diseases.  It  is  well 
known,  on  the  authority  of  Murchison  and  others,  that 
the  nuilignant  pustule  is  taken  by  gnats  from  the  animal 
and  communicated  to  man  by  its  bite.  So  there  are  many 
ways  that  diseases  might  be  carried  and  communicated  by 
insects  or  fungi. 

"I  will  here  mention  a  fact  which  1  have  often  noticed 
myscdf  with  regard  to  mosquitoks/  but  have  never  seen  it 
alluded  to  by  others.     These  insects  are  so   abundant    in 

^Nott:     Annual  Report  of  the  Board  of  Health  of  the  Health 

Department  of  the  City  of  New  York,  1870,  p.  363. 
*  The  emphasy  is  ours.     G.  A. 


4G  HISTORY    OF     YELLOW     FEVER. 

:Mobile,  New  Orleans,  and  other  Southern  cities,  that  it  is 
iiii]»()ssible  to  sk'e])  at  nijiht  Avitlioiit  the  pr(;tectiou  of  mos- 
(luito  nets.  Fair-skinned  persons  from  more  northern 
climates,  and  particularly  .younji;  children  recently  intro- 
duced, sufTer  iireatly  from  tlie  hitfs  of  this  insect,  the  bites 
often  intiaminjj;,  and  even  makiiiu-  tedious,  troultksome 
sores;  Avhereas  the  children  of  parents  who  have  lived  a 
iicneration  or  two  in  the  climate  suffer  comparatively 
little;  they  seem  To  become  acclimatized  against  the 
jKvison  of  these  insects  as  they  do  against  the  poison  of 
yellow  fever.  On  rising  from  my  own  bed  in  the  morning 
I  have  many  times  seen  my  little  children  lying  in  a  trun- 
dle-l)ed  covered  l)y  mosquitoes,  after,  as  Mrs.  Jackson  said, 
'kicking  the  kivcr  off.'  The  insects  had  been  biting  at 
tliem  for  hours,  and  yet  by  br(ndvfast-time  every  mark  had 
disai)peartd.  Sucli  Y\ould  not  be  the  case  with  children  of 
fair-skinned  parents  recently  brought  into  the  clime. 
Some  Southern  children,  it  is  true,  are  more  -susceptible 
to  the  poison  of  mosquitoes  than  others,  and  so  it  is  with 
regard  to  susceptibility  to  yellow  fever." 

If  Dr.  Xott  had  simply  gone  a  little  further  and  directly 
accused  the  mosquito  of  being  the  active  agent  of  trans- 
mission, yellow  fever  would  have  been  eradicated  from  the 
American  Continent  years  ago  and  tlie  illustrious  Soutli- 
erner  would  have  occupied  a  place  in  the  annals  of  fame 
which  would  have  endured  for  all  time  to  come. 

Tiktine,  in  an  article  entitled  '^Contagion  through  the 
Intluence  of  Insects, ''•''  relates  facts  of  great  interest.  In 
a  review  of  this  paper  made  in  the  BnUctin  of  the  Pasteur 
Institute  for  April,  1897,  mention  is  made  of  an  epidemic 
of  rela])sing  fever  which  occurred  in  Odessa,  Ixussia, 
where  the  disease  is  almost  unknown.'"'  It  seems  that  a 
saib)r  who  came  from  Jaffa  was  suffering  from  this  mal- 
ady and  was  admitted. to  the  hospital.  A  week  later  an- 
other patient  was  admitted,  and  soon  after  a  tremendous 
epidemic  occurred,  which  affected  more  than  ten  thousand 
individuals.  !Most  of  these  were  sailors,  living  about  the 
harbor,  who  usually  applied  for   admission    after    a    de- 

'  Bulletin  Medical  (Paris),  February  3,  1S97. 
'This  disease  is  exceedingly  rare  in  the  United  States,  but  is 
quite  prevalent  in  Great  Britain. 


INSECTS    AS     PROPAGATORS    OF     DISEASE.  4? 

baiicli.  Dr.  Tiktiiie  weut  to  see  a  number  of  them,  aud 
was  struck  by  the  enormous  number  of  bed-bugs,  lice  and 
fleas  with  whicli  they  were  covered.  He  tlien  thoui»ht  tliat 
tlie  {'(nitaiiion  miiiht  liave  arisen  from  these  parasites 
g-oin<>-  from  one  individual  to  the  other.  One  of  these  in- 
sects, passing  from  a  sick  man  to  a  healthy  one,  might 
inoculate  the  latter  by  its  sting,  still  smeared  with  Wood, 
or  else  the  sleeper,  abrading  his  skin  by  scratcliing,  might 
become  infected  by  crushing  the  parasite,  full  of  septic 
blood,  over  the  sore  places. 

The  Doctor  collected  some  bed-bugs  and  allowed  them 
to  fast,  after  whicli  he  jdaced  them  upon  the  skin  of  pa- 
tients sutferinu'  from  an  attack  of  rela^jsing  fever.  Tliey 
raiiidlv  filled  themselves  with  blood  which,  upon  micro- 
scropic  examination,  was  found  to  contain  large  numbers 
of  spirilli  s^'U  in  motion.  He  was  able  to  show  that  tlieir 
A'italitv  persiKted,  witiun  the  insect,  for  more  than 
eiiihteen  In  urs.  Besides  this,  bed-bugs  were  fed  u])on  the 
blotkl  of  a  monkey  that  had  been  inoculated  with  s])iril- 
lun'i  fever.  They  were  then  placed  upon  a  healthy  monkey, 
and  the  latter  soon  had  a  characteristic  attack  of  the  dis- 
ease. 

"We  can  therefore  see  what  a  preponderating  place  is 
taken  by  insects  in  the  spreading  of  contagious  diseases," 
ccnchides  the  reviewer.  ''We  know  that  flies  often  carry 
about  the  bacilli  of  tuberculosis,  of  cholera,  of  puruhuit 
ophthalnua,  and  of  anthrax.  Finlay  of  Havana,  believes 
that  flies  are  the  principal  agents  in  the  dissemination  of 
yellow  fever,  and  Hammond  shares  this  view.  Texas 
fever,  according  to  Smith  and  Kilborne,  is  i)ropagated  by 
ticks  which  spread  about  a  h.Tmatozoa,  belonging,  like 
that  of  the  malarial  infection,  to  the  class  of  protozoa." 

Howard,  Avhcse  great  work  on  the  natural  life  of  the 
mos(iuito  is  a  standard,  thus  (Uscrilies  liow  typhoid  fever 
is  i)ro])agated  by  the  common  house-fly  :^ 

''The  princii)al  insect  agent  in  this  spread  is  the  com 
mon  house  fly  and  this  insect  is  especially  abuii<i:nit  in 
counti-y  houses  in  the  viciidty  of  stables  in  wliich  horses 
are  kept.    The  reason  for  this  is  that  the  preferred  food  of 

'Howard:      Farmers'   Bulletin  No.   155,  U.   S.   Department  o£ 
Agriculture,  1902,  p.  12. 


48  HISTORY    OF    YELLOW    FEVER. 

the  larvjp  of  house  flies  is  horse  manure.  House  flies 
breed  in  incredible  numbers  in  a  manure  pile  lari^ely  de- 
rived from  horses.  Twelve  hundred  house  flies,  and  per- 
haps more,  will  issue  from  a  pound  of  horse  manure.  Ten 
days  completes  a  generation  of  house  flies  in  the  summer. 
The  number  of  eggs  laid  by  each  female  fly  averages  120. 
Thus,  under  favorable  conditions,  the  offspring  of  a  single 
over-wintering  house  fly  may  in  the  course  of  a  summer 
reach  a  flgure  almost  beyond  belief.  With  an  uncared-for 
pile  of  horse  manure  in  the  vicinity  of  a  house,  therefore, 
flies  are  sure  to  swarm.  Their  number  practically  will 
be  limited  only  by  breeding  opportunities.  They  are  at- 
tracted to,  and  will  lay  their  eggs  in,  human  excrement. 
Under  favorable  conditions  thej'  will  breed,  to  some  ex- 
tent, in  this  excrement.  They  swarm  in  kitchens  and 
dining  rooms  where  food  supplies  are  exposed.  They  are 
found  commonly  in  box  privies,  which  sometimes  are  not 
distant  friuu  the  kitchens  and  dining  rooms.  Therefore, 
with  an  abundance  of  flies,  with  a  box  privy  near  by,  or 
with  excremental  desposit  in  the  neighborhood,  and  with 
a  ])erhai)S  unsuspected  or  not  yet  fully  developed  case  of 
typhoid  in  the  immediate  neighborhood,  there  is  no  reason 
why,  thrcHigli  the  agency  of  contaminated  flies  alighting 
upon  food  supplies,  the  disease  should  not  be  spread  to 
healthy  individuals.  That  it  is  so  spread  is  not  to  be 
questioned.  That  under  the  unusual  conditions  of  the 
aruiy  concentration  caui])S  in  the  summer  of  1S1)8  it  was 
so  spread  to  a  shocking  extent  has  been  deuionstrated  by 
the  army  typhoid  fever  commission.  And  the  remedy  is 
plain.  It  consists  of  two  courses  of  procedure :  (1)  Pro- 
per care  of  excereta;  (2)  the  destruction  of  flies." 

The  same  authority  says,^  that  while  in  malaria  and 
tyi)hoid  we  have  the  two  j»rincii)al  diseases  common  to  the 
United  States  which  may  be  conveyed  by  insects,  the 
agency  of  these  little  creatures  in  the  transfer  of  disease 
germs  is  much  more  widespread  in  warm  countries,  and  it 
is  by  no  means  conflned  to  human  beings.  In  Egypt  and 
in  the  Fiji  Islands  there  is  a  destructive  eye  disease  of 
human  beings  the  germs  of  which  are  carried  by  the  com- 

»Loc.  cit.,  p.  17. 


INSECTS    AS    PROPAGATORS    OF    DISEASE.  49 

mon  house  fly.  In  our  Southern  States  an  eye  disease 
known  as  piuk-eye  is  carried  by  certain  very  minute  flies 
of  the  genus  Hippelates.  In  certain  tropical  countries  a 
disease  known  as  filariasis,  whicli  somewhat  resembles  cer- 
tain forms  of  leprosy,  is  transferred  among  human  beings 
by  certain  mosquitoes.  There  is  good  reason  to  suppose 
that  the  germs  of  the  bubonic  plague  may  be  transferred 
from  sick  people  to  healthy  people  by  the  bites  of  fleas. 
The  so-called  Texas  fever  of  cattle  is  unquestionably 
transferred  by  the  common  cattle  tick  and  this  was  the 
earliest  of  the  clearly  demonstrated  cases  of  the  transfer 
of  disease  by  insects.  In  AJfrica  a  similar  disease  of  cattle 
is  trasferred  by  the  bite  of  the  famous  biting  fly  known  as 
the  tsetse  fl}'.  The  germs  of  the  disease  of  cattle  known  as 
anthrax  are  carried  by  gadflies,  or  horse  flies,  and  when 
these  flies  subsequently  bite  human  beings  malignant  pus- 
tules ma3'  result;  and  other  discoveries  of  this  nature  are 
constantly  beiiig  made.  Even  the  common  bedbug  is 
strongly  suspected  in  this  connection. 

Jellitte,  in  speaking  of  flies  as  carriers  of  disease,  gives 
the  following  example:'^ 

To  prove  that  flies  as  well  as  men  and  animals  were  able 
to  contract  the  plague,  a  certain  number  of  insects  were 
allowed  to  feed  on  the  crushed  organs  of  an  animal  that 
had  died  of  it,  while  an  equal  number  of  flies  were  fed 
on  similar  organs  of  a  healthy  animal.  In  several  repeti- 
tions of  this  experiment  all  the  infected  flies  were  dead  at 
the  end  of  six  or  seven  days,  while  nearly  all  the  other  flies 
were  alive.  All  the  dead  flies  had  the  living  germs  of  the 
plague  in  their  intestines.  In  plague  stricken  countries 
where  there  are  no  sewers,  no  garbage  laws,  and  no  sani- 
tation, where  dead  animals  lie  unburied,  where  families 
live  and  eat  and  sleep  in  tlie  same  room,  it  is  logical  to 
conclude  that  the  flies,  the  only  natural  scavengers,  should 
become  infected,  and  should,  in  the  few  days  that  elapse 
before  they  die,  infect  all  the  food  they  light  on. 

The  following  experiment  is  also  i-elated  by  Jeliffe: 

"Flies  are  not  the  only  insects  that  carry  the  plague. 
Ants  and  fleas  are  just  as  dangerous.     In  India,  when  a 

"Jeliffe:     Munsey's  Magazine,  1901,  Vol.  25,  p.  707. 


50  HISTORY    OF    YELLOW    P'EVER. 

rat  dies  of  the  pla.uue,  liis  body  is  pi'oiui)tly  eaten  by  ants. 
To  prove  that  the  insects  contract  the  infection,  an  experi- 
luenter  dipped  the  point  of  a  needle  in  their  excreta,  and 
witli  it  ])ricked  some  livin<>'  rats  and  mice,  whicli  he  kept 
carefully  in  cai^es.  They  in  turn  died  of  the  plajiue. 
That  such  a  slight  thing  as  a  pin  prick  is  enough  to  allow 
the  germs  to  enter  the  body  of  a  human  l)eing  is  shown  by 
the  case  of  the  two  Japanese  i)hysicians  who  scratched 
themselves  with  the  points  of  their  instruments  while 
nuiking  autopsies  on  plague  patients,  and  immediately 
took  the  disease.'' 

It  will  thus  be  seen  that  not  only  flies  and  mosquitoes, 
but  ''all  insects  that  bite"  should  be  looked  upon  with  sus- 
picion and  destroyed. 

The  earliest  reference  to  mosquitoes  in  connection  with 
yellow  fever  that  we  have  been  able  to  discover,  is^  made 
by  Benjamin  Rush  in  his  Medical  Incpiirics  and  Observa- 
tions, (Vol.  5,  p.  18),  edition  of  1T9S.  In  speaking  of  the 
yellow  fever  epidemic  at  rhiladeli)hia  in  1797,  he  says: 

"In  addition  to  the  register  of  the  weather,  it  may  not 
l)e  iui]u-op(r  to  add,  that  mos<|uitoes  were  more  uuuierous 
during  the  prevaleuce  of  the  fcAcr  than  in  1703.  An  un- 
usual number  of  ants  and  cockroaches  were  also  observed ; 
and  it  was  said  that  the  martins  and  swallows  disap- 
peared froui  the  city  and  its  neighb()i]i()(;(l."' 

The  presence  of  mosquitoes  during  the  prevalence  of 
y(^llow  fever  was  also  noted  by  an  early  writer.  Dr.  John 
Vauglian,^**  in  his  observations  on  the  ejjidemic  at  Wil- 
nungton,  Delaware,  in  1S02.  "Myriads  of  mosquitoes," 
says  this  wiiter,  "infested  the  lower  parts  of  the  town 
from  July  until  frost,  having  gradually  diffused  them- 
selves over  the  borough  in  September.'  The  eldest  of  our 
inhabitants  do  not  recollect  this  insect  being  so  trouble- 
some here  in  any  previous  season;  while  the  unanimous 
rci)ort  of  persons  from  the  fenny  counties  of  Kent  and 
Sussex,  the  annual  haunts  of  these  winged  pests,  Avas  that 
they  were  unusually  free  from  theui." 

It  is  also  worthy  of  note  that  the  fever  did  not  spread 
f 

"Vauglian:     Medical  Repository,  N.  Y.,  1803,  vol.  6,  p.  299. 


INSECTS    AS    PROPAGATORS    OF    DISEASE.  51 

to  Kent  and  Sussex  counties,  but  spent  all  its  virulence 
in  the  district  where  the  mosquito  was  more  abundant.^ ^ 

The  idea  that  yellow  fever  could  be  transmitted  by  mos- 
quitoes originated  with  Dr.  Carlos  Finla^',  of  Havana,  in 
1881.  The  doctor  noticed  a  correspondence  between  the 
abundance  of  mosquitoes  and  a  period  of  increase  of  yel- 
low fever  in  the  autumn,  while  during  the  summer  yellow 
fever  had  not  prevailed  to  any  extent  and  mosquitoes  had 
also  been  less  numerous.  This  set  the  doctor  to  thinking 
and  a  suspicion  lurked  in  his  mind  that  these  pestiferous 
insects  were  probably  responsible  for  the  spread  of  the 
dsease.  He  immediately  began  a  series  of  experiments, 
which  resulted  in  the  great  discovery  which  has  revcilu- 
tionized  the  antiquated  theories  concerning  the  propaga- 
tion of  yellow  fever  and  which  are  detailed  in  the  medical 
part  of  this  volume. 

We  will  end  this  summary'  by  giving  the  conclusions  of 
Keed,  Carroll  and  Agramonte,  taken  from  their  masterly 
essay  on  the  etiology  of  yelloAV  fever,  which  sums  up  the 
whole  situation  in  a  nutshell  '}^ 

1.  The  mosquito^ — C.  fasciatus — serves  as  the  inter- 
mediate host  for  the  parasite  of  yellow  fever. 

2.  Yellow  fever  is  transmitted  to  the  non-immune  in- 
dividual by  means  of  the  bite  of  the  mosquito  that  lias  pre- 
viously fed  on  the  blood  of  those  sick  with  this  disease. 

•  3.  An  interval  of  about  twelve  days  or  more  after  con- 
tamination appears  to  be  necessary  before  the  mosquito  is 
capable  of  conveying  the  infection. 

4.  The  bite  of  the  mosquito  at  an  earlier  period  after 
contamination  does  not  appear  to  confer  any  immunity 
against  a  subsequent  attack. 

5.  Yellow  fever  can  also  be  experinu^ntally  produced 
by  the  subcutaneous  injection  of  blood  taken  from  the 
general  circulation  during  the  first  and  second  days  of 
this  disease, 

6.  An  attack  of  yellow  fever,  produced  by  the  bite  of 
the  mosquito,  confers  immunity   against   the   subsequent 


"  See  Chapter  on  "Yellow  Fever  in  Maine,"  in  this  volufhe. 
'-  The    Etiology    of    Yellow    Fever,    By    Walter    Reed,    James 
Carroll  and  Aristides  Agramonte,  1901. 


52  HISTORY    OF    YELLOW    FEVER. 

iujection  of  the  blood  of  au  individual  suffering  from  the 
uon-experiniental  form  of  this  disease. 

7.  The  period  of  incubation  in  thirteen  cases  of  ex- 
perimental yellow  fever  has  varied  from  forty-one  hours 
to  five  days  and  seventeen  hours. 

8.  Yellow  fever  is  not  conveyed  by  fomites,  and  hence 
disinfection  of  articles  of  clothing,  bedding,  or  merchan- 
dise, supposedly  contaminated  by  contact  with  those  sick 
with  this  disease,  is  unnecessary. 

9.  A  house  may  be  said  to  be  infected  with  yellow  fever 
only  when  there  are  present  within  its  walls  contamin- 
ated mos(]uitoes  capable  of  conveying  the  parasite  of  this 
disease. 

10.  The  spread  of  yellow  fever  can  be  most  effectually 
controlled  by  measures  directed  to  the  destruction  of  mos- 
quitoes and  the  protection  of  the  sick  against  the  bites  of 
these  insects. 

11.  While  the  mode  of  propagation  of  yellow  fever  has 
now  been  definiteh'  determined,  the  specific  cause  of  this 
disease  remains  to  be  discovered. 

BIBLIOGRAPHY    ON    TRANSMISSION    O**    OIS«=ASE    BY    INS«^CTS. 
NOTE  BY  THE  AUTHOR. 

As  this  work  treats  principally  of  yellow  fpver,  we  give  below  only 
a  partial  bibliography  of  the  trausmissioT>  of  disease  by  insects.  The 
literature  on  the  relation  between  the  transmission  of  malaria  and 
the  mosquito  is  enormous  and  can  be  found  in  the  Index  Medicus, 
the  Index  Catalogue  of  the  Surgeon-n'<n<^'-irs  Office  and  medical 
journals. 

The  bibliography  of  the  transmission  c*  yellow  fever  by  the  mos- 
quito will  be  found  in  another  part  c*  tJ '•'  volume. 

BOOKS  AND  MOVOaRAPHS. 

CORXOLDI  (G.  M.).  La  Mosca  et  il  Colera.  (Octavo.)  Venice: 
1S84. 

HOWARD  (L.  O.).  How  insects  affect  health  in  rural  districts. 
U.  S.  Dept.  of  Agriculture:    Farmers'  Bulletin  No.  155,  1902. 

HEISE  (J.  G.).  De  insectorum  noxio  effectu  in  corpus  humanum. 
Halae  Magdeb.,  1757. 


INSECTS    AS    PROPAGATORS    OF    DISEASE.  53 

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Ibid.     Ann.  d'Ig.  Sper.,  Rome,  1899,  vol.  9,  p,  272. 

Ibid.     Malaria  and  Mosquitoes.     Lancet,  London,  1900,  vol.  1,  p.  79. 

(See  also  other  articles  by  the  above  authors,  published  in  European 
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BUCHANAN  (W.  J.).  Cholera  diffusion  by  flies.  Indian  M.  Gaz., 
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CAMPBELL  (C).  House  flies  and  disease.  Brit.  M.  J.,  Lond., 
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CHAPMAN  (C.)  and  JOHNSTON  (J.).  House  flies  and  disease. 
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INSECTS    AS    PROPAGATORS    OF    DISEASE.  55 

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56  HISTORY    OF    YELLOW    FEVER. 

HELLER  (C).  Ueber  septische  Infection  wahrscheinlich  durch 
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Yearbook  U.  S.  Dep.  Agric.  1901,  Wash.,  1902,  p.  177. 

HOWARD  (L.  O.).  Experimental  work  with  fungous  diseases  of 
grasshoppers.     Ibid.,  p.  459. 

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JELLIFFE  (S.  E.).  Insects  as  Carriers  of  Disease.  Munsey's  Maga- 
zine, N.  Y.,  1901,  Vol  25,  p.  707. 

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mission des  maladies  infectueus«s.  (Abstract.)  Gazette  des  Hopi- 
taux,  Paris,  1898,  Vol.  71,  p.  1202. 

KELLY  (H.  A.).  A  historical  note  upon  Diptera  as  carriers  of  dis- 
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LAVERAN  (A.).  Comment  prend-on  le  paludisme?  Revue  d'Hy- 
giene,  Paris  1896,  Vol.  18,  p.  1049. 

Ibid.  Des  mesures  a  prendre  contre  les  moustiques.  Revue  Gen. 
de  Clin,  et  de  Therap.,  Paris,  1899,  Vol.  13,  p.  257. 

Ibid.  Sur  um  anopheles  provenant  de  Madagascar.  Compte  Rendu. 
Soc.  de'  Biologie,  Paris,  1900,  II.  Series,  Vol.  2,  p.  109. 

LEIDY  (J.).  The  common  fly  as  a  factor  in  the  transmission  of 
disease  germs.     Phila.  M.  J.,  1901,  Vol.  7,  p.  49. 

MACRAE  (R.).  Flies  and  cholera  diffusion.  Indian  M.  Gaz.,  Cal- 
cutta, 1894,  Vol.  29,  p.  407.     1  pi.     Also,  Reprint. 


INSECTS    AS    PROPAGATORS    OF    DISEASE.  '  57 

MADDOX  (R.  L.).  Further  experiments  on  feeding  insects  with  the 
curved  or  "comma"  bacillus.  J.  Roy.  Micr.  Soc,  Lond.,  1885,  2d  s., 
Vol.  5,  p.  941. 

MALARIA  (A)  conference  in  Rome.  British  Med.  Jl.,  1900,  Vol.  1, 
p.  323. 

MALARIA  (The)  expedition  to  Sierra  Leone.  British  Med.  Jl., 
London,  1,  1899,  Vol.  2,  pp.  675;  746;   869;   1033. 

MALARIA  (The)  expedition  to  West  Africa,  Lancet,  London,  1899, 
Vol.  2,  p.  1041. 

MANSON  (PATRICK).  The  Goulstonian  Lectures  on  the  life- 
history  of  the  malaria  germ  outside  the  human  body.  British  Med.  Jl., 
London,  1896,  Vol.  1,  pp.  641;  712;  774. 

Ibid.  The  mosquito  and  the  malarial  parasite.  British  Med.  Jl., 
1898,. Vol.  2,  p.  849. 

Ibid.  Surgeon-Major  Donald  Ross'  recent  investigations  on  the 
mosquito-malarial  theory.     British  Med.  Jl.,  1898,  Vol.  1,  p.  1575. 

Ibid.  The  role  of  the  mosquito  in  the  evolution  of  the  malarial 
parasite;  the  recent  research  of  Surgeon-Major  Ronald  Ross.  Lancet, 
London,  1898,  Vol'.  2,  p.  488. 

Ibid.  An  exposition  of  the  mosquito-malaria  theory  and  its  recent 
developments.     Jl.  Tropical  Med.,  London,  1898-99,  Vol.  1,  p.  4. 

MARCHOUX.  Au  sujet  de  la  transmission  du  paludisme  par  les 
moustiques.  Annals  d"Hygiene  et  de  Medecine  Colonial,  Paris,  1899, 
Vol.  2,  p.  22. 

McCOLLOM  (J.  H.).  The  role  of  insects  in  the  propagation  of 
disease.     Am.  J.  Nursing,   Phila.,  1901-2,  Vol,  2,  p.  181. 

McFARLAND  (J.).  Relation  of  insects  to  the  spread  of  disease. 
Medicine,  Detroit,  1902,  Vol.  8,  p.  1. 

MACKAIG  (A.).  Insects  and  cholera.  Edinb.  M.  J.,  1902,  n.  s., 
Vol.  12,  p.  137. 

MADDOX  (R.  L.).  Experiments  in  feeding  some  insects  with  cul- 
tures of  comma  or  cholera  bacilli.  Tr.  Am.  Micr.  Soc.  1898,  Lincoln, 
Neb.,  1899,  Vol.  20,  p.  75.     (1  Plate.) 


58  HISTORY    OF     YKLLOW     FEVER. 

MANNING  (J.).  A  preliminary  report  on  the  transmission  of 
pathogenic  germs  by  the  common  house-fly.  Am.  J.  Nursing,  Phila., 
1901-2,  Vol.  2,  p.  920.  Also:  J.  Am.  M.  Ass.,  Chicago,  1902,  Vol.  38, 
1291. 

MARPMANN  (G.).  Ueber  d'e  Vernichtung  von  Bakterien  durch 
Fliegen  und  stechende  Insekten  und  uber  den  Zusammenhang  von 
epidemischen  Krankheiten  mit  dem  Auftreten  und  der  Entwicklung 
von  Stechfliegen,  Mucken,  etc.,  in  den  insektenreichen  und  insekten- 
armen  Jahren.  Apoth.  Ztg.,  Berl.,  1S97,  Vol.  12,  p.  616. 

MARPMANN  (G.).  Ueber  den  Zusammenhang  von  pathogenen 
Bakterien  mit  Fliegen.  Centralbl.  f.  Bakteriol.,  etc.  1.  Abt..  Jena, 
1897,  Vol.  22,  p.  127. 

MONNIER  (U.).  Du  role  des  insectes  dans  la  propagation  des 
maladies  infectieuses  Gaz.  med.  de  Nantes,  1898-9,  Vol.  17,  p.  179. 

MUHLING  (P.).  Die  Uebertragung  von  Krankheitserregern  durch 
Wanze  und  Blutegel.  Centralbl.  f.  Bakteriol,  etc.  1.  Abt.,  Jena,  1899, 
Vol.  25,  703. 

NOTES  on  the  part  played  by  insects  as  carriers  of  infection.  Brit. 
M.  J.,  Lond.,  1900,  Vol.  1,  p.  328. 

NUTTALL  (G.  H.  F.).  Zur  Aufklarung  der  Rolle,  welche  stechende 
Insekten  bei  der  Verbreitung  von  Infektionskrankheiten  spielen. 
Cen  tralbl.  f.  Bakteriol,  etc.     1.  Abt.,  Jena,  1898,  Vol.  23,  p.  625. 

NUTTALL  (G.  H.  F.).  Remarks  upon  a  paper  by  Dr.  Calmette  en- 
titled: "Intertropical  medicine;  on  the  part  played  by  insects  in  the 
dissemination  of  the  diseases  of  hot  countries."  J.  Trop.  M.,  Lond., 
1899-1900,  Vol.  2,  p.  182. 

NUTTALL  (G.  H.  F.).  Die  Mosquito-Malaria  Theorie.  Centralbl. 
f.  Bacteriol,  1.  Abt.,  Jena  1899,  vol.  25,  pp.  161;  200;  245;  285;  387. 

NUTTALL  (G.  H.  F.).  On  the  role  of  insects  *  *  *  in  the  spread 
of  bacterial  and  parasitical  diseases.  Johns  Hopkins  Hospital  Re- 
ports, Baltimore,  1890,  Vol.  8,  p.  1.     (3  plates.) 

Ibid.     (Abstract.)     British  Med.  Jl.,  London,  1899,  Vol.  2,  p.  642. 

Ibid.  (Abstract.)  Journal  of  Tropical  Medicine,  London,  1899-1900, 
Vol.  2,  p.  107. 

Ibid.     (Abstract.)     Lancet,  London,  1899,  Vol.  2,  p.  775. 

Ibid.  (Translation.)  Hyg.  Rundsehau,  Berlin,  1899,  Vol.  9,  pp. 
209;  289;  393;  503;  606. 


INSECTS    AS    1  ROPAGATORS    OF    DISEASE.  59 

PAULLINUS  (C.  F.).  Musca  dysenteriae  genitrix.  Acad.  nat. 
curios,  ephem.  1687,  Norimb.,  1707,  decuria  2,  vi  (ap.p. ),  30-34.  Also, 
trans.  Abstr.  Collect.  Acad.  d.  mem.,  etc.,  Dijon,  1766,  Vol.  7,  510. 

RAMIREZ  (R.).  The  diptera  from  a  hygienic  point  of  view.  Am. 
Pub.  Health  Ass.  Rep.,  Columbus,  1898,  Vol.  24,  p.  257.  Discussion, 
p.  356. 

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insectes,  et  sur  leur  traitement.  Experience,  Par.,  1838,  Vol.  1,  pp. 
425-429.     Also:  Ann.  d  med.  beige,  Brux.,  1838,  Vol.  2,  1-5. 

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ROSS  (RONALD).  Some  observations  on  the  ci-escent  sphere- 
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Ibid.     Indian  Lancet,  Calcutta,  1896,  Vol.  7,  p.  227. 

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SANGREE  (E.  B.).  Flies  and  typhoid  fever.  Medical  Record,  N. 
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60  HISTORY    OF    YELLOW    FEVER. 

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4,  pp.  34;    44. 


PART  SECOND. 


YELLOW   FEVER. 


PRELIMINARY  OBSERVATIONS. 


CHAPTER  I. 

PERTINENT  POINTS  ABOUT  YELLOW  FEVER. 

Geographical  Limits  of  Yellow  Fever  and  Other  Pestilential  Dis- 
eases.— Mortality  of  Yellow  Fever  in  September,  Compared  with 
Other  Months. — Historic  Mortalities  from  Yellow  Fever. 

Geographical  Limits  of  Yellow  Fever. 


No  disease  possessing"  such  pestiferous  proclivities  as 
yellow  fever  is  confined  within  such  restricted  limits.  In 
America,  it  has  never  prevailed  further  north  than  Quehec 
(latitude  4(>°  50\)  nor  has  it  heen  noticed  further  south 
than  Montevideo  (latitude  34°  54').  In  the  Eastern 
Hemisphere,  Swansea,  in  Wales  (latitude  51°  37')  has 
been  its  northernmost  limit,  while  St.  Paul  de  Loanda,  in 
Africa  (about  9°  S. )  has  been  the  southernnu)st  habitat. 
Its  western  limits  have  been  the  shores  of  the  Pacific  from 
]Montevideo  to  Lower  California,  except  on  one  occasion 
(1883)  when  an  imported  case  died  in  San  Francisco, 
Cal.  In  Europe,  it  has  never  been  seen  fui-ther  East  than 
Leghorn,  in  Italy  (7°  5G').  In  Africa,  Egypt  and  ]Mada- 
gascar  are  said  to  have  been  invaded  by  the  disease,  but 
the  report  lacks  authenticity.  Tlie  same  may  be  said  of 
the  alleged  prevalence  in  Asia  Elinor  during  the  .  cam- 
paigns of  Napoleon.  , 

The  present  foci  of  yello^\'  fever  are  still  more  restricted 
than  fonuerly.  Juan  Guiteras  recognizes  the  following 
three  areas  of  infection  : 

1.  The  Focal  Vjjuc,  in  which  the  diseases  is  never  ab- 
sent, including  Havana,  Vera  Cruz,  Rio  Janeiro  and 
other  South  American  ports. 

2.  The  Perifocal  Zo»r.  or  region  of  periodic  epidemics, 
including  the  ports  of  the  troi)ical  Atlantic  in  America 
and  Africa. 


64  HISTORY     OK    YELLOW     FEVER. 

3.  The  VjOuc  of  Accidental  Epidemics^  between  the 
parallels  of  43°  uortli  aud  35°  south. 

To  better  understand  the  meaning  of  this  eminent 
authority,  the  reader  is  referred  to  the  map  of  the  world, 
where  he  will  observe  three  great  regions  of  pestilential 
disease:  First,  of  the  plague;  secondly,  of  cholera; 
thirdly,  of  yellow  feyer. 

These  regions  are  distributed  as  follows : 

From  the  equator  to  20°  North  may  be  regarded  as  the 
true  yellow  feyer  region.  This  includes  the  West  Indies, 
the  coast  towns  of  Mexico,  the  Isthmus  of  Panama,  Col- 
umbia, Venezuela,  the  eastern  shores  of  South  America 
as  far  south  as  the  Eio  de  la  Plata,  and  the  western  coast 
of  Africa,  embracing  Sierra  Leone  aud  the  Gold  Coast. 

From  30°  to  40°  North,  in  the  Eastern  Hemisphere,  is 
the  region  of  the  plague,  including  Arabia,  Egypt,  Turkey 
and  Asia  Minor. 

From  20°  to  40°  North,  in  the  Eastern  Hemisphere,  is 
theValky  of  the  Ganges,  the  principal  centre  of  the  cholera 
region. 

Mortality  of  Yellow  Fevkr  in  September. 

A  study  of  the  statistics  of  yellow  feyer  demonstrates 
the  peculiar  fact  that  the  disease  is  connected  in  its  epi- 
demic appearance  with  certain  seasons  of  the  year.  The 
months  of  July,  August  and  September  are  those  in  which 
epidemics  are  more  prevalent  and  the  disease  seems  to  at- 
tain its  greatest  mortality  in  the  latter  month.  A  resume 
of  nine  epidemics  in  New  Orleans,  made  by  Chaille,  and 
completed  (so  far  as  1905  is  concerned)  bj'  the  compiler 
of  this  work,  shows  that  in  six  of  these  visitations,  the 
mortality  was  greatest  in  September,  viz : 

*  Some  Yellow  Fever  Data,  by  S.    E.    Chaille,    New    Orleans 
Medical  and  Surgical  Journal,  1905,  vol.  58,  p.  191. 


PERTINENT    POINTS    ABOUT    YELLOW    FEVER. 


65 


Mortality  in  Nine  Notable  Epidemics  in  New 
Orleans. 


May 

June 

July 

August  

SEPTEMBER 

October 

November 

December 

MODtHsOaKDOWD.. 


74 
965 

laoo 

198 
12 
10 
445 


4 

33 

200 

467 

126 
20 

22 


31  2 

1521  29 

5:33  53 J 

982  1234 

147  490 

28  131 

4  7 


5 

382 

1286 


2 
132 

1140 


3 

II    26 
255       1025 


42 

217 


874  2204  1837  1780  III 


97 
19 


137 

1072 

1065 

61 

224 

103 

147 

6 

15 

26 

3 

0 

TOTAL 


2804   872   7848   24«5   2670   4854   3107  ,  4046 


A  glance  at  the  above  figures  proves  that  in  only  three 
instances  (1853,  1858  and  1905)  August  proved  more 
fatal  than  September.  In  1853,  the  mortality  reached  the 
appalling  aggregate  of  5133  in  August,  against  892  in 
September  and  a  grand  total  of  7848  for  the  entire  year. 

A  search  into  the  records  of  nearly  every  place  where 
yellow  fever  has  been  epidemic  reveals  the  same  state  of 
affairs,  with  the  exception  of  Havana,  wliere  July  seems 
to  be  the  most  fatal  montli. 

Even  as  far  back  as  1793,'Currie,-  in  speaking  of  the 
great  epidemic  at  Philadelphia  that  year,  sa^s : 

''In  September,  the  disease  increased  amazingly.  In 
the  course  of  the  month,  about  1100  citizens  were  added 
to  the  list  of  mortality;  towards  its  close,  from  50  to  90 
were  buried  of  a  day,  though  the  mercury  now  seldom  rose 
above  80°.'' 

"After  the  first  of  September,  there  was  no  disease  to 
be  seen  but  yellow  fever."^ 

-A   Treatise  on   the    Synochus    Icterodes,    etc.,    by    William 

Currie  (1794),  p.  15. 
•'Epidemic  at  Philadelphia  of  1797,  Rush,  vol.  5,  p.  19. 


66  HISTORY    OF    YELLOW     FEVER. 

In  1822,  when  New  York  was  visited  by  the  disease,  the 
deaths  in  September  mounted  up  to  110,  against  58  in 
Aufiust  and  1)0  in  October.^ 

The  excess  in  moitalit^^  in  September  over  the  other 
months  during  the  prevalence  of  yellow  fever,  has  also 
been  noted  in  the  following  epidemics: 

New  York,  1799;  Providence,  1\.  I.,  1797;  Baltimore, 
1819;  AVilmiuoton,  ( Del.  I  1798;  Charleston,  ( S.  C.)  1807, 
1817,  1819,  1821,  1827  and  1838 ;  Natchez,  1823  and  1825 ; 
Mobile,  1839;  New  Haven,  (Conn.),  1791;  Xew  Orleans, 
1819,  1820,  1821  and  1833. 

La  Roche''  notes  that  the  mortality  has  occasionally 
been  greatest  in  August,  as  was  the  case  in  Charleston  in 
1838  and  in  New  Orleans  in  1817,  1839  and  1853.  But 
these  were  isolated  exceptions. 

The  apparent  reason  for  the  greater  mortality  in  Sep- 
tember seems  to  l)e  that  the  disease,  beginning  early  in 
summer,  has  had  time  to  spread  and  to  attack  a  larger 
number  of  persons;  also,  the  virulence  is  greater  because 
by  that  period  the  infected  mosquitoes  are  more  numerous 
and,  everything  else  e(]ual,  exposed  persons  receive  more 
bites  and  consequently  a  larger  dose  of  poison.'' 

This  did  not  follow  in  1905,  because  by  September  the 
effect  of  the  active  anti-mosquito  campaign  was  showing 
itself  by  diminishing  number  of  cases  as  well  as  by  lower 
mortality. 

lIisTouic  MouTALiTiE.s  Fuo:m  Ykllow  Fever. 

Whenever  yellow  fever  has  spread  its  sombre  nmntle 
over  a  community,  it  has  left  in  its  wake  countless  heca- 
tombs. 

"The  reack'r  need  scarcely  be  informed,""  says  Lalv(jche, 
in  his  monumental  work  on  yellow  fever,  ''that  the  yellow 
fever,  wherever  it  has  assumed  the  epidemic  form,  has 
fully  estaldished  its  claims  to  being   classed  among  the 


♦Proceedings  Board  of  Health  of  the  City  of  New  York  (1823), 

p.  123. 
'  Vol.  i,  p.  545. 
"  See  Article  by  Dr.  Chassaignac,  in  the  medical  part  of  this 

volume. 


PERTINENT     POINTS     ABOUT    YELLOW     FEVER.  67 

most  formidable  diseases  to  which  tlie  human  body  is 
liable." 

The  island  of  St.  Lueia,  in  the  West  Indies,  furnishes 
the  earliest  authentic  example  of  iii-eat  mortality  from  yel- 
low fever.  In  1(164,  accordino  to  Keatingy  it  killed  1,411 
out  of  a  population  of  1,500  soldiers,  being-  in  the  ratio 
of  1.06  of  the  whole  number.  In  1665,  in  the  same  locali- 
ty,  out  of  500  sailors,  200  died,  being  one  in  2:5;  and 
again,  in  ir>66,  the  unfortunate  island  was  invaded  by  the 
disease,  when  every  man,  wonmn  and  child,  5,000  in  all, 
died. 

In  1703^  in  Grenada,  West  Indies,  yellow  fever  appeared 
among  the  sailors,  the  proportion  of  deaths  in  cases 
amounting  to  1  in  3 ;  and  of  a  total  of  1,130  soldiers,  630 
died. 

In  1791,  the  disease  attacked  Sir  Charles  Gray's  Army, 
in  the  Windward  and  Leeward  Islands,  and  of  an  esti- 
mated population  of  12,000,  there  was  a  mortalitv  of 
6,012. 

In  Guadeloupe,  in  1796,  out  of  an  estimated  population 
of  20,000,  there  was  a  mortality  of  13,807.  That  same 
year,  out  or  367  artillerymen  stationed  jit  the  island,  129 
died.  In  1802,  Guadeloupe  was  again  decimated,  5,057 
deaths  occurring  in  a  population  of  16,363. 

In  1802,  at  San  Domingo,  in  a  population  estimated  at 
40,000  (principally  soldiers),  there  were  27,000  cases  and 
20,000  deaths.  The  mortality  among  French  troops  in  the 
West  Indies  in  1802  amounted  to  57  per  cent. 

Quebec,  Canada,  Avas  invaded  by  yellow  fever  for  the 
first  and  last  time  in  1805.  Of  one  company  of  55,  be- 
longing to  an  English  regiment,  all  but  six  died. 

The  greatest  mortality  ever  recorded  in  Havana  was 
in  1819,  when  5,162  died.  As  yellow  fever  had  visited 
Havana  almost  every  year  since  1620,  this  mortality  is 
especially  worthy  of  note. 

In  1852,  at  Barbadoes,  West  Indies,  out  of  1,380  sol- 
diers, there  were  879  cases  and  173  deaths. 

At  Martinique,  during  a  period  of  five  years,  1802  to 


Keating:     History  of  the  Yellow  Fever  of  1878,  p.  77. 


68 


HISTOKY    OF    YELLOW     FKVER. 


1807,  ill  a  poi»iilati(»ii  of  11,085  soldiers,  there  were  8,673 
eases  and  2,891  deaths. 

Aecordiui'  to  Joseph  eJones,^  the  total  deaths  from  all 
diseases  iu  New  Orleans  from  1838  to  1883,  a  period  of 
fort3'-five  years,  amoniited  to  272,619,  of  Avhich  31,207 
were  from  yellow  fever,  10,009  from  cholera  aud  (),136 
from  smallpox.  It  will  thus  he  seen  that  of  the  17,612 
deaths  from  eontagii.ns  aud  infectious  disease,  the  mor- 
tality from  yellow  fever  reached  the  appalliii<j,-  figure  of 
31,207,  or  a  yearly  average  of  693  for  the  period  above 
mentioned. 

The  greatest  mortality  from  yellow  fever  iu  a  single 
year  in  Xew  Orleans  took  place  in  1853,  when  7,818  died. 
From  1853  to  1858,  a  period  of  six  yeai-s,  the  mortality 
was  as  follows : 

1853    7,818 

1851    2,125 

1855    2,670 

1856    71 

1857    200 

1858    1,815 

Total  for  six  years   18,062 

Since  1858,  there  have  been  only  two  great  epidemics 
in  New  Orhans:  1867,  Avhen  3,107  died,  aud  1878,  when 
the  pestiknce  made  4,016  victims. 

The  North  also  presents  a  melaneiioly  record. 

In  his  summary  of  the  epidemics  which  devastated 
lMiil;id(  l]ihia  iu  the  ])ast.  La  Koche  states  that  during  the 
visitati<;ii  of  ir»99,  wlicu  the  city  was  only  17  years  old 
and  the  jjopulation  did  not  exceed  3,800,  the  mortality 
from  yellow  fever  was  220,  or  one  in  17.3  of  the  entire 
number  of  I'csidcuts.  Ninety-four  years  later  (1703), 
wben  the  poi)ulation  of  lMiilad<  li)hia  aiuouuted  to  60,000, 
occurred  the  "gTcat  e])idemic,"  commencing  iu  August 
and  ending  in  December,  and  causing  a  fearful  total  of 
1,041  deaths.     Four  years  later  (1797),  a  severe  epidemic 

"Jones:     "Medical  and  Surgical  Memoirs,  vol.  3,  part  2,  Table 
='0." 


PERTINENT    POINTS    ABOUT    YELLOW    FEVER.  69 

visited  the  city,  the  mortality  amounting"  to  1,300.  The 
year  following*  (1798),  yellow  fever  again  assumed  a 
virulence  which  caused  such  a  widespread  terror,  that 
nearly  the  whole  population  fled.  The  epidemic  of  that 
year  made  3,(345  victims.  It  will  thus  be  seen  that  in  the 
short  space  of  five  years  (1793  to  1798),  yellow  fever 
made  the  melanchol^^  rec(n-d  of  8,98G  victims  in  that 
scourge-ridden  city. 

In  New  York,  Boston,  Baltimore,  Portsmouth  (Va. ) 
and  on  the  North  Atlantic  seaboard,  the  disease  has  at 
times  assumed  pestilential  proportions,  the  details  of 
which  will  be  found  in  that  part  of  this  volume  devoted 
to  the  history  of  yello^v  fever. 

Europe  furnishes  an  appalling  list  of  mortalities.  Ac- 
cording to  LaKoche,  Spain  has  been  the  principal  sufferer 
on  occasions  of  this  kind,  experiencing,  in  the  course  of 
nine  epidemics— 1800,  1801,  1803,  1804,  1810,  1813,  1818, 
1819  and  1821 — the  immense  loss,  by  jellow  fever,  of  up- 
wards of  130,000  individuals.  During  one  single  season — 
that  of  1800 — not  less  than  thirty  places  in  Andalusia 
were  visited,  and  in  them  the  loss  amounted  to  61,303. 

The  year  1804,  according  to  LaKoche,  was  another  of 
great  calamity.  On  that  occasion,  twenty-five  places  in 
Spain,  with  a  combined  population  of  427,228,  lost  52,559 
souls,  or  one  in  8.12. 

The  disease  also  prevailed  epidemically  in  some  parts 
of  France,  England,  Italy  and  Portugal  during  the 
eighteenth  and  nineteenth  centuries,  but  Spain  seems  to 
have  been  the  most  fertile  spot  for  the  propagation  of 
yellow  fever  in  the  Old  World. 


70  HISTORY    OF    VKI.LOW    FETER. 

CHAPTER  II. 

NOMENCLAIURE  OF  YELLOW  FEVER. 

Peculiar  Names  given  the  Disease  by  Medical  Writers. — A  List  con- 
taining One  liundred  and  Fifty-two  Synonyms. 

Xames  in  Vogue  at  the  Present  Day. 

Eiiglisli:     Yellow  Fever. 
Freiicli :     Fievre  Jaiiue. 
Spanish :     Fiebre  Amarilla. 
Portugese:     Febre  Amarella. 
German :     Gelbts  Fielier. 
Italian:     Febbre  Gialla. 
Latin :     Febris  Flava. 

Synonyms. 

No  disease  under  heaven  has  had  more  synonyms  than 
yellow  fever.  Beginning  with  1494,  when  it  was  generally 
designated  by  the  name  of  Contof/ion,  and  ending  with 
the  Year  of  Grace  1007,  A\hen  the  term  Mosijnito  Fcrcr 
seemed  decidedly  appro^jriate,  the  nomenclature  of  the  dis- 
ease has  been  stupendous.  The  subjoined  list,  which  has 
been  carefully  ])repared  from  the  writings  of  American, 
English,  Si)anish,  Italian,  INirtugesc  and  Sp:inisli  chron- 
iclers, will  convey  an  idea  of  the  jKCuliar  names  which 
were  used  in  former  times  to  designates  the  yellow 
scourge,  the  nature  and  origin  of  which  we  are  no  wiser 
to-day  than  Avere  those  worthy  and  illustrious  observers. 

1.  Ami:ki(".vn  liiLious  ]Mali(;nant  Feviok. 
Moultrie,  1719. 

2.  American  Fever. 
Ceresa,  1829. 

3.  American  Pestilence. 

llaygarth,  in  a  work  published  in  1801,  theorizes 
on  the  ''pi'evention  of  infectious  fever,  especially 
the  American  l*estilence." 


SYNONYMS    OF    YELLOW    FEVER.  71 

4.  American  Typhus. 

Term  used  by  the  disciples  of  the  school  of  Bally. 

5.  American  Yellow  Fever. 

Lining,  in  his  "Essays  and  Observations;"  also 
Jolivet,  1831,  and  others. 

G.     Ardent  Fever. 

Fermin  thus  mentions  it  in  his  Avork  on  "Traite 
des  Maladies  les  Plus  Frequentes  a  Surinam," 
published  in  1763. 

7.  Ardent  Summer  Fever. 

English  writers,  middle  of  Eighteenth  Century. 

8.  Ataxic  TyphUvS. 
Bally  and  his  followers. 

9.  Autumnal  Endeiniial  Epidemic  Fever. 
Davidge,  in  a  work  published  at  Baltimore,  in  1798. 

10.  Autumnal  Epidemic  Fever. 
Shaw,  1801. 

11.  Autumnal  Fever. 

Yaughan,  in  his  "Concise  History,"  etc.,  1802. 

12.  Barbadoes  Distemper. 

American  and  English  wi-iters,  in  the  beginning  of 
the  Eighteenth  Century. 

13.  Bari'.adoes  Fever. 

rhiladelphia,  in  1()99,  because  the  pestilence  of  that 
year  was  imported  from  Barbadoes,  West  ludies. 

11.     Barcelona  Fever. 

Eochoux,  1822,  and  those  who  advocated  the  theory 
that  the  epidemics  which  ravaged  Spain  in  the 
beginning  of  the  last  century,  were  endemic  to 
that  country. 


72  HISTORY    OF    YELLOW    FEVER. 

15.  Bilious  Fever. 

Gamble,  Eochefort,  Hughes,  Chanvalon,  Bajon  and 
Fermin. 

16.  Bilious  Epidemic  Fever. 
Yates,  1813. 

17.  Bilious  Fever  of  Warm  Climates. 

Eiiolisli  and  American  writers  in  the  middle  of  the 
last  century. 

18.  Bilious  Malignant  Fever. 
Joseph  Brown,  1797. 

19.  Bilious  Putrid  Fever. 
Hillary. 

20.  Bilious  Kemittent  Fever. 
Arnold. 

21.  Bilious  Remittent  Putrid  Fever. 
Rush  and  his  disciples. 

•  22.     Bilious  Remittent  Yellow  Fever. 
Rush  and  his  school. 

23.     Bilious  Remitting  Fever. 
Rush,  1793. 

21.     Bilious  Yellow  Fever. 
Williams. 

'25.     Black  Vo:\nT. 

Popular  name  adopted  by  old  English  writers  and 
derived  from  the  Spanish  Vomito  Negro. 

26.  Bronze  John. 

Chambers'  Encyclopedia,  article  on  "Yellow  Fever." 

27.  Bulam   Fever. 

Pym,  Chisolm,  and  their  disciples,  who  propagated 
the  visionary  doctrine  that  the  fever  had  been 
imported  from  the  Island  of  Bulam,  West  Africa. 


SYNONVMf!    OF    YELLOW    FEVER.  73 

'28.     Calentura. 

This  name  had  its  origin  in  the  dogma  that  heat 
was  the  prime  cause  of  yellow  fever.  It  was  only 
in  the  beginning  of  the  nineteenth  century  that 
this  designation  was  abandoned  by  the  Spaniards, 
who  substituted  ''Fiebre  Amarilla,"  a  term  which 
is  used  to  this  day  in  Spain  and  in  Central  and 
South  America. 

29.  Calentura  Amarilla. 
Cibat,  1803. 

30.  Calentura  Maligna  Contagiosa. 

Gonzales,  in  his  dissertation  on  the  yellow  fever  in 
Cadiz,  published  in  1801. 

31.  Calentura  Amarilla  De  America. 
Jose  Fernandez  de  Madrid,  1821. 

32.  Calenturas  Putridos  y  Maligna. 
Masterall,  1797. 

33.  Calenturas  Tifoideas. 
Burdin,  1820. 

34.  Calenturas      Thermo-Adynamica      y      Thermo- 

Ataxia. 
Jose  Fernando  de  Madrid,  1821. 

35.  Cardite  Amarille. 
Mentioned  by  Berenger-Feraud. 

36.  Causos  or  Ardent  Fever. 
Desperriere,  Gillespie. 

37.  Causus. 

Name  used  by  Fermin,  in  his  work  above  quoted, 
and  by  Miller,  McArthur  and  others. 

38.  Causus  Malin  D'Amerique. 
Berenger-Feraud  is  authority  for  this  expression. 


74  HISTORY     OF    YELLOW     FEVER. 

39.     Causus  Tropicus  Endemic  us. 

Moseley,  in  his  ''Treatise  on  Tropical  Diseases," 
etc.,  1795. 

'  40.     Chapetonada. 

Coreal  and  Ulloa.  This  name,  which  signifies 
"brigand"  in  the  Peruvian  language,  was  origin- 
ally given  to  the  followers  of  Pizarro  by  the  na- 
tives and  was  sub8e(|uently  adopted  by  the  in- 
habitants of  Martinique  to  mean  all  Europeans 
who  landed  on  their  shores.  These  unfortunate 
colonists  dying  by  the  thousands  from  the 
endemic  fever  of  the  country,  the  name  was 
tinally  applied  to  the  disease  itself. 

41.  COCOLITZLE. 

Herrera,  in  his  famous  work  published  in  1601, 
says  that  this  name  was  given  by  the  Carib  In- 
dians to  the  disease. 

42.  Concentrated  Endemic  Fever. 

Jackson,  in  a  work  published  in  Edinburg,  1789. 

43.  Contagion. 

This  name  is  quite  prevalent  in  the  writings  of  early 
8])anish  and  French  authors  from  1494  to  1634. 
After  that  date  and  up  to  the  end  of  the  Seven- 
teenth Century,  the  diseas  was  designated  as 
Coup  (Ic  lidirc  by  the  l^rench  and  <Utl<  iitiira  by 
the  Spanish. 

44.  CONTINUA    PUTRIDA    ICTERODES    CaROLINIENSIS. 

Macbride. 

45.  Contagious  Fever. 

Rochedort,  Bajon,  Fermin,  Chanvalon,  Hughes, 
Schotte. 


SYNONYMS    OF    YELLOW    FEVER.  75 

46.  Coup  De  Bakre. 

Labat  aud  other  early  Aiitillian  chroniclers.  The 
literal  meauiug  of  the  word  is:  "I  am  struck 
with  a  whij^-stock,"  aud  is  expressive  of  the 
suddeuuess  of  the  ouset  of  the  malad}^  aud  the 
uiuscular  paius  Avhich  accompany  it. 

47.  Elodes  Icterodes. 
Vogel. 

48.  EXDEMIAL  CAUSUS,  OR  BURNING  FEVER. 

Mentioned  by  Moseley  in  his  treatise  on  Tropical 
Diseases. 

49.  Epauotus  Malignus  Flavus. 
Goode. 

50.  Epidemic. 

Sahagun,  Salgado,  Salamanca  and  other  early 
writers. 

51.  Epidemical  Distemper. 
Sandiford. 

52.  Examthema  Externum  Contagiosa. 
According  to  Jackson  (1821),  this   name    was    ap- 
plied to  the  disease  by  Spanish  physicians  during 
the  great  epidemics  in  Aiidalusia  in  the  begin- 
ning of  the  last  century. 

53.  Fep.p.re  Gialla  Pestilenziale  D'Amerique. 
Palloni  and  other  Italian  writers,  in  tlie  beginning 

of  the  nineteeuth  century. 

54.  Febbre  LivoRXO. 

Palloni  and  Tonuisini,  in  their  descrijjtions  of  the 
epidemic  at  Leighorn  in  1804. 

55.  Febre  Endemica  Indiarum  Occidentalum. 
Latin  writers. 


6  HISTORY    OF    YELLOW    FEVER. 

56.  Febre  Flava  Indiae  Occidextales. 
Ciillen,  1778. 

57.  Febre  Flava  Regiorum  Caijdarum. 
Fisher,  1795. 

58.  Febre  Hispanae  Flava. 
Fago,  1818. 

59.  Febre  Ixdlie  Occidentalis. 
Mackittrick,  1766. 

60.  Febris  Ardens  Aestiva. 
Rouppe,  1772. 

61.  Febris  Ardens  Biliosa. 
Towne,  1726. 

62.  Febris  Cum  Xigro  Vo:mito. 
Name  adopted  by  Dowell. 

63.  Febris  Flavae  Americaxae  Causis. 
Ferrello,  1825. 

64.  Febris  Icterodes. 

General  term  adapted  by  medical  men  from  1791  to 
1815. 

65.  Ferris  ^Ialigxa  Biliosa. 
Moultrie. 

66.  Febris  Putrida  Colloquativa. 
Rouppe,  1772. 

67.  Febris  Typhus  Icterodes. 
Dowell. 

68.  Fiebre     Amarilla     Hispanorum      Et      Hispano- 
Americaxum. 

Early  Spanish  writers. 


SYNONYMS    OF    YELLOW    FEVER.  77 

69.     FiEYRE  Des  Lacs. 
Berenger-Feraud. 

rO.     FlEVRE  Gastro-Adynamique. 
Pinel. 

71.  FiEVRE  Jaune. 
Modern  French  writers. 

72.  Fievre  Jaune  D'Amerique. 
Valentin. 

73.  Fievre  Matelotte. 

Early  French  writers.  This  expression  owed  its 
origin  to  the  belief  that  seamen  were  especially 
susceptible  to  yellow  fever. 

74.  Fievre  Putride  Continue. 
Pugnet. 

75.  Fievre  Spasmodico-Lypirienne  Des  Pays  Chauda. 
Chabert,  1821. 

7G.     Flava  Febre  Tropica. 
Bartholomaei,  1822. 

77.  Flava  Indiarum  Febre. 
Hunter,  1798. 

78.  Gastro-Cephalite. 
Vatable,  1828. 

79.  Gastro-Enteritis. 
LeRiveraud. 

80.  Gelbe  Fieber. 

Longermann,  1801,  and  German  writers  to  the 
present  da}'. 

81.  Gibraltar  Fever. 

Term  used  by  medical  writers  in  the  beginning  of 
the  Nineteenth  Century. 


78 


HISTOin      ()!•      ^  KI.I.OW     FEVER. 


82.  Haemaga.stuic  Pestilence. 

Coplaud,  "Dictionary  of  Practical  Medicine." 

83.  Haemelitic  Epidemic. 
Nicholson. 

84.  Inflammatory  Endemic. 
Dickson,  1819. 

85.  Jail  Feyer. 

So  called  by  the  inhabitants  of  the  island  of  Ber- 
muda, West  Indies,  in  1779,  because  the  feYer 
first  manifested  itself  among  the  prisoners  of 
war. 

8G.     Kendal's  Feyer. 

Humboldt  and  Hughes. 

87.     Maladie  De  La  Saison. 

Early  Antillian  writers,  who  propagated  the  theory 
that  the  disease  only  occurred  at  certain  seasons 
of  the  Year. 


88.     ]Malai)ie  Du  Diable. 

I'alligant.     The  word  which    means    "The    Devil's 
Illness,''  was  inspired  by  the  terror  it  created. 


^ 


89.     Maladie  Du  Pays. 

Early  Antillian  riironiclers.  This  signifies,  liter- 
ally, "■endemic  disease,''  and  is,  in  our  opinion, 
decidedly  appropriate. 


90.     ^Maladie  Matelotte. 
Early    French   writers. 
"FicYre  Matelotte."  • 


Companion  expression  of 


91.       :M  ALA  DIE  Si'ECIALE  Du  FOIE. 

Bercnger-Feraud. 


SYNONVyS    OF    YELLOW    FEVER.  79 

92.  Mal  De  Siam. 

So  called  because  of  the  general  belief  in  early  col- 
onial days  that  the  disease  had  been  imported 
from  Siam.  It  is  mentioned  by  Labat,  Chavalon, 
Desportes,  Morean  de  Saint-^Iery,  and  other 
chroniclers  of  the  period  and  was  known  by  this 
name  in  Martinique  and'  San  Domingo  near  the 
close  of  the  seventeenth  century.  It  is  found 
designated  by  this  name  in  the  old  Government 
and  local  records  (if  these  islands. 

93.  Maladie      Spasmodico-Lyperienne      Des       Pays 

Chauds. 
Chabert. 

94.  Malignant  Fever. 
Walsh. 

95.  3IALIGNANT   ATAXIC    FEVER. 

Disciples  of  the  School  of  Bally. 

9G.     Malignant  Contagious  Fever. 
Cathrall. 

97.  Malignant  Fever. 

AVarren,  1740;  Blauchini,  1750. 

98.  Malignant  and  Nervous  Fever. 
Berenger-  Feraud. 

99.  Malignant  Pestilential  Fever. 
Chisolm,  1795. 

100.  Malignant  Pi'trid  Pestilential  Fever. 
Berenger-Feraud. 

101.  ^fALIGNANT   REMITTENT   FEVER. 

AlcDiarmid,  London  Med.  Gaz.,  vol.  2,  p.  444. 

102.  ;Malignant  Yellow  Fever. 
Berenger-Feraud. 


80  HISTORY    OF    YELLOW    FEVER. 

103.     ^Iatlazahuatl. 

Humboldt  says  that  the  Aztecs  thus  called  the  dis- 
ease and  claims  that  their  records  speak  of  the 
pestilence  as  ravaging  Mexico  even  as  far  back 
as  the  Eleventh  Century. 

10 J:.     Meditteranean  Fever. 
Burnett,  181G. 

105.     Meningo-Cephalo-Gastrite. 

Maher. 

I 

100.     Mosquito  Fever. 

This  expression  was  first  used  by  New  Orleans 
newspapers  in  1905,  to  commemorate  the  most 
glorious  victory  over  i^estilential  diseases  which 
has  ever  been  achieved. 

107.  Xautical  Typhus. 

Adouard,  Faget,  Gamgee,  and  adherents  of  the 
ship  origin  of  yellow  fever. 

108.  XovAE  Pestis  Americae. 
Eisner,  1805. 

101).     XER^'ous  Gastric  Fever. 
Berenger-Feraud. 

110.  New  Distemper  of  1791. 

American  writers,  beginning  of  Nineteenth  Cen- 
tury. 

111.  Occidental  Pestilence. 
Berenger-  Feraud. 

112.  OCHROPYRA. 

From  '•'Ochre,"  yellow,  and  "Pyra,"  fire,  meaning, 
literally,  a  burning  or  ardent  fever. 


SYNONYMS    OF    YELLOW    FEVER.  81 

.   113.     Palatine  Fever. 

Name  originally  given  to  the  pestilence  which 
reigned  at  Philadelphia  in  1741,  owing  to  the 
popular  notion  that  it  had  been  brought  to  the 
City  by  some  German  emigrants  from  the  Pala- 
tinate. 

111.     Peste  or  Pestilenx'ia. 

Early  Spanish  chroniclers. 

115.  Peste  Caraibe. 

Early  French  and  Spanish  writers. 

116.  Pestilential  Fever. 

Rochefort,  Bajon,  Hughes,  Fermin,  Chanvalon, 
Chirac. 

117.  Pestis  Tropicus. 
Hosack. 

118.  Poulicantina. 
Carib  Indians. 

119.  Putrid  Inflammatory  Synocope. 
Berenger-Feraud. 

120.  Putrid  Fever. 
Hughes,  1750. 

121.  Putrid  Malignant  Fever. 
Berenger-Feraud. 

122.  Putrid  Synocope. 
Berenger-  Feraud. 

123.  Ship  Fever. 
Audouard  and  his  school. 

124.  Spanish  Fever. 
Cadet,  1822. 


82  HISTORY    OF    YELLOW    FEVER. 

125.  Strangers'  Fever. 

Simons,  1839.  So  called  in  Charleston,  S.  C,  as 
the  disease  was  thought  to  attack  only  new- 
comers. 

126.  Synochus. 
Young. 

127.  Synochus  Atrabiliosa. 
Schotte,  1782. 

128.  Synochus  Icterodes. 
Currie,  1794. 

129.  Synochus  Maligna. 
Cathrall,  1794. 

130.  Tanardilla. 

Moreau  de  Saint-Mery  says  this  designation  was 
quite  prevalent  in  San  Domingo  and  Spanish 
America.  It  is  derived  from  the  Spanish  and 
means  a  febrile  illness  followed  by  jaundice, 

131.  TiFus  Icterodes. 
Flores,  1813. 

132.  Tritopheia  Americana. 
Sauvages. 

133.  Tropical  Fever. 
Berenger-Feraud. 

134.  Tropical  Continued  Fever. 

Lemprierre. 

135.  Tropical  Endemic  Fever. 
Dickson;  Belcher. 

136.  Typho-Icterode  Animadversion es. 
Leiblin,  1815. 


SYNONYMS    OF    YELLOW    FEVER.  83 

137.  Typhus. 

According  to  Laroche,  yellow  fever  has  been  re- 
garded as  a  hybrid  form  of  typhus  by  such  emi- 
nent authorities  as  Blane,  Lempriere,  Dickson 
and  Chisolm. 

138.  Typhus  Accidentel  Ou  Igterique. 
Savaresy. 

139.  Typhus  Amarilla. 

This  term  came  into  general  use  shortly  after  the 
War  of  1812.  It  was  then  that  the  great  discus- 
sion about  the  contagiousness  of  yellow  fever 
reached  its  zenith. 

140.  Typhus  Icterodes  Padecido. 
Moreno,  1813. 

141.  Typhus  Cum  Flavedine  Cutis. 
Cullen. 

142.  Typhus  D' Amerique. 
Bally. 

143.  Typhus  Icterodes. 
Sauvages. 

144.  Typhus  Tropicus. 

English  and  American  writers,  beginning  of  last 
century. 

145.  Typhus  Miasmatique  Ataxique  Putride  Jaune. 
Bally. 

146.  Vomito. 

From  1709  to  1790,  Yellow  Fever  was  popularly 
known  as  "Vomito." 

147.  Vomito  Amarilla. 

According  to  Chambers'  Encyclopedia,  article  on 
Yellow  Fever,  the  disease  is  designated  by  the 
above  name  in  Central  America. 


84 


HISTORY     OF    YELLOW     FEVER 


148.  VoMiTO  Negro  Epidemico. 
Gastiblondo,  1755. 

149.  Vo:mit()  Negro. 

Early  colonial  writers.  The  word  is  Spanish  and 
means  "Black  Vomit." 

150.  VOMITO  Prieto. 

Spanish  writers.  Same  meaning  as  "Vomito  Ne- 
gro." 

151.  Yellow  Fever. 

At  the  present  day  the  name  Yellow  Fever  and 
translations  is  used  by  all  writers,  to  the  exclu- 
sion of  all  other  names.  The  term  was  first  used 
by  Griffith  Hughes  in  1750,  in  his  "Natural  His- 
tory of  Barbadoes." 


152.     Yelli)\v  Jack. 

A  popular  name  for  the  disease  in  England  and  the 

United  States. 


CHAPTER  III. 

HISTORCCAL  SUMMARY. 

Where  was  the  Cradle  of  Yellow  Fever? — The  Theory  of  American 
Origin.— The  African  Theory. — The  Asiatic  Theory. — The  Gulf  Stream 
Theory. — Observations  by  the  Author  on  the  above  Theories. 

Where  was  the  Cradle  of  Yellow  Fever? 

There  is  no  subject  in  medicine  ujjon  which  there  has 
been  such  a  diversity  of  opinion  as  the  origin  of  yellow 
fever.  From  the  time  of  Bally,  in  the  seventeenth  century, 
when  the  controversy  can  really  be  said  to  have  begun,  to 
the  present  day,  medical  writers  and  historians  have  been 
theorizing  and  conjecturing  on  the  matter,  but  nothing 
has  been  adduced  which  can,  in  the  remotest  way,  be  said 
to  have  thrown  any  new  light  on  the  vexed  and  seemingly 
unending  question.  As  soon  as  one  writer  would  launch 
a  doctrine  which,  in  his  opinion,  was  plausible  and  in- 
contestable, another  Avould  come  to  the  front  and  adroitly 
dissect  it,  laying  bare  its  imperfections  to  the  glaring 
light  of  logic,  and  inaugurate  a  theory  of  his  own,  which, 
in  turn,  would  be  mercilessly^  denuded  of  every  semblance 
of  common  sense  by  a  third  disputant,  who  would  bring 
columns  of  statistics  and  page  after  i)age  of  deuuci- 
atory  arg-uments  to  prove  that  no  one  but  himself  was 
on  the  right  track  and  that  every  previous  writer  hold- 
ing a  contrary  view  had  either  erred  owing  to  gross  ignor- 
ance of  what  he  was  proclaiming  or  had  intentionally 
juggled  with  the  facts. 

Some  authors  assert  that  yellow  fever  has  affected  man- 
kind from  pre-Christian  times,  citing  in  support  of  their 
contention  the  writings  of  ancient  observers  and  philoso- 
phers; others  claim  that  it  is  a  purely  American  product 
and  deny  its  existence  before  the  discovery  of  America, 
laying  the  blame  for  its  importation  into  Europe  and 
Africa  to  the  slave  trade  and  indiscriminate  commerce  of 
colonial  days. 

A  careful  search  into  the  voluminous  literature  on  the 
origin  of  yellow  fever  naturally  leads  to  the  query: 

Where  was  the  cradle  of  vellow  fever? 


86  HISTORY    OF    YELLOW    FEVER. 

The  problem  is  as  difficult  of  solution  as  the  Si/Uogismus 
CrocodUus  of  Airistotle.  After  centuries  of  discussion,  we 
are  no  nearer  the  truth  than  our  forefathers  were.  Such 
eminent  observers  as  Bancroft,  Cornilliac,  Bally,  Moreau 
de  Jonnes,  Phvsick,  Chaille,  Toner,  Saint-Mery,  Finlay, 
Cullen,  Sternberg,  Ferreira,  Rochefort,  Audouard,  Ber- 
anger-Feraud,  Valdez,  Rush,  La  Roche,  Jones,  Faget  and 
others,  have  conjectured  ah  lihitum  upon  the  origin  of  the 
disease,  but  their  conclusions  have  only  left  us  a  diver- 
gence of  opinion  which  no  amount  of  conjecture  can 
bridge  and  which  defies  the  most  abstruse  laws  of  com- 
mon sense  and  logic. 

That  great  American  philosopher,  Humbolt,^  admir- 
ably sums  up  the  situation  in  the  following  words : 

''In  all  climates  men  appear  to  find  some  consolation 
in  the  idea  that  a  disease  considered  pestilential  is  of  for- 
eign origin.  As  malignant  fevers  easily  originate  in  a 
numerous  crew  cooped  up  in  dirty  vessels,  the  beginning 
of  an  epidemic  may  be  frequently  traced  to  the  period  of 
the  arrival  of  a  squadron;  and  then,  instead  of  atribut- 
ing  the  disease  to  the  vitiated  air  contained  in  vessels  de- 
prived of  ventilation,  or  to  the  effects  of  an  ardent  and 
unhealthy  climate  on  sailors  newly  lauded,  they  affirm 
that  it  was  imported  from  a  neighboring  port,  where  a 
squadron  or  convoy  touched  at  during  its  navigation  from 
Europe  to  America.  Thus  we  frequently  hear  in  Mexico 
that  the  ship-of-war  which  brought  such-or-such  a  viceroy 
to  Vera  Cruz  has  introduced  the  yellow  fever  wliich  for 
several  years  had  not  prevailed  here;  and  in  this  manner 
during  the  season  of  greatest  heat  the  Havana,  Vera  Cruz, 
and  the  ports  of  the  United  States  mutually  accuse  one 
another  of  communicating  the  germ  of  the  contagion.  It 
is  with  the  yellow  fever  as  with  the  nu)rtal  typhus  known 
by  the  name  of  'Oriental  pest,'  which  tlie  inhabitants  of 
Egypt  attribute  to  the  arrival  of  Greek  vessels,  while  in 
Greece  and  Constantinople  the  same  pest  is  considered 
as  coming  from  Rosetta  or  Alexandria.'' 

Let  us  now  consider  these  theories  seriatim. 


*  Humboldt:  Poltical  Essay  on  the  Kingdom  of  New  Spain,  vol. 

1,  1).  219. 


HISTORICAL     SUMMARY.  87 

1.     The  Origin  of  Yellow  Fever. 

A  search  through  musty  archives,  time-yellowed  tomes 
and  worm-eaten  volumes  two  or  more  centuries  old,  re- 
veals the  fact  that  the  first  epidemic  of  yellow  fever  in  the 
New  World,  took  place  in  the  West  Indies  in  1647,  the  de- 
tails of  which  are  faithfully  chronicled  in  Ligon's  History 
of  Barbacloes.  Outbreaks  of  the  fever  are  noted  by  other 
observers  as  having  caused  much  mortality  before  this, 
among  which  is  the  pestilence  which  mowed  down  the  fol- 
lowers of  Columbus  in  1494  and  the  series  of  epidemics 
in  Brazil  which  lasted  from  1G88  to  1694.- 

We  shall  now  proceed  to  give  the  views  of  the  best 
authorities  upon  the  subject,  believing  with  Quiutilian  that 
"searching  into  every  particular,  we  sometimes  discover 
truth  where  we  least  expected  to  find  it." 

The  earliest  authentic  description  of  yellow  fever  is 
that  of  the  Portuguese  physician  Ferreira  da  Kosa,  who 
observed  the  epidemics  which  prevailed  at  Olinda,  in 
Brazil,  from  1687  to  1694,  shortly  after  the  Portuguese 
army  had  made  the  conquest  of  Pernambuco.  Ilumboldt 
notes  the  fact  that  it  is  known  with  certainty  that  in 
1691  yellow  fever  manifested  itself  at  the  Island  of  Bar- 
badoes,  West  Indies,  where  it  went  by  the  name  of  ''Ken- 
dal's Fever,"  without  the  slightest  proof  that  it  Avas 
brought  tliere  by  vessels  from  Pernambuco.  The  natural 
conclusion  is  that  the  disease  must  have  been  ei)idemic  in 
the  locality  at  that  time. 

Ulloa,^  speaking  of  the  Cliapctonadas,  or  fevers  to 
which  Europeans  were  exposed  on  their  arrival  in  the 
West  Indies,  relates  that  according  to  the  opinion  of  the 
people  of  the  country,  the  vouilto  pricto  was  unknown  at 
Santa  Martha  before  1729  and  at  Carthugena  previous  to 
1740.  The  first  epidemic  at  Santa  Martha  is  described  by 
de  Gastilbondi,'*  a  Spanish  i)hysician.  Since  that  time, 
the  inroads  of  yellow  fever  have  been    almost     universal 


^'Ferreyra  da  Rosa:     Traitado  da  Constitucion  Pestilencial  de 

Pernambuco,  by  Joam  Ferreira  da  Rosa  (1694). 
=  Ulloa:     Voyage,  etc.,  pp.  41  and  149. 
*Gastiblondi:     Lazuriaga  de  la  Calentura  Biliosa,  p.  7. 


88 


HISTORY    OF    YELLOW    FEVER. 


and  are  given  in  detail   under  proper   classifications  in 
other  portions  of  this  volume. 

The  Twentieth  Century  Fraefice,  a,  work  which  occu- 
pies a  foremost  place  in  medical  literature,  in  an  article 
on  the  history  of  yellow  fever,  says  :"* 

"It  would  afford  the  student  of  the  disease  a  great  deal 
of  satisfaction  if  he  could  locate  its  first  habitat,  but  that 
privilege  is  denied  him.  As  far  as  we  moderns  are  con- 
cerned, we  date  the  disease  from  the  time  of  Columbus 
and  his  followers.  The  disease,  no  doubt,  existed  in  pre- 
historic times,  and  is  buried  in  that  nebulous  past  that 
envelopes  so  many  infectious  and  contagious  diseases." 

La  l\oche*^  adheres  to  the  belief  that  the  West  Indies, 
and  part  of  the  coast  of  North  and  South  America,  con- 
stitute the  proper  soil  of  yellow  fever. 

Herrera,  Oviedo  and  other  early  Spanish  writers,  relate 
that  shortly  after  the  arrival  of  the  Europeans  in  Ameri- 
ca, they  were  decimated  by  a  sudden  and  very  fatal  pestil- 
ence, which  committed  fearful  ravages.  Columbus  him- 
self was  stricken  by  the  malady  on  his  second  voj^age- 
while  at  the  island  of  Moua,  AVest  Indies,  and  was  in 
great  danger,  escaping  death  b3'  immediately  sailing  for 
the  high  seas. 

Berenger-Feraud,^  one  of  the  ablest  and  most  conscien- 
tious authorities  on  the  subject,  tells  us  that  the  first  at- 
tempts to  colonize  Porto  Eico  were  frustrated  by  the  pre- 
valence of  tliis  unknoAvn  pestilence  and  notes  the  fact 
that  of  the  1500  men  which  had  been  left  by  Columbus  at 
Monte  Cristo  in  1493,  there  remained,  two  j'cars  after- 
wards, only  two  hundred  foot  soldiers  and  twenty  cavalry- 
men. The  attempts  to  colonize  St.  Domingo  (1191:  and 
1504),  Porto  Rico  (1508  and  1513),  the  Isthmus  of 
Darien  (1509  and  1514),  were  also  retarded  by  the  rav- 
ages of  the  saiiu'  disease.  So  fatal  was  this  malady,  es- 
l)ecially  in  Saint  ])()ming(>,  that  the  Spanish  Government, 
loth  to  lose  this  coveted  possession,  but  not  wishing  to  ex- 
pose its  soldiers  to  annihilation,  sent  as  colonists  to  the 


"Page  401, 

"La  Roche:     Vol.  1,  p.  219. 

'  Gazette  des  Hapitaux,  1S84,  vol.  57,  p.  660. 


HISTORICAL     SUMMARY.  89 

island  two  hundred  convicts.     These   criminals    can     be 
said  to  have  been  the  i)ioneer  settlers  of  the  island. 

At  Darien,  in  1509,  the  expedition  commanded  by  Da- 
vila  lost  seven  hundred  men  in  a  single  month.  Panama 
had  the  same  experience.*^ 

Fathers  Breton  and  Dutertre,^  who  describe  the  epi- 
demic of  1635,  in  Guadeloupe,  sa3^s  that  it  was  known 
among  the  Caribs  b^'  the  name  of  Poulicantlna,  a  word 
which  signifies  "I  am  struck  vdih.  a  switch,"  which  meant 
to  describe  the  suddenness  which  characterized  the  onset 
of  the  fever.  These  same  observers  say  that  the  disease 
was  considered  so  infectious  by  the  natives,  that  those 
stricken  were  often  abandoned  to  their  fate  and  whole 
villages  were  deserted  when  the  first  cases  appeared,  the 
torch  being  applied  by  the  terror-stricken  Caribs,  so  as 
to  prevent  the  further  spread  of  the  infection. 

Ziemssen's  Cyclopedia  of  the  Practice  of  Medicine ^^ 
that  wonderful  storehouse  of  medical  lore,  which  is  edited 
with  that  careful  attention  to  accuracy  and  to  the 
minutest  details  which  characterize  the  German  mind, 
has  the  following  observations  on  the  subject: 

"We  are  entirely  without  trustworthy  information  re- 
garding the  first  appearance  of  yellow  fever.  It  is  highly 
probable,  that  the  communication  of  various  authors, 
which  inform  us  of  the  prevalence  of  the  disease  in  the 
Antilles  since  the  memory  of  man,  really  refer  to  yellow 
fever.  The  theory  is  much  more  tenable  that  the  disease 
was  first  developed  after  the  immigTation  of  Europeans 
into  the  West  India  Islands;  at  least,  it  agrees  better 
with  many  facts,  which  have  been  since  observed,  to  con- 
sider yellow  fever  as  an  acclimation  disease  (of  the 
tropics),  to  which  immigrants  are  liable,  tlian  to  assume 
that  it  originally  prevailed  as  an  epidemic  disease  among 
the  natives,  and  afterwards  underwent  a  complete  altera- 
tion of  its  character.  The  Antilles  were  probably  the 
cradle  of  yellow  fever;  at  least,  accurate  observations  of 
the  disease  in  question  were  first  made  here." 

The  Board  of  Experts  authorized  by  Congress  to  in- 


Mbid. 

^Du  Teitre:     Histoire  General  des  Antilles,  vol.  1,  p.  30. 

^"Vol.  1  (1S74,),  p.  489. 


90  HISTORY    OF    YELLOW    FLVKR. 

vestigate  the  ygIIow  fever  epidemic  of  1878,  after  tliorough 
and  minute  investigations,  reached  the  following  conclu- 
sions :^^ 

"Yellow  fever  was  not  known  to  the  people  of  the  East- 
ern Hemisphere  until  after  the  discovery  of  America  by 
Columbus.  The  earliest  epidemics  of  which  we  have  any 
historical  information  occurred  during  the  first  half  of 
the  seventeenth  century,  in  the  West  India  islands." 

Joseph  Jones,  one  of  Louisiana's  most  distinguished 
physicians,  whose  works  on  fevers  are  acknowledged 
authorities,  makes  the  following  observations:^^ 

"After  a  critical  examination  of  the  works  of  Herod- 
otus, Strabo,  Justin,  Cornelius,  Nepos,  Eutropius,  Plu- 
tarch, Titus,  Linus,  Thucidides,  Homer,  Sallust,  Virgil, 
Flores,  Vallerius,  Particulus,  Caesar,  Horace,  Cicero, 
Xenophon,  and  Tacitus,  we  have  failed  to  recognize  the 
disease  now  called  yellow  fever,  in  any  descriptions  of 
particular  plagues  or  allusions  to  any  pestilence;  and  in 
like  manner,  while  in  the  writings  of  the  middle  ages  we 
have  descriptions  of  wide-spread  and  mortal  plagues, 
amongst  which  may  be  recognized  the  oriental  glandular 
plague,  small-])ox,  measles,  typhus  and  typlioid  fevers,  the 
sweating  sickness,  elephantiasis  or  leprosy,  cholera, 
dysentery,  and  cerebro-si)inal  meningitis;  yellow  fever 
finds  no  place  in  these  annals  of  general  history,  or  of 
nu'dicine,  previous  to  the  discovery  of  Anuu-ica  l)y  Colum- 
bus. As  we  have  failed  to  find  any  history  or  record  of 
3'ellow  fever  before  the  voyage  of  Christopher  Columbus, 
the  first  question  of  importance  which  presents  itself  is, 
whether  yellow  fever  had  ever  prevailed  among  the 
aboriginal  inhabitants  of  North  and  South  America  and 
the  West  Indies  previous  to  the  discovery  of  America  and 
the  explorations  of  the  Spanish  adventurers,  and  the  es- 
tablishment of  the  Spanish,  French,  Portuguese,  Dutch 
and  English  colonies?" 

Dr.  Jones  then  goes  on  to  say  that  the  West  India 
Islands  and  certain  portions  of  North  and  South  Ajueri- 
ca,  as  the  Valley  of    the    Mississippi,     Mexico,     Central 

"  See  Report,  p.  — 

"Jones:     Proceedings  Louisiana  State  Medical   Society,  1879, 
p.  54. 


HISTORICAL     SUMMARY.  91 

America  and  Peru,  appear  to  have  been,  at  the  time  of 
their  discovery  by  Europeans,  peopled  with  a  suflflciently 
dense  population  for  the  existence  of  those  conditions 
upon  which  the  origin  and  spread  of  certain  diseases  de- 
pend. The  wholesale  destruction  of  the  native  popula- 
tion b}^  cruel  wars,  and  by  still  more  cruel  slavery,  and 
by  the  introduction  of  certain  diseases,  as  the  small-pox, 
as  well  as  the  wanton  destruction  of  the  pictorial  works 
by  which  the  hieroglyphics  of  the  more  advanced  nations 
of  America  might  have  been  deciphered,  and  the  sudden 
and  utter  subversion  of  the  systems  of  religion  and  science 
peculiar  to  these  people,  and  the  rapid  disappearance  of 
the  royal  families  and  priests  who  were,  as  in  ancient 
Egypt,  the  custodians  of  the  national  science  and  art,  have 
involved  in  obscurity  many  subjects  of  gTeat  and  lasting 
interest  to  the  medical  historian. 

The  medical  historian  has  only  imperfect  and  doubtful 
data  upon  which  to  found  any  opinion  as  to  the  nature 
of  tiie  epidemic  and  contagious  diseases  which  afflicted 
the  aborigines  previous  to  the  discovery  of  the  Western 
Hemisphere. 

That  the  more  populous  nations  of  America  were  not 
exempt  from  diseases  of  an  epidemic  and  pestilential  na- 
ture, has  been  well  established. 

The  pestilence  called  by  the  Mexicans  "Matlazahuatl" 
desolated  the  cities  of  tlie  Toltecs  in  the  eleventh  century, 
and  forced  them  to  abandon  Mexico,  and  to  continue  their 
migrations  southward,  and  to  the  west  and  northwest;  it 
invaded  the  populous  cities  of  Central  America,  and  a 
similar  disease  committed  great  ravages  amongst  the  In- 
dian tribes  which  occupied  the  country  between  the 
mountains  and  the  Atlantic  coast  a  few  years  before  the 
landing  of  the  Pilgrim  Fathers. 

The  Matlazahuatl,  a  disease  closely  resembling  yellow 
fever,  but  Avhich  is  said  to  be  peculiar  to  the  Indian  race 
of  America,  has  seldom  appeared  more  than  once  in  a 
century;  it  raged  in  the  eleventh  century  amongst  the 
Toltecs,  it  made  great  ravages  amongst  the  Mexicans  in 
1545,  157G,  1730,  1737,  17(3i  and  1703,  and  amongst  the 
Indians  of  the  Atlantic  coast  in  1018  and  1019. 

According  to  Alexander  Humboldt,  the  Matlazahuatl, 


92 


HISTORY    OK    YELLOW    FEVER. 


although  pestilential  in  its  nature,  and  attended  with 
htTMuorrhaue  from  the  nose  and  stomach,  was  distinct  from 
the  ^'omito  l*iieto,  and  Avas  peculiar  to  the  aborigines 
of  America.  The  Spanish  authors  call  this  disease  a 
plague.  The  following  j)iissage  from  Humboldt's  "Politi- 
cal Essay  on  New  Spain"'  appears  to  embody  all  that  is 
known  with  reference  to  the  nature  of  the  Matlazahuatl  of 
the  Mexicans : 

"The  ]Matlazahuatl,  a  disease  peculiar  to  the  Indian 
race,  seldom  api)ears  more  than  once  in  a  century'.  It 
raged  in  a  particular  manner  in  1545,  157G  and  1736.  It 
is  called  a  plague  by  the  Spanish  authors.  As  the  latest 
epidemic  took  place  at  a  time  when  medicine  was  not  con- 
sidered as  a  science,  eyen  in  the  cai)ital,  we  haye  no  exact 
data  as  to  the  ^Matlazahuatl.  It  bears  certainly  some 
analogy  to  the  yellow  feyer  or  black  yomiting;  but  it 
neyer  attacks  white  people,  whether  Europeans  or  de- 
scendants from  the  natiyes.  The  indiyiduals  of  the  race 
of  Caucasus  do  not  appear  subject  to  this  mortal  typhus, 
while,  on  the  other  hand,  the  yellow  feyer  or  black  yomit- 
ing yery  seldom  attacks  the  Mexican  Indians.  The  prin- 
cipal site  of  the  Vomito  Prieto  is  the  maritime  region,  of 
wliich  tlie  climate  is  exeessiye^ly  warm  and  humid;  but  the 
Matlazahuatl  carries  terror  and  destruction  into  the  yery 
interior  of  the  country,  to  the  central  table-land,  and  the 
coldest  and  the  most  arid  regions  of  the  kingdom. 

"Father  Forribio,  a  Franciscan,  better  known  by  his 
Mexican  name  of  Motolina,  asserts  that  the  small-pox  at 
its  introduction  in  1520,  by  a  negro  slaye  of  Naryaez,  car- 
ried oft"  half  tlie  inhabitants  of  ^Fexico.  Tixpiemada  ad- 
yances  the  hazardous  ()])iiii(>n  that  in  tlic  two  Matlaza- 
huatl epidemics  of  1545  and  1576,  800,000  Indians  died 
in  the  former,  and  2,000,000  in  the  latter.  But  when  we 
reflect  on  the  difficulty  with  which  we  can  at  this  day 
estimate  in  tlie  eastern  parts  of  Europe  the  number  of 
those  wlio  fall  yictims  to  the  plague,  we  shall  yery  reas- 
onably be  inclined  to  doubt  if  the  Viceroys  Mendoza  and 
Almanaza,  goyernors  of  a  recently  conquered  country, 
were  able  to  ])ro(ure  an  enumeration  of  tTie  Indians  cut 
off  by  the  Matlazahuatl.  I  do  not  accuse  the  two  monkish 
historians  of  want  of  yeracity,  but    there   is    yery    little 


HISTORICAL     SUMMARY.  93 

probability  that  their  calculation  is  founded  on  exact 
data. 

"A  very  interesting"  problem  remains  to  be  resolved. 
Was  the  pest  which  is  said  to  have  desolated  from  time 
to  time  the  Atlantic  reij;ions  of  the  United  States  before 
the  arrival  of  the  Europeans,  and  which  the  celebrated 
Kush  and  his  followers  look  upon  as  the  principle  of  the 
yellow  fever,  identical  with  the  Matlazahuatl  of  the 
Mexican  Indians?  We  may  hope  that  this  last  disease, 
should  it  ever  reappear  in  New  Spain,  will  be  hereafter 
carefully  observed  by  the  physicians."^-'' 

Humboldt  further  states  that  long  before  the  arrival 
of  Cortez  there  had  almost  periodically  prevailed  in  New 
Spain  an  epidemical  disease  called  by  the  natives  Matlaza- 
huatl,  which  several  authors  have  confounded  with  the 
Vomito  or  yellow  fever.  This  plague  was  i)robably  the 
same  as  that  which  in  the  eleventh  century  forced  the 
Toltecs  to  continue  their  emigrations  southwards.  It 
made  great  ravages  amongst  the  Mexicans  in  1545,  15TG, 
1730,  1737,  1761,  and  17()3 ;  but  as  has  already  been  ob- 
served, it  differed  essentially  from  the  Vomito  of  Vera 
Cruz.  It  attacked  few  except  the  Indians  or  copper-col- 
ored race,  and  raged  in  the  interior  of  the  country  on  the 
central  table-land,  at  twelve  or  thirteen  hundred  feet 
above  the  level  of  the  sea.  It  is  true,  no  doubt,  that  the 
Indians  of  the  valley  of  3Iexico  who  ])erished  by  the  thou- 
sands in  1701  of  the  Matlazahuatl,  vomited  blood  at  the 
nose  and  mouth;  but  these  hjenuitemeses  frequently  oc- 
curred under  the  troi)ics,  accom])anying  bilious  ataxical 
((if(i.ri</itc.s)  fevers;  and  they  were  also  observed  in  the 
epidemical  disease  which  in  175!)  prevailed  over  all  South 
Anu^rica,  from  Potosi  and  Oraso  to  C^uito  and  Po])azan, 
and  which,  from  the  incomi)hte  descri])tion  of  Tnh)a,  was 
a  typlius  peculiar  to  the  eh'vated  regions  of  the  Cordil- 
leras. 

In  summing  up  the  result  <^f  his  investigations.  Dr. 
Jones  says: 

"It  is  evident,  therefore,  that  the  origin  of  the  American 
plague  or  typhus   {vomito  prieto,    fievre    jaune,     yellow 

"Humboldt:      Political  Essay  in  the  Kingdom  of  New  Spain, 
vol.  1,  p.  I'll. 


94  HISTORV    OF    YELLOW    FEVER. 

fever)  is  involved  in  doubt,  on  account  of  the  prevalence 
in  the  tropical  and  sub-tropical  regions  and  temperate 
zones,  both  amongst  the  natives  and  foreigners,  of  some 
forms  of  malarial  fever,  often  attended  with  jaundice, 
passive  luemorrhages,  and  black  vomit.  If  it  could  be  de- 
termined at  what  time  this  terrible  disease  was  clearly 
recognized  by  the  medical  profession  and  historical 
writers  as  distinct  from  paroxsymal  malarial  fever,  and 
as  dependent  upon  a  specific  cause  or  upon  a  combination 
of  causes  peculiar  to  itself,  a  firm  ground  for  the  discus- 
sion of  its  origin  and  of  its  relations  to  the  native  popula- 
tion, as  well  as  to  the  foreign  elements,  would  be  estab- 
lished. But  it  is  well  known  that  many  of  the  descrip- 
tions given  by  various  authors  will  apply  as  well  to  the 
severer  forms  of  paroxysmal  malarial  fever  as  to  yellow 
fever,  and  also  that  the  distinction  of  the  one  from  the 
other  has  been  the  result  of  comparatively  recent  labors, 
and  even  at  the  present  time  there  are  not  a  few  physi- 
cians who  hold  to  the  identity  of  both  diseases  in  their 
origin  and  essential  nature." 

Clemow-^*  says  that  so  far  as  a  somewhat  imperfect 
knowledge  of  the  history  of  the  disease  enables  us  to 
judge,  it  seems  certain  that  originally  yellow  fever  was 
essentially  an  American  disorder,  and  that  though  the  in- 
fection has  to  some  extent  become  domiciled  on  the  African 
shores,  it  is  more  than  i)robable  it  was  originally  brought 
there  from  South  America  or  the  West  Indies.  ''It  is  to 
be  noted,"  continues  this  author,  "that  some  writers  have 
held  exactly  the  contrary  view  and  believed  that  yellow 
fever  was  originally  imported  to  the  West  Indies  l)y  means 
of  infected  negroes  from  Africa. ^^  The  facts  of  history 
are,  however,  against  this  view,  and  there  is  much  evi- 
dence to  show  that  this  fever  was  known  in  those  part  of 
America  wliere  it  still  prevails,  even  before  the  discovery 
of  the  continent  by  Europeans,  and  long  before  the  trans- 

"Clemow:     The  Geography  of  Disease,  by  Frank  J.  Clemow, 

(jS03),  p    520. 
"In  1699  an  English  vessel  carrying  slaves  transported  yellow 

fever  to  Mexico  from  the  Atlantic  coast  of  Africa.     Dot 

the  disease  was  already  endemic  along  the  shore  of  the 

Gulf  of  Mexico.     G    A. 


I 


HISTORICAL     SUMMARY.  95 

port  of  negroes  from  Africa  to  the  West  Indies  began  to 
be  practised." 

Toner  believes  that  the  conceded  home  of  yellow  fever 
is  the  West  Indies.^*^ 

Stille^"  asserts  that  yellow  fever  unquestionably  ori- 
ginated in  the  West  Indies,  where  it  was  observed  at  St. 
Domingo  at  the  end  of  the  fifteenth  century.  It  was  then 
carried  to  Mexico  and  other  localities  bordering  on  the 
Gulf  of  Mexico,  where  it  i^revailed  to  a  great  extent  in  the 
seventeenth  century. 

Finlay,^^  in  commenting  on  the  history  of  the  disease, 
asserts  that  the  remotest  records  about  epidemic  disease 
in  the  Old  World  fail  to  show  that  yellow  fever,  or  any 
other  malady  presenting  similar  epidemiological  features, 
had  ever  been  observed  previous  to  the  discovery  of 
America  in  1402;  while  in  the  newly-discovered  lands  it 
soon  became  apparent  that  every  expedition  of  P^uropean 
settlers  that  came  to  the  Antilles  or  to  the  Spanish  Main 
had  to  pay  a  heavy  tribute  to  an  unknown  pestilence,  dur- 
ing the  first  summers  of  their  residence,  suffering  there- 
after no  further  trouble  from  the  climate. 

About  fifteen  years  ago,  Drs.  Finlay  and  Berenger- 
Feraud,^^  independently  of  each  other,  undertook  minute 
historical  researches  regarding  this  "unknown  pestilence," 
and  came  to  the  conclusion  that  the  disease  mentioned  in 
the  old  Spanish  chronicles  as  the  "peste,"  "coutagio"  or 
"epidemia,"  was  no  other  than  our  modern  yellow  fever. 
They  also  reached  the  conclusion  that  at  the  time  of  the 
discovery  of  America  the  disease  was  endemic  on  the 
coast  of  Mexico,  at  the  present  site  of  Vera  Cruz,  as  well 
as  on  the  Atlantic  site  of  the  Isthmus  of  Panama,  and  on 
the  Spanish  Main  along  the  coast  of  Colombia  and  Ven- 
ezuela, inhabited  by  the  Carib  Indians. 


'« The  Distribution  and  Natural  History  of  Yellow  Fever  in  the 
United  States,  by  J.  M.  Toner.  American  Public  Health 
Association  Reports,  1873,  vol.  f,  p.  359. 

"Stille:     Medical  Record,  N.  Y.,  1879,  vol.  15,  p.  193. 

"Finlay:  Reference  Handbook  of  the  Medical  Sciences,  Vol. 
8,  p.  322. 

"  Ibid. 


96  HISTORY    OF    YELLOW    FEVER. 

This  view  is  also  concurred  in  by  Anders,-'^  who  states 
that  yellow  fever  lirst  appeared  at  Barbadoes  (West  In- 
dies) in  1G47  and  was  subsequently  conveyed  along  the 
channels  of  commerce,  until  it  became  widely  dissemin- 
ated. 

Even  the  old  stand-by  of  every  American  school-boy, 
the  venerated  and  verbose  Xoah  Webster,-^  has  something- 
to  say  on  the  subject.  He  tells  us  in  all  seriousness  that 
yellow  fever  prevailed  among  the  Indians  of  Canada  and 
New  England  in  1G18,  was  again  epidemic  in  1740  and 
nuide  spasmodic  appearances  among  the  noble  sous  of  the 
forest  at  various  stated  periods. 

According  to  the  report  of  Beyer,  Parker  and  Pothier,-^ 
yellow  fever  has  been  endemic  in  Vera  Cruz  since  1509. 

Manson,  Avhose  work  on  Tropical  Diseases  is  one  of  the 
classics  of  medical  literature,  does  not  consider  the  mat- 
ter of  much  importance,  summing  up  the  situation  in  a 
few  words,  simply  stating  that  it  is  impossible  to  deter- 
mine from  existing  records  whether  it  was  originally  an 
African  or  a  AVest  Inelian  disease.-^ 

One  of  the  strange  freaks  of  yellow  fever  visitations  is 
recorded  by  Stille,-^  who  claims  that  the  disease  was  in- 
troduced into  Dutch  Guiana  in  ITJI.'i  from  the  West  In- 
dies. For  a  i)eriod  of  37  years  after  this,  it  never  invaded 
that  province.  At  the  end  of  this  long  period  of  immunity 
the  colony  suffered  from  a  new  imjjortation  of  the  disease, 
which  visited  it  annually  thereafter  for  ten  successive 
years,  when  it  ceaseel  and  for  the  six  following  years  failed 
to  occur.  It  was  then  reintroduced  by  an  infected  vessel 
and  spread  moie  widely  than  before. 

At  the  time  s])<)ken  of  by  Stille,  Sjjain  iK)ssessed  by  far 
the  best  and  largest  jxjrtion  of  the  American  continent, 
extending  from  the  north  of  California  to  the  Straits  of 
jNIagellan — a  space  between  (),000  and  7,000  miles — and 

-■"Practice  of  Medicine,  by  James  M.  Anders,  (1899)  p.  119. 
-'  History  of    Epidemic    and    Pestilential    Diseases,    by    Noah 

Webster,  vol.  1,  p.  177. 
"Report  of  Yellow  Fever  Party  No.  1,  Yellow  Fever  Institute, 

p.  ]2. 
=' Tropical  Diseases,  by  Patrick  Manson  (1903),  p.  187. 
=' Medical  Record,  N.  Y.,  1879,  vol.  15,  p.  193. 


HISTORICAL     SUMMARY.  97 

the  systeiii  of  coiiinierce  A\hi(li  prevailed  tlieii  appeared 
to  be  emiuentl}'  favorable  to  tlie  orii^iii  and  spread  of  yel- 
low fever.  The  Spanish  galleons  (h.tted  the  seas  and, 
during  times  of  peace  (whieh  were  not  frequent  in  that 
age  of  buccaneering  and  aggressive  colonization)  visited 
the  principal  ports  of  the  Spanish  Empire,  where  they 
were  always  royalh^  entertained.  It  was  therefore  easy 
for  them  to  carry  disease  from  one  port  to  another,  a  fact 
which  is  attested  by  the  melancholic  record  of  the  fearful 
epidemics  which  visited  the  New  AA'orhl  in  the  early  days 
of  its  history. 

Joseph  Jones-'^  thus  interestingly  describes  the  usual 
programme  followed  by  the  galleons : 

"They  sailed  from  Cadiz  to  the  Canaries,  thence  for  the 
Antilles,  and  after  reaching  this  longitude  they  bore 
away  for  Carthagena.  As  soon  as  they  canu:'  in  sight  be- 
fore the  mouth  of  Rio  de  la  Haclia,  after  having  double<l 
Cape  de  la  Vela,  advice  of  their  arrival  A\as  sent  to  all 
parts,  that  everything  might  be  prepared  for  their  recep- 
tion. They  remained  a  month  in  the  harbor  of  Cartha- 
gena, and  landed  there  whatever  was  designed  for  terra 
firina.  They  tl.ien  sailed  to  l*uerto  Velo,  where,  liaving 
stayed  during  the  fair,  which  lasted  five  or  six  weeks, 
they  landed  the  merchandise  intended  for  Peru,  and  re- 
ceived tlie  treasures  and  commodities  sent  from  tlience. 
The  galleons  then  sailed  back  to  Carthagena,  and  re- 
mained tlure  till  their  return  to  Spain,  wliich  usually  hap- 
l)ened  within  the  space  of  two  years.  When  orders  for  re- 
turning home  arrived,  they  sailed  first  to  the  Havana, 
and  having  joined  the  fiota,  and  what  other  shii)S  were 
bound  to  Eui'ope,  they  steered  uortliward  as  fai-  as  Caro- 
lina, and  then,  taking  the  westei-ly  winds,  they  sh:i])ed 
their  course  to  the  Azores,  when,  having  watered  and 
victualed  afresh  at  Terceii-a,  they  thence  contiinicd  their 
voyage  to  Cadiz." 

What  a  glamour  of  romance  and  interest  invariably 
surrounds  the  writings  of  this  great  son  of  Louisiana! 
The  paragraph  above  cited  almost  carries  one  back  to  the 
good  old  days  when  men  lived  only  to  fight,  eat,  drink 

-"'Jones:      Transaction  Louisiana  State  Medical  Society,  1879, 
p.  64. 


98  HISTORY    OF    YELLOW    FEVER. 

and  write  sonnets  tO'  their  lady-loves  and  eared  naught  for 
the  morrow. 

But  mv  enthusiasm  makes  me  forget  my  task.  Let  us 
return  to  our  mutton. 

In  an  interesting  pajier  read  by  LeBeuf  before  the  Or- 
leans Parish  Medical  Society,  and  published  in  the 
Transactions  of  that  Society  for  1905  and  also  in  the 
New  Orleans  ^ledical  and  Surgical  Journal  for  December, 
1905,  a  thorough  review  of  the  history  of  yellow  fever  is 
given.  In  commenting  on  the  probable  origin  of  the  dis- 
ease, the  doctor  says : 

"The  Aztecs  called  the  disease  AlatlazaJniatl  and  Hum- 
boldt tells  us  that  it  existed  as  early  as  the  eleventh  cen- 
tury. In  1545,  1576,  1736,  1737,  1761  and  1777,  it  greatly 
deciminated  the  native  Mexican  race  in  a  number  of 
places.  Before  the  advent  of  the  white  colonists  it  was 
not  general.  The  natives  travelled  very  little,  on  account 
of  the  lack  of  roads  and  the  high  mountain  ranges.  They 
had  no  vessels  large  enough  to  make  the  voyage  to  the 
West  Indies  and  did  not  have  free  communication  with 
outsiders.  When  the  white  colonists  came,  they  were 
more  susceptible  to  the  dangers  of  the  disease,  as  they 
were  unacclimated,  and  were  quickly  the  transmitting 
agent  of  it  through  all  the  low  austral  regions.  It  was 
also  more  fatal  to  them  than  to  the  natives,  and  it  re- 
tarded the  settlement  of  many  calonies  on  account  of  the 
panics  it  caused.-' 

The  same  Avriter,  quoting  Prescott,  says  that  it  seems 
that  Euro])ean  civilization  carried  with  it  the  germ  of 
the  i)oison.  The  moment  a  town  was  founded  or  a  com- 
mercial centre  created,  it  was  certain  to  cause  the  ex- 
plosion of  the  latent  malignity  of  this  poison  in  the  air. 

AVe  will  conclude  this  resume  of  tiie  American  origin  of 
yellow  fever  by  quoting  from  that  inexhaustible  source  of 
information,  Dr.  Joseph  Jones  :-•' 

''If  it  were  possible  to  determine  with  accuracy  the  na- 
ture of  the  severe  and  fatal  forms  of  fever  which  afflicted 
the  first  exi)lorers  and  colonists  of  the  tropical  and  sub- 
tropical regions  of  America,  and  even  the  very  compan- 
ions of  Columbus,  the  question  of  the  origin  of  yellow 

="■  Trans.  La.  State  Med.  Society*,  1879,  p.  63. 


HISTORICAL     SUMMARY.  09 

fever  would  be  relieved  of  much  uncertainty  and  doubt. 
If  we  are  to  credit  the  accounts  of  some  authors,  the  first 
trace  of  yellow  fever  was  observed  at  the  end  of  the  fif- 
teenth and  beginning  of  the  sixteenth  century  at  San 
Domingo  and  Porto  Eico,  in  the  Continent  of  South 
America,  and  in  the  Gulf  of  Darien,  at  which  latter  place 
it  is  said  to  have  prevented  the  Spaniards  from  settling. 
In  November,  1493,  Columbus  landed  at  San  Domingo 
with  1500  Spaniards,  in  order  to  found  the  city  of  Isa- 
bella. A  severe  and  fatal  fever  carried  off  the  greater  part 
of  them  within  a  year  after  their  arrival,  and  the  disease 
is  described  as  being  'yellow  as  saffron  or  gold.'  From 
1544  to  1568  there  is  no  record  of  the  disease  having  pre- 
vailed as  an  epidemic  until  1035,  when  it  appeared  in 
Guadeloupe,  and  thenceforward  it  occurred  at  regular  in- 
tervals. Tn  the  seventeenth  century  it  spread  along  the 
Continent  of  South  America  to  latitude  8°  south,  and 
in  North  America  to  latitude  42°,  but  only  on  the  eastern 
coast  of  both.  The  first  appearance  of  the  disease  in  the 
United  States  was  at  Boston  in  1693,  and  in  Charleston 
and  Philadelphia  in  1699.  It  is  said  first  to  have  appeared 
in  the  Gulf  of  Mexico,  at  Biloxi  Bay  in  1702,  and  Mobile 
in  1705 ;  but  Huml)oldt  held  that  it  had  prevailed  from 
the  very  foundation  of  Vera  Cruz,  and  was  indigenous  to 
this  city.    It  prevailed  at  Pensacola  and  Mobile  in  1765. 

"In  the  eighteenth  century  it  ap[>eared  on  the  west 
coast  of  South  America  in  latitude  2°  south.  On  the 
North  American  Continent  it  spread  to  latitude  42°;  it 
extended  even  to  Eurctpe.  and  reached  the  Pacific  and 
Madagascar.  At  the  beginning  of  the  nineteenth  century 
it  penetrated  deeper  into  the  North  American  Contin- 
ent than  formerly,  reaching  as  high  as  latitude  47°  north, 
and  in  Europe  it  extended  to  latitude  48°,  and  prevailed 
in  the  Canary  Islands  and  Leghorn. 

"Ever  since  yellow  fever  attracted  attention  it  was 
recognized  as  a  distinct  disease  from  the  remitent  autum- 
nal fevers  of  the  temperate  zone.  It  1ms  prevailed  as  an 
endemic  in  Havana,  raging  epidemically  from  April  to 
December,  and  occurring  sporadically  during  the  rest  of 
the  3^ear.  From  time  immemorial  it  lias  been  endemic  at 
Vera  Cruz,  in  the  Gulf  of  Mexico,  where  its  chief  victims 


100  HISTORY    OF    YELLOW    FEVER. 

are  straugers  who  come  from  cold  regions  during  the  hot 
season,  as  well  as  Europeans  and  those  native  who  ex- 
change the  more  elevated  and  cool  regions  of  Mexico  for 
the  coast." 

African  Ohkjin  of  Yellow  Fever. 

The  doctrine  that  Africa  was  the  original  home  of  j'el- 
low  fever  has  been  promulgated  by  many  writers. 

As  early  as  1815,  Pyni,  in  his  "Observations  on  Bulam, 
or  Yellow  Fever,''  propagated  the  doctrine  that  yellow 
fever  was  endemic  to  Africa,  had  always  existed  there  and 
that  the  world  was  indebted  to  that  continent  for  the 
spread  of  the  disease  to  the  four  points  of  the  compass. 
This  theory  was  warmly  espoused  by  Audouard  in  the 
Revue  Mcdicalc  (Paris,  1825),  who  thickened  the  plot  by 
fastening  the  onus  on  the  slave  trade  of  colonial  days  and 
asserting  that  the  disease  also  developed  spontaneously 
in  the  holds  of  ships  packed  with  living  cargoes  of  slaves, 
reeking  with  tilth  and  germ-propagating  material.  These 
views  were  seriously  championed  by  many  writers,  one  of 
them  being  that  distinguished  Louisiana  authority  on  yel- 
low fever,  Faget,  who,  in  his  work  entitled  Etudes  Medi- 
cales  dc  (Jiie.stions  1  iii porta iites  pour  la  Louisianey  pub- 
lished in  1851),  speaks  in  eulogistic  terms  of  the  views  of 
Pym  and  Audouard  and  gives  as  his  opinion  that  the 
theory  advanced  by  these  famous  contagionists  is  the  only 
rational  solution  of  the  ])roblem. 

In  su]>])(Ht  of  his  contention,  Dr.  Faget  claims  that 
when  the  traffic  in  slaves  was  interfered  with  by  the 
United  States  government  and  the  channels  of  this  com- 
merce changed  to  sub-troi)ical  ports,  yellow  fever,  for  the 
first  time,  broke  out  in  Prazil.  The  learned  doctor,  in 
making  this  assertion,  evidently  overlooked  tlie  great  ei)i- 
demic  which  broke  out  in  Pernambuco  in  1088  (according 
to  Ferreira  da  I\osa)  and  which  ravaged  the  Prazilian 
coast  for  several  years  afterwards. 

In  an  interesting  little  book  ])ublished  in  181)8,  Cole- 
man (History  of  Yellow  Fever,  etc. )  revives  the  doctrine 
enunciated  by  Audouard,  citing  many  examples  in  an  ef- 
fort to  prove  that  the  l^'rench  observer  was  correct,  but 
advances   nothing    decidedly    novel    or    convincing. 


HISTORICAL     SUMMARY.  101 

According  to  Byrd,-^  the  disease  was  introduced  into 
Soutlierii  Europe,  the  West  India  Ishinds  and  the  con- 
tinent of  North  and  South  America  from  the  ^^'est  coast 
of  Africa,  "where  it  originally  flourished."  This  author 
blames  the  importation  of  the  disease  into  Europe  upon 
the  ambition  for  extended  territory  which  dominated  tlie 
Caucasian  race  in  the  Middle  Ages  and  holds  the  view  that 
if  the  avarice  and  cupidity  of  the  New  England  slave- 
trader  had  not  tempted  him  to  invade  the  jungles  of  West 
Africa,  to  kidnap  the  unwary  and  guileless  aborigines, 
there  is  reason  to  believe  that  the  hecatombs  which  have 
marked  the  visitations  of  the  pestilence  in  the  West  In- 
dies and  the  shores  of  the  American  Continent,  would 
never  have  been  known.  The  natives  of  those  lands  knew 
nothing  of  the  disease  until  brought  to  them  by  ships  en- 
gaged in  a  most  unholy  commerce. 

Eochefort,  one  of  the  earliest  writers  on  the  subject,  al- 
luding to  the  West  Indies,  says:  "This  noxious  air  was 
brought  by  vessels  coming  from  the  African  Coast. "-^ 

Another  disciple  of  the  African  origin  of  the  disease  is 
found  in  Turpinseed,-^  who  says  that  the  gTeat  difference 
of  temperature  between  day  and  night  in  the  great  desert, 
the  air  being  174°  by  day  and  24°  by  night,  undoubtedly 
had  an  influence  in  furnishing  the  embryonic  conditions 
necessary  to  the  origin  and  propagation  of  the  disease. 
The  infection  was  then  carried  by  the  desert  winds  to  the 
coast  towns  of  W^st  Africa  and  thence  scattered  to  sus- 
ceptible foci  throughout  the  world. 

Strobel,'^*^  who  also  blames  Africa  for  having  been  the 
original  source  of  infection,  furnishes  considerable  in- 
formation concerning  the  origin  and  spread  of  yellow 
fever,  but  his  views  are,  unfortunately,  too  biased  to  be 
of  any  reliable  historical  value.  The  learned  essayist  cites 
only  events  which  lend  color  to  his  rabid  views  on  conta- 
gion and  he  eludes  facts  which  prove  the  contrary  in  such 


"Philadelphia  Medical  Times,  1872,  vol.  3,  p.  726. 

-*  Ce  mauvais  air  y  avait  ete  apporte  par  des  navires  qui 
venoient  de  la  Coste  d'Afrique.  Histoire  Naturelle  et 
Morale  des  Isles  Antilles  d'Amerique  (1658),  vol.  1,  p.  3 

="Turpinseed:    Medical  Record.  N.  Y..  1878,  vol.  14,  p.  304. 

'"  Strobe! :     An  Essay  on  the  Subject  of  Yellow  Fever,  1840. 


102  HISTORY    OF    YELLOW    FEVER. 

a  tactful  and  unconcerned  way,  that  it  is  a  pity  his  efforts 
should  not  have  been  directed  to  a  better  purpose.  He 
deplores  the  fact  that  the  French  Academy  awarded  Mon- 
sieur Chervin  a  premium  of  10,000  francs  for  his  admir- 
able (this  is  our  word,  not  Strobel's)  treatise  on  the  non- 
contagiousness  of  yellow  fever,  and  holds  up  Dr.  Bahi  as 
a  martyr  because  the  latter  was  chased  out  of  Barcelona 
for  having'  propagated  the  doctrine  that  the  fever  which 
prevailed  in  that  city  in  1821  was  contagious.  "They  ex- 
ecrated and  threatened  with  death  those  physicians  sufli- 
ciently  well-informed  to  recognize  this  character  of  the 
disease,"  continues  Strobel ;  "they  called  them,  by  way  of 
insult  and  derision,  the  authors  of  yellow  fever: ''^'^  (The 
italics  are  SStrobel's.  j 

But  it  is  not  our  purpose  to  quarrel  with  the  A'iews  of 
the  respected  and  dei)arted  disciple  of  Bally,  who  was,  Ave 
feel  certain,  honest  in  his  opinion.  We  simply  desire  to 
say,  en  passant,  that  Monsieur  Chervin  earned  those 
10,000  francs  by  a  large  margin,  for  it  is  of  record  that 
he  not  only  put  on  the  linen  of  patients  that  had  died  of 
yellow  fever  and  slept  in  their  beds,  but  that  he  also  ate 
of  the  black  vomit  and  inoculated  himself  with  it,  in  order 
to  prove  the  non-contagiousness  of  the  disease.'^- 

DowelP^  speaks  in  positive  terms  concerning  the  source 
of  yellow  fever,  giving  Africa  as  the  undoubted  original 
focus.  He  also  states  that  it  existed  in  Africa,  Eastern 
Asia,  and  Southern  Europe,  long  before  the  establishment 
of  the  Oreek  and  Roman  Empires,  even  running  back  a 
thousand  years  before  Christ. 

Chisoliii  was  an  advocate  of  the  African  importation  of 
the  disease,  as  will  ai)pear  by  a  perusal  of  his  w(u*k  pub- 
lished in  1799."^ 


"'Ibid,  p.  8. 

"Lancet,  1849,  vol.  2,  p.  433. 

"Dowell:     Yellow  Fever  and  Malarial  Diseases,  etc.,  1876,  p. 

13. 
"'Chisolni.     An  Essay  on  the  Malignant  Pestilential  Fever  iu- 

trodiiced  into  the  West  India  Island  from  Bouliam,  etc., 

1799. 


HISTORICAL     SUMMARY.  103 

Sternberg^^  saj-s  that  the  early  history  of  the  disease  is 
involved  in  obscurity  and  it  is  not  possible  to  determine 
whether,  as  maintained  by  some,  it  was  endemic  at  certain 
points  on  the  shores  of  the  Gulf  of  Mexico  at  the  time 
of  the  discovery  of  the  New  World,  or  whether  it  Avas  im- 
ported to  the  West  Indies  from  the  African  coast,  as  ad- 
vanced by  others. 

In  commenting  on  the  African  theory  of  the  origin  of 
the  disease,  Sternberg  adds  that  it  seems  very  probable 
that  the  jjestilential  malady  which  prevailed  for  a  time  in 
these  usually  healthy  islands  (the  West  Indies)  and  then 
disappeared,  was  in  fact  .yellow  fever,  and  that  it  was  in- 
troduced by  ships  from  the  west  coast  of  Africa  is  not  at 
all  incredible.  "Indeed,"  continues  this  authority,  '4t  al- 
most seems  necessary  to  look  for  an  endemic  of  the  dis- 
ease outside  of  the  West  Indies,  for  the  reason  that  in  the 
comparativeh'  few  places  in  which  it  is  now  endemic, 
there  is  historical  evidence  to  show  that  there  was  first  im- 
portation and  a  previous  period  of  exemption;  while,  on 
the  other  hand,  the  conditions  upon  which  endemicitj^  at 
the  present  daj^  seems  mainly  to  depend,  were  formerly 
unknown — conditions  arising  from  the  aggTcgate  of  ])opu- 
lation  at  seaport  cities,  as  in  Havana,  Vera  Cruz  and  Kio 
Janeiro."^** 

Elliott,^^  in  commenting  on  the  endemic  diseases  of 
West  Africa,  saj's :  "There  is  an  old  doctrine  that  yellow 
fever  had  its  original  home  on  the  West  African  coast,  and 
that  its  existence  in  the  tropical  regions  of  the  American 
continent  and  in  the  West  Indies  is  the  result  of  the 
slave  traffic.  On  the  other  hand,  certain  French  authors, 
notably  Berenger-Feraud,  contend  that  the  disease  was 
first  imported  into  Africa  from  America.  However  this 
may  be,  there  is  no  doubt  about  the  fact  that  yellow  fever 
has  frequently  shown  itself  in  epidemic  form  in  Senegam- 
bia,  and  that  the  British  possessions  on  the  ^^'est  African 
littoral  are  liable  to  outbreaks  of  a  peculiar  malignant 


^=  Sternl)erg:      Reference   Handbook  of  the  Medical   Sciences, 

vol.  8,  p.  5S3. 
'"Ibid,  p.  584. 
"Elliott:     .lournal  of  Tropical  Medicine,  London,  1899,  vol.  1, 

p.  317. 


lO-t  ilISTORY    OF    YELLOW    KEVER. 

form  of  fever  which  is  confined  to  the  European  residents, 
and  which,  after  thinninj;  their  numbers  to  an  appalling 
degree,  and  within  a  l)rief  period,  suddenly  disappears." 

It  is  a  matter  of  history,  and  cannot  therefore  he  contra- 
dicted with  any  degree  of  safety,  that  in  December,  1493, 
when  Columbus  reached  St.  Domingo,  bringing  with  him 
the  first  Europeans  who  had  eyer  set  foot  on  American  soil 
f about  fifteen  hundred,  according  to  rornilliac'^^)  that 
a  pestilential  disease  broke  out  in  the  yillage  of  Ysabella 
( then  in  process  of  construction ) ,  and  nearly  annihilated 
the  yenturesome  little  band  that  had  brayed  the  terrors  of 
a  long  yoyage  through  unknown  seas  to  colonize  a  strange 
and  wonderful  land,  where,  according  to  the  fabulous 
stories  then  current,  "gold  grew  on  trees  and  diamonds 
strewed  the  ground.'' 

Pouppe-Des-Portes,"^  a  French  surgeon,  who  practiced 
at  8t.  Domingo  from  1732  to  1718,  says  that  yellow  feyer 
was  quite  prevalent  in  the  West  Indies  at  that  time  and 
was  called  Mai  dc  *S'?Vn//,  from  the  tradition  that  it  had 
first  been  observed  at  St.  Domingo  during  the  visit  of  a 
French  man-of-war  coming  from  the  kingdom  of  Siam  in 
the  seventeenth  century. 

No  one  who  has  read  the  works  of  Bally  will  dispute 
the  fact  that  he  is  generally  reliable  and  accurate  in  his 
statements,  but  his  unalterable  belief  in  the  doctrine  of 
contagion  and  importation  made  him  blind  to  the  true 
state  of  affairs  in  this  particular  instance.  Even  such  an 
eminent  authority  as  LaKoche  criticizes  the  great  apostle 
of  contagion,  observing  that  the  course  he  pursued  in  the 
controversies  about  his  ])et  theory  was  assuredly  not  com- 
mendable.^'^ 

In  this  connection,  it  is  oi>i)ortune  to  remark  that  up 
to  1793,  a  majority  of  American  i)hjsicians  were  believers 
in  the  contagi(»usness  of  yellow  fever,  but  during  the  epi- 
demics occurring  between  that  date  and  1S2."),  tlie  practi- 
cal experience  so  changed  the  mind  of  the  medical  world, 
that,  while  five  hundred  and  sixty-seven  were  against  the 


**  Pierre  Martyr,  in  his  "Decades,"  says  the  number  was  1200. 

™  Histoire  des  Maladies  de  A.  St.  Domingue,  vol.  1,  p.  191. 

*"  Americ«\n  Journal  of  the  Medical  Sciences,  April,  1853,  p.  317. 


HISTORICAL     SUMMARY.  105 

doctrine  of  contagion,  twenty-eight  only  remained  in  fa- 
vor of  it.^^ 

The  physicians  of  two  hundred  years  ago  were  just  as 
bitter  and  acrimonous  when  it  came  to  discussing  the 
subject  of  yellow  fever  as  those  of  our  present  enlightened 
age.  A  glance  over  the  pages  of  the  Medical  Repository, 
the  Edbiburg  Medical  Review,  the  British  and'  Foreign 
Medico-Chirurgical  Review,  and  other  old-time  medical 
journals,  reveals  page  after  page  of  decidedly  personal  re- 
marks directed  by  some  venerable  Esculapius  against  a 
brother  who  held  a  contrary  view  to  those  which  were,  in 
his  opinion,  the  only  tenable  way  of  explaining  certain 
things.  The  amount  of  vituperative  ammunition  which 
those  ancient  disputants  possessed  certainly  puts  all  mod- 
ern efforts  in  that  line  in  the  shade.  The  terms  "medical 
buccaneers,"  "malignant  drivelers,"  "inexperienced  and 
transient  practitioners,"  etc.,  were  among  the  lukewarm 
expressions  used  in  these  amiable  diatribes. 

Sometimes,  finding  discussions  through  the  medical 
press  too  tame  or  monotonous,  the  disputants  abandoned 
the  quill  for  more  strenuous  modes  of  clinching  an  argu- 
ment and  we  find  mention  here  and  there  of  violent  per- 
sonal encounters  between  opponents  of  contending  theo- 
ries. One  of  the  most  remarkable  Avays  of  settling  a  dis- 
pute concerning  the  diagnosis  of  yellow  fever,  took  place 
at  Kingston,  Jamaica,  between  Drs.  Williams  and  1km- 
nett,  who  met  on  the  lield  of  honor  on  the  29th  of  Decem- 
ber, 1750,  and  fought  so  ferociously  that  they  finally  suc- 
ceeded in  killing  each  other.^- 

Asiatic  Origin  of  Yellow  Fevkk. 

An  anonymous  writer,  more  audacious  and  original 
than  his  contemporaries  or  those  who  lived  before  him, 
and  whose  identiy,  unfortunately,  we  have  been  unable  to 
unravel,  asserts  that  the  ancient  and  malodorous  city  of 
Smyrna,  in  Asia  ^Minor,  was  the  original  focus  whence 
yellow  fever  infected  the  world,  and  cites  in  su])port  of 
his  theory  certain  passages  of  history  referring  to  the  re- 

"  Dowell,  p.  107. 

*■■  Medical  Repository,  N.  Y.,  180.5-06,  vol.  9,  p.  187. 


106  HISTORY    OF    YELLOW    FEVER. 

mittent  fevers  Avhieli  devastated  the  Grecian  Archipelago 
and  the  shores  of  Asia  Minor  as  far  back  as  the  age  of 
Pericles. 

French  writers  of  the  seventeenth  century^  adhered  to 
the  theory  that  the  Typhus  miasmatique  ataxique  putride 
jaiine,  the  name  by  which  the  disciples  of  Bally  desig- 
nated yellow  fever,  had  its  origin  in  Siam.  Bally^^  as- 
sures us  that  the  disease  was  brought  to  the  island  of 
Martinique  by  the  ship  of  war  rOriflaiiiine  in  1682,  in 
which  year  "the  French  people  who  had  settled  in  Siam 
tied  from  the  insurrection  in  that  country  and  established 
themselves  at  Fort  Eoyal."  Bally  also  States  that  the 
OrifJdinuie  stopped  at  some  Brazilian  port  on  its  way  to 
Martinique.  According  to  Ferreira  and  others,  yellow 
fever  was  epidemic  in  Brazil  at  the  time  spoken  of  by  Bal- 
ly, and  if  such  was  the  case,  how  could  the  disease  have 
been  imported  from  Siam,  when  it  was  already  implanted 
on  American  soil?  There  is  certainly  a  historical  faux- 
pas  somewhere. 

Moreau  de  Saint-Mery,  one  of  the  most  reliable  and 
learned  chroniclers  of  his  time,  in  commenting  on  the  al- 
leged Siamese  importation,  makes  certain  observations 
which  leave  no  doubt  that  the  disease  brought  to  Martin- 
ique by  the  Onflamme  was  yellow  fever,  no  matter  Avhere 
the  original  infection  of  the  vessel  took  place.  Ak^cord- 
ing  to  this  authority,  the  ship  was  a  hotbed  of  disease 
when  it  reached  Martinique.  Spotted  fever  {le  jwiirpre, 
to  use  his  exact  expression)  and  an  unknown  "pestilen- 
tial fever  had  committed  fearful  ravages  among  the  offi- 
cers and  crews  of  the  ill-fated  Oriflaiuiuc,  the  mortality 
exceeding  one  hundred  souls,  among  the  victims  being 
]\rc«isieur  de  Lestrille,  the  commandant  of  the  expedition. 
Saint-^fery  also  speaks  of  the  bloody  uprising  which  took 
place  in  the  Siamese  Empire  and  tlie  tiiglit  of  the  French 
settlers  on  board  the  ships  VOriflaiinnc,  Le  Loutrc  and 
the  »S7.  Nicholas,  which  set  sail  for  France  with  all  possi- 
ble haste.    When  the  miniature  flotilla  entered  the  Atlan- 


•'  Description  Topographlque,  Physique,  etc.,    de    I'lle    de    St. 

Domingue,  by  Victor  Bally  (1814),  p.  700. 
^'  The  distinguished  contagionist  evidently  got  his  dates  mixed, 

us  the  insurrection  in  Siam  took  place  in  1688.    G.  A. 


HISTORICAL     SUMMARY'.  107 

tic  Ocean,  it  was  diverted  from  its  course  by  storms,  com- 
pelling the  ships  to  make  for  the  west.  The  OriflanituG 
arrived  safely  at  Fort  Royal,  Martinique,  but  the  fate  of 
her  sister  ships  is  left  in  doubt.  Nowhere  does  Saiut- 
Mery  speak  of  the  vessel  having  touched  at  any  port  in 
Brazil,  as  asserted  by  Bally  and  those  cited  by  him.  The 
date  given  by  Saint-Mery  (1090)  is  certainly  more  accu- 
rate than  that  stated  by  Bally  (1682),  as  a  reference  to 
the  political  history  of  Siam,  reveals  the  fact  that  the  mas- 
sacre of  the  handful  of  Englishmen  in  the  factory  at 
Ayuthia,  then  capital  of  the  kingdom,  which  was  the  sig- 
nal for  the  anti-foreign  demonstration  which  put  an  end 
to  the  intrigues  of  the  French  court,  took  place  in  1G88. 

Coi-nilliac^^  gives  1G90  as  tlie  date  of  the  arrival  of  the 
Oriflamme  at  Martinique. 

Father  Labat,  a  Dominican  friar,  who  arrived  in  Mar- 
tinique in  January,  loOl,^*^  tells  of  the  ravages  of  the  dis- 
ease, which  he  claims  was  imported  by  the  warship 
VOrifldminc,  which  had  touched  at  a  Brazilian  port  on  its 
way  from  Siam. 

AVhat  led  additional  color  to  the  story  of  the  disease 
having  been  imported  from  Siam,  was  the  fact  that,  in 
1G91,  two  vessels  arriving  from  Pondichery,  capital  of  the 
French  East  Indian  settlement  of  that  name,  in  Siam, 
were  found  to  be  nests  of  yellow  fever,  which  caused  an 
appalling  mortality  among  the  crews  of  both  vessels.  It 
was  afterwards  proved,  however,  that  the  infection  had 
been  contracted  at  Fort  Royal. 

Whether  or  not  the  disease  was  imported  to  the  West 
Indies  from  Siam,  or  vice  versa,  is  a  point  which  we  will 
leave  for  others  to  dispute  and  theorize  upon;  but  the 
importation,  if  it  ever  ha])pened,  certainly  did  not  take 
place  for  the  first  time  either  in  3082  or  1090,  as  the  reli- 
able and  unassailable  records  of  such  historians  as 
Oviedo  y  Valdez,  Goniora,  Coreal,  Humboldt,  Ulloa,  Cor- 
nilliac,  and  Rochefort,  give  details  of  epidemics  which  de- 
vastated the  West  India    Islands    as    far     back     as     the 


«  Recherches  Chronologiques  et  Historiques  sur  I'Orlgine  et  la 
Propagation  de  la  Fievre  Jaime  dans  les  Antilles,  by 
Cornilliac  (1867),  vol.  2,  p.  72. 

"Ibid.,  p.  73. 


108  HISTORY    OK    YELLOW    FEVER. 

fifteenth  century.  We  are  more  inclined  to  lean  to  the 
theory  that  the  disease  was  first  brought  to  the  East  from 
the  tropical  coasts  of  America. 

Moseley^"  speaks  at  length  of  the  ravages  committed 
by  the  fever  at  Martinique  in  IfiOo  and  the  majority  of 
authors  of  the  time  concur  in  saying  that,  although  yellow 
fever  prevailed  in  the  West  Indies  ever  since  the  voyages 
of  Columbus,  there  is  no  authentic  instance  of  the  disease 
having  been  noticed  on  vessels  previous  to  1690,  when  the 
Orifhimine  incident  set  the  whole  medical  world  agog. 
On  the  contrar}',  these  ancient  writers  agree  in  the  opin- 
ion that  yellow  fever  prevailed  as  an  endemic  in  the  sev- 
enteenth century  in  all  the  localities  in  the  New  World 
bordering  on  the  Gulf  of  Mexico  and  the  Atlantic  shores 
of  South  America,  almost  as  far  South  as  the  Kio  de  la 
Plata. 

We  will  conclude  by  quoting  from  Hillary  (Observa- 
tions on  the  Changes  of  the  Air,  etc.,  London,  1759),  p. 
144 :  "We  observe  no  trace  of  this  scourge  in  the  descrip- 
tions given  by  ancient  Avriters,  not  even  by  the  Arabian 
observers,  who  practiced  in  warm  climates." 

So  far  as  history-  informs  us,  yellow  fever  has  never 
been  observed  in  Asia,  althougli  this  vast  continent  is 
studded  with  regions  which  i)()ssess  all  the  requirements 
for  engendering  and  spreading  the  disease,  including  the 
Stcgowi/ia.  Let  the  Panama  Canal  be  pierced,  however, 
thus  reducing  time  of  commercial  intercourse  between  the 
AVest  Indies  and  the  East  to  a  few  days,  and  we  shall,  in 
all  probability,  see  yellow  fever  transplanted  to  these 
ancient  shores  and  commit  fearful  ravages  among  its  bil- 
lions of  souls. 

This  is  not  a  fanciful  fiight  of  the  imagination,  but 
simply  a  "look  forward,''  a  calm,  dispassionate  prophecy, 
based  upon  experiences  of  the  past  and  whose  ultimate 
truth  will  thrill  humanity  with  horror  and  despair  when 
the  mists  which  veil  the  future  have  melted  away. 

The  Gulf  Stream  Theory. 

Professor  P.  Stille,  of  INIobile,  differs  from  all  the  pre- 
ceding authorities,  and  advances  a  novel    theory    to     ac- 

'-'A  Treatise  on  Tropical  Diseases,  p.  421. 


HISTORICAL     SUMMARY.  109 

couDt  for  the  origin  of  yellow  fever.  He  attributes  it  to 
the  Gulf  Stream.  Calling  attention  to  the  equable  atmoa- 
pheric  conditions  of  the  tropical  lands  of  both  hemi- 
spheres, he  says:  "Coming  up  the  south-east,  across  the 
torrid  zone,  is  an  ocean  current  which,  where  it  sweeps 
around  the  north  coast  of  South  America,  is  called  the 
Guiana  Current.  It  makes  its  way  directly  into  the  Gulf 
of  Mexico,  where  it  takes  the  name  of  the  Gulf  Stream. 
After  washing  the  smaller  islands  of  the  West  Indies,  it 
forces  itself  with  great  strength  through  the  narrow  chan- 
nel between  Cuba  and  Yucatan,  and  rushes  all  around 
the  shores  of  the  gulf,  taking  its  turn  towards  the  east, 
and  (juitting  the  land  immediately  after  passing  the 
soutliern  point  of  Florida.  Within  the  gulf  its  tempera- 
ture stands  at  from  85°  to  80°,  but  soon  after  having 
passed  Florida  its  temperature  goes  suddenly  down  to  G5°, 
and  finally  to  54°,  and  50°.  Now,  if  we  examine  every 
part  of.  the  sea  we  shall  find  no  other  spot  where  a  warm 
current  washes  the  land  at  anything  like  so  high  a  tem- 
])erature  as  is  exliil)ited  in  the  (Julf  of  Mexico.  A  goodly 
portion  of  the  time  the  temperature  of  the  water  stands 
entirely  above  that  of  the  air,  consequently  a  heavy  mist 
is  taken  up.  In  (;ther  words,  the  atmosphere  is  com- 
pletely saturated  with  moisture  to  such  an  extent  as  to 
render  it  too  heavy  to  rise  in  obedience  to  the  usual  laws 
governing  evaporation,  the  high  temperature  of  the  laud 
preventing  condensation.  As  a  result,  there  lies  upon  tlie 
surface  of  tlie  low  country  a  thin  stratum  of  air  so  heavy 
and  so  damp  as  to  tempt  us  strongly  into  coining  suba- 
(puM)s  as  a  designation  by  which  to  represent  its  condi- 
tion. For  proof  that  such  conditions  do  arise  in  all 
cases  where  the  water  stands  at  a  temperature  higher 
than  that  of  the  air,  we  refer  you  to  latches'  Physical 
Geography,  page  152 ;  and  for  proof  that  they  exist  in  the 
West  India  Islands,  see  Ilumboblt's  Island  of  Cuba,  page 
172.  And  here,  in  my  humbk^  judgment,  we  have  arrived 
at  a  knowledge  of  the  main  conditions  necessary  to  the 
propagation  of  the  yellow  fever:  A  stratum  of  atmos- 
pliei-e  saturated  with  moisture  to  such  an  extent  as  can 
only  occur  urdtr  li':(^  circumstances  as  exist  in  the  West 
Indies,  and  a  tropical  clime  such  as  prevails  there,  and  is 


110  HISTORY    OF    YELLOW    FEVER. 

every  now  and  then,  as  I  contended,  carried  into  regions 
far  above  its  natural  lines.  This  thin  stratum  of  heavy 
atmosphere  is  carried  from  the  ocean  equator  and  thrown 
upon  our  shores  from  the  <i'ulf  breezes,  so  called,  but  in 
ordinary  seasons  the  low  temperature  of  the  earth  con- 
denses the  moisture  permanently  before  it  has  passed  far 
inland.  In  seasons  like  the  present,  however,  when  there 
have  been  two  summers  together,  as  it  were,  the  earth  with 
us  is  too  warm  to  admit  of  permanent  condensation.  A 
portion  of  the  moisture  may  fall  as  heavy  as  dew,  but  the 
rising  temperature  of  the  morning  will  take  it  up  again, 
and  hence  it  will  be  carried  on,  wave  after  wave,  as  it 
were,  until  it  has  reached  its  final  stopping  place,  possibly 
many  degrees  above  the  shore  of  the  Gulf  of  Mexico.  The 
immediate  agent  working  in  yellow  fever  (be  it  living 
atom  or  fungus)  is  semi-aquatic  in  its  nature,  perhaps, 
and  therefore  always  finds  itself  a  home  in  this  peculiar 
character  of  heavy  and  wet  atmosphere;  hence  it  flour- 
ishes wherever  a  footing  can  be  secured  in  it;  and  fattens 
upon  its  human  victims  the  more  the  further  it  gets  from 
its  nursery  bed  and  finds  them  the  less  acclimated  against 
its  effects.  This  heavy  atmosphere  theory  would  explain 
why  yellow  fever  is  mainly  confined  to  the  low  grounds — 
in  all  cases  waves  of  heavy  atmosphere,  like  currents  of 
water,  find  their  ways  through  the  depressions  upon  the 
surface  of  the  earth.  If  our  (iulf  breezes  should  drive 
tliem  inland,  they  would  very  naturally  roll  up  the  valleys 
of  our  rivers."' 

Prof.  Btille  was  without  doubt  one  of  the  South's  fa- 
mous sons  and  a  scholar  of  recognized  ability,  but  his 
theory  is  decidedly  untenable,  especially  when  viewed 
through  twentieth  century  spectacles.  A  reference  to  the 
medical  part  of  this  volume,  where  will  be  found  practi- 
cal and  scientific  arguments  concerning  the  origin  and 
spread  of  yellow  fever,  will  be  sufficient  to  remove  any 
doubt  which  the  skeptical  reader  may  entertain  in  the 
premises.  We  have  given  a.  place  in  this  work  to  Prof. 
Stille's  theory,  not  because  we  endorse  or  admire  it,  but 
simply  to  put  it  on  record  among  the  many  odd  views  ad- 
vanced concerning  the  origin   of  yellow  fever.      It  is  a 


HISTORICAL     SUMMARY.  Ill 

close  second  to  the  views  of  the  College  of  Physicians  of 
Paris,  published  in  a  preceding  chapter. 

Observations  by  the  Author. 

Emerging  from  the  heterogenous  avalanche  of  opinions 
promulgated  by  sedate  and  learned  chroniclers  of  ages 
past  and  present,  bewildered  by  the  positiveness  of  each 
and  every  argument  advanced  to  prove  that  yellow  fever 
originated  anj'^where  except  in  the  natal  land  of  the  ob- 
server, we  pause  for  a  moment  on  the  threshold  of  trepi- 
dation before  making  a  digest  of  the  theories  advanced  in 
the  foregoing  pages.  We  stop  just  to  take  a  breath,  rivet 
the  wobbling  places  in  our  armor,  and  then  rush  into  the 
fray  with  the  satisfaction  that  we  will  at  least  make  the 
situation  still  more  unintelligible. 

The  West  Indian  Theory. — We  are  free  to  confess 
that  we  see  much  to  admire  and  theorize  upon  in  the  doc- 
trine that  yellow  fever  is  a  West  Indian  product.  Look 
into  the  history  of  every  notable  epidemic  and  you  will 
see  that  "a  ship  from  the  West  Indies''  carried  the  infec- 
tion.   Of  course  there  are  exceptions,  but  they  are  few. 

A  search  through  the  works  of  Oviedo,  Pierre  Martyr 
d'Anghiera,  Fernand  Columbus  (a  son  of  the  great  dis- 
coverer), Herrera  and  other  early  writers,  reveals  the 
fact  that  yellow  fever  attacked  the  Spaniards,  English, 
French,  Dutch  and  Portugese  wherever  they  tried  to  es- 
tal)lisli  themselves  in  the  New  World.  In  the  following 
table,  we  give  the  first  four  historic  outbreaks  of  yellow 
fever  in  the  West  Indies.  We  have  purposely  selected  ex- 
amples where  the  scourge  manifested  itself  within  a  few 
months  after  the  landing  of  the  colonists,  as  this  is  all 
that  is  needed  to  illustrate  the  point  we  wish  to  em- 
phasize : 


112 


HISTOR^      OF    YELLOW     FEVER. 


Fiu.sT  Kecorded  Outbreaks  of  YELLO^y   Fever  ix  the 

West  Indies. 


San 
Domingo 


Ysabella  was  the  first  town  established  in  the 
Western  Hemisphere  bj-  Europeans,  beingr  found- 
ed by  Christopher  Columbus  in  December  14')3, 
fourteen  months  after  the  discovery  of  America. 
That  same  month  the  colonists  were  attacked  by 
a  pestilential  disease  (now  known  as  s-ellow  fever) 
which  raged  until  14%,  when  the  town  was  aban- 
doned. 


Porto  Rico       Capara 


1508  Capara,  founded  by  Ponce  de  Leon  in  1508,  Was 

abandoned  the  same  year,  owing  to  the  ravages 
of  the  "  unknown  pestilence." 


Jamaica 


Sevilla 
•^  Mel  ilia 
^Oristan 


Sevilla  was  founded  by  Diego,  a  son  of  Colum- 
bus, in  1509.  The  Yellow  Spectre  soon  invaded 
the  place  and  the  inhabitants  fled  in  terror  to 
the  north  of  the  island,  where  they  built  the  town 
of  Melilla.  The  pestilence  pursued  the  colonists 
into  their  new  abode  and  they  again  fled,  this 
time  to  the  southern  p  rt  of  the  island,  where,  for 
a  third  time,  they  launched  a  new  town  Oristan). 
Like  its  predecessors.  Oristan  wasso(m  laid  waste 
bj- the  same  terrible  disease  which  has  to  this 
day  been  the  curse  of  the  Antilles. 


Gaude-  St.  Pierre 

loupe  liGrande 

Anse 


In  11)35.  L'Olive  and  Duplessis.  agents  of  the 
French  (Jovernment.  with  a  following  of  550, 
founded  the  towns  nf  St. Pierre  and  Grande  Anse. 
Three  months  after  the  arrival  of  the  colonists, 
yellow  fever  made  its  appearance,  Duplessis  him- 
self dying  of  the  scourge.  The  epidemic  devasted 
the  island  from  1035  to  1652,  a  period  ol  seventeen 
years. 


Some  doubtful  Thomas  will  probably  slirui;'  his 
shoulders  aud  irouieally  ask  us  to  explain  how  it  is  that 
Columbus  and  his  intrepid  sailors  were  not  attaeked  by 
yellow  fever  when  they  set  foot  on  the  Island  of  San  Sal- 
vador, if  the  theory  of  Antillian  endemicity  of  the  dis- 
ease is  correct. 

It  is  not  necessary  to  call  into  action  Kooseveltian  low- 
ers of  reasoninjij  to  explain  this. 

Tlie  discoverer  of  the  New  ^^'orld  and  his  followers  es- 
ca])ed  an  attack  on  theii'  tirst  voyage  for  the  reason  tliat 
they  lauded  on  the  Island  of  San  Salvador  duriui*  the  cool 
season   (October  12,  1492),  at  a    time   when     mosquitoes 


HISTORICAL     SUMMARY.  1  1  3 

were  inactive ;  tliat  tliev  did  not  mingle  much  with  the  na- 
tives and,  finally,  that  they  confined  their  explorations  to 
the  coasts  and  did  not  venture  into  the  interior  of  the 
"unknown  country"  which  was  destined  to  change  the 
whole  political  aspect  of  the  then  known  world. 

On  the  second  voyage  of  Columbus  things  were  differ- 
ent. The  Europeans  landed  hundreds  of  miles  further 
South  (San  Domingo),  at  a  place  where  the  breath  of 
Boreas  is  never  felt,  and  found  all  the  conditions  neces- 
sary to  contract  the  disease,  including  the  ^tcgomyia 
CaJopus.  Frequent  intercourse  with  the  natives, 
fatigues,  privations  and  exposure,  rendered  the  new- 
comers easily  susceptible  to  the  germs  which  were  only 
awaiting  new  fuel  to  kindle  the  fires  of  pestilence  anew. 
And,  from  that  date,  wherever  the  Spaniards  went,  the 
jaundiced  handmaiden  of  death — yellow  fever — was 
awaiting  their  arrival. 

The  African  Theory. — It  does  not  require  a  profuse 
waste  of  gray  matter  to  relegate  the  African  theory  of 
the  origin  of  yellow  fever  to  the  oblivion  it  richly  deserves. 

In  looking  over  the  literature  on  the  subject,  Ave  notice 
that  even  such  a  learned  author  as  Berenger-Feraud  was 
nearly  converted  to  the  doctrine  of  African  endemicity, 
being  somewhat  inclined  to  believe  that  the  epidemics  in 
Senegal  were  of  spontaneous  origin.  But  he  guarded  his 
views  with  the  statement  that  he  was  not  totally  convinced 
and,  in  a  later  article,  showed  the  absurdity  of  tliis  doc- 
trine. 

We  believe,  like  Berenger-Feraud,  that  tlie  African 
theory  is  untenable  and  easily  disproved.  The  West 
Coast  of  Africa  has  been  known  to  Europeans  ever  since 
the  sixth  century  Before  Christ,  when,  Hammo,  a  Car- 
thagenian,  nmde  a  voyage  along  that  coast  and  is  said  to 
have  got  as  far  as  the  Bight  of  Benin.  The  I*ortugese, 
however,  were  the  first  i)eople  of  modern  times  to  under- 
take the  ex])loration  of  the  Dark  Continent.  In  1433, 
they  doubled  Cape  Bojador,  in  1441  reached  Cape  Jihinco, 
in  1442,  Cape  de  Yerde,  and  in  1462  discovered  Sierra 
Leone.  In  1484,  Diego  Cam,  an  audacious  •  Portugese 
navigator,  discovered  the  moutli  of  tlie  Congo.  That 
same  nation  established  the  first  European  settlement  in 


I  14  HISTORY    OF    YEM.OW    FltVER. 

Africa  at  Angola  about  the  year  150(),  eight  j-ears  after 
the  discover}^  of  xVmerica  by  Columbus. 

From  the  inception  of  its  colonization,  the  commerce 
between  Africa  and  Europe  was  an  active  one,  and  had 
A'ellow  fever  been  endemic  in  the  Dark  Continent  at  the 
time  it  was  first  visited  by  Europeans,  the  disease  would 
certainly  have  been  imported  by  the  ill- ventilated  and  un- 
sanitary craft  engaged  in  this  primitive  intercourse  and 
woiihl  have  caused  memorable  epidemics  in  Europe,  which 
would  have  been  noted  by  the  historians  of  the  period, 
who  had  a  knack  of  writing  about  everything  and  every- 
body, no  matter  how  trivial  or  private.  It  is  a  matter  of 
history,  clKi'onicled  by  many  writers,  that  it  was  only  after 
the  discovery  of  America  that  yellow  fever  was  observed 
in  Africa.  The  first  authentic  account  is  that  of  the  voy- 
agers ^Mndham  and  Piuteado,  Avho  speak  of  having  ob- 
served yellow  fever  on  vessels  off  the  coast  of  Benin  in 
1558.  This  is  not  at  all  improbable,  as  slave-hunters  from 
the  ^>panish  colonies  in  the  Xew  AVorld  frequented  the 
coast  of  Africa  as  early  as  the  middle  of  the  sixteenth 
century,  to  replace  Avith  negroes  the  dearth  of  labor  caused 
by  their  massacres  of  the  Indians  in  Cuba,  ^Mexico  and 
South  America.  After  stealing  the  gold  which  the  Aztecs 
and  Incas  had  taken  centuries  to  amass,  the  Spaniards 
forced  their  victims  to  work  their  mines  and  till  their 
]>lautations.  Unused  to  such  toil,  Avhicli  was  rendered 
still  more  onerous  by  the  cruelties  practiced  upon  them  by 
their  conquerors,  the  Indians  perished  by  millions.  His- 
torians tells  us  that  more  than  half  the  population  of 
Peru  were  consumed  in  the  mines. 

A\'afer,  an  English  surgeon  (according  to  Aloseley"*^), 
says  that  he  and  some  others  landed  at  Vermejo,  in  I'eru, 
in  1()87,  and  marched  four  miles  up  a  sandy  bay,  "all  of 
which,''  he  says,  "we  found  covered  with  bodies  of  men, 
women  and  children,  Avhich  lay  so  thick,  that  a  man 
miglit,  if  he  would,  have  walked  half  a  mile  and  never  trod 
a  step  off  a  dead  human  body.  These  bodies,  to  appear- 
ance, seemed  as  if  they  had  not  been  above  a  week  dead; 
but  if  you  handled  them,  they  proved  as  dry  and  light  as 
a  sponge,  or  i)iece  of  cork."    The*  voyagers  soon  came  upon 

''Moseley:     A  Treatise  on  Tropical  Diseases,  1792,  p.  155. 


HISTORICAL     SUMMARY.  115 

a  Spanish  Indian,  wlio  Avas  picking  np  dried  soa-weed,  and 
asked  liini  how  those  dead  bodies  came  there?  To  which 
he  answered  that,  in  his  father's  time  the  soil,  "which 
now  yielded  nothing,  was  green,  well-cultivated  and  fruit- 
ful ;  that  the  city  of  Worniia  had  been  well  inbabited  by 
Indians;  and  that  they  were  so  numerous,  that  they 
could  have  handed  a  tisli,  from  hand  to  hand,  twenty 
leagues  from  the  sea,  until  it  had  come  to  the  Inca's 
hands ;  and  that  the  reason  of  those  dead  bodies  was, 
that  when  the  Spaniards  came  and  blocked  up  and  laid 
seige  to  the  city,  the  Indians,  rather  than  lie  at  the 
Spaniards'  mercy,  dug  holes  in  the  sand  and  buried  them- 
selves alive/' 

AVhen  the  Spaniards  saw  that  the  natives  were  about 
to  become  extinct,  and  that  the  majority  of  those  that 
were  left  had  Hed  to  caverns  and  mountain  fastnesses, 
they  had  recourse  to  Africa,  and  negroes  Avere  imported 
by  the  thousands  to  take  the  places  of  the  ^Mexicans,  Peru- 
vians and  West  Indians.  This  was  the  beginning  of  the 
slave  trade,  and  the  constant  voyages  to  and  from  Africa 
in  (piest  of  new  victims,  gave  a  semblance  of  truth  to  the 
theory  that  yellow  fever  had  been  imported  from  Africa 
to  America. 

Let  us  now  juggle  with  dates  and  obtain  some  poignant 
conclusions : 

A  glance  at  the  table  on  page  112  will  show  that  the  first 
epid(Miiic  of  yellow  fever  in  the  w(u-ld  of  which  there  is 
any  record  took  place  at  Ysabella,  San  Donungo,  in  De- 
cember, 1193,  fourteen  months  after  the  discovery  of 
America.  According  to  Lind,  the  first  outbreak  of  yellow 
fever  on  the  mainland  of  Africa  took  place  in  Senegal  in 
175!!,  two  hundred  and  sixty-six  years  after  the  Ysabella 
incident.  As  the  mainland  of  Africa  was  colonized  b\ 
Euroi)eans  about  the  year  1500,  and  yellow  fever  was 
never  observed  i)rior  to  1751),  or  two  liundnMl  and  fifty- 
nine  years  after  its  colonization,  it  is  not  necessary  to  in- 
dicate with  a  pointer  on  the  map  of  the  world  where  the 
natural  home  of  yellow  fever  was,  is  and  will  continue  to 
be  for  all  time  to  come — unless  our  Southern  neighbors 
stop  long-  enough  launching  new  revolutions  and  attend  to 


116  HISTORY    OF    YELLOW    FEVER. 

intelligent  preventive  measures  against  a  disease  which 
science  has  proved  can  be  conquered. 

A!nother  noteworthy  fact  before  we  conclude: 
The  ei)ideiiiics  of  yellow  fever  in  the  West  Indies  fol- 
lowed one  another  in  rapid  succession  and  hardly  a  year 
has  passed  since  1493  without  the  disease  manifesting 
itself,  either  sporadically  or  as  an  epidemic,  in  one  of  the 
Antilles.  In  Africa,  the  record  is  different. 
Let  us  take  Senegal  to  illustrate  our  point : 

From  1759  to  1882,  a  period  of  one  hundred  and  twenty- 
three  years,  there  were  six  ei)idemics  in  iSenegal.  Be- 
tween the  tirst  and  second  epidemics  (1759-1778),  nine- 
teen years  elapsed;  between  the  second  and  third  (1778- 
1830),  fifty-two  years;  between  the  third  and  fourth 
(1830-1807),  thirty-seven  years;  between  the  fourth  and 
fifth  (1807-1878),  eleven  years;  between  the  fifth  and 
sixth  (1878-1882),  four  3'ears. 

By  reference  to  the  chronological  tables  in  another 
part  of  this  volume,  it  will  be  seen  that  during  this  same 
period  of  one  hundred  and  twenty-three  years,  there  is  a 
record  of  nearly  two  hundred  outbreaks  of  yellow  fever  in 
the  AVest  Indies. 

A  soil  which  can  produce  yellow  fever  will  do  so  annu- 
ally; the  long  intervals  between  the  epidemics  in  Africa 
gives  the  palm  to  the  West  Indies. 

The  Ship  Theory. — The  theory  that  yellow  fever 
originates  on  shipboard  was  based  on  the  fact  that,  in  sev- 
eral noteworthy  instances — such  as  the  outbreaks  at  St. 
Nazaire,  ]>i'(^st,  Falmoutb,  etc. — it  was  noticed  that  so 
long  as  the  hatches  remained  closed,  the  disease  did  not 
manifest  itself,  but  as  soon  as  the  scuttles  and  hatches 
were  opened,  tlu^  fever  invaded  the  vessel  and  often  spread 
to  the  port  wliere  she  was  riding  at  anchor. 

This  is  easily  cx]>lained:  The  infected  mosquitoes, 
which  had  fed  on  yellow  fever  patients  at  the  port  of  sail- 
ing, had  been  imprisoned  in  the  hatches  during  the  long 
voyage  across  the  seas,  Avith  no  chance  of  gaining  access 
to  the  upper  i)arts  of  the  ship.  AMieu  the  vessel  reached 
her  destination  and  the  hatches  were  opened,  the  insects 
were  liberated  and  swarmed  with  famished  haste  all  over 
the  vessel,  inoculating  with  the  poison    of    yellow     fever 


HISTORICAL     SUMMARY.  117 

every  susceptible  person  they  bit.  Tliese  persons,  in  turn, 
were  so  inan^'  new  foci  of  infection  and  served  to  spread 
the  disease. 

In  the  present  liiilit  of  the  mosquito  transmission  of 
yellow  fever,  nothing  can  be  more  simple;  but,  when  we 
come  to  think  over  the  matter,  we  can  hardly  blame 
Audouard  and  his  dintinguished  champions  for  having 
blundered,  as  they  were  groping  in  the  dark  and  launched 
the  theory  which  seemed,  under  the  circumstances,  the 
most  plausible  and  intelligent. 

The  Gulf  Stream  Theory. — This  doctrine  cannot  for 
a  moment  be  seriously  entertained  and  does  not  need  to 
be  dissected  here  to  lay  bare  its  imperfections.  It  ex- 
plains nothing  and  is  dismissed  without  further  comment. 

The  Asiatic  Theory. 

There  is  a  theory,  however,  which  takes  our  fancy  and 
which  we  are  prone  to  espouse — the  opinion  that  yellow 
fever  originated  on  the  western  shores  of  Asia  centuries 
before  the  advent  of  Christianity.  The  city  of  Smyrna, 
in  Asia  Minor,  is  just  the  sort  of  place  where  a  pestiferous 
disease  could  originate  de  iioi^o.  Since  the  date  of  its 
foundation,  in  prehistoric  times,  it  has  been  renowned 
for  its  filthiness  and  pestilences,  a  fame  which  clings  to 
it  to  tliis  day. 

Smyrna  occupies  the  unique  position  in  history  of 
being  the  only  great  city  of  the  west  coast  of  Asia  ]Minor 
which  has  survived  to  the  present  day.  Unlike  good  wine, 
however,  it  does  not  seem  to  have  imi)roved  with  age,  from 
a  sanitarian  point  of  view.  It  is  as  insalubrious  to-day 
as  it  was  in  distant  past,  when  it  cradled  Homer  and  was 
the  glorious  capital  of  Antigonus.  The  appearance  of 
the  city  at  the  present  day  is  very  attractive  when  viewed 
from  the  harbor,  l)ut  a  closer  inspection  dis])els  the  illu- 
sion. The  houses,  mostly  built  of  wood,  are  mean  and 
fragile  looking;  the  streets  Jose  and  filthy  and  tilled  with 
intolerable  stenches,  proceeding  from  illy-constructed 
sewers  and  drains.  ITaving  thus  all  the  necessary  condi- 
tions present  to  harl>or  and  propagate  pestilence,  it  is 
within  the  reasonable  bounds  of  probability  that  it  could 


118  HISTORY    OF    YELIOW    FKVER. 

have  beeii  the  original  nidus  of  yellow  fever.  How  yellow 
fever  was  engendered  there,  what  special  atmosphere  con- 
stitutions precipitated  its  origin  or  how  it  sj^rung  spon- 
taneously into  existence,  our  feeble  powers  of  imagination 
cannot  conjecture,  but,  for  the  purpose  of  propping  up  the 
doctrine  we  advance,  we  shall  admit  that  it  did  spring 
from  somewhere  within  the  walls  of  the  malodorous  ori- 
ental town — in  fact,  grew,  like  the  immortal  Topsy — and 
was  thence  disseminated  by  the  mosquito-infected  vessels 
of  the  Pheuicians  and  other  ancient  adventurers  through- 
out the  then  known  world. 

The  immigration  of  the  Phenicians  to  the  Mediter- 
ranean coast  of  Asia  took  place  in  remote  antiquity. 
When  the  Children  of  Israel  settled  in  Canaan,  they  found 
the  Phenicians  already  established  in  the  country,  and 
history  tells  us  that  the  tribes  of  Naphtali,  Asher  and 
Dan,  to  which  that  section  of  Syria  was  assigned,  did 
not  conquer  Phenicia,  but  occupied  only  a  small  portion 
of  it.  The  Phenicians  were  a  commercial  and  not  a  war- 
like race  and  their  policy  from  the  onset  towarcls  the 
Chosen  People  was  one  of  conciliation  and  the  two  races 
afterwards  became  stalwart  friends. 

From  the  earliest  period  the  Phenicians  occupied  them- 
selves in  distant  voyages  and  their  skill  in  shipbuilding  is 
a  matter  of  history.  Lebanon  supplied  them  with  abun- 
dance of  timber  and  Cyprus  gave  them  all  necessary  tiaval 
equi])ments,  from  the  keel  to  the  topsails.  In  the  reign 
of  IMiaraoh-Necho,  these  daring  navigators  even  circum- 
navigated Africa.  The  commerce  of  Tyre  extended  all 
over  the  ancient  world,  from  India  to  England,  and  the 
maritime  knowledge  and  experience  of  the  IMienicians  led 
to  the  founding  of  numerous  colonies  in  Cyprus,  Kliodes, 
Sicily,  Sardinia  and  even  in  distant  Spain,  where  they 
founded  the  famous  city  of  Gaddier,  now  known  as  Cadiz, 
eleven  centuries  before  the  Christian  Era. 

With  Smyrna  as  a  nidus,  yellow  fever  could  thus  easily 
have  been  imported  to  the  seaports  of  the  Mediterranean 
by  the  active  commerce  in  which  these  remarkable  people  ^ 

were  engaged  in.     ]Mosquitoes  are  plentiful    in     Western  J| 

Asia  and  Southern  Euro])e  and  the  great  jdagues  which 
history  recounts  as  having  almost  depopulated  the  world 


HISTORICAL     SUMMARY.  119 

at  certain  epochs  in  the  distant  past,  were  possibly  yellow 
fever  epidemics,  spread  far  and  wide  through  the  medium 
of  mosquito-infected  ships,  which  sailed  from  infected 
points  to  countries  free  from  the  disease.  These  countries, 
in  their  turn,  proved  so  many  foci  of  infection,  whence  yel- 
low fever  radiated  to  susceptible  localities.  In  course  of 
time,  the  disease  was  imported  to  America  b}'  the  early 
voyagers  who  visited  this  country  centuries  before  the 
time  of  Columbus  and  gradually  spread  over  the  con- 
tinent, until  it  found  a  home  suited  to  its  permanent 
hibernation  in  what  is  now  known  as  the  yellow  fever 
zone.  Simple,  is  it  not?  We  shall  undoubtedly  find  scof- 
fers and  unbelievers,  but  Ave  advance  the  theory  with  the 
same  assurance  that  all  i^revious  theories  have  been  pro- 
mulgated and  can  safely  challenge  auA'one  to  prove  the 
contrary.  This  is  the  beauty  of  theories.  You  may  not  be 
able  to  prove  what  you  say  by  what  lawyers  call  ''docu- 
mentary evidence,"  but  the  burden  of  proving  the  con- 
trary is  on  the  other  fellow,  and  he  is  generally  in  the 
same  fix  when  it  comes  to  trotting  out  facts  to  prove  that 
you  are  talking  through  your  chapeau. 

"Admitting  your  theory  to  be  correct,"  observes  my 
astute  friend,  Mr.  Doubting  Thomas,  "why  has  yellow 
fever  ceased  to  visit  Smyrna?" 

For  the  same  reason  that  it  is  no  longer  prevalent  in 
Spain,  Philadelphia,  Boston,  New  York,*  and  scores  of 
other  places  Avhere  it  was,  at  some  time  or  other,  consid- 
ered endemic. 

What  has  brouglit  about  this  change?  ''The  disappear- 
ance of  the  Stcgomyia  Calopus  from  these  localities," 
Avould  be  the  logical  answer.  But  smh  is  not  the  case. 
The  yellow  fever  moscpiito  has  been  banislicd  from  New 
York,  Boston,  Philadelphia  and  other  Northern  places, 


*  See  the  very  interesting  theory  advanced  by  Col.  W.  C. 
Gorgas  concerning  the  disappearance  of  the  Stegomyia 
from  Philadelphia,  New  York  and  other  Northern  locali- 
ties, published  in  another  part  of  this  volume,  under 
the  caption  "The  Effect  that  the  Completion  of  the 
Panama  Canal  Will  Have  Upon  the  Probable  Extension 
of  Yellow  Fever  to  Asia." 


120  HISTORY    OF     YELLOW     FEVER. 

but,  according  to  Theobald,^^  these  insects  are  still  to  be 
found  in  Spain  at  the  present  da.y.  And  yet,  yellow  feyer, 
except  in  a  few  isolated  instances,  has  been  unknown  in 
that  kiniidom  since  the  great  epidemics  which  rayaged 
it  in  the  beginning  of  the  last  century. 

Theobald  does  not  designate  Smyrna  as  one  of  the  habi- 
tats of  the  Stego)ui/ia  CuJopu.s,  but  mentions  the  tact  that 
the  insects  are  preyalent  in  Tjre,  Sidon  and  Palestine, 
neighboring  localities.  "Where  the  climate  is  not  too 
dry,"  obseryes  Howard,'''^  '"Sfegoinj/Ui  Fasciata  will,  with 
little  doubt,  upon  close  search,  be  found.*'  The  climate  of 
Smyrna  is  an  ideal  one  for  the  propagation  of  the  insect 
under  discussion  and  it  has  no  doubt  been  domiciliated 
there  from  time  immemorial. 

But  here  comes  the  clincher :  "If  Stcgomi/iae  flourished 
in  Smyrna  ages  j^ast  and  yellow  feyer  was  an  endemic, 
how  is  it  that,  with  all  the  conditions  which  were  then 
present  existing  at  the  present  day,  the  disease  no  longer 
manifests  itself?'' 

The  only  way  to  get  rid  of  this  Gordian  Knot  is  to 
treat  it  a-la-Alexander : 

Let  us  suppose  that  the  great  pestilences  which  deyas- 
tated  Europe,  Asia  and  Africa  centuries  before  the  Chris- 
tian Era  were  yellow  feyer  epidemics.  History  tells  us 
that  these  outbreaks  caused  fearful  mortalities  and  that 
at  times  "nearly  half  the  population  of  the  world"  was 
swept  away.  As  the  years  went  by,  new  generations  were 
attacked  by  the  disease,  which  became  milder  and  less 
murderous  for  want  of  fresh  material,  until  it  came  to 
pass  that  those  who  remained  became  immune  through 
acclimatization  or  because  they  had  withstood  a  preyious 
attack,  and  the  disease  gradually  disappeared  from  its 
old-time  haunts.  Immigration,  one  of  the  most  fertile 
feeders  of  endemic  disease,  was  no  longer  a  factor  in  the 
Old  A\'orld  after  the  twelfth  century  of  the  Christian  Era, 
for  the  nomads  of  that  period  had  penetrated  as  far  as 
they  dared  to  go,  and  with  the  whole  population  of  the 

"Theobald:    A  Monograph  of  the  Culicidae  of  the  World,  1891. 
'* Howard:      Concerning    the    GeograpJiic    Distribution    of    the 
Yellow  Fever  Mosquito,  1905. 


HISTORICAL     SUMMARY.  121 

world  iiiiinime  from  yellow  fever,  it  is  natural  that  the 
scourge  should  cease  to  manifest  itself. 

It  is  a  remarkable  truth  that  persons  born  in  a  com- 
munity' where  a  disease  is  endemic,  seldom,  if  ever,  experi- 
ence an  attack.  Humboldt  notes  the  fact  that  a  person 
born  and  brought  up  in  Vera  Cruz  is  not  subject  to  the 
disease.  The  same  observation  has  been  nmde  in  regard 
to  Havana.  And  yet,  the  natives  of  Havana  are  often  at- 
tacked with  yellow  fever  when  they  visit  Vera  Cruz  in 
August  and  September ;  Avhile,  on  the  contrary,  natives  of 
Vera  Cruz,  who  were  known  to  have  passed  unscathed 
through  violent  epidemics  in  their  natal  place,  have  died 
of  yellow  fever  in  Havana,  Jamaica  and  the  United  States. 

"New  sources  of  disease  are  developed  by  civilization," 
observes  Gouverneur  Smitli,-^^  "new  measures  of  prophy- 
laxis germinate  simultaneously  with  each  genesis.  Many 
of  the  poisons  with  Avliich  we  are  familiar,  and  which  were 
known  to  our  ancestors,  are  not  as  yet  to  be  extinguished, 
but  are  to  continue  to  harass  posterity.  Posterity  will  en- 
counter ills  which  have  not  afflicted  us,  and  the  medical 
literature  of  future  centuries  will  relate  the  outcrops  of 
novel  disorders,  and  record  the  successful  means  by  which 
they  were  held  in  abeyance.  If  the  chemists  are  capable 
of  producing  new  compounds,  it  can  be  inferred  by  anal- 
ogy, and  even  inferred  from  a  study  of  past  ages,  that  in 
the  mutations  of  society  new  forms  of  aerial  contamina- 
tions and  new  zymotic  affections  will  be  developed  by 
reason  of  the  overcrowdings  of  population,  by  the  influ- 
ences of  new  occupations  and  of  new  relations  of  life. 
The  opening  of  new  territories  to  civilization  will  be  at- 
tended with  its  dangers.  Indigenous  germs  of  disease  may 
exist  in  unexplored  Africa  and  in  other  secluded  parts  of 
the  globe,  which  are  in  time  to  be  conveyed  to  marts  of 
commerce,  and  thence  to  be  still  more  widely  diffused." 

Gouverneur  Smith's  observations,  made  thirty  years 
ago,  upholds  the  point  we  Avish  to  elucidate. 

What  has  kept  alive  the  fires  of  pestilence  in  tlie  West 
Indies?  War  and  the  S]janish  soldiery.  For  hundreds  of 
years,  Spain  was  engaged  in  putting  down  insurrections  in 

"  Trans.  N.  Y.  Academy  of  Medicine,  vol.  2,  1876,  p.  362. 


122      .  HISTORY    OF    YELLOW    FEVCR. 


Cuba,  and  for  liimdreds  of  years  has  yellow  fever  mowed 
down  her  soldiers  by  the  thousands. 

During  the  period  of  ten  years,  from  1870  to  1879, 
there  arrived,  at  the  port  of  Havana,  151,423  Spanish  sol- 
diers. During  that  same  period,  out  of  a  total  death-rate 
of  92,231  from  all  diseases  in  Havana,  there  were  11,837 
fatalities  from  yellow  fever  alone,  of  which  4,139  were 
newh'-arrived  soldiers,  or  nearly  half  the  total  mortality 
from  yellow  fever. 

Look  over  the  long  list  of  epidemics  in  the  West  Indies 
since  the  beginning  of  the  last  century,  and  you  will  see 
that  in  almost  every  instance  the  disease  was  either  im- 
ported or  attacked  the  newly-arrived.  The  natives  (that 
is,  descendants  of  the  original  settlers  of  the  islands),  if 
they  had  not  been  contaminated  I)}-  this  susceptible  ele- 
ment from  a  foreign  clime,  would  never  have  contracted 
the  disease. 

According  to  the  views  of  the  Havana  Yellow  Fever 
Commission,^-  the  pure-blooded  American  red  Indian  an- 
nually proves  at  Vera  Cruz  his  present  susceptibility  to 
3^ellow  fever;  hence  there  is  no  reason  to  disbelieve  that 
the  aborigines  of  San  Domingo  and  other  Antilles  were 
susceptible,  but  had,  in  1492,  acquired  immunity  from  the 
disease  by  the  same  process  and  to  tlie  same  general  extent  , 

now  enjoyed  b^^  the  white,  black,  and  yellow  or  red  natives 
of  habitually  infected  localities  in  Cuba  and  elsewhere. 

The  same  reasoning  holds  good  for  Smyrna,  Spain  and 
other  old-world  localities.  Natives  of  susceptible  climes 
not  having  emigrated  to  these  countries  for  centuries  past, 
the  occasional  visitor  of  to-day  is  safe  from  attack,  as  the 
infected  mosquitoes  and  their  immediate  posterity  have 
long  since  "passed  in  their  checks"  and  their  descendants 
content  themselves  in  disseminating  malaria  and  kindred 
transmissibh'  diseases.  I>iit  let  a  single  case  of  yellow 
fever  be  imported  into  the  heart  of  Spain,  Smyrna  or  any 
presunmbly  former  habitat  of  the  disease,  and  the  world 
will  witness  a  repetition  of  the  terrible  ravages  of  the 
past. 

Previous  to  1793  yellow  fever  was  unknown  in  Dem- 

^-  Annual  Report  National  Board  of  Health,  1880. 


HISTORICAL     SUMMARY.  123 

erara,  Britisli  Giiiaiia,  wliich  is  noted  for  its  low,  swampy 
soil,  aboundiug  iu  vegetable  matter  iu  a  state  of  decom- 
position, the  whole  constituting  a  true  hot-bed  of  pollu- 
tion, where  ^tcfjomykic  breed  by  millions.  Yellow  fever 
could  not,  and  never  would  have,  developed  itself  in  that 
region;  but,  according  to  Bally,^^  it  was  introduced  by 
the  schooner  Futifan,  in  the  ^^ear  above  mentioned,  and 
finding  an  habitat  suited  for  its  propagation,  became  es- 
tablished there,  and  Demerara  is  to-day  one  of  its  focal 
points. 

Diseases,  like  fashions,  have  their  whims.  A  locality 
may  for  years — aye,  even  centuries — be  afflicted  with  a 
certain  ailment  and  then,  souu^times  suddenly,  sometimes 
with  such  gradual  decadence  as  to  be  scarcely  noticeable, 
,the  endemic  disappears,  to  manifest  itself  in  places  where 
it  was  unknown  before  and  create  the  same  havoc,  inspire 
the  same  terrors  and  display  the  identical  idios^^ncrasies 
whiclr  characterized  it  iu  its  old  habitat. 

According  to  Muhrj',^^  if  we  except  the  admirable  and 
accurate  descriptions  of  diseases  contained  in  the  writings 
of  the  Arabian  physicians,  we  have  scarcely  any  of  an 
earlier  date  than  the  beginning  of  the  sixteenth  centurj^, 
sufficiently  full  and  correct  to  enable  us,  by  comparing 
the  phenomena  of  the  diseases  which  now  prevail  with 
those  by  which  the  same  diseases  were  accomi)anied  at 
former  periods,  to  detect  their  points  of  i'eseud)lance  or 
discrepanc} .  Judging,  however,  from  the  few  and  imper- 
fect details  furnished  us  by  medical  writings  of  former 
daA's,  we  believe  that  there  are  good  reasons  for  conclud- 
ing that  the  more  prominent  diseases  to  which  the  human 
organism  is  now  liable,  are  essentially  tlie  same,  in  all 
their  leading  features,  with  those  to  which  it  was  subject 
as  far  back  as  medical  histoi-y  leads  us. 

Muhry  further  asks  if  it  is  true,  however,  that  diseases 
which  formerly  prevailed  have  entirely  disai)peared? 
This  is  by  no  means  improbable.  The  history  of  endemics 
proves  very  clearly  that  certain  forms  of  disease  depend 
upon  cases  of  a  sti-ictly  local  character,  and  no  longer 
occur  when  these  local  causes  are  removed.     It  is  cMiually 

"^  Bally:    Typhus  d'Amerique,  p.  60. 

"Muhry:    Historical  Immutability  of  Nature  and  Disease,  1844. 


194  HISTORY     OK     YELLOW     FEVER. 

reasonable  to  suppose  that  morbitic  causes  of  wider  extent 
may  become  extinct  either  spontaneously  or  through  the 
agency  of  nuin,  and  with  their  extinction  would,  of  course, 
cease  the  diseases  i)r(;duccd  by  them.  ]>ut  it  is  not  so  very 
certain,  that  among  the  diseases  to  which  the  human  or- 
ganism is  still  subject,  some  at  least  of  those  which  are 
presumed  to  have  disapeared  are  not  to  be  included,  but 
in  a  form  so  far  modified  that  the  resemblance  between 
them  and  their  prototypes  is  overlooked.  It  is,  also,  prob- 
able that  disease^  which  formerly  prevailed  as  endemics 
or  epidemics,  still  occur  sporadically;  isolated  cases  ap- 
])earing  occasionally  and  at  long  intervals,  and  hence  at- 
tracting little  attention,  being  viewed  as  anomalous  forms 
of  some  one  of  the  more  prevalent  att'ections. 

Muhry's  masterly  diagnosis  is  admirably  suited  to  the 
subject  under  discussion  in  these  pages.  Take  away  the 
Stcgonn/ia  Calopiis  and  you  take  away  yellow  fever.  The 
experience  of  New  Orleans  in  1905  is  incontestible  proof 
of  the  truth  of  this  assertion.  Although  all  the  conditions 
which  prevailed  in  1905  existed  in  1900  ( with  the  excep- 
tion, of  course,  of  the  millions  of  Stegomyia),  not  a  case 
of  yelllow  fever  occurred  among  the  vast  cosmopolitan 
population  of  the  ^letropolis  of  the  South,  and  only  a 
single  case,  undoubtedly  imported,  is  known  to  have  oc- 
curred throughout  the  entire  State  of  Louisiana.  And 
this,  thanks  to  the  untiring  work  of  the  eminent  sanitari- 
ans in  whose  hands  were  the  destinies  of  the  State  and 
City  Boards  of  Health,  was  soon  rendered  inocuous. 

Let  us  again  look  into  the  fascinating  question  of 
Asiatic  origin  of  yellow  fever. 

Without  desiring  to  be  irreverent  to  the  shades  of 
Audouard,  Bally,  Chisolm  and  others,  we  think  that  there 
is  more  in  the  theory  of  Asiatic  origin  than  appeai-s  on 
the  surface,  when  one  comes  to  weigh  it  in  the  balance  of 
conjecture.  How  do  we  know  that  the  pestilential  ardent 
fevers,  or  can. si,  of  whicli  rei)eated  mention  is  made  in 
the  works  of  ancient  writers,  were  not  yellow  fever  mani- 
festations? In  reading  descriptions  or  the  can  si,  not  only 
in  the  Epidemics  of  Hippocrates,  but  also  in  the  writings 
of  his  contemporaries,  Thucy<lides  and  Isocrates,  one  is 
struck  by  the  similaritv  of  the  diajinosis  iriven  and  the 


HISTORICAL     SUMMARY.  125 

present  accepted  symptoms  of  yellow  fever.  The  writings 
of  Galen,  Pauhis  Egineta,  Aretus,  Avicenna,  Hippocrates 
(First  and  Third  Books  on  Epidemics),  Procopiiis  {rHis- 
toire  de  Son  Temps),  Gregorius  (Histora  Franconun,  de 
417  a  591  A.  D.),  Anglada  {Etudes  sur  les  Maladies 
Eteintes  et  les  Maladies  Nouvelles),  Black  {Histolre  de 
la  Medicine  et  de  la  Chirur<jle),  and  others,  also  lead  to 
the  presumption  that  a  disease  posessing  all  the  peculiari- 
ties of  yellow  fever  was  epidemical  long  before  the  Chris- 
tian Era. 

"In  the  works  attributed  to  Hipprocates,"  saj^s  Ban- 
croft, ''mention  is  made  of  violent  febrile  disorders,  which 
sometimes  proved  fatal  on  the  fourth  day,  and  even 
sooner,'''^  and  were  attended  with  incessant  vomiting, 
sometimes  of  black  matters,  yellowness  of  skin,  and  other 
affections  so  similar  to  those  which  are  frequently  ob- 
served in  the  Yellow  Fever,  that  I  am  disposed  to  believe 
that  tliey  could  be  no  other  disease.'- 

Lyons,'"'^  commenting  on  the  above,  says : '  "At  Avhat  his- 
toric i)erio(l  yellow  fever  became  an  established  epidemic, 
it  may  perhajis  be  not  possible  now  to  determine.  Some 
writers,  and  amongst  them  Bancroft,  seem  to  think  that 
certain  of  the  fevers  described  by  Hippocrates  as  being 
attended  with  black  vomiting  and  yellowness  of  the  skin, 
were  of  the  same  nature  as  the  yellow  fever  of  later  times. 
I  doubt  much  that  the  question  admits  of  absolute  solu- 
tion, so  meagre  are  the  accounts  left  us  in  the  fragments 
of  the  works  of  the  great  Father  of  ^Medicine.'- 

Had  Hii)i)ocrates  an3'  knowledge  of  yellow  fever?  At 
first  thought,  this  looks  like  a  startling  and  foolhardy 
(juestion,  but  a  careful  perusal  of  the  works  of  the  Fatlier 
of  .Alcdicine  certainly  leads  to  the  conclusion  that  yellow 
fever,  or  some  distemper  possessing  almost  the  identical 
symptoms  of  the  disease,  prevailed  among  the  Greeks  and 
their  neighbors  in  the  nebulous  past.  According  to  that 
learned  and  wellqtosted  observer,  Dr.  Samuel  Latham 
Mitchel,  who  edited  the  New  York  Medical  J{ej)osllorij  in 
the  beginning  of  the  last  century,  this  inference  is  readily 

"'  This  fact  is  noted  by  Alcee  Chastant,  of  New  Orleans,  in  his 

Observations  on  Yellow  Fever,  published  in  1878. 
""Lyons:    A  Treatise  on  Fever,  1861,  p.  249. 


126  HISTORY    OF    YELLOW    FEVER. 

drawn  from  the  (jbscrvatious  wliicli  Hippocrates  makes  of 
the  pestilential  (listem])ers  of  Persia  and  Greece.  Dr. 
]\[itchell  holds  the  o])inion  that  it  is  mncli  to  be  lamented 
that  the  (Jrecian  sai^e  has  not  left  to  posterity  an  account 
of  this  distemper,  and  of  the  methods  he  took  to  nuard 
against  it.  AVe  mijilit,  in  all  probability,  have  derived 
some  information  that  would  be  of  priceless  value  to  us 
at  the  i)resent  time.  However,  althouiih  he  has  not  left 
us  the  history  of  the  disease  which  afflicted  the  Persian 
arnn^  ,and  which  gave  so  much  concern  to  the  Greeks, 
there  are  several  passages  in  his  works  which  show  that 
the  southern  parts  of  Europe  and  the  western  countries 
of  Asia  were  visited  by  disorders  marked  by  yellow  skin 
and  black  vomiting,  at  least  four  hundred  years  before 
the  Christian  era.  One  cannot  help  noticing"  that  the 
writings  of  Hippocrates  contain  (nidence  enough  of  mor- 
bid yellowness;  and  that,  although  the  different  kinds  are 
meant  by  the  same  word,  the  yellow  suffusion  incidental 
to  fevers  is  clearly-  distinguishable  from  the  yellow  tinc- 
ture caused  by  an  absorption  of  bile  when  the  liver  is 
obstructed. 

Black  Aomit  is  also  alluded  to  in  the  works  of  the 
Father  of  IMiysics.  Hi  the  twelfth  section  of  his  Proif- 
nosticH,  he  affirms  that  if  the  matter  vomited  be  of  a  livid 
or  black  color,  it  betokens  ill.  In  the  first  section  of  the 
first  book  of  his  (Joun  PrognosticOy  he  enumerates  black 
vomiting  among  a  number  of  the  most  desperate  symp- 
toms. Hi  the  fourth  section  of  the  same  book,  he  considers 
leek-green,  livid  and  black  vomiting  as  omens  of  sad  im- 
port. The  ])assage  in  the  eleventh  ])aragra])h  of  the  first 
book  of  his  i*redictioiis,  indicates  strongly  the  unfavorable 
issue  of  a  fever  after  black  vomiting.  The  connection  be- 
tween black  vomiting  and  death  is  notieed  likewise  in  the 
third  paragiai)h  (if  tlie  second  section  of  the  Coan,  Pioy- 
nostico.  The  same  sym])1<)m  is  mentioned  in  the  first 
])ai'agraph  of  the  first  s( ctictn  of  the  same  book.  And  the 
like  will  be  found  to  recur  in  the  fourth  paragraph  of  the 
tliird  scM'tion  of  the  same  book. 

From  the  above,  it  will  be  seen  that  this  alarming  sym])- 
toni  was  frecpient  among  the  ancient  Greeks  laboring  un- 


HISTORICAL     SUMMARY.  127 

der  fevers,  was  well-known  to  their  physicians,  and  was 
noticed  by  Hippocrates  as  a  familiar  occnrrence. 

It  ninst  not  be  forj^otten,  however,  that  this  symptom 
frequently  occurs  in  the  late  stages  of  other  dangerous 
septic  conditions. 

Littre,  whose  famous  work  is  one  of  the  classics  of 
medical  literature,  denies  that  Hippocrates  had  any 
knowledge  of  yellow  fever  and  asserts  that  the  vausi  were 
merely  remittent  fevers,  the  same  as  is  observed  in  our 
days  in  the  countries  bordering  on  the  Mediterranean. 

But  Littre,  in  our  liuml)le  opinion,  is  not  infallible.  It 
is  a  matter  of  history  that  yellow  fever  was  unknown  by 
that  name  previous  to  1G94,  when  Ferreira  da  Ifosa  pub- 
lished his  admirable  treatise  on  the  pestilential  diseases 
of  rernambuco.  The  fact  that  the  disease  was  not  men- 
tioned in  ancient  times  by  the  name  we  now  know  it,  how- 
ever, does  not  mean  that  it  did  not  prevail  throughout  the 
world  then  or  at  any  other  time.  The  works  of  noted 
chroniclers,  from  the  time  of  Aretus'^'^  to  Guyzot,"*^  abound 
with  accounts  of  pestilences  which  ravaged  Euroi)e,  Asia 
and  Africa  at  specified  epochs,  depopulating  cities,  deci- 
nmting  armies  and  creating  widespread  terror  and  demor- 
alization. 

Even  as  far  back  as  1184  B.  C,  during  the  Trojan  war, 
it  is  said  that  INulalirius,  a  sou  of  Esculapius,  was  invited 
by  the  Greeks  to  their  camj)  "to  stop  a  pestilence  which 
had  ballied  the  skill  of  the  physicians.'''''^  This  disease  is 
said  to  have  resembled  yellow  fever. 

Certain  authors,  among  them  Marius  de  Bamberg,  as- 
sert that  the  plague  of  Athens  described  by  Thucidides 
and  Lucretius,  was  nothing  less  than  yellow  fever.  Ber- 
enger-l*\'raud  tries  to  dispose  of  this  theory  by  saying  that 
although  the  malady  which  afflicted  the  ancient  Greeks 
duiing  the  Peloponesean  wars  was  characterized  by  a 
sudden  onset,  great  i)ain  in  the  head,  injection  of  the  eyes, 
rai)id  res])iration,  etc.,  sym])toms  which  nmy  appear  to 
denote  yellow  fever,  it  is  also  woi*thy  of  notice  that 
Thucydides  speaks  of  the  red  appearance  of  the  facies  of 
those  affected,  black  and  putrid  ulcers,  gangrene  of  the  ex- 

"  Adams'  translation. 

'"See  his  "History  of  France.' 

""  Lepriere's  Classical  Dictionary,  p.  543. 


128  HISTORY    OF    YELLOW     FEVER. 

tremities  and  the  cicatrices  which  reiiiaiued  after  the  pa- 
tients had  been  cured.  These  latter  characteristics  seem 
to  indicate  that  the  Greeks  were  either  attacked  by  the 
plaiiue  or  ])\  nialii>uant  smallpox,  or,  at  all  events,  a 
malady  totally  dittereut  from  yellow  fcyer. 

Sydenliam,  the  ij;reatest  epidemiologist  of  modern  times, 
describes  the  Plague  of  London,  in  the  summer  and 
autumn  of  16G5,  as  haying  been  ushered  in  by  a  malignant 
feyer,  and  also  alludes  to  a  disease  similar  to  yellow  feyer 
which  prevailed  in  Moscow  in  1771,  where  it  destroyed 
80,000  persons.  Alccording  to  Merlins,  one  of  the  physi- 
cians appointed  by  the  Empress  of  liussia  to  attend  the 
infected,  the  pestilence  was  introduced  in  Moscow  by 
Turkish  prisoners. 

In  Hume's  Histonj  of  Eiujland  (page  33),  occurs  the 
following  passage:  ^'The  reign  of  Oswy  was  rendered 
memorable  by  a  most  destructive  pestilence  called  the 
YcJloir  Phif/uc,  which,  commencing  in  GG4,  ravaged  the 
whok'  island  during  twenty  years,  with  the  exception  of 
the  liighlunds  of  Scotland.'' 

A  fever  similar  to  yellow  fever  has  been  observed  in 
England  and  Ireland.  Dr.  Hamilton  describes  its  appear- 
ance at  Norfolk  and  Drs.  Graves  and  Stokes''''^  speak  of 
its  prevalence  in  Dublin  in  1826,  though  the  latter  ex- 
presses some  doubts  as  to  the  disease  being  yellow  fever. 
Dr.  Graves,  however,  avers  that  the  symptoms  and  ana- 
tomical cliaracters  were  the  same  as  those  laid  down  in 
cases  of  ycHow  fever  by  the  best  authorities. 

Anstie/'^  in  comparing  English  epidemical  disease  with 
yelbtw  fever,  says:  "In  trutli,  it  is  diflicult  to  read  care- 
fully the  histories  of  West  Indian  epidemics  of  yellow 
fever  without  being  tempted  to  believe  that  the  disease  has 
strong  affinities  with  our  English  ty]ihus;  and  the  ])ecu- 
liar  symptoms  (jaundice  and  Itlack  vomit)  of  wliich  so 
mucli  has  been  made,  are  in  truth  phenomena  which  are 
not  infrequently  witnessed  in  typhus  and  relapsing  fever 

""Lectures  on  Fever,  by  Wm.  Stokes   (1876).  p.  37, 

""Notes  on  Epidemics,  by  Francis  Edmund  Anstie  (1866),  p.  86. 


HISTORICAL     SUMMARY.  129 

ill  Britain/'-  So  often  has  this  been  the  case,  that  one  can 
hardly  avoid  thinking  that,  were  these  latter  fevers  trans- 
ported to  the  peculiar  tropical  regions  which  liave  been 
mentioned,  tliev  would  develop  these  features  with  con- 
stancy, instead  of  occasionally,  and  would  then  be  indis- 
tinguishable from  true  yellow  fever." 

The  great  American  historian  and  philosopher.  Hum- 
bolt,  makes  the  following  observations:  "It  is  certain 
that  the  voinito,  which  is  endemic  at  Vera  Cruz,  Cartha- 
gena,  and  Havana,  is  the  same  disease  as  the  yellow  fever, 
whicli,  since  the  year  1793,  has  never  ceased  to  afflict  the 
people  of  the  United  States.  This  identity,  against  which 
a  very  small  number  of  physicians  in  Europe  have  started 
doubts,  is  generallv  acknowledged  by  those  of  the  Faculty 
who  have  visited  the  Island  of  Cuba  and  Vera  Cruz,  as 
well  as  the  coast  of  the  United  States,  and  by  those  who 
have  carefully  studied  the  excellent  nosological  descrip- 
tions of  M.  M.  Makittrick,  Kush,  Valentin,  and  Luzuriaga. 
We  shall  not  decide  whetlier  the  yellow  fever  is  percepti- 
ble in  the  caiisus  of  Hippocrates,  which  is  followed,  like 
several  remittent  bilious  fevers,  by  a  vomiting  of  black 
matter ;  but  we  think  that  the  yellow  fever  has  been  spor- 
adical in  the  tAvo  continents  since  men  born  under  a  cold 
zone  have  exposed  themselves  in  the  low  regions  of  the 
torrid  zone  to  an  air  infected  with  miasmata.  Wherever 
the  exciting  causes  and  the  irritability  of  the  organs  are 
the  same,  the  disorders  which  originate  from  a  disorder  in 
the  vital  functions  ought  to  assume  the  same  aijpear- 
ances." 

Conclusion. 

As  previously  observed,  we  lean  to  the  doctrine  of 
Asiatic  origin  of  yellow  fever,  but  we  are  in  no  wise  unal- 
terably wedded  to  the  hypothesis.  We  have  tried  hard  to 
be  convinced,  but  the  bewildering  mass  of  evidence,  pro 
et  con,  has  raised  a  lingering  doubt  in  our  mind,  which 
no  amount  of  reasoning  has  been  able  to  eradicate. 


The  diffai'ential  diagnosis  between  typlius  and  yellow  fever 
in  this  country  is  too  well  established  to  need  comment- 
ing upon. — G.  A. 


ISO  HISTORY    OF    YELLOW    FEVER, 

We  now  bring  this  historical  summary  to  an  end,  think- 
ing it  uuuecessary  to  burden  these  pages  with  further 
quotations  and  observations.  We  feel  we  have  proved 
nothing  new  concerning  the  origin  of  yellow  fever  and, 
taking  you  into  our  contideuce,  patient  reader,  we  must 
confess  we  never  had  the  remotest  idea  of  launching  a  new 
theory.  AVe  simply  culled  from  the  best  observers  and 
trust  to  the  iutelli<^ence  of  the  reader  to  make  whatever 
deductions  may  seem  proper  or  reasonable  in  the  premises. 
So  far  as  we  are  personally  concerned,  we  beg  to  express 
our  opinion  of  the  whole  business  by  the  following  quota- 
tion from  Peisse,  taken  from  his  great  work.  La  Medecine 
et  Lcs  Medccins : 

"Quand,  par  Vohservation  directe  da  regne  animal, 
etiid'iG  dans  son  organization  intcriciirc  la  jjZms  delicate, 
Curicr  eat  fini  son  traca'il,  il  trouca  qwil  etait  arrive  a 
pen  pres  aux  memes  dimsions  qii/Aristote  avadt  etahlies, 
il  y  a-  plus  de  deux  mille  ans." 

To  paraphrase  the  above:  After  carefully  sifting  the 
opinions  of  the  most  noted  writers  on  the  origin  of  3'ellow 
fever,  we  have  arrived  at  the  same  conclusions  reached  by 
all  of  them — that  the  disease  either  was  endemic  in 
America  centuries  before  the  arrival  of  Columbus,  or  was 
imported  from  some  transatlantic  country  hy  the  hordes 
of  nondescript  personages  who  swarmed  to  the  New 
World  in  search  of  riches  and  adventure.  But  where  the 
invaders  primarily  contracted  the  disease,  is  a  question 
which  reminds  us  of  the  immortal  (piestiou  of  the  small 
boy,  ])ropounded  ages  ago  to  his  preceptor: 

"\\  liich  was  born  first,  the  egg  or  the  chicken?" 

AV'e  find  no  record  of  the  learned  gentleman's  explana- 
tion, and  the  problem  will  undoubtedly  remain  forever 
unsolved.  We  cheerfully  relegate  the  jellow  fever  brain- 
racker  to  the  same  fate. 


PART  THIRD. 


HISTORY 


OF 


YELLOW   FEVER, 


BY    LOCALITIES. 


I 


YELLOW  FEVER 


AS  IT 


CONCERNS    ASIA 


THE  EFFECT  THAT  THE  COMPLETION  OF  THE 

PANAMA  CANAL  WILL  HAVE  UPON  THE 

PROBABLE  EXTENSION  OF  YELLOW 

FEVER  TO  ASIA. 

By  Col.  W.  C.  Gorgas. 

Assistant  Surgeon-General,  U.  S.  Army;    Chief   Sanitary 
Officer,  Panama  Canal  Zone. 

To  get  a  basis  for  the  discussion  as  to  what  will  be  the 
probable  effect  of  commerce  through  the  Panama  Canal 
upon  the  introduction  of  yellow  fever  into  Asia,  it  will  be 
necessary  to  review  roughly  the  past  and  present  habitat 
of  yellow  fever,  and  its  method  of  extension  in  the  past. 

Yellow  fever  has  only  been  recognized  as  a  disease  since 
the  discovery  of  America,  and  its  principal  habitat  since 
that  time  has  been  the  West  India  Islands,  and  the  main 
lands  of  both  North  and  South  America  bordering  the 
Gulf  of  Mexico  and  the  Caribbean  Sea.  It  has,  however, 
extended  at  time  very  widely  from  these  localities,  on  the 
eastern  and  western  coast  of  North  and  South  America, 
and  the  western  coast  of  Africa,  and  the  southwestern 
coast  of  Europe.  It  seems  to  have  had  its  widest  exten- 
sion during  the  latter  part  of  the  eighteenth  century  and 
the  earlier  part  of  the  nineteenth.  It  has  been  as  far 
North  as  Quebec  in  North  America  and  as  far  South  as 
Montevideo  in  South  America.  There  have  been  several 
epidemics  in  Spain,  and  minor  epidemics  in  France  and 
Wales.  In  Europe  a  few  cases  have  originated  as  far 
east  as  Genoa,  Italy.  It  has  never  extended  farther  east 
in  Europe  than  Genoa,  nor  has  it  a;t  any  time  affected 
Asia,  or  the  islands  of  the  Pacific. 

With  our  present  knowledge  of  its  means  of  propaga- 
tion one  can  readily  understand  why  it  has  not  spread 
beyond  these  limits.  The  great  road  of  travel  during  the 
old  days  of  sailing  ships,  between  Europe  and  America 
on  the  one  hand,  and  Asia  on  the  other,  was  around  the 
Cape  of  Good  Hope.  This  took  four  or  five  months.  The 
only  possibility  of  such  a  ship  transmitting  yellow  fever 
would  be  that  the  ship  itself  would  become  infected,  and 


156  HISTORY    OF    YELLOW    FEVER. 

continue  to  have  a  snecessiou  of  ca^es,  and  thus  keep  alive 
infected  mosquitoes  during  the  whole  voyage.  She  would 
have  to  be  breeding  stegomyia  mosquitoes  aboard  and 
have  a  case  of  yellow  fever  introduced,  and  infect  these 
mosquitoes,  and  then  have  a  succession  of  cases  of  yellow 
fever  among  her  non-immunes  that  would  keep  up  the  dis- 
ease for  several  months.  The  probabilities  are  greatly 
against  this.  The  probabilities  are  that  within  the  first 
two  months  all  the  nonimmunes  aboard  would  contract 
the  fever,  and  at  the  end  of  a  couple  of  months,  we  would 
have  a  ship  peopled  by  immunes.  Every  probability  is 
that  the  infected  mosquitoes  left  at  the  end  of  two  months 
would  die  from  natural  causes  within  the  following  three 
months,  and  by  the  time  the  ship  reached  India,  she  would 
be  entirely  free  from  infection.  Another  gTeat  means  of 
protection  was  the  fact  that  the  vessel  was  exposed  to 
freezing  weather  for  several  weeks  in  jiassing  the  Cape. 
Before  the  days  of  the  Suez  Canal  there  was  not  a  great 
deal  of  traffic  through  the  ^Mediterranean  Sea  to  Asia,  and 
what  there  Avas,  was  carried  on  by  means  of  pack  trains 
of  various  kinds.  One  can  readily  understand  the  im- 
probability of  transmitting  yellow  fever  in  this  way.  I 
think  our  experience  points  to  the  fact  that  yellow  fever 
is  nearly  always  transmitted  from  place  to  place  by  a  sick 
person  going  from  an  infected  point,  and  infecting  the 
mosquitoes  in  an  uninfected  place.  It  apparently  takes 
pretty  frequent  communication  to  transmit  the  disease. 

In  tlie  earlier  days  of  yellow  fever  in  the  United  States 
it  was  almost  entirely  confined  to  tlie  littoral  and  was 
looked  upon  as  a  disease  of  the  sea  coast.  As  the  country 
became  settled  up  and  river  traffic  became  great,  it  was 
found  that  it  would  spread  up  the  rivers,  but  it  was  still 
looked  upon  as  a  disease  confined  to  the  sea  coast  and 
large  rivers.  AVhen  railroads  were  introduced,  it  was 
found  that  it  spread  with  equal  facility  along  railroad 
routes. 

The  small  amount  of  commerce  and  the  great  length 
of  time  that  it  took  for  a  sailing  vessel  to  cross  the  Pacific 
would  readily  account  for  yellow  fever  not  having  spread 
across  the  Pacific.  With  the  introduction  of  steam  ves- 
sels one  would  have  expected  that  yellow   fever  would 


ASIA.  1S7 

have  been  more  likely  to  spread  to  Asia,  but  a  steam  ves- 
sel breeds  many  less  mosquitoes  than  a  sailing  vessel.  The 
sailing  vessel,  for  her  long-  voyage,  had  to  carry  large  quan- 
tities of  fresh  water,  which  were  prolific  breeding  places 
for  the  stegomyia.  A|  steam  vessel,  while  she  can  and  does 
breed  mosquitoes,  does  not  do  so  to  anywhere  near  the  ex- 
tent that  the  sailing  vessel  does.  Her  expenses  being 
large,  she  cannot  afford  to  spend  such  length  of  time  in 
port  as  the  sailing  vessel  does,  and  is,  therefore,  less  likely 
to  become  infected.  And  then  again,  the  routes  of  com- 
merce do  not  extend  directly  from  infected  ports  to  Asia. 
It  is  very  seldom  that  a  vessel  goes  directly  from  Havana 
or  Kio  de  Janeiro  to  Asia.  The  exchange  is  almost  en- 
tirely carried  on  by  means  of  London  or  Hamburg,  or 
some  other  European  port. 

The  effect  that  the  Suez  Canal  has  had  as  a  means  of  the 
introduction  of  infectious  and  contagious  diseases  from 
Asia  to  Europe,  would  be  some  indication  of  what  effect 
the  Panama  Canal  will  have  upon  the  introduction  of 
such  diseases  from  America  to  Asia.  The  probabilit.y, 
while  remote,  of  the  introduction  of  j^ellow  fever  from 
America  to  Asia,  was  certainly  increased  by  the  opening 
of  the  Suez  Canal.  The  city  of  Para,  in  Brazil,  is  the  port 
in  America  nearest  to  Asia  going  east  by  the  Suez  Canal, 
which  is  at  present  permanently  infected  with  yellow 
fever.  The  time  by  steamer  from  Para  to  India  has  been 
reduced  by  the  Suez  Canal  more  than  half.  The  whole 
route  via  the  Suez  Canal  lays  in  tropical  and  subtropical 
latitudes.  The  likelihood  of  the  introduction  of  yellow 
fever  from  Para  to  India  via  the  Suez  Canal  is  at  present 
just  about  the  same  as  it  is  for  the  transfer  of  the  same 
disease  from  Guayaquil  to  Hong  Kong.  Both  Guayaquil 
and  Para  are  permanently  infected  with  yellow  fever  and 
have  been  for  years.  The  steaming  distance  from  Para 
east  through  the  Suez  Canal  to  India  is  about  the  same  as 
that  west  from  (juayaquil  over  the  Pacific  to  Hong  Kong. 

While  we  would  have  to  acknowledge  the  possibility  of 
the  conveyance  of  yellow  fever  to  Asia  by  either  of  these 
routes,  it  is  evidently  extremely  improbable.  The  Suez 
route  has  been  in  use  for  a  generation,  and  the  Pacific 
route  for  some  three  centuries,  with    never   a     single    in- 


138  HISTORY    OF    YELLOW    FEVEH. 

stance  of  jellow  fever  getting  to  Asia.  But  it  is  probable 
that  in  that  time  there  has  never  been  a  single  instance 
of  a  vessel  going  directly  from  either  Para  or  Guayaquil 
to  Asia.  As  commerce  goes  on  increasing  they  may,  how- 
ever, occur. 

A  very  good  example  of  a  large  commerce  between  ports 
infected  with  3'ellow  fever,  without  the  transmission  of 
the  disease,  is  that  between  the  i)orts  of  Rio  de  Janeiro 
and  Para,  infected  ports  on  the  eastern  coast  of  South 
America,  and  England.  Also  that  between  Guayaquil,  an 
infected  port  on  the  west  coast  of  South  America  and 
San  Francisco.  Commerce  is  very  intimate  between  these 
infected  ports  south  of  the  equator  and  the  non-infected 
regions  mentioned  north  of  the  equator.  Vessels  sail 
between  these  ports  oftener  than  weekly,  and  the  steam- 
ing time  is  less  than  a  month,  yet,  to  my  knowledge,  yel- 
low fever  has  never  been  carried  either  to  England  or 
San  Francisco  from  these  sources.*  But,  before  the  open- 
ing of  the  Suez  Canal,  one,  in  discussing  the  probable 
dangers,  would  have  thought  that  plague  and  cholera 
would  be  much  more  likely"  to  be  introduced  from  Asia  to 
Europe  than  yellow  fever  from  Europe  to  Asia.  The  com- 
merce is  large  and  the  trip  not  more  than  three  weeks, 
infection  from  this  source.  Europe  has,  however,  taken 
Yet  there  has  been  little,  if  any,  trouble  in  Europe  with 
the  precaution  to  establish  an  International  Board  of 
Health  which  has  sanitary  supervision  over  the  Canal  and 
guards  this  route  very  carefully'. 

I  think  the  above  fairly  satisfactory  reasons  why  yel- 
low fever  in  the  past  has  not  spread  to  Asia.  It  is  inter- 
esting here  to  note  the  fact  that  tlie  yellow  fever  zone  had 
greatly  decreased  before  we  knew  that  it  was  transmitted 

*  In  one  isolated  in-stance  (1883),  yellow  fever  was  imported 
into  San  Francisco,  but  did  not  spread.  In  1897,  1898, 
1902  and  1903,  vessels  coming  from  South  American 
ports  infected  with  yellow  fever,  or  on  which  cases  had 
had  developed,  died  or  convalesced,  were  detained  at 
the  San  Francisco  Quarantine  Station,  but  no  new  cases 
developed  while  the  ships  were  in  the  harbor.  For  full 
particulars,  see  detailed  account  under  "California,"  in 
another  part  of  this  volume.     G.  A. 


fl 


ASIA.  139 

by  the  mosquito,  and  before  any  general  measures  of  any 
kind  were  taken  for  its  extinction.  It  extended  most 
widely  about  the  beginning  of  the  nineteenth  century.  At 
this  time,  Philadelphia,  New  York,  Boston,  Baltimore 
and  Charleston  were  all  liable  to  yellow  fever  and  had  fre- 
quent epidemics.  From  this  time  it  has  become  less  and 
less  frequent  on  the  Atlantic  Seaboard  of  the  United 
States  and  in  the  United  States  itself.  At  present,  I  do 
not  think  the  stegomyia  is  found  fartlier  north  than  Nor- 
folk, and  she  proba]>ly  had  the  same  habitat  a  hundred 
years  ago,  and  it  is  hard  to  understand  how  New  Yorli 
and  Philadelphia  could  have  ever  had  yellow  fever.  But 
the  probable  explanation  is  that  before  they  had  water 
supplies  they  used  Avells  and  cisterns  generally  as  a  means 
of  storing  water  and  thus  had  excellent  means  of  breeding 
stegomyia.  Sailing  vessels  frequently  came  in  with  num- 
bers of  stegomyia  aboard.  When  these  arrived  in  the 
summer  time,  the  ships  continued  to  breed  mosquitoes  for 
weeks  at  a  time  while  they  were  tied  up  to  the  wharves. 
Many  of  these  mosquitoes  wandered  otf  to  the  neighboring 
houses  where  they  fouud  ready  means  of  breeding,  and 
thus,  in  a  few  weeks,  the  town  became  well  stocked  with 
stegomyia.  Quarantines  were  very  lax  and  a  case  would 
be  introduced  from  an  infected  ship  and  find  a  good 
ground  for  spreading  the  disease"  through  the  city.  As 
the  cold  weather  came  on  all  the  stegomyia  would  be 
killed,  but  in  some  other  year  the  same  thing  would  occur 
over  again.  At  present  in  Philadelphia  thev  have  no 
tanks  or  cisterns  and  very  few  places  where  the  stegomyia 
would  breed,  but  communication  with  ports  where 
stegomyia  breed  is  almost  altogether  through  steamers 
which  are  not  likely  to  bring  many  stegomyia,  and  she 
has  a  good  quarantine  which  stops  the  large  majority  of 
yellow  fever  cases.  These  are  the  causes,  I  think,  that 
have  led  to  the  contraction  of  tlie  zone  of  yellow  fever. 

The  samie  statements  would  apply  to  Spain  and  Eng- 
land. They  are  not  countries  where  the  stegomyia  breed, 
and  these  mosquitoes  couhl  only  flourish  there  when  in- 
troduced during  the  summer  time,  and  when  the  condi- 


140  HISTORY    OF    YELLOW    FEVER. 

tions  as  to  water  receptacles  were  favorable  to  their  breed- 
inu,* 

In  our  Southern  Gulf  States  the  stegomyia  has  its 
natural  ha]>itat.  The  weather  duriniLi'  the  winter  is  not 
sufficiently  cold  to  kill  otf  all  tlie  adults,  so  that  we  are 
still  liable  to  an  occasional  epidemic  when  the  disease  is 
introduced  from  the  neij^^hborinj^'  West  Indian  ports.  But 
even  in  these  localities  the  winters  are  so  cold  that  the 
mosquito  becomes  dormant  and  yellow  fever  disajjpears, 
even  no  sanitary  measures  are  taken.  As  we  go  farther 
south  and  get  into  the  tropics  we  find  that  the  stegomyia 
breeds  as  well,  as  far  as  temperature  is  concerned,  in  one 
season  as  in  another,  and  Aaries  principally  according  to 
rain  fall,  or  conditions  that  give  more  or  less  numerous 
breeding  places. 

Now  let  us  consider  a  moment  the  distribution  of  yel- 
low fever  at  the  present  time  and  the  possibility  of  its 
transmission  to  Asia.  It  is  at  present  in  Cuba,  ^Mexico, 
Central  America,  and  on  the  east  and  west  coast  of  South 
America.  At  present  I  do  not  think  there  is  any  direct 
communication  between  an  infected  port  and  Asia.  The 
West  Indies  and  the  eastern  coast  of  South  America  ex- 
change their  wealth  with  the  wealth  of  Asia  principally 
through  the  European  ports,  and  Guayaquil,  which  is  the 
only  infected  port  of  auj-  consequence  on  the  west  coast, 
carries  on  whatever  commerce  she  has  with  Asia  through 
San  Francisco. 

In  Southern  Asia  and  the  Philippines  the  stegomyia  is 
a  very  common  mosquito.  The  population  in  China  and 
India  is  very  dense  and  non-immune;  the  Cliinaman  and 
Coolie  being  just  as  liable  to  yellow  fever  as  tlie  European, 
and  as  far  as  we  can  see,  it  will  only  require  the  introduc- 
tion of  a  case  of  yellow  fever  to  cause  a  very  devastating 
e])idemic,  wliich,  in  the  state  of  civilization  existing  in 
Asia,  would  be  entirely  unconti'ollaltlc. 

If  the  Canal  were  opened  to-morrow  I  do  not  think  the 
chances  of  carrying  j-ellow  fever  to  Asia  would  be  one 
whit  increased  over  what  they  are  to-day.    At  the  present 

*  According  to  Theobald  (Monograph  of  the  Culicidae  of  the 
World,  published  in  1891),  stegomyia  have  been  found 
in  Spain.     G.  A. 


ASIA.  141 

time  sucli  danger  is  very  remote.  It  is  only  a  possibility. 
On  the  Pacific  side  we  have  only  one  infected  port,  Guaya- 
quil. It  is  within  the  bounds  of  possibility^  for  a  steamer, 
to  sail  directly  from  Guayaquil  to  an  Asiatic  port,  be- 
come infected  at  the  time  of  leaving  Guayaquil,  continue 
the  infection  h\  means  of  a  succession  of  cases  during  the 
two  months  it  would  take  her  to  reach  an  Asiatic  port  and 
implant  the  infection  at  such  port.  But  it  is  extremely 
improbable.  If  a  weekly  steamer  sailed  from  Guayaquil 
to  a  tropical  Asiatic  port  the  probabilities  would  be  in- 
creased. The  chances  of  a  ship  remaining  infected  for 
two  months  are  snmll.  Take,  for  instance,  the  relations 
between  Cuba  and  Spain.  For  the  twenty  years  befoi'e 
the  Auun-ican  occupation  of  Cuba  frequent  steamers  sailed 
from  Havana  to  the  ports  of  Spain.  They  were  crowded 
with  i)assengers,  civil  and  military.  Havana,  during 
these  years,  always  had  yellow  fever,  summer  and  winter. 
Spain,  as  previous  history  has  shown,  Avas  capable  of  be- 
coming infected.  But  such  intimate  commerce  ccmld  go 
on  for  twenty  years  without  establishing  yellow  fever  in 
the  country.  Small  local  epidemics  have  been  established 
two  or  three  times  in  Spain  by  this  commerce  since  the  in- 
troduction of  the  steamship.  But  it  is  rare.  Now  if  the 
time  of  transit  were  made  eight  weeks,  instead  of  two,  the 
probabilities  of  carrying  the  disease  would  be  greatly  de- 
creased. I  think  that  if  such  had  been  the  case,  Europe 
would  have  remained  as  free  from  yellow  fever  as  has 
Asia. 

The  Commission  which  was  appointed  by  the  United 
States  to  examine  and  report  upon  routes  across  the 
Isthmus,  and  which  finally  recommended  the  Panama 
route,  discussed  at  considerable  length  as  to  what  would 
be  the  probable  amount  of  ccnimerce  through  the  Canal 
and  as  to  where  it  would  conu^  from.  They  (juote  the 
commerce  of  the  great  canals  of  the  world  at  present  in 
operation  and  its  rate  of  increase  yearly  from  the  open- 
ing of  these  canals.  From  this  data  they  conclude  that 
ten  millions  tons  per  year,  will  be  a  large  touage  for  the 
first  ten  years. 

Assuming  that  commerce  will  always  follow  the  short- 
est and  quickest  routes  between  two  points,  they  show 


142  HISTORY    OK    VELLOW    FEVER. 

that  almost  all  European  ports  are  nearer  Asiatic  ports 
via  the  Suez  Canal  than  via  the  I'anania  Canal,  and  that, 
therefore,  l*anama  will  get  very  little  trade  from  Europe. 
They  conclude  that  the  traffic  through  the  Suez  Canal 
will  not  be  interfered  with  by  the  Panama  Canal;  that 
this  traffic  will  come  principally  from  the  United  States; 
some  from  the  West  Indies  and  South  America  and  a  very 
little  from  England.  Accepting  this  as  a  basis  for  discus- 
sion, we  see,  that,  if  yellow  fever  infection  is  distributed, 
at  the  time  of  the  opening  of  the  Canal,  as  it  is  at  present, 
ships  passing  through  the  Canal  and  going  to  Asia  from 
Vera  Cruz,  Havana  and  Rio  de  Janeiro,  would  be  the 
only  ones  which  could  possibly  carry  infection.  A  half 
a  dozen  ships  a  year  Avould  be  a  large  average  for  these 
ports.  The  other  ports  at  present  infected  will  probably 
never  send  a  ship  through  the  Canal  to  Asia. 

How  will  the  opening  of  the  Panama  Canal  affect  the 
chances  of  this  introduction?  It  will,  no  doubt,  increase 
somewhat  the  commerce  between  infected  ports  and  Asia, 
and  vastly  increase  the  commerce  between  Xorth  America 
and  Europe,  on  the  one  hand,  with  Asia  on  the  other. 
Ships  in  passing  through  the  Canal  will  touch  at  Panama 
and  Colon  and  be  some  twelve  or  fifteen  hours  crossing 
the  Isthmus.  If  this  territory  is  infected  with  yellow 
fever  at  this  time  it  will  greatly  increase  the  chances  of 
some  of  these  numerous  vessels  becoming  infected,  and 
therefore,  the  possibility  of  yellow  fever  spreading  to  Asia. 
If  we  could  bring  about  such  conditions,  therefore,  that 
no  vessel  in  passing  through  the  Isthmus  would  be  liable 
to  become  infected  witli  yellow  fever,  and  so  that  no  ves- 
sel from  an  infected  port  would  be  alloAved  to  go  through 
the  Canal,  with  am'  possibility  of  her  carrying  infection, 
Asia  would  be  no  more  liable  to  get  yellow  fever  from  us 
than  she  is  at  present. 

To  bring  this  happy  condition  about,  we  would  have  to 
keep  the  Isthmus  itself  free  from  yellow  fever,  and  to 
guarantee,  by  means  of  rigid  quarantines,  that  no  infect- 
ed vessel  ])assed  through  the  Canal.  Both  these  things 
are  p(;ssible  of  acc(;m])lishment.  31odern  sanitary  meas- 
ures liJive  demonstrated  the  fact  that  even  in  the  tropics 
it  is  possible  to  rid  a  locality  of  yellow  fever  and  keep  it 


ASIA.  143 

free.  This  has  already  been  done  at  Panama.  It  has  been 
over  a  jear  since  a  case  of  yellow  fever  has  occurred  in 
the  city  of  Panama,  and  only  one  case  has  occurred  on 
the  Isthmus  in  the  year  190G.  There  is  a  much  larger  non- 
immune population  on  the  Isthmus  at  present  that  was 
ever  here  before,  and  that  probably  ever  will  be  here  after 
the  construction  of  the  Canal, 

The  same  system  of  quarantine  that  has  kept  yellow 
fever  for  the  past  three  years  from  being  introduced  by 
shipping  from  the  neighboring  infected  ports,  into  the 
Zone,  Avill  also  in  the  future  prevent  an  infected  ship 
from  passing  through  the  Canal. 

Whether  the  Panama  Canal,  when  completed,  will  be 
a  menace  to  the  health  of  Asia  all  depends  upon  the  effi- 
ciency of  the  government  which  controls  the  Zone  through 
which  it  passes.  If  the  Zone  remains  an  endemic  focus, 
as  in  years  past,  the  probabilities  of  transmittina-  yellow 
fever  to  Asia,  by  the  largely  increased  direct  traffic,  will 
be  augmented.  If  the  Zone  is  kept  free  from  yellow  fever, 
and  the  last  three  years  of  sanitary  work  by  the  United 
States  Government  at  Panama  has  shown  that  this  is 
entirely  possible,  then  the  liability  of  the  introduction  of 
yellow  fever  into  Asia  will  not  be  at  all  increased  by  the 
opening  of  the  Canal. 


SYRIA. 

Geographical  and  Historical. 

Syria  forms  part  of  Asiatic  Turkey,  south  aud  south- 
east of  Arabia  aud  borders  ou  the  Mcditerraueau.  It  has 
a  popuhitiou  of  about  1,500,000,  aud  area  of  about  70,000 
square  miles.  In  ancient  times,  Syria  formed  a  part  of 
the  Byzautine  Empire,  aud  was  successively  conquered  by 
the  Persians,  the  Greeks  and  the  Komans,  Siuce  then, 
its  political  history  has  been  varied  and  sensational.  It 
was  taken  hy  the  Arabs  in  63G  A.  D,,  by  the  Sedjuk  Turks 
in  1078,  by  the  Crusaders,  by  the  Mamelukes  and  by  the 
Ottoman  Turks,  who  added  it  to  their  empire  in  1517.  In 
1833,  it  was  couipiered  by  Mehemet  Ali  aud  annexed  to 
Egypt,  but  was  restored  to  Turkcn-  in  1810  by  the  interven- 
tion of  the  great  powers  of  Europe.  Bethlehem,  the  birth- 
place of  our  Savior,  is  located  in  Syria. 

Alleged  Oiitbrcah  of  Yellow  Fever  in  1800. 

Yellow  fever  has  never  invaded  Asia,  so  far  as  history 
informs  us.  The  probability  of  the  disease  being  carried 
to  the  Ancient  Continent  is  ably  and  compveheusiveh'  dis- 
cussed by  Col.  Gorgas  in  the  preceding  Chapter.  We  do 
not  believe  that  the  incident  related  below  was  an  out- 
break of  yellow  fever,  but  gi\e  it  a  i)lace  in  this  volume  to 
complete  our  rec<u-ds  of  reported  eruptions  of  the  disease. 

According  to  Dr.  Larrey,  who  was  Surgeon-in-Chief  in 
the  Army  of  Napoleon  during  the  cauipaigus  in  Egypt  and 
Syria,  yellow  fever  j)revailed  in  ^Vi'steru  <V.sia  auiong  the 
troo])s  under  (Jeueral  Kochler,  in  tlie  f-ummcr  and  autumn 
of  1800.  Dr.  Larrey  gathered  his  facts  from  the  medical 
journal  of  Dr.  Witnum,  a  physician  who  was  with  the 
English  military  (•(Jiiiuiission.  AVc  cuil  the  following  from 
Dr.  l.arrcy's  observations:' 

Dr.  Witman  relates  that,  in  the  autumn  of  1800,  while 

^  Memoirs  of  Military  Surgery  and  Campaigns  of  the  French 
Armies,  etc.,  by  D.  J.  Larrey  (Hall's  Translation),  1814, 
p.  234. 


SYRIA  145 

the  military  commissiou  remained  on  the  coast  of  Jaffa — 
a  maritime  town  of  Palestine,  31  miles  northwest  of  Jeru- 
salem— where  it  was  encamped  Avith  the  army  of  the 
Grand  Vizier,  a  malignant  Inlions  remittent  fever  made 
its  appearance.  It  commenced  abont  the  middle  of  Au- 
gust, and  continued  with  much  severity  through  the 
months  of  September  and  October,  lasting  until  Decem- 
ber. The  weather  was  foggy,  and  very  warm,  the  tempera- 
ture ranging  from  90°  to  98°.  The  nights,  however,  were 
cool  and  moist.  The  first  victims  of  this  disease  were  two 
of  the  artificers  attached  to  the  English  forces ;  the  malady 
soon  extended  to  the  camp  of  the  Turks,  where  it  caused 
great  mortality. 

The  symptoms  that  appeared  in  this  disease,  according 
to  Dr.  Witman,  were  at  first  chilliness,  pains  in  the  head 
and  prostration  of  strength;  after  these  a  lurniug  pain  of 
the  stomach  and  abdomen,  nausea,  a  bitter  taste  in  the 
mouth,  and  copious  vomiting  of  bloody  and  bilious  matter, 
with  a  diarrhea  of  the  same  appearance;  the  tongue  of  a 
yellowish  Idack,  an  ardent  thirst,  the  pulse  quick  and 
strong,  the  skin  yellow  and  hot,  the  respiration  hurried. 
When  the  fever  assumed  an  unfavorable  character,  it  was 
attended  by  delirium ;  the  eyes  were  inflamed,  and  the  skin 
often  affected  with  dark  colored  spots.  This  disease  ad- 
vanced with  more  or  less  rapidity,  according  to  the  state 
of  the  mind  and  body,  age,  and  particular  regiment ;  also 
with  nmny  circumstances  connected  with  the  ]>]ace  and 
the  atmosphere. 

The  wife  of  General  Kochler,  commandant  of  the  Eng- 
lish forces,  was  the  first  to  be  stricken  with  the  disease 
after  the  artificers  had  been  attacked,  and  died'  on  the 
seventh  day.  The  general,  who  had  faithfully  nursed  his 
consort  during  her  illness,  also  contracted  the  disease.  He 
died  on  the  third  day  after  being  taken  ill. 

The  disease  caused  much  mortality  among  the  soldiers. 
In  the  months  of  November  and  December  it  subsided 
and  was  replaced  by  the  i)lague,  Avhiih  was  brought  into 
Egy])t  by  the  invading  armies  and  raged  with  unusual 
violence  in  that  already  much  afflicted  country. 

It  is  to  be  regTetted  that  Dr.  Larrey  could   not   collect 


146 


HISTORY    OF    VE.  LOW    FEVER. 


irioio  oircumstantial  details  relative  to  this  outbreak,  os- 
Ijecially  as  reoards  the  ])atliolo<iY  of  the  disease.  The 
results  of  the  dissections  which  were  undoubtedly  made  by 
Dr.  Witman  and  his  fellow  physicians  would  have  proved 
a  Valuable  addition  to  the  history  of  this  epidemic. 


I 


HISTORY 


OF 


YELLOW    FEVER 


X 


AFRICA. 


ANGOLA. 

Description. 

Angola  is  a  Portugese  colonT  ou  the  >vest  coa»t  of  Africa, 
south  of  tlie  Cougo  Free  State.  It  consists  of  four  dis- 
tricts— Cougo,  Loauda,  Beuguela  and  Mossamedos.  An- 
gola was  for  a  long  time  the  radiating  point  of  the  slave- 
trade.    Capital,  St.  Paul  de  Loanda. 

YELLOW  FEVER  YEARS. 

1860  ;  18(32 ;  18C3 ;  1SC5. 

SUMMARY  OF  EPIDEMICS. 

18C0. 

Although  the  coast  of  Angola  was  discovere]  h\  the 
Portugese  in  148(1  and  colonized  soon  after,  we  find  no 
mention  of  yellow  fever  having  prevailed  in  that  locality 
previous  to  18(50.  As  Angola  was  the  most  active  centre 
of  the  slave-trade  in  the  past,  there  is  no  douht  that  the  dis- 
ease was  iin]»oi't(<l  and  flourished  there  ofteU;  although 
official  contirmation  is  lacking  on  this  score  Rut  we 
come  across  the  same  hiatus  almost  everywhere  in  Africa. 
All  the  <'olonies  along  the  Atlantic  seahoard  are  controlled 
by  I]uvo])eau  governments,  whose  policy  of  conceahnent 
and  sui)})ression  has  been  instruuu'utal  in  closing  every 
avenue  of  research  in  that  direction,  so  as  to  throw  dust 
in  the  eyes  of  their  own  i)eople  and  put  down  the  bars  to 
imuiigration. 

The  outbreak  of  18(10,  according  to  R(  renger-Feraud* 
(page  13())  was  (piite  severe;  but,  beyond  the  mere  men- 
tion of  this  fact,  the  noted  epidemiologist  is  as  silent  as 
the  proverbial  bivalve. 

♦Berenger-Feraud:    Traite  Theoriquc  et  Clinique  de  la  Fievre 
Jaime,  Paris,  1891. 


i 


ANGOLA.  151 

1802. 

St.  Paul  de  Loanda  was  ai»ain  visited  by  yellow  fever 
ill  1862  (Berenger-Feraud,  page  139).  No  detaiJs  are  ob- 
tainable. 

18G3. 

The  epidemic  which  had  its  inception  in  i8C2,  continued 
in  1803  ( Berenger-Ferand,  page  140  >.  It  was  brought 
that  year  from  Angola  to  Grand  Bassam  \{\.  v.). 

1805. 

The  year  1805  furnishes  the  last  record  of  jellow  fever 
in  Angola.  According  to  IMackay  (cited  by  Berenger- 
Feraud,  page  111),  it  was  quite  severe  at  St  Paul  de 
Loanda. 


ASCENSION  ISLAND. 

Description. 

The  Island  of  Ascension  is  a  mere  speck  near  the  middle 
of  the  South  Atlantic  Ocean,  about  750  miles  northwest 
of  the  historic  Island  of  St.  Helena,  and  belongs  to  Great 
Britain,  It  is  only  36  miles  in  circumference;,  8  miles  at 
its  widest  part,  is  of  volcanic  origin,  and  is  chiefly  cele- 
brated for  its  turtle,  which  are  the  finest  in  the  world. 
The  capital,  George  Town,  located  on  the  west  side,  has  a 
population  of  about  150,  and  is  governed  under  the  admir- 
alty by  a  naval  officer.  The  total  jjopulation  of  the  colony 
is  about  400. 

YELLOW  FEVER  YEARS. 

1818;  1823;  1838;  1847;  1859;  1873. 

SUMMARY  OF  EPIDEMICS. 

1818. 

According  to  the  Second  Report  on  Quarantine,^  page 
197,  a  fever  called  "bilious  remittent,"  but  which  was,  no 
doubt,  yellow  fever,  prevailed  on  the  Island  of  Ascension 
in  1818.  The  fever  attacked  "every  man  on  the  island,"  but 
the  mortality  was  small.  In  the  journal  kept  by  Mr. 
Robert  ^Falcolm,  who  was  stationed  at  George  Town  in 
1818,  api)ears  the  history  of  a  case  of  the  disease,  which 
commenced  on  the  first  day  of  June  and  '^as  terminated 
by  death  the  next  day,  "with  all  the  symptoms  of  yellow 
fuffusion  and  black  vomit," 

The  fever  was,  no  doubt,    imported    from    America    by 

*  Second  Report  on  Quarantine :  Yellow  Fever,  with  Appen- 
dixes, by  the  General  Board  of  Health;  Presented  to 
Both  Houses  of  Parliament  by  Command  of  Her  Majesty. 
London,  1852.  The  First  Report  is  a  general  treatise  on 
epidemic  disease's;  the  Second  Report  deals  principally 
with  yellow  fever. 


ASCENSION    ISLAND.  1'5S 

some  of  the  many  trading  ships  v^hich  stopped  at  Ascen- 
sion on  their  way  to  African  ports,  but  the  framers  of  the 
"Second  Eeport'-  vehemeutl}'  deny  this,  claiming  that  the 
fever  was  engendered  "b^^  an  unusually  wet  turtle  season, 
when  the  men  are  much  exposed  by  watching  at  night  to 
turn  these  animals." 

This  explanation  seems  amusing  and  absurd  when 
viewed  in  the  light  of  our  present  knowledge  of  the  trans- 
mission of  yellow  fever,  but  the  statement  was  undoubted- 
ly acceiJted  as  gospel  truth  by  the  learned  men  of  the 
period.  It  must  also  be  remembered  that  the  "Second  Re- 
port" was  written  under  direction  of  the  British  Govern- 
ment, and  as  England's  merchant  marine  dotted  the  seas 
at  that  time,  the  interests  of  her  vast  commerce  demanded 
that  the  theory  of  importation  be  tabooed  and  ridiculed, 
even  at  the  sacrifice  of  truth.  According  to  an  old  saying 
of  the  ante-bellum  Louisiana  negro,  Ravct  pa  (jdif/niii 
raiso)i  divan  poulij-  and  the  astute  and  narrow-minded 
compilers  of  this  "Report"  resort  to  all  sorts  of  ingenious 
metaphors  in  their  attempt  to  refute  every  proved  instance 
of  importation  of  ^'cllow  fever,  twisting  facts  with  amaz- 
ing cold-l)loodeduess  and  striving  with  every  fiber  of  their 
prejudiced  minds  to  prove  that  everybody  but  themselves 
are  falsifiers. 

We  regret  not  l)eing  able  to  give  a  detailed  account  of 
this  outbreak,  the  first  on  record  in  tlie  epidemiological 
history  of  Ascension.  Even  our  old  reliable  friend,  Ber- 
enger-Feraud,  disposes  of  the  subject  >vitli  barely  two  lines, 
referring  the  reader  to  the  unsatisfactory  account  con- 
tained in  the  "Second  Report  on  Quarantine,"  which,  as 
we  have  seen,  is  historicall}^  incomp>(  to. 

An  Heirloom  in  the  Annals  of  Medicine. — 77/ r  Case  of  the 

''Bann." 

In  1823,  the  diminutive  islet  of  As^cension,  whi<li  looks 
like  a  pin-head  in  the  vast  wastes  of  wpters  which  surround 

*  The  roach  has  no  voice  in  an  argument  with   chickens. 


154  HISTORY    OF     YKI.L    W     FEVER. 

it,  assumed  tlic  iiiai>nitu(le  of  a  cont  ?i(Mit  in  tli'.*  iiiiagiiia- 
(ion  of  the  lioar.v-headed  cln-oiiielM's  wlio  cjiteied  to  public 
opinion  in  tlie  heiiinninu  of  the  last  centurv.  Tlii.s  anomal- 
ous state  of  tliinjis  was  broui»ht  about  by  an  oecurrence 
wliieli  led  the  medical  men  of  the  period  into  a  renewal  of 
the  aci'imonious  and  endless  controversies  concerning  the 
contaiiiousuess  or  non-contagiousness  of  yellow  fever — a 
war  of  words  which  had  been  waged  with  more  or  less 
fierceness  since  1793,  and  which  furnished  material  for  dis- 
cussion in  tlie  lay  and  medical  press  for  fifty  years  after- 
ward.^. This  noteworthy  event  ^\as  the  arrival,  on  April 
25,  1823,  of  the  British  sloop  lianii  in  the  harbor  of  George 
Town,  the  lava-fringed  capital  of  the  Islai.d. 

The  case  of  the  Bunn  is  an  heirloom  in  the  annals  of 
epidemiology.  To  publish  all  that  has  been  said,  dis- 
cussed and  written  about  this  "celebrated  case,"  would 
take,  at  least,  half  a  dozen  volumes  of  several  hundred 
pages  each-;  so  we  will  merely  confine  ourselves  to  a  recital 
of  the  incidents  wliich  led  to  the  infection  of  the  Island  of 
Ascension,  as  abstracted  from  the  report  of  Sir  William 
Burnett,  in  his  comprehensive  work  published  in  1819.^ 

Owing  to  the  universal  interest  which  was  evinced  in 
the  case  of  the  Baun  during  the  last  c.'ntury,  we  have  seen 
fit  to  go  into  details  which  will  d(5ubtless  seem  unimi)or- 
tant — and,  iiiaylia]),  tirescjuu^ — to  the  lay  nader,  but 
which  are  absolutely  essential  to  a  faithful  narration  of 
the  historic  event. 

The  Bi'itish  sbjop  Batiu  a;ichor(Ml  in  the  Sierra  Leone 
river,  AVtst  Africa,  on  the  11th  of  J^niuary,  1823,  after 
having  cruiscMl  in  the  Bight  of  Benin.  She  remained  at 
Sierra  Leone  until  the  25th  of  ^larcli,  part  of  her  crew  be- 
ing employed  in  her  tender,  the  Kmi  RuphdiL  The  men 
were  greatly  (\\]»osed  in  refitting  Ihe  i-igging  of  both  ves- 
sels, and  the  schooner  having  been  sent  up  the  river  to 
Bounce  Island  to  have  her  bottom  repaired,  she  was  there 
laid  on  the  beach,  and  the  men  ex])os(Hl  (in  shore  in  one  of 
the  raost  unheal tliy  s])ots  in  the  colony. 

On  the  1st  of  Mardi,  Mr.  Higgon  was  seized  with  fever 
while  on  the  t<<ut  NapJuicI,  where  he  had    been    for    some 

'Burnett:    A  Report  upon  the  Diseasps  of  the  African  Coast, 

1S49. 


ASCENSION    ISLAND.  155 

days  with  a  party  of  men  actively  employed  gettinji,-  her 
ready  for  sea.  Ou  the  moruiug  of  the  second  he  was  better, 
but  became  worse  in  the  evening.  He  had  mo^'e  fever, 
which  increased  until  the  ord,  when  in  the  evening  he  re- 
mitted. On  the  Jrth  and  ."ith  it  appears  to  have  been  moder- 
ate, and  on  the  6th  he  was  free  from  all  complaint  but  de- 
bility.   Plis  eyes  were  sliglitly  yellow. 

On  the  10th  of  March  four  cases  occurred  in  the  same 
vessel,  the  Sou  RaphaeJ,  wliile  at  sea.  In  only  one  of  the 
cas:es,  which  is  detailed  at  length,  there  were  slight  remis- 
.uons,  as  in  the  preceding.  On  the  loth  the  skin  assumed 
a  yelb)\v  tinge,  but  the  i)atieut  recovered,  and  Avas  dis- 
charged to  duty  on  the  21th.  On  the  25tli  another  man 
was  attacked  in  the  tender,  which  had  returned  to  the 
anchorage  of  Freetown.  Re  had  l(e(^n  onlv  thrte  days  on 
board.  On  the  2()th  there  was  a  slight  remission,  followed 
l)y  an  accession  of  fever.  On  the  27th  there  was  a  second 
remissioji,  folh.wed  by  an  accession.  On  Hie  29th  he  be- 
gan to  sink,  and  died  early  on  the  30tli.  The  integuments, 
wliicli  were  slightly  yellow,  assumed  a  very  deep  color  aft(n' 
death.  This  was  the  first  fat-J  case  that  occurred  amongst 
the  crew  of  the  Bami.  Three  men,  two  on  the  San  Raphael 
and  one  on  the  Haiui.  were  attacked  on  the  26th,  but  they 
all  recovered. 

The  Ha  nil  sailed  on  the  27th  of  March,  but  remained 
about  the  mouth  of  the  river  until  the  29th.  Three  cases 
occurred  on  the  27th,  but  they  were  all  of  an  ephemeral 
nature,  the  whole  of  the  men  having  returned  to  duty 
within  a  w(>ek.  On  the  -Slst  there  was  a  case  of  more 
sT'vcritv,  the  patient  having  been  on  the  sick  list  for  nine- 
teen days.  On  the  3rd  of  April,  there  were  four  attacks. 
These,  with  one  exception,  were  all  slight  cases.  On  the 
7th  of  A])i'il,  eleven  days  after  the  Ha  mi  left  Sierra  Leone, 
there  was  a  severe  case,  which  terminated  fatally  on  the 
12th.  I-'rom  this  time  the  disease  assumed  a  greater  de- 
gr(M'  of  malignity  and  tlie  (b  atlis  IxM-ame  more  frcipient. 
Only  one  of  the  cases  which  occurred  about  this  period 
is  detailed  in  the  surgeon's  journal.  The  patient  was  at- 
t;\cked  on  tbe  11th,  but  ba<l  felt  uriwll  foi-  a  few  days 
previously.     He  had  the  usual  symptoms   of   fe^er,    wbicli 


156  HISTORY    OF    YELLOW    FEVER. 

were  relieved  by  bleeding.  Early  on  the  15tli,  he  suffered 
less  from  pain,  tbe  skin  was  hot,  but  moist  and  the  pulse 
was  full  and  (luiclc.  At  1)  a.  m.  he  was  again  bled,  whicli 
seemed  to  relieve  him,  but  at  noon  the  bad  symptoms  re- 
turned. The  skin  became  A'ery  hot.  the  pulse  120  and 
strong.  There  was,  in  fact,  an  accession  of  fever.  On  the 
evening  of  the  Kith  slight  stup(!r  siipervened,  and  the  fever 
continued  to  be  high.  On  the  17th  the  symptoms  were 
more  favorable  and  there  was  a  decrease  of  pyrexia,  but 
on  the  18th,  about  noon,  the  patient  became  suddenly 
worse  and  died  almost  immediately  afterwards.  Neither 
black  vomit  nor  yellowness  of  skin  is  mentioned. 

It  was  intended  to  proceed  witli  the  vessel  to  the  Island 
of  St.  Thomas,  in  the  Bight  of  Biafra,  but  on  account  of 
the  ra])id  increase  of  the  fever  and  the  bad  state  of  the 
weather,  a  run  was  made  for  the  Island  of  Ascension, 
which  was  reached  on  the  25th  of  April,  the  Bonn  having 
lost  thirteen  men  by  fever  up  to  that  per'od.  The  viru- 
lence of  the  fever  was  most  marked  about  the  third  week 
in  Ai)ri],  a  few  days  after  the  vess(^l  crossed  the  ecpiator, 
and  when  within  a  few  hundred  miles  of  Ascension.  On 
April  22d  eight  men  were  attacked,  not  one  of  whom  sur- 
vived ;  three  died  on  the  20111,  two  on  the  27th,  two  on  the 
20th  and  one  on  the  third  of  May.  The  total  number  of 
cases  on  board  the  Barm  was  99  and  the  mortality  34. 

The  fever  was  carried  by  the  officers  and  crew  of  the 
Ba)!)}  to  the  detachments  of  Royal  ^farines  stationed  at 
George  Town,  the  capital  of  Ascension,  and  spread 
throughout  the  island.  There  were  altogether  28  cases 
and  15  deaths,  a  mortality  of  over  fifty  per  cent. 

Tlie  theory  of  importation  in  the  above  instance  is 
viciously  assailed  by  the  "Second  Keport  on  (Quarantine,'' 
pages  89  and  19(5,  but  the  .irguirients  advance;!  are  de- 
cidedly vapid  and  irreconciliable  with  strict  veracit}'  and 
common  sense. 

1838. 

The  Case  of  the  ''Etna/' 

From  1823  to  1838,  the  Island  of  Ascension  was  free 
from  yellow  fever.     In  1837.  there  was  a  severe  epidemic 


ASCENSION    ISLAND.  I  57 

in  Sierra  Leone  and  the  infection  avrs  finally  bronf^ht  to 
the  island  in  1838  by  one  of  the  many  English  war  vessels 
which  were  constantly  cruising  about  the  South  Atlantic 
waters,  ready  to  pounce  upon  the  enemy  and  annex  every- 
thing reachable.  The  source  of  infection  was  finally 
.  traced  to  three  vessels,  l)ut  which  one  of  the  three  was  the 
active  cause  of  the  epidemic  is  a  mooted  question  to  this 
day. 

The  facts,  according  to  the  literature  of  the  period,  are 
as  follows  :^ 

The  ship  Etna  arrived  from  Gibraltar  in  the  roads  off 
Sierra  Leone  in  November,  1837.  The  fever  at  the  time 
was  committing  great  ravages  among  the  prize  crews  and 
merchnnt  seanun.  On  the  3rd  of  December,  the  Etna,_ 
having  watered,  and  taken  on  board  some  African  boys 
and  Kroomen,  sailed  from  Sierra  Leone.  On  the  8th,  one 
of  the  African  boys  was  taken  ill  with  a  slight  feverish 
attack,  which  did  not  attract  any  attentioij.,  On  the  10th 
(  December)  two  serious  cases  of  vellow  fever  occurred  in 
two  Europeans,  who  had  been  on  shore  and  much  exposed. 
On  the  12th  two  more  cases  occurred,  and  of  these  four 
coses,  three  died  of  black  vomit  On  the  20th  two  other 
cases  occurred  and  five  on  the  21st.  The  disease  then  at- 
tacked officers  and  men  indiscriminately.  On  the  20th  of 
January,  when  the  vessel  anchored  at  Ascension,  99  cases 
had  occurred  and  25  deaths.  Only  five  of  the  ship's  crew 
entirely  escaped. 

Shortly  after  the  departure  of  the  Etna,  the  Forester 
left  Sierra  Leone  for  Ascension,  with  the  fever  raging  on 
board.  On  the  Avay  to  Ascension,  she  fell  in  with  the 
li()nctta,  bound  also  for  Ascension,  and  sent  on  board  a 
])rize  crew.  Immediately  after  this,  yellow  fever  api)eared 
on  board  the  Botictta  and  was  extremely  fatal.  Both  ves- 
sels arrived  at  Ascension  simultaneously  and  shortly  after- 
wards yellow  fever  apjx'ared  among  tlie  rcsich-nls  of  the 
Island.  Now,  whether  the  infection  was  l)rought  by  the 
Etna,  the  Bonctta,  or  the  Forester,  or  by  all  three  vessels, 
which  arrived  at  Ascension  about  the  same  time,  is  a 
problem  which  nearlv  made  driveling  idiots  of  the  honor- 


*  British  and  Foreign  Medico-Chirurgical  Review,  1849,  vol.  4, 
p.  467. 


158  HISTORY    OK    VEI.LOW    FEVER. 

able  medical  men  who  fought  over  the  momentous  ques- 
tion, and  wliich  tlie  writer  is  too  modet-t  to  presume  to  un- 
ravel. 

The  evidence  further  <ioes  to  s]\()\v  tiiat  the  Watenritch, 
arrivinji;  at  xVscension  from  a  healtliv  port,  with  a  healthy 
crew,  contracted  yellow  fever  at  Ascension  and  carried  it 
to  sea.  losin<>  15  men  out  of  (50  within  a  period  (»f  40  days. 
But,  to  the  credit  of  the  astute  disputants  of  the  period, 
the  Waterwitch  was  never  accused  (^f  liaving  brought  the 
pest  to  Ascension, 

1847. 

Importation  J)i/  tJic  "'Edaii'.'" 

Eiglit  years  elapsed  without  a  single  case  of  yellow 
fever  being  noticed  at  Ascension,  but  an  epidemic  was  nar- 
rowly averted  in  the  beginning  of  1847,  when  tAVO  cases 
developed  on  board  the  British  ship  Rosumo)id,  formerly 
the  Eclair,  which  vessel  had  played  such  a  sensational  role 
in  the  transmission  of  yellow  fever  to  Boa  Vista,  Cape 
Verd  Islands,  in  1845,  and  to  Woolwich,  England,  the 
following  year  (1840).  The  history  of  the  inception  and 
progress  of  the  disease  on  board  the  Eclair  is  interesting. 
To  avoid  repetition,  we  refer  the  reader  to  the  compre- 
hensive account  given  elsewhere  in  this  volume  of  the 
memorable  ei)idemic  which  devastated  Boa  Vista  in  1845.'' 
The  facts  of  the  outbreak  of  1847  are  as  follow? : 
From  the  account  given  by  the  i^ecoud  Report  on  Quar- 
antine, page  J)8,  the  Eclair  was  completely  overhauled  and 
fitted  out  anew  at  ^Voohvich.  where  she  was  commissioned 
for  the  Cape  of  (Jood  lloi)e  on  November  5,  184G,  under 
the  new  name  of  Rosamond,  as  the  old  name  was  looked 
upon  as  a  "hoodoo."  It  is  of  record  that  during  the  time 
of  fitting  out,  four  cases  of  typlius  f<ver  occurred  on  the 
shi])  and  were  sent  to  the  hos])ital,  where  two  of  them  died; 
but  it  is  also  known  that  ty])hus  prevailed  at  Woolwich 
at  that  time.  The  steamer  left  England  for  the  Cape  on 
February  28,  1847.  Three  (hiys  after  sailing,  one  of  the 
men  was  altVcted  with  slight  febrile  symptoms  and  he  con- 
tinued more  or  less  indisi)osed  for  a  nund)er   of  days,   but 

'  See  "Cape  Verd  Islands." 


ASCENSION    ISLAND.  159 

occasionally  felt  so  well  that  he  retiuued  to  his  work. 
After  the  ship  entered  the  tropics,  however,  the  disease 
began  to  assume  a  new  and  alarminji,-  character;  and  when 
oft"  the  Island  of  St.  Nicholas,  and  almost  in  sight  of  Boa 
Vista,  the  man  died,  having  had  for  two  days  previous 
black  vomit  and  other  characteristic  symptoms  of  yellow 
fever.  Within  a  few  days  afterwards,  the  Rosamond  ar- 
rived at  Ascension,  where  two  other  cases  develo])ed.  The 
infection  did  not  spread  to  the  inhabitants  of  the  Island, 
and  no  mention  is  made  in  the  Report  of  any  additional 
cases  on  board  the  ship,  so  we  take  it  for  granted  that  there 
were  none. 

The  great  point  of  interest,  however,  is  the  persistence 
with  which  the  spectre  of  yellow  fever  hovered  over  the 
Eclair,  and  the  only  explanation  which  we  can  make  at 
this  latter  day,  is  that  infected  mosquitoes  were  impris- 
oned in  the  hold  of  the  vessel  and  were  the  active  agents  in 
the  distribution  of  the  poison  wliich  caused  the  sporadic 
outbreaks  which  followed  in  the  wake  of  the  vessel. 

1S59. 

Yellow  fever  was  carried  to  Ascension  by  the  British 
war  vessels  Trident  and  Sharpshooter ,  in  1859,  under  the 
following  circumstances  i*^ 

Yellow  fever  was  ([uite  severe  at  Sierra  Leone  in  1859. 
In  the  middle  of  ^lay,  the  war- vessel  Trident  was  infected 
at  Freetown.  The  disease  spread  rapidly  to  the  officers 
and  men  and  the  ship  was  put  to  sea,  with  a  view  of  ar- 
resting the  progress  of  the  maladv,  but  witl'out  tlie  Avished- 
f(U*  result.  She  returned  to  Sierra  Leone  oii  June  10  and 
sailed  for  Ascension  on  June  IT,  where  she  arrived  on 
June  27,  having  lost  17  men  since  tlie  eruption  of  the 
fever.  Fifty-two  cases  were  then  on  the  sick  list,  31  of 
which  w(  re  sent  on  slioi^e  to  the  gari'ison  hospital,  and  the 
remainch'r  to  the  convalescent  hosjiital  on  the  (Jreen  Moun- 
tain. The  remaining  part  of  the  ci'ew  wa.s  landed  and 
])Iace(l  under  canvass  in  a  small  bay  al)out  two  miles  from 
the  garrison,  with  which  all    communicati(.n    was     inter- 

"  statistical  Report  of  the  Health  of  the  Navy  of  Great  Britain 
for   1859    (London,   1862),   p.   83. 


160  HISTORY     OK    YELLOW     FEVER. 

(licttHl.  Tlie  disease  coiiliinied  to  txteud  anion^-  the  crew 
ou  sliore  iiutil  the  middle  of  July,  when  it  eutirely  ceased. 
Of  143  of  all  ranks  and  ratings  on  board,  nainely,  110 
Europeans  and  33  Africans,  100  were  attacked  and  14 
died. 

Eleven  cast^5  of  yellow  fever  occurred  on  the  Sharp- 
shooter, which  lay  otf  Sierra  Leone  from  the  0th  to  the 
16tli  of  December.  Disease  is  said  to  have  originated  thus : 
On  December  12  the  WmrpHliooter  was  taken  alongside  a 
schooner  for  a  sui)})ly  of  coal ;  in  this  vessel  the  bod^'  of  a 
seaman,  who  had  died  on  the  ^Surprise  of  yellow  fever,  was 
deposited  previous  to  interment ;  and  though  the  fever  was 
su])])osed  to  have  ceased  in  tlie  town  it  was  still  prevalent 
in  merchant  vessels.  The  Shurpshooters  men,  who  were 
employed  in  the  coal  vessel,  complained  of  the  eMuvium 
of  bilge  watei',  and  said  it  gave  them  headache.  On  De- 
cember 21  the  Sharpshooter  i-ailed,  and  on  that  day  a  boj^ 
who  had  been  com])laining  the  day  before  of  severe  head- 
ache was  attacked ;  the  fever  ran  a  rapid  course,  and  he 
died  (tn  the  morning  of  the  22nd.  Other  cases  followed 
rajndly.  The  ship  then  stood  out  to  sea  for  a  few  days 
and  kept  about  00  miles  from  land.  This  -seemed  to  check 
the  progress  of  the  fever.  On  D(>cember  27  several  new 
cases  occurred  and  the  ship  sailed  for  the  Island  of  Ascen- 
sion. In  neither  of  the  above  instances  was  the  disease 
communicated  to  the  inhabitants  of  Ascension. 

1873. 

The  Case  rjf  the  '-'Amethyst:' 

For  fourteen  years,  Ascension  had  a  respite  from  yellow 
fever,  and  would  have  enjoyed  innnunity  to  this  day,  had 
not  importation  again  threatened  tc  kindle  anew  the  dor- 
mant tires  of  i)estilence.  It  does  not  ai)peai'  that  any  cases 
of  yellow  fever  were  observed  among  (he  British  war  ves- 
sels or  the  land  forces  in  the  vicinity  of  the  Island,  yet  the 
ship  Amethj/st  is  accused  of  having  brought  the  fever  to 
Ascension  from  Cape  Coast,  Africa. 


ASCENSION    ISLAND.  161 

This  war  steamer,  accordiut'-  to  Smart,^  was  despatched 
from  the  coast  with  a  large  number  of  invalids,  many  of 
whom  were  from  Elmina.  After  five  days  at  sea,  she 
reached  Ascension  on  the  20th  of  December,  and  landed 
her  invalids.  Among  these  there  was  a  case  of  continued 
fever  with  great  nervous  tremor^  who  died  on  the  seventh 
day  after  landing.  Another  case  was  moribund  when  sent 
ashore,  dying  in  thirty-six  hours.  The  symptoms  were 
great  anxiety,  intense  headache  yvitli  deafness,  epigastric 
pains,  dry  red  cylindrical  tongue  rapid  pulse  and  respira- 
tion, injected  eyes,  a  yellow  surface,  ecchymosed  as  deatli 
approached,  relaxed  boAvels,  vomiting  of  dark  tar-like 
fluid,  and  suppression  of  urine — symptoms  closely  allied 
to  those  of  yellow  fever. 

On  the  third  day  after  being  landed,  one  of  the  invalids, 
after  a  few  hours  of  slight  discomfort,  fell  down  almost 
lifeless,  and  vomited  and  purged  at  the  same  moment  a 
dark  tar-like  fluid  mixed  with  pure  blood;  the  features 
were  deathlike,  the  surface  cold  and  of  a  dii'ty  yellow  color, 
pulse  scarcely  perceptible,  respiration  slow  and  sighing. 
Under  treatment  by  stimulants,  with  opiates,  he  rallied, 
vomiting  ceasing  after  a  few  hours,  when  a  typhous 
state  supervened,  lasting  to  the  end  of  the  second  day,  after 
which  he  convalesced. 

Another  case  was  similarly  attacked  on  the  fourth  day 
after  landing,  went  through  an  analogous  course  of  symp- 
toms, convalescing  from  the  end  of  the  following  day. 

The  train  of  symptoms  and  events  in  the  above  cases, 
according  to  Dr.  Smart,  were  sufficiently  diagnostic  of 
severe  bilious  remittent  fever  of  the  English  nosology,  and 
of  the  gastroenteric  type  of  algide  pernicious  fever  of  the 
French  nosology;  from  which  tlie  Doctor  infers  that  the 
disease  carried  from  Cape  Coast  to  Ascension  in  the 
Amethyst  was  of  the  remittent,  and  not  of  the  yellow  fever 
type.  Be  that  as  it  may,  we  think  the  cases  sufficiently 
diagnostic  of  yellow  fever  to  class  them  as  such  and  place 
this  outbreak  amonff  our  records. 


'Smart:    Transactions    Epidemiological    Society    of    London, 
vol.  3,  p.  508. 


BANANA   ISLANDS. 

Description. 

The  Banana  Islands  are  a  i»roiip  of  small  islands  off  the 
coast  of  Sierra  Leone,  Africa.  They  are  seldom  visited  by 
white  men,  which  no  doubt  accounts  for  the  fact  that  only 
a  single  outbreak  of  yellow  fever  is  recorded  as  having 
taken  place  there. 

.  YELLOW  FEVER  YEAR. 

1847. 

SUMMARY  OF  EPIDEMIC. 

Our  authority^  does  not  give  the  Kjurce  of  infection,  but 
relates  the  folhnving  facts :'  On  the  2Gth  of  eTuly,  1847,  the 
British  brig  ^ijren  detached  a  party  of  three  officers  and 
twenty  seven  men  to  the  Banana  Isla*jds,  for  the  purf)ose 
of  blockading  the  Sherbo  River.  On  August  14,  a  case 
of  fever  occurred,  and,  sul)sequently,  scattered  cases  ap- 
peared till  September  20tli,  when  the  blockade  was  aban- 
doned. The  first  cases  were  said  to  be  of  a  purely  endemi- 
cal  character.  The  disease  then  assumed  a  worse  form, 
until  it  merged  into  yellow  fever,  witli  its  characteristic 
symptom,  black  vomit. 

The  number  of  cases  and  deaths  is  not  oiven.^ 


*Bryson:      British    and    Foreign    Medico-Chirurgical    Review, 

1849,  vol.  4,  p.  470, 
°  This  is  unfortunately  the  case  in   about    every    account    of 

yellow  fever  in  Africa. 


BENIN. 

Description. 

Benin  i«  a  nei>To  kingdom  of  West  Africa,  in  Upper 
Guinea,  on  the  Bight  of  Benin,  extending  along  the  coast 
on  both  sides  of  the  Benin  Biver,  west  of  the  Lower  Niger, 
and  some  distance  inland.  It  Jias  no  political  unity  and 
has  no  commercial  importance.  Benin,  the  principal  town, 
has  a  population  of  about  15,000.  In  the  days  gone  by,  it 
was  the  great  slave  emporium  of  the  district.  The  religion 
is  fetichism.  Human  sacritices  are  numerous  and  cruelty, 
in  its  most  atrocious  forms,  is  characteristic  of  the  people. 

YELLOW  FEVER  YEARS. 

1520;  1553;  1558;  158S;  1828;  1852;  1853;  1851;  1855; 
1850;  1857;  1862;  1873. 

SUMMARY  OF  EPIDEMICS. 

1520. 

Berenger-Feraud/^  quoting  Valkanaer,^^  gives  an  ac- 
count of  an  epidemic,  said  to  be  yellow  fever,  which  at- 
tacked the  crews  of  the  Portugese  explorers  in  the  Gulf  of 
Benin  in  1520.  No  information  as  to  the  origin  of  the  dis- 
ease is  given. 

1553. 

In  August,  1553,  an  Englishman  named  Windham  and 
a  Portugese,  Antoine  Pinteado  sailed  from  Plymouth, 
England,  for  the  West  Coast  of  Africa,  to  exi)lore  and 
colonize  the  country.  The  ex])edit^*on  consisted  of  two 
ships,  manned  by  a  crew  of  140  men.  Shortly  after  reach- 
ing the  Gulf  of  Benin,  the  vessels  were  attacked  by  a  malig- 
nant fever,  which  proved  so  fatal  that  it  was  found  neces- 

"  Berenger-Feraud :    Traite  Theorique  et  Pratique  de  la  Fievre 

Jaune  (Paris,  1890),  p.  27. 
"Vol.  1,  p.  370. 


IGi  HISTORY    OF    YELLOW    FEVER. 

sary  to  bni-ii  the  ships,  there  uot  being  enough  men  left 
to  man  them.  Only  39  of  these  adventurers  returned  to 
Plymouth,  making  a  death-rate  of  70  per  cent.  This 
"malignant  fever"  is  said  to  have  been  yellow  fever,  but 
how,  where  and  by  what  means  the  infeoticn  was  contract- 
ed, oui  source  of  information^-  does  not  say.  As  AVind- 
ham's  vessels  originally  sailed  from  a  port  where  fever  has 
never  prevailed  de  novo,  communication  Avas  evidently  had 
with  some  of  the  slcive-ships  which  then  did  quite  an  ex- 
tensive business  between  Africa  and  Cuba^  Alexico  and 
t^outh  America — for  even  at  that  early  period  the  Span- 
iards stole  negroes  by  the  thousands  to  work  their  planta- 
tions in  the  New  World — and  the  sturdy  sons  of  a  north- 
ern clime  proved  easily  susceptible  to  the  bites  of  the 
stegomyia. 

1558. 

In  1558,  an  explorer  named  Torwson  and  his  compani- 
ons were  stricken  with  yellow  fever  while  in  the  Gulf  of 
Benin. ^'^    The  data  as  to  this  outbreak  are  very  meagre. 

1588. 

Bird  and  Xewton,^^  intrepid  voyagers  in  search  of  ad- 
venture and  wealth,  and  their  companions  are  said  to  have 
experienced  vellow  fever  while  in  the  Gulf  of    Benin    in 

1588. 

1828. 

From  1588  to  1828,  a  period  of  two  hundred  and  forty 
years,  there  is  no  record  of  any  yellow  fever  outbreak  in 
the  (iulf  of  l^enin.  This  seems  almost  incredible,  but  even 
such  a  careful  observer  as  Berenger-Feraud  has  failed  to 
find  any  data  for  these  "silent  years."  In  1828,  however, 
the  disease  broke  out  afresh,^'*  being  imported  from  Sierra 
Leone  by  the  ship  La  JionJclaisr,  and  ravaged  all  the  coast 
*owns  from  the  Gulf  of  Benin  to  Gambia. 


^-  Gazette  des  Hopitaux,  Paris,  vol.  57,  p.  661. 

"Berenger-Feraud,  loc.   cit.,  p.   27. 
•■■  Berenger-Feraud,  loc.  cit.  p.  27. 
'=*  Berenger-Feraud,  loc.  cit.,  p.  105. 


I 


BENIN.  165 

1852  to  1857. 

After  an  iiiterral  of  twenty-four  years,  yellow  fever 
was  ao-ain  imported  to  the  Gulf  of  Benin  in  1852  nnd  cases 
occurred  sporadically^  every  year  from  that  date  until  1857. 
Our  authority^^  does  not  give  any  details. 

1862. 

In  18G2,  yellow  fever  was  imported  to  Benin  and  other 
countries  on  the  West  Coast  of  Africa  (presumably  from 
Havana  or  South  America)  by  some  of  the  nondescript 
craft  engaged  in  the  slave-ti'ade  between  Africa  and  the 
Spanish-American  countries.  Early  in  ^lay,  the  fever 
l)roke  out  among  the  natives  huddled  in  the  towns  and 
liaudets  located  along  the  banks  of  the  Bonny  T?iver,  and 
spread  ra])idly  to  the  officers  and  white  porti(  i«s  of  the 
crews  of  the  palm-oil  vessels  in  the  river.  The  contagion 
then  successively  attacked  the  crews  of  vessels  lying  at 
anchor  in  the  numerous  rivers  flowing  into  the  Gulf  of 
Biaffra/"  more  especially  tlie  Okl  and  New  Calabar  and 
Brass  rivers.  It  was  particularly  fatal  at  Bonny,  then  a 
notorious  slave-mart,  where  it  mowed  down  natives  and 
Europeans  alike.  The  epidemic,  although  of  a  vicious 
and  generally  fatal  type,  was  of  short  duration,  disappear- 
ing from  all  the  rivers  and  bordering  villages  by  the  end 
of  June. 

The  source  of  this  epidemic  has  never  been  clearly  estab- 
lished. That  section  of  Africa  was  then  one  of  tlie  most 
active  centres  of  the  slave  trade  and,  although  British  war 
vessels  blockaded  the  coast  and  were  on  the  lookout  for 
slave-traders,  the  high  rate  of  speed  possessed  by  the  ves- 
sels engaged  in  this  nefarious  trade  and  the  thorough 
knowledge  the  marauders  had  of  the  many  inlels  where 
they  could  find  a  safe  hiding  place  Avhen  the  scout-ships 
were  sighted,  enabled  them  to  navigate  the  mar.y  rivers 
of  that  section  almost  unmolested.  As  most  of  these  slave- 
ships  came  from  Cuba  or  South  America,    where    yellow 

'"  Berenger-Feraiid,  loc.  cit.,  p.  122. 

"  Statistical  Report  of  the  Healtli  of  the  Navy  for  the  Year 
1862    (London,  1865),  p.  157. 


166  HISTORY    OF    YELLOW    FEVER. 

fever  reigns  at  almost  any  season  of  the  3'ear,  the  yellow 
fever  mosquitoes  could  easily  be  imported.  The  only  mat- 
ter of  surprise  is  that  tlie  disease  has  not  been  more  fre- 
quently propagated  by  these  vessels. 

1873. 

In  1873,  yellow  fever  was  imported  to  the  island  of 
Sal,  one  of  the  Cape  Verds,  from  Brazil,  and  tl'ence  to 
Benin.  Small  vessels,  laden  with  grain  from  South  Ameri- 
ca were  then  in  the  habit  of  first  stopping  at  tlie  Cape 
Verd  Islands  on  their  way  to  West  Africa,  and  as  yellow 
fever  has  been  epidemic  in  Brazil  almost  every  3-ear  since 
1819,  this  visitation  can  surely  be  attributed  to  importa- 
tion from  that  country. 

The  first  knowledge  at  Cape  Coast  Castle  of  the  pres- 
ence of  yellow  fever  in  the  Bights  was  late  in  November, 
on  the  arrival  of  the  mail  packet  Anihri::,  having  the  dis- 
ease among  her  crew.^^  The  vessel  was  at  once  quaran- 
tined, her  mails  being  put  on  board  the  Biafra  and  both 
vessels  steamed  off.  The  Amhriz  lost  thirteen  of  her  crew 
before  she  reached  the  Cape  Verds,  and  the  Biafra  six. 
From  the  meagre  report  furnished,  this  outbreak  does  not 
appear  to  have  been  either  extensive  or  attended  with  much 
mortality. 

BOA   VISTA. 

(See  Cape  Verd  Inlands.) 

"  Smart:     Trans.   Epidemiological   Society  of  London,    vol.    3, 
p.  507. 


BONNY. 

Description. 

Bonny  is  a  town  of  West  Africa,  on  the  Bonny  Eiver. 
Jt  is  surrounded  by  a  pestilential  swamp  and  is  inhabited 
by  degraded  savages.  It  does  a  good  exporting  business  in 
palm  oil.  It  was  once  the  most  notorious  slave-port  in 
Africa. 

YELLOW  FEVER  YEARS. 

1862;  1891. 

SUMMARY  OP  EPIDEMICS. 

1802. 

The  epidemic  of  1862  almost  deciminated  Bonny  and 
was  as  fatal  among  the  blacks  as  among  the  few  white 
settlers  of  the  colony.  The  fever  was  originally  intro- 
duced by  some  of  the  trading  vessels  plying  between  Bonny 
and  the  Cape  Verd  Islands.  Two-thirds  of  the  inhabitants 
of  Bonny  are  said  to  have  perished.  Out  of  a  population 
of  140  Europeans,  70  were  attacked  in  the  space  of  a 
month.  In  one  day,  as  many  as  twenty  bodies  were  taken 
out  of  the  same  house. 

The  mortality  in  the  shipping  was  heavy.  The  bark 
PhrcnoJof/ist  lost  its  captain,  pilot,  first  mate  and  two 
sailors.  The  ship  G^ra*i  Bonny  lost  four  men.  Between 
April  4  and  ^May  5,  there  were  62  deaths  among  the  crews 
of  vessels  at  Bonny.  ^^ 

"Landa:  La  Espana  Medica,  1863,  vol.  8,  p.  427;  also:  Statisti- 
cal Report  of  the  Health  of  the  Navy  for  the  Year  1862 
(London,  1865),  p.  157. 


168  HISTORY    OF    YELLOW    FEVER. 

1891. 

The  second  recorded  outbreak  of  yellow  fever  at  Bonny 
occurred  in  1891.  The  epidemic  histed  from  February  to 
April. -^  Cases  and  deaths  are  not  given.  As  this  is  the 
only  locality  in  Africa  where  the  fever  prevailed  in  1891, 
it  was  probably  imported  from  that  prolific  source  of  in- 
fection— Brazil.  A  glance  at  the  consular  reports  and  re- 
ports of  quarantine  officers  published  in  the  Weeklt/  Ab- 
stracts of  Sanitarij  Reports  for  1891,  brings  out  the  fact 
that  almost  every  vessel  reported  as  "infected  with  yellow 
fever'-  during  that  year  originally  sailed  either  from  Bahia, 
Eio  de  Janeiro,  Santos,  Para,  Pernambuco,  or  other  in- 
fected Brazilian  i^orts.  It  is  surprising  that,  owing  to  the 
lax  quarantine  methods  then  in  vogue  in  Africa,  that  tlie 
whole  coast  was  not  infected.  An  explanation  will  no 
doubt  be  found  in  the  absence  of  the  festive  Calopus  from 
the  localities  which  escaped  a  visitation. 

=»  Weekly  Abstracts  of  Sanitary  Reports,  U.  S.  P.  H.  &  M.  H. 

S.,  1891,  vol.  6,  p.p.  266,  298. 


4 


BULAM. 

Description. 

Biilani  or  Boullam  (now  called  Biilam  or  Bolama),  is 
one  of  the  Bisagos,  a  group  of  about  thirty  islands  near 
the  west  coast  of  Africa,  opposite  the  mouth  of  the  Rio 
Grande,  between  lat.  10°  and  12°  N.  The  largest  of  the 
archipelago,  Orango,  is  about  25  miles  in  length,  and  most 
of  the  islets  are  inhabited  by  a  rude  negro  race,  with  whom 
some  desultory  trade  is  carried  on.  Most  of  the  islands 
are  under  native  chiefs,  nonunally  vassals  of  Portugal. 
At  Bulama,  once  a  British  settlement,  but  abandoned  as 
unhealthy  in  1793,  there  is  a  Portuguese  town,  a  thriving) 
and  pleasant  x)lace,  the  seat  of  government  for  the  I'ortu- 
guese  possessions  in  this  quartero 

The,  earliest  description  of  Bulam  is  given  b}'  the  Che- 
valier de  Marchais,  in  Father  Labat's  Voyages  du  Cheva- 
lier de  Marchais  en  Quince  ct  au.x  Ties  Voisincs.  vol.  1,  p. 
68,  of  which  the  following  is  a  translation :  ''The  bed  of 
that  river  (Sierra  Leone)  contains  a  quantity  of  islands, 
densely  wooded;  the  soil  is  rich  and  produces  all  that  is 
necessary  to  life.  The  air  is  very  jjure  and  one  is  not  sub- 
ject to  those  violent  and  dangerous  diseases  which  prevail 
on  the  Coast  of  Guinea  and  which  are  so  fatal  to  Euro- 
peans." , 

Dr.  Lind,  in  his  Diseases  of  Hot  Climates^  ]}.  5G,  also 
speaks  favorably  of  these  islands. 

According  to  Chisolm,-^  the  most  correct  description  of 
the  Island  of  Bulam  can  l)e  found  in  the  African  Plot,  a 
paper  published  by  Capt.  Norris  in  1796  (or  thereabouts), 
in  which  it  is  stated  that  "Boullam"  is  located  in  "latitude 
11°  N.  and  longitude  3°  W.  from  Farro,  almost  in  the 
moutli  of  the  Rio  Grande,  having  Hen  Island  between  it 
and  tlie  ocean.  It  appears  to  be  nearly  circular,  about 
15  miles  long  and  15  broad;  and,  consequently^  about  45 
round." 


-'An  Essay  on  the  Malignant  Pestilential  Fever  introduced  into 
the  West  India  Islands  from  Boullam,  etc.,  by  C.  Chisolm 
(1799),  p.  85. 


170  HISTORY    OF  ^TEXtOW   *>eVE«. 

YELLOW  FEVER  YEAR. 
1792. 
.     A  VENERABLE  MEDICAL  HEIRLOOM. 

The  alleoecl  importation  of  3'ellow  fever  by  the  British 
ship  Hankcij  from  Biihuii  to  the  ishind  of  Greuada,  West 
Indies,  in  1793,  is  one  of  the  mustiest  heirlooms  in  the 
annals  of  medical  history.  Tooethcr  with  the  case  of  the 
Bann  (Island  of  Ascension,  1823)  and  that  of  the  Eclair 
(Boa  Vista,  1815-6),  it  forms  a  triumvirate  which,  for 
nearly  a  century,  was  the  cause  of  most  acrimonious  con- 
flicts between  medical  men  and  gave  rise  to  controversies 
which  remain  unsettled  to  this  day.  The  believers  in  the 
specific  nature  of  yellow  fever,  headed  by  Sir  William 
Pym,  and  the  "other  side,-'  composed  of  men  who  upheld 
the  theory  that  the  disease  should  be  placed  in  the  same 
category  as  malarious  fevers,  wrote  books  and  brochures 
by  the  score  and  burdened  the  columns  of  the  medical 
press  of  the  i)eriod  with  articles  which  are  brimful  with 
personalities  of  the  most  volcanic  type.  When,  through 
sheer  exhaustion,  partisans  abandoned  the  fray,  fresh  re- 
cruits would  take  up  the  gauntlet  and,  imbued  with  seem- 
inglv  ii'repressible  liatred,  would  '"sail  in"  with  fiendish 
fury  and  renew  hostilities,  scattering  vituperation  right 
and  left,  without  the  least  regard  for  age,  official  position 
or  facts. 

A  specimen  of  this  mode  of  warfare  will  prove  interest- 
ing. According  to  the  British  and  Foreign  Medico-Chir- 
urgical  Rcrieu-f-  we  find  Sir  William  Pym  stating  that 
Sir  William  Burnett  and  Dr.  Bryson,  his  antagonists, 
''have  gone  unnecessarily  and  wantonly  out  of  their  way, 
to  make  unfounded  and  malicious  statements,"  and  giving 
utterance  to  a  pious  wish  that  these  gentlemen  may  profit 
by  the  information  he  has  given  them,  and  may  "pray  for- 
giveness for  their  inconsistencies  and  misrepresentations." 
He  informs  us  that  lie  has  been  induced  to  take  up  the 
gauntlet  again,  by  the  "wanton,  false,  abusive,  and  un- 
founded attack"  made  by  Sir  William  Burnett  upon  him 

=-Vol.  4,  1849,  p.  459. 


BULAM.  171 

in  reference  to  the  Eclair.  On  the  other  side,  Dr.  Bryson 
accuses  Sir  William  Pjni  of  attacking  him  "in  inost  un- 
justifiable and  unprofessional  languai-e ;"  of  making  use 
"of  garbled  and  unfair  extracts;"  of  ''disingenuously  mix- 
ing up  facts  and  statements  in  a  confused  manner,  for  the 
purpose  of  making  out  charges  of  inconsistency,"  and  he 
regrets  that  Sir  William  Pyni's  review  of  his  "Heport  of 
the  Diseases  of  the  African  Station"  "is  written  in  a  style 
which  prevents  his  replying  to  it  with  the  respect  due  to 
a  man  of  Sir  William  Pym's  age  and  position  in  society." 

Other  equally  amiable  diatribes  are  of  record,  but  we 
will  pass  them  by  and  revert  to  the  fossilized  case  under 
discussion. 

HOW  bula:*!  became  famous. 

Up  to  1792,  Bulani  was  an  unknown  quantit3^  m  the  af- 
fairs of  men.  It  is  true  that  it  occupied  a  ])lace  in  the 
charts  of  the  bold,  but  cautious  navigators  of  the  time, 
but  insofar  as  its  climate  and  the  people  which  inhabited 
it  were  concerned,  it  was  as  deep  a  mystei-y  as  the  North 
Pole  is  to  us  at  the  present  writing.  How  it  suddenly 
sprang  into  world-wide  prominence  and  a<hieved  a  jioto- 
riety  which  clings  to  it  to  this  day,  and  which  gave  the 
name  of  ''Bulam  Fever"  to  the  nomenclature  of  yellow 
fever,  is  faithfully  chronicled  in  Dr.  Chisolni's  immortal 
work,  from  which  the  information  which  follows  is  ex- 
cerpted. 

SUMMARY  OF  EPIDEMIC. 

According  to  Dr.  Chisolni,-^  the  Hankey  sailed  from 
P^ngland,  in  company  with  the  Cah/pso,  both  chartered  by 
the  Sierra  Leone  Company,  loaded  with  stores  and  adven- 
turers for  the  projected  colony  at  Boullam,  about  the  be- 
ginning of  the  month  of  April,  1792.  When  these  ships 
saile.l,  the  crews  and  passengers  were  all  healthy  and  con- 
tinued so  until  they  reached  their  destination.  These  ad- 
venturers, who  were  mostly  the  well-to-do  mid'lle  class, 
had  been  induced  to  settle  in  this  "new  country"  more 

^Chisolm:  loc.  cit.,  p.  83. 


172  HISTORY    OF    YELLOW    VFEER. 

from  the  delusive  prospect  of  wealth  held  out  to  them  and, 
the  faijatie  enthusiasm  for  the  abolition  of  the  slave  trade, 
than  by  any  deprivation  of  the  means  of  subsistence  in 
their  own  country.  Boullam  had  been  depicted  to  them 
as  an  ideal  place.  Wlien  the  Haukeji  arri\ed  ott'  the 
island,  it  was  found  to  be  nnhabitatef,!  and  lurid  tales  were 
told  by  some  of  the  sailors  who  had  l)ecn  in  the  neighbor- 
hood before  concerning  the  aborigines  who  inhabited  the 
mainland.  They  were  pictured  as  being  ferocious  to  an 
extraordinary  degree  and  some  were  even  said  to  be  rabid 
cannibals.  These  rumors  unnerved  the  prospective  settlers 
and  hindered  them  from  making  a  permanent  landing  on 
the  island.  For  nine  months  they  lived  on  board  the 
Haukcij.  ''The  rainj^  season  coming  on  almost  immedi- 
ately after  their  arrival,''  observes  Dr.  Chisolm,-^  "and  the 
heat  being  at  the  same  time  excessively  great,  tliej'  en- 
deavored to  shelter  themselves  from  both  by  raising  the 
sides  of  the  ship  several  feet,  and  covering  her  Avith  a 
wooden  roof." 

Amid  such  cramped  and  unsanitary  surroundings,  it  is 
not  surprising  that  the  worst  forms  of  disease  should  be 
engendered.  We  shall  continue  the  recital  of  this  famous 
case,  as  culled  from  the  Second  Report  on  Quarantine, 
pages  71  to  83 : 

According  to  the  estimate  of  Dr.  Chisolm.  the  settlers 
and  crew,  numbered  in  all  upwards  of  200  j.eople,  includ- 
ing women  and  children.  These  persons,  he  says,  con- 
fined in  a  sultry,  moist  atmosphere,  inattentive  to  cleanli- 
ness, and  neglecting  to  sweeten  the  ship  and  to  destroy 
the  clothes,  bedding,  etc.,  of  those  that  died,  were  seized 
with  a  malignant  fever  which  produced  such  havoc  among 
them  that  when  the  time  for  which  the  Hanlcey  was  char- 
tered had  ex])ired,  there  Avere  no  seamen  left  to  navigate 
the  ship;  and  conseciuently  they  were  obliged  to  proceed 
to  sea.  having  on  board  only  the  captain,  who  was  sick,  the 
mate,  one  of  the  settlers  (^Ir.  Paiba  ),  and  two  seamen.  It 
is  stated  that  with  much  difliculty  they  arrived  at  St. 
Jago^  where  they  found  the  Charon  and  Scorpion,  ships 
of  war,  from  each  of  which  they  received  two  men  to  as- 
sist them  in  navigating  their  vessel;  that  with   this   aid 

"'  Loc.  cit.,  p.  85. 


BALUM.  173 

they  proceeded  to  the  West  Indies — a  voyage  to  England 
being  impracticable  in  their  state;  and  thnt  on  the  third 
day  after  leaving  St.  Jago,  the  fonr  men  transferred  to 
them  from  the  ships  of  war^  were  themselves  seized  with 
the  fever,  two  of  whom  died,  and  the  remaining  two  were 
put  on  shore  at  Grt  nada,  "in  the  most  wretched  state  pos- 
sible." 

Dr.  Chisolm  further  states  that  Captain  Dodd  of  the 
CJiaroii,  having  occasion  al)Out  that  time  to  come  to 
Orenada,  and  hearing  of  the  mischief  of  which  the  Hankey 
had  been  the  cause,  mentioned  that  several  of  the  Charon's 
and  ^corpiois  people  were  sent  on  board  the  Hanlccij  at 
St.  Jago  to  repair  her  rigging,  etc. ;  that  from  this  circum- 
stance and  the  communication  which  his  barge's  crew  had 
with  tlie  ship,  the  pestilence  Avas  brought  on  board  both 
ships;  and  that  of  tlie  Charon  s  crew  thirty  died;  and  of 
t\i(i\SvQr plonks  about  fifteen. 

Tlie  Hankcif  arrived  at  the  port  of  St.  Oeorge  on  the 
IDtli  of  February.  The  first  person  who  visited  the  ship 
after  her  arrival  in  St.  George's  Bay  was  Captain  Reming- 
ton an  intimate  acquaintance  of  Captain  Coxe,  the  captain 
of  the  Hankci/.  Tliis  person  went  on  board  of  her  in  the 
evening  after  she  anchored,  and  remained  three  days,  at 
the  end  of  which  time  he  left  St.  George's  and  proceeded 
in  a  drogher  (a  coasting  vessel)  to  Grenville  Bay,  where 
his  shipj  the  Adventure  lay.  He  was  seized  with  the  pes- 
tilential fever  on  the  passage,  and  the  violence  of  the 
syiui)t()ms  increased  so  rapidly  as  on  the  third  day  to  put 
an  end  to  his  existence.  The  crew  of  the  Defiance,  in 
Blytlie  Port  near  Newcastle,  were  the  next  who  suffered 
by  visiting  this  ship;  the  mate,  boatswain,  and  four  sailors 
went  on  l)oard  the  day  after  her  arrival ;  the  nmte  re- 
mained either  on  deck  or  in  the  cabin,  but  the  rest  went 
below  and  stayed  all  night  there.  All  of  them  were  imme- 
diately seized  with  the  fever,  and  died  in  tliree  days.  The 
mate  was  also  taken  ill  but  recovered.  Tlie  crew  of  the 
ship  liaillie.s  were  the  nc^xt  who  suffered;  these  communi- 
cated the  infection  to  the  ships  nearest  them,  and  so  it 
gradually  spread  from  those  nearest  the  mouth  of  the 
carenage,  where  the  Hankey  for  some  time  lay,  to  those  at 


174  HISTORY    OF    YELLOW    FtVER. 

the  bottom  of  it,  not  one  escaping  in  succession  whatever 
means  the  captains  took  to  prevent  it. 

About  the  middle  of  April  the  disease  began  to  appear 
on  shore.  The  first  house  it  showed  itself  in  was  that  of 
Messrs.  Stowewood  and  Co.,  situated  close  to  the  wharf; 
and  the  infection  was  evidently  introduced  bv  a  negro 
wench  who  took  in  sailor's  clothes  to  wash.  The  whole  of 
the  family  were  successively  afflicted  with  it;  and  by  them 
communicated  to  all  those  Avith  whom  they  had  any  inter- 
course. All  who  from  friendship,  business^  or  duty,  com- 
municated with  the  diseased  were  themselves  infected,  and 
no  instance  occurred  wherein  the  contagion  could  not  be 
traced  to  its  particular  source.  A  few  who  seduloiisly 
avoided  the  houses  Avhere  the  infected  actually  were,  es- 
caped. 

That  part. of  the  garrison  quartered  nearest  to  where 
the  Haiikci/  lay,  were  the  first  of  this  class  of  men  who  re- 
ceived the  infection.  A  barrack  containing  nearly  one-half 
of  the  4r)tli  regiment,  was  situated  exactly  to  leeward  of 
the  Ha  like  1/  and  distant  from  her  about  200  yards.  One 
of  the  officers  visited  the  Hankeij,  and  with  two  or  three 
soldiers  who  rowed  his  boat,  remained  on  board  some  time. 
The  C(mse(iuence  of  this  imprudence  was  fatal  to  himself 
almost  immediately  after,  and  in  a  little  tiiue,  tc  many  of 
the  men.  All  the  officers  and  men  were  successively  seized 
with  the  disease;  but  it  proved  fatal  C'ul^^  to  recruits  who 
had  lately  joined. 

About  the  beginning  of  ^Iny  the  disease  made  its  ap- 
pearance in  the  detacliment  of  Royal  Artillery;  a  circum- 
stance rather  extraordinary,  as  that  corps  were  quartered 
in  a  situation  far  removed  from  the  focus  of  infection.  5t 
was  evidently  ])roduc('d,  however  by  the  commiuiication 
wliicli  the  gunners,  doing  duty  in  l-'ort  George,  had  with 
the  Jroih  regiment.  Of  S4  people  Itelonging  to  the  ordin- 
ance department  at  that  time,  about  56  were  seized  with 
Hie  disease  before  the  1st  of  July,  and  of  these  5  died;  a 
ti-itling  mortality,  considering  the  nature  of  the  complaint. 
All  these  men,  however,  luul  ]»een  about  three  jears  in  the 
country,  and  consequently  suffered  less  from  the  disease, 
than  about  27  recruits  who  joined   the  artillery  in   July. 


BUL4M.  175 

Of  26  of  these  unfortunate  men  who  were  iufected,  21  died 
before  the  middle  of  August. 

About  the  1st  of  June,  the  disease  began  to  appear 
among  the  negroes  of  the  estates  in  the  neighborhood  of 
the  toAvn,  but  it  did  not  spread  much  among  them,  nor  was 
it  marked  with  the  fatality  which  attended  it,  when  it  ap- 
peared among  the  whites. 

About  the  middle  of  June,  the  disease  broke  out  in  the 
67th  regiment,  and  among  the  artificers  and  laborers  on 
Richmond  Hill.  The  infection  was  communicated  by  some 
of  the  latter,  who  had  visited  their  friends  in  town  labor- 
ing under  it.  All  were  successively  seized  with  it;  but  it 
fell  heavier  on  the  officers  than  the  men,  several  of  the 
former  being  young  men  lately  arrived  from  Europe. 

The  disease  in  the  course  of  the  months  of  May,  June, 
and  July,  appeared  in  several  distinct  and  distant  parts 
of  the  country,  where  the  infection  was  carried  by  per- 
sons--^ who  had  imprudently  visited  infected  houses  in 
town. 

But  the  infection  Avas  not  confined  to  Grenada  alone; 
from  this,  as  a  focus,  it  spread  to  the  other  islands;  to 
Jamaica,  St.  Domingo,  and  Philadelphia,  by  means  of  ves- 
sels on  board  of  which  the  infection  was  retained  by  the 
clothes,  more  especially  the  woollen  jackets  of  the  deceased 
sailors.-*^ 

Sucli  are  the  facts  of  this  celebrated  legend,  on  which 
whole  libraries  have  been  written.  That  tlie  Hunkci/  was 
ravaged  by  yellow  fever,  there  is  not  the  slightest  doubt; 
but  the  disease  did  not  and  could  not  originate  at  Bulam, 
for  the  simple  reason  that  it  had  never  prevailed  there  be- 
fore and  has  never  been  observed  there  since.  As  yellow 
fever  was  epidemic  at  Fernando-Po  in  1792^  the  Hankey 
was  in  all  probability  visited  by  the  commanders  and 
crews  of  the  innumerable  tramp  and  senii-piratic  ships 
which  then  infested  these  waters  and,  once  contaminated, 
acted  as  firebrands  in  ])r(!i)agating  the  pest. 

The  statement  made  by  the  veneral)le  Chisolm  that  the 
disease  which  raged  on  the  Haulci/  Avliile  the  ship  was  in 

^  It  is  needless  to  add  that  we  dissent  from  this  view. 
^Dr.    Chisolm    evidently    had    not    been    introduced    to    the 
Stegomyia  Calopus.     G.  A. 


176  HISTORY    OF    YELLOW    FEVER. 

the  liarl)or  of  George  Town  was  "uiikuown  in  tliis  coun- 
try"-' is  easily  refuted  b}^  history.  A  reference  to  our 
chronokjgical  tables  and  also  to  the  history  of  yellow 
fever  at  the  island  of  Grenada,  will  show  that  the  saffron 
scourge  made  its  first  appearance  among  the  inhabitants 
of  that  island  in  1094,  antedating  by  almost  a  hundred 
years  the  alleged  importation  so  graphically  outlined  by 
Chisolm. 

"Chisolm:    Loc.  cit.,  p.  89, 


CALABAR. 

Descriptiou. 

Calabar  is  a  maritime  district  of  West  Africa,  in  Upper 
Guinea,  betAveen  the  bights  of  Benin  ai^jd  Biaffra.  The 
native  population  consists  principally  of  slaves.  The  cli- 
mate is  extremeh'  unhealthy  and,  with  the  exception  of 
missionaries,  there  are  no  Avhite  men  in  the  district. 


1862 


YELLOW  FEVEE  YEAK. 


SUMMARY  OF  EPIDEMIC. 


There  is  a  solitary  instance  of  yellow  fever  having  vis- 
ited Calabar.  In  1802,  according  to  Berenger-Feraud,-^ 
the  disease  was  introduced  into  the  district,  but  no  details 
are  given.  As  the  fever  ravaged  the  whole  African  coast 
that  year,  from  the  Congo  to  Sierra  Leone,  it  was  no  doubt 
imported  into  Calabar  by  the  palm-oil  vessels  trading 
along  the  coast. 

^  Berenger-Feraud,  loc.  cit.,  p.  139. 


CANARY  ISLANDS. 

Description. 

Canary  Islands,  or  Canaries,  are  a  cluster  of  islands  in 
the  Atlantic  Ocean,  about  00  milts  northwest  of  the  Afri- 
can coast,  and  belong  to  Spain.  They  are  thirteen  in  num- 
ber, seven  of  which  are  of  considerable  size,  namely,  Palma, 
Ferro,  Goiaera,  Teneriffe,  Grand  Canary,  Fuerteventura 
and  Lancerota.  The  other  six  are  very  small :  Graciosa, 
Roca,  Allegranza,  Santa  Clara,  Inferno  and  Lebos.  The 
population  of  the  islands,  which  is  a  mixture  of  Portugese 
and  Spanish,  is  estimated  at  300,000.  Santa  Cruz  de  Ten- 
eritfC;  Avith  a  population  estimated  at  46,000,  is  tlie  capital 
of  the  group.  Las  Palmas,  with  a  population  of  about 
12,512,  is  the  next  city  in  importance. 

Historical  ^iinnnariL 

Two  years  after  the  discovery  of  America,  or,  to  be  more 
explicit,  in  1191,  yellow  fever  is  said  to  have  made  its 
debut  in  the  Canaries.  No  previous  record  of  the  appear- 
ance of  the  disease  among  the  Gua aches,  the  mysterious 
tribe  which  originally  peopled  the  islands,  is  in  existence. 
This,  of  itself,  is  sufficient  to  forever  set  at  I'est  the  theory 
that  yellow  fever  is  an  African  product,  for  were  this  the 
case,  tlie  Canaries,  whicli  are  only  about  00  mile.-;  from  the 
mainbnid  and  directly  in  the  path  of  vessels  plying  be- 
tween A\'esteru  Africa  and  Europe,  and  were  no  iloubt  vis- 
ited by  the  mediaeval  freebooters  using  this  route,  would 
certainly  have  been  infected  long  before  1191. 

The  Canaries,  which  are  supposed  to  be  the  "Fortunate 
Islands''  of  the  ancients,  Avere  known  to  Europeans  from 
time  immemorial.  The  elder  Pliny  s])eaks  of  them,  but,  by 
one  of  these  strange  freaks  which  characterize  history, they 
were  lost  sight  of  for  many  centuries  and  not  rediscov- 
ered until  1313,  when  they  were  invaded  by  the  Spaniards, 
who  retained  possession  of  the  islands  until  1334,  when 
they  passed  into  the  hands  of  the  Portugese.  In  1102,  tlie 
Xorman  adventurer,  Jean  de  Eethencourt,    fitted    out   an 


CANARY    ISLANDS,  179 

expedition  for  the  purpose  of  conquering  the  archipelago. 
He  was  assisted  by  the  Spanish  Crown  and  succeeded  in 
mastering  four  of  the  group.  After  his  death,  his  suc- 
cessor sokl  all  his  rights  to  Spain.  In  1477,  the  King  of 
Spain  sent  out  a  large  force  to  subdue  the  Guanches,  but 
the  natives  put  up  such  a  brave  and  stubborn  fight,  that  it 
was  net  until  1495  that  the  islands  were  completely  sub- 
jugated. The  aborigines  were  nearly  extirpated  by  the 
conquerors  and  have  long  ceased  to  exist  tis  a  separate 
people.  Of  this  mysterious  race,  little  is  known.  They 
are  supposed  to  have  been  of  Lybian  or  Berber  stock,  but 
this  is  only  a  conjecture.  They  are  said  to  have  been  a 
brave,  intelligent  race,  of  large  stature,  and  comparatively 
fair  and  to  have  been  proficient  in  the  making  of  pottery 
ware.  Specimens  of  their  craft  are  preserved  in  the 
Britisli  museums. 

It  is  a  significant  fact  that  the  first  recorded  introduc- 
tion of  yellow  fever  into  the  Canaries  sliould  be  coincident 
with  the  exodus  of  the  panic-stricken  Spaniards  from  the 
"New  World,"  fleeing  from  a  nova  pestis,  engendering  a 
dread  which  even  overshadowed  their  innate  greed,  for  gold 
and  conquest.  The  terror  which  the  new  hemisphere  in- 
spired began  to  be  manifest  about  1494  and  not  only 
caused  hundreds  of  the  adventurers  to  return  to  their  na- 
tive land,  but  hindered  others  from  attempting  the  voyage. 
"Not  a  single  vessel,"  says  Oviedo,-^  "left  Spain  during 
the  third  voyage  of  Columbus,^^  because  the  men  who  had 
returned  with  him  from  San  Domingo  were  of  such  a  sick- 
ly hue,  that  they  resembled  corpses." 

Such  was  the  curse  of  God  in  atonement  for  the  atroci- 
ties perpetrated  by  these  merciless  conquerors  upon  an  in- 
offensive and  peace-abiding  race,  whose  only  crime  was 
that  they  defended  their  native  land.  What  the  poor 
Guanches  could  not  do,  however,  was  wrought  by  the  pes- 
tilence, and  tlie  countless  hecatombs  whicli  mark  the  ad- 
vent of  the  Spaniards  in  the  New  W^orld,  bear  silent  wit- 
ness to  the  merciless  work  of  the  avenging  spirit. 

"' Goncalo  Oviedo:    La  Historia  General  de  las  Indias,  1547,  vol. 

2,  chap.  4. 
'^  March.  1496. 


180  HISTORY     OF    YELLOW     FEVER. 

YELLOW  FEVER  YEARS. 

1494  ;  1495 ;  149G ;  1512 ;  1531 ;  1582 ;  1599 ;  ICOl ;  IGOG ; 
1707;  1771;  1772;  1773;  1810;  1811;  1828;  184G;  1847; 
1862;  1888;  1905. 

SUMMARY  OF  EPIDEMICS. 

1494, 

Aceording  to  Finlay,'''^  a  pestileiilial  disease,  said  to  be 
yellow  fever,  appears  to  have  been  carried  froDi  Hispauola 
(San  Domingo)  to  the  Canary  Islands  in  1494,  either  by 
the  vessels  of  Antonio  Torres,  or,  more  probaldy,  by  the 
three  Avhicli  returned  to  Spain  after  having  landed  Don 
Bartolome  Colon  at  Ysabella,  San  Domingo.  What  makes 
this  assertion  seem  still  more  plausible,  is  the  faoi,  record- 
ed by  Humboldt'^-  and  Bonpland,'^''  that  Avhat  remained  of 
the  (iuanches  on  tlie  island  of  TeneriftV  perirdieJ  mostly  in 
1494,  in  the  terrible  epidemic  called  the  "•Mordora." 


1495. 

Oviedo^^  informs  ns  that  the  island  of  ToneritTe,  one  of 
the  Canaries,  was  visited  by  a  great  pestilence  in  1495,  pre- 
sumed to  have  been  imported  from  Hispanola  by  the  flee- 
ing Spaniards,  who  stopped  at  tlie  island  on  tlicir  home- 
ward voyage.  This  epidemic  was  uudoiiLtedly  yellow 
fever,  for  the  adventurers  who  returned  home  were  of  a 
^'sickly  saffron  color"^*'  and  were  so  p(?rmeated  with  terror- 

*^Finlay:  Reference  Handbook  of  the  Medical  Sciences  (New 
York,  1904),  p.  323. 

=-Ibid. 

^Aime  Bonpland,  French  botanist,  1773-1858.  While  pursuing 
his  studies  in  Paris,  he  made  the  acquaintance  of  Alex- 
ander von  Humboldt,  the  famous  historian,  and  agreed 
to  accompany  him  in  his  celebrated  expedition  to  the 
New  World.  During  this  expedition,  he  made  many  valu- 
able botanical  discoveries. 

"  Goncalo  Oviedo:  La  Historia  General  de  las  Indias,  1547, 
vol.  2,  chapter  15. 

^Oviedo:    Loc.  cit.,  vol.  2,  chap.  4. 


I 


CANARY    ISLANDS.  181 

that  neither  promises  of  gold  nor  assurances  of  lordly 
power  in  the  "New  World"  could  tempt  them  to  cross  the 
seas  again. 

149G. 

Teneriffe  seems  to  have  been  again  infected  in  1496,  ac- 
cording to  Cornilliac,^''  but  wliether  it  was  a  recrudescence 
of  the  epidemic  of  1495  or  a  new  importation,  is  left  to 
conjecture. 

1512. 

Berenger-Feraud  is  of  the  opinion  that  the  epidemic 
which  reigned  in  the  Canaries  in  1512,  and  Avhich  was 
designated  b}"  the  name  of  pcstc.  was  an  invasion  of  yellow 
fever.^' 

1531. 

This  year  was  also  characterized  by  an  outbreak  of  the 
peste  in  the  archipelago.  The  autliority  (luoted  in  the 
preceding  paragraph  thinks  it  Avas  yellow  fever.^^ 

1582. 

Half  a  centur^^  elapsed  without  ^^ellow  fever  being  ob- 
served in  the  Canaries.  It  was  introduced  that  year,  pre- 
sumably from  the  West  Indies,  and  is  designated  by  the 
name  of  peste  by  the  Spanish  chroniclers.  Berenger- 
Feraud,  however,  says  it  was  undoubtedly  yellow  fever.^^ 

1599. 

In  1599,  a  pestilential  disease,  designated  By  the  Span- 
iards by  the  name  of  ealcntura,  ravaged  the  Canaries. 
Towards  the  end  of  1599,^^  the  squadron  commanded  by 

'°  Cornilliac:     Recherches   Chronologiques    et   Historiques    sur 
rOrigine  et  la  Propagation  de  la  Flevre  Jaune  dans  les 
Antilles    (Fort-de-France,   1867). 
"Berenger-Feraud,  loc.  cit.,  page  38. 
^ Ibid. 
''•  Ibid. 
*'Cop:    Histoire  de  la  Medecine  Navale  Ho'landaii-e. 


182  HISTORY    OF    YELLOW    FEVER. 

Admiral  Van  der  Docs,  of  the  Dutch  Navy,  consisting  of 
75  vessels  and  8,000  men,  made  an  attack  on  th?  Spanish 
vessels  at  Coruuna,  Spain,  but  meetinij^  with  poor  success, 
set  sail  for  the  West  Indies.  Tlie  vessels  stopped  at  the 
Canaries  to  harass  the  Spanish  colonists  located  on  the 
islands  and  were  soon  afterwards  infected  by  the  disease 
then  rai>ins-  in  the  archipelago.  On  tlie  admiral's  flag-ship 
alone,  15  died.  The  fever  is  said  to  have  been  brought  to 
the  Canaries  by  Spanish  vessels  returning  from  San 
Domingo.'*^ 

IGOl. 

The  year  1601  witnessed  another  outbreak  of  pestilential 
disease  in  the  Canaries.  Some  chroniclers  says  it  was  the 
plague,  but  Berenger-Feraud^-  is  of  the  opinion  that  it 
was  yellow  fever. 

1006. 

The  Canaries  were  again  afflicted  in  1606.  Opinions 
are  divided  as  to  whether  this  epidemic  was  yellow  fever 
or  the  Oriental  plague,  but  Berenger-Feraud  thinks  it  was 
yellow  fever."*^ 

1701. 

For  nearly  one  hundred  years— 1606  to  1701 — the 
Canaries  were  free  from  yellow  fever.  No  explanation  of 
this  extraordinary  immunity  for  such  a  long  period  is 
given  by  historians,  even  our  old  stand-by,  Berenger- 
Feraud,  whose  writings  we  always  consult  when  ''up  a 
tree,"  being  as  mum  as  the  proverbial  clam.  Of  course, 
we  could  venture  an  opinion,  but  as  same  could  not  be 
based  upon  even  a  scintilla  of  fact,  it  would  be  valueless. 

In  1701,  yellow  fever  was  c])idemic  in  Havana,  Barba- 
does,  Martini(pie  and  the  English  Antilles,  and  according 
to  Arejula,^^  was  brought  from  Havana   to  the  Canaries,    i\ 


"  Berenger-Feraud,  loc  cit.,  p.  27. 

*- Berenger-Feraud,  loc.  cit.,  p.  38. 

"  Berenger-Feraud,  loc.  cit.,  p.  38. 

■"Arejula:    Archives  de  Medecine  Navale,  Paris,  Vv>l.  7,  p.  251. 


CANARY    ISLANDS.  18S 

where  it  caused  a  great  mortality.  As  is  the  case  with 
every  meution  of  epidemics  of  yellow  fever  during  colonial 
days,  no  details  are  given.  In  speaking  of  this  outbreak, 
Berenger-Feraud  informs  us  that  elle  fit  dc  grands 
ravagcs,^^  but  says  nothing  of  the  number  of  victims  nor 
of  the  extent  of  the  disease. 

As  will  be  seen  b}^  consulting  our  Chronology,  yellow 
fever  was  also  present  in  Spain  in  1701. 

1771. 

Another  prolonged  lapse  of  time  took  place  before  yel- 
low fever  again  visited  the  Canaries  In  1771,  a  vessel 
from  the  West  Indies,  where  yellow  fever  prevailed,  in- 
fected the  islands.^*^.  The  outbreak  was  attended  with 
much  mortality. 

1772. 

A  Spanish  regiment  is  said  to  have  brought  j-ellow  fever 
from  Havana  to  the  Canaries  in  1772.  Though  not  as  gen- 
eral as  the  year  previous,  the  epidemic  was  quite  severe.^"^ 

1773. 

A  mild  epidemic  of  yellow  fever  prevaikd  in  the  Cana- 
ries in  1773.^^  The  source  of  infection  couid  not  be  ascer- 
tained. 

ISIO. 

The  year  1810  witnessed  another  murderous  eruption 
of  yelh)w  fever  on  the  island  of  Teneriffe. 

The  history  of  this  outbreak  is  interesting,  and  goes  to 
show  how  steadily  and  treacherous  is  the  advent  of  this 
terrible  disease.  What  makes  the  circumstance  i-^till  more 
remarkable,  is  the  fact  that  tlie  Canaries  escaped  un- 
scathed during  the  great  epidemics  which  devastated  Spain 

*"  "It  caused  great  mortality." 
"Berenger-Feraud,  loc.   cit.,   p.   55. 
"  Berenger-Feraud,  loc.  cit.,  p.  55. 
•"  Berenger-Feraud,  loc.  cit,  p.   56. 


184  HISTORY    OK    YELLOW    FEVER, 

in  1800  and  1804 — an  immunity  wliicli  one  can  only 
ascribe  to  Divine  Providence,  for  communication  between 
the  islands  and  their  Mother  Country  was  free  and  fre- 
quent during-  the  above  mentioned  years. 

To  Spain  belongs  the  credit  of  having  imported  the 
fever  to  Teneriffe  in  1810.  The  disease  was  almost  general 
in  Andalusia,  causing  much  mortality  in  Cadiz,  Barce- 
lona, Carthagena,  Seville  and  (libra] tar.  In  the  beginning 
of  October  of  that  year,'*^  a  panto nc,  or  prison-ship,  sailed 
from  Cadiz  with  French  prisoners  on  board  and  landed 
at  Santa  Cruz  de  Teneriffe.  where  the  human  cargo  was 
disembarked  and  lodged  in  the  town  barracks.  It  is  said 
that  the  prison-ship  was  a  hot-bed  of  yellow  fever,  but  this 
fact  was  withheld  from  the  port  authorities,  and  as  the 
disease  had  not  been  observed  on  the  island  since  1773, 
they  were  lulled  by  a  false  sense  of  security.  About  the 
middle  of  October,  the  practitioners  of  Santa  Cruz  de 
Teneriffe  noticed  that  there  was  an  unusual  number  of 
cases  of  malignant  bilious  fever  and  the  fact  was  reported 
to  the  health  authorities.  The  warning  was  at  first  un- 
heeded, but  the  malady  soon  became  so  widesiiread,  that 
an  investigation  was  ordered  and  it  was  found  by  ex- 
perts— men  who  had  already  gone  through  epilemics  of 
yellow  fever — that  the  prevailing  sickness  presented  the 
identical  symptoms  whicli  had  characterized  tlie  disor- 
ders of  Andalusia  in  1800  and  1801.  The  authorities 
awoke  from  their  lethargy,  but  it  was  too  late.  The  disease 
had  spread  indiscriminately  to  several  quarters  of  the 
town  and  ])reventive  measures  were  unable  to  ch^^ck  its  de- 
structive progress.  To  prevent  the  pestilence  from 
being  carried  to  the  other  towns  of  the  island,  a  sanitary 
cordon  was  established  around  Santa  Cruz  de  Teneriffe 
and  intructions  were  sent  to  the  other  islands  of  the  archi- 
pelago to  take  the  necessary  precautions  to  prevent  the  in- 
troduction of  the  fever.  These  jjrompt  and  rigid  measures 
limited  the  epidemic  to  its  original  <iite. 

This  is  the  first  epidemic  in  the  Canaries  where  definite 
details  could  be  obtained.  In  each  of  the  other  instances, 
chroniclers  speak  of  "the  great  mortality"  caused   by   the 

"Fellowes:    Reports  of  the  Pestilential  Disorders  of   Andalusia 
(London,  1815),  p.  230. 


CANARY    ISLANDS.  185 

disease  or  that  the  inhabitants  "died  by  thousands,"  but 
here  we  have  cold-blooded  statistics,  carefully  compiled, 
which  give  an  intelligent  and  comprehensive  resume  of 
the  visitation. 

The  total  number  of  cases  in  the  epidemic  of  1810  at 
f^anta  Cruz  de  Teneritf e  is  said  to  have  been  5,000 ;  deaths, 
1,450.  The  estimated  population  uf  the  town  at  the  time 
of  the  outbreais.  was  12,000. 

1811. 

The  epidemic  of  1811  was  still  more  disastrous  than 
that  of  1810.  How  the  disease  originated,  our  j  (.urces  of 
information  (Moreau  de  Jonnes,^*^  Fellowes"^  and  Beren- 
ger-Feraud''-)  fail  to  enlighten  us,  but  the  mortality  is 
said  to  have  been  great.  In  San  Juan  Orotava,  on  the 
island  ot  Teneriffe,  which  had  then  a  population  of  3,000, 
there  were  500  fatalities.  In  the  island  of  Grand  Canary, 
there  were  over  3,000  deaths. 

1828. 

During  the  summer  of  1828.  yellow  fever  was  brought 
from  Spain  to  the  Canaries.'^'^  The  outbreak  was  not  gen- 
eral, but  it  claimed  many  victims. 

1817. 

In  1847,  we  must  look  to  America  for  importation  of 
yellow  fever  to  the  Canaries.  The  outbreak  does  not  ap- 
pear to  have  been  virulent,  however,  for  out  of  a  total  of 
5,000  cases,  a  mortality  of  only  60  is  recorded.^* 

We  doubt  that  this  was  yellow  fever. 

'•Morea  de  Jonnes:     Monographie  Historiqiie  et  Medicale   de 

la  Fievre  Jaune  des  Antilles  (Paris,  1820),  p.  342. 
"Fellowes:     Loc.  cit, 
'"' Berenger-Feraud :  Loc.  cit.,  p.  83. 
"'  Berenger-Feraud,  loc.  cit.,  p.  106. 
"Ibid.,  p.  116. 


186  HISTORY    OF    VELIOW    FEVER. 

1862. 

The  Spanisl::  frigate  Niraria  sailed  from  Havana  on 
June  30,  1802,  after  being  in  port  thirty  days.  The  vessel 
arrived  at  Vigo,  Spain,  in  the  beginning  of  July.  The 
authorities  were  informed  that  there  had  been  a  death 
from  yellow  fever  on  the  frigate  shortly  after  her  depart- 
ure from  Havana,  and  as  the  disease  was  known  to  be  epi- 
demic at  that  port  and  it  was  feared  that  other  cases 
would  break  out,  the  captain  was  ordered  to  proceed  to 
the  quarantine  station,  where  the  vess^el  was  thoroughly 
fumigated  and  retained  eight  days.  She  was  then  per- 
mitted to  proceed  to  her  destination  and  arrived  at  Santa 
Cruz  de  Tenerift'e,  where  she  wa.s  imi)rudently  admitted 
to  free  pratique.  There  had  been  no  new  cases  since  the 
death  on  the  way  from  Havana  and  the  health  aiithorities 
of  the  island  thought  that  all  danger  was  over.  The  crew 
had  hardly  started  discharging  the  cargo,  when  two  of 
them  were  taken  ill  and  died  shortly  afterwards,  with  all 
the  symptoms  of  yellow  fever.  Stringent  precautions  were 
taken,  and,  for  some  time,  no  other  cases  manifested  them- 
selves ;  but  on  October  2,  Valentin  Zamora,  who  had  com- 
municated with  the  vessel,  was  stricken  and  died  after  an 
illness  of  seven  days.  Cases  began  to  show  themselves  here 
and  there  in  the  immediate  neighborhood  of  the  shipping 
and  then  suddenly  spread  throughout  the  town.  A  panic 
ensued.  Almost  the  entire  population  fled  to  the  interior 
of  the  island,  onl^^  about  3,000  remaining.  The  epidemic 
lasted  until  the  beginning  of  1803,  resulting  in  2,000  cases 
and  380  deaths.^^ 

The  Nivaria  was  engaged  in  transporting  arms  to  Cuba. 

1863. 

The  epidemic  which  began  in  1802  did  not  subside  until 
the  beginning  of  1803,  after  which  the  public  health  re- 
sumed its  normal  state. 

"Landa:     Espana  Medica,  Madrid,  1863,  vol.  8,  pp.  377,  395, 

411,  427,  442,  475,  491. 


CANARY    ISLANDS.  187 

Interesting  accounts  of  this  epidemic  are  given  by  Do 
Vailc/'*^  Berenger-FeraucP^  and  Landa.""^ 

18S8. 

In  1888,  Santa  Cruz  de  las  Palmas,  capital  of  the  island 
of  Palma,  experienced  a  stubborn  epidemic  of  yellow 
fever,  which,  though  not  attended  with  much  mortality, 
caused  great  uneasiness  throughout  the  archipelago,  owing 
to  the  difficultly  which  the  authorities  encountered  in  their 
attempts  to  stamp  out  the  disease.  Even  as  late  as  De- 
cember 17,  1888,  the  island  of  Palma  was  still  un^ier  strict 
quarantine,  having  been  totally  isolated  from  the  rest  of 
the  group  by  the  Spanish  Government.^^  These  precau- 
tionary measures  confined  the  disease  to  Palma,  We  have 
been  unable  to  obtain  more  definite  details  concerning  this 
outbreak. 

1905. 

The  melancholy  history  of  yellow  fever  in  the  Canaries, 
extending  over  a  period  of  four  hundr«rd  and  eleven  years,, 
closes  with  a  case  of  the  disease  on  board  the  Spanish 
steamship  Montevideo,  June  30;  1905,  in  the  harbor  of 
Santa  Cruz  de  Teneriffe.^''  Fortunately  for  the  islanders, 
who  had  paid  dearly  in  the  past  for  neglecting  precaution- 
ary measures,  the  vessel  was  not  allowed  to  communicate 
with  the  shore,  not  even  her  mails  being  landed,  but  was 
remanded  to  Port  ]Mahon  quarantine  station,  where  she 
remained  until  all  danger  of  contamination  was  past. 
The  ])atieut  recovered  and  no  other  cases  developed  on 
board  the  steamship.  The  Montevideo  had  been  infected 
at  Colon,  Isthmus  of  Panama,  from  Avhich  port  she  ori- 
ginally sailed. 

""Do  Valle:    Echoliaste  Medicale,  Lisbon,  1S64,  vol.  15,  p.  6. 

"  Berenger-Feraud,  p.  139. 

"'Landa:     Siglo   Medical,   Madrid,   1863,   vol.   10,   pp.   339,   375, 

403,  418,  434,  451. 
""Weekly  Abstracts  of  Sanitary  Reports,  18S8,  vol.  3,  p.  296; 

Ibid.,  1889,  vol.  4,  p.  2. 
■^U.  S.  Public  Health  Reports,  1905,  vol.  20,  pp.  1511,  2770. 


188 


HISTORY    OK    YELLOW    FETER. 


Another  infected  vessel  arrived  at  Santa  Cruz  de  Ten- 
eriffe  on  November  1,  1905.^^  The  captain  reported  the 
death  from  yeUow  fever  of  a  passcn<»er  who  had  taken 
passage  for  Spain  at  Sabanilla,  Colombia,  and  who  was 
buried  at  sea  three  days  after  the  vessel  had  left  San 
Juan,  Porto  Rico.  On  arrival  at  Teneriffe,  the  steamer 
was  not  admitted  to  pratique,  but  proceeded  to  Spain  for 
quarantine  and  fumigation.  No  other  cases  occurred  on 
board. 


Ibid.,  p.  2628. 


CAPE   VERD    ISLANDS. 

Descrij^tion. 

The  Cape  Verd  Islands  (Portugese  Ilhos  Yerdes,  i.  e., 
"green  islands")  are  a  group  of  fourteen  volcanic  islands 
and  rocks,  situated  off  the  coast  of  Africa,  in  the  Atlantic 
Ocean,  320  miles  west  of  Cape  Verd.  The  archipelago  con- 
sists of  the  following  islands :  Sal,  Boa  Vista,  Mayo,  San- 
tiago, Fogo,  Brava,  Grando,  Bombo,  Sao  Xicolao,  Santa 
Luzia,  Branco,  Bazo,  Sao  Vincente  and  Santo  Antonio; 
also,  several  smaller  islets.  Area,  1680  square  miles.  The 
group  belongs  to  Portugal  and  together  witli  the  Portugese 
possessions  on  the  mainland  of  Africa,  constitute  the  pro- 
vince of  Cape  Verde,  the  capital  of  which  is  Porto  Praya. 

Historical  Stoiur.arjf. 

The  Cape  Verd  Islands  were  discovered  in  1441  by  the 
Portugese,  who  colonized  them.  The  populatioii  is  quiet 
and  docile,  but  extremely  indolent.  The  first  invasion  of 
yellow  fever  is  said  to  have  taken  place  in  1510,  and  to 
have  lasted  for  several  years  after  that  date;  but  the  re- 
port does  not  bear  the  seal  of  authenticity.  Although 
within  the  geographical  limits  of  yellow  fever,  the  archi- 
pelago has  been  visited  by  the  disease  onlv  at  infrequent 
intervals,  and  but  for  the  epidemic  of  1845,  would  have 
been  sufficiently  disposed  of  with  lialf  a  dozen  lines.  It 
has  been  thought  very  extraordinary  by  observers  that 
these  islands,  situated  in  the  direct  path  of  vessels  coming 
from  localities  where  yellow  fe\er  is  pereniall>  present, 
should  not  have  been  frequently  ravaged  by  the  scourge; 
but,  with  the  exception  of  the  islands  of  San  lago  and  Boa 
Vista,  the  group  has  been  remarkably  free  from  tlie  disease. 

YELLOW  FEVER  YEARS. 

1510;  1511;  1512;  1513;  1514;  1515;  1639;  1807;  1821; 
1822;  1827;  1837;  1838;  1845;  1847;  1862;  1864;  1868; 
1873. 


190  HISTORY    OF    YCLLOW    FEVER. 

SUMMARY  OP  EPIDEMICS. 

1510  to  1515. 

Berenger-Feraiid,®-  quoting  Yalkenaer  (vol.  1,  p.  370), 
says  that  yellow  fever  prevailed  at  the  Cape  Verd  Islands 
from  1510  to  1511.  No  details  as  to  how  the  disease  was 
brought  to  the  islands  or  the  extent  of  the  invasit>n,  could 
be  obtained.  The  mortality  is  said  to  have  been  consider- 
able on  the  vessels  stopping  at  the  archipelago  during 
these  years,  on  their  way  from  Europe  to  the  West  Indies 
and  vice-versa. 

1639. 

One  hundred  and  twenty-four  years  elapsed  without  yel 
low  fever  being  noticed  at  the  Cape  Verd  islands.  In  1639, 
the  Spanish  fleet,  on  its  way  to  Brazil,  stopped  at  the 
islands  and  is  said  to  have  been  contaminated  by  a  pestil- 
ential disease,  which  carried  off  3,000  soldiers.  (Berenger- 
Feraud,  p.  27.)  The  disease  is  said  to  have  been  yellow 
fever,  but  how  it  reached  the  Cape  Verds,  history  does  not 
informs  us.  It  is  worthy  of  note,  however,  that  yellow 
fever  made  its  initial  appearance  in  Brazil  in  1640  and  it 
is  plausible  to  incriminate  the  Cape  Yerds  in  this  out- 
break. 


According  to  Boudin,  yellow  fever  prevailed  in  the 
island  of  Santiago  in  1778.  He  gives  the  testimony  of  Dr. 
Bochard,  surgeon  of  the  French  frigate  Coitsolantc,  who 
states  that  his  ship  stopped  for  a  week  at  Santiago  in  the 
latter  part  of  1778.  He  was  told  by  the  inhabitants  that 
they  were  just  recovering  fr(»m  an  invasion  of  yellow 
fever.  AVhat  gives  additional  creden  e  to  this  statement, 
is  the  fact  that,  a  few  days  after  leaving  the  island,  yelloAV 
fever  broke  out  on  board  the  Consolante,  resulting  in  the 
death  of  150  seamen  in  the  short  space  of  five  weeks.^^ 

"-  Berenger-Feraud,  loc.  cit.,  p.  26. 

•"Boudin:  Traite  de  Geographie  et  de  Statistique  Medicales 
des  Maladies  Endemiques,  Paris,  1857;  Cornilliac,  La 
Fievre  Jaune  Dans  le  Antilles,  1886,  p.  445. 


CAPE    VERD    ISLANDS.  191 

The  report  does  not  state  how  and  whence  the  disease 
came  to  Santiago,  but  as  j^ellow  fever  was  epidemic  in 
Senegal,  Sierra  Leone,  the  Gold  Coast  and  Gambia  in  1778, 
we  can  safely  incriminate  Africa. 

1821. 

From  1778  to  1821  the  islands  were  free  from  epidemic 
disease.  In  1821,  according  to  M'Williams,'^"^  an  outbreak 
of  the  fever  took  place,  but  was  not  attended  with  much 
mortality. 

1822. 

In  1822,  another  mild  outbreak  took  place.^^  No  details 
are  obtainable. 

1827. 

YelloAv  fever  was  imported  to  Santiago  in  1827,  pre- 
sumably by  a  ship  from  America.  The  mortality  was 
very  great.  Among  the  victims  were  the  British  Consul 
and  some  of  the  members  of  his  family.  The  American 
Consul,  who  was  then  just  recovering  from  an  attack  of 
the  fever,  took  charge  of  both  consulates  The  British 
ship  Tweed,  which  was  on  its  way  to  the  Cape  of  Good 
Hope  Station,  touched  at  San  Jago  and  a  part}^  of  junior 
officers  went  on  sliore.  These  were  all  attacked  with  fever 
and,  with  one  exception,  died.  The  Portugese  troops  were 
decemated.^^ 

1833. 

There  was  a  mild  outbreak  in  18n3.^" 

1837. 

In  1837,  yellow  fever  ravaged  the  whole  coast  of  Guinea 
and  was  imported  to  the  Cape  Yerds,^^  where  it  caused 
mucli  mortalitv. 


"Second  Report  on  Quarantine   (1852),  p..  110. 

"  McWilliams :     Second  Report  on  Quarantine,  p.  110. 

"*Ibid.;   also:    Lancet,  London,  1848,  vol.  1,  p.  52. 

"  Berenger-Feraud,  p.  108. 

•^Ibid.,  p.  109. 


I 


192  HISTORY    OF    YBLLOW    FEVER. 

18^5. 
The  Famous  Case  of  the  "Eclair." 

The  epidemic  of  1845  fiiruislies  the  first  iutelligent  and 
coniprc^liensive  report  of  yellow  fever  in  the  Cape  Verd 
archipelago.  This  outbreak,  Avhich  was  confined  to  the 
island  of  Boa  Yista,  was  considered  at  the  time  the  car- 
dinal point  in  the  discussion  of  the  contagiousiLess  of  yel- 
low fever.  All  the  acrimony  which  had  been  smouldering 
broke  out  afresh  and  the  honorable  and  dignified  medical 
men  airayed  on  both  sides  renewed  the  conflict  with 
greater  frenzy  and  venom.  The  controversy,  -svhich  had 
begun  with  the  epidemic  of  Philadelphia  in  1793,  had 
bo])l>ed  up  again  when  the  Spanish  disorders  of  1800-1804 
took  i)]ace,  had  been  once  wiuve  rejuvenated  by  the  Bann 
episode  at  Ascension  in  1823,  was  gone  all  over  again  and 
made  still  wider  the  breach  between  the  rabM  contagionists 
and  their  opponents. 

As  this  is  another  cause  cclchre  in  the  annals  of  epi- 
demiology, we  will  give  it  generous  s]>ace.  The  facts  are 
as  follows  •.^'■^ 

On  July  23,  1845,  the  British  ship  Eclair  sailed  from 
Sierra  Leone,  which  seems  to  have  been  the  natural  source 
of  infection  during  the  last  century,  and  reached  Boa 
Vista  in  August  of  the  same  year.  During;  the  voyage,  60 
of  the  crew  died  of  yellow  fever.  According  to  the  testi- 
mony of  Dr.  Xavier  de  Almeida,  who  went  to  practice 
medicine  in  Boa  Vista  in  1809  and  was  the  only  resident 
j)hysician  of  the  island  for  tliirty-eight  years,  yellow  fever 
had  not  been  seen  in  the  vicinity  for  nearly  fifty  years  pre- 
vious to  the  arrival  of  the  Eclair.  The  disease  was,  there- 
fore, undeniably  imported  by  the  infected  ship- 

While  at  Boa  Vista  the  ofticers  and  crew  of  the  Eclair 
mingled  freely  with  the  inhabitants  and  when  the  ship 
finally  weighed  anchor,  she  left  the  nucleus  of  the  epi- 
demic in  the  towns  of  Eabil  and  Porto  Sal  Key.  Of  the 
three  soldiers  who  constituted  the  guard  at  the  fort  when 
the  vessel  left  the  island,  two,  a  corporal  and    a    private, 

*"  British  and  Foreign  Medico-Chirurgical  Review,  1848,  vol.  2, 
p.  164. 


CAPE    VERD    ISLANDS.  193 

were  stricken  Avitli  tlie  disea.se.  Thev  died  on  September 
22d,  after  an  illness  of  five  or  six  days.  The  surviving 
private  of  this  guard,  being  attacked  Avitli  a  high  fever 
some  days  after  this,  was  removed,  togetter  Avith  a  sick 
comrade,  to  a  small  hut  at  Pao  de  VereUa.  Here  the 
stricken  men  were  visited  and  nursed  by  a  woman  named 
Anna  (lalinha,  who  also  contracted  the  disease  and  died 
on  the  10th  of  October.  The  scourge  subsequently  spread 
through  the  town  and  committed  much  havoc. 

The  case  of  Louis  Pathi,  a  laborer  of  Rabil,  who  was 
taken  ill  after  having  worked  for  two  da^^s  on  board  the 
Eclair  is  of  pathetic  interest,  even  at  this  late  date,  sixty- 
three  years  after  the  occurrence.  We  quote  the  following 
from  the  report  of  Dr.  ^McWilliams,  who  was  sent  by  the 
Bi'itish  Government  to  investigate  the  origin  and  cause  of 
the  epidemic  '?'^ 

Tcsiiiiioiiij  of  Louis  Pathi. 

il.  llow  long  were  you  employed  on  bonrd  the  Eclair? 

A.  About  eight  days. 

<}.  AVhat  family  have  3'ou? 

A.  1  have  none  left. 

Q.  What  family  had  you? 

A.  I  had  a  wife  and  three  children. 

Q.  Did  they  all  die  of  fever? 

A.  Yes,  all  of  them. 

(i.  AVere  you  attacked? 

A.  Yes;  I  was  first  attacked. 

(^  When  were  you  attacked? 

A.  Three  days  after  I  went  to  Rabil  from  the  ship. 

Q.  You  were  with  vour  family  wlien  you  were  taken 
sick? 

A.  No ;  I  was  at  Moradinha. 

Q.  How  long  did  you  stay  at  Moradinha? 

A.  I  was  there  eight  days,  sick. 

Q.  What  did  you  complain  of? 

A.  I  had  general  fever,  headache,  pain  of  back  and 
limbs ;  very  sick. 

"Report  on  the  Fever  at  Boa  Vista,  by  J.  O.  McWilliam,  Lon- 
don,  1847.  * 


194  HISTORY    OF    YELLOW    FEVER. 


Q.  How  long  were  you  sick  after  returu  to  your  owd 
house? 

A.     Kearl}^  three  weeks. 

Q.     Who,  after  yourself,  was  first  takeu  ill? 

A.     My  daughter,  12  years  of  age. 

Q.     How  long  after  your  return  from  the  Eclair? 

A.     It  was  in  the  beginning  of  October. 

Q.     AYho  Avas  next  attacked? 

A.  Another  girl,  7  years  of  age,  four  days  after  the  first 
died. 

Q.     AVho  was  next? 

A.  My  boy,  11  years  of  age.  He  was  taken  ill  eiglit 
days  after  the  second  girl  died. 

Q.     And  your  wife  last? 

A.  Yes ;  my  wife  was  taken  ill  the  same  day  as  the  last 
of  the  children  died. 

A  melancholy  sequel  to  the  above  happened  in  the  home 
of  iNlanoel  Fachina,  who  lived  next  door  to  Pathi  and  who, 
together  with  his  wife,  nursed  the  stricken  family.  After 
the  death  of  Pathi's  wife,  the  Fachinas  were  taken  sick 
with  the  fever,  but  recovered.  Their  child  caught  the  dis- 
ease and  died  in  three  days. 

We  find  the  Eclair  again  playing  tbe  role  of  importa- 
tionisf  in  181(1  After  the  melancholy  experience  she  had 
undergone  in  1815,  the  ship  was  sent  to  the  navy-yard  at 
Plymouth,  England,  where  she  Avas  thoroughly  cleaned 
and  repainted  and  given  the  name  of  Kosamond.^^  She 
was  put  in  commission  and  left  England  for  the  Cape  of 
Good  Hope  in  Februar}-,  181G. 

1817. 

Yellow  fever  is  said  to  have  prevailed  at  the  Cape  Verds 
in  1817,  but  whether  it  was  a  recrudoscence  of  the  previ- 
ous visitation  or  a  new  importation,  our  source  of  informa- 

"  For  fuller  details,  see  notice  of  epidemic  at  Island  of  Ascen- 
sion in  1846,  page  152  of  this  volume. 


1 


I 


CAPE    VERD    ISLANDS.  195 

tion'^^  does  not  say.  It  is  claimed  that  the  British  ship 
Grotcltr  was  contamiuated  at  the  Cape  Verds  and  brought 
the  disease  to  Barbadoes. 

1862. 

18G2  was  a  disastrous  yellow  fever  year  in  Africa.  Al- 
most the  entire  coast,  from  Senegal  to  St.  Paul  de  Loanda 
and  the  Cape  Verd  and  Canary  Islands,  suffered  from  the 
disease.^^  The  outbreak  was  not  verv  severe  at  tlie  Cape 
Verds. 

1864. 

The  Cape  Verds  were  again  invaded  in  1864,'^^  but  no 
details  are  obtainable. 

18G8. 

In  1868,  yellow  fever  was  imported  to  the  Cape  Verds 
from  French  colonies  of  the  West  Coast  of  Africa,  Goree 
and  Senegal,  and  made  its  first  appearance  in  Bissam.''^^ 
The  epidemic  was  most  severe  in  the  city  of  Praia,  in  the 
island  of  Santiago.  Commencing  in  the  middle  of  July, 
1868,  the  disease  spread  with  such  rapidity  that  a  very 
large  proportion  of  the  European  inhabitants  became  suc- 
cessively or  simultaneously  affected,  so  much  so,  that  dur- 
ing the  month  of  August  there  were  received  into  the 
Military  Hospital  at  Misericordia  no  less  than  285  cases, 
of  which,  by  September  1,  41  had  proved  fatal.  During 
the  month  of  October,  there  was  a  considerable  decline  of 
the  epidemic,  the  affected  persons  being  those  who  came 
from  the  interior  of  the  island  of  Santiago  or  other 
points.  The  disease,  however,  spread  to  the  island  of 
Braza.  one  of  the  first  victims  being  the  medical  officer, 
Theophilio  .Toa(|uim  Vieiria.  There  were  also  ,^oine  cases 
in  individuals  who  had  fled  from  the  city  of  Praia  to  other 

"  Berenger-Feraud,  p.  118. 

"  Ibid.,  p.  139. 

"Ibid.,  p.  141. 

"  Medical  Times  and  Gazette,  London,  1869,  vol.  1,  p.  119. 


196  HISTORY    OF    YELLOW    FKVKR. 

points  of  the  island  of  Santiago.  Nearly  the  whole  med- 
ical stall'  stationed  on  the  island  suffered,  Senor  Pimenta, 
of  the  Pharinaceutical  Branch,  succumbing  from  the 
disease. 

1873. 

In  1873,  yellow  fever  was  imported  to  the  Cape  Verds, 
presumably  from  Brazil.^'"'  The  invasion  vras  confined  to 
the  island  of  Sal,  where  the  fever  ran  a  mild  cour,<e  during 
the  summer  months.  Sal  was  put  under  strict  (piarantinCj 
the  authorities  prohibiting  any  communication  whatever^ 
with  the  rest  of  the  archi])elago,  and  ta  this  sanitary  pre- 
caution is  no  doubt  due  the  snuill  extent  of  the  outbreak. 
The  mortality  was  small. 

There  is  no  other  record  of  any  inva;>ion  of  yellow  fever 
in  the  Cape  Verd  archipelago  after  1873.  The  geiieral  use 
of  steam-power  and  the  strict  attenth)n  given  ta  ventila- 
tion and  hygiene  in  the  construction  of  vessels  at  present, 
has  done  much  to  destroy  the  breeding  places  of  the  mos- 
quitoes in  the  holds  of  sea-going  craft  and  thus  given  a 
quietus  to  the  importation  of  the  saff'ron  pcstilenie. 


"Smart:    Transactions  Epidemiological  Society  of  London,  voK)r 
3,  p.  508. 


I 
£• 

U 


CONGO   COAST. 

Descript'tGn. 

Tlie  ConjiO  Coast  was  formerly  iinderstcod  t  >  embrace 
all  the  countries  ou  the  West  coast  of  Africa  behveen  the 
equator  and  latitude  18°  South,  but  is  now  restricted  to 
the  northernmost  district  of  the  Portugese  colony  of  An- 
gola.    Cabinda,  with  a  population  of  8,000,  is  the  capital. 

YELLOW  FEVER  YFAES. 

1816;  1860;  1862;  1000. 

SUMMARY  OF  EPIDE:^[IC?. 

1816.    , 

.1  Mcniorahic  J-J.r/xdifioii  and  its  Disa's1rou,j  End. 

Tiie  history  of  the  tirst  invasion  of  the  C')ni>o  by  yellow 
fever  I'cads  like,  a  romance.  We  have  been  much  interested 
in  the  quaint  account  of  the  famous  Tuckey  expedition, 
l)ublished  in  an  old  hybrid  French  medical  journal  hmu; 
since  defunct  and  f<;r,ii((tten,  and  iiive  in  the  followiuijj 
lines  a  faithful  translation. ^"^ 

In  the  bejiinninjj;-  of  1816,  the  British  Government  fitted 
out  an  expedition  to  explore  the  Con<i;o  River,  under  the 
leadership  of  Fa])tain  J.  K.  Tuckey,  an  experienred  navi- 
j;ator.  Anion*;'  tliose  who  cast  their  fortunes  witli  the  un- 
dertaking;, were  Dr.  Tudor,  Messrs.  Smith,  Lockhart  and 
Crancli,  naturalists,  a  few  less  noted  i^entlemen  in  search 
of  adventure,  and  a  crew  of  twenty  ])ir-l.:ed  men. 

The  expedition  consisted  of  the  schooner  Congo  and 
the  transport  Doroilica,  and  left  England  about  the.  middle 
of  March,  1816.  On  account  of  contrary  winds,  slow  pro- 
gress was  nmde.  The  A-essels  touched  at  Porto-Praya,  one 
of  the  Fape  Verd  Islands,  where  they    remained     a     few 

"  Moreau  de  Jonnes:    Nouveau  .Tournal  de  Medecine,  Chirurgie, 
Pharmacie,  etc.,  Paris,  1822,  vol.  44,  p.  330. 


198  HISTORY    OF    YELLOW    FEVER. 

days,  and  then  proceeded  to  the  mouth  of  the  Congo,  where 
they  anchored  in  the  beginning  of  July,  three  months  and 
a  half  after  their  departure  from  England. 

On  July  8,  1816,  the  explorers  entered  the  Congo.  Pro- 
gress was  slow,  as  the  current  was  rapid  and  treacherous 
and  when  about  30  miles  up  the  stream,  the  Dorothea, 
being  found  too  unwieldy  to  attempt  the  ascent  unassist- 
ed, was  taken  in  tow  by  the  Co)i go.  When  the  village  of 
Embomma  was  reached,  about  75  miles  from  the  mouth  of 
the  river,  Captain  Tuckey  concluded  that  this  mode  of 
voyaging  was  too  slow  and  dangerous  aud  decided  to  leave 
the  vessels  at  anchorage  near  the  town,  and  to  pioceed  by 
row-boat  or  by  foot  in  quest  of  the  source  of  the  river. 

On  August  5,  the  little  party  left  Embomma.  They 
were  in  fine  spirits  and  splendid  health  and  for  the  first 
eleven  days  of  the  arduous  journey  experienced  no  mis- 
hap. On  August  9,  they  reached  the  cataract  of  Yellala, 
which  extends  across  the  entire  bed  of  the  river,  aud  the 
boats  had  to  be  abandoned.  It  was  then  that  the  explorers 
encountered  their  first  set-back.  Dr.  Tudor,  the  youngest 
member  of  the  party,  was  taken  ill  witli  fever.  He  insisted 
on  going  on,  but  had  to  l)e  carried  by  his  C(mipanions.  On 
the  16th  the  naturalist  Cranch  and  several  other  members 
of  the  party  having  been  attacked  by  fever,  Captain 
Tuckey  sent  all  the  sick,  including  Dr.  Tudor,  back  to 
Embomma,  which  place  they  reached  on  August  22,  or 
fourteen  days  after  the  doctor  had  experienced  the  first 
symptoms  of  his  illness.  With  only  a  handful  of  men  left, 
Captain  Tuckey  bravely  persevered  in  his  quest,  but  on 
September  9th,  when  about  160  miles  from  the  mouth  of 
the  river,  he  was  forced  to  turn  back,  as  nearly  every  mem- 
ber of  the  little  hand  was  sick  with  fever  and  further 
progress  was  impossible.  When  the  footsore  travelers 
finally  reached  Embomma,  they  found  that  Dr.  Tudor  had 
died  on  August  29  and  that  the  balance  of  their  com- 
panions had  either  perished  or  were  in  a  dying  condition. 
When  the  epidemic  had  subsided,  it  was  found  that  out  of 
sixty-one  robust  men  who  had  left  Englaud  on  this  fnteful 
expedition,  only  forty  were  left  alive,  tweuty-on:  having 
fallen  victims  to  the  terrible  maladv,  including  Cajjtaiu 
Tuckey,  Dr.  Tudor  and  the   three   naturalists    who    had 


CONGO    COAST.  199 

braved  the  dangers  of  a  tropical  climate  in  the  interest  of 
science. 

Thus  came  to  an  end  the  historic  Tuckey  expedition,  on 
which  England  had  counted  so  much  and  which  cast  such 
a  gloom  over  the  civilized  world,  that  fifty  years  elapsed 
before  the  Congo  was  again  navigated  by  white  raen.'^ 

An  interesting  question  presents  itself:  Was  the  sick- 
ness which  made  such  ravages  among  the  little  band  of 
adventurers  led  by  Captain  Tuckey  yellow  fever,  or  the 
endomic  pernicious  fever  of  the  Congo  region? 

Let  us  analyze  the  situation :  When  the  Dorothea  and 
the  Coufjo  anchored  off  the  mouth  of  the  great  African 
river,  there  was  no  sickness  on  either  vessel;  the  health  of 
the  party  was  also  excellent  on  August  5,  nearly  a  month 
afterwards,  when  the  vessels  were  ieft  at  anchorage  at 
Embomma.  Some  historians  claim  that  the  vessels  were 
infected  at  Porta-Praya.'^  Admitthig,  for  the  sake  of 
argument,  that  an  epidemic  disease  was  raging  at  the 
Cape  Yerd  Islands  when  the  vessels  stopped  at  Porto- 
Praya,  the  long  period  which  elapsed  between  that  time 
and  the  day  youug  Tudor  was  taken  ill  (almost  four 
months),  precludes  beyond  doubt  the  theory  of  infection 
from  these  islands. 

Dr.  Tudor,  the  first  of  the  party  to  be  attacked,  was 
taken  ill  on  August  9  and  died  on  the  29tl-  of  the  same 
month.  Admitting  that  the  young  man  dieJ  of  the  disease 
which  showed  its  first  symptoms  on  the  9th,  it  will  be  seen 
that  he  fought  against  its  insidious  inroads  for  twenty 
days,  which  is  far  beyond  the  usual  run  of  the  violent 
tropical  fevers  endemic  to  West  Africa;  but  if  we  simply 
admit  that  he  was  originally  attacked  by  the  local  fever 
on  'the  9th  and  that,  while  still  weak  and  prostrated,  con- 
tracted the  pestilential  fever  which  t'^en  reigned  at  the 
mouth  of  the  Congo  on  his  arrival  there  on  August  22d,  it 
will  be  seen  that  only  seven  days  elapsed  between  his  ar- 
rival.on  board  the  Congo,  where  several  deaths  had  already 
occurred  from  a  disease  resembling  yellow  fever,  and  his 

'*  Livingstone,  1867. 

"According  to  the  various  autliors.  vi^e  have  consulted,  yellow 

fever  was  never  observed  in  the  Cape  Verd  Islands  from 

1516  to  1821.— G.  A. 


200  HISTORY    OF    VELIOW    FEVER. 

death,  Auj^ust  29tli.  As  yellcw  fever  is  geuerallv  fatal  on 
the  sixth  day,  it  does  not  re(iuire  volumes  of  argument  to 
arrive  at  the  conclusion  that  the  pestilential  fever  which 
almost  annihilated  the  intrepid  explorers,  was  yellow 
fever. 

''But,'"  we  hear  some  astute  disputant  observer,  ''as  it 
has  never  been  proved  that  yellow  fever  ever  originated  in 
Africa,  but  was  always  imported  to  its  shores,  whence  the 
infection  in  this  particular  instance?" 

The  services  of  a  medical  Sherlock  Holmes  are  not 
needed  to  solve  this  problem. 

The  theory  of  infection  from  the  Cape  Verd  Islands 
has  already  been  disposed  of.  We  must  look  elsewhere, 
and  experience  leads  us  to  that  natural  hot-bed  of  yellow 
fever,  the  West  Indies.  Let  us  see  what  were  the  hygienic 
conditions  of  the  Antilles  in  181C : 

A  cursory  reference  to  the  Avorks  of  Moreau  dt  Jonnes, 
Amic,  Berenger-Feraud,  ]Musgrave  Keating,  and  numer- 
ous otlier  chroniclers  who  have  written  on  the  subject, 
shows  that  yellow  fever  was  quite  prevalent  in  the  West 
Indies  in  1810.  It  prevailed  with  much  severity  at  Mar- 
tiui<|ue  and  also  ravaged  Antigua,  Barbadoes,  Guadeloupe, 
and  St.  Thomas. 

Here  we  Imve  a  repetition  of  whit  has  happened  again 
and  again  since  the  discovery  of  America. 

Tbe  traffic  in  slaves  was  quite  extensive  in  1816,  the 
agents  of  the  Spanish  Government  making  bold  arid  fre- 
quent raids  on  the  African  coast  in  quest  of  unfortunate 
blacks  to  work  their  plantations  in  tbe  West  Indies  and 
Soutli  America.  In  si)ite  of  the  vigilance  of  the  English 
scout-ships,  these  marauders,  coming  from  countries  in- 
fested with  yellow  fever,  sailed  up  tlu^  many  wide  estu- 
aries wliich  indent  the  coast  and  acted  as  a  firebrand  in 
disseminating  the  seeds  of  pestilence. 

A\'e  have  spoken  of  tliis  in  relating  the  histories  of  the 
epidemics  of  the  Canary  and  Cape  Verd  islands  and 
hope  the  reader  will  pai'don  us  if  we  prove  irksome  in  our 
efforts  to  take  advantage  of  every  fact  we  can  gather  to 
prove  that  yellow  fever  is  not  an  African  product,  but  has 
always  been  imported  to  that  continent. 

Let  us  now  return  to  the  unfortunate  adventurers: 


CONGO    COAST. 


W\ 


It  will  be  remembered  that  the  explorers  finally  reached 
the  Coniio  in  the  beoinninjj;-  of  July.  Aecor cling  to  Moreau 
de  Jonues,^^  seven  persons  on  board  the  Dorothea  and  one 
or  two  on  the  Comjo  Avere  ill  Avith  fever  during  the  long 
journeA  from  England  to  the  Congo  Coast,  due  to  expos- 
ure. No  serious  after-effects  ensued  and  the  health  of  the 
A'oyagers  continued  excellent. 

\Ve  Imve  read  every  line  of  the  exhaustive  a:  tide  by 
Moreau  de  Jonnes  in  the  Journal  de  Medecinc  above  cited 
— scA-enteen  pages — but  noAvhere  find  mention  that  the  ex- 
plorers met  Avith  any  vessel,  stopped  at  any  port  or  mingled 
Avith  any  strangers  from  the  time  they  left  England  until 
they  entered  the  Congo,  save  the  solitary  instance  of  tht- 
brief  stay  at  Port:-Praya.  As  the  vessels  could  possibly 
not  haA'e  been  infe-ted  at  that  port,  we  Avere  at  a  loss  to 
locate  the  original  focus,  Avhen  Ave  came  across  a  short 
account  of  the  epidemic  in  the  scholarly  Avork  cf  Berenger- 
Ferau(l,~Avhich  clears  the  mystery.  It  is  certainlv  jjeculiar 
that  such  a  close  observer  as  Moreau  de  Jonnes  makes  no 
mention  of  this  fact,  but  as  the  authorities  quoted  are  un- 
assailable, it  deserves  a  tardy,  but  merited  place  in  history. 

A  perusal  of  the  article  by  Berenger-Feraud^^  rcA-eals 
the  fact  that  Avhile  riding  at  anchor  at  the  mouth  of  the 
Congo,  Captain  Tuckey's  A'essels  Avere  in  frequent  com- 
munication Avith  the  officers  and  crcAV  of  a  foreign  A'essel 
flying  the  American  flag,  but  Avhich  Avas  afterA\'ards  found 
to  be  a  Spanish  slave-ship  from  Brazil.  There  ^^ere  some 
s\is])ici()us  cases  of  fcA'er  on  board  the  stranger,  but,  being 
informed  that  the  craft  had  come  direct  from  the  United 
States,  Captain  Tuckey  had  no  suspicion  of  the  nature 
of  the  illness  preAailing  on  board  and  alh  Aved  free  com- 
munication l)etween  the  comi)lement  of  the  three  A'essels, 
as  he  Avas  anxious  to  obtain  all  the  information  he  could 
about  the  mysterious  riA'er  he  AA'as  about  to  explore  and 
did  not  Avish  to  offend  the  ncAVComers^  Avho  seemed  to  be 
Avell-v(>rs('d  in  the  topogra])hv  of  the  country.  Alas  for 
hunuin  short-sightedness  and  ambition!  This  Avant  of 
caution  undoubtedly  pa\'ed  the  an'Rv  for  the  terrible  afflic- 
tion Avhich  afterAvards    annihilated    the    I'ttle    baud    of 

""Loc.  cit.,  p.  332. 

"  Berenger-Feraud,  loc.  cit.,  p.  87. 


202  HISTORY    0¥    YELLOW    KKVER. 

pioneer  explorers  and  deprived  science  of  some  of  its  most 
enthusiastic  devotees. 

18G0. 

Yellow  fever  i)revailed  quite  extensively  along  the  Congo 
Coast  in  18G0  and  was  particularly  severe  at  Angola  and 
St.  Paul  de  Loanda.^^  The  source  of  importation  is  not 
given. 

1862. 

In  18(32,  yellow  fever  invaded  almost  the  entire  African 
coast  from  Sierra  Leona  to  ^>aiut  Paul  de  Loanda.  (Ber- 
enger-Feraud,  p.  139.)  The  epidemic,  though  widespread, 
was  not  very  severe. 

18G5. 

The  epidemic  of  1-865  was  mild  and  was  not  attended 
with  much  mortality.  Berenger  Ferand  (page  111)  only 
makes  a  hrief  mention  of  the  incident. 

1900. 

In  1900  yellow  fever  was  imported  from  Senegal  to  the 
French  Congo. ^^ 

On  May  26,  the  steamship  VilJe  dc  Pernamhiico,  plying 
hetween  France,  West  Africa  and  Brazil,  stopped  at 
Dakar  where  yellow  fever  was  prevailing.  While  riding 
at  anchor,  three  sisters  of  charity  who  were  on  board  the 
vessel  exchanged  greetings  with  members  of  their  order 
who  had  come  to  the  wharf  to  see  them.  It  is  claimed  that 
no  other  communication  was  had  with  the  inhabitants  of 
Dakar,  but  the  statement  must  be  taken  cum  r/ratiis  sails. 
The  vessel  left  Senegal  for  the  usual  voyage  down  the  coast 
and  arrived  at  Loango,  one  of  the  ports  of  tht  Fi-ench 
Congo,  on  June  15th,  wliere  the  sisters  disembarked.  They 
were  all  successively  taken  ill.  One  of  the  sisters  died  on 
June  20th  and  another  on  July  2d.    The  third  recovered. 

"  Berenger-Feraud,  ix  136. 

"Kermorganl:    Receuil  des  Trav.  du  Com.  Con.  d'Hyg.  Pub.  de 
France,  1901  (Paris,  1903),  vol.  33,  p.  394. 


CONGO    COAST.  205 

Autopsies  revealed  the  fact  that  the  two  deaths  bad  been 
caused  by  yellow  fever. 

The  fourth  case  at  Loanj^o  mauifested  itself  iu  the  per- 
son of  a  young  negress  aged  16;  who  had  nursed  the  sister 
of  charity  that  recovered.  The  patient  died  a  few  days 
later,  with  black  vomit.  The  port  physician  took  extra- 
ordinary precautions  to  prevent  a  spread  of  the  disease, 
which  was  contiued  to  the  cases  above  mentioned. 

A'  remarkable  feature  of  this  invasion,  is  that  the  only 
person  infected  by  the  sisters  was  a  native  African  and 
that  the  few  whites  in  the  town  escaped  an  attack.  The 
natives  of  Western  Africa  are  generally  immune  and  the 
rare  occurrence  of  a  case  among  them  certainly  deserves 
special  mention. 

This  is  the  fifth  and  last  authentic  instance  of  yellow 
fever  on  the  Congo  Coast ;  but  other  visitations  of  the  dis- 
ease no  doubt  took  place  before,  between  and  after  the 
dates  chronicled  in  this  history,  for  it  is  a  notorious  fact 
that  St.  Paul  de  Loanda  was  one  of  the  most  infamous  cen- 
tres of  the  slave-trade  in  by-gone  days  and  was  frequented 
by  the  worst  class  of  trans-oceanic  freebooters. 


DAHOMEY. 

Description. 

Dahomey  is  a  ne^TO  kingdom  of  WestoMi  Afj'ica,  in 
Guinea,  with  a  coast-line  only  35  miles  in  leng;th,  nearly 
the  whole  of  wliieh  is  composed  of  islands  and  swamps. 
The  natives  are  all  pa<ians  and  their  worship  fetishism. 
Population,  250,000,  of  which  230;00  are  said  to  be  slaves. 

YELLOW  FEVER  YEARS. 

1905 ;  190G ;  1907. 

SUM:\rARY  OF  EPIDE^MIC-i. 

1905. 

Yellow  fever  had  never  been  observed  in  Dahomey  pre- 
vious to  1905.  The  immunity  of  this  negro  kingdom  from 
the  disease  is  easily  understood,  when  one  reflects  that  it 
is  hardly  ever  visited  by  white  men.  How  the  fever  was 
imported,  we  were  unable  to  ascertain,  owing  to  tli'e  diffi- 
culty of  obtaining  information  from  a  region  governed  by 
savages  and  ouly  exploited  by  white  men  when  in  quest  of 
wihl  aniuials  for  circuses  and  zoological  gardens.  Com- 
munication between  the  Euro])ean  settlements  on  the  coast- 
line of  Dahomey  and  other  African  ports  are  frequent  and 
uninterrupted.  The  fact  that  the  first  cases  were  observed 
in  the  persons  of  custoudiouse  employes  at  Orand-Popo, 
gives  weight  to  the  hypothesis  tliat  tlie  disease  was  con- 
tracted on  shii)board,  as  the  duties  of  these  officers  also  in- 
clude the  sanitation  of  vessels  coming  from  foreign  ports. 
They  were  thus  com])elb'd  to  spend  much  (tf  their  time  on 
"sus])i(i(;us  vessels"  and  wei-e  thus  exposed  to  infection. 

According  to  the  report  of  the  ".Gouverneuient  Oeueral 
de  I'Afrique  Occidentale  Francaise,"  published  in  the 
Annalc!^  d'Hi/f/iciif  ct  de  Medeeine  Colon  idlest.  Paris,  1907, 
vol.  10,  page  449,  the  first  case  erujjted  at  Grand-Popo  in 
January,  1905,  in  the  person  of  an   old    customhouse    in- 


DAMOHEY.  205 

spector.  The  patient  died  four  days  after  tlie  onset  of  the 
fever. 

Fifteen  da^s  later,  another  customhouse  inspector,  a 
young'  man  aged  28,  Avho  had  recently  arrived  from  France, 
was  stricken.     Death  ensued  in  a  few  days. 

The  third  case,  a  nun,  also  ended  fatally. 

The  bislio])  of  the  colony,  who  had  nursed  the  nun,  was 
next  attacked  and  furnished  the  fourth  victim.  His  death 
occurred  at  Ouidah,  where  he  had  gone  when  he  felt  indis- 
posed. 

In  less  than  a  month,  nine  additional  cases  erupted  in 
(irand-Popo,  six  of  whom  died. 

Thrown  into  consternation  by  the  rapid  and  malignant 
nature  of  the  fever  which  was  decimating  their  ranks  in 
such  a  short  space  of  tiuie  (six  weeks),  the  handful  of 
Europeans  which  had  been  spared  by  the  scourge  (about 
14),  lied  to  France.  Only  six  or  seven  whites,  whose  offi- 
cial duties  prevented  them  from  deserting  their  posts  re- 
mained in  the  town.  Great  precautions  were  taken  by  this 
little  band  against  infection.  The  Odonial  Government 
had  their  living  apartments  thoroughly  screened  and  they 
were  especially  instructed  to  wage  an  incessant  warfare 
against  mosquitoes.  Tliese  precautionary'  measures  put  an 
end  to  the  epidemic,  as  no  other  cases  erupted  after  the 
exodus  of  the  colonists. 

If  one  takes  into  consideration  the  comparatively  lim- 
ited population  of  Grand-Popo  and  its  environs  (30  or 
35),  the  number  of  cases  (13,  followed  by  10  deaths), 
sliows  that  the  fever  was  decidedly  malignant  and  would 
certainly  have  been  more  fatal  had  the  segregation  of  the 
population  not  taken  place. 

1906. 

One  of  the  strange  characteristics  of  yellow  fever  is  the 
fact  that  when  an  epidemic  is  especially  severe  in  a  locali- 
ty, it  is  almost  certain  to  recrudesce  the  following  year. 
We  were  therefctre  not  surjjrised  to  note,  in  the  report 
above  cited  (page  451),  that  the  disease  under  discussion 
re-appeared  in  Dahomey  in  1006. 

The  first  case  erupted  at  Ouidah,  April  12.    The  patient, 


206  HISTORY    OK    YELLOW    FEVER. 

the  wife  of  a  German  subject,  died  a  few  days  after  being 
attacked. 

Between  April  23  and  ^lay  3,  4  deaths  were  reported 
from  Togo. 

^lay  5,  2  cases  were  observed  in  Grand- Popo.  One  of  the 
victims  died.  The  patient  recovering  was  the  husband  of 
the  German  bidy,  mentioned  above. 

On  May  10,  a  fatal  case  was  observed  at  Ouidah.  This 
was  followed,  on  May  20,  by  another  case,  which  termin- 
ated fatally  on  June  3. 

Maj'  21.  Cotonou,  until  then  immune,  became  infected. 
One  case,  followed  by_  death  on  the  29th,  is  recorded. 

May  29.     One  case  at  Grand-Popo.    Recovered. 

June  5.  One  case,  a  nun,  at  Ouidah.  Died  June  8.  An- 
other case  at  Ouidah  on  the  5th,  imported  from  Toffo, 
where  unconfirmed  cases  had  been  observed.    Eecovered. 

June  16.     One  death  at  Ouidah. 

June  23.  One  case  at  Ouidah,  followed  bv  death  on 
25th. 

This  was  the  last  case  of  the  epidemic.  There  were  alto- 
gether 15  cases,  with  12  deaths,  distributed  as  follows: 

Locality.  Cases.        Deaths. 

Cottonou 1  1 

Grand-Popo 3  1 

Ouidah 7  fi 

Togo 4  4 

Total 15  12 

The  origin  of  the  epidemic  is  unknown. 

1907. 

In  January,  1907,^^  Dahomey  was  still  under  the  ban  of 
quarantine,  yellow  fever  having  made  its  appearance  at 
Grand  INipo  in  the  })eginning  of  the  year.  Up  to  the  time 
of  tlie  <l(»sing  of  this  report,  no  details  could  be  obtained. 

'*  Kermorgant :    Annales  d'Hygiene  et  de  Medecine  Colonialos, 
1907,  vol.  10,  p.  299. 


EGYPT. 

Description. 

Eojpt  is  a  country  in  the  northeastern  part  of  Africa, 
governed  by  a  viceroy  (khedive),  who  pays  tribute  to  the 
Sultan  of  Turkey,  but  is  otherwise  independent.  Egypt 
is  bounded  on  the  north  by  the  Mediterranean  Sea,  on  the 
east  by  Arabia  and  the  Red  Sea,  on  the  south  by  Abyssinia 
and  other  unimportant  countries;  and  on  .he  west  by  the 
Desert  of  Sahara.    Capital,  Cairo. 

"THE  PLAGUE  SPOT  OF  THE  WORLD." 

According  to  the  opinion  of  medical  writers,  we  have  to 
accept  Egypt  as  the  country  whence  pestilence  most  fre- 
quently originated  and  extended  itself.  This  is  why  that 
ancient  land  has  been  christ'^ned  "The  Plague  Spot  of  the 
World."  From  time  immemorial,  the  terrible  Oriental 
Plague  and  epidemic  cholera  were,  in  almost  '.very  in- 
stance, first  observed  in  Egypt  before  they  began  their 
journey  of  death  and  desolation..  Cairo  and  the  villages 
of  the  Delta  were  generally  attacked  first;  thence  the 
whole  civilized  Avorld  Avas  infected. 

HOW  MEHEMET  ALI  REDEEMED  EGYPT. 

A  little  historical  causerie,  to  relieve  the  mind  from  the 
array  of  cold-blooded  statistics  whioh  are  part  and  parcel 
of  a  work  of  this  kind,  will  be  found  refreshing  and  inter- 
esting. 

The  Egyptians  are  the  earliest  people  known  to  us  as  a 
nation.  When  Abraham  entered  the  Deltn  from  Canaan, 
they  liad  long  been  enjoying  the  advantages  of  a  settled 
government.  They  had  built  cities,  invented  hieroglyphic 
signs,  and  improved  them  into  syllabic  writing,  and  almost 
into  an  alphabet.  They  had  invented  records,  and  wrote 
tlie  names  of  their  rulers  and  their  heroic  actions  on  the 
massive  tenii)les  which  they  raised.  INlore  than  2000  years 
B.  C,  the  Egyptians  had  duodecimal  as  well  as  decimal 
numbers,  and  weights  and  measures.    The  masonry  of  the 


208  HISTORY    OF    YELLOW    FEVER. 

passajies  in  the  Great  Pyramid  has  not  been  surpassed  at 
any  aj»e.  In  mechanical  arts,  the  carpenter,  boai-builder, 
potter,  leather-cutter,  glass-blower  and  others,  are  often 
represented  on  their  ancient  monuments.  They  were  also 
adepts  in  other  arts  too  numerous  to  mention.  The  social 
and  domestic  life  of  the  ancient  Ejryptians  is  depicted  on 
the  walls  of  their  temples  and  tombs. 

Cairo,  the  capital  of  Modern  Euypt,  is  situated  on  the 
right  bank  of  the  Nile,  12  miles  above  the  apex  of  its  delta, 
and  150  miles  by  rail  from  Alexandria,  and  has  a  popula- 
tion of  374,838  souls.  The  character  of  the  tov.n  is  still 
!uaiuly  Arabic,  though  in  modern  times  the  European 
.style  (;f  aichitecture  land  other  matters  has  become  more 
and  more  prevalent.  The  city  is  partly  surrounded  by  a 
fortified  wall,  and  it  is  intersected  by  seven  or  eight  great 
streets,  from  which  runs  a  labyrinth  of  narrow  crooked 
streets  and  lanes.  There  are  several  large  squares,  or 
places,  the  principal  being  the  Ezbekiyeh.  To  the  south- 
east of  the  town  is  a  citadel,  on  the  last  spur  of  the  Mo- 
kattam  Hills,  overlooking  the  city.  It  contains  the  fine 
mosque  of  Mehemet  Ali,  a  well  270  feet  deep  called 
Joseph's  Well,  cut  in  the  rock,  the  palace  of  the  Viceroy, 
and  other  things  of  interest  to  tourists.  There  are  up- 
wards of  100  mosques.  The  finest  is  that  of  Sultan  Has- 
san. There  are  also  some  forty  Christian  churches,  Jew- 
ish synagogues  and  other  denominations.  The  tombs  in 
the  burying-grounds  outside  of  the  city  also  deserve  men- 
tion, es})ecially  those  known  as  the  tombs  of  tlu  Caliphs. 
The  trade  of  Cairo  is  large,  and  the  bazaars  and  markets 
are  numerous.  Of  these  tlie  Khan  el  Khalili.  in  the  north- 
east of  the  town,  consists  of  a  series  of  covered  streets  and 
courts  in  whicli  all  kinds  of  eastern  merchandise  are  dis- 
played in  open  stalls.  Cairo  has  railway  communication 
with  Alexandria,  Suez,  and  Siout. 

Before  the  watering  and  sweeping    of    the     streets    of 


EGYPT.  209 

Cairo  was  introduced  by  the  Yicc-voy,  Mohoniet  Ali/*^'^  in 
the  beginnini^'  of  the  hist  century,  they  were  full  of  filth. 
A  canal  runniug  through  the  city  v-eceived  all  kinds  of 
refuse,  and  was  much  neglected;  its  borders  had  always 
been  considered  as  most  unhealthy,  and  most  fre(iuented 
by  the  plague.  Moreoyer,  Cairo  was  surrounded  with  an 
almost  complete  circle  of  hills,  one  hundr,^d  and  tifty  to 
three  hundred  feet  in  height,  and  where  these  ceased,  by  a 
projection  of  the  ]Mokattam  mountains.  Thus  purifying 
winds  were  cut  off  from  tlie  r-ity.  The  disease  always  ap- 
peared after  the  receding  waters  of  the  Nile  had  left  much 
animal  and  yegetable  nuitter  decaying,  producing  uias- 
mata  under  the  combined  influence  and  moisture,  and 
after  raging  seyeral  months,  disappeared  with  tlie  nucta 
(a  lieayy  dew)  and  the  scorching  rays  of  the  June  sun. 

Mehemet  Ali  gaye  orders  to  clean  the  city,  and  to  water 
and  sweep  the  streets  eyery  morning,  but  the  state  of 
health  did  not  materially  improye.     It  had  already  been 

*^  Mehemet  Ali,  Viceroy  of  Egypt,  born    at    Kavala,    in    Mace- 
donia, in  1769.     He  entered  the  Turltish  army,  and  served 
in   Egypt  against  the  F'rench;    rose    rapidly    in    military 
and  political  importance;    became  Pasha  of  Cairo,  Alex- 
andria, and  subsequently  of  all  Egypt.     In  1811  he  mas- 
sacred  the   Mamelukes   to   the   number   of   470   in   Cairo, 
and  about  1200  over  the  country.     He  then  commenced, 
by  the  orders  of  the  Porte,  a  war  of  six  years'  duration 
against  the  yv^ahabees  of  Arabia,  which  was  brought  to 
a  successful  conclusion  by  his  son  Ibrahim,  and  secured 
him   the  possession  of  Hejaz.      Ibrahim    also    aided     in 
bringing  a  large  part  of  the  Soudan  under  Egyptian  rule. 
By  means  of  a  vigorous   domestic    policy    Mehemet    re- 
duced  the  finances  to  order;    organized  an  army  and  a 
navy;   stimulated  agriculture,  and    encouraged    manufac- 
tures.    In  1824-27  he  assisted  the  Sultan  in  endeavoring 
to  reduce  the  Morea,  which  led  to  the  destruction  of  his 
fleet  by  the  allied  European  powers  at  Navarino   (1827). 
Subsequently  he  turned  his  arms  against  the  Sultan,  and 
in  his   efforts  to  secure   dominion  over  Syria  by  armed 
invasion,  he  was  so  far    successful    that    the     European 
powers  had  to  interfere  and  compel  him  to  sign  a  treaty 
in  1839,  which  gave  him  the  hereditary  pashalic  of  Egypt 
in  lieu  of  Syria,  Candia,  and    Hejaz.      This    remarkable 
personage  died  in  1S49  at  the  age  of  eighty. 


210  HISTORY    OF    YELLOW    FEVER. 

remarked  by  pliTsicians  of  the  army,  at  tbe  time  of  the 
Freiich-EiiYptiau  expedition,  that  the  encircled  position 
of  the  city,  combined  with  other  nnfayorablt  circum- 
stances, must  be  Aery  unhealthy.  Adyiseis  of  Mehemet 
All  repeated  the  renmrk,  and  the  Viceroy,  who  was  a 
tyrant,  but  seldom  shrinkinu,'  from  the  extent  of  an  enter- 
jji'ise,  took  the  bold  resolution  of  carrying  down  a  large 
portion  of  the  hill  into  the  fields,  \yhich,  atter  having  suf- 
ficiently eleyated,  he  intended  to  water  artificially  and  to 
conyert  into  beautiful  gardens.  As  once  the  Pharaohs 
dragged  thousands  of  men  to  the  erection  of  temples  and 
pyramids,  so  Mehemet  Ali  forced  thousands  of  fellahs 
(Egyptian  peasants)  to  execute  his  plans.  Many  died  un- 
der the  excessiye  labor,  but  the  ranks  Ayere  filled  by  others, 
and  the  work  itself  Avas  always  adyaucing.  Thus  a  long 
chain  of  hills  Ayas  carried  doAyn.  and  miasmatic  marshes 
conyerted  into  charming  oliye  and  fruit  gardens.  And 
as  the  Avork  progressed  the  health  of  Cairo  impr^.ved. 

The  disease,  no  longer  brought  from  Egypt  to  other 
parts  of  the  Turkish  Empire,  disai)])eared.  Mehemet  Ali 
has  proyed  Ayhat  can  be  done,  eyen  under  the  most  unfayor- 
able  circumstances,  by  his  grand  and  energetic  measures, 
in  improying  the  health  of  one  city;  and  In-  thus  desti-oy- 
ing  the  germ  of  this  most  destructive  of  all  diseases,  he  has 
unconsciously  sayed  the  lives  of  millions.^^ 

ALLEGED  YELLOW  FEVER  YEAR. 

1800. 

SUMMARY  OF  EPIDEMIC. 

Wiih  the  exce]>tion  of  the  alleged  epidemic  de])icted  by 
Dr.  Larrey,''^  Ave  fail  to  find  anywhere  any  mentk  n  of  j'el- 
low  fcA'er  in  Egypt.  We  have  ransacked  the  works  of 
ancient,  medieval  and  modern  Avriters  on  epidemiology, 
but  oidy  find  tbe  solitai-y  instance  narrated  by  Baron 
Larrey.     In  our  opinion,  this  Avas  not  yellow  ityer,  for 

**Dowell:    Yellow  Fever  and  Malarial  Diseases  (1876),  p.  25. 
"Larrey:    Memoirs  of  Military  Surgery  and  Campaigns  of  the 
French  Armies,  etc.,  (Hall's  Translation),  1814,  p.  230. 


EGYPT.  ;2  I  1 

that  disease  could  uot  originate  in  Egypt,  and  nowhere  in 
Larrey's  account  do  we  find  any  mention  of  importation. 
We  would  have  passed  this  account  by  without  giving  it 
any  attention  had  the  author  been  an  irresponsible  or  less 
distinguished  personage,  but  Baron  Larrey  was  one  of  the 
most  noted  surgeons  of  his  day,  holding  the  post  of  Sur- 
geon-in-Chicf  of  the  Army  of  Napoleon  in  his  foolhardy 
invasion  of  Egypt,  and  was  the  author  of  notable  surgical 
works  His  post  naturally  afforded  him  abund:?.nt  oppor- 
tunities for  practical  study  and  a  careful  perusal  of  his 
writings  shows  that  he  studiously  availed  himse-f  of  his 
astute  powers  of  observation  and  (1  eduction  by  collecting 
numberless  important  and  interesting  facts. 

Dr.  Larrey  was  a  close  and  intelligent  observei,  and  his 
descriptions  of  the  several  jjliases  of  the  disease  he  had  to 
deal  with,  even  if  antagonistic  to  the  tenets  of  this  en- 
lightened age,  are  so  replete  with  interesting  dv^ail,  that 
we  Avill  quote  at  length  from  his  views  on  the  cause,  path- 
ology and  treatment  of  the  maladv  which  decimated  the 
ar:sny  of  the  great  Xapoleon  in  the  campaigns  wlii(  h  proved 
so  disastrous  to  the  French  arms. 

"The  fatal  consequences  which  took  place  in  a  great 
number  of  our  men  who  Avere  wounded  in  the  battle  of 
Heliopolis,-'  observes  Dr.  Larrey,  "and  at  the  siege  of 
Cairo  in  1800,  led  our  soldiers  to  belitve  that  th(^  balls  of 
our  enemy  were  poisoned.  It  was  not  difficult  to  unde- 
ceive them;  but  not  so  easily  could  we  arrest  the  progress 
of  the  disease." 

This  eminent  authority  further  asserts  that  the  malady 
presented  all  the  symptoms  of  the  yellow  fpver  observed  in 
America  during  the  caniiiaigns  of  the  French  armies  in 
the  West  Indies  and  which,  according  to  the  re])ort  of  Dr. 
(xilbert,  his  former  colleague,  Avhu  Avas  pliysician-general 
of  the  army  of  St.  Domingo,  reappeared  among  the  French 
troops  during  the  expedition  to  that  island  in  tb-f"  last  de- 
cade of  the  eighteenth  century. 

A  peculiarity  noted  by  Dr  Larrey  in  Egypt  Avas  that  the 
fever  attacked  none  luit  the  Avounded.  ami  more  particu- 
larly those  Avho  had  been  injured  in  tlie  articulations,  or 
had  fractured  bones,  Avith  injuries  of  the  nerAX-s,  of  the 
head,  of  the  abdomen  or  thorax.      The  disease   appeared 


212  HISTORY    OF    YELLOW    PEVKR. 

about  the  5th  of  April,  1800.  and  d'saj.peaced  alout  the 
last  of  31ay.  Dr.  Larrey  skives  th':  followinji  details  of 
the  principal  symptoms  which  tlie  malad}''  presented: 

''The  wcmnded  had  scarcely  received  the  jirst  assistance, 
or  submitted  to  an  operation,  when  they  f(^ll  into  a  state 
of  faintntrss  and  anxiety;  rigors  were  felt  over  'he  whole 
bod}',  and  esi)eeially  in  the  inferior  extremities.  At  the 
first  attack  the  eyes  were  heayy,  the  eonjunctiya  yellow, 
the  yisaiie  copper  eolortd,  and  the  pulse  slow  and  eon- 
tracted.  The  patient  felt  pain  in  his  right  hypochondrium, 
and  his  wounds  were  dry,  or  diseharged  a  red  serum. 
These  syni])t()ms  were  followed  by  much  general  heat, 
burning  thirst,  yiolent  pains  of  the  intestines  and  head, 
sometimes  aceompanied  by  delii-inm,  frenzy,  op^)ression, 
and  frequent  sighing.'- 

Speaking  of  the  causes  of  the  epidemic,  Di.  Larrey 
says : 

"T  think  that  many  causes  coneurr«Ml  in  producing  the 
yellow  feyer  among  our  wounded  The  tirst  was,  crowd- 
ing the  hospitals;  as  insurmountable  difficulties  opposed 
the  formation  of  other  estal)lishments,  we  could  not  reme- 
dy this.  Besides,  the  wounded  occTi])ied  th(^  wards  on  the 
ground  lioor,  the  moisture  of  which  increased  the  disease,, 
It  did  not  appear  in  the  elevated  and  airy  A\ards  to  any 
considerable  extent.  ^Nloreoyer.  the  troops,  of  which  these 
wounded  \yere  formerly  a  ])arr.  wei'e  encam])ed  on  the  west 
of  Cairo,  between  this  city  and  Boula(i,  in  a  situation  low 
and  moist,  more  espeeially  after  the  waters  of  the  Nile 
had  recech  d  from  a  ])lace  where  they  had  undergone  de- 
composition, by  remaining  long  expos«^d  to  the  heat.  The 
sudden  ti-ansition  from  the  scorching  heat  of  the  day  t(» 
the  moisture  of  the  night,  to  which  the  troops  were  ex- 
posed, necessarily  tended  to  weaken  them  and  predispose 
to  the  disease.  The  atmosplu  re,  in  the  s(as(,n  of  khamsyn, 
is  hot  and  moist,  and  consecpiently  injnrious  to  health.  At 
this  time  also  the  ])lague  prevails,  and  we  might  say  that 
the  yellow  fever,  from  the  sinularity  of  its  effeets.  and  its 
speedy  termination,  bears  some  analogy  to  this  scourge. 

"To  the  causes  already  enumerated,  we  might  add  the 
excessive  fatigue  of  the  soldiers,  the  deficiency  of  good  ali- 


EGYPT.  213 

luent:  of  cooliufi:  remedies  and  acid  drinks,  and  the  want 
of  cloaks  to  cover  them  during  tlie  night," 

The  surrender  of  Cairo  having  re-established  coniniuni- 
cation  with  the  outside  world,  the  French  were  enabled 
to  establish  new  hospitals,  and  to  procure  good  aliment, 
medicines,  linen  and  bed  furniture.  Tiiey  removLd  a  great 
part  of  their  sick  to  more  sanitary  quarters.  These  cir- 
cumstances, and  the  return  of  the  wind  to  the  north,  in 
the  judgment  of  Dr.  Larrev,  soon  caused  the  disease  to 
disappear. 

The  following  mode  of  treatment  followed  by  Dr.  Larrey 
is  certainly  unique: 

"When  yellow  fever  was  acute,  and  presented  the  symp- 
toms of  an  inflammatory  fever  with  jaundice,  spasmodic 
vomiting,  delirium,  etc.,  dry  scarifications  of  the  liga- 
mentum  nuchae  and  on  the  iiypochondria,  produced  very 
good  etfects,  or  in  lieu  of  them,  a  small  quantity  of  blood 
was  taken  from  the  arm.  But  copious  blood  letting  was 
fatal,  and  it  was  even  necessary  to  use  the  greatest  cir- 
cumspection in  the  first  detraction  of  blood.  Nitrated 
tanuirind  water,  sweetened  with  honey  or  sugar,  or  a  few 
glasses  of  nitrated  and  anodyne  camphorated  emulsions 
taken  at  night,  relieved  thirst  and  moderated  intestinal  ir- 
ritation. If,  in  conjunction  with  these  remedies,  the 
bowels  were  moved  in  the  first  t^^enty  four  hour^-^.,  Ave  had 
hopes.  We  then  continued  the  use  of  cooling  medicines,  of 
anodynes,  of  antispasmodics,  followed  by  laxatives  of 
neutral  salts,  and  calomel,  tonics,  and  antise])ti<-s  by  de- 
grees. Emetics  would  have  been  pernicious.  But  if  in  an 
opposition  to  these  means  the  symptoms  increased,  the 
disease  terminated  fatally.  When,  on  the  contrary,  the 
disease  commenced  with  ataxic  symptoms,  such  as  pros- 
tration of  strength,  faintness,  chillhic^s,  blackish  tinge  of 
the  tongue,  and  constipation,  emetics  in  gruel  removed  the 
spasm,  re-established  the  powers  of  the  stoma/^h,  and 
facilitated  the  actions  of  the  tonics  and  antiseptics;  we 
then  exhibited  these  latter  with  some  success;  chinchona, 
camphor  combined  with  opium,  Hoffmann's  mineral 
licpior.  and  l)itters  in  suitable  doses.  The  cortex  appeared 
to  be  less  effectual  than  jiood  wine  brewed  with  sweetened 


214  HISTORY    OF    YELLOW    FiJVER. 

lemonade,  and  to  wliicli  a  portion  of  ether  ^vas  a^ierwards 
ad  led 

"CoftYe  was  to  ns  liiglilv  useful,  and  we  employed  it  to 
great  advantage  when  the  disease  had  passed  tie  second 
stage,  Avlien  suppuration  was  re-established  in  the  wounds, 
and  the  patient  was  about  to  recover.  It  expedited  in  these 
cases  the  return  of  the  vital  powers  and  gave  nourishment. 
These  means  were  persevered  in,  and  their  use  modified  at 
every  stage  of  the  disease.  Spurge-laurel  and  mustard, 
pounded  with  vinegar,  and  applied  to  the  hypochondria  or 
back,  co-operated  greatly  with  these  remedies.  In  this  dis- 
ease, I  remarked  the  injurious  effects  of  cantharides; 
therefore,  I  seldom  used  them. 

''Wounds  complicated  witli  bilic.us  fevers,  Avere  dressed 
according  to  the  particular  indicrtion  They  were 
sprinkled  with  camphor  and  bark,  wlicn  they  were  threat- 
ened with  gangrene,  and  we  used  the  vegetable  acids, 
L'hiefiy  of  the  lemon,  which  is  abundant  in  thi«  country. 
If  they  assumed  the  symptoms  of  putridity,  I  also  ordered 
lotions  of  vinegar  strongly  camphorated,  to  be  nsed  on 
the  head  and  over  the  surface  of  the  body. 

"Those  who  survived  the  \ellow  fever,  had  a  tedious 
convalescence;  some  even  had  rela])ses  and  died  in  a  few 
days.  The  yellow  fever  did  not  si)are  the  Turks  who  were 
wounded.  Being  requested  by  the  commander-in-chief, 
after  the  surrender  of  Cairo,  to  afford  them  assistance,  I 
had  them  all  collected  in  a  mosfpie,  to  dress  V\oni  more 
conveniently. 

"■A  large  proportion  of  the  Turks  who  were  attacked  by 
this  disease  fell  victims  to  it.  We  nm.v  attribute  these  un- 
fortuiuite  results  to  the  bad  treatment  to  wliich  tliey  were 
subjected,  and  to  the  privations  v.iiich  tley  u'iderwent 
during  the  siege." 

The  following  remarks  on  the  pathology  of  tlie  disease 
are  interesting : 

"The  effects  of  this  disease  appeared  on  opening  the 
dead  bodies.  We  found  a  reddish  serum  in  the  cavities  of 
the  chest  and  abdomen,  inflation  and  ■.nflammation  of  the 
intestines;  obstruction  of  th{>  liver  and  spleen;  Ihe  gall 
bladder  contained  but  little  bile,  and  this  was  thick  and 
of  a  black  color:  gangrenous  affections  were  seen  in  differ- 


EGYl'T.  215 

ent  parts  of  the  body,  and  csY)ecially  in  tlie  ad* pose  sub- 
stance.  The  organs  of  the  thorax  presented  notlung  re- 
markable; all  the  soft  parts  of  the  wounded  limb  were 
ganjirenous,  and  emitted  a  nauseous  and  fetid  odor.  Two 
hundred  and  sixty  out  of  six  hundred,  who  were  wounded 
at  the  seige  of  Cairo  and  the  taking  of  Boulaci,  died  with 
a  eomijlication  of  this  disease."  ' 

An  exhaustive  review  of  Ur  Larrey's  work  is  given  in 
the  I'Jdiiihiirg  Medical  Bci'icic^^  and  the  epidemic  de- 
scribed by  him  is  commented  upon  by  Gamgee  in  his 
treatise  on  yellow  feA'er.^"-^  AVe  find 'no  mention  of  the  in- 
cident in  other  works  on  epidemiolcgy. 

A  curious  passage  occurs  in  Dr.  Larrey's  book,  which 
throws  some  light  upon  the  peculiar  beliefs  of  the  time.  It 
seems  that  before  Napoleon's  army  left  Syria,  a  great 
numb(>r  of  the  soldiers  were  attacked  by  the  plr.gue.  "It 
seldom  attacked  the  wounded  men,"  observes  the  doctor, 
"and  scarcely  an  instance  occurred  of  anyone  bemg  affect- 
ed by  it  whilst  the  wounds  were  in  a  state  of  su])puration, 
though  man}'  were  infected  as  soon  as  the  wonnds  were 
healed." 

According  to  the  Edlnhurff  Medical  Journal  of  1804 
(page  217),  the  above  observation  was  made  by  all  .writers 
on  the  plague,  and  it  was  currently  reported  at  the  time 
that  Europeans  Avho  were  established  in  Egypt  and  Syria 
guarded  themselves  from  this  pest,  or  at  least  seemed  to  be 
less  disposed  to  be  affected  by  it,  by  means  of  ha))itual  ill- 
ness. 

Whether  the  sporadic  outbreak  depicted  by  Baron  Lar- 
rey  was  yellow  fever  or  not,  we  cannot  say,  as  no  corrobo- 
rative evidence  can  be  found  to  sustain  the  eminent 
Frenchman's  views;  but  if  the  disease  was  yellow  fever,  it 
certainly  could  not  have  sprung  from  the  soil  or  from 
climatic  conditions,  but  must  have  been  imported  by  the 
French  war  vessels,  either  from  Spain,  whore  the  disease 
was  widespread  in  1800,  or  from  Mexico  or  the  West  In- 
dies, where  yellow  fever  was  ever  present  in  the  past. 
From  the  West  Indies  or  Mexico  to  Egypt  is  a  long  jour- 

*U804,  p.  213. 

*"  Gamgee:    Yellow  Fever  a  Nautical  Diseases,  1879,  p.  105. 


?16 


HISTORY    OF    YELLOW    FEVER. 


noy,  to  ])('  sure,  Inii  Slcf/fjiiij/ia  have  been  known  to  live  for 
months  in  tlio  holds  of  vessels  and  to  be  just  as  active  in 
ino(iilatin«i"  tlie  liernis  of  yellow  fever  on  being  liberated 
as  if  tliev  were  fresh  from  the  nidus  of  infection. 


I 


FERNANDO-PO. 

Description. 

Feniaudo-Po  forms  one  of  a  group  of  four  ii-hmds  in 
the  Bight  of  Biaffra,  West  Africa,  20  miles  off  the  coast  of 
Guinea.  Tlie  other  islands  of  this  group  are  Annobon, 
Princess  Island  and  St.  Thomas.  The  two  last  named  be- 
long to  England;  the  others  to  Spain.  Fernando  Po  and 
Annobon  were  discovered  bv  the  Portugese  navigator, 
Fernao  de  Poo,  in  149(5,  and  annexed  to  the  croAvn  of  Por- 
tugal. The  islands  were  ccdonized  by  that  country  in 
1592,  but  proving  an  unprofitable  venture,  were  ceded  to 
Spain  in  1777.  In  1827,  the  islands  had  become  merely  a 
nominal  Spanish  possession.  English  intrigue  having  al- 
most absorbed  them ;  but  Spain  suddenly  woke  up  to  the 
state  of  things  and  filed  a  vigorcms  protest  against  the 
machinations  of  the  English  court.  Tlie  British  Govern- 
men,  balked  in  its  scheme  to  surreptitiously  annex  the 
islands,  offered  to  purchase  them  for  1300  000.  This 
proposition,  after  being  considered  ami  debated  for  nearly 
fourteen  years,  was  finally  rejected  by  the  Corte-  in  1841. 
Eniiland  reluctantly  disgctrged  the  prize,  recalled  its  gov- 
ernor-general and  tlu^  Spanish  flag  has  been  floating  over 
the  islands  to  this  day.  But  John  Bull,  wh(»'^e  hind- 
grabbing  policy  has  Avon  for  him  a  niche  in  the  hall  of 
di])lomatic  intrigue,  no  doubt  still  looks  with  covetous 
eyes  upon  those  two  islets  and  Ave  may  Avake  u])  one  of  tlu^se 
fine  mornings  and  read  of  England  being  sole  )wner  and 
dictator  of  this  quartette  of  islands  nestling  like  huge 
rocks  deep  in  the  Bight  of  Binffra. 

The  population  of  Fernando  Po  is  about  20,000,  being 
a  mixture  of  negroes,  Portugese  and  other  Europeans. 
The  capital  is  Clarence  Town 

YELLOW  FEVER  YEABS. 

1792;  1812;  1829;  1839;  1857:  l.%0 ;  18G2;  1804;  18G0; 
1868;  18G9. 


218  HISTORY     OF    YKLLOW     FEVKR. 

NUMMARY  OF  EPIDE?.nCS. 

1792. 

Th3  first  recorded  invasiou  of  yellow  fever  at  Fernaudo 
Po  took  place  iu  1792,  Xo  details  are  given  bj  our 
authoritv."^"^' 

1812. 

In  the  bejiinning  of  the  year  1812,  the  disease  was  im- 
ported by  three  vessels,  the  Carldad^  the  Isabel  aud  the 
Perla.  We  have  becu  unable,  beyond  ascertaining-  the 
i5ames  of  the  vessels,  to  cull  any  data  concerning  this  out- 
break, as  our  authority'-^'^  has  unfortunately  neglected  to 
touch  upon  this  important  detail.  The  ferer  was  either 
imported  from  the  West  Indies,  as  the  names  of  the  ves- 
sels suggest  that  they  sailed  under  the  Spanish  flag  and 
the  commercial  relations  between  Fernando  Po  and  the 
West  Indies  Avere  frequent  aud  extensive;  or,  which  is  no 
doubt  still  more  probable,  these  vessels  came  from  Spain 
or  Portugal,  stopped  on  their  way  to  Fernand(»  Po  at 
Sierra  Leone,  aud  were  infected  while  at  anchor  in  one  of 
the  harbors  of  that  notorious  focus  of  yellow  fe*.  er  propa- 
gation. 

Xo  mention  is  made  in  the  account  of  this  outbreak  of 
the  cas(^s  of  mortality  at  the  island,  but  the  statement  is 
given  that  the  total  luortality  on  board  the  three  vessels 
aggregated  42,  including  the  surgeou-in-chief  of  the  Pcrla. 
'  In  this  connection,  it  is  to  be  dei)b>red  that  such  an 
authority  as  Dr.  Pey,  who  writes  so  minutely  and  inter- 
estingly of  the  history,  climate,  topography  and  natural 
resources  of  Fernando  Po,  did  not  take  the  trouble  to  give 
the  details  of  this  "epidemic" — as  he  terms  it  and  thus 
add  additional  historical  value  to  his  v\-ork.  Put  he  little 
dreamed  that  this  infornuition  would  be  of  immense  value 
to  the  compiler  of  this  history  and  overlooked  the  impor- 
tant function.  This  is  only  one  of  the  million  illustrations 
of  that  trite  Americanism,  "everv  little  bit  Li-lps." 


""  Berenger-Feraud,  loc.  cit.,  p.  60. 

"Rev:     Archives   de  Medecine  Navale,    Paris,    1878,    vol.    29, 
•    p.  407. 


FERNANDO-PO.  219 

1829. 

After  a  lull  of  fifteen  j^ears,  yellow  fever  again  made  its 
appearance  at  Fernando  Po.  This  time,  the  infection  is 
indisputably  traced  to  Sierra  Leone.  Tlie  facti*  are  as 
follows:'-'-    "' 

At  the  inception  of  the  epidemic  of  yell(.>w  fever  which 
decimated  Sierra  Leone  in  1829,  the  British  ship  Ed€)i 
was  anchored  in  the  roads,  off  Freetown,  and,  as  was  the 
usual  custom  in  those  days,  her  officers  were  occasionally 
on  shore.  On  the  3d  of  iMay,  a  man,  who  two  days  previ- 
ously had  come  aboard  the  IJdcn  from  Freetown,  was 
taken  ill  with  yellow  fever  and  died  on  the  Tth.  On 
May  5,  two  days  after  this  man  had  been  taken  ill,  a  mid- 
shijjman,  who  had  been  on  board  a  detained  vessel  of  which 
lie  had  charge,  returned  on  1)oard  tlie  Edcii.  He  had  been 
taken  ill  on  April  29th  and  died  the  da}-  following  his  re- 
moval to  the  Eden.  On  May  12,  some  other  cases  occurred 
among  the  ship's  crew,  and  on  the  20ih  of  ^lay  the  Eden 
left  for  Fernando  Po.  She  arrived  at  her  destination  on 
the  11th  of  June,  having  lost  during  this  period  25  officers 
and  men.  She  was  thoroughly  cleaned,  fumigated,  and 
whitewashed  at  Fernando  Po,  and  then,  re-embarking  her 
coiivalescents,  sailed  for  Princess  Island  on  the  9th  of 
July.  After  the  departure  of  the  Eden,  the  disease  broke 
out  at  Fernando  Po,  where  it  prevailed  with  great  severity. 
The  mortality  Avas  not  very  great. 

During  the  voyage  from  Fernando  Po  to  Princess 
Island,  the  fever  reappeared  aboard  the  Eden,  and  the  mor- 
tality was  considerable.  The  fever  continued  to  rage  till 
August,  and  the  Eden  lost,  between  the  months  of  May 
and  December,  110  persons  out  of  a  complement  of  IGO. 

At  the  same  time  that  tlie  Eden  carried  the  disease  to 
Fernando  Po,  the  C/utnipion  sailed  from  Sifrra  Ltone  with 
several  bad  cases  of  fever  on  board  and  arrived  at  Clarence 
Town  three  days  after  the  Eden.  As  on  board  the  Eden, 
the  fever  which  was  ravaging  the  Champion  was  of  a  most 
malignant  type  and  the  landing  of  her  sick  at  the  little 

"^Bryson:    Report  on  the  Climate  and    Principal    Diseases    of 
the  African  Stations,  p.  39. 


220  HISTORY     OF     VELT.OVV     FEVER. 

town  added  fuel  to  the  dormaut  fires  of  pestileuce  already' 
kindled  by  the  Eden. 

Aecoi'din<i'  to  Brvson,'^^  from  the  time  it  was  first  occu- 
pied by  Europeans,  Fernando  Po  proved  a  perpetual  hot- 
bed of  disease.  Most  of  the  people  who  were  located  at  Clar- 
ence Cove  during  the  years  1827  and  1828,  were  attacked 
with  fever  or  ulcer,  and  cut  off  in  the  course  of  a  few 
months  after  their  arrival.  But  as  the  medical  returns 
only  commence  subsequently  to  the  {'.rrival  of  the  Eden 
and  Champion,  the  accounts  respecting  the  fevers  which 
pri^-ailed  ]»revi(;usly,  can  only  ])e  «»leaned  from  other 
sources,  which,  althouj^h  sufliciently  authentic  us  to  their 
fatality,  do  not  give  the  information  requisite  to  follow 
them  out  in  full  detail.  That  it  had  acquired  the  charac- 
ter of  l)einii'  a  most  unhealthy  locality,  the  nundx-r  of  medi- 
cal officers  wlio  accompanied  the  marines  and  mechanics 
sent  out  in  the  Champion,  sufficiently  attests;  and  it  is  a 
melancholy  reflection  that  only  two  out  of  the  three 
reached  the  auchorame  in  time  to  have  their  bones  deposited 
in  that  desolate  grave-yard. 

1839. 

Yellow  fever  was  again  brought  to  Fernando-Po  in 
1839  and  was  ([uite  severe.^^ 

1857. 

In  1857,  yellow  fever  again  invaded  Fernando  Po.^"* 

1800. 


A  sliij)  from  the  West  Indies  is  incriminated  in  the  in- 
fection of  Fernando-Po  in  1860.  The  epidemic  was  quite 
severe. '"^^ 


"  Bryson :    Loc.  cit.,  p.  '49. 

"^Bryson:     Loc.  cit.,  p.    .. 

"'Huard:     Theses   de   Montpollier,   1868. 

»*Yglesias  y  Pardo  (Ferrco),  1874,  p.  12. 


i 

I 


FERNANUO-PO.  221 

1862. 

In  the  early  days  of  July,  18(52^  yello\y  feyer  broke  ont 
at  Feriiando-lV)  aiiioiii;'8t  the  vSpanisli  population.  The 
disease  was  first  obseryed  in  one  oi'  two  conyict  hulks  in 
Clarence  Eay  and  spread  rapidly  to  the  conyicts  and  sail- 
ors in  the  otlier  hulk,  ^yhenee  it  attacked  the  soldiers  coni- 
posiUi>  the  small  juarrison  and  the  mechanics  on  shore. 
In  a  yery  short  time,  7G,  out  of  200  composing  the  entire 
purely  Spanish  population,  were  carried  away  by  the  dis- 
ease. A  remarkable  phase  of  this  epidemic  is  that  it  Ayas 
confined  exclu?iyely  to  the  Spaniards  of  unmixed  blood 
and  did  not  attack  the  colored  (^'uban  settlers  {cinanci- 
/>«Jo.s'),  althouii'li  the  latter  nursed  the  sick  and  yisited 
freely  all  the  foci  of  infection.  This  proyi^s  conclusiyely 
I  hat  the  disease  was  the  genuine  West  Indian  yellow 
feyer,^  lor  the  cniaiicipados,  who  cyi(hntly  had  experi- 
enced an  attack  in  their  own  country,  escaped  unscathed. 

The  .scsurce  of  importation  is  dispuicd.  Some  authori- 
ties claim  that  the  inter-colonial  mail  steamer  Jxctricrcr 
brought  the  disease  from  Bonny,  Af]'ica,  while  Bourru, 
Berenger-Feraud  and  Yglesias  y  Pardo^"  assert  that  the 
English  ship  Fcrrol,  wliich  left  Hayana  on  June  10,  1802, 
with  200  eiiKiiiciixKJo.s,  should  be  looked  upcui  as  the  nidus 
of  infection. 

The  French  ship  La  Zclcc  was  infected  at  Fernando-Po 
in  1802  and  brought  the  disease  to  Grand  Bassam  (q.  y. ), 

1864. 

Another  outbreak  of  yellow  feyer  occurred  at  Fernando- 
Po  in  1861.     No  details  are  giyen.'''* 

180G. 

The  ei)idemic  of  1866  c(»ntinues  the  cliain  of  importa- 
tion. 

On  August  2,  18()6,  the  sliip  Rosa  (hi  Turia,  having  on 


"Bourru:     Geographie  des    Epidemics  de  Fievre  Jaune,  p.  7; 
Berenger-Feraud,  p.  139;  Yglesias  y  Pardo,  loc.  cit.,  p.  12. 
"'  Berenger-Feraud,  loc.  cit.,  p.  141. 


22?  HISTORY     OF    YELLOW     FEVER. 

board  about  200  couvicts,  sailed  from  Havana  for  Fernan- 
do-Po,  wbich  Avas  theu  a  penal  settlement,  arriving  at  her 
destination  on  October  3  of  the  same  year.  During  the 
two  months  the  vessel  took  to  make  ti^e  trip,  yellow  fever 
prevailed  to  a  more  or  less  extent  among  Ler  crew  and 
living  cargo,  but  this  did  not  deter  those  in  conanand  of 
the  vessel  from  landing  the  200  convicts  on  the  island.  A 
disastrous  epidemic  broke  out  shortly  aftervrards,  which 
caused  much  mortality  on  the  island  and  lasted  until  the 
end  of  November. 

Again  we  find  occasion  to  criticize  the  excellent  and 
astute  Dr.  Eey,^^  to  whom  we  are  indebted  for  the  above 
narration  of  the  epidemic  of  ISO'G.  The  genial  doctor  de- 
cries the  attempts  made  by  certain  chroniclers  of  the 
period  to  hide  the  true  nature  of  this  epidemic  under  the 
name  of  bilious  pernicious  fever,  but  overlooks  the  most 
important  information,  the  statistics  ot  the  outbreak.  He 
informs  us  that  the  Perle  lost  ten  of  her  crew,  but  is  mute 
as  to  what  happened  to  the  uufortuimie  inhabitants  of  the 
island. 

18CS. 

On  September  24,  1808,  the  ship  General  Alia  arrived 
at  Fernando-l*o  from  Havana. '^'^  A  few  days  after  the 
vessel'^'  arrival,  yellow  fever  broke  out  on  the  inland,  but 
was  not  very  severe. 

1869. 

On  ^NFay  22,  1809,  the  transport  San  Franeisco  dc  Borja 
arrived  at  Fernando-Po  witli  250  men  deported  from  Ha- 
vana.^"^'"^  Yellow  fever  prevailed  to  some  extent  en  board 
the  vessel,  but  no  mention  is  made  of  the  disease  having 
reached  shore. 


*Rey:    Archives  de  Medecine    Xavale,    Paris,    1878,    vol.    29, 
p.  407. 

""Bourru:     Geographie   des   Epidemies   de  Fievre  Jaune    (Bor- 
deaux, 1883),  p.  7. 
^°*  Penard  and  Boye:    Annales  d'Hygiene   et   de    Medecine    Col- 
oniales,  1904,  vol.  7,  p.  509, 


FRENCH   GUINEA. 

Description. 

Freucli  Guinea,  as  the  name  implies,  is  a  French  col- 
onial possession  on  the  west  coast  of  Africa,  bounded  on 
the  north  by  Seneiiambia,  on  the  east  by  the  Ivory  Coast, 
on  the  soutli  by  Liberia  and  bierra  Leone  and  on  the  west 
by  the  Atlantic  Ocean.  Capital.  Conakry,  situated  on  the 
Tombo  Peninsula,  Conakry  is  of  recent  ori«iin.  It  was 
founded  in  1889  and  has  at  present  a  population  of  about 
12,000,  principally  natives.  The  European  population  is 
about  350,  but  is  hardly  275  during'  the  sickly  season, 

YELLOW  FEVER  YEAR, 

1901. 

SUM^IARY, 

French  Guinea  was  in  imminent  danger  of  being  invaded 
by  vellow  fever  during  the  epidemics  at  Senegal  in  1900 
aiid  1901  and  at  Grand  Bassam  in  1902  and  1^03 ;  but  save 
for  a  single  case,  observed  December  21,  1901,  at  {'ouakry, 
tlie  territory  seems  to  have  been  exempt  fvoui  tlie  disease. 
It  is  not  known  definitely  whethei'  or  net  isiegoiiii/ia 
Calopus  breed  at  Conakry,  as  no  special  observations 
Iiave  been  made  in  that  direction,  but  tlie  fact  that  this 
solitary  instance  of  the  appearame  of  yellow  fevei-  iri  the 
locality  did  not  cause  a  general  eruption,  may  be  taken  as 
a  tentative  proof  of  the  non-existence  of  tlie  in,s;'ct  there. 

The  case  mentioned  above  was  pjob^ddy  iinjjorled  from 
Senee:al. 


GAMBIA. 

Dcscripticn. 

■riui.ihia  is  a  British  colony  of  Western  Africr,  consist- 
i''o-  (..[•  the  ishmd  of  St.  ^lary,  the  town  of  IJatLnrst  (the 
caj  it.']  )  and  other  minor  dependencies.  Area;  \>J  square 
Mih.'s     ropulation  about  15,000. 

YELLOW  fp:vek  YEAKS. 

170;^;  17()4;  1700;  1708;  1700;  1778;  1825;  1828;  1837; 
1850;  1800;  1805;  1800;  1878;  1884;  i:)00. 

SUMMARY  or  EPIDEMICS. 

1703. 

Tlie  first  outbreak  of  velloAV  fever  in  Gambia  (17G3)  is 
coincident  with  the  tirt-t  appearance  of  tie  di-ease  in 
Si(  ri-a  Lecnie  and  was  no  doultt  importevl  fr  <m  thut  colony, 
wliich  since  then  has  ])layed  such  a  notorious  role  in  radi- 
ating the  scouroe  to  the  otlierwise  lieaitliy  stations  of  the 
West  African  coast  and  the  near-by  insular  colonies.  In 
iieaily  every  instance,  tlie  cliain  of  imitoi-tatioii  iias  been 
the  sauie:  Sierra  Leone,  infected  by  ships  from  the  West 
Indies  or  South  America,  lias  contaminated  (Jambia; 
(lamltia  has  sent  tlie  disease  to  Sene.i.»al,  and  the-  latter 
colonv  has  ]tro])a.iiate(l  the  pestih  nee  to  other  African  set- 
tb'meiits. 

It  is  unfortunate  that  no  detailed  accounts  exist  of  these 
first  outbreaks  on  the  African  coast.  Our  authority^  iy 
(h'])h;r;ibh'  unc(;miiiuuic;iti\'e  on  thi*^  score. 

1704. 

Yellow  fever  aj:;ain  invaded  Gambi;'  in  1701.  Only  a 
mere  mention  of  tlie  fact  is  made  by  our  source  of  in- 
forination."- 


'  Berenger-Feraud,  p.  53. 
Mbid.,  p.  53. 


GAMBIA.  S25 

liOO. 

Anotlier  eruption  in  Gambia,^     No  details  cljtainable. 

17G8. 

The  outbreak  of  17G8  furnishes  us  with  tlie  first  intelli- 
gent account  of  yellow  fever  in  Gambia.  According  to 
Lind,^  in  August,  1708,  the  British  ship  McrVm,  while  in 
the  Gambia  l\iver,  lost  several  of  Ler  crew  from  yellow 
fever.  Lind  would  have  us  believe  that  the  fever  was 
caused  by  effluvia  rising  from  freshly  cut  timber,  but  as 
yellow  fever  was  then  reiguiug  at  Batliurst,  the  capital  of 
Gambia,  where  the  Merlin  stopped  on  its  voyage  up  the 
Gambia,  the  source  of  infection  is  clearly  established. 
How  the  fever  got  to  Batliurst,  is  left  to  conjecture. 

17C9. 

Yellow  fever  prevailed  in  Gambia  in  July.  1769.  In  the 
mouth  of  August  following,  the  British  warships  Weasel 
and  Hon  lid  were  contaminated  at  Batliurst  and  Ljst  many 
of  their  crews.    The  disease  is  sa-id  to  have  been  severe.*" 

1778. 

In  1778,  yellow^  fever  was  almost  general  on  the  western 
coast  of  Africa.*^  The  memorable  ep  deuilc  of  Senegal, 
about  which  so  much  has  been  written,  occurred  that  year. 
Gambia  was  infected  by  Sierra  Leone  and  sutff^red  cou- 
siderablv. 

1825. 

A  lull  of  nearly  fifty  years  took  place  before  yellow^  fever 
again  manifested  itself  in  Gambia.  Although  t^ie  disease 
prevailed  in  Sierra  Leone  in  1815,  1816  and  1823,  it  does 
not  appear  to  have  reached  Gambia ;  but,  in  1825,  it  was  no 

nbid.,  p.  54;   Schotte. 

*Lind:    Diseases  of  Hot  Climates,  vol.  1,  p.  250. 

"  Berenger-Feraud,  p.  55. 

'  Berenger-Feraud,  p.  56;   Schotte. 


226  HISTORY    OF    YELLOW    FEVER. 

doubt  imported  from  Sierra  Leone.  The  diseas;'  caused 
mucli  mortality  at  Bathurst  and  the  surrounding  country, 
three- fourths  of  the  cases  terminating;  fatally."  Bryson 
(pao-e  33)  informs  us  that  a  detachment  of  one  hundred 
and  eight  men  landed  at  Gambia  in  1825;  in  the  course 
of  four  months  seventy-four  died  of  fever,  and  thirteen 
of  other  diseases,  leaving  only  twenty-one  alive 

1826. 

The  fever  re-appeared  in  Gambia  in  1826  and  was  very 
severe.    As  in  1825,  the  majority  of  those  attacked  died.^ 

182S. 

The  epidemic  of  1828  ravaged  the  whole  African  coast 
from  Benin  to  Gambia.^    It  was  not  severe  in  Gambia. 

1837. 

After  an  absence  of  nearly  ten  year«!,  yellow  fever  made 
its  appearance  with  renewed  virulence  in  Gambia  in  1837. 
The  epidemic  was  attended  with  a  high  death-rate.^*' 

1859. 

Yellow  fever  prevailed  at  McCarthy  Island,  in  the 
Gambia  River,  in  1859,  according  to  Berenirer-Feraud 
(page  136). 

1860. 

Yellow  fever  re-appeared  in  Gambia  in  18G0.  The  dis- 
ease does  not  seem  to  have  manifested  itself  on  Hie  main- 
land, but  prevailed  on  ^McCarthy  I;-larid,^^  in  the  Gambia 
Eiver,  127  miles  from  its  mouth,  inhabited  i^rincipally  by 
liberated  slaves. 


'Second  Report  on  Quarantine  (1S52),  p.  288. 

*  Second  Report  on  Quarantine,  p.  288. 

*  Berenger-Feraud,  p.  105. 
"  Berenger-Feraud,  p.  105, 
"  Berenger-Feraud,  p.  136. 


CAMBIA  227 

1885. 

Another  outbreak  of  yellow  fever  caused  much  mortality 
in  Gambia  in  1865.  Our  authority^^  does  not  furnish  any 
details. 

18o6. 

Yellow  fever  reigned  with  much  virulence  at  Bathurst 
in  186G.  One-half  of  the  European  population  perished.^^ 
No  official  account  of  this  epidemic  exists,  as  tbe  facts 
were  suppressed  by  the  British  GovernmeLt,  for  commer- 
cial reasons,  and  only  reached  the  public  through  a  private 
letter  published  in  the  London  Times.  An  investigation 
was  demanded  by  the  public,  but  dilat(!ry  measures  by  the 
authorities  soon  caused  the  episode  to  be  forgotten. 

1872. 

In  1872  yellow  fever  was  quite  severe  at  Bathurst.  Out 
of  a  white  population  of  31,  there  were  13  deaths.^'* 

1878. 

The  yellow  fever  epidemic  of  1878  may  truly  be  called 
a  pandemic.  A  reference  to  our  chrorological  tables  will 
show  that  it  prevailed  on  both  sides  of  the  Atlantic,  on  the 
Pacific  coast  and,  for  the  first  and  last  time  in  the  history 
of  the  disease,  a  case  was  imported  to  London  and  died. 

The  official  records  of  Gambia  are  silent  regarding  the 
prevalence  of  yellow  fever  in  that  colony  in  1878,  but 
Berenger-Feraud*^  claims  that  the  facts  were  suppressed 
and  that  the  disease  was  present  that  year,  in  a  mild  form. 
The  noted  author  takes  issue  with  Lejemble,  who  tries  to 
prove  that  the  lever  could  not  have  been  in  Gambia  in 
1878,  because  that  country  maintained  a  strict  (|uarantine 
against  Senegal  and  that  the  oflficial  reports  do  not  men- 
tion yellow  fever  at  all.    Berenger-Fevaud  cites  :n  refuta- 

"  Berenger-Feraud,  p.  141. 
"London  Lancet  (New  York),  1867,  p.  60. 
"Lejemble:    Theses  de  Paris,  1882,  No.  U,  p.  22. 
^°  Berenger-Feraud,  p.  154. 


228 


HISTORY    OF    YELLOW    FEVER. 


tion  of  this  ass^rtiou  the  faot  that  in  1872  yellow  fever 
raged  tiercely  iu  Sierra  Leone  and  GaiMbia,  yet  the  official 
records  of  the  colony  are  a  i)erfect  blank  regarding  this 
outbreak,  ^^'e  can  verily  concur  Avlth  this  eminent  chron- 
icler, for,  by  referring  to  our  own  account  of  the  epidemic 
in  Gand)ia  in  18()(>,  it  will  be  seen  that  tlie  authorities  sup- 
pressed the  fact  that  a  virulent  eruption  of  yellow  fever 
was  causing  great  mortality  at  Bathurst  and  ihe  sur- 
rounding country  and  it  was  only  when  the  LoniJoii  Times 
received  private  information  concerning  the  state  of  affairs 
and  gave  the  matter  ]»nblicity,  that  an  "investigation''  was 
ordered  by  the  British  Government. ^'^ 

18S4. 

In  June,  1884,  yellow  fever  Avas  present  in  Sierra  Leone; 
in  August,  it  invaded  Gambia  ^"  Here  we  And  the  same 
old  story  of  importation  from  Sierra  Leone.  The  outbreak 
does  not  appear  to  ha^e  been  severe. 

1900. 


The  year  1900  furnishes  the  last  recorded  appearance 
of  yelloAV  fever  in  Gaud)ia.  A  s])oradic  outbreak  occurred 
at  Bathurst,  but  the  disease  did  not  gain  a  very  disastrous 
footing,  as  the  white  settlers  fl<?d  at  the  first  signs  of  the 
feA'er,  seeking  refuge  on  board  flie  iTrt-sj^^t^atf?  bound  for 
European  ports.^'^  As  usual,  no  offi(-ial  records  of  tht  out- 
break could  be  obtained. 


^"London  Lancet  (New  York  edition),  1867,  p.  60. 

"  Berenger-Feraud,  p.   190. 

"  U.  S.  Public  Health  Reports,  1900,  vol.  15,  p.  2025. 


GOLD    COAST. 

Description 

Gold  Coast  is  a  British  crown-eolony  in  West  Africa, 
between  the  Slave  Coast  and  the  Ivory  Coast,  nnd  com- 
prises that  part  of  the  coast  of  Guinea  which  extends 
from  50°  W.  to  20°  E.  loni^itiide,  stretching  inland  to  an 
averaj>e  distance  of  fifty  miles  The  climite  is  very  un- 
healthy. The  chief  forts  and  settlements  are  Cape  Coast 
Castle,  Elmina,  Accra,  Axim,  Dixcove  and  Arnamabee. 
Estimated  population,  1,500,000,  of  whom  only  about  200 
are  Europeans. 

YELLOW  FEVER  YEARS. 

1778;  1786;  1822;  1823;  1824;  1852;  1853;  1854;  1855; 
1856;  1857;  1862;  1898. 

SUM^IARY  OF  EPIDE^nCS. 

1778. 

Althouj2,h  the  Gold  Coast  was  colonized  by  tl  e  Portu- 
gese in  the  early  years  of  the  seventeenth  century,  the  first 
recorded  invasion  of  the  territory  by  yellow  fever  took 
])lace  in  1778,  when  an  epidemic  wave  of  the  disease  swept 
almost  the  whole  West  African  coast  occupied  by  Europe- 
ans.   No  details  of  the  epidemic  are  i]i;iven.^'' 

1786. 

Another  outbreak  of  yellow  fevi  r  took  place  in  1786, 
but  the  original  source  of  infectioji  i^  not  given.  It  is 
stated,  however,  that  the  ship  E.vperiment,  v/liich  had  been 
sent  by  the  British  Government  to  assist  in  the  establish- 
ment of  trading  places,  lost  many  of  her  men  by  a  "malig- 
nant fever."^^ 

"  Berenger-Feraud,  p.  56. 

^  Berenger-Feraud.p.  58;  Valentin,  p.  77. 


230  HISTORY    OF    YELLOW    FEVER. 

1822  to  1824. 

No  mentiou  of  yellow  fever  havinia;  prevailed  along  the 
Gold  Coast  is  made  from  1786  to  1S22.  According  to 
BrysoD,-^  the  mortality  was  great  among  the  detachments 
which  arrived  at  Cape  Coast  Castle  in  1822,  1823  and  1821. 

1852  to  1857. 

In  1852  yellow  fever  was  imported  to  the  GoM  Coast 
and  sporadic  cases  were  observed  e\'ery  year  from.  1852  to 
1857.  The  Government  records,  following  the  nsual  cus- 
tom, give  no  detail  of  this  series  of  outbreaks,  and 
Berenger-Feraud--  disposes  of  the  matter  ?n  a  few  words 
only. 

1862. 

Yellow  fever  was  almost  general  along  the  T\cst  coast 
of  Africa  in  1862.  The  Gold  Coast  suffered  considerably. 
(Berenger-Feraud,  page  139.) 


GOREE. 

{See  Senegal.) 

GUINEA. 

{See  Benin,  Dahomey,  French  Guinea,  Gold  Coast,  Grand 
Basani,  Ivory  Coast,  Lagos,  and  Sierra  Leone.) 

"Bryson,  loc.  cit.,  p.  33. 
"=  Page  122. 


IVORY  COAST. 

Description. 

The  lYory  Coast  is  a  part  of  the  coast  of  Gumea,  be- 
tween Cape  Appolonia  and  Cape  Palmas,  West  Africa, 
Its  western  portion  belongs  to  Liberia;  its  eastern  half, 
now  counted  as  part  of  the  Gold  Coast  (q.  v.),  ?s  shared 
between  England  and  France.  The  French  colony  com- 
prises three  fortified  centres :  Grand  Bassam,  Assinie  and 
Dabou.  The  first  two  are  situated  at  the  mouth  of  the 
Grand  Basam  Eiver,  on  a  narrow  tongue  of  land  between 
the  sea  and  a  shallow  lagoon.  Dabou  is  sixty  miles  from 
Grand  Bassam.  Since  the  date  of  their  establish- 
ment, these  colonial  towns  have  been  visited  nine  times 
by  yellow  fever.  In  every  instance,  the  disease  was  im- 
ported. 

YELLOW  FEVEE  YEAKS. 

1852;  1857;  1862;  1863;  1899;  1902:  1903;  1901;  1905. 
SUMMARY  OF  EPIDE:\[ICS. 

1852. 

In  1852,  many  localities  on  tlie  CJulf  of  Guinea  were  in- 
vaded by  yellow  fever.-^  At  Grand  Bassam  the  mortality 
was  over  fifty  per  cent,  among  the  French  troops  stationed 
at  that  post. 

1857. 

Grand  Bassam. 

Sporadic  cases  of  yellof  fever  began  to  be  observed  at 
Grand  Bassam  in  February,  1857.  The  disease  pursued 
an  uneventful  course  until  April,  when  it  seemed  to  have 
died  out.     About   the   middle   of   April,     the    >;+eamship 

^  Berenger-Feraud,  p.  122. 


232  HISTORY    OF    YELLOW    FEVER. 

P(in(ir,fa  arrived  from  France,  having  on  board  many  col- 
onist*^ Avlio  liad  been  employed  to  work  at  the  town  factory. 
One  man  came  on  shore  on  April  15,  was  taken  sick  the 
next  day,  and  died  on  the  19th.  Fifteen  days  later,  three 
more  colonists  landed.  They  were  all  taken  ill  and  died 
between  the  12th  and  IGth  of  ^Nlay.  At  abont  the  same 
time,  a  soldier  arrived  from  Dabou,  was  taken  ill  and  died. 
These  new  cases  revived  the  epidemic  and  many  who  had 
previously  l)een  spared  were  attacked  and  died. 

During  the  revival  of  the  epidi'mic,  the  gunboat  La 
Tourmcnte  arrived  near  Grand  Bitssam,  but  could  not 
reach  the  town  on  account  of  shallow  water.  The  Cap- 
tain was  rowed  to  shore,  contracted  the  disease  and  died 
during  the  first  days  of  June. 

AVe  have  no  data  concerning  the  mortality  among  the 
natives,  but  the  fatalities  among  the  Avhite  colonists  was 
excessive,  for,  out  of  a  population  of  GG,  there  were  22 
deaths.2^ 

The  disease  did  not  spread  to  the  other  ports  of  the 
Ivory  Coast,  with  the  exception  of  two  imported  cases  at 
Dabou. 

Dahou. 

In  IS.")",  two  employes  of  a  comr;ierc:al  house  at  Grand 
Bassam  went  on  a  mission  t>  Dab;.u.  Shortly  after  their 
arrival,  the  men  were  almost  simuUaneously  at  acked  by 
yellovr  fever  and  died.     Xo  new  cases  resulted. 

1802. 

The  Epidemic  on  Board  the  Dispatch-Boat  V Archer,  at 
(I rand  Basisam. 

In  ]iis  account  of  the  epidemic  of  18G2,  Sarrouille  gives 
more  elal>orate  details.-^  A  r-efereuce  to  ou"  chronological 
tables  will  show  that  yellow  fever  was  widespread  along 
the  west  coast  of  Africa  in  1862.    Rumors  of  the  existence 


"Salis:    Archives  des  Hopitaux  du  Senegal;  Sarrouille,  Theses 

de  Paris,  1869,  No.  150,  p.  14. 
=°  Sarrouille:    Theses  de  Paris,  1869,  No.  150,  p.  21. 


IVORY    COAST.  233 

of  the  disease  reached  Giaud  Bassam  as  early  as  the  mid- 
dle of  the  year,  but  it  was  not  until  November  that  the  first 
case  was  observed  in  the  dependency.  On  the  IGth  of  that 
month,  the  French  dispatch  l)oat  V Archer,  which  had  been 
infected  at  Saint  Paul  de  Loanda,  by  communicating  Avith 
the  Diulniath^  arrived  at  Grand  Bassam  and  lai-ded  one 
white  and  ten  native  sailors.  The  white  sailor  was  taken 
ill  on  the  17th  and  died  on  the  20th,  with  unmistakable 
symptoms  of  yellow  fever.  None  of  the  blacks  who  were 
put  on  shore  at  the  same  time  contracted  the  disease. 

The  fever  did  not  spread  immediately  to  the  mainland, 
but  soon  broke  out  on  the  vessel.  On  November  26  the 
second  steersman  was  strickeri.  The  *:*ever  spread  rapidly, 
five  deaths  occurring:  between  November  28  and  J>ecember 
5.  Dr.  Sarrouille  himself  was  attacked.  On  December  7 
the  commandant,  thinking  tliat  VArdwr  had  been  infected 
at  (irand  Bassam,  took  on  board  all  the  white  inhabitants 
of  the  post  Avliich  could  be  si)ared,  and  sailed  foi-  Dabou. 
But  the  disease  continued  to  lage  ow  board  and  l)y  the  time 
the  A'essel  reached  Oabou,  December  12,  three  more  sailors 
had  succumbed.  The  men  who  had  ])een  taken  on  board 
at  Grand  Bassam  were  landed  at  ^)abou  and;  strange  as 
it  may  seem,  not  a  single  case  developed  among  (hem,  the 
pestilence  being  confined  exclusively  to  the  sailois.  This 
immunity,  in  our  opinion,  can  onh^  be  explained  on  the 
ground  that  the  landsmen  slept  on  d«  ck,  where  the  in- 
fected mos(|uitoes  had  no  access,  wliile  tlie  poor  sailors 
were  com])Llled,  in  the  performance  of  their  duties,  to  re- 
main below  decks  most  of  the  time,  A\here  they  were  un- 
protected from  the  bites  of  the  insects. 

On  Deceml)er  12tli,  when  tlie  ship's  mechanic  died,  only 
three  of  the  eleven  men  who  com])rised  the  comiih-ment  of 
V Archer  on  NoA'ember  2(1,  when  the  first  case  broke  out,  re- 
mained, namely,  the  captain.  Dr.  Sarrouille  and  a  sailor. 
It  was  thought  that  the  e])idemic  had  ceased  witli  the  death 
on  the  12th,  but  on  the  18th  tlie  \\(-V(y.c  captain,  whc;  liad 
nursed  his  comrades  throughout  the  terrible  ordeal  and 
had  seen  them  die  one  after  the  other,  was  takrr.  ill  and 
was  soon  added  to  the  list  of  victims.  It  will  tin  s  be  seen 
that,  out  of  a  crew  of  eleven,  we  have  <he  ao]>;dliug  record 
of  ten  attacks  and  nine  deaths,  Dr.  Sarrouille  beiuj?  the 


234  HISTORY    OP"     YELLOW     FEVER. 

only  one  who  survived  an  attack  and  the  sailor  ahove  men- 
tioned being-  the  only  member  of  the  crew  who  proved  im- 
mune to  the  pestilence. 

Grand  Bassarn. 

Cases  begin  to  appear  at  Grand  Eassam  shortly  after  the 
death  of  the  sailor  landed  from  V Archer.  The  outbreak 
was  quite  severe,  resulting  in  twelve  cases  and  s*x  deaths, 
out  of  a  white  population  of  eighteen. 

Assinie. 

The  European  population  at  Assinie  in  1802  consisted 
of  (n\\\  five  persons — the  governor,  the  resident  surgeon 
and  three  soldiers.-*^  About  'he  lOtli  of  December,  two  of 
the  soldiers  were  taken  ill  and  the  symptoms  diagnosed 
tis  yellow  fever.  Both  died  s  few  days  later.  The  gov- 
ernor and  the  surgeon  were  then  sacce'sively  attacked,  the 
latter  dying  on  the  27th.  The  former  recovered.  The  na- 
tives of  the  villages  contiguous  to  Assinie  suffered  severe- 
ly, but  in  the  town  proper  there  were  only  four  deaths 
among  the  blacks,  making  a  total  mortality  of  eight. 

General  Summary  of  the  Epidemic  of  lS6i. 

The  epidemic  which  began  at  Grand  Bas.sam  lu  Novem- 
ber, 1S()2,  was  one  of  the  most  virulent  on  record,  for  out 
of  27  Europeans  attacked,  18  died.  The  cases  and  deaths 
were  as  follows: 

Locality.  Cases.  Deaths. 

On  boiu-d  the  V Archer 10  '      9 

Grand  Bassam 12  (\ 

Assinie  (white  population  only  5) 10  8 


32  23 

The  combined  white  population  of  Grand  Bassam  and 
Assinie  amounted  to  23.    As  will  be  seen,  this  small  num- 

"  Sarrouille,  loc.  cit.,  p.  35. 


IVORY    COAST.  235 

ber  furnisbed  IT  cases  and  9  deatbs.  "'^be  most  appalling 
mortality,  however,  was  ou  board  of  V Archer^  y.here  ten 
cases  were  followed  by  nine  fatalities. 

The  disease  did  not  spread  to  Dabou.-^  •, 

18C3. 

Sporadic  cases  of  yellow  fever  appeared  at  Assinie  and 
Grand  Bassam  in  1863,  but  almost  entirely  among  the 
natives.  We  find  the  record  of  only  one  death  among  the 
Europeans  at  Grand  Bassam,  an  agent  sent  by  a  French 
commercial  house  to  est/iblish  a  factory  at  this  post.  He 
arrived  at  the  '"unhealthy  season*'  and  remaiued  three 
months  on  board  a  vessel  in  the  harbor.  During  the 
month  of  February,  thinking  that  a  1  danger  was  past, 
he  went  on  shore.  Fifteen  days  later,  he  wa«  stricken  with 
yellow  fever  and  died  eight  days  after  the  onset  of  the 
maladv.^^ 

1809. 

Through  some  source  which  is  not  given,  yellow  fever 
was  brought  to  Grand  Bassam  in  1899  and  for  a  time 
threatened  to  assume  epidemical  proportions.  Strict  sani- 
tary measures  were  adopted,  however,  and  the  disease 
was  restricted  to  the  vicinity  of  the  original  outbreak,  re- 
sulting in  six  cases  and  five  deaths.  The  infected  terri- 
tory extended  from  the  Gold  Coast  up  to  and  including 
Half  Jack  on  the  west,^®  The  other  African  stations  were 
not  affected. 

1902. 

The  epidemic  of  1C02  broke  out  .suddenly  and.  'although 
it  lasted  hardly  a  month,  was  characterized  by  nearly  one 
hundred  per  cent,  mortality. 

On  July  14,  1902,  a  sergeant  of  infantry,  who  had  only 
been  at  Grand  Bassam  two  or  three  weeks,  was  taken  ill 


-'Huard:    Theses  de  Montpellier,  1868. 
.  ^  Sarrouille,  loc.  cit.,  p.  41. 

^'U.  S.  Public  Health  Reports,  1899,  vol.  14,  pp.  1336,  1812; 
Annales  d'Hygiene  et  de  Medecine  Coloniales,  1903,  vol. 
6,  p.  325. 


236  HISTORY    OF    YkLLOW    FEVER. 

with  fever.  He  died  on  the  19th  v^ith  "suspicious  symp- 
toius,"  but  as  yellow  fever  had  not  been  observed  in  the 
colony  since  1899,  the  case  was  diagnosed  as  "pernicious 
fever''  by  the  attending  physician 

On  July  20,  an  Australian  prospector,  aged  30,  who,  to- 
gether with  three  other  prospectors,  had  landed  at  Grand 
liassam  June  27,  died  with  ))lack  vouiit,  and  the  authori- 
ties concluded  that  they  were  face  to  face  with  an  invasion 
of  yellow  fever  and  cabled  the  facts  to  the  colonia'  officials. 
Orders  were  received  to  take  ininitdiale  sanitary  measures 
and  to  nuike  war  against  mosquitoes. 

The  three  other  prospectors,  room-mates  of  the  case 
above  mentioned,  were  successively  atracked,  on  the  23d, 
25th,  and  26th  of  Julv;  one  recovered,  thf'  others  died  on 
the  30th. 

In  the  four  last  cases  above  noted,  bla-k  vjmit  was 
present. 

On  July  24,  a  white  servant,  aged  34,  who  had  been  in 
the  colony  two  months,  died  at  the  infirmary,  a  iter  four 
days'  illness. 

On  July  24,  a  notary's  clerk,  also  a  new  arrival,  died 
after  tliree  days'  illness.  A  young  cor.plc  who  occupie<l 
the  same  residence  as  this  young  clerl ,  and  who  nursed 
him  through  his  illness,  proved  immune,  although  they 
had  arrived  from  France  onlj'  six  weeks  previously. 

Two  custondiouse  officers  v.ere  taken  ill  on  July  23;  one 
died  on  the  27th  and  the  othei'  on  the  28th. 

An  Englishman,  aged  26,  who  had  arrived  at  Grand 
Bassam  on  June  26,  furnislied  the  tenth  case.  He  was 
taken  ill  on  July  25th.  He  «'ontinued  to  attend  to  his 
duties  until  the  28th,  when  he  was  f:uud  in  a  coma  by 
one  of  his  fellow-clerks.  Death,  preceded  by  black  vomit, 
took  ])lace  shortly  afterwards.  His  companion  ^^as  taken 
sick  in  a  few  days,  but  suffered  only  a  slight  attack,  which 
resulted  in  an  uneventful  recovery. 

The  twelfth  case  was  an  Alsatian  who  had  arrived  at 
Grand  Bassam  on  June  27.  On  the  morning  of  July  27 
he  left  town  to  "iscdate"  himself  at  tin  village  of  Abidjan, 
where  he  died  on  July  31  with  black  v  mit. 

A  second  death  took  place  outside  o^  the  town  limits,  at 
Eloca,  a  native  village  near  Grand  Bassam.     This  was  an 


.  IVORY    COAST.  iiSl 

EuropcaD,  aged  33,  who  liad  spent  a  fevr  lionrs  in  tJie  liouse 
where  (he  Australians  liad  died.  He  was  taken  ill  a  few 
days  after  his  return  to  Eloea  and  died  on  August  2. 

The  fourteenth  case  was  furnished  l»y  a  priest  who  had 
been  doing  missionarv  work  along  the  west  eoast  of  Africa 
for  six  or  seven  years,  lie  was  taken  ill  Aui-ust  2  and  died 
on  the  12th. 

The  last  case,  a  mulatto,  had  been  a  resident  of  Grand 
Bassani  since  181)4  and  had  gone  through  the  epidemic  of 
3899.  He  was  taken  ill  on  .Vugust  12th  and  died  on  the 
19th.  This  is  one  of  the  few  instances  in  which  a  ])erson 
with  African  blood  has  died  of  yellow  fever  on  African 
soil.  The  disease  is  generally  fatal  a:nong  the  Mhite  col- 
onists, but  the  mulattoes  are  generally  immune  while  the 
blacks,  despite  their  unsanitary  and  I)arbarous  mode  of 
living,  rarely  contract  the  disease.  Such  has  beer  the  case 
in  almost  every  epidemic,  not  only  at  Grand  BaBsam,  but 
along  the  entire  coast  of  the  Dark  Continent  ,\here  the 
saffron  scourge  has  manifested  itself. 

The  epidemic  of  1902  may  be  summarized  as  follows: 

Grand  Bassam,  13  cases;  11  deatlis. 

Abidjah,  1  case,  resulting  in  deatlr.  Imported  liom 
Grand  Bassam. 

Eloca,  1  case,  resulting  in  death.  Imporl(^l  fritm  (Jiand 
B^asam. 

(Jtand  total,  15  cases;  13  deaths. 

The  Bource  of  the  ei)idemic  has  never  been  definitely  es- 
tablished. Some  claim  it  Avas  imported  from  ihe  Gold 
Goast;  others  incriminate  Senegal.  Dr.  Kousselot- 
Benaud,'^^  frbm  whose  account  this  resume  is  luade,  be- 
lieves that  the  xliseat^e  was  not  im])orted,  biit  wa-s  due  to 
extensive  excavations  made  in  a  lago<  n  where  the  debris 
of  the  epidemic  of  1899  had  been  thrown  and  left  undis- 
turbed since  that  tiii^e.  It  is  needless  to  explain  why  this 
hypothesis  is  untenable. 

1903. 

The  epidemic  of  1903,  following  so  closely  upon  the  out- 
bT<i«ilv  of  1902,  caused  widespread   paiiic   throughout   tlie 

*Rousselot-Benaucl:    Annales  d'Hygiene   et   de   Medecine    Col- 
oniales,  1903,  vol.  6,  p.  319. 


238  HISTORY    OF    YELLOW    FEVER, 

colony.  According  to  Gouzien  and  liC  Hardy^^^  the  first 
suspicious  cases  occurred  in  January.  On  the  2J:lh  of  that 
month,  a  Syrian,  who  had  landed  at  Gj*and  Bassam  in  De- 
cember, 1902,  and  who  lived  in  the  native  section  of  the 
town  with  seven  or  eight  of  his  countrymen,  died  with 
black  vomit.  The  corpse  was  burned  by  the  authorities 
and  the  dead  man's  compatriots  were  isolated  for  nine 
days,  during  which  time  a  strict  watch  was  kept  over 
them. 

On  January  29  another  case  was  observed,  followed  by 
death  in  a  rew  days.  A  third  case  occurred  about  the  same 
time  in  the  person  of  a  customhouse  employe. 

The  outbreak  seemed  to  subside,  no  cases  being  ob- 
served during  February,  On  March  8,  a  sergeant  of  in- 
fantry died  at  the  infirmary.  This  death  was  followed  by 
another  on  March  11,  in  the  same  room  where  tin  sergeant 
had  succumbed. 

The  reappearance  of  the  disease  caused  consternation  in 
the  town.  The  cabin  where  the  tv.o  deaths  occurred  was 
burned,  as  was  also  the  clothes  and  bed  linen  of  the  unfor- 
tunates. 

On  March  11,  a  fatal  case  was  observed,  followed  short- 
ly by  two  cases,  which  recovered. 

On  March  15,  a  sister  of  charity  died. 

About  that  time,  the  Government  oidered  the  isolation 
of  the  white  inhabitants  of  Grand  Bassam.  To  avoid 
spreading  tlie  contagion,  this  was  done  by  groups  of  two 
or  three,  until  the  town  was  nearly  depopulated.  On 
July  17,  only  23  Europeans  were  present. 

The  fever  soon  began  to  show  itself  at  the  places  where 
the  refugees  had  been  sent.  On  July  19,  a  death  occurred 
at  Adjeo,  followed  by  two  fatalities  at  Tmperie  on  the  23rd. 
On  the  27th  a  death  was  registered  at  Arriounna. 

Tlie  sixtb  deatli  at  Grand  Bassam  was  furnished  by  a 
city  official  who  had  been  two  months  in  ihe  coiony. 

On  July  28,  a  Catholic  priest  died  after  an  illness  of 
onlv  forty-eight  hours. 

On  August  1,  the  white  population  amounted  to  13, 


'^  Gouzien  and  Le  Hardy:    Annales  d'Hygiene  et  de  Medecine 
Coloniale's,  Paris,  1904,  vol.  7,  p.  558. 


IVORY'    COAST.  239 

On  August  3,  case  occurred  at  Schneider  Plantation,  in 
the  person  of  a  refugee  from  Grand  Bassam,  followed  by 
death  on  the  4:th. 

The  last  case  at  Grand  Bassam  occurred  on  August  7th, 
resulting  in  recovery. 

The  cases  and  deaths  may  be  summarized  as  follows: 

Cases.  Deaths. 

Grand  Bassam 10  7 

Adjeo 1  1 

Imperie 2  2 

Arriounna 1  1 

Schneider 1  1 

Total 15  12 

The, epidemic  was  probably  a  recrudesceDce  of  that  of 
1902,  caused  by  the  renewed  activitx  of  the  infected 
Stegomyia. 

1901-1905. 

Yellow  fever  was  brought  to  the  very  doors  of  the  colony 
in  1901  and  1905. 

The  steamship  Tibet  arrived  at  Dabou  towards  the  end 
of  October,  1904.  Her  physician  had  just  died  trom  an 
attack  of  "pernicious  fever,"  but  subserjuont  events  justify 
tlie  assertion  that  it  was  probablv  a  cai^e  of  yelhnv  fever. 

On  the  next  trip  of  the  vessel  to  the  colony,  Jaiiuary  20, 
1905,  while  in  the  harbor  of  Grand  Ba«jsam,  a  case  of  "sus- 
picious fever"  was  reported  on  board.  This  proved  to  be 
the  ship's  physician,  who  had  taken  the  place  left  vacant 
by  his  comrade's  death.  The  patient  was  well  enough  to 
be  on  deck  that  evening,  but  fell  into  a  coma  on  the  28th 
and  died  on  the  29th.     lie  vras  buried  on  shore. 

A  few  days  later,  while  the  T!J)et  was  in  the  harbor  of 
Cotonou,  the  hospital  steward  was  attackctl  by  wliat  was 
pronounced  a  typical  manifestation  of  yellow  fever.  The 
case  was  a  mild  one  and  the  patient  recovered. 

The  Tihft  was  then  given  fi'ee  pratique  and  left  for 
Grand  Bassam,  where  she  arrived  Februarv  21th,  and  took 


1 


;240 


HISTORY    OF    YELLOW    FEVER. 


a  passono;er  for  France.  The  man  was  an  invali'l,  of  dis- 
sipated habits,  Avlio  had  been  in  the  iiospital  foi  about  a 
month  and  was  weak  from  fever.  That  same  night,  while 
at  Dabou,  he  fell  into  a"  comatose  state  and  died  the  day 
followiuo-  (  February  2f)th)  with  black  vomlt.^^ 

A  perplexing  (jnestion  now  ])resents  itself:  Wiiere  did 
this  man  contract  yelloAV  fever?  Xo  '-poradic  case  had 
been  seen  at  Grand  Bassam  before  the  erui;tion  of  this 
fatal  one,  and  none  were  observed  during  the  balance  of 
the  year.  The  patient  came  directly  from  the  hospital  to 
the  ship,  did  not  communicate  with  anyone,  and  had  not 
left  his  ro(un  for  nearly  a  montli  The  rapid  evolution  of 
the  disease  precludes  the  possibility  of  the  patient  having 
been  infected  on  board  on  the  24tlL  and  as  he  presented  all 
the  symptoms  of  yellow  fever,  even  the  black  von  it,  there 
is  no  gainsaying  the  fact  thut  he  was  contauiinatcd  sonie- 
wJicre.  But  to  take  down  the  map  of  the  world  and  point 
out  that  "somewhere"'  is  the  piece  <lc  rei-istancc.  The  only 
loop-hole  we  see,  is  the  assumi)tion  flat,  when  the  Tibet 
was  in  the  harbor  of  (Jrand  Bassam  on  her  first  visit  (Jan- 
uary 20th),  the  unfortunate  Frenchman  was  bitlen  by  an 
infected  iii(ts(iuit(>  either  at  the  whr.rf  ;.r  on  board  the  ves- 
sel and  afterward  had  a  mild  attack  of  yellow  fe\er.  Be- 
ing convalescent  when  transferred  to  the  Tibet,  the  excite- 
ment incidental  to  his  removal  brought  on  a  relapse,  which 
terminated  as  above  set  forth. 

This  circuitous  mode  of  infection  may  seem  a  little  far- 
fetched, but  it  is  plausible,  and^  in  the  absence  of  proof  to 
the  contrary,  is  just  as  good  as  any  other  theory. 

'^Vivie:    Annales  d'Hygiene  et  de  Medecine  Coloniales  (Paris), 
1907,  vol.  10,  p.  121. 


JOHANNA   ISLANDS. 

Dcscrijdion. 

Jolianua  is  one  of  the  Coiuore  Islands,  in  the  ^Nfozam- 
bi(ine  Channel,  between  Mada.uasrar  a  ad  tlie  maiiilaud  of 
Africa.    Its  capital  is  the  walled  town  cf  Johanna. 

ALLEGED  YELLOW  FEVER  YEAR. 

1801. 

SUMMARY   OF   ALLEGED  OUTBREAK. 

Bancroft,  in  his  t^c</Hel  to  An  E-s.^aij  on  Ye/.'^wc  Fever 
(1817:  pao-e  132),  tells  of  an  outhvcak  of  "Bnlaiii  Fever" 
on  board  a  sloop  of  war  whi'h  had  stopped  at  Ji  lianna  in 
1801  for  provisions,  water  and  fuel.  Soon  after  sailing;, 
symptoms  of  a  fever  ''of  an  nnnsiipJ  kind"  ai)pearcd  anionj;- 
those  of  the  crew  that  had  l)een  on  the  island.  The  iicneral 
symptoms  were:  An  oppressed  ])iilse,  -pnn'^cnt  lu  at  on  the 
surface,  bloated  countenance,  a  dull,  heavy,  inflamed  eye, 
violent  headach(%  pain  at  the  epii>astric  re«i;ion,  and  an  in- 
vincible irritability  of  the  stomacli;  t!ie  vomitini;,  in  all 
cases,  beinii,-  of  a  bilious  nature  and  a  yellow-ureenish  as- 
pect, which,  towards  the  fatal  teripination  of  the  disease, 
assumed  a  dark-brown  olive  or  clu  <()l»te  crdor  In  none 
of  the  bad  cases  were  remissions  well  mark«nl,  and  in  most 
of  those  who  died,  a  yellow  suffusi(tu  of  tl.e  skin  of  a 
lemon  hue,  was  conspicuous  i-nly  a  shr.it  time  pr-jvious  to 
death;  in  all,  however,  after  death  th\<  appearance  was 
common.  The  discharges  by  stool  manifested  a  similar 
variety,  but  they  were  so  hiiihly  corrosive  and  acid  as  to 
excoriate  the  anus  and  natex,  and  to  excit*^  tlie  ji<'neral 
dread  in  the  patient  on  the  apjiroach  of  the  evacutition. 

Out  of  twelve  men  attacked,  six  dicl ;  those  wlio  recov- 
ered did  not  have  the  dark  colored  von  itin^  and  their  <-on- 
valescence  was  extremely  tardy. 

With  the  exception  of  the  alletied  oi'tbre.'^k  at  ^ladagas- 
car   (q.  v.),  this  is  the  only  record  o"  yellow  ffver,  or  a 


242  HISTORY    OF    YELLOW    FEVER. 

disease  simulatiu*::  that  seoiiri?e,  on  the  eastern  sliores  of 
Africa.  Bancroft  says  that  this  sloop  of  war  car.ie  direct 
from  England,  which  precludes  the  thr-cry  of  inijortation. 
We  arc  prone  to  believe  that  it  was  simply  a  vir\:lent  out- 
break of  paludial  fever,  aggravated  by  exposure  and 
fatigue. 


f 


LAGOS. 

Description. 

Lajoos  is  a  British  colony  in  Upper  Guinea,  on  the  Gulf 
of  Benin.  The  capital,  Lai»os,  the  largest  port  in  Western 
Africa,  has  a  population  of  about  40,000.  The  population 
of  the  colony  is  about  100,000,  mostly  negroes.  Lagos  was 
once  a  noted  slave  mart. 

YELLOW  FEVEE  YEAR. 

1864. 

SUMMARY  OF  EPIDEMIC. 

There  is  a  solitary  record  of  yellow  fi  ver  having  invaded 
Lagos  (Berenger-Feraud,  p.  141).  In  1864,  the  disease 
was  in  Sierra  Leone  and  was  brought  to  Lagos  by  trading 
vessels.  The  outbreak  does  not  appear  to  have  been  of 
much  consequence,  as  it  is  barely  mentioned  in  the  official 
reports. 


MADAGASCAR. 

Description. 

Madagascar,  the  third  largest  island  iu  the  wor-d,  is  sit- 
uated iu  the  Indian  Ocean,  210  miles  from  the  ^^^st  coast 
of  Africa,  from  which  it  is  separated  by  the  ^lozandnque 
Channel.  It  is  about  1,000  mile«  loni;  and  has  an  aver- 
age breadth  of  250  miles.  ro])ulation,  3,520,000.  Capital, 
Tananarive.  Chief  port,  Tamatave.  The  island  is  under 
French  protectorate. 

YELLOW  FEVi:i{  AS  IT  COXCERXS  MADAGASCAK. 

Berenger-Feraud,  in  the  (razctte  Medical  dc  Xanfcs*  and 
Joseph  Jones,  in  the  Transactions  of  ihc  Loiiisiaua  State 
Medical  Society  for  1879  (page  63),  make  brief  mention 
of  yellow  fever  having  been  observed  in  .Madagascar  in 
1790,  but  a  search  through  the  litei'ature  of  that  a  ear  and 
a  careful  perusal  of  the  principal  works  on  Madagascar, 
fails  to  throw  any  light  on  ^he  subjcL  Bancroft,  in  his 
Sequel  of  Yellow  Fever  (page  135)  claims  that  an  English 
warship  contracte'l  a  pestilential  disease  at  Madagnscar 
in  1800,  but  makes  no  mentiiai  of  +he  alleged  outbreak  of 
1790.     Bancroft's  account  is  as  follows: 

In  the  year  1800,  a  seventy-fonr  gun  ship  of  th-  British 
navy  st<)i)ped  at  Madagascar  for  the  ])nr])ose  of  obtaining 
fresh  l)eef,  vegetabU^s,  fruit,  wood  and  water.  In  conduct- 
ing these  duties  it  was  necessary  to  em])l()y  mai]y  of  the 
men;  and  of  all  the  parties  thus  employed,  none  remained 
on  shore  during  the  night,  (^\cei)t  ;i  guard  of  marines,  sent 
in  the  evening  on  i)urp()se  for  the  i)r()tection  of  Avate|r 
casks,  etc.;  and  it  was  so  arranged  thai  no  man  bad  occa- 
sion to  be  out  of  the  ship  more  than  one  night.  Notwith- 
standing these  ])recauti()ns,  a  fever  of  malignant  nature  ap- 
peared among  the  marines,  and  of  twenty-four  attacked 
in  a  violent  degree,  six  fell  victin)s  to  the  disease.  The 
symptoms  here  were  not  exactly  similar    to    those     wit- 

*  1S83-4,  vol.  2,  p.  6. 


f 


MADAGASCAR.  245 

nessed  in  Joliauna  ;^"''  death  in  several  cases  v.as  sudden 
and  unexpected,  preceded  by  a  vi<;]ent  buininii  sensation 
at  the  epigastrium,  which  was  only  a  precursor  of  death 
by  a  few  hours,  and  in  one  case  by  a  few  minutes.  In 
these  cases  neither  was  a  yellow  suffusion  of  the  skin  con- 
stant, nor  the  eyes  so  hij^hly  inflamed,  nor  the  countenance 
so  much  flushed  as  in  the  fever  of  Johanna;  but  a  sallow, 
dingy,  disagreeable  aspect  of  the  countenance  prevailed. 
In  some  of  these  cases  the  ship's  surgeon  was  inclined  to 
think  the  individuals  in  a  state  of  intoxication,  from  the 
very  great  degree  of  vertigo  and  staggering  present;  but 
a  siiort  time  served  to  convince  him  of  his  error.  This 
variety  of  appearance  in  the  two  diseases  thi^  officer 
ascribed  to  peculiarity  of  constitu.tion  only,  and  not  to  any 
difference  of  climate;  those  who  were  alTected  at  Johanna 
were  young  and  recently  arrived  from  their  nativ^^  climate; 
whereas  the  people  subjected  to  the  Madagascar  fever  had 
been  some  length  of  tinu^  in  India,  and  had  but  lately  ar- 
rived from  a  long  cruise  of  four  months,  tlie  greater  part 
of  which  they  had  subsisted  on  salt  provisions,  and  symp- 
toms of  scurvy  had  appeared  among  them  for  s<»me  time 
before  their  arrival  at  jMadagascar. 

This  outbreak  Avas  certainly  not  yellow  fever.  Nowhere 
can  we  discover  in  Bancroft's  account  any  mention  of 
previous  contamination  of  the  wai'ship,  and  unless  the 
vessel  stopi)ed  at  some  infected  port  on  its  way  f'/om  Eng- 
land to  Madagascar,  the  contagion  which  prevailed  on 
board  was  not,  and  could  not  have  been,  undef  the  wildest 
stretch  of  the  imagination,  yellow  fever.  The  mode  of 
propagation  of  this  disease  is  now  too  well  established  to 
need  elucidation,  and,  unless  the  mosijuitoes  of  Mada- 
gascar were  imbued  with  the  venom  of  infection  simply  for 
this  special  occasion,  the  incident  can  positivelv  and  for- 
ever be  dismissed  as  being  ])uerile  jmkI  <'himerical.  It  is  a 
well  known  fact,  however,  tliat  i)alndial  fever  reigns  with 
great  intensity  in  the  litoral  of  the  island  and  commits 
fearful  ravages  among  the  whites.  In  this  conne;  tion,  the 
historic  words  of  liadama,  King  of  the  Hovas,  ^^hen  con- 
fronted with  invasions  by  tlie  FreLch,  "I  have  at  my  ser- 
vice the  great  General  Tago  (fever)  and  in  his  hands  I'll 

^'■'  See  article  on  Johanna  Island,  in  this  volume. 


I 


246 


HISTORY    OF    YELLOW    FEVER. 


leave  tlie  whites  for  a  while;  I  have  no  fear  of  the  results," 
proved  terribly  prophetic,  for  the  shores  of  the  great 
island  are  so  thickly  studded  with  the  gTavestones  of  the 
invading  French,  that  Madagascar  h?s  been  christened 
Le  Tombcau  des  Francais. 


I 


MADEIRA   ISLANDS. 

Description. 

The  Madeiras  are  located  in  the  Atlantic  Ocean,  about 
440  miles  off  the  west  coast  of  Africa  and  consist  of  the 
islands  of  Madeira  and  Porto  Santo  aiul  th.ree  islets  called 
the  Desertas.  The  group  belongs  to  Portugal.  Popula- 
tion, 123,841.    Capital,  Funchal^,  on  the  island  of  Madeira. 


1738. 


YELLOW  FEVER  YT:AK. 


SUMMAPiY  OF  EPIDEMIC. 


Altliough  the  Madeiras  hav-e  been  Iviiown  to  Europeans 
for  four  hundred  and  seventv-six  .year>,  only  once  has  yel- 
low fever  invaded  the  group.  Like  the  Canary  and  Cape 
Verd  islands,  the  Madeiras  are  directly  in  the  path  of  com- 
merce between  Europe  and  Africa  and  were  no  doubt  the 
rendezvous  of  the  delightfully  unsanitary  galeons,  buc- 
caneers, slave-traders  and  gentlemanly  cut-throats  of  by- 
gone days;  but,  strange  and  inex])licable  as  the  ^.tatement 
may  seem,  the  dreaded  pcste,  altlKuigli  it  devastated  the 
other  islands  off  the  African  coast,  only  found  lodgment 
once  on  the  shores  of  this  salubrious  Portugese  possession. 

This  solitary  record  of  tlie  ap])earMnce  of  the  "Ameri- 
can Pestilence"  in  the  Madeira  Islands  nuiv  be  found  in 
an  old  Portugese  Avork  published  nearly  two  hund'ed  years 
ago,  by  Jose  Rodriguez  de  Avreu,^^  phvskian  to  King 
Juan  V,  of  Portugal.  No  details  are  given  of  this  inva- 
sion, beyond  the  statement  that  it  caused  much  mortality 
in  the  city  or  Funchal. 

From  1738  to  this  day,  yellow  fever  has  never  been  ob- 
served at  the  Madeira  archipelago. 

How  can  this  immunity  be  explained?  Only  by 
hypothesis,  and  as  hypotheses  are  generally  concocted  of 
such  volatile  ingredients  that  they  collapse  of  their  own 
weight,  we  shall  not  indulge  in  any,  but  will  sum  up  the 

"Jose  Rodriquez  de  Avreu;    Historiologfa  Medica,  vol.  1.  p.  620. 


248  HISTORY     OF    YELLOW     FEVER. 

whole  matter  in  five  little  "words:  The  abscnc'^  of  the 
Stegoiiiijia.  This,  in  our  opinion,  is  the  true  explanation. 
It  is  not  a  liyi)oth('sis,  bnt  a  fact,  that  the  HiajOiiniia  CaJ- 
opus,  the  only  active  a<>eut  in  .the  transmission  of  yellow 
fever,  does  not  flourish  in  the  ^ladeira  group.  The  insect 
was  imported  once  to  the  islands  and  that  solitary  instance 
furnished  the  delijihtfnl  little  city  of  Fnnclial  the  only  epi- 
demic of  yellow  fevei^  Avliich  ha.s  ever  invaded  that  locality; 
and,  as  soon  as*  the  climatic  conditions  k  f  the  island  proved 
hostile  to  the  propagation  of  the  mosquito  and  the  im- 
ported insects  died,  the  pestilence  wLivh  they  liad  pro- 
duced ceased  and  the  old-time  health  con^litions  of  the 
country  re-established  themselves  and  ]iave  endured  to  the 
present  day. 


t 
I 


MOROCCO. 

Description 

Morocco  is  a  country  occupying-  the  uortlnvest  pxtremity 
of  Africa.  Area,  about  200,000  s<iiiare  miles.  Population, 
6,000,000.  The  empire  has  three  capiials — Fez,  with  au 
estimated  population  of  100,000:  Morocco,  with  40,000 
souls,  r.nd  Tangier  (the  diplomatic  sea!:),  estimated  to  con- 
tain about  14,200  inhabitants. 

YELLOW  FEVER  YEARS. 

1804 ;  1881. 

SUMMARY  OF  EPIDEMIC^. 

1804. 
Peiioih  dc  Velez. 

The  only  recorded  epidemic  of  yellov-  fever  in  northwest 
Africa  took  place  in  1804,  at  Penon  de  Velez,  a  fortified 
Spanish  fortress  situated  on  a  lofty  reck  in  the  ^lediter- 
ranean,  80  miles  southeast  of  Cev.ta.  ^lorocco.  In  the 
last  years  of  the  eighteenth  century,  this  islet  was  used  as 
a  prison  for  refractory  presidarios,  or  Jja-ley  slaves.  It 
is  now  a  Spanish  penal  colony. 

In  1804,  yellow  fever  was  epidemic,  almost  throuiijhout 
Spain  and  the  infection  was  cari-ied  to  Penon  de  Velez  by 
tradespeople  and  soldiers  from  Malaga,  between  which 
port  and  Morocco  there  was  constant  and  uninterrupted 
commnnication.  No  detailed  account  could  be  fonnd  of 
this  epidemic.  Fellowes"''  and  Moreau  de  Jonnes''''  inform 
us  that  the  disease  was  imported  fi'on^.  Malaga  and  was 
widespread  among  the  garrison  and  galley  slavvs  which 
formed  the  sole  po])ulation  of  the  islet,  but  give  no  in- 
formation regarding  the  nu miter  of  cases  or  the  fatalities. 

^Fellowes:  Reports  of  the  Pestilential  Disorders  of  Andulasia 
which  appeared  at  Cadiz  in  the  years  ISOO,  1S04,  1810  and 
1813(London,  1815),  p.  101. 

^Moreau  de  Jonnes:  Monographic  Historique  et  Medicale  de 
la  Fievre  Jaune  des  Antilles  (Paris.  1817),  p.  341, 


250 


HISTORY    OF    YELLOW    FEVER. 


1881. 


Tangier. 


Thfc  second  and  last  invasion  of  Morocco  by  yellow  feyer 
took  place  in  1881,  at  Tangier,  one  of  the  capitals  of  the 
empire,  situated  at  the  entrance  to  the  Strait  of  Gibraltar, 
which  had  then  an  estimated  population  of  15,000.  It  is 
unfortunate  that  only  a  bare  mention  :s  made  of  this  out- 
break in  the  consular  reports.  Tliere  were  only  a  few 
sporadic  cases  and  no  deaths.  ■"  The  source  of  importation 
is  not  itiven. 

=' National  Board  of  Health  Bulletin,  1881-1882,  vol.  3,  p.  337. 


SAINT  HELENA. 

Description. 

Saint  Helena  is  a  volcanic  rock  in  the  South  Atlantic 
Ocean,  700  miles  south-east  of  the  Isla^-d  of  Ascension,  and 
1400  miles  west  of  the  west  coast  of  Africa.  It  is  10  1-2 
miles  in  length,  7  miles  in  breadth  and  belongs  to  Great 
Britain.  Population,  4,116.  Capital,  James  Town,  on 
the  north-west  shore.  Saint  Helena  i>:  famous  in  history 
as  having  been  the  living  tomb  of  the  Great  Napoleon  from 
the  date  of  his  banishment,  1815,  to  his  death.  1821. 

YELLOW  FEVER  YEAR. 

1830. 

SUMMARY  OF  EPIDEMIC. 

It  is  surprising  that  yellow  fever  has  never  invaded 
Saint  Helena,  for,  previous  to  the  cutting  of  the  Suez 
Canal,  the  island  was  a  favorite  port  of  call  f^^r  vessels 
bound  to  and  from  India  by  way  of  the  Cape  of  Good 
Hope  and  the  inhabitants  did  a  large  trade  in  furnishing 
these  vessels  with  provisions  and  other  supplies.  The  only 
explanation  is  found  in  the  absence  of  the  Stegomijia  Col- 
opus  from  this  lonely  rock,  as  A'cssels  infected  with  yellow 
fever  no  doubt  stopped  long  enough  a<^  James  Town  in  its 
palmy  days  to  communicate  the  disease  to  the  inhabitants. 

The  outbreak  of  1830  was  solely  in  the  harbor  and  did 
not  spread  to  the  shore.  It  took  place  cu  board  tht  British 
ship  Sybille,  under  the  follov>'ing  circumstances  (Bryson, 
loc.  cit.,  p.  57)  : 

The  HijhiUe  was  infected  by  some  vessel  attached  to  the 
British  South  Atlantic  squadron  in  1820  and  suffered 
much  from  the  ravages  of  yellow  fcve/'.  On  September  1, 
1821),  she  arrived  at  Saint  Helena.  The  epidemic  had  ceased 
and  no  one  was  on  the  sick  list.  She  shortly  sailed  on  a 
cruise  and  met  with  the  Black  Joke,  with  which  she  com- 


252 


HISTORY    OF    YELLOW    FEVER. 


iimnicatcd.  Tliis  v(  ssol  had  just  recovered  from  a  severe 
visiiatiou  of  vcllow  fever.  The  disease  a<iam  broke  out 
on  board  the  SijhiJIc.  She  returned  to  Saint  Helena  and 
anchored  in  the  harl)or  of  James  Town  on  ]\[arch  22,  1830. 
The  disease  was  widespread  amonii;  the  crew,  there  being 
26  cases  and  6  deaths  while  the  ship  was  at  Saint  Helena. 
The  fever  was  confined  to  the  ^^i/hiUe. 


SAINT  THOMAS. 

Haiut  Thomas  is  an  island  iu  the  Gulf  of  (iiiluea,  belong- 
ing- to  Portugal.  Area,  145  square  miles.  Capitnl,  Chaves. 
Population,  20,441. 

YELLOW  FEVER  YEARS. 

1558;  1588. 

SUMMARY  Oi'  EPIDEMICS. 

155S. 

We  find  only  two  instances  of  the  a.-pearanee  ot  j^ellow 
fever  on  the  island  of  Saint  Thomas.  There  is  no  doubt 
that  the  disease  has  prevailed  there  oa  numerous  occa- 
sions, as  the  Portugese  have  never  been  over-strict  in  en- 
forcing quarantines  in  their  colonial  Mossession.s  and  the 
locality  has  always  been  a  nest-egg  of  smugglers  and  lax 
maritime  transactions.  But  the  available  sources  of  in- 
formation, as  is  always  the  case  when  the  cohjuies  of 
Western  Africa  are  concerned,  are  eitbc^r  stei-ile  or  untrust- 
worthy, so  we  shall  confine  our  observations  to  the  two 
outbreaks  herein  noted. 

According  to  R(n'enger-l-'(vtaud  (I'oc.  fit.,  p.  27),  yellow 
fever  was  observed  among  the  Y\iiite  settlers  of  the  island 
in  1558.    Be.yond  this  mere  inentioii,  i>o  details  are  given. 

1588. 

The  same  authority  ( ]).  27)  also  informs  us  tliat  Bird 
and  Newton,  English  explor-rs,  and  their  crew.s,  were  at- 
tacked by  yellow  fever  at  Saint  Thoiuj-s  in  1~8S.  Where 
the  disease  was  contracted,  whether  it  was  lla'u  pievailing 
on  the  island  or  was  brought  there  by  the  explorers,  our 
source  of  information  does  not  reveal. 


SENEGAL. 

Description. 

Senegal  is  a  French  colonial  dependency  in  West  Afri- 
ca, in  Senegambia,  comprising  the  island  and  to\yn  of 
Saint-Louis,  at  the  mouth  of  the  Senegal  River,  the  island 
and  town  of  Goree,  Albunda  on  the  Gambia,  and  other 
stations  south  of  Cape  Verd.  It  was  first  settled  by  the 
French  in  the  beginning  of  1600.  taken  by  the  Fnglish  in 
1756,  retaken  by  the  French  in  1759  ar^d  1779,  and  subse- 
quently held  by  the  English  until  18 j 4,  when  it  again 
came  under  control  of  the  French,  who  have  retained  pos- 
session to  this  day.  Capital,  Saint-Louis.  Other  towns 
and  stations:  Goree,  Dakar,  llufisque,  Thies. 

Senegal  being  one  of  the  most  important  colonial  pos- 
sessions on  the  West  Coast  of  Africa,  having  extensive 
trade  relations  with  America  and  Europe,  v,  description  of  ^ 

its  principal  centres  of  popuLition  will  not  be  out  of  place 
in  this  volume.  The  reader  Avill  thus  be  in  a  better  posi- 
tion tc  understand  the  radiations  of  ihe  many  epidemics 
which  have  ravaged  this  distant'  land. 

Saint-Louis. 

Saint-Louis,  capital  of  the  French  possessions  in  Sene- 
gambia,  was  founded  in  1626,  It  is  situated  on  an  island 
of  the  same  name,  at  the  mouth  of  the  Senegal  River.  It 
has  tine  public  buildings  and  mission  schools.  The  white 
population  occupies  the  centre  of  the  is'and,  whik  the  huts 
of  the  natives  are  located  at  both  extremities.  The  streets 
are  large  and  macadamized  in  the  business  section,  but  the 
houses,  with  few  exceptions,  are  of  ancient  construction. 
Several  bridges  over  the  small  arm  of  the  Senegal  connect 
the  island  with  the  peninsula  of  Barbary,  a  narrow  sand- 
bar, on  Avhich  are  located  the  native  villages  of  Guet  N'Dar 
and  N'dar  Toute.  The  cemeteries  are  located  at  Sorb,  on 
the  mainland  and  separated  from  the  island  by  (he  great 
arm  of  the  Senegal.  A  single  bridge  connects  Sorb  with 
the  capital. 


SENEGAL.  255 

The  natives  are  exceedingly  filthy  in  their  habiis*.  Those 
residing-  in  the  Enropean  section  of  the  city  occupy  the 
basements,  where  they  operate  small  stores.  In  the  small 
court-yards  attached  to  these  houses,  they  keep  chickens, 
hogs,  sheep  and  often  cows,  and  when  the  yards  become 
overcrowded,  which  is  a  common  occurrence^  tiiese  ani- 
mals are  often  quartered  in  the  living  ;ipartment-ji  Under 
such  conditions,  it  is  not  surprising  that  the  lieairh  of  the 
city  is  always  on  the  wrong  side  of  thc^  balance 

Saint-Lotiis  has  a  population  of  15,758,  mostly  natives. 
The  white  population  is  transient  and  licnerally  ;eaA'es  for 
Europe  at  the  beginning  of  the  rainy  season. 

Gorce. 

The  rocky  island  of  Goree,  which  Is  entirely  occupied 
by  the  town  of  the  same  name,  lic;s  in  the  Atlantic  Ocean, 
south  of  the  Cape  Verd  Peninsula  It  is  directly  opposite 
Dakar,  with  which  town  it  is  so  closfiy  allied  that  the 
name  Goree-Dakar  is  now  generally  used  when  alluding  to 
the  twin  cities.  It  is  claimed  to  be  tie  healthiest  place  in 
West  Africa.  The  native  quarter  is  composed  of  grass 
huts,  but  the  houses  of  the  Europeans  are  of  fair  construc- 
tion and  decorated  with  tine  flowering  plants  and  shrubs. 
The  elevation  of  Goree  above  the  sea  level  varies  from  2 
metres  on  the  northwest  to  31  on  the  southeast 

Goree  was  for  years  the  pi'incipal  port  of  the  colony, 
making  rapid  strides  in  population  <ind  commercial  im- 
])ortance,  but  it  is  now  being  outstrijqied  by  Dakar  and 
l{utis(|ue. 

Population,  2,452,  mostly  natives.  The  wliire  mer- 
chants, as  is  the  case  everywhere  throiighout  Senegal,  gen- 
erally sail  for  Euroi)e  every  .year  at  tlie  beginning  of  the 
warm  season.  i 

Dakar  is  situated  on  the  continent,  almost  at  the  ex- 
trenie  point  of  Cape  Verd,  and  is  1  1-2  miles  from  Goree, 
from  which  it  is  separated  by  an  arm  of  the  Atlantic 
Ocean.  Up  to  very  recent  years  Dakar  was  an  obscure 
negro  village  and  was  simply  a  vast   uecrophile,    having 


256  HISTORY     OK    VEI.l.OW     FEVER. 

been  used  as  a  l)nrviii«»-  i»Toiind  for  tlie  inhabitants  of 
(Toiee  from  time  immemorial.  In  tlie  ci<i,ht!es.  its  natural 
advantaj;es  bej^an  to  be  reeoi^uized  and  European  eommer- 
cial  houses  established  agencies  there.  The  building  of 
modern  lesideiices  followed  and  to-dav  the  town  occupies 
a  foremost  ])lace  in  the  affairs  of  the  .-olorv.  It  is  103 
miles  from  Saint-Louis,  with  which  it  is  connected  by  rail. 
IN)pulation,  3,417,  of  which  only  a  few  hundreds  are 
Europeans. 

,  Rufisque. 

liutis(iue,  the  second  city  m  Seufgai  from  a  point  of 
po})ulation,  is  situated  on  the  Atlantic  Ocean,  opposite 
Goree,  about  ten  miles  from  Dakar,  and  is  the  principal 
statioji  on  the  Dakar-Saint-].,oui>  ra-'road.  Population. 
5,280. 

YELLOW  FEVER  YEARS. 

1759;  17()();  17«)9:  1778;  1779:  1828;  1829'  1S30;  1837; 
1859;  1800;  1807;  1872;  1878;  1879;  1880;  1881;  1882: 
1900;  1901;  1905. 

SUMMARY  OF  EPIDE]MICS. 
1759. 

The  tirst  aj^jjcarance  of  yellow  fc'ver  on  the  mainland  of 
Africa,  according  to  Lind,^^  occurred  at  Senegal  in  1759. 
We  can  find  no  details  of  this  invasi(^n.  It  would  cer- 
tainly ])rove  interesting  to  be  abl"  to  trace  tlie  origin  of 
this  outbreak,  which  planted  the  seeds  of  a  disease  hereto- 
fore^ unobseryed  on  the  continent  (»f  Africa,  and  wiiich  was 
destined  to  commit  such  fearful  ravages  among  tlie  unfor- 
tunate pioneers  sent  to  colonize  its  slujjes. 

1700. 

Oorrr  (dhI  Sainl-Loiiis. 

The  second  a])pearance  of  yellow  fever  on  continental 
Africa  took  i)lace  in  Senegal  in  1700,  when  the  iowns  of 

^^Lind:    An  Essay  on  Diseases  Incidental  to  Europeans  in  Hot  j 


Climates,  vol.  1,  p.  51. 


SENKGAL.  2.57 

GorcG  and  Saint-Louis  lost  nearly  their  entire  wli'te  popu- 
lation, composed  of  Freneli  soldiv'is  and  traders.  No  de- 
tailed accounts  of  this  e])ilenii.:  aie  obtainable,  our 
autliorities  (Lind  and  l?eren!j;er-I''eTaiul )  being  deplorably 
uncommunicative  on  this  score. 

1709. 

Berenoer-Feraud  (page  55)  goes  into  more  explicit  de- 
tails concerning  the  outbreak  of  IKiO,  but  is  certainly  not 
prolix.  We  could  obtain  no  statistics,  but  learn  from  his 
account  that  the  French  troops  sent  U>  capture  Galam,  on 
the  Senegal  IJiver,  were  so  decimatrd  hy  yellow  fever,  that 
there  were  not  enough  men  left  to  undertake  tlie  task. 

1778. 

Saint-Louis. 

The  epidemic  of  1778,  which  is  the  first  on  African  soil 
where  details  are  obtainable,  was  murderous  in  its  inten- 
sity and  almost  depopulated  the  d-^pendency  of  its  white 
settlers.  Senegal  was  then  in  the  turmoil  of  war,  the 
English  having  wrested  the  <-olony  fr(>m  the  French.  Tlie 
fever  first  appeared  on  the  (iold  Coast,  Avhence  it  was 
brought  to  Sierra  Leone,  which,  in  its  turn,  infected  Gam- 
bia. From  Gambia,  it  s])read  to  Goree  and  thence,  accord- 
ing to  Hirsch,'^'^  to  Saint-Louis. 

The  i)rogress  of  the  disease  in  the  town  of  Saint-Louis 
is  one  of  the  saddest  pages  in  the  history  of  the  colony. 

We  cull  our  information  from  an  old  work  ]»ublish(  d  by 
Schotte  in  1782,  Avhich  gives  a  compichensive  account  of 
the  rise  and  fall  of  the  epideuiic."^'^  Srhotte,  wh(f  was  sur- 
geon-in-chief of  the  British  garrison  at  Sainl-Loui.  in  1778, 
lirst  wi'ote  this  treatise  in  Latin,  but  .vas  finally  ])revailed 
to  i)ublish  it  in  English.     The  work  was  considered  of  such 

^"Hirsch:     Handbusch  der    Historich     Georgraphischen     Path- 

ologie,  Stuttgart,  1881. 
*"  Schotte;  A  Treatise  on    the    Synochus    Atrabiliosa,    London, 

1782. 


258  ,  HISTORY    OF    YELLOW    FEVER. 

importaiue  at  the  time,  that  it  was  trar^slated  into  French 
and  German. 

The  first  case  in  Saint-Lonis  was  imported  from  Goree- 
Dakar  and  was  observed  in  tlie  hospital  on  August  3,  ter- 
minating fatally  on  the  7th.  The  last  death  was  that  of 
Governor  Clarke,  the  commandant  of  the  island,  on  Sep- 
tember 18th. 

Schotte  observes  that  up  to  the  end  of  July  1778,  the 
garrison  and  the  inhabitants  of  Senegal  were,  for  that  time 
of  Ihe  year,  remarkably  healthy.  Ii;  the  beginning  of 
August,  "a  sudden  and  most  dreadful  disease  broke  out," 
which,  raging  until  the  middle  of  Se]  tember,  carried  off 
the  greatest  part  of  the  Europeans  and  a  great  number  of 
the  native  mulattoes  and  blacks.  The  whites  suffered 
much  more,  in  proportion,  than  the  mulattoes  and  the 
latter  much  more  than  the  blacks.  The  few  who  had  es- 
caped the  fury  of  the  pestilence  were  not  attached  after 
September  18th;  but  those  who  had  recovered  were  seized 
with  rela])se  during  the  following  month  and  some  died 
as  late  as  December, 

The  course  of  the  disease  was  frightfully  rapid.  There 
was  hardly  a  day  between  the  9th  of  August  and  the  18th 
of  September  without  one  or  two  deaths.  Out  of  so  small 
a  pojjulation  as  02  Europeans,  we  find  tlie  melancholy 
record  of  four  deaths  on  August  28d,  four  on  the  26th, 
three  on  the  27th  and  five  on  September  5th. 

The  total  number  of  deaths  reached  59.  Eigl  t  of  the 
convalescents  were  still  too  feeble  to  walk  when  the  French 
took  possession  of  the  island  on  January  28,  17'^0. 

Schotte,  who  was  a  valorous  champ'cn  of  African  ende- 
micity  of  yellow  fever,  believes  thot  the  disease  originated 
spontaneously  on  the  Gold  Coast  and  was  then  spread  by 
contagion  to  the  localities  mentioned  in  this  account.  As 
the  French  and  English  were  at  loggerheads,  however,  and 
probably  drew  on  their  West  Indian  tleets  for  transports 
and  l)lockade  runners,  it  does  not  require  a  gigantic  stretch 
of  the  powers  of  observation  to  see  ho^v  easily  the  disease 
could  liave  been  imported  to  the  w?Rt  cnast  of  Africa. 


Si, 


SENEGA  I-.  2.59 

Saint-Louis. 

The  French,  undaunted  by  the  many  reverses  and  the 
ravaj>es  of  disease  whicli  had  marked  their  attempts  to 
colonize  Senegal,  determined  to  recapture  Saint-Louis, 
and,  in  1779,  sent  a  force  of  about  200  men,  headed  by  the 
Due  de  Lauzun,  to  dislodge  the  British.  The  soldiers  were 
recruited  from  the  crack  Walsh  Regiment,  the  Queen's 
Regiment  and  volunteers  and  were  a  fine  body  of  men,  vig- 
orous and  healthy.  The  invading  force  arrived  afc  their 
destination  January  29,  1779,  in  the  dead  of  nighi,  intend- 
ing to  take  the  garrison  by  surprise,  but  they  found  that 
not  even  a  solitary  sentry  guarded  the  place,  and  the  33 
Englishmen  who  had  survived  the  terrible  epidemic  which 
had  just  come  to  a  close,  too  Aveak  aud  disheartened  to 
offer  any  resistance,  surrendered  unconditionaUy,  and 
were  sent  to  France  as  prisoners  of  war.  Two  were 
drowned  by  the  upsetting  of  a  boat  at  the  mouth  of  the 
Senegal  and  three  died  in  transit,  so  ihat  out  of  99  men 
whicli  originally  comprised  the  garrison,  only  28  reached 
Europe  alive. 

But  the  bloodless  victory  achieved  by  the  French  was 
destined  to  have  a  terrible  .^e<iuel.  TJie  landing  of  these 
unaccli mated  soldiers  in  this  charncl  house  of  disease  acted 
like  oil  upon  a  smoldering  tire  and  the  pestilence  soon 
broke  out  with  renewed  fury.  In  the  space  of  a  few 
months,  the  expedition,  Avhich  had  started  out  «o  auspi- 
ciously, was  almost  annihilated.  The  exact  number  of  the 
invading  force  is  not  given,  but  Lejemb'e'^^  informs  us  that 
on  the  mortuary  register  of  Saint  Louis  for  1779,  kept  at 
that  time  by  the  parisli  priest;  appear  the  names  of  one 
Imndred  and  cigJiti/ aoldiersl  A  melancholy  record,  to  be 
sure,  but  what  of  it?  Senegal  was  oncf*  more  a  French  pos- 
session, and  wlien  the  news  of  the  ctipture  of  the  place  from 
the  hated  Englislimen  reached  Pai-is,  there  was  much  re- 
joicing over  the  glorious  deed.  Such  is  the  egoism  of  the 
people.  Life  is  short,  glory  imperishable,  and  it  mat- 
tered not  if  a  hundred  or  so  brave  men  laid   down     their 


Lejemble:    Theses  de  Paris,  1882,  No.  91,  p.  19. 


2  GO 


HISTOR^      OK    YELLOW     FKVER. 


lives  for  the  honor  of  tlicir  codiiti-v,  so  long  as  their  mission 
was  crowned  with  the  laurel  of  triiinijih. 

1828. 

(jorec-L)<ik(u\ 

For  tifty  rears,  Senegal  was  fr(H'  fr-nn  yellow  fever.  In 
1828,  the  Freueh  shij)  La  Bonhlaisc,  infeeted  at  Sierra 
Leone,  bronglit  the  disease  to  Goret-Dakar  ( Hereuger- 
Feraud,  p.  105).  ^Fany  soldiers  attached  to  the  garrison 
were  attacked,  Init  the  outbreak  was  of  short  dura  lion  and 
was  not  followed  by  much  mortality.  On  the  BordcJuisv, 
out  of  a  crew  of  50,  there  resulted  .34  cases.  The  number 
of  fatalities  is  not  stated. 

1S29. 
Goree-Dakar. 

In  the  beginning  of  1821),  a  slave-ship  and  a  ])ii'ate  were 
ca])tured  by  the  Frendi  otf  the  Gold  Coast  and  bvought  to 
Goree-Dakar.^-  The  sailois  from  the  pirate  ship  were 
taken  sick  and  died  at  the  military  hoxj»ital  at  Goree. 

The  disease  soon  manifested  itself  in  the  town.  In 
three  inonths,  out  of  113  Euro])oan  residents,  14  died. 

IS^iO. 
Oorcc-Ddldr. 


The  epidemic  which  radiated  from  (Joroe-Dakar  in  1830, 
without  any  previous  warnini?;,  in  a  mosc  remark- 
annei-,  as  will  be  seen  from  tlif  account  of  the  out- 
given  Ix^low,  taken  from  the  writings  of  three  emi- 
'rench  authors,    Berenger-l-'erai-.d,    Duval    and     Le- 
The  facts  are  as  follows 


began 
able  m 
break 
nent  !• 
jemble, 

On  -Tune  13,  1830,  a  religious  festival  was  in  progress  at 


4:? 


'- Berenger-Feraud,  p.  107. 

*^  Berenger-Feraud,  p.  107;   Ruval,    La    Fievre    Jaune    a    Goree 

(Bordeaux),  1883,  p.  16;  Lejemble,  Theses  de  Paris,  1882, 

No.  91,  p.  20. 


$ 


SENEGAL 1830.  261 

Goree  and  a  jireat  number  of  people  tlironged  tlio  streets. 
AYliile  the  jollification  was  at  its  lieicht,  a  nnniber  of  Sis- 
ters of  Charity  were  taken  ill  and  soon  gave  unmistakable 
evidences  of  yellow  fever  infection.  Jv.  a  few  days,  the 
epidemic  was  in  full  sway  and  between  its  inception  and 
the  first  days  of  August,  when  the  last  cases  were  ob- 
served, out  of  a  white  population  of  ir^O,  there  resulted  144 
cases  and  85  deaths. 

From  Goree,  the  fever  spread  to  the  .  adjoining  negro 
villages  in  the  Gape  Yerd  p^^ninsula  ;md  was  especially 
severe  at  Gandiole  and  Guet  N'dar. 

Saint-Louiy. 

During  the  first  days  of  August,  a  whitG  woman  resid- 
ing at  Saint-Louis  visited  the  market-place  t^t  Guet  N'dar, 
where  a  fair  was  in  progress,  and  retui-ned  home  the  same 
da.^^  On  August  4,  she  was  taken  ill  with  fever  and  died 
in  a  few  days.  A  young  mnlattress  v  ho  had  nursed  this 
woman  was  taken  ill  and  succuml)ed.  A  notary's  clerk, 
who  assisted  in  taking  an  inventory  of  the  possessions  of 
the  white  w-onian,  furnished  the  next  victim.  From  these 
cases,  the  disease  pro]>agated  itself  throughout  tlie  town. 
Saint-Louis,  which  had  a  white  population  of  OoO,  suf- 
fered cruelly,  for  out  of  600  cases,  tliere  resulted  32S  fatali- 
ties. Out  of  ten  physicians,  eight  were  attacked  and  six 
died.^-* 

Probable  Cause  of  the  Epidemic. 

For  a  long  time  epidemiologists  were  at  a  loss  to  account 
for  the  cause  of  this  fulininating  outbreak,  which  seemed 
to  have  si)rung  from  the  ground.  No  suspicious  vessels 
had  been  observed  in  the  harl)or  of  Goree  at  that  period 
and  the  entire  colony  was  in  a  perfect  sanitary  condition. 
Some  tried  to  prove  that  it  was  a  reawakening  of  the 
''germs"  of  the  epidemic  of  the  previous  season  and  even 

"  Berenger-Feraud's  statistics  say  that  out  of  12  physicians  10 
were  attacked  and  6  died;  but  Duval  and  Lejemble  attest 
to  the  correctness  of  the  figures  given  in  the  above  ac- 
count. 


262  HISTORY    OF    YELLOW    FEVER. 

Berentjer-Feraud  half-lieartedly  espoused  that  theory. 
This  view  was  no  doubt  plausible  years  ago,  but  its  ludi 
crousness  at  the  present  age  is  too  apparent  to  need  com- 
menting upon.  The  elusive  yellow  fever  germ  may  be 
eaten  for  breakfast,  lunch  and  supiier,  j-et  no  iH  results 
will  follow;  you  can  take  it  by  its  caudal  appendage  and 
toy  with  it  from  sunrise  till  moonset,  smear  it  all  over 
your  body,  bite  its  head  off  or  swallow  it  in  your  milk  or 
pousse-cafe — you  .may  do  all  this  and  set  remain  healthy 
and  frisky.  But  let  a  Stegomyia  which  has  taken  a 
draught  of  blood  from  a  yellow  fever  sufferer  in  the  first 
stages  of  the  disease  bite  you,  and  if  yt>u  are  not  an  im- 
mune, it's  a  chance  out  of  a  thousand  that  you  will  con- 
tract the  disease. 

The  outbreak  at  Goree  in  1830  can  easily  and  satisfac- 
torily be  elucidated.  All  we  have  to  do,  is  to  take  a  peep 
into  the  past  and  see  what  was  happening  in  that  far-ott' 
land  at  the  time  of  the  outbreak.  As  we  ha\e  already  seen, , 
-the  inhabitants  were  celebrating  a  religious  feast,  and,  as 
is  usually  the  case  with  celebration;.-  of  the  Catholic 
church,  the  whole  zeal  of  the  people  Avas  concentrated  in 
making  the  event  as  gay  as  the  solemn  rites  of  the  Church 
AvouJcl  permit.  Flags,  decorations  and  bunting  were  uSed 
with  profusion.  Berenger-Feraud  anri  Lejemble  inform 
us  that,  for  some  days  previous  to  the  «;elebration,  the  Sis- 
ters of  Charity  were  busy  making  odds  and  ends  with  a 
lot  of  bunting  which  had  been  stored  in  an  out  of-the-way 
room  since  the  epidemic  of  the  year  before.  The  room  had 
never  been  aired  since  the  rags  were  jdaced  tliert.  When 
the  good  sisters  removed  tiie  lot,  the  mosquitoes,  which 
had  been  hibernating  during  the   wirier,   v/ere   liberated  |i' 

and,  famished  after  such  a  long  fast,  fed  eagei'ly  apon  the 
blood  of  the  ]>(>])ulace,  ])ropagating  the  germs  of  the  terri- 
ble disease  far  and  wide. 

1S3T. 

(Jorce-Dalar.  1 

The  epidemic  of  1837  was  the  result  of  flagi'aut  neglect 
on  the  part  of  the  authorities  of  Goree-Dakar.  Since  the 
begin7iing  of  June,  rumors  of  the  existi  nee  of  yellow  fever 


SENEGAL.  26S 

at  Batliurst,  iu  Gambia,  reached  the  town.  In  the  be- 
ginning of  July,  the  Britisli  Government  sent  to  Goree- 
Dakar  for  medical  assistance  and  the  surgeon-in-chief  of 
the  colony.  Dr.  Dupuis,  was  sent  to  the  afllicted  locality. 
He  returned  on  July  21  and  rei)ortel  that  the  fever  had 
subsided  at  Bathurst,  but  advised  that  strict  qiiarantine 
be  maintained.  On  August  12,  a  coaster  arrived  at  Goree 
from  Bathurst,  having  on  board  three  Europeans.  In 
spite  of  the  warning  of  the  colonial  surgeon,  the  vessel  was 
allowed  free  pratique  and  two  of  thj  white  passengers, 
AA'ho  were  ill,  were  admitted  into  the  liospital.  The  third 
passenger  was  next  attacked  and  a)l  t)  ree  died  with  un- 
mistakable symptoms  of  j^ellow  fever.  The  disease  soon 
manifested  itself  in  the  town  and  lasted  until  November 
23,  during  which  time,  out  cf  a  white  population  of  160, 
there  were  80  cases  and  46  deaths.'^''' 

The  French  ship  Malouine,^*^  which  ^ad  been  sent  by  the 
French  Government  to  found  a  town  at  the  mouth  of  the 
Casamanza  Eiver,  in  Senegambia,  wis  contaminated  at 
Goree  and  experienced  a  severe  epideiuic.  Out  (  f  a  crew 
of  57,  there  Avere  42  cases. 

Saint  Lot! ifi. 

The  fever  was  introduced  from  Goree  into  Saint-Louis 
late  in  the  year,  but  did  not  become  epidemic.  About  a 
dozen  cases  were  observed.^" 

1859. 

For  twenty-two  years  Goree  guarded  itself  against  yel- 
low fever  invasion.  On  August  9^  185t),  the  dis])atch  boat 
Le  Ruhi,s  arrived  at  Goree  from  Bathurst,  where  the  fever 
was  prevailing,  with  two  sick  passengt  rs,  the  vicai-general 
and  a  merchant.  The  vessel  was  allowed  free  pratique 
and  the  patients  transferred  to  the  hospital.  The  mer- 
chant recovered,  but  the  priest  died  on  the  12tl).  I'rom 
that  date  to  Septend)er  30,  no  otlu^r  cases  were  observed, 

"Dupont:    Archives  de  Medecine  Navale,  1880,  vol.  34,  p.  262. 
**  Duval:    La  Fievre  Jaune  a  Goree  (Bordeaux,  1883),  p.  17. 
■"  Berenger-Feraud,  p.  111. 


264  HISTORY    OP'    YELLOW    FEVER. 

whou  the  death  of  a  niercliaut  was?  recorded.  TL's-  was  fol- 
lowed by  anotlier  death  on  Octol>er  li't.  The  physician 
who  attended  these  two  cases  contracted  the  disease  and 
died  on  October  12.  The  dis<  as'-  ther  became  A\idespread 
and  there  were  54  deaths  in  October,  25  in  November  and 
G  in  December.  Ont  of  a  wliite  population  of  267,  there 
were  in  all  244  casese  and  102  deatlis.^^ 

Haint-Loiiis 

The  infection  spread  from  Goree  to  Saint  Lou-s,  result- 
ing in  41  cases  and  11  deaths.^^ 

1SC6. 

Go7^ee. 

The  epidemic  of  1800  is  dhecth'  traceable  to  Gambia. 
News  of  the  existence  of  yellow  fever  along  the  coasts  of 
Sierra  Leone  and  Gambia  reached  Goree  early  in  ^lay  and 
measures  were  at  once  taken  to  prevent  importation  of 
the  disease.  On  August  3,  a  coastinj.:  vessel,  the  Marie 
Antoinette,  arrived  from  Bathurst  and,  tlirough  false 
representations,  was  admitted  to  pra^icpie.  It  v,  as  after- 
wards discovered  that  tlie  vessel  did  n<  t  have  a  cb'an  bill 
of  Ileal th.  The  captain  was  arrested  and  lined  heavily,  but  ^ 
the  evil  had  already  been  done.  On  September  15,  a  case  i 
of  yellow  fever  erupted  in  the  town,  followed  l>y  sj^oradic 
cases.  The  ei)idemic  lasted  until  January  27,  1807,  re- 
sulting in  241)  cases  and  110  deaths. •''•*^ 

The  civil  population  of  Goree  in  1800  was  as  follows: 

**  Berenger-Feraud ;  Duval;  Lejemble.  x 

*^  Berenger-Feraud,  p.  135. 

""Cedont:     Archives   de  Medecine  Navale,  Paris,   1868,   vol.   9, 
p.  334. 


SENEGAL— 1866.  2G5 

Natives  (blacks) 2,500 

Miilattoes,  JMales .     3*55 

Mulattoes,  Females „ , .     4;]! 


Europeans  (whites),  ]Males 55 

Eiiropeaus  (whites),  Females iS 


'GG 


103 


3,309 
Miiitar^^  population  (white)    105 

Total , 3,534 

The  cases  and  deaths  were  disti'lbut  h1  as  follows: 


Whites  .  . 
Mulattoes 
Blacks  .  .  . 


Cases. 

Deaths 

242 

107 

4 

•) 

3 

1 

T<;tal 249  110 

It  will  thus  he  seen  tliat  out  of  a  total  white  ix/pulation 
of  268,  there  resulted  242  cases  and  107  deaths.  The  mulat- 
toes,  numherino-  7()(),  furnished  4  cases,  foHowul  by  3 
deaths,  while  tlie  l)hicks,  2,500  strong,  had  onlv  3  cases, 
with  1  death.  Tliis  remarkable  immuTiity  has  always  ])re- 
vailed  among  the  blacks,  not  only  in  Africi',  but  through- 
out the  world. 

Dakar. 

The  ]m)ximity  of  Dakar  to  Goree  and  tlx'  unrestrained 
communication  between  the  two  towns,  could  not  fail  from 
resulting  in  the  infection  of  (he  latter. 

The  first  case  in  Dakar  was  observed  on  O^'tober  ]2tlT, 
followed  by  death  on  the  14tli.  From  that  date  until  the 
end  of  the  e])idemic,  there  resulted  80  cases  and  30  deaths, 
distributed  as  follows: 

("ases.         Deaths. 

Civilian  population 24  11 

INfilitary  population 50  25 

80  36 


266  HISTORY    OF    YELLOW    FEVER. 

Tho  last  death  at  Dakar  oeciuTcd  on  January  21,  1807. 

Oil  the  Snrpri'^e. 

The  gunboat  ^Sur prise  was  the  only  vessel  which  did  not 
take  any  i)iv('autions  a<;ainst  infe<  t'on  and  it  was  also  the 
only  one  to  experience  a  visitation  of  the  disease.  On 
November  5th,  while  in  the  harbor  of  Dakar,  the  first  case 
manifested  itself  on  board".  Nearly  the  entire  crew  was 
attacked,  resulting  in  14  deaths. 

Rupsque  and  i^icdhninn. 

From  Dakar,  the  fever  spread  to  Rufisque  and  Sedhnion, 
but  was  not  severe.  It  will  be  seen  below  how  the  infection 
was  carried  from  Eufisque  to  Gorte  ihe  following-  year 
(1867). 

^aiut-Louis 

Thaidvs  to  the  rigid  quarantine  ob.^erved  by  tlie  health 
otticers,  not  a  single  case  was  observed  at  Saint-Louis. 

18GT. 

In  October,  18(>(),  a  clerk  emplcytd  in  Rutisque  who  had 
gone  on  a  visit  to  Dakar,  Avas  taken  ill  on  his  return  home 
and  died  in  a  few  days.  His  employer  sent  to  France  for 
a  new  clerk,  who  arrived  in  January  1867.  Tlie  new-comer 
was  given  the  same  room  which  liis  predecessor  had  occu- 
l)ied  and  soon  shared  the  same  fate.  In  April,  another 
tlerk  arrived  from  France,  was  given  the  same  living 
room  as  the  two  employes  who  had  died  of  fever.  A  few 
days  aftei-  his  arrival,  he  was  taken  ill  and  died.  A  third 
unfortunate  shared  the  same  fate.  A  friend  i>i  the  latter, 
who  had  been  his  room-mate  on  board  the  ship  which 
brought  him  from  h^rance,  visited  him  while  he  Avas  in  the 
first  stages  of  the  disease,  and,  taking  pity  upon  his  lone- 
liness, resolved  to  nurse  him.  He  soon  contracted  the  sick- 
ness, and,  together  with  his  companion,  was  transported 
to  the  Hospital  of  Goree,  where  both  oatients  died  a  day 
or  two  after.     The  news  of   the   reappearance    of    yellow 


SENEGAL.  267 

fever  in  the  town  created  profound  consteriiatiou  and  the 
governor  ordered  the  embarkation  of  i\\\  the  troo])S  on 
board  the  Crocodile  and  VEtoile  and  tcausjiorted  them  to 
Saint  Louis.  Shortly  afterwards,  the  disease  broke  out  in 
Saint-Louis  and  histed  until  the  cool  season. 

The  disease  spread  to  Leybar^  Lam],gar  and  other  mili- 
tary posts  of  the  colony,  whore  many  cases  and  deaths  oe- 
curred. 

The  cases  and  deaths  in  the  localitie.?!  affected  by  the  epi- 
demic of  18()7  are  not  given  by  Berenger-Feraud,  Lejemble 
nor  Duval,  from  whose  works  the  above  resume  is  made. 

1868. 

According  to  the  London  Medical  Times  and  (kizettcj^^ 
yellow  fever  was  present  in  Senegal  in  1868  and  was  im- 
jtorted  to  the  Cape  Verd  Islands  (q.  v.)  by  trading  vessels 
from  (joree-Dakar.  The  French  authors  deny  th;it  the  dis- 
ease Avas  in  Senegal  that  year  and  implicate  Sierra  Leone 
in  the  importation. 

1872. 

Ooree-Dalvar. 

On  October  5,  1872,  the  ship  Baal  arrived  at  Gioree- 
Dakar  from  Bathurst,  where  yellow  fever  was  raging,  with 
three  European  passengers,  and  ap])liecl  for  pratique. 
This  was  refused  l)y  the  liealth  officer  in  charge.  Dr.  Ber- 
enger-Feraud.  The  merclunits  uf  tlie  town  {protested 
against  what  they  considered  harsh  measures,  asserting 
that  there  was  no  sickness  on  board  the  Baal^  but  their  ob- 
jections were  overruled  and  tlie  vessel  ordered  to  tlie 
quarantine  station  at  Dakar,  ^Much  pj'essui'c  was  brought 
to  have  the  order  revoked  and  the  govf^'nor  was  about  to 
yield,  when  the  quarantine  officer  reported  that  one  of  the 
white  passengers  had  been  taken  ill  with  fever.  The  pa- 
tient was  at  once  taken  to  the  lazaretto,  where  lie  expii-ed 
on  the  0th.  A  second  passenger  was  taken  ill  and  died 
on  the  lOth.  The  third,  a  Spaniard,  who  had  had  yellow 
fever  at  Buenos  Ayres  the  year  before,  was  not  alTected.^- 

"  Medical  Times  and  Gazette,  London,  1869,  vol.  1,  p.  119. 
'"  Berenger-Feraud,  p.  147. 


268  HISTORY    OK    YELLOW     FEVER. 

Sliortly  afterward,  another  vessel  f?"(>m  Bathurst  fur- 
nished a  tliird  ease,  whicli  also  res\dt^^d  in  death  at  the 
lazaretto.  Only  one  inhabitant  of  Dakar  was  attaeked,  a 
soldier  who  had  been  one  of  the  henlth-jiuards  around  the 
lazarLito,  and  who  died  in  a  ^ew  days  after  the  onset. 

It  will  thus  be  S(^''n  that  of  the  four  j^orsons  attaeked,  all 
died,  and  tlie  salvation  of  tlie  eohuiy  v.as  no  doubt  due  to 
the  energetic  measures  taken  by  the  eoinnuindirg  health 
offtetr. 

1S78. 

Gotrc-Dalar. 

We  must  look  to  (Taml)ia  auvl  Sierra  Leone  for  the  seeds 
of  the  terrible  epidemic  which  decin-.at''d  Seneg'al  in  1878.''^ 

During  the  first  five  months  of  1878,  the  public  health 
was  excellent  throughout  Senegal.  A  J<nv  eases  of  dengue 
were  observed  here  and  there,  but  otlierwise  tlifre  were 
no  febrile  disorders.  Yellow  fever  was  in  Sierra  Leone 
and  (xambia  and  precautions  were  taken  at  Goree  to  pre- 
vent its  imi)ortation,  but  these  sanitary  measures  were  un- 
doubtedly elastic,  for  nine  Enro])ean  r^'fugees  fi'om  a  little 
settlement  near  Bathurst  were  ])ermitted  to  land  at  Goree 
in  the  beginning  of  July  and  mingle  with  the  population. 
At  about  the  same  time,  an  English  vessel  arrived  at  Goree 
from  Sierra  Leone  and  was  given  pratique. 

The  ci'iminal  im])i'iidence  of  the  authorities  in  harbor- 
ing these  refugees  from  localities  whicli  had  infected  Goree 
again  and  again  in  the  past,  soon  bore  fruit.  On  July  11, 
the  chief  nmgistrate  of  the  t<)wn  was  taken  ill  and  died  on 
the  18th.  A  few  days  later,  othei*  » asev^  were  observed,  one 
terminating  in  death  at  the  hospital  on  July  22.  Another 
death  occurred  on  the  24th,  one  on  the  2(>th  and  three  on 
the  27tli.  The  state  of  affairs  was  ^a  ell-known  to  the 
authorities,  who  were  day  by  day  informed  of  the  progress 


In  compiling  the  history  of  this  memorable  epidemic,  we 
have  consulted  the  writings  of  the  following  eminent 
French  writers:  Berenger-Feraud,  Lejemble,  Duval, 
Dupont,  Daril,  Forne,  Kermorgant,  and  Vincent.  The 
full  title  of  these  works  will  be  found  in  the  Bibliography 
at  the  end  of  this  volume. 


I 


SENEGAL — 1878.  269 

of  the  outbreak,  but  the  facts  were  suppressed  from  the 
general  i)ublic  and  it  was  only  on  July  30,  when  it  was 
seen  that  the  ei)ide]uic  was  gettinji-  beu«nd  coiiti'ol,  that  a 
proelaniation  announcing  the  existence  of  tlic  disease  was 
published  in  the  3Ionitenr  Officicl  du  Senegal. 

Saint-Louis  was  thrown  into  a  panic.  Strict  (juai-antine 
Avas  maintained  against  (Joi-c^e  and  tlu  pest  was  tempora- 
rily kei)t  away  from  its  doors. 

The  epidemic  made  rapid  progress  at  Goree  and  soon 
spread  to  its  suburb,  Dakar,  At  the  end  of  July,  the  bar- 
racks were  evacuated,  as  a  sanitai-y  precaution,  and  the 
sohli(a-s  dispersed  to  minor  posts  of  the  colony,  being;  (piar- 
tered  at  Ilann,  ^rBidgen,  Bel- Air  arid  Thies.  But  this 
exodus  did  not  sto])  the  ravages  of  the  disease  Between 
tlie  1st  and  15th  of  August,  30  deaths  occurred  at  (ioree- 
Dakar;  between  the  15t'h  and  30th,  20.  The  epidemic  then 
seemed  to  be  on  the  wane,  for  only  12  deaths  occurred  in 
tlie  months  of  Septeml)er  and  October.  Only  one  death 
took  ])lace  from  Se])t(Miibei-  2S  to  October  28,  and  the  ei)i- 
demic  was  thouglit  to  be  emUMl,  whei'  some  ne>\  arrivals 
rekindk'd  the  spark  of  contagion  and  we  find  a  record  of 
3  deaths  on  October  29th  and  4  on  Deceml^er  9th. 

The  population  of  (loree-l)akar  in  1S78  was  about  3243, 
of  whicli  120  were  Eui'iJjx'ans.  When  'he  (i)ideiuic  broke 
out,  21  tied  to  Europe,  leaving  a  white  population  of  99. 
Out  of  this  number,  there  were  88  deaths, 

Saint-Louis  I'emained  uncontaiiiinat  d  uiitil  Siptember 
(I,  when  the  dispatch  boat  ll^jntilini  a  'rived  from  Jiakel 
and  was  allowed  free  communication  with  the  inhabitants 
of  the  town.  On  Se])tember  9,  the  ship's  surgeon  was 
taken  ill  with  "bilious  fever"  and  trans]K)rtrd  to  the  mili- 
tary hos])ital,  where  lie  died  on  the  13! h,  with  unmistak- 
able symptoms  of  yellow  fever. 

The  invasion  would  in  all  probnbility  have  been  con- 
fined to  this  case,  for  Saint-Louis  had  up  to  that  date  suc- 
cessfully ballled  the  jK'stiieiire  whi(  h  was  at  its  very  doors, 
had  it  not  been  for  an  un])ardonable  'mi)rudencc  on  the 
part  of  the  health  authorities,    caused   by   over-contidence 


270  HISTORY    OF    YELLOW    FKVIR. 

and  commercialism.  On  September  29,  the  dispatch  boat 
Cygne.  which  had  taken  part  in  the  expedition  against  the 
natives  of  the  Upper  Senegal,  returird  to  Saint-Louis, 
having'  on  board  51  wounded,  of  which  17  were  Europeans. 
The  Cyyne  was  permitted  to  land  her  passengers  unmo- 
lested, although  it  was  known  that  the  vessel  came  from 
an  infected  territory.  The  soldiers  returned  to  their 
homes  and  mingled  freely  with  the  pojulation.  In  a  few 
da3%  the  poison  began  to  diffuse  itself  through  the  town 
and  the  tirst  death  from  yellow  fever  oocurT-ed  on  October 
6.  The  next  day,  another  case  terminated  fatally.  Other 
cases  followed  rapidly,  proving  fatal  in  almost  every  in- 
stance. On  October  8,  the  disease  was  widespread.  In 
spite  of  this  deplorable  state  of  affairs,  the  authorities 
strenuously  denied  all  knowledge  of  the  existence  of  j-ellow 
fever  in  the  town,  even  after  eight  fatalities  had  taken 
place  between  the  9tli  and  15th  of  October.  About  that 
date,  although  still  refusing  to  admit  that  the  epidemic 
was  one  of  yellow  fever,  the  administ. ation  began  sending 
the  sick  and  the  "suspicious  cases"  to  an  improvised  lazar- 
etto at  the  Pointe-aux-Chameaux,  a  short  .listauce  from 
Saint-Louis. 

The  truth  of  the  presence  of  the  terrible  disease  in  their 
midst  soon  l)ecame  too  apparent  to  Iv?  discountenanced 
and  the  stolid  optimism  of  the  little  group  of  Europeans 
suddenly  gave  place  to  panic  and  despair.  A  rumor  was 
circulated  that  all  the  cases  transported  to  Pointe-aux- 
Chameaux  died  as  soon  as  they  reached  the  lazeretto  and 
the  families  of  the  "suspicious  cases"  soon  began  to  con- 
sider an  order  for  the  transportation  of  a  beloved  one 
equivalent  to  a  burial  permit.  ^, 

Lcjcml)le  graphically  descril)es  the  wav  in  v.hich  the 
unfortunates  were  transferred  to  the  lazarettu.  Every  |^* 
morning,  about  nine  o'clock,  the  patrol  Avould  make  its  f:~ 
rounds  and  anyone  found  with  fever,  or  even  "suspicious," 
was  taken  in  tow.  It  was  a  gi-uesome  sight  to  see  these 
wretches  dragging  their  Avays  thrcugb  the  streets  of  the 
town,  some  clad  only  in  the  blanket  which  had  covered 
them  on  the  sick-bed,  some  so  weak  that  they  had  to  be 
propped  up  and  helped  along  by  the  native  healtli-guards. 
But  tlie  people,  dazed  by  the  teriiiiie  Jiav^c    which     was 


SENEGAL. 1878.  87  1 

goiug-  on  iu  their  midst,  looked  on  >vitli  sullen  indifference 
at  the  spectacle  of  their  relatives  cr  comrades  being  driven 
like  cattle  to  the  water's  edge,  where  tiicy  would  be  packed 
into  a  small  boat  hardly  able  to  contain  half  their  num- 
bers and  rowed  by  blacks  for  two, Weary  hours,  under  a 
blazing  tropical  sun,  to  the  pest-hovse  at  the  Pohite-aux- 
Chameaux.  No  wonder  that  they  were  either  dead  or  mori- 
bund vrhen  they  reached  their  destination.  And  (lie  terror 
which  the  simple  Avord  "Lazaretto"  caused  the  people  was 
certainly  well-founded,  for  out  of  about  150  yellow  fever 
patients  transported  from  Saint-Loui?!  to  the  Pointe-aux- 
Chameaux  between  October  15  and  T\oven'iber  IT,  there 
were  108  fatalities. 

If  the  mortality  at  the  Pointe-aux-Chameaux  lazaretto 
was  excessive,  other  localities,  where  the  soldiers  were  sent 
by  the  authorities  in  a  frantic  endeavor  to  stop  the  ravages 
of  the  disease,  suffered  as  much.  At  O'Niaga,  Lampsar, 
N'Dialakkar,  Bel-Air,  Cape  Manuel,  Hann,  M'Bidgen, 
Tides,  and  other  j^osts,  we  find  the  same  terrible  record  of 
fatalities. 

The  fatalities  in  Saint-Louis,  when  ihe  last  death  took 
place  (December  17),  amounted  to  3r>  among  the  civil 
population  (Europeans)  and  30  sold'ci's. 

The  Disastrous  Lor/o  U-vpt  Jition 

While  the  epidemic  was  raging  at  Goree,  the  French 
government  ordered  that  a  punitive  foi  ce  be  sent  lo  Logo, 
a  district  northeast  of  Sieri-a  Leone,  +o  avenge  some  fan- 
cied wrong  committed  by  tlie  natives.  The  chief  health 
officer  of  Saint-Louis,  the  starting  ])oint  of  the  expedition, 
sent  a  vigorous  protest  against  su^di  a  measure,  urging 
as  the  ])rinci])al  reason  the  unsanitary  coMdition  of  the 
country,  the  fact  that  yellow  fever  was  raging  "up  the 
river,"  and  the  distance  of  the  territory  to  be  invided;  but 
his  protestations  were  unheeded  On  September  11,  a  few 
days  before  the  fever  broke  out  in  Saiiit  Louis,  the  troops 
were  embarked  on  the  dispatch  boats  Arahc,  Ci/f/nc  and 
Espadon.  The  expedition  consist',  d  of  535  iiit  n,  317 
Europeans  and  218  native  soldiers.  The  l.ealtl:  of  the 
column  was  perfect. 


272 


HISTORY    OP"    YELLOW    FEVER. 


The  fii>t  cases  on  board  the  flotiihi  took  place  in  the 
vicinity  of  Daiiana  and  Podor  and  the  first  death  occurred 
at  Kakel,  in  FriMich  Sondan  v<|.  v.),  on  September  15,  foui' 
days  after  leavini*  Saint-Louis.  ]*revions  to  the  arrival 
of  the  vessels  at  l^akel,  where  the  ••jirrison  consisted  of 
only  eij^lit  Europeans,  there  had  becTi  seven  deaths  from 
yellow  fev(  r  in  the  villaiie  Ijetwc-n  Aujnist  10  and  Se])teni- 
ber  11.  Includinii  tht^  case  Avhich  terr-inated  f-iLally  on 
September  15,  and  wliich  was  im])orted  by  the  exi^edition, 
lliei'e  were  altogether  17  deaths  at  Bnkel  between  Aujiust 
10  and  October  27.  Nine  of  these  denths  resulted  from 
eases  landed  from  tlie  Arahc  and  Esjxnlon. 

Yellow  fever  was  also  prevailinji  at  Salde,  a  small  post 
on  the  Upper  Sene<»al  Kiver,  which  haO  been  contaminated 
by  Tialiel,  for  some  time  previous  to  tlie  arrival  of  the  fleet. 
A  death  occurred  on  August  22d,  one  on  tlie  2(it)i,  and  a 
third  on  September  5th.  After  the  "battle"  of  Saboucire, 
the  soldiers  stopi)ed  at  Salde  on  their  \,  av  to  Sanit-Louis 
and  we  tind  a,  record  of  three  deaths  on  October  3  and  one 
on  October  11,  making  a  total  of  nine  deatlis  between 
August  22  and  October  11. 

The  "battle"  of  Saboucire  t(K>k  j)lace  on  September  22 
and  lasted  four  hours,  Avithout  accomplishing  anytliing 
decisive.  The  column  immediately  Ik  gan  its  journey 
h(uiiewai-d.  For  ten  days  the  expedition  slowlv  wended  its 
way  down  the  Senegal  Kiver,  harassed  by  disease  and 
fatigu' .  Tnable  to  proceed  further,  owing  to  the  wide- 
sjiread  ])revalence  of  fev<'r  in  their  ianl>s,  a  portion  of  the 
retreating  column  halte<l  at  Oauana,  while  the  balance 
proceeded  as  far  as  Kichard-Toll,  wh(?e  further  progress 
was  found  intpossible.  The  intensity  (f  the  fever  which 
was  decimating  the  soldiers  Is  proAcd  hy  th"  fact  that  113 
were  luiried  at  l)(»gana  and  22  at  Kiel  ard-T(»ll. 

ll  will  be  seen  that  the  ill-advised  Logo  expedition  acted 
like  a  firebrand  in  spreading  the  pestilence.  Post  after 
post  was  infected  during  its  funereal  march  an<l  when  the 
remnants  of  the  column  finally  reached  Saint-Louis,  after 
having  "])unished"  the  savages  in  a  manner  which  reflected 
doubtful  honor  upon  the  French  aims,  yellow  fever  had 
claimed  (tne  hundred  and  seventy-six  victim?. 


SENEGAL — 1878.  273 

Statistics  of  the  Scncf/al  Fpidonic  of  1878. 

Th^  yellow  fever  epidemic  of  1878  ia  Senegal,  which  be- 
gan at  Goree-Dakar  on  Jnly  11  and  ended  at  Suint- Louis 
on  December  17,  resulted  in  719  deaths'.  This  ligure  only 
represents  the  fatalities  among  the  white  population,  con- 
sisting of  271  civilians  and  1200  soldiers.  The  course  of 
the  disease  among  the  blacks,  who,  in  nearly  every  in- 
stance, proved  immune  to  yellow  fever  duriog  epidemics  in 
Senegal,  is  lightly  touched  upon  by  the  numerous  authors 
we  have  consulted  and  the  natural  inference  is  that  the 
natives  must  either  have  totally  escaped  or  suffered  so 
little,  that  it  was  not  thought  worth  while  to  go  into  de- 
tails. 

^    The  mortality  among  the  whites  was  as  follov.'s : 
Arrondissement  of  Goree   (Goree-Dakar  and  neigh- 

moring  villages)    373 

Logo  Expedition    17G 

Arrondissement  of  Saint-Louis  (Saint-Louis,  Poihte- 

aux-Chameaux  and  neighboring  villages)   ....      .  .     200 

Total  deaths .  .     749 

1879. 
Dagana. 

A  single  case  of  yellow  fever  manifested  itself  in  Sene- 
gal in  1879,  at  Inigaua,  in  the  person  of  an  arniy  officer. 
The  patient  recovered.^^ 

1880. 
Saint-Louis. 

In  ^farch,  1880,  s])oradic  cases  of  yellow  fever  were  ob- 
served in  a  small  house  adjoining  the  barracks  at  Saint- 
Louis,  occupied  by  tailors  attached  to  the  regimeT>t.  Sani- 
tary measures  were  at  once  taken  and  the  disease  restrict- 

"Noury:    Gazette  Medicale  de  Nantes,  1884,  vol.  2,  p.  85. 


27*  HISTORY    OF    YELLOW    FEVER. 

ed  to  its  orij»iiial  site.  The  j»ensis  of  this  outbreak  has 
never  been  clearly  elucidated.  Beren^er-Feraud^^  notes 
the  fact  that  the  tailors  liad  been  occupied  in  remodeling 
cloth  iiarments  wliich  had  been  stored  juuce  the  great  epi- 
demic of  1878,  and  attributes  the  infection  to  this  fact.  But 
this  theory  can  hardly  be  seriously  entertained.  The  epi- 
demic of  1878  came  to  an  end  on  Drcember  J  7  of  that  year 
and  the  outbreak  under  discussion  took  place  in  March, 
1880.  It  will  therefore  be  seen  that  th*^,  veteran  fit.egomyia 
Calopac  of  1878  must  have  been  endowed  with  phenome- 
nal powers  of  endurance  to  hibernate  for  fifteen  months  in 
a  lot  of  old  garments  and  then  be  possessed  with  sufficient 
l)ugnacity  and  vigor  to  introduce  tlie  poison  into  the 
systems  of  the  unfortunate  wielder«  ol  the  needle  and 
tiiread. 

That  the  health  authorities  of  Saii't-Louis  l)Plieved  in 
the  theory  promulgated  by  Rerenger-P'.-raud^  was  proved 
by  the  fact  that  the  offending  garments  were  oidered  to 
be  incinerated  and  the  vestment  makers  were  put  under 
strict  surveillance.  The  outbreak  wa<  stamped  out  at 
once  and  the  public  health  continued  to  be  excellent 
throughout  the  winter.  In  tlie  beginning  of  November, 
however,  the  fever  again  broke  out  in  tlie  infantry  barracks 
of  the  garrison  of  Saint-Louis  and  lasted  until  the  begin- 
ning of  1881,  resulting  in  eighty  d(atliJ-.  Tbe  cause  of  this 
second  outbreak  has  never  been  lu<  idlj  explained. 

1S81. 

Saint-Louis. 

The  year  1881  witnessed  another  terrible  epidemic  of 
yelloAv  fever  in  Senegal.  We  are  indebted  to  Berenger- 
Feraud,  Duval,  de  Bois'se,.  Xourv  and  Esclagon  for  the 
facts.'"' 

'The  first  case  was  observed  on  June  20,  in  a  soldier  at- 
tached to  the  marine  infantry  of  Snint-Louis,  wlio  was  ad- 

°*  Berenger-Feraud,  p.  169. 

'*  Berenger-Feraud,  loc.  cit.,  p.  170;  Duval,  loc.  cit,  p.  24;  de 
Boisse:  Theses  de  Paris,  1884,  No.  52;  Noury:  Gazette 
Medicale  de  Nantes,  1884,  vol.  2,  pp.  84;  103;  Esclagon; 
Theses  de  Paris,  1883. 


i 


SENEGAL 1881.  275 

mitted  into  the  hospital  on  the  27th,  and  died  July  2d.  On 
July  20,  another  soldier  entered  tlie  It  spital  and  died  on 
the  23d,  with  unmistakable  symptoms  of  yellow  fever. 

In  the  interval  between  these  two  eases,  three  others, 
followed  by  death,  had  broken  ont  in  different  sections  of 
the  town — one  on  July  5th,  which  proved  fatal  on  the  10th ; 
one  death  on  the  lltli  and  another  on  ti'e  15th. 

On  July  23,  several  cases  suddenly  manifested  them- 
selves all  over  the  city  and  at  the  barracks.  From  that 
date,  the  epidemic  had  full  sway  ai-d  Ir.sted  until  Septem- 
ber 26th.  Out  of  a  population  of  1,000  Europeans,  there 
resulted  524  cases  and  425  deaths. 

M  alcana. 

On  July  25th  and  28th,  108  sohlieis  were  transferred 
from  ^aint-Louis  to  Makana,  a  village  near  Lampsar.  Al- 
most immediately  after  their  arrival,  eight  men  were 
stricken  with  fever  and  died  in  a  day  or  two  nfter  the  onset 
of  the  disease.  A  ninth  case  liianifested  itself  and  died 
August  14th.  On  the  20th  another  case  occurred,  followed 
by  death  on  the  23d.  This  concluded  the  outbreak  at 
Makana.  No  cases  originated  in  the  village,  the  attacks 
being  confined  to  persons  who  had  ret  ently  arrived  from 
Saint-Louis.  This  probably  saved  the  balance  of  the 
refugees,  for  every  attack  resulted  in  death. 

Pointe-aux-Cham  eanv. 

Ninety-three  soldiers  were  sent  fr'jm  Saint-Louis  to 
rointe-aux-Chameaux ;  92  to  N'Dijigo  and  83  to  Eichard- 
Toll.    Not  a  single  case  occurred  at  any  of  these  posts. 

Bop-Diarra. 

On  July  30th,  215  men  from  the  Saint-Louis  barracks 
were  transported  to  Bop-Diara.  From  that  date  to  Sep- 
tember 10th,  21  cases  and  13  deaths  were  recorded  in  the 
three  camps  improvised  at  this  post. 


276  HISTORY    OF    YELLOW    FEVER, 

Govee-Dalcur. 

The  Castor  played  a  more  uiifortuiiate  role  iu  the  chain 
of  iufection  than  any  other  vessel  in  Liie  waters  of  the 
Senegal,  for  it  transmitted  the  di^^ea-'C  to  Gorte-Dakar, 
which  had  remained  uncontaminat(Ml  whil?  the  ])estilenee 
was  being  carried  in  every  direction  by  rcfngers  from 
Saint-Lonis  and  other  infected  posts.  The  Castor  will  be 
remembered  as  one  of  the  dispatcli- boats  which  helped  in 
the  transportation  of  the  Logo  Expedition  of  1878  and 
which  fnrnislied  its  qnota  of  Aictims  in  Ihe  memorable 
ei)idemic  of  that  year.'''' 

In  the  l)eginning  of  the  epidemic  of  1881.  a  case  of  yel- 
low fever  had  been  bronght  from  the  Castor  to  the  military 
hospital  at  Saint  Louis.  The  vessel  was  then  sent  on  a 
mission  to  the  Cape  Verd  Islands,  wiih  the  hope  that  the 
trip  would  prove  sanitary  and  prevent  further  eruptions. 
No  further  cases  occurred.  ^Vllen  the  vessel  returned  to 
Saint-Louis,  it  was  learned  that  the  disease  had  assumed 
grave  proportions  in  the  town  and  she  was  ordered  to 
Goree.  Tlie  crew  continued  healthy  and  Goree  was  con- 
gratulating itself  upon  having  kej't  the  pestileuce  away 
from  its  doors,  when  the  commandant  of  the  Castor  was 
taken  seriously  ill.  On  the  pretext  that  it  was  simply  mal- 
aria, for  if  yellow  fever  had  been  mentioned  the  pati(mt 
would  have  been  turned  away,  tlie  case  was  admitted  into 
the  hospital  at  Goree.  The  patient  died  on  September  5th. 
The  attending  physician.  Dr.  Carpentin,  who  had  seen  the 
disease  at  Guadeloupe,  unhesitatingly  pronounced  it 
yellow  fever,  but  refi-ained  fi-om  givi'ig  publicity  to  the 
fact,  fearing  a  panic  and  thinking  no  other  cases  would 
ensue.  A  day  or  so  after  the  death  of  the  officer,  a  work- 
man on  board  the  Castor  was  taken  i'l  and  died  in  a  few 
days.  Tlie  news  of  tliis  second  case  roused  the  health 
authorities  from  their  lethargy  and  tl.e  vessel  was  put 
under  strict  quarantine  and  sent  to  Bel -Air.  On  Septem- 
ber 12,  another  yellow  fever  death  took  place  on  the  Castor. 
The  crew  was  transported  to  tents  on  shore  and  Hie  vessel 
thoroughly  fumigated.    The  creAV  v^'as   then   re-tmbarked, 

"  See  account  of  the  Senegal  epidemic  of  187S  in  this  volume. 


SENEGAL 1881.  877 

as  the  accommodatious  on  sliore  wore  mise^^ably  deficient. 
The  health  of  the  sailors  continuing  to  be  bad,  the  vessel 
was  ordered  to  France. 

But  the  evil  was  already  beyond  redemption.  The  germs 
of  infection  created  by  the  adniis\sion  of  the  commandant 
of  the  Castor  at  the  Goree  military  hospital,  though  slow 
to  manifest  themselves,  finally  gave  evidence  of  their 
virility.  Two  physicians  attached  to  the  liospital  were 
successively  attacked,  one  of  the  cases  resulting  in  death. 
Dr.  Carpentin's  secretar}^  was  the  next  victim.  The  doc- 
tor himself  contracted  the  disease  and  died  and  the  young 
man  who  had  succeeded  the  first  secretary  shared  the 
same  fate.  The  disease  seemed  to  be  confined  tc  the  hos- 
pital, when  a  Sister  of  Charity  iittacl:c-d  to  the  parochial 
school  was  suddenly  stricken,  dying  shortly  af.'^erwards. 
After  this,  sporadic  cases  were  observed  here  and  there 
throughout  the  city. 

The  disease  was  at  no  time  virulent  at  Goree-Dakar. 
There  were  altogether  16  deaths. 

The  Fever  on  the  GovernAiievi  Vessels. 

While  the  epidemic  was  raging  at  Soint-Louis,  five  gov- 
ernment vessels  w'ere  moored  at  the  wh.irves,  namely:  The 
Jaguar,  the  Alecton,  the  African,  Vae  Cijf/ne  and  the 
EcureuU. 

The  dispatch-boat  VAfricain.  an  "(»!d  tub,"  and  at  the 
time  seldom  in  active  service,  had  a  crew  of  forty  whites 
at  the  inception  of  the  epidemic.  It  was  anchored,  or 
rather  tied,  to  the  wharf  at  Saint-Louis  and  was  used  as 
a  sort  of  floating  workshop  bv  the  military  authorities. 
It  was  in  continuous  communication  with  the  shore.  On 
July  2()th,  the  first  case  of  yelloAv  fever  was  observed  on 
board,  followed  shortly  after  by  six  others.  On  August 
12th,  the  old  hulk  was  take'i  in  tow  by  VEcureidl  and 
brought  to  -Mouit,  where  her  crew^  was  transported  to  im- 
provised tent-hospitals  on  shore,  a  short  distance  from 
those  occupied  by  the  sick  from  the  Jacfuai,  On  August 
10,  a  new  case  developed  in  the  camp,  and  from  July  20, 
the  date  of  the  first  case,  until  October,  ihere  were  33  cases 
and  23  deaths. 


278  HISTORY    OF    YELLOW    FEVER. 

The  Jaffuar,  an  old  wooden  gunboo.t,  illj-constructed 
and  badly  ventilated,  and  wliicli  had  i.ininterrupted  com- 
mnnieation  with  Saint-Louis,  had  a  crew  of  GO  whites  and 
25  blacks.^^  On  July  29,  the  first  ease  broke  out  on  board, 
followed  on  the  31st  by  six  others.  August  1st,  another 
case.  The  vessel  was  ordered  down  the  river  to  ^Mouit, 
where  three  large  tents  were  constructed  for  th'^  accom- 
modation of  the  sick  and  other  members  of  the  crew.  In 
spite  of  these  precautions,  up  to  the  fii&t  days  of  October, 
43  new  cases  developed  in  the  improvised  hospitals.  Total 
cases,  51 ;  deaths,  23. 

The  Cygne  was  in  dock  when  the  epidemic  began.  On 
August  4,  the  repairs  being  completed,  the  vessel  was 
again  placed  in  commission  with  a  crew  of  21  whites  and 
24  blacks,  and  anchored  at  the  same  place  where  the 
Jaguar  had  been  Avhen  the  fever  first  manifested  itself  on 
board,  where  it  remained  four  days.  On  August  8,  the  ves- 
sel left  its  moorings  and  anchored  in  the  middle  of  the 
river.  On  the  9th,  four  members  of  the  crew  Avere  taken 
ill  with  fever,  but  recovered  after  only  three  days'  illness. 
These  four  cases  presented  no  symptoms  whatever  of  yel- 
low fever,  but  on  the  13th,  two  other  members  of  the  crew 
were  taken  ill,  presenting  totally  different  symptoms,  and 
were  sent  to  the  hospital.  One  of  the  cases  recovered  after 
a  brief  illness,  but  the  other  proved  to  be  a  typical  case  of 
yellow  fever  and  died  three  days  after  the  onset.  The 
Cygnc  left  Saint-Louis  on  xVugust  lO  for  Bop-Diarra,  hav- 
ing in  tow  a  barge  containing  a  large  number  of  patients 
destined  for  the  hospital  at  tliat  point.  On  September  26, 
the  Cjjgnc,  which  in  the  interval  had  made  several  voyages 
from  the  Point-aux-Chameaux  to  Saint-Louis,  returned 
to  her  ancliorage  at  tlie  latter  town.  Being  the  only  vessel 
then  available,  it  was  immediately  pressed  into  service  and 
sent  up  tlie  river  Avith  a  tow  of  barges  containing  pro- 
visions and  medicines  for  the  yellow  fever  sufferers.  It 
Avas  soon  discovered  that  the  machinery  of  the  Cygnc  Avas 
not  strong  enough  for  such  a  heaA'y  toAA',  but  the  necessity 

''All  vessels  plying  in  the  waters  of  the  Senegal  River  are 
equipped  with  native  sailors,  who  do  most  of  the  out- 
door work,  as  the  whites  cannot  stand  the  fierce  rays  of 
the  tropical   sun. 


SENEGAL 1881.  279 

being-  urgeut,  the  cariio  was  traiis])orted  on  board  the  ves- 
sel, Avhicli  proceeded  on  its  mission.  The  voyage  came  to 
an  end  on  October  8  and  the  vessel  returned  to  Saint-Ix)uis 
October  17,  where  two  white  army  officers  from  Bop- 
Diarra,  where  yellow  fever  was  still  present,  and  one  hun- 
dred negro  workmen  from  Saint-Louis,  were  embarked, 
destined  for  work  on  the  railroad  in  course  of  construction 
up  the  Senegal  Kiver.  During  the  voyage,  which  lasted 
until  October  30,  not  a  single  case  of  yellow  fever  was  ob- 
served on  board  the  vessel.  On  its  return  to  Saint-Louis, 
forty  Africans  and  fifty  Moroccans' were  sent  on  board 
and  ordered  transported  to  the  railroad  camps  up  the 
river.  The  jMoroccans,  who  originally  nundiered  150,  had 
lost  one-third  of  their  fellow-men  by  yellow  fcA^er  at  Saint- 
Louis.  The  voyage  was  uneventful  and  when  the  Cijgne 
returned  to  the  capital,  the  epidemic  had  almost  died  out. 
The  last  death  in  town  took  place  on  November  20th  and 
quarantine  was  raised  December  10th. 

We  have  given  a  full  account  of  the  transactions  in 
which  the  Cycjne  participated,  because  the  vessel  showed 
a  remarkable  freedom  from  infection.  Out  of  21  Euro- 
peans on  board,  only  one  attack,  followed  by  death,  took 
place,  although  the  vessel  was  activel}^  engaged  in  trans- 
porting the  sick  and  the  pestilence  was  raging  all  around 
her.  Tlie  fact  that  the  vessel  was  fresh  from  the  dock, 
where  she  had  been  thoroughly  overhauled  and  repaired, 
probably  saved  her  from  an  invasion  of  the  Stegomijia 
Calopiis,  and  to  this  must  we  attribute  lier  immunity 
after  the  first  case,  Avhich  had  evidently  been  imi)orted. 

The  Alevton,  a  dispatch-boat  employed  in  the  coast  ser- 
vice, was  at  Dakar  when  the  epidemic  broke  out  at  Saint- 
Louis.  She  was  forbidden  communication  with  the  in- 
fected town.  About  the  end  of  August,  she  left  Dakar  and 
sailed  up  the  Senegal  Biver,  anchoring  a  short  distance 
below  Saint-Louis,  to  the  windward  of  two  merchant-ves- 
sels,  the  General  Bcif/c  and  tlie  (lahrlcUr.  There  had  been 
yellow  fever  cases  on  board  both  these  vessels,  but  the  fact 
had  been  withheld  from  the  authorities  and  the  little  dis- 
patch-boat remained  for  a  week  in  the  vicinity  of  the  ships, 
unsusi)ici()us  of  danger.  On  Se])tember  0,  she  was  sent  to 
the  Cape  Verd  Islands  with  a  dispatcli  from  the  Governor 


280  HISTORY    OF    YELLOW     FSVER. 

of  the  colony.  "While  enroiite  to  the  islands,  snspirions 
cases  began  to  show  themselves  among  the  officers  and  the 
vessel  was  sent  to  the  Saint  Vincent  Island  quarantine  sta- 
tion on  her  arrival  at  the  Cape  Yerds,  but  only  remained 
there  a  few  hours,  her  captain  preferring  the  open  sea. 
On  September  14,  on  the  return  voyage  to  Saint-Louis,  the 
first  death  took  place,  followed  the  next  day  by  two  others. 
On  tlie  17th,  the  vessel  re-entered  the  Senegal  River  and 
the  crew  was  disembarked  and  placed  in  a  tent  on  Baba- 
guay  Island,  where  the  last  death  took  place  on  October  1. 
There  were  altogether  15  cases  and  8  deaths. 

The  Ecureuil,  a  new  vessel,  with  a  crew  of  40  whites  and 
25  blacks,  arrived  at  Saint-Louis  on  the  same  day  that  the 
epidemic  broke  out.  Her  officers  and  crew  had  uninter- 
rupted communication  Avith  the  town,  and,  being  the  only 
available  vessel  for  the  purpose  at  the  time,  it  was  used 
to  transport  the  troops  to  the  several  towns  up  and  down 
the  Senegal  River.  No  ill  effects  were  observed  on  board 
until  August  lltli,  when  the  cook  and  the  mess-boy  pre- 
sented characteristic  symptoms  of  yellow  fever  and  were 
transported  to  the  military  hospital  at  Saint-Louis,  where 
they  died  in  a  few  days.  On  August  15,  the  Ecureuil  was 
sent  on  a  mission  up  the  Senegal  and  during  a  cruise  last- 
ing a  little  over  a  month,  no  other  cases  developed.  About 
the  end  of  September,  the  vessel  returned  to  Saint-Louis, 
but  profiting  by  past  experience,  it  did  not  anchor  opposite 
the  town,  luit  proceeded  to  the  Pointe-aux-Chameaux, 
where  it  remained  until  the  end  of  the  epidemic. 

Statistics  of  the  Epidemic. 

The  total  mortality  from  yellow  fever  among  the  Euro- 
pean population  during  the  epidemic  of  1881  has  been  esti- 
mated at  TOO  (Duval).  We  could  only  get  statistics  of 
transactions  at  the  principal  places  of  the  colony.  No- 
where do  we  find  a  word  about  the  progress  of  the  malady 
among  the  natives.  The  following  recapitulation  will  give 
an  idea  of  the  malignity  of  the  outbreak : 


51 

23 

33 

23 

15 

8 

2 

2 

1 

1 

SENEGAL.  281 

Locality.  White  Population.     Cases.  Deaths. 

Saint-Louis 1,000  524  425 

Bop-Diarra 215  21  13 

Makana 108  10  10 

Goree-Dakar 16  14 

Unclassified 362  181 

On  vessels :  ' 

Jaguar 60 

L'Africain 40 

Alecton 47 

L'Ecureuil 40 

Le  Cygne 21 

1035  700 

The  number  of  "unclassified"  cases  (362)  is  estimated 
on  a  mortality  of  fifty  per  cent.,  based  upon  the  excessive 
death-rate  at  every  locality  where  the  disease  prevailed. 
For  example,  Saint-Louis,  with  a  population  of  1,000 
Europeans,  had  524  cases  and  425  deaths;  ]Makana  had  a 
mortality  of  one  hundred  per  cent. ;  the  gunboat  Jaguar, 
with  a  crew  of  60,  had  51  cases  and  23  deaths.  The  "un- 
classified" mortality  being  181,  we  believe  that  the  cases 
were  certainly  not  over  double  that  number;  they  were 
probably  less. 

The  soldiers,  as  usual,  paid  a  heavy  tax  to  the  pestil- 
ence.   The  following  figures  speak  for  themselves : 

Total  number  of  soldiers  in  the  colony,  550. 

Number  attacked,  246,  or  44  per  cent. 

Deaths,  216,  or  81.7  per  cent,  of  the  number  attacked. 

Forty-five  officers  succumbed. 

1882. 

Goree. 

The  epidemic  of  1882  does  not  appear  to  have  been  im- 
ported, but  to  have  been  of  spontaneous  origin.     The  de- 


282  HISTORY    OK    YELLOW    FEVER. 

molition  of  the  old  military  hospital  at  Goree  is  given  as 
one  of  the  causes.  This  work  was  to  have  been  done  dur- 
ing the  winter,  but,  for  some  cause  or  other,  was  delayed 
until  June.  It  is  natural  to  infer  that  the  razing  of  this 
old  pest-house  should  liberate  thousands  of  mosquitoes 
and  that  these  insects,  still  impregnated  with  the  virus  of 
the  epidemic  of  the  year  before,  should  engender  another 
outbreak  of  a  disease  which  has  been  the  executioner  of 
the  unfortunate  European  residents  of  Senegal  for  nearly 
two  centuries. 

The  first  case  manifested  iteslf  on  June  12,  in  the  per- 
son of  Dr.  Duval,  one  of  the  health  officers  of  the  colony, 
who  wrote  an  elaborate  historj^  of  his  illness  and  to  whom 
we  are  indebted  for  the  facts  of  the  rise  and  progress  of 
the  epidemic.''^ 

It  seems  that,  while  the  workmen  were  engaged  in  tear- 
ing down  the  old  building.  Dr.  Duval  moved  his  office  to 
a  room  which  had  in  former  years  been  occupied  by  the 
munici])al  board  of  health.  Owing  to  the  warm  weather, 
the  windows  were  kept  open  during  the  business  hours, 
thus  allowing  full  ingress  to  the  dust  and  mosquitoes  from 
the  falling  timbers.  The  doctor  states  that  he  began  feel- 
ing ill  about  June  12,  but  did  not  take  to  bed  before  the 
15th.  He  gives  a  detailed  account  of  the  attack,  which 
was  a  typical  case  of  mild  yellow  fever.  He  was  confined 
to  his  room  for  eleven  days  and  made  an  uneventful  re- 
covery. 

Xo  other  case  was  observed  until  July  7,  when  a  wash- 
erwoman employed  in  the  barracks  was  taken  ill,  dying  on 
the  12th.  On  July  8,  a  merchant  was  stricken,  recovering 
after  an  illness  of  thirty-four  days.  The  fourth  case,  July 
9  (a  clerk),  recovered. 

The  four  sporadic  cases  above  noted  were  not  made  pub- 
lic by  the  authorities. 

On  July  24,  the  number  of  cases  became  so  numerous, 
that  the  fever  was  declared  officially  present,  and  active 
sanitary  measures  were  put  into  execution.  On  July  26, 
the  other  posts  in  Senegal  quarantined  against  Goree. 

When  the  fever  was  declared  epidemic,  there  were  1,800 
blacks  and  about  67  whites  at  Goree.     Of  these  67,  there 

"Duval:    La  Fievre  Jaune  a  Goree  (Bordeaux,  1883),  p.  94. 


I 


SENEGAL !88«.  283 

were  37  who  had  already  suffered  an  attack  of  yellow 
fever  in  previous  epidemics,  thus  leaving  30  susceptible  to 
infection.  The  virulence  of  the  epidemic  was  certainly 
notable,  for  of  this  small  number,  27  were  attacked  and 
15  died.  The  last  case  manifested  itself  on  September  17 ; 
the  last  death  occurred  September  22d. 

The  epidemic  of  1882  gave  rise  to  much  discussion 
among  the  French  medical  men.  Some  claimed  it  was 
imported  from  Brazil,  others  from  Gambia,  while  the  ma- 
jorit^^  (among  whom  we  notice  Duval  and  Berenger- 
Feraud)  insist  that  it  originated  at  Goree.  AVe  tliink  the 
last  hypothesis  correct,  as  there  was  no  yellow  fever  in 
Gambia  in  1882  and  no  suspicious  vessels  from  Brazil 
were  observed  in  the  waters  of  the  Senegal  that  year.  The 
demolition  of  the  old  military  hospital  probably  hastened 
the  outbreak,  but  the  infected  Stcgomjjia  would  no  doubt 
eventually  have  ventured  into  the  open  and  diffused  the 
X)oison  among  the  susceptibles. 

Dakar. 

Dakar,  a  suburb  of  Goree,  separated  from  the  town  by  an 
arm  of  the  Atlantic  Ocean,  observed  a  strict  quarantine, 
but  the  harl)ormaster  of  tlie  vilhiige  went  on  a  secret  visit 
to  Goree  about  the  end  of  August  and  was  stricken  with 
yellow  fever  a  few  days  after  his  return  home.  This  im- 
prudence cost  him  his  life. 

No  other  cases  were  noticed  in  Dakar  until  the  middle 
of  November,  wlien  the  quartermaster  of  the  dispatch- 
boat  AUnitvofiS,  then  anchored  opposite  Dakar,  died  at  tiic 
hospital  under  circumstances  which  strongly  pointed  to 
yellow  fever  infection.  A  soldier  at  the  barracks  was  the 
next  victim.  A  panic  ensued  when  the  news  of  these  two 
deaths  became  known  and  eight  white  men  engaged  in  rail- 
road work  fled  to  Yof,  some  distance  from  Dakar,  wliere 
the  fever  broke  out  among  them.  Concluding  that  they 
would  receive  better  medical  attention  at  Dakar,  they  re- 
turned to  the  village,  where  three  of  their  nund>er  died. 
The  fever  pursued  an  erratic  course  at  Dakar  and  finally 
came  to  an  end  on  December  22.  There  were  altogether  10 
cases  and  30  deaths. 


284  .  HISTORY     OF    YELLOW     FEVER. 

Riifisque. 

Rufisqiie,  also  located  on  the  continent,  opposite  Goree, 
furnished  two  cases,  one  on  August  10,  followed  by  re- 
covery, and  the  other  in  the  beginning  of  September,  re- 
sulting in  death.  The  source  of  infection  is  not  given,  but 
the  natural  inference  is  to  incriminate  Goree. 

0)1  the  Albatross. 

The  dispatch-boat  Albatross,  newly-built  and  fresh  from 
France,  arrived  at  Saint-Louis,  September  10,  1882'.  It 
had  a  crew  of  52  whites,  which  was  increased  to  80  by  ^ho 
addition  of  28  blacks  upon  reaching  the  capital.  Tli3 
quarantine  against  Goree  was  raised  October  27,  1882. 
The  Albatross^  which  had  in  the  meantime  been  emxjloyed 
in  carrying  the  mails  from  Saint-Louis  to  Dakar,  took 
some  passengers  from  Goree  for  Saint-Louis  on  the  day  the 
quarantine  Avas  raised.  These  consisted  of  whites  and 
blacks,  who  had  been  in  the  infected  town  for  some  time 
and  who  were  anxious  to  return  home.  On  November  T, 
the  vessel  returned  to  Dakar,  Avith  passengers  for  a  ves- 
sel then  about  to  sail  for  France.  On  the  Avay  to  Dakar, 
the  Albatross  stopped  at  the  Pointe-aux-Chameaux  and 
took  some  passengers.  One  of  these  men  had  been  ill  for 
some  days  and  was  brought  on  board  in  a  litter.  There 
being  no  suspicious  sickness  at  the  Pointe,  no  objections 
were  raised  to  the  embarkation  of  the  patient,  who  was 
said  to  be  suffering  from  malaria.  Arrived  at  Dakar,  the 
patient  Avas  transported  to  the  hospital,  Avliere  he  died  on 
Koveml)er  13.  An  autopsy  reAeahnl  lesions  which  raised 
some  doubts  as  to  the  natui'e  of  his  illness  and  his  com- 
panions were  put  under  surA'eilance.  No  cases  dcAeloped 
among  them.  A  fcAV  days  later,  the  quartermaster  of  the 
Albatross  was  taken  ill  and  trans])orted  to  the  hospital  at 
Dakar,  where  he  died  shortly  afterAvard.  A  soldier  was 
taken  ill  at  the  barracks  and  died. 

Yellow  fever  was  then  officially  declared  present  on  the 
Albatross  and  at  the  Dakar  hospital.  The  crcAv  of  the 
vessel  were  transported  to  the  lazaretto  on  November  21. 
SeA'eral  deaths  occurred  at  the  lazaretto.      On   December 


I 


SENEGAL — 188a.  285 

30,  the  sailors  retiirued  on  board  the  Albatross^  which  had 
been  thoroughly  disinfected,  A  few  days  after  the  return 
of  the  crew,  the  new  cases  developed.  This  was  followed 
by  live  fatal  cases  between  the  8th  and  11th  of  January, 
18S3.  Orders  were  then  received  to  return  to  France  and 
the  vessel  arrived  at  Brest  on  March  15. 

The  course  of  the  disease  on  board  the  Albatross  was 
very  severe.  Out  of  a  crew  of  52  whites,  there  resulted  21 
cases  and  IS  deaths,  including  two  officers. 

A  perplexing  question  now  presents  itself:  Where  did 
the  Albatross  contract  the  infection?  Xot  at  Saint-Louis, 
for  not  a  single  case  was  observed  there  in  1882 ;  not  at 
the  Pointe-aux-Chanieaux,  for  the  place  is  said  to  have 
been  remarkably  healthy  at  the  time  and  to  have  had  no 
communicaticn  wliatsocver  with  infected  localities.  These 
two  places  being  disposed  of,  suspicion  naturally  falls 
upon  the  only  other  locality  visited  by  the  unfortunate 
vessel — Dakar.  Duval  incriminates  the  Point-aux-Cham- 
eaux  in  the  infection  of  the  Albatross,  basing  his  accusa- 
tion on  the  fact  that  the  tirst  case  of  fatal  illness  observed 
on  board  was  that  of  the  passenger  from  that  hamlet.  We 
do  not  believe  this  was  a  case  of  yellow  fever  at  all.  The 
fact  that  none  of  the  other  passengers  were  attacked  (ex- 
cept some  time  afterwards,  when  the  disease  had  assumed 
epidemiological  proportions  at  Dakar)  leads  us  to  believe 
that  it  was  simply  an  aggravated  case  of  paludism. 

Now,  let  us  see  what  Avere  the  conditions  at  Dakar. 
Duval  himself]  (Joe.  cit.,  page  40)  relates  the  case  of  the 
harbormaster  of  Dakar,  who  is  supposed  to  have  nmde  a 
secret  visit  to  Goree,  in  spite  of  the  rigid  quarantine  then 
existing,  and  who  died  of  yellow  fever  at  Dakar  during 
the  last  days  of  August.  It  will  be  remembered  that  tlie 
Albatross  was  in  constant  communication  with  that  vil- 
lage from  the  date  of  her  ari'ival  in  Senegal  (September 
ID),  doing  service  as  mail-])a(ket  between  that  pla<'e  and 
Saint-Louis.  The  quarantine  against  Goree  was  raised 
on  October  27.  This  was  followed  by  an  exodus  from 
Goree  to  Saint-Louis,  but  none  of  the  refugees  infected 
Saint-Louis  and  it  is  natural  to  presume  that  they  did  not 
carry  the  contagion  on  board  the  Albatross.  The  first 
case  of  vellow  fever  officiallv  observed  after  the  quarantine 


a86  ilISTORY    OK    YELLOW    FEVER. 

against  Goree  had  been  raised  did  not  take  place  on  board 
the  Albatross,  but  originated  in  the  barracks  at  Dakar 
and  it  was  only  after  the  crew  had  been  transported  to  the 
lazaretto  at  Dakar  that  the  disease  manifested  itself 
among  the  unfortunate  sailors.  It  is  true  that  the  death 
of  the  quartermaster  of  the  Albatross  preceded  that  of 
the  soldier,  but  the  former  was  oftener  on  shore  than  on 
boai'd  while  at  the  village  wharf  and  could  easily  have 
been  infected  while  off  duty.  We  make  this  explanation 
to  escape  the  charge  of  inconsistency. 

From  the  end  of  August,  the  date  of  the  fatal  illness  of 
the  harbormaster,  to  the  middle  of  November,  when  the 
first  death  took  place  among  the  sailors,  is  undoubtedly 
a  long  time  between  cases,  but  it  must  be  borne  in  mind 
that,  in  1882,  Dakar  was  peopled  principally  by  negroes, 
with  a  sprinkling  of  whites  here  and  there,  most  of  them 
immune  through  having  suffered  during  previous  epi- 
demics, and  it  was  only  wlien  non-immunes  arrived  at  the 
village  that  the  ^itcgoinyiac,  infected  months  lU'eviously, 
proved  their  virility. 

1000. 
The  First  Prc-Epidemic  Cases. 

The  demolition  of  tlie  old  military  hospital  wliich  had 
for  years  been  the  disgrace  of  Goree  must  have  given  the 
quietus  to  the  infected  ^tef/omi/iac  which  had  been  the 
bane  of  Senegal  since  1878,  for  not  a  single  case  of  yellow 
fever  was  <sl>served  in  tlie  colony  from  1882  to  1900,  a 
period  of  eighteen  years. 

The  focus  of  tlie  epidemic  of  1000  began  at  Dakar.  On 
April  IG,  a  clerk  employed  in  that  village  was  admitted 
into  the  Goree  hospital,  in  the  last  stages  of  an  illness 
diagnosed  by  the  attending  physician  as  "diphtheria."  He 
died  an  hour  after  admission,  with  black  vomit.  The 
autopsy  revealed  no  trace  whatever  of  diphtheria.  Sus- 
picious lesions  were  observed,  but  as  yellow  fever  had  not 
been  noticed  in  the  colony  for  years,  no  thought  was  given 
to  this  malady  and  a  verdict  of  "death  from  pernicious 
fever"  recorded. 


I 


SENEGAL 1900.  287 

On  April  19,  a  patient  entered  the  hospital,  suffering 
from  lieadache,  dizziness  and  ditliculty  of  speech.  He 
g-radually  became  worse  and  died  on  the  27th.  The 
autopsy  revealed  unmistakable  lesions  of  yelloAV  fever,  but 
the  physicians  present  scouted  the  idea.  One  of  those  who 
participated  in  the  autopsy  remarked  that,  at  any  other 
time,  he  would  have  had  no  hesitation  in  pronouncing-  it 
a  case  of  genuine  yellow  fever,  but  that  the  health  of  the 
colony  and  the  surrounding  country  was  perfect  and  lie 
joined  his  confreres  in  giving  a  verdict  of  death  from  "in- 
fectious jaundice." 

The  first  case  had  already  been  forgotten  and  no  one 
thought  of  connecting  the  two  deaths  with  a  common 
cause,  although  they  had  occurred  at  an  interval  of  only 
eleven  days  and  had  presented  identical  pathological 
lesions. 

The  third  case  was  admitted  into  the  hospital  on  April 
30  and  died  on  ]May  3. 

On  May  8,  a  man  and  a  woman  were  transported  to  the 
hospital.  The  first  case  died  the  following  day ;  the  second, 
five  days  later. 

All  these  cases  came  from  Dakar  and  in  each  instance 
presented  typical  symptoms  of  yellow  fever.  The  last  two 
deaths  awakened  a  vague  suspicion  on  the  part  of  the 
authorities  that  the  sanitary  conditions  of  Dakar  demand- 
ed an  investigation,  but  not  wishing  to  alarm  the  popula- 
tion, orders  were  given  to  proceed  with  great  secrecy.  Un- 
der such  conditions,  no  open  precautionary  steps  were 
taken  and  the  slumbering  pestilence,  untrammeled  by  pre- 
ventive measures,  gathered  fresh  fuel  each  day. 

On  May  11,  a  Moroccan,  who  had  left  Dakar  seven  days 
previously,  died  at  Thies,  an  army  post  on  the  railroad,  be- 
tween Rufisque  and  Tivaouane. 

A  mulatto  girl,  aged  4,  was  taken  ill  at  Dakar  about  the 
same  time  and  died  on  the  IGth. 

On  INfay  18,  the  disease  was  for  the  first  time  officially 
admitted,  the  director  of  public  health  giving  oi-ders  that 
the  following  be  inserted  in  all  bills  of  health  given  vessels 
leaving  the  colony:  There  exists  a  few  isolated  cases  of 
suspicious  ijrUoir  fever  at  Dalar  a)id  its  ricinifi/. 


HISTORY     OF    VKIICW    FEVER. 


Dakar  was  declared  infected  aud  placed  under  quar- 
antine. 

The  people  of  Dakar,  far  from  being  frightened  by  this 
official  declaration,  indignantly  denied  that  such  a  state 
existed.  They  claimed  that  the  doctors  had  blundered ; 
that  yellow  fever,  according  to  the  views  of  the  oldest  in- 
habitants, had  never  been  known  to  proceed  at  such  a 
snail's  pace,  luit  by  leaps  and  bounds.  They  claimed  that 
the  prevailing  illness  was  an  aggravated  type  of  malaria, 
caused  by  extensive  digging  operations  at  Hann,  a  neigh- 
boring village. 

The  merchants,  seeing  their  trades  imperiled,  took  ad- 
vantage of  the  trend  of  public  opinion  and  vigorously  pro- 
tested against  the  institution  of  rigorous  sanitary  meas- 
ures. The  authorities  were  hamj)ered,  hooted  and  abused, 
cases  were  hidden  and  the  way  thus  paved  for  an  epidemic 
which  was  destined  to  ravage  nearly  every  city,  town  and 
hamlet  in  Senegal. 

On  ]May  22,  the  troops  stationed  at  Dakar  and  Rufisque 
were  ordered  dispersed  along  the  railroad  running  between 
Dakar  and  l^aint-Louis,  only  about  four  hundred  being 
left  behind.  This  was  done  without  consulting  the  author- 
ities of  Dakar,  and  a  storm  naturally  ensued  when  the 
news  became  public.  In  this  connection,  it  is  interesting 
to  note  tliat  the  first  cases  were  all  among  the  civilians, 
the  military  being  attacked  onh^  in  June,  two  months  after 
the  outbreak  at  Dakar. 

On  May  22,  two  cases  broke  out  anunig  the  personnel 
of  the  railroad  com])any  at  Dakar,  followed  the  next  day 
by  a  case  in  the  same  house  where  the  first  victim  of  the 
epidemic  had  died  (April  16).  Two  of  these  cases  proved 
fatal. 

The  railroad  hospital,  where  the  two  first  cases  were 
originally  l)rought,  was  at  once  disinfected  by  the  authori- 
ties and  ordered  closed. 

On  jMay  17,  tour  workmen  arrived  at  Senegal  from 
^Forocco.  Two  lemained  at  Dakar,  while  the  other  two 
])r( needed  to  v^aint-Louis.  On  ]May  23,  the  two  who  had 
been  left  behind  were  taken  suddenly  ill  and  transferred 
to  the  town  hospital,  where  they  died  on  the  28th,  with 
undeniable  symptoms  of  yellow  fever. 


SENEGAL,    1900.  '289 

By  a  peculiar  coincidence,  one  of  the  ^Moroccans  was 
taken  ill  at  Saint-Louis  on  the  23d,  the  same  day  his  com- 
rades were  stricken  at  Dakar,  and  died  on  the  2Gth.  It 
will  thus  be  seen  that,  notwithstanding-  the  fact  that  yel- 
low fever  had  been  present  at  Dakar  since  April  KUh,  and 
that  communications  between  that  village  and  Saint-Louis 
was  figuratively  unrestrained,  the  capital  was  only  in- 
fected on  May  23. 

May  28,  another  death  at  Dakar. 

From  that  date,  the  situation  seemed  to  improve.  Some 
of  the  more  timid  Europeans,  however,  left  the  colony, 
but  the  majority,  thinking  the  outbreak  was  at  an  end, 
concluded  there  Avas  no  danger  and  laughed  at  the  fears 
of  their  less  courageous  countrymen. 

Recrudescence  at  Dakar. 

The  slow  progress  of  the  disease  is  one  of  the  most  re- 
markable features  of  this  epidemic  and  can  only  be  ac- 
counted for  by  the  fact  that  the  Calopae  had  not  yet  be- 
come active,  the  weather  being  still  a  little  too  cool  to  per- 
mit them  to  freely  circulate  among  the  population. 

From  May  2Sth  to  June  7th,  no  cases  were  observed. 
Lulled  into  a  false  sense  of  security  by  this  subsidence  of 
the  disease,  the  quarantine  against  Dakar  was  raised. 

From  April  IG  to  May  28,  there  had  been  14  cases  and 
11  deaths.  Tliis  is  what  Dr.  Kermorgant  terms  the  "first, 
or  pre-e])idemic  period."  Tlie  progress  of  the  epidenuc 
under  discussion  showed  the  identical  characteristics 
which  has  attended  nearly  every  outbreak  of  yellow  fever 
in  Senegal :  First,  a  few  cases,  followed  at  long  intervals 
by  others.  The  disease  then  seemed  to  advance  by  gusts, 
each  time  more  serious  and  less  removed,  until  its  viru- 
lence finally  asserted  itself  and  each  day  brought  a  case 
or  two  or  a  death. 

Up  to  June  8,  the  mortality  had  been  78.6  per  cent.  On 
that  day,  a  sergeant  of  infantry  stationed  at  Camp  ]Made- 
leine  No.  2,  near  Dakar,  was  stricken  and  died  on  the  10th. 
Before  dying,  this  officer  admitted  that  he  had  evaded  the 
quarantine  regulations  and  had  slept  at  Dakar  on  several 
occasions. 


290  HISTORY     OF    YELIOW     FEVER. 

June  9.  The  bishop  of  Saint-Louis,  while  making  pas- 
toral calls  at  Dakar  and  Kufisque,  was  taken  suddenly  ill 
and  died  on  the  13th. 

June  10.  A  clerk  at  Dakar  succumbed,  after  a  brief 
illness. 

June  11.  Two  sisters  of  charity,  one  of  whom  had 
nursed  the  bishop,  were  stricken. 

On  June  10,  Dakar  was  again  quarantined.  A  military 
sanitary  cordon  was  placed  around  Cape  Yerd  peninsula 
and  the  terminus  of  the  railroad  moved  to  Rufisque.  The 
authorities  had  at  last  awakened  to  the  seriousness  of  the 
situation ;  but  it  was  a  sad  analogy  of  the  trite  expedient 
of  locking  the  stable  after  the  horse  had  been  stolen — the 
germs  of  pestilence  were  already  too  widely  disseminated 
and  no  preventive  measures  under  heaven  could  check  the 
march  of  the  saffron  scourge. 

The  mass  of  the  people,  still  unconvinced,  looked  upon 
these  acts  as  an  uncalled  for  usurpation  of  power  and 
continued  to  clandestinely  visit  the  nidus  of  infection. 

June  15,  two  new  cases  at  Dakar,  followed  by  one  death. 

On  June  27,  a  new  case  at  Dakar,  followed  by  another 
on  the  20th.  The  first  case  died  on' the  30th,  the  second 
on  July  1. 

There  liad  been  no  new  cases  since  June  15. 

From  tliat  date,  the  epidemic  had  full  sway.  Every 
place  in  Senegal  became  suspicious  of  its  neighbor.  Local 
quarantines  were  established,  every  town  and  hamlet  inter- 
dicting communication  with  the  other.  The  panic  reached 
such  an  acute  stage,  that  armed  guards  were  stationed 
everywhere  and  natives  who  attempted  to  get  within  the 
lines  were  shot  down  like  dogs. 

Panic  and  Flight. 

It  was  only  towards  the  end  of  June  that  the  European 
population  of  (loree,  Saint-Louis  and  other  towns  of  Sene- 
gal began  to  realize  that  something  unusual  was  taking 
place  in  the  health  conditions  of  the  colony,  The  peo- 
ple awoke,  as  if  from  a  dream,  to  find  itself  facing  what 
seemed  inevitable  death.  All  the  horrors  of  previous  epi- 
demics were  suddenlv  brought  to  mind.     Indifference  to 


SENEGAL,    1£00.  291 

existing  condition^  gave  way  to  consternation  and  panic. 
The  physicians  were  no  longer  hooted  or  ridiculed,  but 
were  besieged  for  advice  as  to  the  best  preventive  methods 
to  follow.  Hundreds  sold  their  belongings  and  sought  se- 
curity in  flight.  The  passenger  steamers  leaving  for 
Europe  were  taxed  to  their  utmost  capacity  and  when  the 
large  mail  steamers,  fearing  to  contaminate  their  crews, 
refused  to  take  passengers,  the  refugees  were  only  too  glad 
to  escape  by  means  of  the  filthy  coasting  vessels,  which 
took  them  to  ports  where  quarantines  were  not  in  force, 
whence  they  proceeded  by  roundabout  ways  to  Europe. 
Some  even  took  passage  on  vessels  bound  for  South  Ameri- 
can ports,  trusting  to  luck  to  meet  some  European-bound 
vessels  on  the  high-seas.  The  official  journals  of  Senegal, 
in  their  accounts  of  this  wholesale  exodus,  state  that  near- 
ly 3,000  persons  left  tlie  colony  between  June  and  Sep- 
tember. 

The  following  tableau  of  departure  from  Senegal  by 
ocean  steamers  from  July  1  to  August  16,  gives  an  idea 
of  the  eagerness  of  the  people  to  flee  from,  this  plague  spot 
of  Western  Africa : 

Passengers. 

July     1.     By  steamer  Faidherhe 15 

July     1.     Bv  steamer  Vcnihan 160 

July  12.     By  steamer  Villc  de  Pernam'biu^o .  ...       82 

July  26.     By  steamer  Caravellas 435 

July  27.     By  steamer  Ranta  Fe 223 

Aug.  13.     By   steamers    Ville   de  Maccio   and 

Macina 278 

Aug.  16.     By  steamers  Richelieu  and  Campana    473 

Total 1.666 

In  addition  to  the  above  total,  must  be  included  the 
departures  prior  to  3\\\y  1st,  and  the  exodus  by  the  coast- 
ing vessels  and  other  French  and  English  vessels,  of  which 
no  record  was  kept  by  the  port  authorities. 

That  the  fears  of  the  owners  of  these  passenger  steamers 
were  well  grounded,  was  exemplified  by  the  fact  that  cases 
occurred  on  many  of  these  vessels.  The  disease  did  not 
spread,    however,    being   confined   to   the   original   cases. 


292  HISTORY    OF    YELLOW    FEVER, 

The  disease  was  ev^en  brought  to  the  lazaj'etto  at  Paulliac, 
France,  where  several  cases  were  treated  without  creating 
any  focus. 

Even  Paris — careless,  wicked,  fun-loving  Paris — was 
wrought  to  fever  heat  at  the  policy  of  concealment  pur- 
sued by  the  colonial  authorities.  The  government  had  sent 
2,000  young  soldiers  a  few  months  previous  to  Senegal, 
to  "pacify"  the  natives  in  the  interior,  and  the  public 
wanted  to  know  why  their  countrymen  were  sent  to  this 
barbarous  region  to  die  like  rats,  alleging  that  these 
dependencies,  whose  only  products  were  pestilences  and 
murderous  negroes,  were  not  worth  keeping.  The  Paris 
Soleil,  in  commenting  on  the  epidemic,  thus  concludes  an 
inspired  article: 

"Physicians  die  like  flies.  Sisters  and  infirmarians  fol- 
low the  same  road.  Mass  is  no  longer  said  in  public  on 
account  of  contagion.  Fortunately,  there  will  always  re- 
main a  negro  priest  to  absolve  the  last  who  die,  for  it  is  a 
curious  fact  that  the  negroes  are  completely  immune." 
.  Consul  Strickland,  the  representative  of  the  United 
States,  at  Senegal,  from  whose  reports  some  of  the  details 
of  the  inception  of  this  epidemic  are  taken,^^  gives  graphic 
pen-pictures  of  the  scenes  at  Goree-Dakar  and  Saint  Louis. 
"The  epidemic  has  brought  the  business  of  the  colony  com- 
pletely to  a  standstill,"  he  observes,  "and  all  Europeans 
have  got  away,  who  could  command  the  means  to  do  so. 
The  stores  are  shut,  and  it  is  difficult  to  obtain  the  neces- 
saries of  life." 

Consul  Strickland  sailed  from  Senegal  during  the  last 
days  of  July,  1900,  and  the  United  States  Consular  reports 
give  no  details  of  the  progress  of  the  epidemic  after  that 
date.  We  are  indebted  to  the  exhaustive  accounts  pub- 
lished by  Dr.  Kermorgant  in  the  Annalcs  cVHygiene  et  de 
Medecine  Coloniales  and  the  Reaiidl  des  Travaux  de 
Comite  Consiiltntif  d'Hygiene  Puhliqiie  de  France,  for 
most  of  the  facts  which  precede  and  follow.®^ 

°'' Strickland:    U.   S.   Public  Health  Reports,  1900,  vol.  25,  pp. 

1679;    1866;   2025;   2188. 
"Annales   d'Hygiene,    etc.,   -rol.    4,    pp.    325,    et    seq. ;    Recueil, 
etc.,   Paris,   1903,   vol    31,   pp..   369,  et  seq. 


SENEGAL,    1900.  293 

MARCH  OF  THE  EPIDEMIC. 
Dakar. 

As  already  noted,  the  true  epidemic  epoch  may  be  said 
to  have  manifested  its-'.elf  Avith  the  series  of  cases  and 
deaths  at  the  end,  of  June,  1900.  On  July  4th,  5th  and 
6th,  cases  cropped  out  everywhere,  and  it  was  a  question 
of  satire  qui  pent.  The  authorities  resorted  to  the  tardy 
expedient  of  sending  the  white  troops  back  to  Europe,  and 
replacing  them  with  native  soldiers. 

From  the  1st  to  the  31st  of  July,  there  were  sixty  cases 
and  thirty-  one  deaths,  at  Dakar. 

The  exodus  of  a  majority  of  the  white  population  does 
not  seem  to  have  done  much  toward  arresting  the  progress 
of  the  pest,  for  twenty-nine  cases  were  admitted  into  the 
hospital,  in  August.  Of  these,  four  cases  came  from  Saint 
Louis  and  Thies,  and  five  were  taken  f'rom  the  steamships 
General  Dodds  and  Vauhan.  The  nine  importations,  there- 
fore, leaves  the  actual  number  for  Dakar  at  twenty. 

The  epidemic  gradually  subsided,  for  want  of  material, 
in  September,  nine  cases  and  four  deaths  being  recorded 
for  that  month, 

October,  three  deaths. 

The  epidemic  finally  came  to  an  end  in  November,  with 
two  cases  and  one  death,  making  a  grand  total  for  Dakar, 
from  April  16,  to  November,  of  one  hundred  and  forty-two 
cases  and  seventy-six  deaths. 

GOREE. 

Goree  quarantined  against  Dakar,  May  27th,  1000,  but 
not  much  attention  was  paid  to  the  mandate,  communica- 
tion between  the  two  localities  beiug  almost  uninterrupted. 

This  lack  of  precautions  soon  bore  fruit.  A  soldier  of 
infantry,  who  had  been  given  a  furlough,  celebrated  the 
event  by  making  a  round  of  the  barroouis  of  Dakar,  on 
Sundaj',  June  17th,  and  returned  to  camp  in  a  beastly 
state  of  intoxication.  On  the  20th,  he  was  sent  to  the 
hospital,  where  he  died  with  black  vomit,  on  the  23rd. 


294  HISTORY    ()!•     \  ELI.O\V    FEVER. 

The  white  garrison  of  Goree  was  immediatelT  trans- 
ferred to  a  point  near  Yof,  only  a  few  being  retained  for 
emergencies.  These  were  quartered  in  the  Castle,  the 
highest  part  of  the  town. 

From  June  23rd,  to  July  4tli,  nothing  abnormal  was 
observed.  Thinking  that  the  death  of  the  soldier  was 
merely  an  imported  case,  and  that  no  others  would  result, 
the  company  which  had  been  sent  to  Yof,  was  recalled. 
The  return  of  their  comrades  was  taken  as  a  pretext  for 
jollification  by  the  soldiers  in  the  Castel,  and  much  carous- 
ing and  drunkenness  ensued.  The  personnel  of  the  gar- 
rison numbered  seventy- five. 

On  July  14th,  one  of  the  soldiers  who  had  returned  from 
Yof,  was  taken  ill  and  died  five  days  later. 

From  that  date,  the  cases  followed  each  other  in  rapid 
succession — three  on  the  16th,  two  on  the  18th,  one  on  the 
19th,  two  on  the  20th,  and  one  on  the  21st.  Thus  it  went 
until  the  end  of  July,  Avhen  a  total  of  nineteen  cases  and 
seventeen  deaths  was  recorded. 

Three  cases  were  observed  in  August,  the  last  on  the 
17th. 

The  total  number  of  cases  at  Goree  were  22 ;  deaths,  20. 
Kot  a  native  was  attacked,  this  frightful  tribute  to  the 
scourge  being  paid  only  by  Europeans. 

RUFISQUE. 

On  ]\ray  12th,  1000,  a  clerk  employed  by  the  Compngnic 
Francaisc  dc  VAfriquc  Occidcniulc  was  taken  ill  at 
Eufisque,  and  transported  to  the  hospital  at  Dakar,  where 
he  made  an  uneventful  recovery. 

May  17th,  two  new  cases. 

For  over  a  month,  no  other  cases.  On  June  21st,  an- 
other employee  of  the  Cowpaf/uic  Francaisc  was  taken  ill 
and  died  shortly  afterward. 

This  case  caused  some  consternation,  and  the  rai/road 
terminus,  which  had  been  moved  from  Dakar  to  Rufisque, 
was  changed  to  Thies.  A  part  of  the  white  population  of 
Kufisque  became  apprehensive,  and  68  took  passage  for 
France  on  the  steamship  Gi/ptis. 


SENEGAL,     1900.  295 

June  22nd,  four  new  cases,  followed  by  three  deaths. 

Nothing  abnormal  until  July  9th,  when  two  new  cases, 
followed  by  death,  were  observed. 

No  other  cases  in  July,  probably  due  to  the  fact  that 
nearly  all  the  non-immunes  had  fled. 

In  August,  3  cases  and  2  deaths. 

In  September,  no  cases  in  town,  but  one  on  board  the 
Steamship  Faidlierhe,  followed  by  death. 

October  26th,  one  case. 

No  cases  in  November,  but  on  December  24th,  a  clerk 
who  had  arrived  from  France  on  the  10th  of  the  month, 
died  with  black  vomit. 

The  total  number  of  cases  reached  18 ;  deaths  15. 

Saint  Louis. 

Saint  Louis  had  more  cases  than  all  the  other  localities 
in  Senegal  combined,  and  came  within  21,  of  equaling  the 
combined  mortality  of  all  the  other  afflicted  places.  The 
statistics  for  the  colony  are  416  cases  and  225  deaths ;  the 
figures  for  Saint  Louis  alone,  218  cases  and  102  deaths. 

It  will  be  remembered  that  a  sporadic  case  of  yellow 
fever  was  observed  in  Saint  Louis,  on  May  23,  1900,  in  the 
person  of  a  Moroccan,  who,  with  a  companion,  had  arrived 
from  Dakar  eight  days  previously.  The  patient  died  on 
May  26th.  The  pliysicians  of  Saint  Louis  denied  at  the 
time  that  it  was  a  case  of  yellow  fever,  but  when  the  dis- 
ease had  become  epidemic  in  the  town,  they  admitted  that 
they  had  been  mistaken  in  their  diagnosis.  . 

The  death  of  the  IMoroccan  was  not  followed  by  imme- 
diate results  and  no  new  cases  were  observed  until  July 
16,  seven  weeks  later,  when  the  fever  manifested  itself 
simultaneously  in  opposite  parts  of  the  town,  one  case  in 
the  Rognat-Sud  barracks,  located  in  the  center  of  the 
island,  and  the  other  at  No.  14  Rue  de  la  Mosque,  at  the 
north  end. 

The  case  in  the  Eue  de  la  Mosque  proved  to  be  the  com- 
panion of  the  Moroccan,  who  had  died  on  ^lay  26th,  in 
this  same  house.  He  died  on  July  17th.  Dr.  Kermor- 
gant  attributes  this  fatal  case  to  emanations  from  a  trunk 


296  HISTORY    OF    YELLOW    FEVER. 

containing  clothes  which  had  been  packed  at  Dakar,  when 
the  foreigners  took  their  departure,  and  which  was  opened 
for  the  first  time  at  Saint  Louis  in  the  beginning  of  July. 

The  infection  of  the  Eognat-Sud  barracks,  acording  to 
Dr.  Kermorgant,  was  caused  by  the  opening  of  hogsheads 
packed  with  military  garments  brought  from  Dakar  by 
the  steamer  Saint-Kilda,  and  which  had  been  distributed 
among  the  soldiers  without  being  disinfected. 

But,  why  not  directly  accuse;  the  Saint-Kilda  of  being 
the  active  agent  of  importation?  It  is  of  record  that  the 
vessel  had  sojourned  five  days  at  Dakar  before  proceeding 
to  Saint  Louis,  and  that  communication  between  the  crew 
and  the  inhabitants  of  the  village  had  been  uninterrupted. 
At  Saint  Louis,  the  Saint  Kihia  was  subjected  to  a  quar- 
antine of  only  three  days,  and  her  cargo  consisting  mainly 
of  cases  of  cotton  and  woolen  goods,  was  disinfected  ex- 
ternally, and  only  unpacked  when  it  had  reached  the  con- 
signees. Of  course,  the  contention  that  the  infection  was 
carried  by  these  goods  is  too  puerile  to  admit  of  argu- 
ment, but  it  is  a  well-known  fact  that  mosquitoes  will  live 
for  days  without  water,  and  even  if  a  solitary  infected 
Stcgom/jjia  had  found  lodgment  in  one  of  the  packing- 
cases,  this  was  sufficient  to  spread  the  contagion.  And 
this  is  undoubtedly  what  happened. 

There  is  no  doubt  in  our  mind  that  the  infection  was 
brought  by  the  Saint-Kilda.  During  the  time  the  ship 
was  quarantined,  the  passengers  and  crew  were  allowed 
free  intercourse  with  the  shore,  and  the  crew  are  said  to 
have  been  quite  "chummy"  with  the  soldiers,  mingling 
with  them  in  barrooms  and  other  places  generally  fre- 
quented by  sailors.  We  do  not  wish  to  convey  the  impres- 
sion that  this  affiliation  could  transmit  the  germs,  as  they 
are  not  disseminated  by  contact,  but  relate  the  incident  to 
show  that  no  precautions  at  all  were  taken  to  prevent  the 
importation  of  the  disease  into  the  capital,  although  it 
was  a  notorious  fact  that  Dakar  was  at  the  time  a  hot-bed 
of  contagion. 

The  simultaneous  explosion  of  the  disease  in  two  widely 
separated  sections  of  the  town  can  be  explained  by  the 
supposition  that  the  Moroccan,  like  all  those  of  his  race, 


SENEGAL,    I  too.  297 

who  come  by  hundreds  to  Senegal  every  year,  was  em- 
ployed as  laborer  along  the  river  front,  and  formed  one 
of  the  gangs  engaged  in  discharging  the  Saint-Kilda.  The 
opening  of  a  trunk  almost  two  months  after  the  death  of 
the  first  Moroccan  could  not  create  a  new  focus  of  in- 
fections. No  Stegomyia,  no  matter  if  endowed  with  phe- 
nomenal vitality,  could  live  for  that  length  of  time  shut 
out  from  water  and  air,  and  we  must  look  elsewhere  for 
the  source  of  <'ontamination.  And,  naturally,  we  incrimi- 
nate the  vessel  under  discussion. 

It  is  worthy  of  note  that  all  the  customjhouse  employes 
who  assisted  in  checking  and  examining  the  cargo  of  the 
Saint-Kilda,  were  one  by  one  attacked  by  the  disease 
in  the  beginning  of  the  epidemic.  This,  of  itself, 
should  suffice  to  incriminate  the  vessel.  There  is  no  record 
of  the  appearance  of  tlie  disease  on  board,  but  as  the  crew 
were  principally  natives,  whose  immunity  to  yellow  fever 
is  proverbial,  and  the  officers  were  probably  acclimatized, 
the  vessel  escaped  an  invasion. 

But  here  comes  our  astute  friend,  Mr.  Doubting 
Thomas,  with  his  over-ready  interrogation  point,  and 
wishes  to  know  how  it  is  that  the  case  of  the  first  Moroc- 
can, who  died  on  May  26th,  did  not  disseminate  the  germs 
far  and  wide,  but  that  the  disease  only  became  epidemic 
in  July?  The  explanation  is  just  as  easy  as  eating  water- 
melon with  a  spoon.  The  case  of  the  first  Moroccan  was 
a  notoriously  imported  one.  The  poison  was  in  his  sys- 
tem when  he  left  Dakar  for  Saint  Louis,  and  the  natural 
sequence  was  that  it  manifested  itself  when  the  period  of 
incubation  had  reached  its  limit.  Had  he  gone  to  Paris, 
London  or  any  other  place  on  the  face  of  the  earth,  which 
could  be  reached  within  the  period  of  incubation,  the  dis- 
ease would  have  asserted  itself  just  the  same.  And,  as 
at  Saint  Louis,  it  would  have  stopped  right  there,  if  the 
active  agent  of  dissemination,  tlie  Stcgomia,  was  not 
present  to  convey  the  poison.  And  what  saved  Saint  Louis 
from  invasion  in  May,  was  the  fact  that  the  cold  season 
was  not  yet  over,  and  the  yellow  fever  mosquito  had  not 
yet  begun  its  activity. 


298  HISTORY    OF    YELLOW    FEVER. 

In  July,  wlien  the  Saint  KUda  arrived  at  Saint  Ix)iiis, 
fresli  from  a  nidus  of  infection,  conditions  were  different. 
The  mosquito  season  was  in  its  zenith,  and  a  single  case 
of  yellow  fever  was  all  that  was  needed  to  cause  an  epi- 
demic. And,  as  we  shall,  see,  the  capital  of  the  colony 
provided  an  ideal  field  for  the  propagation  of  the  malady 
and  paid  the  heaviest  penalty. 

Although  the  first  death'  from  yellow  fever  in  the 
Rognat-Sud  barracks  took  place  on  July  ITth,  the  garri- 
son was  only  removed  from  that  place  on  July  25th,  up  to 
which  time,  eleven  soldiers  had  already  been  attacked. 
About  twenty  Avere  left  behind,  and  this  imprudence  was 
the  cause  of  successive  contaminations,  the  barracks  thus 
becoming  one  of  the  most  active  foci  of  infection. 

The  second  focus,  created  by  the  case  in  the  Rue  de  la 
Mosque,  radiated  towards  the  north,  successively  infecting 
all  that  section  between  the  starting  point  and  the  native 
quarters. 

A  third  focus  was  created  in  the  quarters  .devoted  to 
colonial  affairs,  where  the  goods  from  the  Saint-Kilda  had 
been  landed,  and  thence  radiated  towards  the  southern 
part  of  the  city  and  across  the  small  arm  of  the  Senegal 
to  tlie  natiA'e  village  of  Guet-X'Dar,  on  the  Barbary 
Peninsnla. 

From  July  16th,  to  August  5th,  cases  cropped  out  here 
and  there,  which  goes  to  jirove  that  the  infection  Avas 
l^retty  widely  distributed,     ^loat  of  these  cases  were  fatal. 

On  August  5th,  seven  new  cases.  From  that  date,  the 
epidemic  waA'O  surged  over  the  island  with  such  fierce  in- 
tensity, that  it  is  hardly  possible  to  keep  ])ace  Avith  its 
progress.  Of  the  tAA^enty  soldiers  Avho  had  remained  at 
the  Rof/))af-Siid  barracks,  fifteen  Avere  sent  to  the  military 
hospital  betAveon  Auguse  Tth  and  21st.  The  majority  sue-  v< 
combed. 

On  August  8th,  forty-fiA'e  soldiers  were  transferred  to 
the  natiA'e  Aillage  of  N'Dartoute  and  tAA'enty  to  Pointe- 
Nord.  These  remained  uncontaminated  until  the  end  of 
September,  Avhen  nineteen  of  the  men  at  Pointe-Xord  were 
attacked.  The  troops  were  then  sent  to  M'Pal  and  Louga, 
Avhre  they  remained  until  the  end  of  the  epidemic. 


^1 


SENEGAL,    1900.  299 

The  epidemic  began  to  subside  at  Saint  Louis,  about 
September  15tli.  .New  cases  were  observed  September 
20th,  25th,  26th  and  27th,  and  October  5th,  10th  13th 
and  14th. 

There  were  no  cases  in  November. 

On  December  31st,  one  new  case,  a  civilian  from  Louga. 

A  civilian  who  had  recently  arrived  in  the  colony  was 
taken  ill  on  January  11th,  1901.  The  epidemic  of  Saint 
Louis  thus  came  to  an  end  on  that  date,  after  having 
la/sted  for  nearly  six  months,  if  we  are  to  compute  the 
true  epidemical  period  from  July  IGth,  or  nearly  eight 
months,  if  we  calculate  from  May  2r)th,  the  date  of  the 
first  case.  During  that  time,  ninety-nine  Europeans  and 
three  natives  had  fallen  victims  to  the  saffron  scourge. 


Thies. 

On  May  lltli,  1900,  a  Moroccan  who  had  arrived  from 
Dakar,  a  week  prevously,  died  at  Thies.  As  in  all  other 
instances  of  "first  cases,"  in  other  localities,  a  long  inter- 
val elapsed  before  another  case  manifested  itself.  On 
August  27th,  more  than  three  months  after  the  case  im- 
ported from  Dakar,  an  agent  and  a  doctor  arrived  at  Thies 
from  Saint  Louis.  The  agent  was  taken  ill  on  his  arrival 
and  the  doctor  on  the  29th.  Both  cases  were  sent  to  the 
Dakar  hospital.  Another  case  erupted  on  Auguse  31st. 
Altogether,  seven  cases  were  observed,  the  last  on  Feb- 
ruary 28th,  1901. 

Total  cases,  7;  total  deaths,  4. 

-    TlVOUANE. 

The  first  case  at  Tivouane,  took  place  in  August,  1900. 
This  case  was  folloAved  by  recovery.  Cases  were 
also  observed  on  October  2nd,  November  15th,  and  Novem- 
ber 25th.     The  last  case  took  place  January  18th,  1901. 

Total  cases,  4;  total  deaths,  4. 


300  HISTORY    OF    YELLOW    FEVER. 

On  Vessels. 

Recalling  the  fearful  ravages  made  by  yellow  fever  on 
board  the  vessels  doing  service  in  the  colony  in  1878,  every 
government  vessel  was  ordered  to  keep  away  from  the 
centers  of  infection  during  the  epidemic  of  1900.  The 
only  vessels  which  were  retained,  were  the  Hirondcllc,  the 
Heroine  and  the  Ahla.     All  three  were  finally  iafected. 

The  Ahka,  Avhich  did  service  as  a  water-boat,  had  a  crew 
of  eleven  natives  and  six  Europeans.  It  was  anchored 
opposite  Saint  Louis  during  the  epidemic  of  1900,  and 
was  used  for  transferring  the  troops  from  one  post  to  an- 
other, as  they  successively  became  infected.  The  first 
case  on  board  occurred  on  August  14th,  followed  by  three 
others.     Only  one  death  resulted. 

The  Heroine,  which  was  used  as  a  floating  hospital,  had 
a  crew  of  twenty-four  Europeans.  The  vessel  was  anchored 
opposite  Dakar.  The  first  case  on  board  occurred  July 
25th,  the  second,  August  10th.  From  August  10th  to 
14th,  five  new  cases.  Between  the  14th  and  25th,  there 
were  only  six  Europeans  on  board  the  pontoon.  On  the 
last  mentioned  date,  two  new  cases,  followed  by  others 
on  the  2Gth  and  27th.  In  short,  from  July  25th,  the  date 
of  the  first  case,  to  August  27th,  nine  cases  developed  on 
board,  followed  by  six  deaths. 

On  August  20th,  contrary  to  the  wishes  of  the  colonial 
government,  a  number  of  officers  were  sent  on  board  the 
Hirondelle,  with  instructions  to  proceed  to  French  Sou- 
dan. Forty-eight  hours  after  the  departure  of  the  vessel, 
yellow  fever  broke  out  on  board.  The  facts  were  imme- 
diately cabled  to  the  government,  and  the  Hirondelle  was 
ordered  to  return  to  the  capital,  without  touching  at  any 
point  on  the  river.  On  her  return,  the  captain  reported 
that  five  cases  and  two  deaths  had  taken  place  during  the 
voyage. 

STATISTICS  OF  THE  YELLOW  FEVER  EPIDEMIC 
IN  SENEGAL,  1900-1901. 

The  yellow  fever  epidemic  which  ravaged  Senegal  from 
April  16th,  1900,  to  February  28th,  1901,  may  be  con- 
sidered as  one  of  the  most  virulent  explosions  of  the  dis- 


SENEGAL,    1900. 


301 


ease  on  record.  Almost  the  entire  non-imimine  popula- 
tion fled  when  the  disease  was  officially  declared  epidemic, 
and  nearly  all  the  white  troops  were  ordered  back  to 
France.  Notwitlistandinj]j  this  depopulation,  one  hun- 
dred and  twenty-nine  soldiers  were  attacked,  and  sixty 
died,  and  of  one  hundred  and  sixty-seven  civilians  at- 
tacked, one  hundred  and  three  died.  The  mortality  would 
certainly  have  been  terrible  had  not  three  thousand 
Europeans  souglit  security  in  flight. 

Every  walk  of  life  was  invaded.  Soldiers,  ecclesiastics, 
civilians,  and  strangest  of  all,  natives  paid  tribute  to  the 
awesome  pestilence.  For  the  first  time  in  the  history  of 
yellow  fever  invasions  in  Senegal,  the  natives  w^ere  pro- 
miscuously attacked.  Tlie  black  troops  alone  furnished 
twent}^  cases  and  eight  deaths. 

The  appended  tables,  compiled  expressly  for  this  work 
from  official  records,  Avill  be  found  interesting,  especially 
Table  B,  as  it  is  the  first  time  in  the  annals  of  epidemiology 
that  a  complete  resume  of  an  epidemic  in  Western  Africa 
has  been  obtained. 


SENEGAL  EPIDEMIC  OF  1900. 
Table  A.  Localities  Afflicted,  with  Cases  and  Deaths. 


Locality 

Soiircfi  ('f 
Infection 

Dat«  of 
1st   Case 

l)»te  of 
l8t  Death 

Date  of 
Last  Case 

Dflteof 
Last  Death 

ToiM 
Ca«e8 

Tofl 
D'th 

Carabane 

4 

4 

Dakar 

Disputed  1  Apr.  16 

Apr.  16 

Nov.  — 

Nov.  — 

142 

76 

Goree 

Dakar 

June  20 

June  23 

Aug.  17 

Aug.  — 

23 

20 

Mehke 

1 

0 

N'Dande..  .. 

1 

1 

Rufisqiie 

Dakar 

May  12 

June  — 

Dec   — 

Dec.  24 

18 

15 

Saint-Louis.. 

Dakar 

May  23 

May  26 

Jan.    14 
1901 

Jan.  '01 

218 

102 

f  hies 

Dakar 
Rufiisque 

May  — 
Aug.  — 

May  11 

Feb.  28 
1901 

Jan.    18 
1901 

7 

*4 
3 

Tivouane 

3 

416 

225 

302 


HISTORY  OF    YELLOW    FRVER. 


Table  B.  CLASSiriKD  Resume  of  Cases  and  Deaths. 


Cases.  Deaths. 

Marines G5  34 

Gunners   29  12 

Spaliis   7  5 

Instructors   8  1 

Total    among    white 

troops   104  52 

Native  sharpshooters.  .   25  8 

Total   among   troops  ■ —  — 
Municipal  Service: 

Hospital  Corps   23  8 

Gendarmes   4  3 

Unclassified 1  1 

Total  among  munici- 
pal employes —  — 

Colonial  Government  Service : 

Local  Marine  Corps  . .     16  10 

Department  of  Fi- 
nance         2  0 

Department   of   Public 

Works    2  2 

Department  of  Agricul- 
ture         4  1 

Department    of    J  u  s  - 

tice 1  1 

Customhouse      Inspec- 
tors          8  6 

Post-Office     and     Tele- 
graph          4  2 

Home  Office 0  2 

Unclassified    9  5 

Total  among  govern- 
ment employes  ...     —  -- 


Total 
Cases.  Deaths. 


129         60 


28         12 


52        29 


SENEGAL,    1900.  303 


23 

13 

5 

5 

2 

0 

10 

3 

167 

103 

416 

225 

Miscellaneous : 
On  board  local  vessels. 

Ecclesiastics  . 

School  teachers   

Sisters  of  Charity  .  . . . 
Civilians    


OlJGlN  OF  THE  EriDJ:MI('. 

When  the  first  case  of  yellow  fever  broke  out  at  Dakar, 
on  April  16th,  1900,  health  conditions  were  excellent 
throu«>hout  the  colony.  There  had  been  no  outbreak  in 
Senegal  since  1882.  Under  the  circumstances,  the  ques- 
tion naturally  propounds  itself:  What  was  the  cause? 
It  could  not  have  been  a  recrudescence  of  the  epidemic,  for 
such  a  tiiinf?  is  impossible  after  a  lapse  of  eighteen  years. 
It  could  not  have  been  caused  by  the  digging  of  the  soil 
and  the  shifting  of  earth  laden  with  dejections  from  pre- 
vious epidemics,  for  yellow  fever  germs  do  not  propagate 
in  this  fashion.  There  is  only  one  door  left  open  :  Impor- 
tation. But  whence  and  how?  The  answer  is  as  elusive 
as  the  honest  man  whom  our  old  friend  Diogenes  is  no 
doubt  looking  for  through  the  trackless  regions  of  the 
nether  world. 

Let  us  see  what  localities  were  suffering  from  yellow 
fever  in  1899  and  1900,  and  we  may  find  a  clue. 

In  1899,  the  French  Ivory  Coast  was  the  only  locality 
in  Africa  where  yellow  fever  prevailed.  The  only  other 
cases  in  the  Eastern  Hemisphere  were  imported  from  A^era 
Cruz,  and  were  observed  on  shipboard  in  the  harbor  of 
Nantes  on  the  western  coast  of  France.  The  fever  pre- 
vailed epidemically  in  Central  America,  Mexico,  the 
United  States,  the  West  Indies  and  South  Ahierica. 

Could  infected  mosquitoes  have  been  imported  from 
Grand  Bassam  to  Dakar,  in  1899,  where  they  hibernated 
until  the  advent  of  warmer  weather?  The  Ivory  Coast  is 
a  French  possession  and  communication  between  the  capi- 
tal of  that  dependency  and  Senegal  was  almost  uninter- 


3j4  history  of  yellow   fever. 

rupted,  in  spite  of  quarantine  regulations.  Smugglers  in- 
fest the  coast  and  they  are  certaiuh'  not  respectors  of  san- 
itary or  any  other  laws. 

In  11)00,  yellow  fever  had.  not  been  observed  in  Africa 
previous  to  the  outbreak  at  Dakar.  We  must,  therefore, 
look  elscAvhere  for  the  source  of  importation.  Epidemics 
of  more  or  less  intensity  prevailed  that  year  in  Central 
America,  Mexico,  the  United  States,  Brazil  and  Columbia. 

The  early  appearance  of  the  disease  at  Dakar,  precludes 
an3-  i^ossibility  of  its  having  been  brought  from  the  United 
States,  for  the  disease  only  manifested  itself  in  this 
country  in  the  middle  of  the  year.  It  rarely  begins  before 
July. 

In  South  America,  however,  conditions  are  different. 
There  we  find  yellow  fever  in  almost  any  season  of  the 
year.  The  disease  was  very  severe  in  Brazil,  in  1S99  and 
1900— the  death-rate  being  731  for  the  former  and  311  for 
the  latter  year.  South  America  has  been  a  notorious  focus 
of  infection  since  the  early  fifties,  when  the  scourge  estab- 
lished itself  epidemically  in  Brazil,  and  it  is  quite  natural 
to  suspect  Rio  de  Janeiro  or  its  sister  cities  of  having  con- 
taminated Senegal  in  1900.  Yellow  fever  is  present  in 
Bio  de  Janeiro,  from  January  to  December,  each  year. 
Trade  relations  between  Brazil  and  the  ^Vest  Coast  ot 
Africa  is  quite  brisk.  In  addition  to  the  independent 
craft  which  ply  between  the  two  continents,  two  French 
steamship  companies  make  regular  trips  from  France  to 
Brazil,  and  the  La  Plata  region,  stopping  at  Dakar  on 
their  return  trip.  A  case  of  yellow  fever,  or  infected  mos- 
quitoes could  thus  easily  be  transported  from  the  epidemic 
foci  of  South  America  to  the  shores  of  Senegal. 

It  is  of  record  that  two  of  these  French  vessels  brought 
yellow  fever  cases  from  Senegal  to  Havre  (q.  v.)  during 
the  epidemic  of  1900.  the  CaravaUcs,  August  9th,  and  the 
^antci  Fc,  August  10th.  These  cases  were  infected  at 
Dakar,  where  the  steamships  had  touched,  to  take  passen- 
gers for  France.  The  fever  did  not  spread,  for  the  simple 
reason  that  the  yellow  fever  mosquito  does  not  flourish  at 
Havre,  and  whatever  infected  insects  had  been  taken  on 
board  the  vessels  while  in  Senegal,  perished  when  they 


SENEGAL 1905.  S05 

reached  an  altitude  hostile  to  their  existence.  Under  the 
same  conditions,  the  fever  could  be  transported  from 
South  America  to  Senegal,  but  with  different  results,  for 
the  Stcgomyia  Calopiis  flourishes  in  nearly  every  country 
on  the  West  Coast  of  Africa,  and  a  single  infected  female 
of  that  species  is  all  that  is  needed  to  start  a  focus, 
which  can  eventually  contaminate  the  entire  coast. 

Dr.  Kermorant  denies  the  charge  of  importation,  either 
from  other  African  stations  or  South  America,  leaning  to 
the  theory  of  revivescence  of  germs  from  previous  epi- 
demics by  the  disturbance  of  the  soil,  a  dogma  which  at 
the  present  day  has  reached  the  last  stages  of  attenuation. 

There  is,  we  repeat,  but  one  possible  source:  Importa- 
tion. But  whence  or  how,  we  can  only  surmise,  having  no 
proofs. 

1901. 

Sporadic'  cases  of  yellow  fever  Avere  observed  in  Senegal, 
during  1901.  The  first  case  of  the  year  manifested  itself 
at  Thies,  on  January  3rd.  A  fatal  case  was  observed  at 
Saint  Louis,  on  January  14th,  and  one  at  Trivouane,  on 
the  18th  of  the  same  month.  Another  case  erupted  at 
Thies,  on  February  28th.  With  the  exception  of  a  case 
at  Dakar,  on  Alpril  10th,  no  others  were  observed  until  late 
in  the  year.  Between  September  21st  and  October  13th, 
two  cases  erupted  at  Dagana  and  three  at  Saint  Louis, 
followed  by  three  deaths. ^- 

Total  cases  for  1901,  10 ;  total  deaths,  5. 

Nearly  all  these  cases  were  new  arrivals  in  the  colony. 
The  disease  did  not  l)ecome  epidemic,  for  the  simple  reason 
that  those  who  had  fled  in  1900,  wisely  remained  in  France. 

1905. 
For  four  years  we  hear  nothing  about  yellow  fever  in 


"Proust  and  Faivre:  Rec.  dcs  Trav.  du  Com.  Consult.  d'Hyg. 
Pub.  de  France,  1901  (Paris,  1903),  p.  336;  also  Ker- 
moTgant:  Ann.  d'Hyg.  et  de  Med.  Colon.,  1903,  vol.  6,  p. 
626. 


306  HISTORY    OF    YELLOW    FEVER. 

Senegal,  not  even  a  sporadic  case  being  mentioned  in  the 
official  reports  of  the  health  of  the  colony. 

On  May  31,  1905,  the  startling  news  was  disseminated 
throughout  the  colony  that  an  engineer  emploA-ed  at  the 
•water  works  at  Dakar  had  died  of  a  malady  officially 
declared  by  the  physicians,  both  civil  and  military,  to  be 
yellow  fever.  As  may  well  be  imagined,  the  announce- 
ment caused  consternation  among  the  European  popula- 
tion, and  a  general  exodus  took  place.  All  steamers  sail- 
ing for  Europe  were  crowded  to  their  utmost  capacity, 
as  a  repetition  of  the  disaster  of  1900  was  apprehended 
and  the  large  number  of  non-immunes  then  in  the  colony 
concluded  that  they  would  be  safer  with  the  ocean  between 
them  and  the  seat  of  contagion. 

According  to  Mr.  Strickland, ^^ American  Consul,  and  Dr. 
Eibot/'*  the  authorities  at  (lOree-Dakar,  warned  by  the 
disastrous  epidemic  of  1900,  used  the  most  energetic  meas- 
ures to  prevent  the  disease  from  spreading.  The  house 
where  the  patient  died  was  burned  and  his  effects 
destroyed,  the  government  assuming  the  loss.  His  family 
was  isolated  and  all  suspicious  cases  of  sickness  were 
closely  watched.  The  chief  health  officer  of  Goree  pur- 
chased two  immense  woven-wire  cages  which  had  been 
used  by  Consul  Strickland  during  his  sojourn  in  Senegal, 
one  to  sleep  in  and  the  otlier  to  enclose  his  writing-table 
and  book-cases.  The  largest  case  was  capable  of  accom- 
modating two  single  beds,  a  chair  and  a  table,  while  the 
smallest  could  contain  a  bed,  a  chair  and  a  table.  The 
cages  were  mounted  in  tlie  hospital,  and  all  cases  of  sus- 
picious fever  were  placed  therein.  Our  representative 
says  that  he  has  used  such  cages  since  1877,  and  attributes 
liis  immunity  from  the  diseases  incidental  to  the  climate 
to  this  precautionary  measure. 

Orders  were  received  by  the  colonial  government  from 
the  mother  country  to  wage  incessant  warfare  against  the 
mosquitoes  in  general  and  the  ^tcf/onri/ia  Calopiis  in  par- 
ticular, as  the  female  of  this  species,  and  not  dirt,  eman- 
"  StrickTand^     U7~sr"Public~^Heartir Reports,   1905,   vol.   207?- 

1473. 
"^Ribot:      Annales  d'Hygiene  et  de  Medicine  Colonialcs  (Paris), 
1907.  vol.  10.  D.  79. 


SIERRA    LEONE  307 

ations  or  buried  germs  were  responsible  for  the  si)read  of 
yellow  fever. 

An  old  and  tried  proverb  asserts  that  an  ounce  of  pre- 
vention is  better  than  a  pound  of  cure,  and  to  the  strict 
sanitary  measures  adopted  by  the  authorities,  Senegal 
probably  owes  her  escape  from  an  epidemic  in  1905.  Be 
that  as  it  may,  no  other  cases  developed  and  the  timorous, 
who  had  been  on  the  anxious  seat  and  only  awaited  the 
eruption  of  a  second  case  to  flee,  settled  down  to  their 
usual  avocations,  and  the  business  of  the  colony  resumed 
its  normal  stage. 

It  would  have  been  interesting  to  analyze  the  genesis 
of  this  isolated  case;  but,  unfortunately,  beyond  the  report 
of  Consul  Strickland,  we  have  failed  to  discover  any  arti- 
cle which  could  throw  additional  light  on  the  subject. 
That  the  case  did  not  originate  de  novo  is  certain,  f^or  it 
would  have  been  followed  by  others.  In  the  absence  of 
proof  that  it  was  imported,  however,  we  cannot  positively 
assert  that  it  was  of  foreign  origin,  although  we  are  in- 
clined to  that  belief.  We  shall  leave  the  question  for 
future  theorists  to  elucidate. 

CONCLUSIONS. 
1908. 

Up  to  the  time  this  transcript  is  handed  to  the 
printer,  October,  1908,  we  have  not  heard  of  any  other 
eruption  of  yellow  fever  in  Senegal,  and  with  the  present 
known  mode  of  transmission  of  the  disease,  there  is  no 
reason  why  yellow  fever,  should  it  manifest  itself  in  that 
far-off  land,  should  not  be  confined  to  a  few  cases. 

SIEREA    LEONE. 

Description. 

Sierra  Leone  is  a  British  crown  colony  on  the  west  coast 
of  Africa.  It  is  a  coaling  station  for  the  Royal  Navy,  and 
the  headquarters  of  the  West  Indian  regiments,  stationed 
on   the  African   coast.      The  colony  consists   of   Sierra 


308  HISTORY    OF    YELLOW    FEVKR. 

Leone  proper,  Sherbro  Island,  several  small  islands  and 
the  whole  coast  region  from  the  lower  limits  of  French 
Guiana,  on  the  northwest  to  Liberia  on  the  southwest. 
Capital,  Freetown,  where  most  of  the  inhabitants  live. 

HISTORICAL  RESUME. 

Sierra  Leone  was  discovered  by  the  Portugese,  in  1463, 
but  no  settlement  was  attempted,  owing  to  the  deadly 
nature  of  the  climate  and  the  ferocity  of  the  savages  who 
inhabited  the  interior..  From  time  to  time,  spasmodic 
efforts  were  made  to  establish  colonies  along  the  coast,  but 
the  mortality  which  attended  these  efforts  was  such,  that 
Sierra  Leone  was  designated  by  Europeans  as  "The  White 
Man's  Grave,"  an  appellation  which  has  clung  to  it  to 
tliis  day. 

On  May  9th,  1787,  about  sixty  Englishmen  and  four 
hundred  blacks  landed  at  the  peninsula  of  Sierra  Leone, 
and  founded  Freetown,  whicli  was  destined  to  be  the  haven 
of  all  the  escaped,  rescued  and  emancipated  slaves  of  the 
world.  On  September  16th,  1787,  disease  had  so  deci- 
mated the  colony,  that  only  two  hundred  and  seventy-five 
IDcrsons  remained.  These  either  emigrated  to  other  climes 
or  were  murdered  by  the  natives.  In  1791,  the  English 
Parliament,  to  encourage  the  work  of  the  abolitionists, 
authorized  the  formation  of  a  powerful  company.  The 
year  following,  this  company  sent  1200  liberated  slaves 
from  Nova  Scotia  and  the  Bahamas  to  rebuild  the  aban- 
doned town  of  Freetown.  Shortly  after,  a  pestilential  dis- 
ease ravaged  the  colony  and  the  project  was  about  to  be 
abandoned,  when  an  Englishman  named  Clarkson,  a 
brother  of  the  originator  of  the  scheme,  took  energetic  con- 
trol, and  induced  the  pioneers  to  remain.  The  ill-starred 
venture  was  destined  to  again  suffer  destruction.  In 
1791,  a  French  squadron,  not  knowing  of  the  philanthropic 
nature  of  the  settlement,  but  seeing  only  a  possession  of 
the  hated  Englishman,  completely  destroyed  the  town. 
The  French  government  severely  censured  the  command- 
ant of  the  squadron  for  this  action,  but  it  was  too  late — 
Freetown  was  a  heap  of  debris. 


SIERRA    LEONE.  309 

With  the  stubbornness  which  characterizes  the  Brit- 
isher, and  to  which  is  due  his  eminence  in  the  history  of 
nations,  John  Bull  resolved  to  again  put  its  pet  scheme 
into  execution,  and  in  1808,  purchased  all  the  rights  of 
the  Sierra  Leone  Company,  and  the  territory  became  an 
English  possession.  In  1812,  a  new  mode  of  colonizing 
the  country  was  put  into  execution.  All  slaves  taken 
iVom  ships  captured  by  the  English,  were  sent  to  Sierra 
Leone,  and  given  their  liberty.  From  that  date,  the  colony 
prospered  and  became  the  Mecca  of  emancipated  slaves. 

Other  towns  were  founded  in  rapid  succession:  Leices- 
ter, in  1809;  Eegent,  in  1812;  Gloucester,  in  1816;  Leo- 
pold and  Kissey,  in  1817;  Charlotte,  Wilbeforce  and  Bat- 
hurst,  in  1818;  Kent,  York,  Wellington,  Hastings  and 
Waterloo,  in  1819. 

The  population  of  Sierra-Leone  grew  rapidly.  In  1811, 
there  were  4,500  persons,  half  of  which  were  liberated 
slaves;  in  1819,  it  had  more  than  doubled,  being  12,000, 
including  200  white  soldiers;  in  1828,  it  had  grown  to 
17,566,  and  in  1819,  to  46,569.  The  last  census  (1891), 
gave  the  dependency  a  population  of  74,835,  mostly  natives 
and  descendants  of  liberated  slaves. 

From  1812  to  1835,  the  liberated  slaves  sent  to  swell  the 
population  of  Sierra  Leone,  amounted  to  27,167. 

The  European  population  was  more  numerous  in  the 
first  years  of  the  colony  than  afterwards.  This  was  due 
to  the  fact  that  the  insalubriety  of  the  climate  is  extremely 
hostile  to  the  whites.  In  1818,  the  town  of  Regent,  alone, 
had  a  population  of  1300  whites  and  1700  blacks.  In 
1826,  only  535  English  soldiers  could  be  found  in  the 
entire  colony.  To-day,  the  population  is  almost  totally 
black.  A  few  white  merchants  remain  during  the  healthy 
season,  but  as  soon  as  the  rains  set  in,  they  return  to 
Europe.  Tlie  white  soldiers  have  been  replaced  by  blacks, 
and  with  the  exception  of  a  few  white  officers,  the  gov- 
ernor and  his  clerical  help,  no  whites  reside  permanently 
in  the  colony. 

1  THE  FEVERS  OF  SIERRA  LEONE. 

Sierra  Leone  may  now  be  considered  as  one  of  the  en- 


310  HISTORY    OF    YELLOW    FiCVKR. 

(lemic  foci  of  yellow  fever  iu  western  Africa.  Previous  to 
1763,  when  the  disease  was  imported  to  the  colony,  it  was 
unknown;  but,  finding  a  home  suitable  for  its  retention 
and  propagation,  it  took  firm  root,  and  is  now  one  of  the 
natural  products  of  that  insalubrious  region. 

According  to  Lamprey,^^  there  are  three  types  of  fevers 
commonly  met  with  in  Sierra  Leone:  (1),  ague;  (2),  bili- 
ous fever,  and  (3),  pernicious  or  yellow  fever.  The  first 
is  not  of  frequent  occurrence;  the  second  is  the  common- 
est; the  third  the  most  fatal.  Dr.  Lamprey,  who  made  a 
special  study  of  the  yellow  fever  outbreaks  in  Sierra 
T^one,  observed  that,  though,  the  character  of  these  fevers, 
when  developed,  show  a  distinctivenss  of  type  one  from 
another,  yet  so  alike  are  they  at  the  incipiency  of  the 
attack,  that  it  requires  some  experience  to  define  them. 
Tt  is  found  expedient  to  carefully  watch  the  various  symp- 
toms of  a  suspicious  case,  before  absolutely  j)ronouncing 
the  disease  to  be  yellow  fever. 

,  The  unsanitary  condition  of  Freetown  is  especially 
adapted  to  the  propagation  of  pestilence.  The  city  is 
situated  in  an  amphitheatre,  surrounded  on  three  sides  by 
a  range  of  hills  rising  from  500  to  3,000  feet  above  the 
town.  In  this  circumscribed  area,  a  large  and  dense  pop- 
ulation are  crowded  together.  The  houses  are,  for  the 
most  part,  unscientifically  constructed  and  illy  ventilated, 
and  are  surrounded  by  privies,  cesspits  and  wells.  From 
the  latter  the  inhabitants  obtain  their  drinking  water. 
During  the  "wet"  season — May  to  August — it  rains  in- 
cessantly. The  natural  slope  of  the  land  drains  this  heavy 
rainfall  into  the  cesspits  and  vaults,  which  overflow  into 
the  wells,  concocting  a  beverage  for  the  benighted  Free- 
townites,  compare<l  to  which  Carizzo  water  would  taste 
like  nectarine  frappe. 

From  the  above  conditions,  it  will  readily  be  understood 
why  the  fever  is  so  often  epidemic  in  Sierra  Leone,  and  is 
productive  of  such  a  high  rate  of  mortality. 


•'Lamprey:     British  Medical  Journal,  1885;  vol.  2,  p.  594. 


SIERRA    LEONE 1763-1778.  311 

) 

A  review  of  the  literature  ou  the  subject  brings  forth 
no  evidence  of  the  fever  ever  having  been  imported  into 
Sierra  Leone,  but  rather  leads  to  the  conclusion  that  an 
endemic  fever  prevails  every  year  in  that  country,  being 
most  prevalent  in  the  lowest  and  most  crowded  sections  of 
Fretown.  It  arises  purely  from  local  causes.  At  certain 
epochs  this  fever  acquires  great  development  and  becomes 
epidemic,  and,  although  its  symptoms  remain  the  same, 
they  are  much  heightened  in  intensity ;  remissions  are  less 
common,  black  vomit  is  more  frequent  and  the  mortality 
greater. 

YELLOW  FEVER  YEARS. 

1763;  1764;  1766;  1778;  1807;  1809;  1812;  1815;  1816; 
1819;  1822;  1823;  1825;  1826;  1828;  1829;  1830;  1836; 
1837;  1838;  1839;  1815;  1817;  1848;  1858;  1859;  1862; 
1864;  1865;  1866;  1868;  1872;  1878;  1884. 

SUMMARY  OF  EPIDEMICS. 

1763  TO  1766. 

According  to  Lind,^^  yellow  fever  prevailed  in  Sierra 
Leone,  in  1763,  1764  and  1766.  The  repoa'ts  lack  authen- 
ticit}'. 

1778. 

The  first  authentic  appearance  of  yellow  fever  in  Sierra 
Leone,  took  place  in  1778,  according  to  Scliott.^'''  No  de- 
tails are  given,  probably  because  the  whites  were  so  scarce 
in  the  country  that  only  a  few  cases  resulted  among  them ; 
but  it  is  an  historical  fact  that  the  fever  was  carried  from 
Sierra  Leone  to  Gambia,  and  from  Gambia  to  Senegal, 
where  it  decimated  the  English  garrison  stationed  at  Saint 
Louis. 

'"Lfind:     Diseases   lueidental   to   Europeans  in   Hot   Climates. 
"Schctte:     A  Treatise  on  the  Synochiis  Atrabiliosa,  London, 
1782. 


31?  HISTORY    OF    YELLOW    FEVER. 

1807  TO  1816. 

Yellow  fever  was  present  in  Sierra  Leone,  in  1807,  1809, 
1812,  1815,  1816,  1819  and  -1822,  but  only  sporadically.^^ 
The  mortality  among  the  Europeans  was  high. 

1823. 

The  first  epidemic  of  which  any  details  are  given, 
is  that  of  1823,  described  by  Bryson.^^  The  focus 
of  this  epidemic  began  on  December  11,  1822,  when  an 
isolated  case  of  "suspicious  fever"  was  observed,  followed 
by  death.  The  patient  was  the  harbor-master  of  Sierra 
Leone,  and  had  been  on  board  no  infected  vessel,  nor  had 
been  exposed,  as  far  as  Dr.  Bryson  could  ascertain,  to  any 
other  infection  except  that  of  the  common  endemic  and 
local  fever.  Six  weeks  afterwards,  another  case  occurred. 
The  third  positive  case  occurred  on  the  22nd  of  February, 
1823,  in  the  person  of  a  seaman  from  the  ship,  Caroline, 
who  had  been  loading  timber  up  the  river.  Some  weeks 
previous  to  the  diagnosis  of  this  case,  the  Caroline  had 
lost  several  of  her  crew  from  fever  contracted  while  the 
vessel  was  being  loaded  at  Freetown.  Cases  subsequently 
occurred  among  the  crew  of  other  vessels  and  among  tne 
inhabitants  of  Sierra  Leone,  and  the  fever  gradually  be- 
came widespread. 

The  epidemic  appears  to  have  gradually  declined,  and 
finally  ceased  at  Sierra  Leone,  and,  as  far  as  can  be  ascer- 
tained, in  the  shipping  in  the  adjacent  rivers,  in  June  or 
July.  As  there  had  been  a.  first  case  of  a  doubtful  char- 
acter preceding  by  several  weeks  or  a  month,  the  general 
outbreak,  so  it  might  be  argued,  there  was  a  last  case  of 
a  similar  nature,  which  followed  its  general  extinction  at 
an  equal  distance  of  time.  The  last  case  which  occurred 
in  June,  proved  fatal  on  the  12tli  of  the  month,  when  the 
heavy  rains  set  in.     But  there  was  another,  an  "isolated 

•*  Berenger-Feraud  and  Lrmprey,  loc.  c:t. 

"Bryson:     An  Account  of  the  Origin,  Spread  and  Declane  of 

the   Epidemic   Fevers   of   Sierra   Leone    (London,   1849), 

p.  14. 


SIERRA    LEONE 1823.  3l3 

case,"  that  of  Mr.  Huddleston,  a  Wesleyan  preacher,  which 
occurred,  about  the  middle  of  July ;  he  was  then  convales- 
cent from  an  attack  of  the  common  remittent,  a  disease 
he  was  subject  to  during  the  rains.  On  returning  from 
his  religious  duties,  he  felt  indisposed,  and  became  fever- 
ish, but  it  was  considered  to  be  merely  a  relapse  of  the 
remittent.  On  the  third  day,  however,  it  manifested  symp- 
toms of  the  fatal  epidemic.  On  the  evening  of  the  fourth, 
black  vomit  made  its  appearance;  and  the  next  evening, 
the  20th  of  July,  the  afflicting  scene  closed.  This  gentle- 
man resided  in  the  same  house  with  his  brother-in-law, 
who  died  of  the  epidemic  fever  on  the  16th  of  April ;  he 
was  besides,  during  that  and  the  following  month,  when 
the  disease  was  at  its  greatest  degree  of  severitj",  fre- 
quently at  the  bedside  of  those  who  were  suffering  from 
it,  without  being  affected  himself."^ 

As  the  epidemic  disappeared,  the  ground  was  found 
occupied  by  the  endemic,  exhibiting  about  the  same  degree 
of  intensity  it  had  when  the  former  threw  it  into  the 
shade,  in  the  early  part  of  the  year ;  subsequently,  it  pre- 
vailed for  several  years  amongst  all  classes  of  Europeans, 
from  the  Gambia  down  to  the  easternmost  point  of  the 
Gold  Coast,  with  unprecedented  severity.  The  deaths  on 
some  of  the  cruisers  were  numerous,  but  amongst  the 
troops  stationed  at  Bathurst,  Cape  Coast  and  Accra,  they 
were  truly  appalling.  To  say  that  upwards  of  three- 
fourths  x)f  the  whole  were  annually,  for  several  j^ears,  cut 
off  by  fever,  would  be  far  within  the  mark.''^^ 

The  fever  was  imported  from  Freetown,  in  ]March,  1823, 
to  the  Island  of  Ascension  (q.  v.)  by  the  sloop  of  war 
Bann,  an  incident  which  gave  rise  to  discussions  which  re- 
main unsettled  to  the  present  day.^^ 

1825. 

Yellow  fever  prevailed  in  Sierra  Leone,  in  1825,  result- 
ing in  a  mortality  of  fifty  per  cent.^^ 

"  '^^Bryson,  p.  3L 

"Bryson,  p.    32. 
"  See  "Ascension  Island,"  in  this  volume,  for  details  cf  this 

famous  case. 
"  Second  Report  on  Quarantine,  1852,  p.  288. 


314  HISTORY    OF    YELLOW    FEVER. 

182G. 

I^o  details  are  obtainable  concerning  the  outbreak  of 
182G,  as  the  English  medical  archives  are  as  silent  as  the 
gTave  on  the  subject,  but  according  to  Dupont  and  Beren- 
ger-Feraud,'''^  the  ship,  SijhiUe  was  infected  at  Freetown, 
during  the  summer  of  1826,  and  lost  a  gTeat  many  of  her 
crew  on  the  voyage  from  that  port  to  Saint  Helena.  The 
English  nosologists  denied  that  the  disease  on  the  SjjhiUe 
was  yellow  fever,  claiming  that  the  contagion  would  have 
spread  to  the  Island  of  Saint  Helena  had  such  been  the 
case,  but  it  must  be  borne  in  mind  that  the  outbreak  took 
place  about  the  end  of  August,  the  coldest  month  in  the 
Southern  Hemisphere,  and  that  S(tcgonii/iac  do  not  circu- 
late when  the  temperature  is  below  the  freezing  point. 

1828. 

Yellow  fever  reappeared  during  the  summer  of  1828. 
The  ship  La  Bordclaise  was  infected  at  Freetown,  and 
carried  the  disease  to  Senegal  (q.  v.)'^^ 

1829. 

The  year  1829  witnessed  another  severe  outbreak  in 
Sierra  Leone.  From  1823  to  1829,  yellow  fever  was 
present  almost  every  year  in  Sierra  Leone.  The  disease 
was  very  fatal,  but  was  not  widespread  during  that  period. 
In  April,  1829,  however,  the  fever  assumed  a  most  malig- 
nant type.  As  in  1823,  the  first  cases  were  scattered  and 
were  not  imported;  they  seemed  to  grow  out  as  it  were 
from  the  endemic  fever,  from  which,  indeed,  some  of  the 
cases  appear  to  have  been  scarcely  distinguishable.  Then, 
gradually  increasing,  the  disease  spread  as  an  epidemic 
among  the  European  seamen  and  the  white  ])opulation 
residing  along  the  lower  left  bank  of  the  river,  the  very 
locality  in  which  the  fever  of  1823,  had  committed  such 
terrible  ravages.^^ 


"Dupont,  loc.  cit. ;   Berenger-Feraud,  p.  104. 
"  Berenger-Feraud,  p.  105. 

'"British   and   Foreign    Medico-Chlrurgical   Review,    1849;    Vol. 
4,  p.  465. 


SIERRA    LEONE 18S9..  315 

According-  to  Bojle/^  the  first  well  marked  fatal  case 
was  that  of  Mr.  Loiighman,  a  writer  in  the  Colonial  Office, 
a  young  man  of  "a  sensitive  mind,  but  somewhat  careless 
as  to  his  modes  of  living."  He  was  seized  on  the  21st  of 
April,  and  died  on  the  28th,  under  all  the  symptoms  of 
the  epidemic,  then  known.  There  was  no  means  of  trac- 
ing this  case  to  imported  contagion,  or  indeed  any  reasons 
to  presume  it  was  so  contracted. 

The  next  case  appears  to  have  been  that  of  a.  midship- 
man of  the  Eden,  who  was  taken  ill  in  the  harbor,  on  the 
29th  of  April,  on  board  a.  detained  vessel  of  which  he  had 
charge,  and  died  on  the  5th  of  May,  on  the  Eden,  to  which 
he  had  been  removed.  In  this  vessel  there  was  another 
subordinate  officer,  who  was  attacked  the  day  after  the 
above,  as  he  himself  supposed,  in  consequence  of  his  hav- 
ing "got  wet  in  a  tornado."  His  symptoms  were  decidedly 
those  of  yellow  fever.  On  the  3rd  of  May,  his  dejections 
became  black;  on  the  4tli,  his  eyes  and  skin  were  yellow, 
with  a  dirty  brown  tinge  on  the  fifth,  his  urine  was  turbid 
and  offensive ;  on  the  6th,  he  began  to  sink,  and  died  early 
on  the  morning  of  the  7th,  on  the  detained  vessel.  Blood 
was  taken  from  the  arm  early  in  the  disease,  but  the 
wound  never  closed,  and  it  bled  to  the  last,  when  the 
bandages  were  removed  or  torn  off  by  the  patient  when 
delirious;  it  resembled  the  orifice  made  in  the  vein  of  a 
dead  subject. 

The  next  case  on  record,  although  there  is  little  reason 
to  doubt  that  there  were  others  occurring  at  the  same 
time,  is  that  of  a  man,  who,  after  wandering  for  several 
days  about  Freetown  in  a  state  of  destitution,  Avas  received 
on  board  the  Eden,  on  the  1st  of  May,  as  one  of  her  crew. 
On  the  evening  of  the  3rd,  he  was  attacked  with  fever; 
on  the  Otli  his  dejections  were  of  a  dark  color,  and  in  the 
evening  he  vomited  a  dark  colored  fluid,  in  which  there 
were  clots  and  streaks  of  coagulated  blood.  On  the  7th, 
hs  eyes  and  skin  having  become  yellow,  he  began  to  sink, 
and  died  at  four  in  the  afternoon. 

"Boyle:        A     Pract'cal     Medico-Hisitorical     Account    of    the 
Western  Coast  of  Africa,  (London,  1831),  p.  255. 


316  HISTORY    OF    YELLOW    FEVER. 

The  next  case  was  that  of  a  traveler  who  came  down  to 
Sierra  Leone  in  an  open  boat,  and  being  intoxicated,  slept 
part  of  the  time,  although  exposed  to  the  fury  of  the  north- 
east tornado,  accompanied  with  heavy  rain.  He  was 
seized  on  the  4th  of  May,  the  day  after  his  arrival  at  Free- 
town, and  died  on  the  10th. 

On  the  9th  of  May,  one  of  the  merchants  of  Freetown 
was  attacked,  and  died  on  the  16th.  In  this  instance 
death  was  preceded  by  yellowness  of  the  skin  and  black 
vomit. 

The  cases  then  became  more  frequent  and  almost  every 
European  who  had  not  fled  from  Freetown,  suffered  an 
attack.  The  malady  lasted  without  interruption  until 
1830,  when  it  gradually  subsided  and  was  succeeded  by  the 
endemic  bilious  fever. 

The  Edcii,  which,  as  we  have  seen,  had  been  infected  at 
Freetown,  in  1823,  an  event  which  caused  endless  contro- 
versies between  the  medical  men  of  the  period,  was  con- 
taminated at  Freetown,  in  1829,  and  lost  110  men  out  of 
a  crew  of  160,  besides  leaving  her  sick  at  numerous  ports 
on  the  African  coast,  which  were  thus  infected  and  suf- 
fered much  from  the  ravages  of  the  disease. 

The  Champion  was  also  infected  at  Freetown,  in  1829, 
and  carried  the  fever  to  Fermando-Po  (q.  v.),  where  it 
caused  much  mortality. 

1830. 

Many  cases  were  observed  in  1830,  but  the  disease  did 
not  become  epidemic,  gradually  subsiding  during  the  sum- 
mer and  finally  blending  with  the  bilious  fever  annually 
present  in  Sierra  Leone. 

1836. 

For  six  years,  nothing  is  said  about  yellow  fever  in 
Sierra  Leone  in  the  official  medical  reports,  although  there 
is  no  doubt  in  our  mind  that  the  disease,  if  it  did  not  pre- 
\ail  annually,  must  certainly  have  been  present  at  some 
time  or  other  during  these  dat«s. 


SIERRA     LEONE. 1837.  317 

In  December,  1836,  the  fever  broke  out  suddenly  at  Free- 
town, and  lasted  until  January,  1837.  The  cases  and 
deaths  are  not  given.^'^ 

1837. 

The  focus  of  the  epidemic  of  1837,  began  in  December, 
1830,  as  mentioned  above. 

The  genesis  of  this  epidemic  as  set  forth  by  Bryscm 
(page  07)  is  interesting  and  shows  how  fatal  to 
Europeans,  especially  new  arrivals,  is  the  African  type  of 
yellow  fever. 

It  appears  by  a  report  from  Staff-Surgeon  Ferguson, 
then  Governor  of  Sierra  Leone,  that  a  vessel  called  the 
Mary,  arrived  from  England  on  the  9th  of  December,  1830, 
and  immediately  afterwards  proceeded  up  the  Bunce 
Kiver  for  a  cargo  of  timber,  anchoring  six  miles  above 
Freetown,  close  to  the  marshy  mangrove-covered  banks  of 
the  river..  Towards  the  close  of  the  month,  the  endemical 
remittent  began  to  attack  the  crew  in  the  order  exhibited 
by  the  following  table: 

Cases.     Deaths. 

Dec.  27,  1836 1  0 

Dec.  29,  1830 5  0 

Dec.  30,  1836 5  4 

Jan.     4,  1837 2  0 

Jan.     6,  1837, 1  0 

Jan.     7,  1837 1  1 

15  5 

The  master  of  the  vessel  was  attacked  on  the  30th  of 
December,  and  died  on  the  20th  of  January.  Four  of  the 
crew  were  also  attacked  on  the  same  day  as  the  master, 
of  whom  three  died.  These,  with  the  cases  of  the  27th 
and  the  29th,  were  considered  to  be  instances  of  the  en- 
demial  remittent.  On  the  0th  of  January,  there  was  but 
one  European  left  on  board  (the  carpenter)  ;  he  also  was 
in  ill  health,  but  refused  to  leave  the  ship.  He,  however, 
became  worse,  was  brought  to  town  on  the  10th  of  Jan- 
uary, and  died  on  the  12th.     Thus  the  whole  of  the  crew 

"  Bryson,  p.  94. 


SIS  HISTORY    OF    ye;  LOW    FEVER. 

were  att.acked  with  the  fever  within  the  space  of  fifteen 
days,  and  a  third  of  the  number  died.  In  these  cases, 
neither  black  vomit  nor  any  of  the  symptoms  character- 
istic of  the  malignant  remittent  occurred. 

During  the  period  embraced  by  the  foregoing  detail,  the 
Europeans  of  Freetown  Avere  healthy.  On  the  4th  of 
January,  a  young  gentleman,  who  had  not  been  a  month 
in  the  colony,  was  attacked  with  fever  of  great  severity, 
which,  after  it  had  been  protracted  beyond  the  ordinary 
duration  of  remittents,  proved  fatal  on  the  16th  of  the 
month.  On  the  following  day,  a  mulattress,  who  had 
been  in  the  colony  eighteen  years,  died  of  fever  of  ten 
days'  duration.  These  two  cases,  the  colony  having  been 
previously  healthy,  excited  great  consternation,  but  no 
other  cases  developing  they  were  soon  forgotten. 

One  of  the  two  sailors  of  the  Mary,  who  had  been 
attacked  with  fever  in  the  early  part  of  January,  iiad  a 
relapse  on  the  9th  of  February',  of  Avliich  he  died  on  the 
18th,  having  had  black  vomit  on  the  day  of  his  death. 
He  had  not  returned  to  the  ship,  but  remained  at  sick 
lodgings  at  Freetown,  taking  a  walk  morning  and  even- 
ing, when  the  fatal  relapse  occurred. 

The  next  cases  were  amongst  the  crew  of  a  vessel  called 
the  Lady  Doufjlass,  which  had  arrived  at  Freetown  on 
the  12th  of  January,  and  afterwards  went  to  Melacoorie, 
a  river  about  forty  miles  to  the  northward  of  Sierra.  Leone, 
for  timber.  Four  men  from  this  vessel  were  unfortun- 
ately sent  to  the  same  sick  lodgings  that  had  been  previ- 
ously occupied  by  part  of  the  sick  crew  of  the  Mnr}i.  The 
men  were  all  taken  sick,  and  only  one  of  the  four  recov- 
ered; the  others  died  after  having  presented  the  symp- 
toms peculiar  to  yellow  fever. 

The  malignant  fever  at  length  broke  out  in  its  worst 
form  among  the  European  residents  of  Freetown.  The 
first  case  occurred  on  the  31st  of  March.  Mr.  White,  a 
West  Indian,  who  had  resided  several  years  in  the  colony, 
Captain  Patrick  and  Mr.  Crummens  were  on  that  day] 
attacked,  and  the  two  last  mentioned  died  on  the  fourth 
day  of  the  fever. 

The  third  fatal  case  occurred  on  the  16th  of  April,  the 


I 


SIERRA    LEONK 18S7.  S19 

fourth  on  the  20th  and  the  fifth  on  the  24th.  All  these 
cases  terminated  with  the  peculiar  symptoms  of  malig- 
nant fever.  The  duration  of  the  fever  in  the  seven  first 
cases  that  terminated  in  death  was  as  follows,  viz. :  The 
first  and  second  on  the  fourth  day;  the  third  on  the 
fourth ;  the  fourth  on  the  fourth ;  the  fifth  on  the  third ; 
sixth  on  the  sixth,  and  the  seventh  on  the  ninth. 

All  these  were  males;  the  next  case  was  a  Mrs.  N.,  who 
was  the  first  female  who  had  the  disease,  and  after  it  had 
assumed  the  epidemic  character,  she  recovered.  The  fever 
tlius,  after,  as  it  were,  maturing  during  a  period  of  about 
two  months,  established  a  footing  in  Freetown,  continued 
with  great  violence  in  May  and  June,  and  declined  in 
July,  the  attacks  gradually  becoming  fewer  and  less  severe 
as  the  raiiiy  season  approached.  Nearly  all  the  patients 
who  wene  attacked  in  the  latter  month  recovered,  and  by 
tlie  end  of  July,  the  fever  in  its  epidemic  form,  was  wholly 
extinct,  although  sporadic  cases  manifested  themselves 
until  the  middle  of  December. 

On  Vessels. 

In  May  1837,  according  to  Bryson  (page  94),  yellow 
fever  was  contracted  by  the  crew  of  the  Curlew,  either 
there  or  in  one  of  the  rivers  between  Sierra  Leone  and  tlie 
Gambia,  but  wherever  contracted,  it  was  communicated  by 
the  chip's  company  to  the  inhabitants  of  Gambia,  and  sub- 
sequently by  the  latter  to  the  inhabitants  of  Goree. 

In  October  and  in  Noyemlier,  the  fever  was  contracted 
either  at  Freetown  or  off  Cape  Palmas,  by  the  crew  of  the 
Raven;  but,  altliough  a  large  proportion  of  the  sick  of 
this  vessel  were  landed  at  Cape  Coast  Castle,  they  did 
not  communicate  the  disease  to  the  inhabitants  of  that 
district. 

In  December,  the  malady  under  discussion  was  con- 
tracted at  Sierra  Leone  by  two  stewards  belonging  to  the 
English  coasting  vessel  Efna;an(].  there  is  reason  to  believe 
it  was  communicated  by  them  in  a  most  virulent  form  to 


3  20  HISTORY    OF     YELLOW    FEVER. 

the  ship's  company,  who  carried  it  to  the  Island  of  Ascen- 
sion, where,  in  a  short  time,  nearly  the  whole  of  the  crew 
having  suffered,  it  became  extinct  in  the  quarantine  tents 
at  Comfort  Cove. 

In  the  latter  end  of  December,  it  broke  out  amongst  the 
ship's  company  of  the  Forester,  at  or  shortly  after  leaving 
Sierra  Leone,  but  ax)pears  to  have  entirely  ceased  on  the 
passage  to  Ascension.  At  sea,  however,  prior  to  its  cessa- 
tion, she  communicated  with  the  Bonitta,  and  discharged 
a  prize  crew  into  her,  which  had  been  embarked  at  Sierra 
Leone.  By  these  men,  or  by  some  other  means,  the  fever 
was  communicated  to  the  ship's  company,  and  by  them, 
the  malady  having  suddenly  assumed  the  greatest  degTee 
of  virulence,  it  was  again  carried  to  Ascension  (q.  v.) 

1838. 

In  1838,  according  to  Lamprey,''^^  yellow  fever  appeared 
in  February,  and  ended  in  March.  The  Island  of  Ascen- 
sion (q.  V.)  was  again  contaminated  by  vessels  from  Sierra 
Leone  in  the  beginning  of  the  year. 

1839. 

In  1839,  a  severe  form  of  "remittent  fever"  caused  the 
death  of  six  officers  of  the  garrison  at  Tower  Hill  bar- 
racks. During  the  months  of  July,  August  and  Septem- 
ber, every  mail  of  the  Royal  African  Corps  in  the  barracks 
at  King  Toms,  Freetown,  suffered  from  the  fever,  and  the 
mortality  amongst  that  corps  is  stated  to  have  been  appal- 
ling.    There  were  seven  officers  and  thirteen  men  of  the 

Koyal  Navy  attacked  with  yellow  fever,  and  every  one 
died.*^o 

1845. 

From  1839  to  1845,  there  is  no  mention  of  yellow  fever 
in  Sierra  Leone,  probably  due  to  the  fact  that  no  new- 
comers arrived  during  that  period. 

— ■ . .    .y 

"Lamprey:     British  Medical  Journal,  1885;  Vol.  2,  p.  594.  ^ 

"'  Lamprey,  Ice.  cit. 


*       SIERRA    LEONE — 1847-1858.  321 

In  1845,  yellow  fever  appeared  amongst  the  crew  of  the 
squadron  at  anchor,  off  Sierra  Leone.  The  Eclair  sailed 
from  the  river  on  July  23rd,  1845,  and  sixty  of  her  crew 
perished  from  yellow  fever.  One  fatal  case  occurred  in 
September.^^ 

The  Eclair  contaminated  Boa  Vista,  one  of  the  Cape 
Verds  (q.  v.) 

1847. 

In  1847,  yellow  fever  was  epidemic  in  Freetown,  in 
June,  July  and  August.  The  ship  Growler  was  contami- 
nated at  Freetown,  and  is  accused  of  having  brought  the 
fever  to  the  Island  of  Barbadoes,  in  the  West  Indies.^^ 
But  as  the  fever  was  already  prevailing  in  the  Antilles, 
this  importation  merely  added  fuel  to  the  pestilence. 

1848. 

Another  outbreak  of  the  disease  took  place  in  1848,  but 
was  not  severe. ^^ 

1858. 

Sierra  Leone  presumably  enjoyed  a  long  immunity  from 
yellow  fever,  for  no  cases  are  recorded  during  the  decade 
from  1848  to  1858.  Whether  the  fever  was  present  or  not, 
we  have  no  means  of  ascertaining,  as  the  inedical  records 
are  silent  on  tlie  subject,  and  even  our  old  stand-by,  Ber- 
enger-Feraud,  was  unable  to  unearth  any  records  which 
could  throw  light  on  the  question.  This  extraordi- 
nary immunity  may  be  explained  on  the  theory  that  the 
whites,  tiring  of  being  mowed  down  like  sheep,  kept  aloof 
from  the  colony  and  the  blacks,  who  are  seldom,  if  ever 
attacked  by  yellow  fever,  furnished  no  cases. 

The  reappearance  of  the  fever  in  1858  is  barely  noticed 
by  Berenger-Feraud  (loc.  cit.,  page  135),  and  is  mentioned 
nowhere  else.     Only  two  causes  are  open  to  conjecture: 

"  Lamprey  and  Berenger-Feraud. 
"  Lamprey  and  Berenger-Feraud. 
"Berenger-Feraud,  p.  118. 


322  HISTORY  OF  vellow   fever. 

( 1 )  That  the  disease  had  been  present  during  all  the  time 
from  1848,  to  the  "official-'  outbreak  of  1858;  or,  (2)  Tliat 
it  was  re-introduced  by  the  shipping.  We  have  nothing 
on  which  to  base  any  argument  which  could  sustain  any 
of  these  propositions,  but  it  is  self-evident  that  one  of  the 
two  must  stand.  Yellow  fever  cannot  originate  from  the 
ground,  and  mosquitoes  could  not,  under  the  most  extra- 
vagant stretch  of  the  imagination,  carry  the  virus  for  ten 
years.  The  introduction  of  a  single  case,  however,  would 
be  sufficient  to  disseminate  the  poison  and  give  rise  to  an 
outbreak  among  the  non-immunes  unprotected  from  the 
bites  of  the  insects. 

That  the  fever  could  easily  have  been  imported  to  Sierra 
Leone,  in  1858,  (admitting,  arguendo,  that  importation 
was  necessarj^),  will  be  evident  by  consulting  our  chrono- 
logical tables  for  that  year.  The  fever  was  widely  distrib- 
uted in  America,  and  was  especially  severe  in  the  West 
Indies  and  the  eastern  coast  of  South  America.  The 
English  possessions  in  the  Antilles  suffered  to  a  great 
extent.  Ships  carried  an  extensive  commerce  between 
Brazil,  the  West  Indies  and  Sierra  Leone  and  the  im- 
portation of  a  single  case  to  Sierra  Leone  was  sufficient 
to  engender  an  outbreak  of  the  disease  under  discussion. 
That  this  importation  took  place,  we  cannot  prove,  but 
the  natural  inference  is  that  it  did.  Experience  has  taught 
us  that  official  reports  are  not  always  trustworthy,  especi- 
ally when  commercialism  is  at  stake. 

1859. 

i 
The  importation  of  1858,  must  have  reinfected  the 
^tcf/onij/iac  of  Freetown  to  quite  an  extent,  for  the  fever 
broke  out  in  April,  1859,  and  became  epidemic  in  May.^* 
There  had  been  an  influx  of  Europeans  during  the  past 
year,  and  100  fell  victims  to  the  disease  between  April, 
1859,  and  January,  1800. 

The  British  war  vessels  Trident  and  Sharpshooter  were 
infected  at  Sierra  T^one  in  1859,  and  carried  the  disease 
to  the  Island  of  Ascension  (q.  v.) 

"Lamprey,  loc.  cit. 


SIEItRA    LEONK  — 1859- (86^2.  325 

Two  seamen  died  of  yellow  fever  on  the  Surprise^  off 
Freetown.  One  of  these  men,  however,  belonged  to  the 
Spiteful,  and  had  arrived  at  Sierra  Leone  on  a  prize 
vessel.  Being  at  the  time  unwell,  he  was  sent  to  the  mili- 
tary hospital  for  treatment,  Avhere  he  recovered  and  was 
discharged  to  the  Spiteful.  A  few  days  afterwards  he 
was  attacked  with  yellow  fever,  and  died  after  four  days' 
illness.  The  other  patient  had  deserted  from  a  merchant 
vessel,  and  subsequently,  after  leading  an  irregular  life  at 
Sierra  Leone,  joined  the  Surprise  as  a  volunteer.  Ten 
days  after  he  came  on  board,  he  was  attacked  and  died  on 
the  sixth  ({ay. 

1860. 

No  mention  is  made  of  yellow  fever  at  Sierra  Leone,  in 
1860,  but  the  disease  was  no  doubt  at  Freetown,  as  the 
British  warship  Arrogant  was  infected  in  that  locality 
"md  lost  two  men. 

1862. 

The  outbreak  of  1862  was  not  severe  and  was  not  at- 
tended by  much  mortality. 

In  the  Statistical  Report  of  the  Health  of  the  Navij  for 
1862  (published  in  1865),  pp.  155-162,  it  is  stated  that  the 
squadron  on  the  West  Coast  of  Africa  suffered  from  yel- 
low fever.Although  Sierra  Leone  is  not  directly  incrimi- 
nated, the  infection  was  no  doubt  contracted  there.  Eleven 
cases  occurred  on  board  of  the  Bloodhound,  seven  of  which 
died.  "At  the  time  of  the  disease  on  board,  however, 
iriany  cases  of  fever  of  a  severe  nature  were  under  treat- 
ment," writes  the  medical  officer,  "but  none  were  classed 
as  yellow  fever,  except  those  in  whom  the  symptoms  were 
unmistakable."  The  disease  made  its  appearance  Avhen 
the- ship  was  lying  at  Batanga.  The  first  case  occurred 
on  September  15th,  and  died  on  the  18th.  Between  the 
15th  of  September  and  the  16th  of  October,  there  were 
nineteen  cases  of  severe  fever  (which  were  not  reported  as 
yellow  fever  for  rasons  above  stated),  which,  assuming 
them  to  have  been  of  the  yellow  fever  type,  would  give 
altogether  thirty  cases  under  treatment. 


S44  HISTORY    OF    YELLOW    FEVKR. 

1864. 

Yellow  fever  did  not  "officially"  prevail  in  1863,  and 
we  find  no  record  of  any  cases.  In  1861,  an  outbreak  took 
place,  the  facts  of  which  would  no  doubt  have  been  sup- 
pressed, but  a  merchant  vessel  brought  a  case  from  Free- 
town to  Falmouth,  England  (q.  v.),  and  the  facts  could 
not  be  hidden  from  the  English  public.  The  case,  which 
proA'ed  fatal,  caused  much  agitation  in  England,  and  the 
whole  African  coast  was  quarantined  until  the  advent  of 
cold  weather. 

1865. 

In  the  Statistical  Report  of  the  Health  of  the  Navy  for 
1865,  (published  in  1868),  pp.  196-208,  it  is  stated  that 
'^during  Michaelmas"  of  that  year,  a  very  malignant  type 
of  yellow  fever  Avas  prevailing  on  shore  at  Sierra  Leone, 
causing  a  mortality  of  seventy-five  per  cent,  amongst  the 
European  population. 

The  same  authority  records  sixty-five  cases  of  yellow 
fever  occurring  on  the  ships  Archer,  Sparrow,  Rattlesnake 
and  Lis,  with  thirty-four  deaths.  The  first  fatal  case 
occurred  September  28.  The  last  case  occurred  on  Decem- 
ber 23Td,  and  died  December  26. 

All  these  vessels  were  infected  at  Sierra  Leone.  It 
seems,  however,  that  there  occurred  quite  a  number  of 
additional  cases  of  yellow  fever  which  were  not  classified 
thus,  for  Surgeon  Samuel  Clift,  of  the  Rattlesnalce,  says: 
"I  have  classed  fifteen  cases  of  fever  as  remittent,  two  as 
e])]iemeral,  and  five  as  yellow  fever,  but  tliey  may  all  be 
looked  upon  as  the  latter  disease,  differing  only  in  inten- 
sity, and  as  to  the  presence  or  not  of  l)lack  vomit."  It 
seems,  too,  as  though  the  general  opinion  prevailed  that 
many  more  cases  of  fever  which  occurred  on  board  the 
ships  mentioned  were  also  yellow  fever. 

1866. 

The  epidemic  of  1886,  was  one  of  the  severest  expe- 
rienced in  the  colony  in  many  years.  BetAvcen  the  months 
of  April  and  October,  one  hundred  Europeans  died  at  Free- 
town.    (Lamprey,  loc.  cit.) 


SIERRA    LEONE — 1866-1872.  395 

In  the  Report  for  18G6,  (published  in  1868),  pp.  204-256, 
it  is  stated  that  the  squadron  of  the  West  Coast  of  Africa, 
consisted  for  1866,  of  twenty-three  vessels,  with  a  mean 
force  of  1,680  men.  There  were  519  cases  of  fever  of  a 
continued  type  or  remittent  type;  30  cases  of  yelloio  fever; 
87  of  agiie.  Died:  Five  cases  of  primary  fever;  25  of 
yellow  fever;  one  of  ague.  The  average  duration  of  each 
case  of  yellow  fever  was  about  seventeen  days.  The  aver- 
age duration  of  the  fatal  cases  4.3  days. 

In  the  epidemic  on  the  ship  Bristol,  1865-66,  the  first 
case  occurred  December  28,  1865 ;  the  first  deatli,  January 
3,  1866.  Last  case,  January  11,  1866;  last  death,  Feb- 
ruary 8,  1866. 

One  case  reported  from  the  ship  Espoir  occurred  about 
May  9,  1866,  died  May  14th. 

The  epidemic  on  the  ship  Bristol  was  derived  throutrh 
communication  with  the  ship  Isis^  which  was  thoroughly 
infected  with  tlie  disease. 

The  Report  gives  two  deaths  from  that  disease  on  the 
Isis.  One  of  them  was  taken  ill  on  December  29,  1865, 
died  January  1,  1866.  The  other  took  sick  January  2, 
1866,  died  January  7th.  This  was  the  last  of  the  series 
of  cases  that  occurred  in  the  Isis. 

Twenty-eight  cases  occurred  on  the  Bristol,  one  on  the 
Espoir,  and  one  on  the  Isis.     Of  these,  25  proved  fatal. 

1868. 

The  year  1868,  witnessed  another  outbreak  at  Freetown. 
(Rerenger-Feraud,  page  144.)  The  exodus  of  the  unac- 
climated  Europeans  prevented  the  disease  from  becoming 
epidemic. 

1872. 

For  four  years,  Sierra  Leone  had  a  reprieve  from  yellow 
fever.  In  1872,  the  disease  reappeared  at  Freetown.  It 
was  of  a  particularly  malignant  type,  the  mortality  being 
especially  high  in  May,  June  and  July.  Even  as  late  as 
December,  six  deaths. are  recorded.     The  average  death- 


526  HISTORY    OF    YELLOW    FEVER 

rate  in  Freetown  during  1872,  was  250  per  1,000.  This 
excessive  mortality  does  not  include  all  the  victims  of  the 
pestilence,  as  many  died  on  shipboard  in  trying  to  escape 
from  the  colony.^^ 

1878. 

Six  years  of  immunity  is  credited  to  Sierra  Leone,  but 
whether  deserved  or  not,  we  cannot  say.  In  1878,  the 
fever  reappeared  and  caused  some  mortality.  The  disease 
was  present  in  many  parts  of  ^A>stern  A!frica  that  year, 
notably  in  Senegal,  Gambia  and  even  in  Soudan. 

1884. 

The  epidemic  of  1872,  and  the  outbreak  of  1878,  had  no 
doubt  decimated  the  non-immune  population  of  Sierra 
Leone,  and  the  fear  of  falling  victims  to  the  climate  had 
been  instrumental  in  keeping  away  emigration,  for  we  find 
no  record  of  the  appearance  of  yellow  fever  from  1878  to 
1881.  The  epidemic  of  1881,  began  in  May.  One  of  the 
peculiarities  of  the  disease,  is  that  it  attacked  the  natives 
in  great  numbers.  The  average  death  rate  among  the 
blacks  was  35  per  1,000  per  month,  while  the  death-rate 
among  the  Europeans  was  six  per  cent,  for  the  same 
period.  The  fever  was  most  severe  in  June  and  July,  and 
declined  with  the  maturity  of  the  rains  in  August.  It 
gradually  decreased  until  December,  when  it  totally  dis- 
appeared.^® 

Conclusions. 

From  1884,  to  the  present  time  (1908),  a  period  of 
twenty-four  years,  there  is  no  record  of  yellow  fever  hav- 
ing prevailed  in  Sierra  Leone.  This  immunity  is  no  doubt 
due  to  the  fact  that  the  British  Crovernment,  profiting  by 
the  terrible  experiences  of  the  past,  garrisons  its  posts 

"Lamprey,  loc.  cit. 
"•  Lamprey,  loc.  cit. 

"  Army     Medical     Department    Report     for     the     Year     1886, 
(London,  1888),  p.  79 


souuAN.  327 

with  black  troops,  whose  immunity  from  yellow  fever  is 
proverbial.  For  example,  in  188G,  the  garrison  at  Free- 
town consisted  of  340  African  soldiers,  commanded  by 
hardly  half  a  dozen  white  officers.  The  mortality  for  the 
entire  j-ear  among  these  340  blacks,  from  all  causes, 
amounted  to  only  six. 

SOUDAN. 

Description. 

Soudan  is  a  country  in  Central  Africa,  south  of  the 
Desert  of  Sahara.,  and  extending  from  the  Atlantic  Ocean 
to  the  Red  Sea.  This  is  the  home  of  the  true  negro  race, 
and  is  for  the  most  part  inhabited  by  degraded  savages. 
Its  area  is  estimated  at  2,000,000  square  miles,  and  its 
population  from  8  to  30  millions.  Arab  colonists  and 
traders  form  a  large  part  of  the  foreign  population.  On 
the  Atlantic  seaboard,  the  French  have  established  a  col- 
ony, but,  with  the  exception  of  prospectors,  soldiers  and 
laborers  employed  on  the  railroad  from  Kayes  to  Kita, 
no  Europeans  are  to  be  found  in  this  vast  region.  Tim- 
buctoo,  the  capital,  is  far  from  being  an  ideal  place.  It 
is  miserably  built,  in  a  wretched  country,  situated  amid 
burning  and  moving  sands,  on  the  verge  of  a  morass. 
There  are  a  few  brick  houses,  but  most  of  the  dwellings  are 
mere  circular  huts  of  straw  and  earth.  Population, 
12,000,  principally  natives,  with  some  Moors. 

YELLOW    FEVER   YEARS. 

1828;  1829;  1878;  1879;  1880;  1881;  1882;  1891;  1892; 
1897;  1901;  1902;  1903;  1907. 

SUMMARY  OF  EPIDEMICS. 

1828-1829. 

The  history  of  yellow  fever  in  Soudan,  begins  with  the 
first  attempt  of  the  white  man  to  penetrate  into  that  in- 


S28  HISTORY    OF    VKI.LOW    FEVER. 

salubrious  region.  According  to  Boyle,^^  the  epidemic  of 
Yellow  fever  Avhicli  ravaged  Sierra  Leone,  in  1829,  first 
made  its  appearance  in  Sangarrali,  a  country  in  the  in- 
terior, about  thirty  days'  journey  in  a  northeast  direction 
from  Medina.  The  fever  broke  out  at  Sangarrah  about 
Christmas,  1828.  It  is  said  that  more  chiefs  were  stricken 
that  year  than  ever  before.  Sangarrath  is  a  low  marshy 
country,  covered  with  jungle.  Bantoe,  lying  in  the  south- 
west of  Sangarrah,  is  also  said  to  have  suffered  exceed- 
ingly. Out  of  twelve  men  sent  out  in  March,  to  hunt 
elephants,  only  one  returned  alive,  the  others  having  died 
in  the  forests.  Between  Sangarrah  and  Footah  Jallon, 
whole  villages  were  said  to  have  been  depopulated. 

From  Laheer  and  down  through  the  Mandingo  country, 
traveling  in  a  southwest  course  to  Fouricaria  and  Melicor- 
ree,  the  number  that  died  was  unprecedented.  In  the  vil- 
lage of  Yongroo,  the  mortality  was  excessive.  From  fur- 
ther and  rather  extensive  inquiries  of  the  natives  from 
various  parts  of  the  main  land,  it  was  ascertained  that  the 
fever  prevailed  among  the  tribes  of  the  following  local- 
ities: Bulani,  Porto  Lago,  Eokelle,  Scarcies,  Mellacoree 
and  Foolah. 

Those  from  whom  these  statements  were  obtained,  were 
unanimous  in  the  opinion  that  the  disease  proceeded  from 
the  eastward.  It  was  greatest  in  the  neighborhood  of 
Porto  Lago,  and  down  to  the  swampy  tongue  of  land  which 
separates  Porto  Lago  from  the  Small  Scarcies,  and  across 
the  country  to  Mellacoree  and  Forrecarreah. 

From  messengers  from  Timbo,  in  the  beginning  of 
August,  it  was  ascertained  that  an  epidemic  prevailed  there 
twelve  months  previously  to  that  date  (1829),  and  that 
it  had  then  ceased  only  four  months.  The  complaint  was 
described  by  these  people  as  being  attented  Avith  pains  in 
the  head,  back  and  loins,  with  hot  skin  and  black  tongue. 
In  the  advanced  stage  of  the  disease,  the  gums  and  tongue 
exhibited  the  color  of  blood;  and  it  was  added  that  some 
threw  up  a  black  fluid  like  a  mixture  of  powder. 

"Boyle:     A  Practical  Medico-Historical  Account  of  the  West- 
ern Coast  of  Africa,  etc.,  1831,  p.  255. 


I 


SOUDAN — 1828-1829.  3^9 

0  in  gin  of  the  Epidemic. 

The  Timbo  people  believed  that  the  sickness  took  its 
origin  in  the  attempt  at  clearing  a  swamp  in  the  neighbor- 
hood of  Timbuctoo,  and  that  it  tlitoce  spread  to  Jenne, 
from  Jenne  to  Footah  Tauro,  and  thence  to  Footah  Jallon. 
It  was  also  said  to  have  prevailed  at  Tamassoo,  Tambacca 
and  Kissy-Kissy. 

Boyle's  assertion  that  the  epidemic  first  made  its  ap- 
pearance in  the  interior,  cannot  be  seriously  entertained, 
for  yellow  fever  is  not  an  African  product,  being  always 
imported  or  caused  by  the  renewed  activity  of  infected 
mosquitoes  who  have  survived  the  rigors  of  the  winter- 
season.  Timl)uctoo,  Avhich  is  near  the  southern  border- 
line of  the  Desert  of  Sahara,  is  totally  deficient  in  natural 
products,  and  provisions  for  the  sustenance  of  its  inhabi- 
tants come  chiefly  from  Jenne,  on  the  Niger,  about  300 
miles  southwest  of  the  capital.  Timbuctoo  is  also  the 
entrepot  for  the  trade  between  Guinea,  Senegal,  Sierra 
Leone  and  North  Africa,  and  in  this  way,  should  yellow- 
fever  be  prevalent  in  Gambia,  Senegal  or  Sierra  Leone, 
it  could  easily  be  imported  to  Bakel,  Medina  or  Kayes  by 
way  of  the  Senegal  River,  and  from  Kayes,  by  caravans, 
to  the  interior. 

In  1828,  tlie  railroad  from  Kayes,  the  head  of  naviga- 
tion on  the  Senegal,  to  Kita,  another  important  town  of 
French  Soudan,  had  not  been  built,  and  the  infection  was 
probably  carried  by  caravans,  which  acting  as  a  firebrand, 
successively  contaminated  every  village  it  passed  through, 
finally  infecting  the  capital  itself.  The  first  cases,  as  is 
always  the  ease,  and  especially  so  in  a  savage  country, 
were  unrecognized,  and  when  the  epidemic  became  wide- 
spread, Timbuctoo  Avas  naturally  accused  of  being  the 
original  focus.  It  is  a  notorious  fact,  that,  even  in  this 
present  era,  when  an  epidemic  of  yellow  fever  breaks  out 
in  a  locality  where  the  disease  prevails  only  accidentally, 
the  original  mode  of  infection  is  generally  disputed  and 
rarely  settled  to  the  satisfaction  of  the  disputants.  The 
New  Orleans  epidemic  of  1905,  is  a  glaring  modern  exem- 
plication  of  this  assertion,  for  up  to  this  day,  over  three 


330  HISTORY    OK     YELLOW     FEVER. 

years  after  the  incident,  controversies  are  still  rife  as  to 
how,  when  and  where  the  "first  cases"  originated. 

It  is  of  no  material  importance  to  this  generation  or  to 
generations  to  come,  whether  an  epidemic  of  yellow  fever 
which  took  place  over  a  century  ago  in  an  unknown  coun- 
try was  imported  or  not ;  but  we  cannot  resist  the  tempta- 
tion of  taking  a  dig  at  the  assertion  that  the  disease  origi- 
nated in  Central  Africa,  and  try  our  hand  at  convincing 
our  readers  of  the  contrary. 

1878. 

Almost  half  a  century  elapsed  before  we  again  hear  of 
yellow  fever  in  Soudan.  In  this  instance,  however,  the 
importation  is  clearly  proved. 

In  1878,  yellow  fever  prevailed  extensively  along  the 
West  Coast  of  Africa,  and  was  especially  severe  in  Sene- 
gal. While  the  epidemic  was  raging  along  the  banks  of 
the  lower  Senegal  River,  the  French  government,  becom- 
ing aggrieved  at  the  conduct  of  certain  chiefs  inhabiting 
the  western  borders  of  Soudan,  fitted  out  a  punitory  force 
at  Saint  Louis,  the  capital  of  Senegal.  The  history  of 
this  expedition,  which  is  detailed  in  our  account  of  the 
epidemic  of  1878,  in  Senegal  (q.  v.),  is  certainly  a  sorrow- 
ful one.  Of  317  Europeans  who  took  part  in  the  expedi- 
tion, 180  fell  victims  to  yellow  fever.  The  travel  of  the 
invading  fleet  up  the  Senegal  River  reminds  us  of  the 
case  of  the  James  D.  Porter,  which,  tbat  same  year,  suc- 
cessively infected  every  city  and  town  it  stopped  at  in  its 
memorable  journey  up  the  Mississippi  River  from  New 
Orleans  to  Gallipelis,  a  distance  of  over  a  tliousand  miles. 

The  spread  of  the  disease  by  the  invading  column  is 
minutely  narrated  by  Lejemble.^^ 

The  first  place  to  be  infected  was  Bakel,  an  important 
mart  on  the  upper  Senegal  River,  three  hundred  and  fifty 
miles  from  Saint  Louis.  It  is  a  walled  town  of  about 
3,000  inhabitants,  and  has  a  large  stone  fortress,  where  a 
French  garrison  is  permanently  maintained. 

*'Lejemble:     Epidemiologie   de   la   Fievre    Jaune    au    Senegal 
Pendant  I'Anne  1878.     Paris,  1882. 


SOUDAN — 1878  331 

A  physician  from  Goree,  who  arrived  at  Bakel  on  July 
28th,  is  accused  of  having-  brought  the  infection  to  that 
village.  Be  that  as  it  may,  the  first  case  at  Bakel  was 
observed  on  August  12th,  followed  by  death  on  the  16th. 
At  that  time,  the  garrison  of 'Bakel  consisted  of  only  eight 
white  soldiers.  When  the  last  case  died,  September  11th, 
there  was  only  one  left.  All  the  others  had  paid  tribute 
to  the  terrible  scourge. 

When  the  punitory  column  reached  Bakel  four  days 
after  leaving  Saint  Louis,  yellow  fever  had  already  in- 
vaded its  ranks.  Those  who  were  too  weak  to  proceed, 
were  left  at  the  village  and  the  transports  proceeded  on 
their  way  up  the  Senegal  River.  Of  the  sick  left  at  Bakel, 
ten  died  with  black  vomit,  between  September  15th  and 
October  27th.  This  makes  a  total  of  seventeen  deaths  in 
the  village  from  August  12th,  to  the  end  of  the  epidemic. 

After  leaving  Bakel,  the  expedition  passed  through 
Kayes,  but  there  is  no  record  of  any  cases  at  that  post. 

Medina,  the  next  important  post,  east  of  Bakel,  on  the 
Senegal  River,  was  less  fortunate.  A  few  days  after  the 
passage  of  the  column,  yellow  fever  broke  out  in  the  vil- 
lage, and  from  September  20th  to  October  11th,  there  were 
twelve  deaths  among  the  sparse  white  population  of  the 
place. 

The  soldiers,  althougli  sick  and  discouraged,  gave  battle 
to  tlie  tribesmen,  on  September  22,  1878,  near  Saboucire, 
a  tf»wn  on  the  borders  of  French  Soudan.  It  was  more  of 
a  slaughter  than  a  battle,  for  the  natives  rapidly  gave  way 
to  the  French,  and  the  conflict  lasted  hardly  an  hour. 
The  return  liomeward  Avas  immediately  begun,  Avith  results 
already  depicted  in  our  account  of  the  epidemic  of  1878, 
in  Senegal. 

The  soldiers  did  not  originally  bring  the  fever  to  Bakel, 
as  seven  deaths  had  already  taken  place  at  that  ]K)st  when 
the  fleet  carrying  tlie  colnmn  arrived,  but  the  otlier  places 
in  Soudan  were  undeniably  infected  by  the  soldiers.  Bakel 
and  Medina  are  the  only  places  in  Soudan  where  a  record 
of  the  deaths  from  yellow  fever  in  1878  was  kept,  but 
there  is  no  doubt  that  the  disease  prevailed  at  Kayes  and 
the  other  places  along  the  banks  of  the  Upper  Senegal 
and  its  branches. 


332  HISTORY    OF    YELLOW     FEVER. 

1879. 

In  1879,  only  a  few  cases  were  observed,  of  which  no 
record  was  kejDt. 

1880. 

In  1880,  cases  broke  out  among  the  laborers  employed 
in  building'  the  railroad  from  Kaves  to  Kita.  The  fatal- 
ities were  few. 

1881. 

In  1881,  the  fever  was  brought  into  Soudan  by  the 
troops  under  Colonel  Desbordes,  and  prevailed  quite  ex- 
tensively. The  colonial  health  authorities  wanted  to  seg- 
regate the  infected  battalions,  but  the  home  government 
positively  refused  to  sanction  such  a  movement,  and  the 
malady  was  allowed  free  play.  The  column  continued  its 
march,  spreading  the  infection  everywhere  it  stopped. 
The  malady  finally  subsided  for  want  of  new  material. 
Medina,  as  usual,  suffered  considerably.  No  official  record 
was  kept  of  the  cases  and  deaths. 

1882. 

In  1882,  the  troops  again  brought  the  fever  into  Soudan. 
The  chief  victims  that  year  were  Chinese  and  Moroccan 
laborers  employed  on  tlie  railroad.  They  were  buried, 
like  dogs,  along  the  railroad  embankment.  Official 
records  are  silent  concerning  the  extent  of  this  outbreak. 

It  is  a  remarkable  fact  that  every  history  of  the  appear- 
ance of  yellow  fever  in  Soudan,  since  1878,  presents  about 
the  same  characteristics:  That  it  has  never  gone  beyond 
its  primitive  limits,  but  has  always  shown  itself  on  the 
railroad  between  the  towns  above  mentioned.  This  can 
no  doubt  be  accounteed  for  by  the  fact  that  new-comers 
were  constantly  arrivinij:  to  take  the  place  of  the  laborers 
who  had  been  mowed  down  by  the  disease,  and  as  they 
only  came  from  tme  to  time  and  were  few  in  number,  they 
sloAvly  fed  the  fires  of  contagion.  This  view  is  reinforced 
by  the  fact  that  cases  generally  cropped  out  shortly  after 
the  arrival  of  imported  laborers. 


SOUDAN 1891.  SSS 

It  is  also  a  curious  fact  that  the  Moroccans  and  Chinese 
who  are  largely  used  in  works  of  construction  in  Western 
aiid  Central  Africa,  are  even  more  susceptible  to  yellow 
fever  than  the  whites.  The  poor  fellows  die  like  flies  when 
an  epidemic  breaks  out  in  Soudan  and  their  bones  literally 
strew  the  line  of  railroad  from  Kayes  to  Kita,  which  was 
built  at  a  cost  of  thousand  of  lives. 

1891. 

In  1891^  there  was  a  sudden  influx  of  Europeans  into 
French  Soudan,  and  yellow  fever  was  again  imported  into 
that  region. 

The  first  news  of  the  prevalence  of  the  disease  reached 
colonial  headquarters  on  October  ITth,  1891,  when  a  tele- 
gram was  received  announcing  that  the  caravan  which 
had  left  Medina,  on  October  6th,  under  military  escort, 
had  reached  Kita  in  a  deplorable  condition. '^^  During  the 
journey,  ten  soldiers  had  died  from  various  causes.  The 
doctors  who  accompanied  the  caravan,  attributed  this  un- 
usual death-rate  to  the  fierce  rays  of  the  sun  and  fatigues, 
but  Dr.  Primet,  chief  health  officer  of  the  colony  was  far 
from  satisfied  with  this  diagnosis  and  requested  that  a 
clinical  history  of  every  man  who  had  died  be  telegraphed 
to  headquarters.  In  spite  of  the  vagueness  of  these  details 
and  the  continued  reiteration  of  the  attending  physicians 
that  the  sun  and  fatigues  were  responsible  for  the  state  of 
affairs.  Dr.  Primet  came  to  the  conclusion  tliat  these 
deaths  were  the  results  of  a  common  cause,  and  strongly 
suspected  an  outbreak  of  yellow  fever.  These  suspicions 
were  communicated  to  the  physicians  of  Kita,  wliich  ap- 
peared to  be  the  center  of  infection,  but  the  hypothesis 
was  regarded  as  preposterous  by  these  gentlemen,  and  the 
reigning  malady  declared  to  be  an  aggravated  form  of 
typho-malaria. 

Dr.  Primet  desired  to  make  an  issue  of  the  matter,  and 
determine  by  investigation  if  an  epidemic  of  some  sort 


** Primet:     Archives  de  Medecine  Navale,  Paris,  1893;  Vol.  59, 

pp.  357,  et  seq. 
"  Primet:     Loc.  cit. 


334  HISTORY    OF    YELLOW    f-EVER. 

was  not  prevalent  at  Kayes,  the  original  point  of  depart- 
ure of  the  caravan,  but  the  colonial  i;overnnient,  fearing 
that  a  panic  Avould  ensue  should  publicity  be  given  to  the 
matter,  protested  against  the  institution  of  such  measures, 
unless  undeniable  proofs  be  furnished  of  the  existence  of 
an  unusual  disorder  in  the  suspected  places.  IS'everthe- 
less,  secret  instructions  were  sent  to  the  physicians  of 
Kayes,  Kita  and  other  towns  in  the  suspected  zone,  en- 
joining them  to  take  extraordinary  ju'ecautions  and  to  iso- 
late all  the  cases  of  typho-malar'a  or  continued  fever. 

These  half-hearted  precautions  did  not  improve  the  sit- 
uation. Other  localities  successively  gave  evidence  of 
abnormal  health  conditions.  Two  cases  of  "bilious  hema- 
turic  fever"  appeared  at  Koudou,  followed  by, one  fatality. 
At  Segou,  many  cases  of  the  same  malady  proved  fatal, 
and  two  arm}^  officers  were  attacked  at  Sigiiiri.  One  of 
these  died.  At  Medina,  an  unusual  number  of  cases  of 
typlio-malaria  prevailed.  At  Bafoulabe,  the  situation  be- 
came more  serious.  Cases  of  "pernicious  fever"  became 
daily  more  frecpient  until  October  30th,  when  the  occur- 
ren(je  of  black  vomit  in  some  cases  left  no  doubt  as  to  the 
nature  of  the  disease. 

But  the  government  was  skeptical ;  it  wanted  a  "posi- 
tive" case.  A  few  days  afterwards,  a  workmen,  originally 
from  Bafoulabe,  was  admitted  into  the  hos])ital,  at  Kayes, 
suffering  from  "continued  fever."  He  died  two  days  later, 
and  the  autopsy  revealed  undeniable  lesions  of  yellow 
fever. 

This  positive  case  gave  Dr.  Primet  the  entering  wedge 
he  was  waiting  for,  and  he  immediately  appealed  to  the 
commandant  of  the  colony  to  institute  rigorous  measures. 
He  pointed  out  that  it  was  undeniably  yellow  fever  which 
was  decimating  the  troops,  and  that  grave  consequences 
would  follow  if ^  the  convoys  whicli  were  on  their  way  to 
Kita  Avere  not  proliibited  from  going  farther  into  the  in- 
terior. In  short,  it  was  imperative  to  arrest  the  progress 
of  the  malady  at  Kita. 

Wishing  to  study  the  situation  himself.  Dr.  Primet  left 
for  Bafoulabe.  On  his  arrival,  he  made  a  rigid  examina- 
tion, which  confirmed  his  reiterated  assertions  that  the 


SOUDAN — 1891.  335 

government  was  face  to  face  with  an  epidemic  of  yellow 
fever.  Orders  were  at  last  received  to  resort  to  stringent 
measures  to  prevent  the  newly-arrived  soldiei'S  from  be- 
coming contaminated.  These  instructions,  althougli  tardy, 
saved  the  new  arrivals  from  being  decimated.  The  gov- 
ernment was  deploying  300  men  in  the  region,  and  the 
turning  away  of  the  soldiers  who  were  marching  to  the 
field  of  operation  into  less  frequented  roads  and  by-ways, 
although,  tedious  and  attended  with  more  hazards,  proved 
their  salvation.  Tlie  malady  was  confined  to  the  troops 
and  laborers  already  in  the  infected  zone.  The  beneficial 
results  of  strict  attention  to  sanitary  rules  and  isolation 
from  infected  centers  was  clearly  proved  by  the  fact  that, 
during  the  three  months  which  the  invading  column  took 
to  reach  the  scene  of  active  military  operations,  only  three 
cases  of  sickness  took  place  and  not  a  single  death 
resulted. 

In  the  infected  region,  the  situation  was  daily  getting 
worse.  It  was  too  late  to  arrest  the  progress  of  the  dis- 
ease. The  criminal  negligence  of  the  government  had 
<iaused  the  poison  to  be  so  widely  diifused,  that  cases 
erupted  at  nearly  every  jilace  on  the  Kayes-Kita  railroad. 

A  convoy-  which  had  started  from  Kayes,  on  October 
25th,  for  Niore,  consisting  of  thirty-five  Europeans,  under 
the  command  of  a  captain  of  dragoons,  lost  seven  men  by 
yelloAv  fever  tliree  days  after  passing  through  Medina,  and 
a  few  days  after  reaching  Niore. 

Another  convoy,  which  had  left  Bafoulabe  the  day  after 
the  arrival  of  Dr.  Primet,  passed  through  Radumbe,  on 
Kovember  IGth,  where  it  left  four  sick  soldiers,  who  all 
died  between  the  21st  and  28th  of  September,  with  unde- 
niable symptoms  of  yellow  fever, 

A  lieutenant  en  route  to  the  Niger,  arrived  at  Kita,  on 
Kovemlier  Stli,  and  died  with  black  vomit  on  the  0th. 

At  Bakel,  one  death  on  November  4th,  followed  by  three 
more  shortly  after. 

It  would  l)e  tedious  to  follow  tlie  progress  of  the  disease, 
as  it  every wliere  presented  tlie  same  characteristics.  The 
appended  table  will  give  an  idea-of  its  ravages  among  the 
small  European  population,  principally  soldiers  and  rail- 
road laborers,  from  October  27th  to  December  31st,  1801: 


5 

0 

5 

1 

3 

4 

3 

0 

3 

3 

0 

12 

0 

0 

1 

5 

0 

5 

1 

0 

11 

336  HISTORY    OF    YELLOW    FEVER. 

Locality.  Oct.  Nov.  Dec.  Total. 

Bafoulabe    6  7  2  15 

Bediinibe   0 

Bakel   0 

Kares 0 

Kita 9 

Kondou    1 

Medina    0 

Nioro    0 

16  35  5  5G 

The  greatest  mortalitj  took  place  in  Xovember,  when 
thirtj-five  deaths  are  recorded.  The  isolation  of  the  troops 
from  the  foci  of  infection  left  the  disease  without  fresh- 
material,  and  cases  occurred  at  rare  intervals  until  Jan- 
uary 8th,  when  the  last  death  took  place. 

Origin. 

Dr.  Primet  accuses  Medina  of  beinp;  the  focus  whence 
radiated  the  Soudanese  epidemic  of  1891-1892.  This  town 
will  be  remembered  as  the  one  which  suffered  the  most 
during-  the  great  epidemic  of  1878,  only  one  European 
being  left  alive  after  the  subsidence  of  the  malady.  lu 
1878,  Medina  was  infected  by  the  Logo  Expedition,  which 
left  a  trail  of  deaths  and  desolation  from  Saint  Louis  to 
Sabourcire;  but,  in  1891,  although  an  expedition  was  sent 
against  the  natives  by  the  French  government,  there  was 
no  yellow  fever  in  Senegal,  and  the  invading  column  can- 
not be  incriminated.  How,  then,  did  Medina  become  in- 
fected? 

A  reference  to  our  chronological  tables  will  show  that 
Bonny  was  the  only  locality  on  the  African  Coast  where 
yf^llow  fever  prevailed  in  1891.  In  the  beginning  of  that 
year,  Bonny  Avas  put  under  quarantine  by  the  other  Afri- 
can colonies,  hut  the  fever  finally  disappearing,  quaran- 
tines were  raised  on  April  10th.  Bonny  is  an  English 
colony,  and  the  commercial  relations  between  that  ix>int 
and  Sen(\iial  are  very  active.  It  is  well-known  that  the 
natives  of  the  interior,  especially  the  Soudanese,  for  some 


SOUDAN — 1 891-1  8Q2.  SS7 

undefined  reason,  prefer  articles  of  English  manufacture, 
such  as  calicoes,  leather,  woolen  goods,  etc,  and  that 
native  courriers  and  Sjii'ian  and  Moroccan  peddlers  do  an 
extensive  importing  business,  often  a  la  Icfjerc.  In  addi- 
tion to  these  smugglers,  the  river-boats  bring  annually  a 
large  amount  of  freight  up  the  Senegal  River  to  Kayes, 
the  head  of  navigation,  whence  the  goods  are  distributed 
to  the  innumerable  towns  and  villages  on  the  railroad 
from  Kayes  to  Kita,  Beyond  Kita,  caravans  bring  the 
products  to  Timbuctoo. 

It  will  be  argued  that  the  distance  between  Bonny  and 
Kayes,  is  too  great  to  admit  of  importation,  but  it  must 
be  borne  in  mind  that  the  coasting-vessels  plying  along  the 
coast  are  built  so  as  to  make  swift  and  ^'t-equent  voyages, 
being  equipped  with  the  latest  machinery,  and  that  they 
lose  no  time  in  their  journey  up  the  Senegal.  jMosquitoes 
infected  at  Bonny,  could  thus  easily  have  been  transported 
to  Medina,  where  their  liberation  created  the  focus  which 
finally  infected  the  several  localities  mentioned  in  this 
history. 

Pi'imet  does  not  take  kindly  to  the  hypothesis  of  im- 
portation, but  believes  that  the  outbreak  was  caused  by 
the  reviviscence  of  the  germs  of  the  epidemic  of  1881, 
which  was  more  severe  at  ^Medina  than  anywhere  else  in 
^Vestern  Africa.  The  bugaboo  of  repullulation  of  germs 
seems  to  be  firmly  imbedded  in  tlie  writings  of  most 
French  authors.  Even  as  late  as  1903,  we  find  this  unten- 
able opinion  promulgated  by  some  of  the  most  eminent 
French  epidemiologists,  although,  the  doctrine  first 
launched  by  Finlay,  in  1883,  and  corroborated  by  innu- 
merable experiments,  should  leave  no  douI)t  in  the  mind 
that  the  mosquito  theory  is  the  only  sensible  one. 

1892. 

Only  four  cases  of  yellow  fever  were  observed  in  Sou- 
dan   in  1802. 

On  January  8th,  two  cases,  followed  by  death,  occurred 
atBakel. 

In  January   a  fatal  case  erupted  at  Kita. 


• 


338  HISTORY    OF    YELLOW    FEVEER. 

On  March  30th  a  case  was  reported  at  Bafoulabe,  i^^ 
the  person  of  a  brigadier  of  artillery  who  had  recently 
arrived.     The  patient  recovered. 

The  French  government  tardily  resorted  to  the  wise  ex- 
pedient of  not  sending  non-immunes  to  the  localities  af- 
fected by  the  epidemic  of  1891,  and  the  outbreak  of  1892 
was  confined  to  these  four  cases.  As  they  occurred  solely 
among  new  arrivals,  they  may  be  considered  merely  as 
echoes  of  the  extensive  epidemic  of  the  previous  year. 

S  1897. 

From  January,  1892,  to  September,  1897,  yellow  fever 
was  kept  out  of  Soudan.  This  immunity  was  no  doubt 
due  to  the  fact  that  the  disease  did  not  prevail  in  the 
Lower  Senegal  Valley,  and  that  the  movement  of  the 
French  troops  were  not  very  active  during  that  period. 

The  first  case  was  observed  at  Talary,  a  military  post 
on  the  Kayesi-Kita  railroad,  between  Galongo  and  Bafoul- 
abe.  The  victim  was  taken  sick  September  20th,  and  died 
on  the  24th. 

On  October  8th,  a  railroad  foreman  died  on  a  train  be- 
tween Galongo  and  Talarj^  while  on  his  way  to  the  hos- 
pital, at  Kayes.  He  had  been  confined  to  his  bed  since  the 
5th  of  the  month. 

The  third  case  occurred  at  Maliina,  a  village  on  the 
railroad,  a  few  days  later,  in  the  person  of  an  army  ser- 
geant, who  died  on  the  15tli. 

Three  deaths  within  as  many  weeks,  from  undoubtedly 
a  common  cause,  aroused  the  suspicions  of  Dr.  Auvray, 
chief  health  officer,  who  fitted  out  a  special  train  and  went 
to  Mahina  to  make  a  personal  examination  of  the  situa- 
tion. While  the  lesions  were  decidedly  suspicious,  the 
doctor  hesitated  to  pronounce  it  a  case  of  yellow  fever,  as 
that  diesease  had  not  been  observed  in  Soudan  for  the 
past  five  years.  He  afterwards  admitted,  when  the  malady 
became  epidemic,  that  this  and  the  other  cases  were  unde- 
niably manifestations  of  yellow  fever. 

On  his  return  from  Mahina,  Dr.  Auvry  stopped  at  Dia- 
mou,  which  is  mid-way  between  Talary  and  Kayes,  where 


SOUDAN — 1897.  3S9 

he  took  in  charge  a  soldier  who  had  been  ill  for  two  days 
previously.  This  patient  was  transported  to  the  hospital 
at  Kayes,  where  he  died  on  the  18th.  The  autopsy  re- 
vealed the  identical  lesions  which  had  been  found  in  the 
case  of  the  army  sergeant.  A  diagnosis  of  yellow  fever 
was  withheld,  howe\^er,  as  the  doctor  feared  the  conse- 
quences wh'ch  would  follow  the  publicity  of  such  an  an- 
nouncement. 

On  October  19th  two  cases  were  admitted  into  the  hos- 
pital, one  from  Galongo  and  the  other  from  Mahina.  The 
first  case  died  on  the  22nd,  the  second  on  the  23rd. 

October  16th,  a  Catholic  missionary  died,  at  Dinguira. 

The  death  of  the  missionary  was  so  undeniably  due  to 
yellow  fever,  that  the  diagnosis  was  given  publicity. 
When  the  news  reached  Senegal,  a  strict  quarantine  was 
inaugurated  against  Soudan,  and  the  movement  of  troops 
ordered  stopped  until  the  subsidence  of  the  epidemic. 

The  government  had  not  forgotten  the  terrible  lesson  of 
1891. 

October  20th,  a  fatal  case  at  Kale. 

October  31st,  two  cases  admitted  into  the  hospital  at 
Kayes,  one  from  Galongo  and  the  other  from  Mahina. 
Botli  recovered. 

November  2nd,  a  case  erupted  at  Dioubeda.  The  patient 
died  on  the  train  while  being  transported,  to  Kayes. 

On  November  2nd,  a  priest  died  at  Kita. 

On  November  10th,  a  case  erupted  at  Diamous.  The 
patient  was  transported  to  the  hospital,  at  Kayes,  where 
he  recovered. 

On  November  10th,  occurred  the  first  case  at  Kayes. 
The  patient  was  an  army  sergeant  who  had  gone  to  Corin- 
ville,  on  November  4th,  where  he  remained  until  the  fol- 
lowing day.  On  his  return,  he  had  stopped  at  Diamou, 
where  he  probably  contracted  the  disease.  He  died  No- 
vember 13th. 

November  12th,  second  case  at  Kayes,  followed  by  death 
on  the  19th. 

The  epidemic  seemed  to  end  with  the  death  on  the  19th, 
and  no  new  cases  being  observed  for  two  weeks,  Senegal 
raised  the  quarantine  which  had  been  instituted  against 
Soudan.     The  medical  constitution  of  the  dependency  ap- 


340  HISTORY    OF    YELLOW    FEVFR. 

peared  to  have  resumed  its  nomal  eondition,  Avlien  a  case  of 
yellow  fever  suddenly  erupted,  at  Kayes,  on  December  6tli, 
in  the  person  of  the  assistant  commissary  of  the  town. 
On  the  same  da^',  two  patients  who  had  been  under  treat- 
ment at  the  hospital  for  simple  fever,  suddenly  showed 
suspicious  sjmptoms  and  were  placed  under  close  ob- 
servation. 

The  three  cases  above  cited  terminated  fatally,  the  first 
on  December  8th,  the  second  on  the  l)th,  and  the  third  on 
the  15th. 

A  mild  case,  followed  by  rapid  recovery,  was  observed 
a  feAV  days  later,  at  Kayes.  This  was  the  last  echo  of  the 
epidemic  of  1897. 

Statistics  of  the  Epidemic  of  1897. 

The  fatalities  of  the  epidemic  of  1897  were  few,  because 
the  European  population  was  small.  There  were  only 
eighteen  whites  employed  along  the  railroad.  These  fur- 
nished fourteen  cases  and  ten  deaths.  There  were  six 
cases  and  four  deaths  among  the  soldiers.  No  mention  is 
made  of  the  course  of  the  disease  among  the  Chinese  and 
Moroccans,  who  generally  die  like  flies  whenever  an  epi- 
demic of  any  sort  prevails  in  the  Soudan,  be  it  yellow 
fever,  malaria  or  typhoid.  Out  of  a  total  of  twenty-five 
cases,  there  were  nineteen  deaths,  foui'teen  on  the  Kayes- 
Kita  railroad  and  live  outside  of  the  infected  zone.  The 
deaths  were  distributed  as  follows: 
Locality.  Sept.       Oct.       Nov.       Dec.     Total. 

Diamou    0  1  0  0  1 

Dinguina 0  1  0  0  1 

Diobede    0  1  0  0  1 

Galongo 0  1  0  0  1 

Kale  "^ 0  2  0  0  2 

Kayes 0  0  13  4 

Kita    0  1  0  0  1 

]\rahina   0  1  0  0  1 

Talary 1  1  0  0  2 

Total     on    Kaves-  ^ 

Kita  Railroad.    1  9  1  3  14 

Unclassified   5 

Total  deaths 19 


SOUDAN — 1897.  341 

Origin. 

The  origin  of  the  epidemic  of  1897  is  shrouded  in 
mystery.  As  no  cases  had  been  observed  for  over  five 
yeai's,  the  genesis  of  spontaneity  can  certainly  not  be  sus- 
pected. Auvray  and  Boury,^-  from  wliose  account  the 
salient  facts  of  this  epidemic  are  taken,  following  in  the 
trend  of  the  majority  of  French  writers,  argue  in  favor 
of  the  telluric  origin  of  the  epidemic.  The  theory  of 
evolution  of  the  yellow  fever  germ  promulgated  b}^  these 
learned  gentlemen  is  certainly  remarkable.  According 
to  their  way  of  reasoning,  yellow  fever  is  produced  by 
a  microbe  which,  continuing  to  evolute  in  the  cadaver, 
finally  invades  the  surrounding  earth,  which  becomes  an 
immense  culture- field,  where  the  organism  develoi)S,  until 
it  either  arrives  spontaneously  at  the  surface  or  is  accel- 
erated into  virulent  activity  by  being  dug  out  from  its 
cachette  by  the  profane  hand  of  man.  Once  at  the  sur- 
face, the  germs  circulate  at  will,  spreading  the  infection 
far  and  wide.  The  digging  of  the  soil  along  the  line  of 
the  Kayes-Kita  Railroad,  where  are  inhumed  thousands 
of  yellow  fever  victims,  is  given  as  the  active  cause  of  the 
epidemic  of  1897. 

The  theory  of  spontaneity  being  untenable,  where  are 
we  to  look  for  the  source  of  infection?  There  was  no 
yellow  fever  in  Senegal  ,in  1897.  As  Soudan  has  always 
been  contaiuinated  by  Senegal,  we  must  look  elsewhere. 
But  where?  A  search  through  consular  reports  and 
official  records  fails  to  bring  to  light  a  single  case  of  yellow 
fever  on  the  Western  Coast  of  Africa,  in  1897;  but,  of 
course,  this  does  not  mean  that  yellow  feiver  was  not 
present  and  the  fact  officially  su])pressed.  The  ways  of 
colonial  governments,  like  those  of  the  Heathen  Chinese, 
are  dark  and  tricky.  The  political  history  of  the  Aifrican 
colonies  demonstrates  that  hygienic  regulations  are  sub- 
servient to  commercialism,  no  matter  what  the  risk  may 
be.  The  penalty  for  this  transgression  has  often  been 
severe,  but  mammon  worshij)  closes  the  eyes  to  past  events 

"'Auvray  and  Boury:     Annales  d'Hygiene  et  de  Medecine  Colo- 
niales,  1898,  vol.  1,  p.  433,  et  ceq. 


3i2  HISTORY    OF    YELLOW    EVER. 

and  the  same  thing  happens  again  and  again. 

How  the  fever  was  imported  into  Soudan  in  1897,  will 
therefore  remain  hidden  behind  the  mists  of  conjecture. 

1901. 

The  year  1901  witnessed  another  outbreak  of  yellow 
fever  in  Soudan.  Thei'e  were  many  cases,  but  the  deaths 
were  not  numerous. 

1902. 

The  first  cases  in  1902  were  observed  about  October 
1st,  in  the  same  localities  as  in  1897  and  "1901.  There 
were  altogether  fourteen  cases  and  ten  deaths.  Five  of 
the  deaths  occurred  at  Kayes  and  five  along  railroad.^^ 

1907. 

After  five  years  of  respite,  yellow  fever  again  made  its 
appearance  in  Soudan,  among  the  same  localities  visited 
by  previous  epidemics,  in  November,  1907.  The  epidemic 
was  attended  with  the  usual  heavy  percentage  of  mor- 
tality. Between  November  1st  and  30th,  a  total  of  thirty- 
cases,  with  sixteen  deaths,  were  reported.^^ 

We  have  not  been  able  to  ascertain  the  source  of  the 
outbreak. 

1908.  f 

We  had  thought  that  the  epidemic  of  1907  would  close 
the  history  of  yellow  fever  in  Soudan,  so  far  as  our  work 
is  concerned,  but,  "as  we  go  to  press,"  to  use  the  favorite 
expression  of  up-to-date  journalism,  we  are  informed  by 
consular  reports  tliat  the  disease  has  again  broken  out  in 
Upper  Senegal  Valley.  Drastic  preventive  measures  are 
being  taken  by  the  French  government,  and  we  hope 
that  tlie  invasion  will  be  throttled  in  its  incepiency. 

We  have  no  means  of  ascertaining,  at  this  late  date, 

^'Kermorgant:     Annales  d'Hygiene  et  de  Medicine  Coloniales, 

1904;  vol.  7,  p.  405. 
•*U.  S.  Public  Health  Reports,  107;  vol.  2,  p.  156.  j-. 


SOUDAN — 1908.  34S 

how  the  fever  was  imported  into  Soudan,  in  1907-1908, 
but  as  every  outbreak  in  the  past  has  co-incided  with  the 
movements  of  the  French  troops  from  Senegal  into  the 
interior,  we  have  no'  doubt  that  the  same  thing  happened 
in  this  instance.  The  disease  has  never  manifested  itself 
outside  of  the  zone  usually  traversed  by  these  troops,  and 
in  only  one  instance  (1828)  has  it  been  observed  further 
east  than  Kita.,  until  very  recently  the  terminus  of  the 
railroad.  The  epidemic  of  1828-1829  (q.  v.)  may  be  con- 
sidered as  an  anomaly,  which  has  never  been  duplicated 
and  probably  never  will  be,  unless  the  white  race,  blind  to 
the  folly  of  such  an  act,  should  attempt  to  permanently 
occupy  this  insalubrious  region. 


CHRONOLOGY    OF    YELLOW    FEVER    IN    AFRICA 

AND  THE  ISLANDS  OFF  THE  COAST 

THEREOF,  FROM  1494  to  1907. 

Fifteenth  Century. 

First  Appearance  of  Yellow  Fever  off  the  Coast  of  Africa. 

1494.  Canary  Islands. 

1495.  Canai'y  Islands. 
149G.     Canai'Y  Islands. 

1497  to  1509.     Period  of  Ininnoiitij.     Thirteen  Years. 

Sixteenth  Century. 

1510.  Cape  Verd  Islands. 

1511.  Cape  Verd  Islands. 

1512.  Canary  Islands,  Cape  Verd  Islands. 

1513.  Cape  Verd  Islands. 

1514.  Cape  Verd  Islands. 

1515.  Cape  Verd  Islands. 

1516  to  1519.     Inwivunitij,     Four  Years. 
1520.     Benin. 

1521  to  1530.     J  mm  unity.     Ten  Years. 
1531.     Canary  Islands. 

1532  to  1552.    Immunity.     Twenty-one  Years. 
1553.     Benin. 

1554  to  1557.     Immunity.     Four  Years. 
1558.     Saint  Thomas  Island.  ^ 

1559  fo  1581.     Immunity.     Ticenty-thrce  Years. 
1582.     Canary  Islands.  ^i 


AFRICA.        CHRONOLOGY 1494   TO    1907.  S45 

1583  to  1587.     Immunitij.     Five  Years. 
1588.     Benin,  Saint  Thomas  Island. 

1589  to  1598.     Immunity.     Ten  Years. 
1599.     Canary  Islands. 

Seventeenth  Century. 
IGOO.     Immunitij.     One  Year. 
1601.     Canary  Islands. 

1602  to  1605.     Immunity.     Four  Years. 
1606.     Canary  Islands. 

1607  to  1638.     Immunity.     Thirty-two  Years. 
1639.     Cape  Verd  Islands. 

1640  to  1700.     Immunity.     Sixty-one  Years. 

Eighteenth  Century. 
1701.     Canary  Islands. 

1702  to  1752.     Immunity.     Fifty -one  Years. 
1753.     Madeira  Islands. 

1754  to  1758.     Immunity.     Five  Years. 
1759.     Senegal. 

1700-1761.     Immunity.     Two  Years. 

17C2.     Gambia. 

1763.  Sierra  Leone. 

1764.  Gambia,  Sierra  Leone. 

1765.    Immunity.     One  Year. 
1766.     Gambia,  Senegal,  Sierra  I-«one. 


S46  HISTORY    OF    YELLOW    FEVER. 

1767.    Immunity.     One  Year. 

1768.  Gambia. 

1769.  Gambia,  Senegal. 

1770.    Immunity.     One  Year. 

1771.  Canary  Islands. 

1772.  Canary  Islands. 

1773.  Canary  Islands. 

1774  to  1777.    Immunity.    Four  Years. 

1778.  Cape  Verd  Islands,  Gambia,  Gold  Coast,  Sene- 
gal, Sierra  Leone. 

1779.  Senegal. 

1780  to  1785.    hnmunity.     Six  Years. 
1786.     Gold  Coast. 

1787  to  1791.     Immunity.    Five  Years. 
1792.     Bulam  Island,  Fernando-Po. 

1793  to  1803.    Immunity.    Eleven  Years. 
Nineteenth  Century. 
1804.     Morocco. 

1805  to  1806.     Immunity.     Tico  Years. 
1807.     Cape  Verd  Islands,  Sierra  Leone. 
1808.     Immunity.     One  Year. 

1809.  Sierra  Leone. 

1810.  Canary  Islands. 

1811.  Canary  Islands. 

1812.  Fernando-Po,  Sierra  Leone. 


AFRICA  CHRONOLOGY 1494  TO  1907.  347 

1813  to  1814.    Jmmumty.     Two  Years. 

1815.  Sierra  Leone. 

1816.  Congo  Coast,  Sierra  Leone. 

1817.    Immunity.     One  Year. 

1818.  AJscension  Island. 

1819.  Sierra  Leone. 

1820.     Immunity.     One  Year. 

1821.  Cape  Verd  Islands. 

1822.  Cape  Verd  Islands,  Gold  Coast,  Sierra  Leone. 

1823.  Ascension  Island,  Gold  Coast,  Sierra  Leone. 

1824.  Gold  Coast. 

1825.  Gambia,  Sierra  Leone. 

1826.  Sierra  Leone. 

1827.  Cape  Verd  Islands. 

1828.  Benin,  Canary  Islands,  Gambia,  Senegal,  Sierra 
Leone,  Soudan. 

1829.  Fernando-Po,  Senegal,  Sierra  Leone,  Soudan. 

1830.  Saint  Helena,  Senegal,  Sierra  Leone. 

1831  to  1836.     Immunity.    Six  Years. 

1837.  Cape  Verd   Islands,    Gambia,    Senegal,    Sierra 
Leone. 

1838.  Ascension   Island,   Cape  Verd   Islands,    Sierra 
Leone.  ! 

1839.  Fernando-Po,  Sierra  Leone. 

1840  to  1844.     Immunity.     Five  Years. 

1845.  Sierra  Leone. 

1846.  Canary  Islands,  Cape  Verd  Islands. 

1847.  Ascension    Island,    Banana    Islands,    Canary 
Islands,  Cape  Verd  Islands,  Sierra  Leone. 

1848.  Sierra  Leone. 

1849  to  1851.    Immunity.     Three  Years. 

1852.  Benin,  Gold  Coast,  Ivory  Coast. 

1853.  Benin,  Gold  Coast. 

1854.  Benin,  Gold  Coast. 


348  HISTORY    OF    YELLOW    FEVER. 

1855.  Benin,  Gold  Coast. 

1856.  Benin,  Gold  Coast. 

1857.  Benin,  Fernando-Po,  Gold  Coast,  Ivory  Coast. 

1858.  SieiTa  Leone. 

1859.  Ascension  Island,  Gambia,  Senegal,  Sierra 
Leone. 

1860.  Angola,  Congo  Coast,  Fernando-Po,  Gambia, 
Sierra  Leone. 

1861.     Immunity.     One  Year. 

1862.  Angola,  Benin,  Bonny,  Calabar,  Canary  Islands, 
Cape  Yerd  Islands,  Congo  Coast,  Fernando-Po,  Gold 
Coast,  Ivory  Coast,  Sierra  Leone. 

1863.  Angola,  Ivory  Coast. 

1864.  Cape  Verd  Islands,  Fernando-Po,  Lagos,  Sierra 
Leone. 

1865.  Angola,  Gambia,  Sierra  Leone. 

1866.  Fei'nando-Po,  Gambia,  Senegal,  Sierra  Leone. 

1867.  Senegal. 

1868.  Cape  Verd  Islands,  Fernando-Po,  Sierra  Leone. 

1869.  I"ernando-Po. 

1870  to  1871.     hninuuitji.     Tuoi  Years. 

1872.  Senegal,  Sierra  Leone. 

1873.  Ascension  Island,  Benin,  Cape  Verd  Islands. 

1874  to  1877.     Immunity.     Four  Years. 

1878.  Gambia,  Senegal,  Sierra  Leone,  Soudan. 

1879.  Senegal,  Sondan. 

1880.  Senegal,  Soudan. 

1881.  Bonny,  ]\rorrocco,  Senegal,  Soudan. 

1882.  Senegal,  Soudan. 

1883.     Immunity.     One  Year. 
1884.     Gambia,  Sierra  Leone. 


.^- 


AFRICA. CHRONOLOGY — 1494x0    1907.  349 

1885  to  1887.     Inimunity.     Three  Years. 
1888.     Canary  Islands. 

1889-1890.     Immiinit}j.     Two  Years. 

1891.  Soudan. 

1892.  Soudan. 

1893  to  1896.     Immunity.     Four  Years. 

1897..    Soudan. 
;1898.     Gold  Coast. 

1899.  Ivory  Coast. 

Twentieth  Century. 

1900.  CongO'  Coast,  Gambia,  Senej»al. 

1901.  French  Guinea,  Senegal,  Soudan. 

1902.  Ivory  Coast,  Soudan. 

1903.  Ivory  Coast,  Soudan. 

1904.  Ivory  Coast  (on  shipboard). 

1905.  Canary   Islands,   Ivory  Coast    (on   shipboard), 
Senegal. 

1900.     Daliomey,  Soudan. 
1907.     Dahomey,  Soudan. 


SUMMARY     OF     YELLOW     FEVEE    YEARS    AND 

PERIODS    OF    IMMUNITY    IN    AFRICA,    FOR 

FOUR  HUNDRED  AND  FOURTEEN  YEARS, 

1494  toi  1907. 


Yellow  Fever  Years.   Periods  op  Immunity. 


1494-1496 3 

1510-1515 G 

1520  1 

1531 1 

1553 1 

1553  1 

1582  1 

1588  1 

1599  1 

1601  1 

1606  1 

1639  1 

1701  1 

1753  1 

1759  1 

1762-1764 3 

1766  1 

1768-1769 2 

1771-1773  3 

1778-1779  2 

1786  1 

1792  1 

1804  1 

1807  1 

1809-1812  4 

1815-1816  2 

1818-1819  2 

1821-1830  10 

1837-1839  3 

1845-1848  ■ 4 

1852-1860  9 


1497-1509  13 

1516-1519  4 

1521-1530  10 

1532-1552  21 

1554-1557  4 

1559-1581  23 

1583-1587  5 

1589-1598  10 

1600 1 

1602-1605  4 

1607-1638  32 

1640-1700  61 

1702-1752  51 

1754-1758  5 

1760-1761  2 

1765  1 

1767  1 

1770  1 

1774-1777  4 

1780-1785  6 

1787-1791  5 

1793-1803  U 

1805-1806  2 

1808  1 

1813-1814  2 

1817  1 

1820  1 

1831-1836  6 

1840-1844  5 

1849-1851  3 

1861  1 


AFRICA. CHRONOLOGY 1494  TO   1907.  351 

1862-1869  8    1870-1871  2 

1872-1873  2    1874-1877  4 

1878-1882  5    1883  1 

1884  1    1885-1887  3 

1888  1    1889-1890  2 

1891-1892  2    1893-1896  4 

1897-1907  11 


Total   Yellow    Fever                   Total    Years   of   Im- 
Years 101  munity   313 

E  ECAPITULATION. 

Yellow  Fever  Years 101 

Years  of  Immunity 313 


Total  years  under  observation 414 


CHRONOLOGY   OF   YELLOAY   FEYER   IN   AFRICA, 
BY  LOCALITIES. 

ADgola— 18G0,  18G2,  1863,  1865.  . 

Ascension  Island— 1818,  1823,  1838,  1817,  1859,  1873. 

Banana  Islands — 1817. 

Benin— 1520,  lc53,  1588,  1828,  1852,  1853,  1851,  1855, 
1856,  1857,  1862,  1873. 

Bonny— 1862,  1891. 

Bulani  (Island  of) — 1792. 

Calabar — 1862. 

Canary  Islands— 1191,  1195,  1196,  1512,  1531,  1582, 
1599,  1601,  1606,  1701,  1771,  1772,  1773,  1810,  1811,  1828, 
1816,  1817,  1862,  1888,  1905. 

Cape  Yerd  Islands— 1510,  1511,  1512,  1513,  1511,  1515, 
1639,  1778,  1807,  1821,  1822,  1827,  1837,  1838,  1816,  1817, 
1862,  1861,  1868,  1873. 

Congo  Coast— 1816,  1860,  1862,  1900. 

Dahomey- 1906,  1907. 

Fernando-Po  (Island  of)— 1792,  1812,  1829,  1839,  1857, 
1860,  1862,  1861,  1866,  1868,  1869. 

French  Guinea — 1901. 

Gambia— 1762,  1761,  1766,  1768,  1769,  1778,  1825,  1828, 
1837,  1859,  1860,  1865,  1866,  1878,  1881,  1900. 

Gold  Coast— 1778,  1786,  1822,  1823,  1821,  1852,  1853, 
1851,  1855,  1856,  1857,1862,1898. 

Guinea — (*SVc  Benin,  Dahoniei/,  French  Guinea^  Gold 
Coase,  Iconj  Coast,  Lagos  and  Sierra  Leone). 

lyory  Coast— 1852,  1857,  1862,  1863,  1899,  1902,  1903, 
1901,  i905.  I 

Lagos — 1861.  / 

Madeira  Islands — 1738. 

:\rorocco— 1801,  188L  | 

Saint  Helena  (on  ship-board) — 1830, 

Saint  Thomas— 1558,  1588. 

Senegal— 1759,  1766,  1769,  1778,  1779,  1828,  1829,  1830, 
1837,  1859,  1866,  1867,  1872,  1878,  1879,  1880,  1881,  1882, 
1900,  1901,  1905. 


AFRICA CHRONOLOGY 1494  TO  1907. 


35S 


Sierra  Leon^l763,  1764,  17G6,  1778,  1807,  1809, 

1812,  1815,  1816,  1819,  1822,  1823,  1825,  1826,  1828,  1829, 

1830,  1837,  1838,  1839,  1845,  1847,  1848,  1858,  1859,  1860, 
1862,  1864,  1865,  1866,  1868,  1872,  1878,  1884. 

Soudan— 1828,  1829,  1878,  1879,  1880,  1881,  1882,  1891, 
1892,  1897,  1901,  1902,  1903,  1906,  1907. 

YELLOW   FEVER   VISITATIONS    IN   AFEICA,    BY 
LOCALITIES. 

Y'ear  of  Year  of 

Locality.               First                Last  Total  Number 

Appearance.    Appearance,  of  Visitations. 

Angola 1860                  1865  4 

Ascension  Island  .  1818                  1873  6 

Banana  Islands  . .  1847                  1847  1 

Benin 1520                   1873  12 

Bonny 1862                  1891  2 

Bulani 1792                   1792  1 

Calabar 1862                  1862  1 

Canary  Islands  . .  1494                  1905  21 

Cape  Verd  Islands  1510                   1900  20 

Congo  Coast 1816                   1900  4 

Dahomey 1906                  1907  2 

Fernando-Po 1732                   1869  11 

French  Guinea  ..1901                 ,1901  1 

Gambia 1762                  1900  16 

Gold  Coast 1778                  1898  13 

Ivors^  Coast 1852                   1903  9 

Lagos 1864                   1864  .      1 

I\Ladeira  Islands  .1738                  1738  1 

Morocco 1804                   1881  2 

Saint  Helena 18.30                  1830  1 

Saint  Thomas 1558                  1588  1 

Senegal   1759                  1905  21 

Sierra  Leone 1763                  1884  34 

Soudan    1828                  1907  15 


Total  number  of  yellow  fever  eruptions  in 

Africa  from  1494  to  1907 200 


354  HISTORY    OF    YELLOW    FKVER. 

GENERAL  STATISTICAL  SUMMARY. 

Yellow  Fever  in  Africa  and  the  Islands  off  the  Coast 
thereof;,  from  1494  to  1907. 

Total  number  of  3'ears  under  observation 411 

Yellow  fever  years 101 

Years  of  ImmunitY 313 

Total   number  of   countries  where   the  disease  pre- 
vailed, either  epidemically  or  sporadically 24 

Total  number  of  yellow  fever  eruptions 200 

(The  alleged  eruptions  of  yellow  fever  in  Egypt, 
Johanna  Island  and  Madagascar,  mention  of  which  is 
made  in  our  historical  resume,  are  not  included  in  the 
above  tables,  for  the  reason  that  we  do  not  think  they 
were  manifestations  of  the  disease  under  consideration. 
G.  A.) 


HISTORY 


OF 


YELLOW    FEVER 


IN 


EUROPE. 


AUSTRIA. 

TRIESTE. 

Trieste,  the  only  place  in  Austria,  ever  invaded  by  yel- 
low fever,  is  an  important  seaport  at  the  head  of  the 
Adriatic  Sea,  seventy-three  miles  northeast  of  Venice, 
Italy.  Population:  isTO,  109,324;  1890,  158,344;  1907 
(estimated)  200,902. 

YELLOW  FEVER  YEAR. 

1894. 

Summary  of  Importation. 

*The  histor^^  of  yellow  fever  in  Austria  is  focused  into 
a  single  importation  of  that  disease. 

In  1894,  the  Italian  steamship  Colombo  arrived  at 
Genoa  Italy,  from  Brazil.  The  captain  re])orted  having 
had  yellow  fever  on  the  homeward  trip.  The  vessel  was 
disinfected  and  allowed  to  land  her  passengers  and  cargo. 
Two  of  the  crew,  Avho  lived  in  Trieste,  took  the  train  for 
their  native  town  as  soon  as  they  were  permitted  to  land. 
They  were  ill  at  the  time,  hut  no  attention  Avas  ]iaid  to 
this  by  the  Genoose  authorities.  On  their  arrival  at 
Trieste,  the  two  sailors  were  taken  violently  sick  and 
removed  to  the  hoi^pital,  where  they  died  a  few  days  later, 
with  all  the  symi)toms  of  yellow  fever. 

vThe  infection  did  not  spread. 


^  Eager:     Bulletin  No.  S,  Yellow  Fever  Institute,  Washington, 
D.  C,  1902,  p.  33. 


AZORES. 

Description. 

The  Azores,  or  Western  Islands,  are  a  group  of  nine 
islands  in  the  Atlantic  Ocean,  900  miles  west  of  Portugal. 
Although,  presumably  discovered  b}-  Cabral,  in  1431,  the 
Azores  were  evidentl}^  known  to  the  ancients  as  they  are 
mentioned  by  the  Arabian  geographer,  Edrisi,  and  are 
distinctly  marked  on  a  map  of  1351.  Punic  coins  found 
on  the  island  of  Covo,  leads  to  the  belief  that  the  archi- 
pelago was  visited  by  the  Carthagenians.  The  islands 
belong  to  Portugal,  and  are  a  geograx)hical  part  of 
Europe.  Population,  270,000.  Capital,  Ponta  Delgado, 
on  the  island  of  Sao  Miguel.  \ 

YELLOW  FEVER  YEAE. 

1858. 

Summary  of  Importation. 

Although  in  the  path  of  commerce  between  America 
and  Europe,  the  Azores  are  seldom  visited  by  merchant 
vessels.  This  is  probably  due  to  the  fact  that  the  archi- 
pelago has  no  good  harbors.  To  this  isolation,  is  no  doubt 
due  the  almost  total  immunity  of  the  gi'oup  from  yellow 
fever,  for  only  a  solitary  invasion  of  the  disease  is 
recorded.  i 

According  to  Avelino^  and  Guimaraes,^  yellow  fever 
was  imported  to  Ponta  Delgado  by  a  vessel  from  Brazil, 
in  1858,  under  the  following  conditions : 


"  Pedro  Alvarez  Cabral,  a  Portugese  navigator,  was  born  about 
1460  and  died  in  1526.  At  the  time  he  discovered  the 
Azores,  the  islands  were  uninhabited  and  had  scarcely 
any  living  things,  except  birds,  particularly  hawks.  The 
Portugese  called  the  whole  group  Azores,  from  "acor" 
or  "azor,"  a  hawk. 

'Avelino:    Gaz.  Med.  de  Lisboa,  1S5S,  vol.  6,  pp.  312;   327;  342, 

*Grimaraes:    Ibid.,  p.  3.^S. 


358  AZORES. 

On  August  1st,  1858,  two  sailors,  Eamao  Jose  and  Jose 
Navio,  arrived  at  Ponta  Delgado  from  Lisbon,  on  the  Bra- 
zilian ship  Dois  Amigos.  The  men  were  in  the  first  stages 
of  yellow  fever  and  were  taken  to  the  Hospital  Misericor- 
dia.  Jose  died  August  4th.  Kavio  recovered  and  was 
discharged  cured  on  August  27th.  He  embarked  on  the 
passenger  packet  Domingo^  and  was  taken  to  the  Cape 
Verd  Islands,  whence  he  returned  to  Lisbon,  on  the  Dois 
Amigos,  the  same  vessel  which  had  brought  him  to  Ponta 
Delgado. 

Avelino  mentions  a  third  case,  that  of  a  servant  at  the 
Hopital  Misericordia,  who  Avas  attacked  on  August  4th, 
the  day  of  the  death  of  the  first  sailor.  This  case  recov- 
ered, the  man  being  well  enough  to  resume  his  duties  by 
August  12th.  ,' 

Avelino  doubts  that  this  third  case  was  yellow  fever, 
but  as  the  patient  had  been  in  contact  with  the  sick,  his 
illness  was  classed  as  such.^ 

Grimaraes'  article  is  far  from  being  a  gold  mine  of  in- 
formation. He  discusses  Avelino's  methods,  but  cites 
nothing  which  could  throw  additional  light  upon  the  sub- 
sequent history  of  this  importation. 


"A  primcira  e  sgunda  observacao  nao  rae  deixaram,  nem  a 
nenhum  dos  metis  collegas  acima  mencionados,  a  menor 
duvida  de  que  os  doentes  que  fazem  o  objecto  d'ellas 
foram  ambos  affectados  de  febre  amarella.  Foram  dois 
casos  esporadicos.  Nao  pensamos,  poreni,  assim  acerca 
do  doents  da  terceira  observacao.  que  persumimos 
ter  apresentado  os  prenomenos  que  descrevi,  por  effeito 
de  alguma  disposicao  gastrica,  cujos  symptomas  morbidos 
foram  despertados  pelas  causas  occasionaes  que  as- 
signalei,  auxiliadas  mui  pix)vave''mente  pelo  terror." — 
Avellino,  loc.  cit. 


FRANCE. 

Unlike  her  neighbor  on  the  southwest,  France  does  notl 
occupy  a  prominent  place  in  the  annals  of  yellow  fever. 
No  cases  have  ever  been  known  to  originate  on  French 
soil.  The  outbreak  at  Saint  Nazaire,  in  1861,  and  the 
sporadic  eruptions  in  the  other  localities  mentioned  in 
this  history  were  flagTant  importations,  and  the  manifes- 
tations of  the  disease  on  shore  were  traced  in  every  in- 
stance to  pensons  who  had  communicated  with  vessels  ar- 
riving from  infected  ports  or  who  had  come  direci  from 
localities  where  the  Antillean  pestillence  was  prevailing. 
The  miniature  epidemic  of  1861,  which  caused  the  little 
town  of  Saint  Nazaire  world-wide  notoriety,  is  the  only 
serious  manifestation  of  the  disease  under  discussion 
which  has  ever  invaded  France.  In  every  other  instance, 
the  malady  was  confined  to  the  quarantine  basins  and  laz- 
arettos of  the  seaports  having  direct  communication  with 
yellow  fever  foci.  When  a  case  occurred  on  shore,  it  was 
unequivocably  traced  to  the  above  sources.  The  "cases 
presenting  all  the  symptoms  of  yellow  fever"  which  epi- 
demiologists claim  to  have  observed  in  Paris,  details  of 
which  are  given  in  the  history  of  yellow  fever  as  it  con- 
cerns Paris,  in  this  volume,  were  not  manifestations  of 
the  disease.  Of  this,  there  can  be  no  doubt,  for  reasons 
patent  even  to  the  most  careless  observer. 


360  HISTORY    OF    YELLOW    FEVER. 

CHRONOLOGY  OF  YELLOW  FEVER  IN  FRANCE. 

1694  to  1908. 


1694.  Rocliefort  (not  authentic). 

1696.  Aix. 

1700.  La  Rochelle  (not  authentic). 

1802.  Brest;  Marseilles. 

1804.  Marseilles. 

1807.  Marseilles. 

1811.  Bordeaux;  Brest;  Marseilles;  Rochefort. 

1815.  Brest. 

1820.  Marseilles. 

1821.  Marseilles;  Montpellier. 

1822.  Paris  (not  authentic). 

1823.  Marseilles. 
1839.  Brest. 

1845.  Paris  (not  authentic). 

1856.  Brest. 

1857.  Nantes. 

1861.  Havre;  Montoir;  Saint-Nazaire. 

1862.  Saint-Nazaire. 
1870.  Marseilles.  / 

1881.  Bordeaux;    Dunkirk;    Havre;    Mindin;    Saint- 
Nazaire. 

1883.  Paris  (not  authentic), 

1891.  Marseilles. 

1899.  Bordeaux;  Marseilles;  Nantes. 

1900.  Havre. 
1908.  Saint  Nazaire. 


FRANCE.  S61 

By  Localities. 

Aix.     1G96. 

Bordeaux.       1811;  1881;  1899. 

Brest.     1802;  1811;  1815;  1839;  1856. 

Dunkirk.     1881. 

Havre.     1861;  1881;  1900. 

La  Eoclielle.     1700   (not  authentic). 

Marseilles.  1802 ;  1804 ;  1807 ;  1811 ;  1820 ;  1821 ;  1823 ; 
1870;  1891;  1899. 

Montpellier.     1821. 

Mindin.     1881. 

Montoir.     1861. 

Nantes.     1857;  1899. 

Paris.  1822 ;  1845 ;  1883.  (None  of  these  alleged  man- 
ifestations are  authentic). 

Rochefort.     1694  (not  authentic)  ;  1811. 

Saint  Nazaire.     1861;  1862;  1881;  1908. 

LOCALITIES      IN      FRANCE      WHERE      YELLOW 
FEVER  HAS  BEEN  OBSERVED. 


Aix.  A  city  in  the  department  of  Bouches-de-Rlionei, 
seventeen  miles  north  of  Marseilles. 

Bordeaux.  A  seaport,  358  miles  southwest  of  Paris,  in 
the  department  of  Garonne  (Guienne),  on  the  Garonne 
River,  sixty  miles  from  its  entrance  into  the  Bay  of  Bis- 
cay. It  has  a  lai'ge  harl)or,  capable  of  containiuij  1,200 
Bhips.  Population:  1875,  215,140;  1891,  242,259;  1907, 
(estimated),  253,000. 


362  HISTORY    OF    YELLOW    FEVER. 

Brest.  A  city  in  the  northwest  extremity  of  France, 
department  of  Finistere  (Bretagne),  about  389  miles  by 
rail,  west  of  Paris.  It  is  advantageously  situated  on  the 
north  shore  of  an  arm  of  the  Atlantic  Ocean,  called  the 
Road  of  Brest.  It  is  one  of  the  foremost  naval  ports  of 
Europe.  Population:  ISTG,  66,828;  1891,  75,851;  1907 
(estimated),  85,263.  ' 

Dunkirk.  A  fortified  seaport  on  the  northernmost  coast 
of  France,  on  the  Strait  of  Dover,  fortv  miles  northwest 
of  Lille. 

La  Rochclle.  A  fortified  seaport,  in  Charente-Infei'i- 
eure  on  the  Atlantic,  nearly  mid-way  between  Nantes  and 
Bordeaux.     Population:  1907   (estimated),  51,553. 

Havre.  A  city  in  the  north  of  France,  department  of 
Seine-Inferieure  (Normandy),  on  the  north  side  of  the 
estuary  of  the  Seine,  at  its  entrance  into  the  English, 
Channel,  113  miles  northwest  of  Paris.  It  is  an  activei 
manufacturing  center.  Being  the  port  of  Paris,  Havre 
does  an  extensive  passenger  traffic  and  is  connected  by 
rail  and  steamships  with  all  parts  of  the  world.  Regular 
lines  of  steamers  ply  between  Havre  and  Havana,  the 
West  Indies  and  South  America.  Population:  1861, 
71,336;  1891,  114,001;  1907  (estimated),  132,130. 

MontpcUkr.  A  city  in  the  south  of  France,  celebrated 
for  the  brightness  of  its  atmosphere  and  the  mild  salu- 
brity of  its  climate.     Population:  1891,  69,238. 

MarsciJIcs.  The  most  important  port  of  Southern 
France,  department  of  Bouches-du-Rhone  (Provence),  at 
tlie  head  of  a  bay  which  opens  into  the  Gulf  of  Lyons.  ^It 
is  200  miles  southeast  of  Lyons  and  535  miles  south  of 
Paris.  Its  commerce  extends  to  all  parts  of  the  world, 
and  it  is  the  principal  point  of  debarkation  of  passengers 
for  the  various  ports  of  the  ^Mediterranean  and  the  East. 
Population:  1802,  260,910;  1881,  269,310;  1891,  403,749; 
1907   (estimated),  517,198. 

Mindin.     A  suburb  of  Nantes. 

]\fonfoir-(7c-Brefaf/)ic.  Commonly  called  ^fontoir.  A 
town  in  Loire-Inferieure,  twenty-nine  miles  northwest  of 
Nantes. 


FRANCE AIX,    1696.  363 

V 

Nantes.  Capital  of  the  department  of  Loire-Inferieure 
(Bretagne),  at  the  confluence  of  the  Erdre  and  Sevre- 
Nantaise  Kivers,  and  245  miles  by  rail  Avest  of  Paris, 
Next  to  Brest,  it  is  the  most  important  port  on  the  Atlan- 
tic coast  of  France.  The  city  is  built  on  several  small 
islands  in  the  Loire,  which  communicate  with  each  other 
by  means  of  numerous  bridges.  A  canal  connects  Nantes 
with  Brest.  It  has  many  manufactures  and  an  extensive 
maritime  commerce.  Population:  1886,  127,482;  1891, 
122,750;  1907  (estimated),  133,247. 

Paris\    Capital  of  France. 

Rochefort.  A  city  on  the  west  coast  of  France,  depart- 
ment of  Charente-Inferieure  (Saint  Onge),  on  the  Char- 
ente  River,  seven  miles  from  its  entrance  into  the  Bay 
of  Biscay.  It  is  twenty  miles  southeast  of  La  Rochelle, 
and  eighty-nine  miles  southwest  of  Poitiers,  and  is  an 
important  commercial  center.  Population :  1851,  15,508 ; 
1871,  18,352 ;  1891,  26,170. 

Saiiit-Nazaire.  A  city  on  the  west  coast  of  France,  in 
Loire-Inferieure  (Bretagne),  at  the  mouth  of  the  Loire, 
thirty-seven  miles  by  rail,  west  of  Nantes.  It  is  the  ter- 
minus of  passenger  steamers  which  ply  between  that  part 
of  France  and  Mexico  and  the  West  Indies.  Population: 
1851,  2,400;  1881,  16,314;  1891,  20,467. 

AIX. 

YELLOW  FEVER  YExVR. 

1696. 

,St:m:\iauy  of  Epidemic. 

The  pestilence  which  ravaged  Rochefort  in  1694  caused 
the  French  government  to  take  extraordinary  precautions 
against  the  importation  of  yellow  fever,  and  to  these  meas- 
ures inaugurated  by  Pontchartrain,  Aix  undoubtedly 
owes  her  escape  from  an  invasion  of  the  dreaded  pest  in 
1696.  In  the  month  of  August,  of  that  year,  the  squad- 
ron of  Admiral  de  Pointis,  which  had  been  cruising  in  the 


364  HISTORY  OF    YELLOW    FF.VER. 

West  Indies,  arrived  in  the  harbor  of  Aix.  There  were 
many  cases  of  yellow  fcxev  on  board  the  vessels,  and  they 
were  ordered  to  quarantine,  for  fear  that  the  disease 
might  be  introduced  on  shore.  These  drastic  steps  were 
instrumental  in  confining-  the  malady  to  the  ships.*" 

BORDEAUX. 

YELLOW  FEVER  YEARS. 
1811,  1881,  1899. 

Summary  of  Epidemics. 

1811. 

Tlie  archives  of  Bordeaux  are  silent  regarding  the  pre- 
valence of  yellow  fever  in  that  town,  in  1811,  but  Robert 
(Guide  Sanitaire,  vol.  1,  page  104),  claims  that  several 
cases  were  observed  in  the  sliipping.       According  to  this 
authority,  no  cases  erupted  on  shore. 

1875. 

No  cases  of  yellow  fever  Avere  observed  in  the  city 
proper,  in  1875.  but  the  following  infected  vessels  were 
detained  at  tlie  quarantine  station:" 

The  Orinoco,  from  Brazil.  Two  deaths  from  yellow 
fevei'  on  the  passage  to  Bordeaux. 

The  Senegal,  two  deaths. 

The  Liguria,  one  death. 

The  Glrouilc.  One  death  while  in  the  harbor  of  Bahia, 
Brazil^  and  four  cases  and  two  deaths  on  the  voyage  from 
Bahia,  one  of  the  deaths  occurring  six  days  before  the 
ariiral  of  the  vessel  at  Bordeaux. 

The  Corcovado,  from  Brazil.  This  vessel  arrived  at 
about  the  same  time  as  the  Gironde,  with  an  unclean  bill 


°  Berenger-Feraud :   Traite  Theorique  et  Pratique  de  la  Fievr^' 

Jaune  (Paris,  1S90),  p.  37. 
'  Armaingiiaud:      Memoires    et     Bulletins    de    la    Societe    do 

Medecine  et  de  Chirurgie  de  Bordeaux,  1875,  p.  253. 


FRANCE BORDEAUX,  1881.  365 

of  health,  and  41G  passengers.  The  authorities,  although 
apprehensive  of  the  introduction  of  yellow  fever,  found 
it  impossible  to  segregate  the  passengers,  as  the  lazaretto 
could  accommodate  only  210  at  the  utmost.  As  no  cases 
had  occurred  during  the  voyage,  pressure  was  brought 
upon  the  government  to  release  the  passengers,  with  the 
result  that  they  were  allowed  to  go  free,  but  the  vessel 
was  remanded  to  quarantine  for  observation. 

The  dumping  of  over  400  persons  from  a  vessel  said  to 
be  infected  with  yellow  fever  upon  an  immense  non-im- 
mune population,  caused  Avidcspread  criticism,  both  in 
France  and  abroad,  but  no  diffusion  of  the  disease  event- 
uating the  incident  was  soon  forgotten. 


ISSl. 


A  severe  epidemic  of  yellow  fever  ravaged  the  French 
possession  of  Senegal  in  1881  and  the  settlers  fled  to 
their  native  land.  By  this  means,  some  of  the  steamers 
plying  between  the  West  Coast  of  Africa  and  Europe  were 
contaminated  and  carried  the  disease  to  several  ports  of 
France. 

The  Case  of  the  Edgard. 

Yellow  fever  erupted  at  Saint-Louis,  the  capital  of  Sen- 
egal, on  July  24th,  1881.  The  English  steamship  Edc/anJ, 
with  a  crew  of  twenty-one,  arrived  at  the  town  on  August 
1st,  and,  although  the  port  had  l>eim  officially  declared 
infected,  remained  at  the  wharf  for  twelve  days,  commu- 
nicating freely  with  the  shore.  On  August  13th,  the  ves- 
sel embarked  seven  refugees  and  left  for  France.  The 
following  day,  yellow  fever  erupted  on  board,  in  the  per- 
son of  a  fireman,  who  died  on  the  17th.  On  the  19th, 
another  fireman  was  attacked  and  died  on  the  2Gth.  On 
the  21st,  an  oiler  was  taken  ill  and  died  on  the  29th ;  on 
the  31st,  a  cabin-boy  was  attacked,  dying  on  September 
2nd.     On  September  1st,  the  second  engineer  was  stricken. 


S66  HISTORY    OF    YELLOW    FEVER. 

Such  was  the  melancholv  record  when  the  Edgard 
steamed  into  the  harbor  of  Bordeaux  on  September  3rd. 

The  passengers  and  crew  were  transferred  to  the  laza- 
retto at  Paulliac,  where  fifteen  additional  cases,  with  one 
death,  occurred,  exclusively  among  the  s?ilors.  The  sec- 
ond engineer  also  succumbed  a  few  days  after  his  removal 
to  the  lazaretto. 

The  most  singidar  phase  of  this  outbreak  on  board  of 
the  Edgard,  is  that  not  a  single  passenger  suffered,  the 
attacks  being  confined  exclusively  to  the  crew.  The 
escape  of  the  passengers  from  infection  is  believed  by 
Duval^  and  Berenger-Feraud^  to  haA'e  been  due  to  the 
fact  that  they  fled  to  the  poop  of  tlie  vessel  as  sorm  as  the 
first  case  erupted  and  remained  aloof  from  the  nidus  of 
infection  during  the  entire  voyage  from  Senegal  to  Bor- 
deaux. The  officers,  witli  one  exception,  had  no  commu- 
nication whatever  with  the  sick,  leaving  them  to  the  care 
of  the  surgeon,  and  escaped ;  but  the  unfortunate  engineer, 
who  communicated  freely  with  tlie  patients,  was  less  for- 
tunate, as  we  have  seen. 

Of  the  twenty-one  composing  the  crew  of  the  Edgard, 
six  were  attacked  and  five  died  on  the  voyage  from  Saint- 
Louis  to  Bordeaux,  and  fifteen  were  affected  and  tAvo  died 
(one  an  officer)  in  tlie  lazaretto  at  Paulliac,  making  ai 
total  of  twent3'-one  cases  and  seven  deaths.^ 

The  Case  of  the  Coxde. 

The  French  steamship  Cnndr,  ])lying  between  Senegal 
and  Bordeaux,  arrived  at  Saint-Louis,  on  August  7th, 
1881.  There  was  no  sickness  on  board.  There  was  un- 
restrained communication  between  the  town  and  the  ves- 
sel.    On  August  ir)tli,  su(l(l(Mi  a])pearance  of  yellow  fever 


Duval :    La  Fievre  .laune  a  Goree,  Senegal  (Bordeaux,  ]88H), 

p.  84. 
Berenjjer — Feraud  :     Traite    Theorique    et    Pratique    de     la 

Fievre  Jaune  (Paris,  1890)  p.  183. 


FRANCE BORDEAUX,  1881.  367 

on  board,  in  the  person  of  two  sailors  and  the  chief  cook. 
)The  three  patients  were  sent  to  the  hospital  on  shore, 
where  they  died  in  a  few  days.  On  the  20th,  the  captain 
was  taken  ill  and  died  on  the  21st;  another  case  erupted 
the  same  day.  That  same  afternoon  (21st),  the  vessel 
left  for  France,  having  taken  thirty-two  refugees  at  Saint- 
Louis.  An  attempt  was  made  to  coal  at  Dakar,  but  when 
the  condition  of  the  vessel  was  made  known  to  the  author- 
ities, permission  was  denied.  After  an  appeal  to  the  colo- 
nial government,  the  vessel  was  allowed  to  coal  from 
barges  in  mid-stream,  extraordinary  precautions-  being 
t^ken  to  prevent  contamination.  On  August  2.3rd,  the 
Conde  resumed  its  voyage.  The  wisdom  of  the  authori- 
ties of  Dakar  in  prohibiting  the  vessel  from  landing  at 
her  wharves  soon  made  itself  manifest.  Three  days  after 
leaving  Dakar,  the  fever  broke  out  again.  Following  is 
the  record  of  deaths  from  the  27th  to  the  time  of  the 
vessel's  arrival  at  Bordeaux,  September  9th: 

August.  September. 

27th 1     1st 1 

29th 2     2nd 2 

30th 2     5th 1 

31st 1      Gth 1 

7th 1 

When  the  Conde  arrived  at  Bordeaux,  the  passengers 
and  crew  were  sent  to  the  lazaretto  at  Paulliac,  where  one 
death  took  place  on  the  9tli,  two  on  the  10th,  and  one  on 
the  11th. 

The  Conde  furnished  altogether  thirty-two  deaths  from 
August  15th  to  September  11th,  seven  at  Saint-Louis, 
twelve  on  the  homeward  voyage  and  four  at  Paulliac.  The 
number  of  cases  is  not  stated  by  our  authority.^^ 


"Duval,  loc.  cit,  p.  85. 


368  HISTORY    OF    YELLOW     FIVER. 

The  Case  of  the  Richelieu. 

A  third  infected  vessel  reached  Bordeaux,  in  1881. 

The  Richelieu,  oue  of  the  largest  passeuger  steamers 
plying-  between  Bordeaux  and  Senegal,  arrived  at  Bor- 
deaux, on  September  2Gth,  1881,  with  105  refugees  on 
board.  The  vessel  had  come  directly  from,  Bop-Diara, 
Senegal,  where  yellow  fever  was  prevailing.  The  captain 
gave  the  following  history  :i^ 

The  Richelieu  arrived  at  Goree,  Senegal,  on  August 
3rd,  1881;  on  the  13th,  arrived  at  Saint-Louis  and 
anchored  near  the  camp  of  Bop-Diarra,  where  most  of  the 
yellow  fever  cases  from  the  capital  were  sent.  On  Sep- 
tember 7th,  the  disease  erupted  on  board,  three  patients 
being  sent  to  the  hospital.  On  the  9th,  another  patient 
was  sent  to  the  hospital.  On  the  9th,  105  refugees,  sol- 
diers and  civilians  were  embarked,  and  the  vessel  left  for 
home.  On  the  10th,  a  young  girl  and  a  seaman  were  taken 
ill  and  sent  ashore,  the  vessel  being  still  in  the  river.  An- 
other cavse  erupted  on  the  evening  of  the  10th,  resulting  in 
death  on  the  12th.  The  captain,  attacked  on  the  11th, 
recovered.  The  chief  cook,  also  attacked  on  the  11th, 
recovered,  although  he  had  black  vomit. '  A  sergeant  was 
taken  ill  on  the  12th,  and  a  soldier  on  the  13th;  both  died 
on  the  IGth.  Another  soldier  died  on  the  17th.  A  sailor 
from  the  Tama  si,  died  on  the  18th.  This  was  the  last 
case. 

AA'hen  the  RicJirlieu  steamed  into  the  harbor  of  ^Mar- 
seilles,  on  September  2r)th,  only  eight  days  had  elapsed 
since  the  last  death,  and  the  vessel  was  detained  at  Paul- 
liac.  Xo  other  cases  erupting,  she  was  given  free  pratique, 
and  the  passengers  allowed  to  proceed  on  their  way  after 
being  detained  only  a  short  while. 

The  Case  of  the  Tamesi. 

The  steamship  Tamesi,  on  board  of  which  there  had 
been  manv  deaths  while  the  vessel  was  in  the  Senegal 


"Duval,  loc.  cit.,  p.  86. 


FRANCE BORDEAUX,  1899.  369 

Kiver,  near  Saint-Louis,  arrived  at  Bordeaux,  on  Septem- 
ber 15th.  She  carried  no  passengers  and  had  had  no 
cases  on  board  since  leaving  Saint-Louis.  The  vessel  was 
disinfected  and  given  immediate  pratique. 

j  Resume. 

It  will  thus  be  seen  that,  in  less  than  fifteen  days,  four 
vessels  infected  with  yellow  fever  entered  the  harbor  of 
Bordeaux,  two  wdth  cases  on  board,  one  with  a  dismal 
history  of  the  ravages  of  the  disease  among  its  passengers 
and  crew  during  the  homeward  voyage,  and  the  other  hav- 
ing been  decimated  while  riding  at  anchor  opposite  a  nidus 
of  pestilence. 

1899. 

The  French  steamship  La  Plata  left  Rio  de  Janeiro, 
October  10th,  1899,  for  Bordeaux,  via  Senegal.  Among 
the  passengers  who  took  passage  at  Dakar,  Senegal,  was 
a  lady,  who  fell  sick  during  the  voyage.  Her  case  was 
diagnosed  as  yellow  fever.  There  was  no  sickness  on 
board  and  no  cases  of  yellow  fever  had  been  observed  since 
she  had  left  Rio  de  Janeiro,  so  it  is  evident  that  the  in- 
fection came  from  Dakar.  On  the  ship's  arrival  at  Bor- 
deaux, the  patient  was  sent  to  the  Lazaretto,  where  she 
died  a  day  or  so  after.i^  No  other  cases  occurred,  either 
on  board  the  La  Plata  or  at  Bordeaux. 


'Havelburg:  U.  S.  P.  H.  &  M.  H.  Reports,  1899,  vol.  14,  p.  2318. 


BREST. 

YELLOW  FEVER  YEARS. 

1802;  1811;  1815;  1839;  185G. 

SUMMARY  OF  EPIDEMICS. 
1802. 

Yellow  fever  was  brouglit  to  Brest,  in  1802,  by  itliei 
French  squadron  commanded  by  Admiral  Yillaret  de 
Joyeuse.  The  fleet  was  composed  of  the  following  vessels : 
Lg  Tourville,  VUnion,  VAigle,  Le  Foudroyant  and  Lo 
Conquerant,  and  came  directly  from  San  Domingo.  Yel- 
low fever  was  then  committing  fearful  ravages  among  the 
European  troops  in  the  West  Indies.  The  returning 
soldiers  were  the  remnants  of  a  splendid  army,  under 
General  Leclerc,  consisting  of  1,500  officers,  20,000 
soldiers  and  9,000  seamen,  which  had  been  sent  by  the 
French  government  to  occupy  San  Domingo,  restored  to 
France  by  the  famous  "Peace  of  Amiens,"  which  treaty 
set  at  rest  the  quarrels  between  England,  France,  Spain 
and  Holland  concerning  their  West  Indian  possessions. 

The  squadron,  which  had  been  infected  at  San  Domingo, 
arrived  in  the  roads  at  Brest  in  the  autumn,  of  1802. 
There  were  forty-two  men  sick  with  yellow  fever  on  the 
different  vessels.  These  w^ere  transferred  to  the  lazaretto 
at  Treberon. 

A  customhouse  employe,  who  liad  been  sent  to  guard 
the  Trouville,  on  which  the  majority  of  the  cases  had 
occurred,  contracted  the  disease  and  died  at  his  home 
on  shore  within  forty-eight  liours.  Two  otlier  inhabitants 
of  Brest  were  infected  and  died  on  the  fifth  day  of  their 
illness.  These  three  cases,  erupting  in  the  very  heart  of 
the  city,  caused  intense  consternation,  and  the  authorities 
took  immediate  steps  topreven  t  any  communication  what- 
ever between  the  vessels,  the  lazaret  and  the  shore.    These 


"Cornilliac:    La  Fie\Te  Jaune  dans  les  Antilles,  1886,  p  403. 


FRANCE BREST.  371 

strict  sanitary  measures  proved  effective,  for  no  other 
cases  occurred. 

Out  of  the  forty-two  cases  sent  to  the  lazaretto  at  Tre- 
beron,  twenty-three  died. 

1811. 

According  to  Eobert  {Guide  Sanitaire,  vol  1,  p.  104),  a 
few  cases  of  yellow  fever  were  observed  in,  the  shipping 
at  Brest,  in  1811.     No  cases  occurred  on  shore. 

1815. 

Yellow  fever  prevailed  in  the  harbor  of  Brest,  in  1815, 
(Cornilliac,  Rcchcrches  Chronologiques,  etc.,  188G,  page 
228).     Only  a  few  cases  are  recorded. 

1839. 

> 

Yellow  fever  was  brought  to  Brest,  in  1839,  by  the  trans- 
port La  Caravane,  from  jMartinique.^^  There  were  116 
cases,  out  of  a  crew  of  112,  on  the  homeward  voyage,  and 
the  convalescents  were  transferred  to  the  lazaret  at  Brest. 
Only  one  case  (a  convict)  erupted  at  Brest.  The  total  num- 
ber of  deatlis  among  the  crew  of  La  Caravane  amounted 
to  thirty-three. 

According  to  Berenger-Feraud,^^,  the  Caravane  had  been 
contaminated  at  Fort  Royal,  Martinique,  where  she  had 
taken  some  soldiers  on  board.     One  of  these  soldiers  was 
taken  sick  with  yellow  fever  and  died.  From  that  moment, . 
the  vessel  becanne  infected. 

1856. 

The  cruiser  La  Fortune  brought  yelloAV  fever  to  Brest, 
in  1856. 

On  May  8th,  1856,  La  Fortune  left  Brest  for  an  ex- 


" Cornilliac:    La  Fievre  Jaune  Dans  les  Antilles,  1886,  p.  414. 
"  Berenger-Feraud,  loc.  cit.,  p.  511. 


S72  HISTORY    OF    YELLOW    FEVER. 

tended  cruise.^*^  After  touching  at  Groree,  Senegal,  the 
vessel  crossed  the  Atlantic  and  arrived  at  the  lies  du 
Salut,  French  Guiana,  on  July  7th.  On  July  10th,  sixty- 
three  passengers  were  embarked  at  Cayenne,  Avhere  yellow 
fever  was  raging  epidemically.  One  of  these  passengers 
was  taken  ill  wth  the  fever  on  the  13th,  but  was  imme- 
diately transferred  to  the  hospital  on  the  island.  La 
Fortune  sailed  on  July  15th,  for  Mai'tinique.  A  second 
passenger,  taken  sick  on  the  22nd,  was  landed  at  Fort- 
de-France  oh  the  2Cth.  Six  passengers  were  embarked 
at  the  latter  place,  and  on  the  29th,  the  cruiser  reached 
Basse-Terre,  GaiUdeloupe,  where  yellow  fever  was  prevail- 
ing, rrhirteen  passengers  were  taken  on  board  at  Basse- 
Terre.  On  the  30th,  the  vessel  set  sail  for  Brest.  On 
August  ist,  the  third  case  of  yellow  fever  erupted  on 
board,  followed  in  quick  succession  by  other  cases,  the 
last  case  occurring  on  Sej^tember  7th,  three  days  after  the 
vessel  had  arrived  at  Brest. 

Out  of  a  crew  of  212,  there  resulted  118  cases,  with 
56  deaths.  Of  the  fourteen  inhabitants  of  Brest,  who  had 
business  relations  with  the  vessels,  three  were  attacked 
and  two  died.^''^ 

DUNKIRK. 

1881. 

A  vessel  from  Senegal  luought  yellow  fe\er  to  Dunkirk, 
in  1881.  The  cases  were  sent  to  the  quarantine  station. 
There  was  no  diffusion  of  the  disease.  (Berenger-Feraud, 
p.  184). 


"  Cornilliac.    La  Fievre  Jaime  Dans  les  Antilles,  1886,  p.  419. 

"Gerardin  and  Reau:  Rapport  sur  des  cas  de  Fievre  Jaime  im- 
portees  a  Brest  en  1856  par  la  Corvette  de  Charge  La 
Fortune,  venant  des  Antilles.  Bulletin  de  I'Academie  de 
Medicine  de  Paris,  1856-7,  vol.  22,  p.  899. 


HAVRE. 

YELLOW   FEVER   YEARS.     . 

1861;  1881;  1900. 

SUMMAHY  OF  EPIDEMICS. 

i 

1861. 

The  ship  Harriet  brought  yellow  fever  to  Havre,  in 
1861.  Immediate  steps  were  taken  to  isolate  the  vessel  as 
soon  as  her  condition  became  known  to  the  authorities, 
who  sent  her  to  the  Island  of  Tatihon,  in  the  English 
Channel.  Nn  new  cases  erupted,  the  disease  being  con- 
fined to  the  original  focus.     [Bcrenger-Feraud,  p.  138).   . 

Melier^^  gives  a  more  elaborate  account  of  the  incident. 
He  states  that  the  Harriet  was  quarantined  at  Havre,  in 
1861,  on  account  of  yellow  fever.  On  page  187,  in  an 
extract  from  a  report  by  Dr.  Launay,  assistant  health 
officer  of  Havre,  it  appears  that  while  at  sea  the  captain 
of  the  Harriet  was  attacked  by  yellow  fever  on  June  15th, 
1861,  died  June  18th,  and  was  buried  at  sea  June  19th. 
The  second  case  occurred  on  July  5th,  1861,  died  July  8th, 
and  was  also  l)uried  at  sea.  Two  more  Avere  observed  July 
6th,  1861,  one  on  July  7th,  one  on  July  18th,  and  one 
on  July  19th.  All  recovered.  Total:  seven  cases;  two 
deaths;  five  recoveries. 

"No  statement  where  the  infection  Avas  brought  aboard 
is  made;  no  mention  of  port  from  which  the  ship  had 
sailed  for  Havre.  Concerning  the  length  of  time  in  quar- 
antine, the  report  states  that  Launay  boarded  the  ship 
and  ordered  a  fumigation  and  remained  on  board  for  five 
days  without  incurring  any  unpleasant  symptoms.  None 
of  the  men  who  had  been  brought  aboard  to  help  disinfect 
the  ship  contracted  the  disease.  In  fact  it  seems  that  the 
cases  taken  down  with  vellow  fever  on  July  18th  and  19th, 


"Melier:     La  Fievre   Jaune   a   Saint-Nazaire    (Reprint,   1863), 
pp.  73  and  187. 


374  HISTORY    OF    YELLOW    FEVER. 

were  recovering  or  almost  recovered  when  the  ship  reached 
Havre,  and  no  further  cases  occurred. 

In  1862,  this  same  vessel  was  quarantined  for  three  days 
at  Marseilles,  merely  on  suspicion. 

According  to  Eager,^^  yellow  fever  was  brought  by  ships 
to  many  French  ports  in  1861,  but  a  search  through  the 
files  of  the  Surgeon  General's  Office,  fails  to  throw  any 
light  on  the  subject. 

1881. 

Yellow  fever  was  brought  to  the  quarantine  station  at 
Havi'e,  in  1881,  by  vessels.  There  was  no  diffusion  of  the 
disease.-^ 

1900. 

The  French  steamship  Beam,  which  it  will  be  remem- 
bered, brought  five  cases  of  yellow  fever  to  Marseilles,  in 
1891,  entered  the  harbor  of  Havre  on  August  11th,  1900. 
The  vessel  had  come  from  Senegal,  where  yellow  fever 
was  prevailing.  She  carried  fourteen  passengers.  An 
officer  of  the  vessel  had  died  from  the  disease  on  the  home- 
ward voyage.  The  passengers  were  disembarked  at  the 
lazaretto,  but  no  cases  erupting,  they  were  released  after 
a  few  days.-i 

On  August  9th,  1900,  the  French  steamer  CaravaUos, 
with  about  300  soldiers  from  Senegal,  arrived  at  Havre 
with  a  case  of  yellow  fever  on  board.  The  patient  wa>s 
then  in  his  ninth  day  and  convalescent.  He  was  sent  to 
the  lazaretto.  On  July  31st,  two  passengers  had  died 
from  yellow  fever  on  board,  and  the  case  mentioned  above 
had  erupted  August  1st.  The  vessel  was  remanded  to 
quarantined^ 

"Eager:  ,  Bull.  No.  8,  Yellow  Fever  Institute,  Washington,  D. 

C,  1902,  p.  29. 
="  Berenger-Feraud,  loc.  cit.,  p.  184. 
=^U.  S.  P.  H.  &  M.  H.  Reports,  1900,  vol.  15,  p.  2235. 
"Ibid,  pp.  2121;  2173. 


FRANCE.  375 

A  third  ship  infected  with  yellow  fever  arrived  at  Havre 
from  Senegal,  in  1900.  On  August  lOh,  the  Santa  Fe  en- 
tered the  port  with  several  cases  of  yellow  fever  on  board, 
having  had  tAvo  deaths  on  the  homeward  voyage.  The 
vessel  was  sent  to  the  quarantine  station.  The  sick  re- 
covered and  no  other  cases  erupted.-^ 

In  none  of  the  above  instances  was  the  disease  diffused 
ashore. 

LA  ROCHELLE. 

In  a  history  of  the  city  of  La  Rochelle,  published  by 
Arcere,  in  1756,  there  is  a  reference  to  an  importation  of 
yellow  fever  into  that  town  in  1700.^^  We  have  been  un- 
able to  find  any  authentic  corroboration  of  this  report. 

MARSEILLES. 

YELLOW  FEVER  YEARS. 

1802;  1804;  1807;  1811;  1820;  1821;  1823;  1870;  1891; 
1899. 

Summary  of  Epidemics. 

1802. 

Yellow  fever  prevailed  on  several  ships  at  the  lazaretto 
at  Marseilles,  in  1802,  but  the  case  of  the  Columhia  is  the 
only  one  of  any  epidemiological  interest.  . 

The  Columbia  took  a  cargo  of  sugar  and  tobacco  at 
Havana  in  tlie  beginning  of  1802,  and  left  that  port  for 
Providence,  Rhode  Island,   where  she  arrived  in   May. 


.      D.  C),  1902,  p.  25. 
="Ibid,  p.  2173. 
=* Eager:    Yellow  Fever  Institute  Bulletin  No.  S   (Washington, 


S76  HISTORY    OF    YELLOW    FEVER. 

She  dischairged  a  portion  of  her  cargo  at  Providence,  and 
took  on  an  entirely  new  crew.  The  vessel  left  the  Amer- 
ican port  on  May  24th,  and  after  touching  at  Malaga, 
Spain,  entered  the  harbor  of  Marseilles,  on  August  9th. 
The  vessel  was  subjected  to  ten  days'  quarantine.  On 
the  very  day  of  its  release,  the  captain  was  taiken  ill  and 
died  on  the  sixth  day  of  the  onset  of  the  malady.  The 
day  after  the  captain's  death,  a  sailor  was  taken  ill. 
While  a  consultation  of  doctors  was  in  progress,  to  de- 
termine what  this  fatal  disease  could  be,  a  third  member 
of  the  crew  was  attacked.  The  vessel  was  immediately 
ordered  again  to  quarantine.  Ten  days  having  elapsed 
without  aoiy  new  case,  the  ship  was  again  released.  No 
sooner  was  this  done,  than  a  sailor  was  taken  ill  and  died 
on  the  sixth  day  of  the  onset.  For  the  third  time,  the 
vessel  was  sent  to  quarantine,  where  three  other  members 
of  the  crew  successively  died  from  yellow  fever. 

There  were  altogether  eight  attacks,  followed  by  as 
many  death.  The  first  case  erupted  on  August  28th,  fol- 
lowed by  death  on  September  3rd,  the  last  case,  October 
10th.  I 

The  disease  did  not  spread  to  the  shore,  according  to 
Chervin,^^  Moreau  de  Jonnes,-^  Robert-'''  and  Berenger- 
Feraud,^^  from  whose  works  this  summai'y  is  taken.  Tlie 
source  of  infection  in  this  instance  was  undoubtedly 
Havana.  It  is  true  that  yellow  fever  was  also  prevailing 
at  Malaga,  where  the  Cohnnhia  touched  on  her  voyagei 
from  Providence  to  Marseilles,  but  the  fact  that  the  fever 
only  erupted  at  Marseilles  after  the  ship  had  begun  dis- 
charging a  cargo  consisting  among  other  things  of  1,000 

^Chervin:     Examen    des    Principes     de     rAdministration    en 

Matiere  Sanitaire  (Paris),  1827,  p.  38. 
^Moreau  de  Jonnes:    Notice  sur  les  Enquetes  Officieles  Con- 

statant  la  Contagion  de  la  Fievre  Jaune  et  de  la  Paste 

(1825),  p.  4. 
"Robert:    Guide  Sanitaire  des  Gouvernemen  Europeans  (Paris, 

1826),  vol.  2,  pp.  470;   708. 
"Berenger-Feraud:    Traite  Theorique  et  Clinique  de  la  Fievre 

Jaune  (Paris,  1890),  p.  72. 


FRANCE MARSEILLES,   1804.  377 

barrels  of  sugar  from  Haivana,  is  strong  enough  evidence 
to  incriminate  the  Cuban  port.  Mosquitoes  are  proverb- 
ially fond  of  sugar,  and  a  few  of  these  infected  insects 
were  undoubtedly  taken  on  board  at  Havana,  where  yel- 
low fever  was  epidemically  present  at  the  time  of  loading. 
As  the  ship  sailed  further  north,  the  mosquitoes  secreted 
themselves  in  the  remotest  corners  of  the  hold,  where  the 
cold  could  not  penetrate,  remaining  hidden  while  the  ves- 
sel was  at  ProA'idence,  and  only  reappeared  at  Marseilles 
when  the  unloading  of  the  sugar  was  begun.  It  was  lucky 
for  the  inhabitants  of  Marseilles,  that  the  first  cases 
erupted  on  board,  and  that  the  summer  was  almost  over, 
for  had  the  Columbia  arrived  a  month  previously,  the  in- 
fected mosquitoes  would  probably  have  inoculated  her 
large  non-immune  population  and  contaminated  the  town. 

1804. 

Marseilles  had  another  narrow  escape  from  yellow  fever 
invasion  in  1804. 

The  Damish  brig  Lc  GuiUaumc,  from  an  English  port, 
touched  at  Malaga  in  August,  1801,  where  she  was  con- 
taminated and  lost  one  of  her  crew  while  at  that  port, 
August  25th.  She  left  for  Marseilles  in  September,  and 
lost  two  more  of  her  crew  on  the  voyage.  She  arrived  at 
the  French  port,  on  October  8th,  and  was  ordered  to  pro- 
ceed to  quarantine.  While  at  the  lazaret,  a  midshipman 
was  attacked  on  October  13th.  Two  of  the  health-guards 
contracted  the  disease,  one  on  October  15th,  the  other  on 
the  25th.  All  these  cases  proved  fatal.  Total  number  of 
cases,  eight;  one  at  Malaga,  two  at  sea  and  tliree  at  the 
lazaret. 

The  following  infected  ships  were  also  brought  yellow 
fever  to  Marseilles,  in  1801 : 

The  Danish  ship  Limpte,  from  3Ialaga.  One  case  at 
Lazaret. 

An  unnamed  Danish  ship  from  ^lalaga.  One  death, 
October  15th,  at  lazaret. 


37 8  HISTORY    OF    YELLOW    FEVER. 

The  Danish  ship  Bonheiir  de  la  Famille,  from  Malaga. 
Arrived  at  Marseilles  October  22nd.  Two  deaths  from 
yellow  fever  on  voyage  from  Malaga.  |The  captain  was 
attacked  on  the  day  of  the  ship's  arrival  and  died  at  the 
lazaret  on  the  31st. 

The  Swedish  brigantine  Amitie  arrived  at  Marseilles,  on 
November  13th,  after  having  touched  at  Seville,  Malaga 
and  Alicante,  all  infected  ports.  Several  deaths  while  at 
sea.  Four  of  the  crew  were  ill  with  yellow  fever  when 
the  ship  reached  the  lazaret,  two  dying  on  the  16th.  The 
captain  died  on  November  20th.  Three  other  cases  erupted, 
there  resulting  altogether  eight  deaths,  four  of  which  were 
from  the  vessel  and  foui*  erupting  at  the  lazaret.^'-^ 

In  none  of  the  above  instances  was  the  disease  com- 
municated to  the  shore. 

1807. 

(On  August  20th,  1807,  the  American  schooner  Fame, 
from  Boston,  Avith  a  crew  of  six,  arrived  at  Marseilles. 
The  captain  claimed  that  he  had  not  touched  at  any  port 
on  his  way  from  Boston,  l)ut  the  vessel  was  nevertheless 
sent  to  quarantine,  and  only  released  on  September  3rd. 
Eight  days  afterwards,  the  captain  was  taken  sick  and 
died  on  shore  with  all  the  symptoms  of  yellow  fever.  No 
other  case  erufited,'^^ 

1811. 

The  sporadic  cases  of  yellow  fever  observed  at  Mar- 
seilles, in  1811,  were  evidently  imported  from  Spain,  as 
the  maritime  annals  of  that  port  are  silent  concerning  the 
prevalence  of  the  disease  on  ships  coming  from  the  An- 
tilles. The  vomito  negro  was  epidemic  in  Cadiz,  Cartha- 
gena,  Alicante  and  other  populous  cities  of  Spain  that 
year,  and  was  no  doubt  brought  to  Marseilles  by  refugees 

=°  Robert:    Guide  Sanitaire,  vol.  2,  pp.  472;  719.    Also:  Berenger- 

Feraud,  loc.  cit.,  p.  79. 
^  Berenger-Feraud,  loc.  cit.,  p.  S2. 


FRANCE MARSEILLES,    1811.  379 

from  the  Spanish  Court,  who  sought  safety  in  flight  from 
the  intrigues  of  the  plotters  against  the  throne  of  the  un- 
fortunate weakling,  Charles  IV,  whoi  during  his  entire 
shameful  reign,  was  under  the  influence  of  his  wife  and 
her  paramour,  Godoy. 

The  weather  conditions  in  Marseilles,  in  1811,)  were 
abnormal.  The  summer  months  were  excessively  hot, 
wheat  and  leguminous  plants  withering  before  attaining 
maturity,  the  torrid  rays  of  the  sun  parching  the  earth 
and  drying  up  springs  and  streams.  Fulminating  apo- 
plexies, bilious  disorders  and  even  cholera-morbus  were 
almost  epidemic,  and  fevers  generally  assumed  a  grave 
or  fatal  type.^^  Under  such  conditions,  it  is  not  surpris- 
ing that  yellow  fever,  once  introduced,  obtained  a  tem- 
porary foothold  in  the  town,  and  the  only  reason  Avhy  it 
did  not  attain  epidemiological  proportions,  is  no  doubt 
due  to  the  absence  of  the  Stegomyla  Calopus  from  the 
localities  where  the  cases  mentioned  by  Eobert  were  ob- 
served. Had  these  carriers  of  infection  been  present,  Mar- 
seilles would  no  doubt  have  experienced  a  pestilence  which 
would  have  been  appalling  in  its  results. 

We  have  been  unable  to  find  any  complete  statistics 
concerning  this  outbreak.  Robert  mentions  that  he  at- 
tended many  cases,  eleven  of  which  proved  fatal. ^^ 
Among  his  patients  were  de  Villena,  the  faithful  field- 
marshall  and  grand  chamberlain  of  Charles  IV,  who  died 
with  black  vomit  a  week  after  being  attacked.  Another 
victim  was  Father  Fernandes,  also  an  attache  of  the 
Spanish  Court.  Robert,  who  is  an  authority  on  yellow 
fever,  says  he  cannot  be  mistaken  as  to  the  natui-e  of  the 
disease.  He  was  in  attendance  daily  at  the  bedside  of 
the  two  Spaniards,  having  been  requested  by  their  sov- 
ereign to  give  them  the  best  medical  care  and  minutely 
describes  every  phase  of  tlie  malady  which  carried  them 
off.  The  illustrious  French  physician  also  gives  a  clini- 
cal history  of  nine  other  cases  in  his  practice  which  ter- 


'^  Robert,  loc.  cit.,  vol.  1,  p.  104. 
'=  Robert,  loc.  cit.,  vol.  1,  p.  104. 


380  HISTORY    OF    YELLOW    FEVER. 

minated  fatally,  making  in  all  eleven  cases.  There  prob- 
ably were  other  manifestations  of  the  disease,  as  Robert 
only  reports  the  cases  which  came  under  his  personal 
observation,  but  we  were  unable  to  find  any  authentic 
evidence  bearing  on  the  subject.  The  first  case  rejHjrted 
by  Robert,  that  of  de  Yillena,  erupted  on  Sunday,  August 
4th,  1811,  and  died  on  August  llth.^^  The  last  case  was 
attacked  on  September  2Gth,  and  died  on  October  loth.^"* 
The  fact  that  the  malady  first  manifested  itself  in  refu- 
gees from  Spain,  where  yellow  fever  was  almost  general, 
strenghtens  the  theory  that  it  was  imported  from  that 
country.  Robert,  like  most  observers  of  his  day,  attri- 
butes the  eruptions  to  abnormal  weather  conditions,  a 
dogma  which  seemed  rational  then,  but  which  modern 
medical  science  has  relegated  to  oblivion. 

1820. 

In  the  month  of  July,  1820,  two  soldiers  who  formed 
part  of  a  sanitary  cordon  on  the  sea-shore  in  the  neigh- 
borhood of  Martigues,  a  town  in  the  department  of 
Bouches-du-Rhone,  France,  twenty-one  miles  southwest  of 
Aix,  were  transported  to  the  hospital  at  Marseilles/where 
they  died  two  days  afterwards  with'  the  characteristic 
symptoms  of  yellow  fever.  There  was  no  diffusion  of  tlio 
disease.^*" 

1821. 

The  yellow  fever  epidemic  which  prevailed  in  the  quar- 
antine slip  of  tlie  Island  of  Pomegue,  in  the  harbor  of 
Marseilles,  in  the  fall  of  1821,  is  interesting  from  a  point 
of  transmission  and  proves  the  danger  of  mooring  infected 
vessels  in  the  immediate  vicinity  of  uncontaminated  ones. 
That  the  wind  blew  infected  mosquitoes  from  one  vessel 
to  another,  the  history  of  the  progress  of  the  epidemic 

■^  Robert,  loc.  cit.,  vol.  1,  p.  113. 
=*  Robert,  loc.  cit,  vol.  1,  p.  125. 
"  Robert,  loc.  cit.,  vol.  1,  p.  142. 


IONS    OF  THE    VESSELS    IN  THE    QUARANTINE    SLIT    AT 
MARSEILLES  DURING  THE  EPIDEMIC  OF  1821. 


FRANCE MARSEILLES,     1821.  381 

plainly  shows.  It  was  impossible  for  the  shijDs  in  the 
quarantine  basin  to  communicate  with  each  other,  as 
health-guards  were  stationed  on  every  one  of  them,  and 
the  distance  between  each  vessel  Avas  too  great  to  admit) 
of  communication  without  having  recourse  to  boats.  As 
all  boats  had  been  ordered  by  the  authorities  to  be  hoisted 
high  above  the  water,  only  craft  convening  provisions  and 
the  sick  or  dead  being  allowed  to  communicate  with  the 
island,  no  other  mode  of  infection  than  the  mosquito- 
laden  Avind  can  be  incriminated. 

The  facts  of  this  memorable  epidemic,  as  related  by 
Robert,^^  Eager,^'  Berengert-Feraud^^  and  Melier,^'^  are 
as  follows: 

Yellow  fever  was  committing  fearful  ravages  in  Spain, 
in  1821,  and  it  was  natural  that  the  disease  should  make 
its  appearance  sooner  or  later  at  one  of  the  j)orts  of 
France.  Anticipating  this,  the  authorities  ordered  that 
the  strictest  quarantine  be  observed,  a  precaution  which 
evidently  proved  the  salvation  of  Marseilles,  as  subsequent 
events  demonstrated. 

;0n  September  7th,  1821,  the  Danish  brig  Nicolino,  Cap- 
tain Mold  arrived  at  the  lazaretto  of  Marseilles  (on  the 
Island  of  Pomegue),  with  a  history  of  yellow  fever  on 
board.  The  vessel  had  come  direct  from  Malaga,  an  in- 
fected port,  where  it  had  remained  from  July  3rd  to 
August  26th. 

On  September  1st,  while  en  route  to  JNIarseilles,  a  sailor 
named  Jenwersen,  aged  20,  was  taken  ill,  but  was  con- 
valescent when  the  NicoUno  entered  quarantine.  On  Sep- 
tember 2nd,  four  days'  journey  from  Marseilles,  another 
sailor,  Stobuy,  aged  23,  was  taken  ill.  The  poor  fellow 
was  abandoned  by  his  companions  and  died  on  Septem- 
ber 3rd.  His  corpse  was  thrown  into  the  sea,  together 
with  all  his  clothes,  bedding,  etc. 

'"  Robert,  loc.  cit.,  vol.  1,  p.  622. 

"Eager:    Yellow  Fever  Institute  Bulletin  No.  8   (Washington, 

D.  C),  1902,  p.  26. 
''Berengfer-Ferand,  p.  9S. 
^'Melier:    Fievre  Jaune  a  Saint-Nazaire  en    1861. 


382  HISTORY    OF    YELLOW    FEVER. 

On  September  8th  the  hatches  of  the  'Nicolino  were 
opened.  The  imprisoned  mosquitoes  undoubtedly  began 
spreading  the  infection  from  that  date,  as  subsequent 
events  will  demonstrate. 

On  September  11th,  four  days  after  the  'NicoUno's 
arrival,  a  third  sailor  was  taken  ill.  He  was  sent  to  the 
lazaretto  on  the  13th,  and  died  the  following  day. 

At  this  time,  there  were  forty-one  vessels,  practically 
from  all  parts  of  the  world,  in  the  quarantine  slip.  The 
position  of  each  vessel  will  be  better  understood,  by  re- 
ferring to  the  plan  which  accompanies  this  account,  taken 
from  the  works  of  Robert  and  Melier.  As  the  illus- 
trious French  nosologists  do  not  always  mention  the  name 
of  the  vessel,  but  in  most  instances  gives  only  that  of 
the  captain,  we  have  inserted  the  latter  where  the  former 
was  not  obtainable. 

The  vessels  infected  were  as  follows : 

I.  The  Nicolino,  the  original  focus  of  infection. 

II.  The  Comte-de-Goes,  Captain  Chiozotto,  arrived 
from  Saint-Jean-d'Acre  and  Cyprus,  August  29th.  Moored 
next  to  the  Nicolino.  On  September  8th,  while  taking 
the  breeze  on  the  bridge  of  his  vessel.  Captain  Chizotto 
was  incommoded  by  the  foul  odors  emenating  from  the 
hold  of  the  Nicolino.  Knowing  that  the  vessel  was  in- 
fected, he  was  greatly  alarmed  and  fled  to  his  cabin,  ex- 
claiming "Somo  morto!"^^  He  was  stricken  with  yellow 
fever  on  the  13th,  and  died  on  the  15th.  The  infection 
spread  to  the  balance  of  the  crew,  composed  of  twenty-one 
persons,  resulting  in  ten  cases  and  five  deaths,  including 
the  captain. 

III.  The  Saint-Georfjes,  Captain  Demorre.  Arrived 
at  Pomegue  September  3rd,  from  Aigles,  Spain.  Moored 
to  the  northwest  of  the  Nicolino,  from  which  it  was  sepa- 
rated by  the  Stevens.  Two  sailors  taken  ill  September 
14th,  died  the  following  day.  There  were  altogether 
eight  cases  and  four  deaths. 


*"'I  am  a  dead  man!" 


FRANCE MARSEILLES 1841.  383 

IV.  The  CatlierlnG,  Captain  Simon.  Left  Malaga, 
August  19th,  and  arrived  at  Marseilles,  September  3rd. 
Was  placed  in  the  quarantine  basin,  to  the  northwest  of 
the  Nicolino.  A  sailor  was  taken  ill  September  14th,  and 
died  on  the  21st.  Four  additional  cases  erupted,  followed 
by  recovery. 

V.  Captain  Bexfield's  ship,  from  Xante,  arrived  on 
September  7th,  and  anchored  next  to  the  NicoUno,  on 
the  northwest.  A  cabin-boy  and  a  sailor  were  taken  ill 
September  11th,  and  the  captain  on  the  14th.  All  re- 
covered. 

YI.  Floating  Dock,  about  fifty  metres  to  the  S.  S.  E. 
of  the  Nicolino.  A  man  who  was  working  on  this  dock 
was  taken  ill  September  20th.  He  was  discharged  cured 
from  the  lazaretto  October  18th. 

VII.  Captain  Matiovich's  vessel,  from  Alexandria, 
Egypt.-  Arrived  September  9th.  Moored  to  the  north- 
west of  the  NoGolbio,  from  which  it  was  separated  by  six 
vessels.  A  sailor  was  taken  ill  on  September  22nd.  He 
recovered. 

IX.  Captain  Vinello's  ship.  Moored  to  the  southeast 
of  the  Nicolino,  from  which  it  was  separated  by  the  Coiitte- 
de-Goes.     Two  cases  erupted  on  board,  followed  by  death. 

Seven  other  vessels  were  contaminated,  making  sixteen 
in  all,  out  of  a  total  of  forty-two  which  were  lying  at 
anchor  in  the  quarantine  basin,  including  the  Nicolino. 
All  the  vessels  where  cases  occurred  were  lying  to  the 
windward  of  the  Nicolino.  This  encouraged  the  general 
belief  of  tlie  period,  that  yellow  fever  was  carried  by  the 
wind.  Eobert  and  others  brought  this  prominently  into 
view,  giving  as  incontrovertible  proof  of  tlie  correctness 
of  this  dogma^  that  the  "foul  ordors"^i  fpojj-i  the  hold  of 
the  Nicolino  were  carried  by  the  wind  to  the  vessels  which 
afterward  became  infected.  Of  course,  we  of  tliis  enlight- 
ened age  know  that  the  wind  merely  accelerated  the  emi- 
gration of  the  Stegomyia  calopns,  but  the  illustrious  med- 
ical men  of  the  period  did  not  have  twentieth  century 


*^  "Les  odeurs  infectes." 


3S4i  HISTORY    OF    YELLOW    FiLVER. 

spectacles,  and  could  only  formulate  myopic  theories. 

A  few  cases  were  also  observed  on  sliore.^- 

On  September  23rd,  a  case  erupted  in  tJie  heairt  of  Mar- 
seilles, This  was  a  health  officer,  who  having  been  em- 
ployed in  cleaning  the  quarantine  quarters,  was  sent  to 
the  lazaretto  when  yellow  fever  appeared  in  the  shipping. 
He  was  released  after  ten  days'  detention,  and  returned 
to  his  lodgings  in  town.  He  wais  shortly  afterward  at- 
tacked with  yellow  fever.  He  was  immediately  sent  back 
to  the  lazaretto,  together  with  all  the  inmates  of  the 
house  where  he  was  stopping.  The  man  died,  but  none 
of  his  companions  contra.cted  the  disease. 

Another  case  erupted  in  a  hospital  at  Marseilles,  in  the 
person  of  a  sailor  who  had  come  by  laud  from  Barcelona, 
Spain.     He  was  sent  to  the  lazaretto. 

A  Danish  ship,  commanded  by  Captain  Fohn,  left  Mal- 
aga, Spain,  September  20th,  and  arrived  at  Marseilles, 
October  1st.  The  captain  was  ill  and  three  of  the  crew 
liad  died  from  yellow  fever  on  the  voyage  from  Malaga. 
Fearing  to  again  kindle  the  fires  of  contagion,  the  author- 
ities positively  prohibited  the  vessel  from  landing  and 
forced  her  to  take  to  sea  again.  The  doomed  vessel  was 
buffeted  by  the  waves,  and  finally  struck  a  reef  near  the 
shore,  foundered  and  was  burned  to  the  water's  edge. 
The  captain,  with  the  remnant  of  his  crew,  were  sent  to 
the  lazaret  at  Pomegue.  One  of  the  sailors  developed 
yellow  fever,  on  October  10th.     The  patient  recovered.'*" 

Tlie  government  thought  it  was  face  to  face  with  an  in- 
vasion of  yellow  fever,  and  communicated  with  the  cele- 
brated Professor  Palloni,  who  had  been  through  the  yel- 
low fever  epidemic  of  1804,  at  Leghorn,  and  whose  advice 
was  no  doubt  largely  instrumental  in  preventing  the 
spread  of  the  disease. 

The  first  case  occurred  September  7th ;  the  first  death, 
September  11th.  Last  case,  October  10th;  last  death, 
October  6th. 


*=  London  Medical  and  Physical  Journal,  1821,  vol.   46,  p.  463. 
*'Berenger:    Feraud,  loc.  cit.,  p.  99. 


FRWrK  -  MARSEILLES,      1823  385 

Cases  and  deaths:  At  lazaretto,  25  cases;  12  dearths. 
At  Marseilles,  2  cases ;  1  death.     Total,  27  cases,  13  deaths. 

1823. 
An  American  ship.  Captain  Thomas,  left  New  Orleans 
for  Marseilles,  on  September  21st,  1822,  and  arrived  at 
her  destination,  November  19th.  Dnring  the  V03^age,  two 
deaths  occurred  from  some  "'unexplained  cause,"  accord- 
ing tO'  the  statement  of  the  captain.  As  yellow  fever  was 
prevailing  at  New  Orleans,  when  the  vessel  sailed,  these 
two  deaths  Avere  undoubtedly  due  to  the  disease.  On  ar- 
riving at  Marseilles,  the  vessel  was  sent  to  the  quaramtine 
station,  at  Pomegue.  On  November  29th,  a  sailor  was 
taken  ill  and  sent  to  the  lazaretto,  as  his  case  appeared 
suspicious.  He  recovered  in  a  few  dajs  without  showing 
any  of  the  symptoms  of  yellow  fever,  and  was  sent  back 
to  Lis  ship  on  December  lOtli.  Nothing  untoward  hap- 
]»ened  until  January  21th,  1823,  when  this  same  sailor 
A^as  suddenly  taken  ill  and  died  at  the  lazaretto  in  thirty- 
six  hours.  The  autopsy  revealed  unmistakable  lesions  of 
yeiloAv  fever.^"^  \ 

This  case  greatly  puzzled  the  learned  medical  men  of 
the  period.  They  knew  nothing  of  the  mosquito  doctrine, 
and  wrote  innumerable  monographs  on  what  they  termed 
one  of  the  most  extraordinary  and  longest  incubations  of 
yellow  fever  on  record.  They  dated  the  sailor's  illness 
from  his  first  indisposition,  Novend)er  29th,  and  looked 
upon  his  fatal  illness  in  January,  as  the  culmination  of 
the  infection  contracted  on  the  previous  date. 

At  tlio  present  age,  the  incident  is  easily  explained. 
The  fact  is,  that  the  first  attack  was  not  yellow  fever, 
but  simply  some  gastric  disturbance  accompanied  by  feb- 
rile manifestations.  On  his  return  to  the  ship,  the  man's 
duties  undoubtedly  required  him  to  be  often  in  the  hold, 
wliere  he  was  evidently  bitten  by  infected  mosquitoes 
taken  on  board  at  New  Orleans. 


"Robert:      Guide     Sanitaire     des     Gouvernemens     Europeens 
(Paris,  1826),  vol.  2    p.  74r-. 


386  HISTORY    OF    YELLOW    FEVER. 

Kobert^^  gives  the  clinical  history  of  a  case  presenting 
most  of  the  symptoms  of  yellow  fever,  which  he  treated 
at  Marseilles  in  1823.  The  patient,  a  woman  aged  62, 
was  taken  ill  July  16th,  and  died  July  31st. 

1862. 

For  nearly  half  a  century  (1823  to  1862)  we  find  no 
mention  of  yellow  fever  having  been  observed  either  at 
the  quarantine  station  at  Marseilles  or  on  vessels  arriv- 
ing from  infected  ports. 

During  the  year  1862,  fifty-nine  vessels  carrying  sixty- 
nine  passengers  and  a  crew  of  792,  arrived  at  Marseilles 
from  Havana,  Matanzas,  Pernambuco,  Sainte-Croix-de- 
Teneriffe,  and  other  infected  ports.  Only  vessels  coming 
from  Havana  were  contaminated,  the  following  giving 
histories  of  yellow  fever  on  board  during  the  voyage  -^^ 

UEtoile,  14  cases,  4  deaths. 

Yille  de  Cannes,  10  cases,  3  dearths, 

Montvernon,  13  cases,  5  deaths. 

Cedars,  4  cases,  no  deaths. 

Ciirra,  2  cases,  no  deaths. 

In  none  of  these  instances  did  any  cases  erupt  while 
the  vessels  were  undergoing  quarantine,  nor  was  there  any 
diffusion  of  the  disease  on  shore. 

1870. 

In  1870,  yellow  fever  was  epidemic  in  several  cities  of 
Spain  (q.  v.),  and  the  sea  coast  towns  of  France  observed 
a  strict  quarantine  against  the  infected  localities. 

On  September  8th,  1870,  the  Spanish  vessel  Carpio 
arrived  in  the  harbor  of  Marseilles,  having  come  directly 
from  Barcelona,  where  yellow  fever  was  prevailing.  A 
quarantine  of  seven  days  was  imposed  on  the  vessel.  No 
cases  developing  on  board,  she  was  given  free  pratique. 


"Robert:    loc.  cit.,  vol.  2,  p.  140. 

^'Blache:    In  Melier's  Fievre  Jaune  a  Saint-Nazaire  (Reprint), 
p.  204. 


FRANCE MARSEILLES.  387 

The  wisdom  of  precautionary  measures  soon  made  itself 
manifest.  On  September  26th  the  Greek  ship  Argos  en- 
tered the  harbor  of  Marseilles  with  yellow  fever  on  board. 
Out  of  a  crew  of  eleven  men,  there  had  been  four  deaths 
from  that  disease — three  while  the  vessel  was  at  Barce- 
lona, and  one  while  at  sea,  September  23rd,  three  days 
before  her  arrival  at  Marseilles.  Extraordinary  precau- 
tions were  taken  to  prevent  contamination.  The  vessel 
was  completely  unloaded  and  sent  to  the  Riou,^^  where 
she  was  thoroughly  disinfected. 

A  Greek,  one  of  the  crew  of  the  Penwya,  died  at  the 
Hotel-Dieu,  the  municipal  hospital  of  Marseilles,  on  Sep- 
tember 29th.  The  autopsy  revealed  characteristic  lesions 
of  yellow  fever.  This  man  had  come  by  land  to  Mar- 
seilles. His  compatriots  on  board  the  Argos,  denied  that 
he  had  communicated  with  them,  but  the  statement  was 
disbelieved  by  the  authorities,  as  there  was  no  pestilential 
disease  on  board  the  Panaya,  and  the  inference  was  drawn 
that  the  sailors  of  the  two  ships  had  probably  mingled, 
either  at  sea  or  at  some  port  on  the  Spanish  coast,  where 
the  Greek  contracted  the  infection. ^^ 

No  other  cases  developed  at  Marseilles  in  1870. 

1891. 

On  May  17th,  1891,  the  French  ship  Beam,  from  Rio 
de  la  Plata,  South  America,  arrived  at  Marseilles  with 
yellow  fever  on  board.  The  vessel  carried  665  passengers. 
There  had  been  several  cases  and  five  deaths  during  the 
homeward  voyage.  On  arrival  at  Marseilles,  five  cases 
were  sent  to  the  lazaretto.  The  passengers  were  isolated 
for  ten  days,  after  which  time,  no  new  cases  developing, 
they  were  given  free  pratique.  Of  the  five  cases  sent  to 
the  lazaretto,  four  recovered.*^ 

"An  islet  seven  miles  south  of  Marseilles. 
«Roux:     Marseille  Medical,  1871,  vol.  8,  p.  193. 
"Skinner:     Bull.  No.  7,  Yellow  Fever  Institute    (Washington, 
D.  C),  1902,  p.  2. 


388  tllSTOKV     OF     YELLOW     KCVKR. 

1899. 


The  French  ship  Aquitaine,  from  Buenos  Ayres,  entered 
the  harbor  of  Marseilles,  on  November  3rd,  1899.  There 
had  been  a  ease  of  yellow  fever  on  board,  followed  by 
death.  Another  case  erupted  shortly  before  the  vessel 
reached  ^larseilles,  and  was  sent  to  the  lazaretto  on  her 
arrival.  The  passen<j;ers  were  released  after  three  days' 
detention.     The  patient  recovered. ''^\ 


MINDIN. 


YELLOW  FEVER  YEAR. 

1881. 

Summary  of  Lmpoktatiox. 


The  steamship  TiUc  dr  P(ni.s,  infected  at  ^fartinique, 
brou<»ht  yellow  fever  to  ]Mindin,  a  suburb  of  Nantes,  in 
1S81.'  The  vessel  left  Maitiniipie,  May  20th,  with  a  crew 
of  J  28  and  forty-five  passengers.  Among  the  latter  were 
four  convalescents  from  yellow  fever.  On  June  2nd,  thir- 
teen days  after  leaving  the  island,  tlie  first  case  occurred 
on  })oard,  followed  by  others  on  the  3rd  and  4th.  The 
vessel  arrived  at  ]Mindin  on  June  5th.  The  patients  were 
transferi'ed  to  the  lazaretto  at  ]\Iindin,  where  out  of  five 
i-ases,  four  proved  fatal.  The  disease  was  confined  to  the 
lazaretto.      (Bcrciu/cr-Fcraiul,  lor.  cit.,  p.  183). 


'■"Skinner:     Bulletin   No.   7.  Yellow   Fever  Institute    (Washing- 
ton, D.  C),  1902,  p.  2. 


MONTOIR-DE-BRETAGNE. 

•       YELLOM'  FEVEI!  YEAI!. 
1861. 

SiMMAKY  OF  Epidemic. 

Maii.y  of  the  loiigslioremeii  employed  in  discharj^ing  the 
cargo  of  the  Annc-^fa^ie  during  the  Saint-Nazaire  out- 
break of  18G1,  lived  at  ;Montoii'-de-Bretagne,  a  village 
twenty-nine  miles  west  of  Nantes.  Four  members  of  this 
gang  being  taken  ill,  knocked  off  work  and  went  home. 
They  were  attended  by  the  village  physician,  Dr.  Chaillon, 
who  also  was  attacked  by  yellow  fever  on  August  13th, 
and  died  on  the  ITth.     The  other  cases  recove^red.^^ 

.1 

MONTPELLIER. 


1821. 


YELLOW  FEVEE  YEAR. 

Summary  op  Importation. 


I 

A  single  instance  of  the  appearance  of  yellow  fever  at 
Montpellier  is  on  record.  Deveze"'-  and  Robert^'  assert 
that  eleven  soldiers  were  treated  in  the  hospital  of  that 
town  by  Broussonet,  in  1821.  The  patients  had  contracted 
the  disease  in  the  little  town  of  Rose,  a  seaport  of  Catalo- 
nia, Spain.  The  infection  did  not  spread.  Our  authori- 
ties do  not  say  whether  the  cases  died  or  recovered- 


"  Berenger-Feraud,    loc.    cit..    p.    137;    Melier,    Fievre    Jauue    a 

Saint-Nazaire. 
'^Deveze:     Memoire  au  Roi    (Paris,  1S21),   p.  14. 
"Robert:    Guide  Sanitaire,  vol.  1,  p.  104. 


NANTES. 

YELLOW   FEVER  YEARS. 
1857;  1899. 

Summary  of  Importations. 

.  1857. 

Yellow  fever  was  quite  prevalent  on  ships  in  the  harbor 
of  Nantes,  in  1857.  The  number  of  cases  is  not  stated, 
but  the  deaths  f»re  said  to  have  amounted  to  seven.^* 

1899. 

In  October,  1899,  there  were  two  cases  of  yellow  fever 
on  board  the  steamship  Navarre,  from  Vera  Cruz,  in  the 
harbor  of  Nantes.  The  cases  proved  fatal.  The  vessel 
was  sent  to  the  Saint-Nazaire  lazaretto.  No  other  cases 
erupted.  {U.  S.  Public  Health  Reports,  1899,  vol.  14,  p. 
2000.  s 

PARIS. 

1775. 

Yellow  fever  has  never  been  observed  in  Paris,  but  on 
three  occasions — 1775,  1822  and  1845 — a  disease  mani- 
festing almost  identical  symptoms  set  the  medical  world 

The  earliest  mention  of  a  disease  resembling  yellow 
fever  being  seen  in  Parish  will  be  found  in  the  works  of 
Portal, ^^  the  celebrated  French  Physician,  who  flourished 
in  the  reign  of  Louis  XVI.  Portal  mentions  several  cases 
which  came  under  his  observation,  some  even  attended 

"Skinner:  Bulletin  No.  7,  Yellow  Fever  Institute  (Washing- 
ton, D.  C),  1902.  p.  1. 

""Portal:  Observations  sur  la  Nature  et  le  Traitement  de 
Melena,  p.  174. 


FRANCE PARIS.  391 

with  black  vomit,  in  which  most  of  the  symptoms  which 
characterize  yellow  fever  were  present.  He  particularly 
describes  a  case  in  which  a  large  quantity  of  black  matter 
was  vomited,  the  description  of  which  corresponds  with 
that  of  the  true  vomit  of  yellow  fever.  One  of  the  indi- 
viduals mentioned  by  Portal  was  no  less  a  personage  than 
the  Comte  de  Vergennes,  Minister  of  Foreign  Affairs, 
under  Louis  XVI,  who  it  will  be  remembered  adopted  the 
deliberate  policy  of  humbling  England  by  promoting  the 
independence  of  the  United  States  by  the  alliance  of  1778. 

1822. 

Robert^^  and  La  Roche^^  relate  that  in  the  summer  of 
1822,  after  a  long  continuance  of  unusually  hot  weather, 
there  occurred  in  the  Hotel  Dieu,  of  Paris,  several  cases 
of  fever  accompanied  with  jaundice  and  black  vomit.  Two 
patients  were,  at  the  same  time,  similarly  affected  at  La 
Charite,  in  the  wards  of  Dr.  Lerminier,  and  several  in- 
stances of  what  was  denominated  sporadic  yellow  fever 
were  seen  in  Paris.  In  reference  to  the  patients  admitted 
in  that  hospital,  AndraP^  informs  us  that  they  had  deli- 
rium, a  black  tongue,  tympanitic  bowels,  a  jaundiced  dis- 
coloration of  the  surface  and  exhibited  evident  signs  of 
an  ataxo-adynamic  state  of  the  system.  They  both  threw 
up  a  quantity  of  a  substance  bearing  a  strong  resemblance 
to  soot — an  appearance  which,  as  we  shaJl  see,  is  often 
assumed  by  black  vomit.  La  Roche  doubts,  however,  that 
those  cases  were  anything  more  than  typhoid  fever  modi- 
fied by  the  extreme  heat  of  the  season.  One  of  the  patients 
recovered  under  the  use  of  the  most  powerful  stimuli. 
The  other  died,  and  the  autopsy  revealed  a  gastro-enter- 
itis,  with  red  softening  of  the  mucous  membrane,  and 
ulceration  of  the  intestines,  an  anatomical  character  which 
our  authority  states  does  not  belong  to  yellow  fever. 


"Robert:    Guide  Sanitaire,  vol.  1,  p.  104. 

"  La  Roche,  loc.  cit.,  p.  272. 

"Andral:   Dictionaire  de  Medecine,  1st  ed.,  vol.  21,  p.  17. 


392  HISTORY    OF    YELLOW    FEVER. 

Magendie^''  mentions,  that  at  about  the  same  period, 
eleven  cases  of  fever  occurred  in  the  hospitals  of  Paris, 
attended  with  brown  yellow  color  of  the  skin,  petechiae 
and  black  vomit. 

Lassis^^  claims  that  there  were  more  patients  ill  with 
what  is  commonly  termed  yellow  fever  in  the  hospitals  of 
Paris  in  the  month  of  April,  1822,  than  at  Barcelona  and 
Port  du  Passage  at  the  time  these  two  i)orts  were  causing 
the  medical  world  such  anxiety. 

Chervin,^!  who  is  anything  but  an  admirer  of  Dr.  Lassis, 
pokes  fun  at  the  Englishman  for  believing  that  these  cases 
were  manisfestations  of  yellow  fever,  and  criticises  him 
for  predicting  that  Paris  may  eventually  become  like  3Ios- 
cow,  Barcelona,  Marseilles,  Aries,  Aix  and  Toulon,  the 
active  seat  of  pestilential  disasters,  whose  magnitude 
would  be  unparallelled  in  the  annals  of  epidemiology. 

We  believe  that  the  stand  taken  by  tlie  eminent  La 
Roche  the  most  correct  for,  unless  imported,  yellow  fever 
cannot  under  the  most  favorable  conditions  of  weather 
and  temperature,  originate  in  Paris.  And,  even  if  the 
disease  were  accidentally  introduced  there,  it  would  not 
spread  beyond  the  imported  cases. 

1S45. 

The  (jazctte  dcs  Hopifau.v  for  August,  1845,  contains 
the  account  of  a  case  of  typhus  whicli  occurred  in  the 
wards  of  Dr.  Bayer,  at  the  Hopital  de  Charite,  Paris, 
which  presented  most  of  the  symptoms  peculiar  to  yellow 
fever.  It  may  also  be  compared  to  the  cases  observed  by 
Portal,  in  1775,  and  by  Andral  and  others,  in  1822,  men- 
tioned in  this  volume. 


"'Magendle:    Lecons  sur  les  Phenomenes  Phjsiques  de  la  Vie, 

vol.  1,  p.  117. 
°°  Lassis:     Calaniites   Resultant   du   Sj'steme   de   la   Contagion 

et  Meme  Celui  de  L'iurection   (Paris,  182 — ),  p.  19. 
"Chervin:    Examen  des  Nouvelles  Opinions  de  M.  le  Docteur 

Lasgis   (Paris,  1823),  p.  3. 


I 


FRANCE  — PARIS,      18  +  5.  S93 

Ou  the  30tli  of  June,  1845,  a  inau  named  Thomas,  of 
strong  constitution  entered  Dr.  Raver's  male  ward.  He 
had  been  ill  for  a  few  days  only.  The  following  were 
the  s^^mptoms  presented:  Yellow-orange  tinge  of  the  en- 
tire body ;  skin  dry  and  hot ;  the  eyes  and  inferior  surface 
of  the  tongue,  j-ellow;  the  superior  surface  of  the  tongue 
covered  with  a  mucous  fur;  nausea;  slight  tympanits  of 
the  abdomen,  painful  on  pressure,  in  the  right  hypoclion- 
drium;  liver  of  normal  size,  on  percussion;  stools  colored 
by  bile,  not  abundant;  urine  deeply  tinged  with  bile;  no 
abnormal  thoracic  symptom,  but  acute  pain  felt  in  the 
hepatic  region  on  deep  inspiration.  Pulse  full,  frecpient, 
but  regular.  The  patient  only  complained  of  i)ain  in 
the  right  hypochondrium,  and  of  intense  cephalagia. 
Venesection  to  twelve  ounces.  Blood  presented  a  thick 
buff.     ^ 

Jiihf  1st. — Same  state.  .Cupped  on  the  hepatic  region; 
blister  on  the  same  region.     Saline  purgative. 

Julij  2)1(1.- — Vomiting  set  in;  the  matters  vomit(Ml  were 
black  and  sanguinolent.  The  stools,  liquid  and  abundant, 
contained  black  and  feces  tinged  with  bile.  Pnlse  very 
frequent  ;  cephalagia;  somnolence;  tongue  dry  and 
cracked ;  teeth  presented  a.  brownish  crust  at  bases ;  abdo- 
men meteorized  not  painful  on  pressure. 

This  state  persisted  on  the  3rd  and  4th.  On  the  4th, 
slight  delirium  appeared.  No  spots  or  ecchymosis  on  tlu* 
skin,  universally  of  an  orange-yellow.  On  the  Oth,  Hie 
state  of  the  patient  seemed  improved.  A  number  of  small 
conial  elevations  appeared  on  every  part  of  the  body, 
similar  to  those  of  variola  in  its  first  stage.  On  the  7th, 
these  elevations  had  formed  red  ecchymotic  s])ots,  like 
those  of  haemorrhagic  roseola.  There  Avas,  however,  no 
symptoms  of  roseola.  'The  patient  appeared,  indeed,  bet- 
ter, although  still  in  a  state  of  semi-somnoleiice.  On  the 
8th,  the  somnolence  had  increased;  an  eschar  appeared  on 
the  sacrum;  the  stools  were  still  sanguinolent.  On  the 
11th,  the  eruption  disappeared;  somnolence  and  general 
depression  increased;  nausea,  ))ut  no  vomiting.     On  the 


394  HISTORY  OF  YELLOW   FEYER. 

12th,  he  remained  in  a  state  of  comatose  sleep,  and  died 
suddenly  on  the  13th. 

Autopsy,  twenty-eight  hours  after  death :  The  body  was 
in  a  state  of  advanced  putrif action,  the  epidermis  separat- 
ing with  the  greatest  case;  icteric  tinge  of  the  skin,  the 
same  as  during  life ;  no  effusion  of  blood  in  the  intermus- 
cular spaces ;  lungs  healthy,  but  containing  a  considerable 
quantity  of  mucus  and  blood;  heart,  soft,  containing 
black  blood;  mucous  membrane  of  the  stomach  softened, 
of  the  color  of  dregs  of  wine;  duodeum  presented  traces 
of  sanguineous  suffusion,  and  contained  yellow  bile;  the 
rest  of  the  intestines  contained  mucous,  colored  with  bile ; 
Peyer's  glands  were  not  enlarged;  no  morbid  alteration 
in  the  large  intestine;  the  liver  presented  the  usual  vol- 
ume, being  soft,  of  an  uniform  icteric  tinge;  the  vena 
porta,  vena  cava  and  its  principal  divisions  were  healthy, 
and  contained  black  fluid  blood;  the  biliary  vesicle  con- 
tained a  considerable  quantity  of  blood;  the  spleen  was 
soft,  of  normal  volume;  the  kidneys,  soft,  yellow,  nearly 
diffluent ;  the  brain,  soft,  and  presenting  the  icteric  tinge.*^^ 

1883. 

According  to  Berenger-Feraud,  a  case  of  yellow  fever 
was  observed  in  Paris,  in  1883,  in  the  person  of  a  diplo- 
mat, "who  had  handled  dispatches  coming  from  an  in- 
fected country."  Beyond  giving  his  source  of  information 
as  "les  journaux  politiques,"  our  authority  is  mum.  We 
have  made  a  strenuous  search  through  the  French  period- 
icals for  the  year  1883  and  1884,  on  file  in  the  Library 
of  the  Surgeon-General's  Office,  at  Washington,  but  find 
no  mention  of  the  incident. 

The  Parisian  Mosquitoes  atid  Yellaw  Fever. 

It  is  within  the  range  of  possibility  that  the  mosquitoes 
of  Paris  could  convey  the  yellow  fever  vims.     The  alarm- 

♦  Lancet  (London),  1845,  vol.  2,  p.  231. 


sti 


FRANCE PARIS.  395 

ing  increase  of  mosquitoes  in  the  capital  of  France  was 
the  theme  for  animated  and  interesting  discussions  by  the 
medical  societies  of  the  metropolis  a  few  years  ago.  At 
the  session  of  the  Academic  de  Medicine  de  Paris,  April 
9-13,  1901,  Dr.  Debove  called  the  attention  of  his  con- 
freres to  the  fact  that,  in  certain  districts  of  Paris,  mos- 
quitoes were  so  numerous  as  to  incommode  the  inhabi- 
tants to  a  great  extent,  and  intimated  that  summary  meas- 
ures should  be  instituted  to  mitigate  the  nuisance. ^^ 

J)r.  Laveran  observed  that  mosquitoes  were  certainly 
more  numerous  in  Paris  than  formerly,  and  ascribed  this 
fact  to  the  vast  number  of  places  Avhere  stagnant  water 
was  allowed  to  remain.  The  learned  scientist  argued 
that  it  should  be  an  easy  task  to  educate  the  people  to 
adopt  measures  to  destroy  the  pests.  If  the  population 
were  instructed  that  the  smallest  amount  of  stagnant 
water  is  sufficient  to  engender  enough  mosquitoes  to  in- 
fect an  entire  district,  they  would  be  more  careful.  The 
Pasteur  Institute  had  been  appealed  to  by  many  indus- 
trial establishments  of  Paris  to  devise  means  to  destroy 
m(x«quitoes,  and  had  given  advice  which  had  already  been 
attended  by  beneficial  results. 

Dr.  Laveran  further  observed  that  the  mosquitoes  of 
Paris  were  of  the  culex  variety,  which  are  positively 
known  to  transmit  filaria  and  malaria.  The  former  dis- 
ease was  very  rare  in  Paris,  but  the  latter  was  quite  com- 
mon, and  its  prevalence  could  no  doubt  be  traced  to  the 
insects  under  discussion. ^^ 

Dr.  Farabeuf,  in  concluding  the  discussion,  related  his 
experience  at  Bourg-la-Reine*'^  and  and  L'Hay,  near  Paris, 
where  the  mosquitoes  were  undoubtedly  responsible  for 
the  many  febrile  disturbances  which  made  life  anything 
but  agreeable  at  these  places.     Measures  should  be  taken 


"Bulletin  Medical  (Paris),  1901,  vol.  15,  p.  319. 
"Ibid,  508. 

"  Bourg-la-Reine  is  a  town  on  the  Seine,  five  miles  southwest 
of  Paris. 


396  HISTORY    OF    VEM.OW     FEYER, 

at  once  to  extcTminate  tliese  insects,  pr  the  localities  in 
qnestion  would  in  the  near  future  become  uninhabitable.^^ 

The  question  was  also  taken  up  by  the  Societe  de  Biol- 
ogic de  Paris,  at  its  session  held  June  1st,  1901.  The 
trend  of  the  discussion  was  the  best  mode  of  protection 
against  the  stings  of  mosquitoes.  It  was  generally  ad- 
mitted by  the  speakers  that  most  of  the  methods  popularly 
u,s<k1,  such  as  essences  and  oils,  were  practically  of  no 
value,  affording  only  temporary  immunit}-,  as  the  mos- 
quitoes finally  got  used  to  the  odor  and  became  as  aggres- 
sive as  ever.*^' 

Dr.  Laveran  said  that  the  only  sure  mode  of  immunity 
Mas  to  jjrotect  the  hands  by  gloves,  and  to  wear  a  A'eil,  so 
as  U)  protect  the  face  and  neck.  This  was  the  plan  in 
vogue  by  most  of  the  railroad  employes  in  the  malarial  dis- 
tricts of  Italy.  Perfumed  oils  Avas  no  protection  against 
the  stings  of  the  insects. *^^ 

Dr.  Laveran's  idea  is  certainly  the  most  efficacious,  but 
we  doubt  very  much  that  the  dandies  of  Paris  would  take 
kindly  to  the  fashion  of  wearing  veils. 

Dr.  de  Gouvea,  a  Brazilian  scientist  who  had  taken 
refuge  in  Paris  after  the  revolution  of  1803,  sounded  an 
additional  note  of  warning  in  an  exhaustive  article  en- 
titled Lcs  Moustiqiics  et  la  Fievrc  J  nunc,  in  which,  among 
other  things,  he  cited  the  historic  epidemic  of  Saint- 
Nazaire  to  prove  the  facility  with  Avhich  yellow  fever  can 
be  transmitted  by  mosquitoes.®'-^ 

ROCHEFORT. 

1004. 

Was  it  yellow  fever  w)uch  devastated  Rochefort  iti 
1004? 


•^"Bulletin  Medical,  loc.  cit.,  p..  341. 
"Bulletin  Medical,  loc.  cit.,  p.  508. 
"'  A  statement  which  can  be  vouched  for  by  the  writer,  who 

has  tried  the  experiment  in  New  Orleans. 
"'De  Gouvea:    Bulletin  Medical,  1901,  vol.  15,  p.  861. 


FRANCE ROCHEFORT,     lGll4.  397 

La  Kodie'*^  clainis  that  tbei-e  can  be  no  doubt  on  that 
score,  and  cites  Chirac  in  support  of  this  contention. 
INIany  autliors,  among  whom  are  sucli  eminent  authorities 
as  Pringle,"^  Boisseau,'-  Bercnger-F?raud"'^  and  Kerau- 
dreu'^  hold  the  view  tliat  the  epidemic  under  discussion 
was  eitlier  typlioid  or  tlic  plague,  an  opinion  we  are  in- 
clined to  share,  after  a  careful  perusal  of  the  writings  of 
the  illustrious  Chirac. 

Yellow  fever  may  have  l)e;'n  l)rouglit  to  IJochefort  in 
1G94  and  occasioned  some  mortality,  but  what  is  com- 
monly understood  as  the  ''great  epidemic"  of  that  year 
was  undoubtedly  the  bubonic  plague  of  the  Orient,  prob- 
ably brought  by  s]ii]»s  fjom  the  eastein  ])orts  of  the 
Mediterranean. 

Chirac,'^'''  who  was  sent  by  Louis  XIV  to  study  auel  re- 
port upon  the  malady  wliidi  was  then  devastating  Ivoche- 
fort,  had  exceptional  facilities  for  observation,  anel  pub- 
lished th(^  result  of  his  researches  in  two  volumes.  The 
work,  which  is  printed  in  tlu^  cpiaint  old  French  style  of 
the  period,  goes  into  tlie  minutest  eletails,  and  is  an  ael- 
mirable  exposition  of  tlie  peculiar  views  of  medicin-e  in 
general  held  by  the  learned  medicos  who  nourished  in  the 
reign  of  the  Grand  Monarch. 

We  note  from  Chirac's  obscn-vations  tliat  most  of  the 
diseases  which  ])revailed  at  Ilochefort    in  1(>04    assumed 


'"La  Ro^che:  Yellow  Fever.  Considered  in  its  Historical, 
Pathological,  Etiological  and  Therapeutical  Relations 
(Phila.,  1855),  vol.  1,  p.  48. 

'^Pringle:  Observations  on  Diseases  of  the  Army  (London, 
1800),  p.  323. 

"Coisseau:  Physiological  Pyretology;  cr,  A  Treatise  on 
Fevers  (Phila.,  1832),  p.  333. 

"  Berenger-Feraud:  Loc.  cit.,  p.  35. 
'^Keraudren:    Projct  de  Reglement,  etc. 


S98  HISOORV    OF    YELLOW    FEVER. 

a  grave  character.  An  epidemic  of  small-pox  was  fol- 
lowed by  one  of  measles,  and  when  the  latter  had  sub- 
sided, fevers  of  a  malignant  and  dealy  type  asserted  them- 
selves. These  fevers  were  eventually  absorbed  in  June  by 
the  pestilential  malady  under  discussion,  which  carried: 
away  two- thirds  of  those  who  were  attacked.''^^  It  wasj 
especially  mortal  in  July  and  August  and  began  to  sub- 
side by  the  end  of  the  latter  month,  after  a  series  of  heavy 
rains  had  filled  the  swamps  about  Rochefort  and  seemed 
to  purify  the  air,  which  during  the  dry  season,  "smelled 
like  burning  gunpowder."'^'^ 

The  symptomatology  of  the  disease,  which  is  minutely 
and  graphically  described  by  Chirac,  leaves  no  doubt  as  to 
its  nature.  The  malady  was  ushered  either  by  a  chill  or 
by  an  intensely  cold  sensation,  with  acute  headache  and 
a  sensation  of  extreme  heaviness.  The  pulse  became  small, 
there  was  a  general  feeling  of  faintness,  attended  by  an 
incessant  agitation  of  the  limbs.  The  facies  became  lead- 
en-hued  and  cadaveric.  In  some  instances,  the  eyes  were 
dull;  in  others,  sparkling  and  restless.  Nausea  and  vom- 
iting were  constantly  present,  many  never  refraining  their 
natural  warmth,  but  being  as  cold  as  marble  when  death 
put  an  end  to  their  sufferings.  Cold  sweats  and  a  com- 
plete coma  generally  preceded  death.     (Page  53). 

In  the  the  majority  of  cases,  the  parotid  glands  were 
affected  and  buboes  appeared  in  the  axillary  regions, 
but  were  rarely  seen  in  the  inguinal  regions.  Those  in 
which  buboes  appeared  on  the  fourth,  fifth  or  sixth  day, 
generally  succombed :  in  cases  where  the  buboes  only  ap- 
peared on  the  seventh,  eiahth  or  ninth  day,  recovery  gen- 
erally ensued.  In  some  cases,  carbuncles  broke  out  on  the 
face  and  hands,  a  symptom  which  was  generally  followed 


"  "Cette  maladie,  qui  fit  perir  les  deaux  tiers  de  ceaux  qui 
etoient  attaques,  ne  relacha  and  ne  finit  que  par  des 
grandes  pluyes  qui  arriverent  a  la  fin  du  moi  d'Aout,  et  gui 
remirent  de  I'eau  dans  les  mares  et  dans  tous  les  marais 
deffeches  dt  la  prairie." — Chirac,  vol.  1,  p.  57. 

7-  ■<*   *    *   jjjjg  odeur  de  poudre  brulee." — Chirac,  vol.  1,  p.  31. 


FRANCE ROCHEFORT,     It 94.  S99 

by  death.  The  stools  were  either  serous,  greenish,  dark, 
viscous  or  sanguinolant,  and  very  often  dysenteric.  Hem- 
orrhages from  the  nose  were  frequent.  The  urine  was 
natural  up  to  the* fourth  day  of  the  onset,  after  Avhich  it 
became  either  red  or  very  dark  until  the  end  of  the  attack. 
When  poured  in  a  vessel,  it  left  a  reddish  residue,  which 
resembled  brick-dust.     (Page  55). 

Such  is  the  description  given  by  Chirac.  We  have  made 
as  literal  a  translation  of  the  original  text  as  possible. 
It  does  not  require  a  Board  of  Experts  to  arrive  at  the 
deduction  that  the  malady  in  question  was  not  yellow 
fever.  The  symptoms,  though  not  exactly  those  of  the 
bubonic  plague,  are  so  nearly  identical,  as  to  easily  lead 
to  the  conclusion  that  the  pestilence  of  Rochefort  was 
simply  a  milder  manifestation  of  that  terrible  disease. 

How  such  an  astute  observer  like  La  Eoche  should  have 
been  led  into  error  by  the  description  of  Chirac,  is  beyond 
our  comprehension.  La  Roche's  work  is  a  classic  and  a 
monument  to  the  author's  genius  and  versability  and  this 
faux-pas  merely  goes  to  show  that  even  the  greatest  minds 
are  not  infallible. 

Whether  it  was  the  bubonic  plague,  yellow  fever  or 
typhoid  which  devastated  Rochefort,  in  1694,  there  is  no 
doubt  that  the  French  government  was  taking  extraor- 
dinary precautions  that  year  to  prevent  the  importation 
of  the  Antillean  pestilence  to  its  shores.  A  search  into 
the  musty  records  of  that  period  reveals  the  fact  that  the 
maritime  archives  of  Rochefort  contain  a  letter  from  the 
Minister  of  Marine  (the  renowned  Pontchartrain),  dated 
September  15th,  1694,  in  which  this  dignitary  states  that 
he  has  been  informed  that  the  disease  (yellow  fever)  was 
still  raging  in  the  "American  Isles,"  and  that  it  was  im- 
portant that  steps  should  be  taken  to  prevent  its  introduc- 
tion into  the  kingdom.  He  also  states  that  he  had  written 
to  the  admiralty  official  of  La  Rochelle  to  renew  the  meas- 
ures which  had  formerly  been  taken  against  the  crews  of 


400  HISluRV     l)K     ^KI.1,0\\      KKVER. 

ves.so.U  coming'  fi-oin  these  coiiutries  aud  to  observe  strict 
quarantine  against  infected  vessels.^'' 

The  narrow  escape  of  Aix  (q.  v.)  from  infection,  in 
IGUG,  proves  that  these  precautionary  measures  were  no  I 
taken  a  moment  too  soon. 

SAINT-NAZAIRE. 

Yeij.ow  Fevkii  Years. 

18G1 ;  1SG2 ;  ISSl ;  1899 ;  1908. 

Summary  of  Epidemics. 

ISGl. 

The  outbreak  of  yellow  fever  which  took  place  at  Saiut- 
Nazaire,  near  Nantes,  in  18G1,  occupies  a  notable  place  in 
the  annals  of  epidemiology,  being  the  only  serious  mani- 
festations of  the  disease  in  France.  Acci<lental  erui)ti()ns 
have  occurred  from  time  to  tim(>  in  the  heart  of  Havre, 
Brest,  Marseilles,  ]\ochefort  and  Nantes,  but  these  were 
directly  traceable  to  persons  who  had  communicated  Avitl'. 
infected  ships  and  were  limited  to  one  or  two  cases.  In 
tlie  Saint-Nazaire  incident,  liowevcr,  I  lie  disease  assumed 
a  yicious  and  aggressive  type,  and  was  even  carried  to 
Montoir-en-Rretagne,  a  village  near  Saint'Xazaire. 

'^  The  original  letters  reads  as  follows: 
"15  Septembre,  1694. — J'apprends  par  les  lettres  que  je  recois 
par  le  vaisseau  le  Leger,  que  la  maladie  continue 
toujours  aux  isles  de  I'Amerique;  cela  est  bien  facheux. 
Cependant,  comme  il  est  important  d'empecher  qu'elle 
ne  s'introduise  dans  le  i-oyaume,  j'ecris  aux  officiers  de 
I'Arairaute  de  la  Rochelle  de  renouveler  les  defenses 
qui  ont  ete  faites  aux  equipages  des  vaisseaux,  qui 
reviennet  de  ces  pays,  de  ne  mettre  pied  a  terre  qu'apres 
que  la  visite  en  aura  ete  faite,  pour  les  obliger  de  faire 
quarantaine,  s'ils  sont  attaques  de  ce  mal  et  c'est  a  quoi 
il  est  necessaire  que  vous  teniez  la  main. 

(Signed)  "PONTCHARTRAIN." 


FRANCE SAINT  NAZAIRK 1861.  401 

Much  has  been  written  about  this  epidemic.  We  cull 
the  following  resume  from  the  comprehensive  work  of 
Melier,"^^  and  from  the  interesting  acounts  given  by 
Eager^*^  and  Berenger-Feraud  :^^ 

The  Anne-Marie,  a  ship  of  the  port  of  Nantes,  with  a 
crew  of  sixteen,  sailed  from  Havana  June  13,  1861.  The 
vessel  carried  barrels  of  sugar,  between  the  the  ti-ers  of 
which  layers  of  sugar  cane  were  placed,  in  order  to  prop- 
erly dress  the  cargo.  After  five  days'  navigation,  five 
days  of  broiling  calms  and  storms  followed  by  rains,  the 
captain,  in  order  to  rest  the  crew,  decided  to  drift  in  the 
Strait  of  Florida  without  using  sails.  Passing  out  of  the 
strait,  the  winds  became  steady,  and  the  men  went  to 
work  with  a  will  to  make  sail,  showing  no  trace  of  fatigue 
or  malady. 

July  1,  eighteen  days  after  the  departure  from  Havana, 
two  seamen  fell  sick  and  died  within  a  few  hours  of  each 
other  on  the  fifth  day  of  their  illness. 

July  2,  another  sailor  was  taken  ill,  but  it  is  recorded 
that  "with  strong  doses  of  the  sulphate  of  quinine  and 
with  violent  purgatives,  he  was  cured  after  ten  days." 
On  successive  days,  six  other  persons  were  stricken,  in- 
cluding the  captain.  All  were  dosed  with  quinine  and 
cathartics,  and  recovered  more  or  less  promptly.  Alto^- 
gether,  among  the  sixteen  persons  aboard,  there  were  nine 
cases  of  sickness  and  two  deaths. 

In  this  condition  the  ship  entered  the  port  of  Saint- 
Nazaire,  twenty  days  after  the  last  death  and  ten  days 
after  the  inception  of  the  final  case  of  suspicious  illness. 
Since  no  case  of  sickness  had  occurred  during  the  last  ten 
days,  and  all  were  well  on  board  at  the  time  of  arrival,  the 
vessel  was  punctually  given  pratique,  in  conformity  with 
the  French  sanitary  regulations. 

"Melier:  Memoires  de  rAcademle  de  Medecine  de  Paris,  1863, 
vol.  26,  pages  1  to  228;  also,  reprint  of  this  article. 

"Eager:  Bull.  No.  8,  Yellow  Fever  Institute  (Washington, 
D.  C).  1902,  p.  26. 

"Berenger-Feraud:  Gazette  Medicaid  de  Nantes,  1883-4,  \o\. 
2,  p.  4. 


402 


HISTORY    OF     YELOW    FFVER. 


As  soon  as  tht;  An^ie-Marie  was  released  from  quaran- 
tine, her  crew  were  paid  off,  and  according  to  the  custom 
in  vogue  at  nearly  all  European  ports,  they  were  dis- 
charged and  an  entirely  new  set  of  men  engaged  to  dis- 
charge the  cargo.  The  men  went  to  their  homes.  The 
subsequent  movements  of  the  crew  of  the  Anne-Marie^  is 
one  of  the  most  interesting  phases  of  the  vagaries  of  this 
epidemic,  as  will  be  seen  by  the  following  tableau: 

Roster  of  the  Crew  of  the  "Anne-Ma/rie;"  the  Localities 

They  Went  to  After  Leaving  the  Ship,  and  What 

Happened  to  Them. 


NAME 

RANK 

Place  tlEy  went  to 

REMARKS 

i 

Voisin 

Eloy - 

Barand  

Captain  .._ 

Second  execu- 
tive officer 

Sailor  

Painbouef 

Saint-Nazaire.. 
Painbouef 

Developed  Yellow  Fever, 
Recovered. 

Developed  Yellow  Fever; 

Died. 
Not  attacked. 

Jabin 

Carpenter  

Nantes 

.|Not  attacked. 

Glot 

Cook 

Unknown  

Unknown 

Riquidel 

Le  Pendernat... 

Sailor 

Sailor 

Nantes 

Concarreau 

Had  Yellow  Fever  during 
homeward  voyage  ;recoy'd 
Not  attacked. 

Compu 

Apprentice 

Crosic 

Not  attacked. 

Le   Baquelin 

Rabier 

Sailor 

Sailor 

Nantes 

Saint-Nazaire ... 

Had  Yellow  Fever  during 
homeward  voyage ;recov'd 
.  Not  attacked. 

Pineau  

Sailor  

Unknown 

Unknown  . 

Guillio _ 

Apprentice 

Saint-Nazaire... 

Not  attacked. 

Monizet — 

Ship's  Boy 

SBint-Nazaire... 

Not  attacked. 

It  will  thus  be  seen  that  of  the  two  officers  and  eleven 
m,en  composing  the  crew  of  the  Anne-Marie,  two  had  yel- 
low fever  during  the  voyage  and  recovered ;  two  developed 
the  disease  after  arriving  at  Saint-Nazaire,  one  succumb- 
ing; two  could  not  be  traced,  and  the  remaining  seven 
continued  well  and  hearty  during  the  whole  progress  of 
the  epidemic. 


i 


FRANCE— SAINT    NAZAIRE 1861.  40S 

The  Ejnd^mic. 

We  shall  now  take  up  the  events  at  Saint-Nazaire. 

In  the  same  basin  where  the  Anne-Marie  was  at  anchor, 
were  the  following  vessels : 

The  Chastang,  a  small  tug  boat  in  the  service  of  the 
government,  having  two  barges  in  tow. 

The  Gormoran,  a  transport. 

The  Lorient  No.  6,  a  steamboat  plying  between  Lorient 
and  St.  Nazaire. 

The  Dwrdenelles,  a  three-masted  merchantman. 

U Areqidpa,  a  three-masted  marchantman. 

The  Chastang  sailed  on  July  29,  two  days  after  the 
opening  of  the  hatches  on  board  of  the  Anne-Marie,  and 
arrived  the  same  day  at  Indret.  The  tug  had  a  crew  of 
five,  who  had  all  been  on  board  the  Anne-3Iarie,  attracted 
by  curiosity.  On  August  1,  one  of  these  men  was  taken 
ill  and  died  on  the  3rd.  His  case  presented  all  the  symp- 
toms of  yellow  fever.  On  the  3rd  or  4th  of  August,  three 
miore  of  the  crew  were  attacked  and  died  in  a  few  days. 
The  fifth  member  of  this  unfortunate  crew  was  stricken 
on  the  5th,  and  died  on  the  10th  of  August. 

The  two  barges  which  were  in  tow  of  the  Chastang, 
had  each  a  crew  of  two  men;  one  of  the  barges  had  in 
addition,  a  woman  on  board.  Only  oiie  out  of  these  five 
people  is  known  to  have  visited  the  Anne-3Iarie,  but  two 
of  them  helped  to  carry  the  dead  from  the  Chastang,  v/hile 
the  tug  was  moored  at  Indret.  Another  of  this  crew  had 
spent  two  nights  nursing  one  of  the  sailors  on  board  the 
Chastang.  The  woman  nursed  and  helped  to  prepare  for 
burial  two  or  the  dead  sailors.  These  five  people  (who 
composed  the  personnel  of  the  barges)  were  all  taken  ill, 
showing  all  the  symptoms  of  mild  yellow  fever.  No  fatal- 
ities occurred  among  them. 

The  news  of  what  had  occurred  at  Indret  had  not  yet 
reached  Saint-Nazaire  when,  August  2,  the  first  oificer  of 
the  Anne-Ma7~ie,  a  robust  man,  aged  28  years,  died  after 
being  ill  of  yellow  fever  for  sixty  hours.  The  next  dfiy, 
a  cooper,  who  had  spent  several  days  in  the  hold  of  the 


404  HISTORY  OF  YELLOW    FEVEH. 

Anne-Marie  engaged  in  repairing  sugar  barrels,  fell  sick 
of  the  same  disease  and  died  in  five  days.  August  4,  a 
master  stonecutter,  who  Avorked  on  the  harbor  front,  2G0 
meters  from  where  the  infected  vessel  w^as  stationed,  ac- 
quired the  disease,  and  after  six  days,  died.  He  had  had 
no  communication  with  the  ship,  no  contact  with  the  men 
or  merchandise  of  the  vessel.  August  5,  five  stevedores 
from  the  infected  ship  were  attacked.  Three  died  in  about 
four  daj's,  the  other  in  eight  days.  August  7,  there  were 
three  more  cases,  and  two  others  the  following  day.  A 
woman  who  sold  old  clothes,  sails  and  cord  was  taken  sick 
with  yellow  fever,  August  G.  She  had  received  in  her  house 
two  seamen  of  the  Anne-Marie,  and  had  bought  from 
them  some  discarded  garments  and  odds  and  ends  of  can- 
vas and  cordage.  The  next  day,  a  woman,  aged  55, 
who  had  intimate  relations  with  the  stevedores  of  the 
pest  ship,  was  prostrated  with  the  same  malady.  A 
laborer,  engaged  in  handling  the  cargo  of  the  Anne-Marie, 
lived  with  a  cobbler,  who  sat  at  his  bench  from  morning 
till  night  and  never  moved  from  the  place  of  his  work, 
was  stricken  with  yellow  fever  and  died  in  a  few  hours. 
His  guest,  the  laborer,  and  the  laborer's  wife,  both  took 
the  disease,  but  got  well. 

The  Cornwran,  the  government  transport  mentioned 
above,  had  a  crew  of  ten  men.  She  arrived  at  St.  Nazaire, 
on  July  31,  and  remained  fifteen  days  alongside  of  the 
Anne-Marie.  This  vessel  sailed  from  St.  Nazaire,  on  the 
3rd  of  August,  and  arrived  at  Lorient  on  the  10th.  On 
August  14th,  two  of  the  crew  were  attacked,  and  died  on 
the  26th.  No  other  attacks  or  mortalities  are  recorded 
as  having  taken  place  on  board  this  vessel. 

The  Lorienf  Xo.  6  remained  from  the  28th  to  the  30th 
of  July,  moored  alongside  of  the  Anne-Marie,  and  left 
on  the  morning  of  August  4th  for  Lorient,  where  she 
arrived  the  same  night.  One  of  the  officers  and  a  cabin- 
boy  were  taken  ill  that  same  night,  presenting  all  the 
symptoms  of  mild  yellow  fever.  They  made  an  uneventful 
recovery.     No  other  cases  on  board. 


FRANCE SAINT    NAZAIRE 1861.  405 

The  DardaneUes,  a  merchantman  from  the  Gulf  of 
Guinea,  weighed  anchor  in  the  same  basin  where  the 
Anne-Marie  was  discharging  her  cargo.  Being  on  the  off- 
shore side  of  the  Anne-Marie,  tlie  crew  of  the  Dardanelles 
were  compelled  to  use  the  above  named  vessel  as  a  passage- 
way to  and  from  the  shore.  Only  one  case  developed  on 
board  of  the  merchantman,  that  of  a  cabin-boy,  who  had  a 
mild  attack  and  quickly  recovered. 

The  Arequipa,  a  merchantman  from  Sierra  Leone,  ar- 
rived at  Saint-Nazaire,  on  June  23.  From  July  26th  to 
August  1st,  she  moored  alongside  the  Anne-Marie,  while 
the  latter's  cargo  was  being  discharged.  On  August  1st, 
the  Areqvipa  sailed  for  Cayenne,  South  America.  On 
the  5th  of  August,  the  second  officer  was  taken  ill  with 
fever  and  died  on  the  10th,  while  the  vessel  was  still  in  the 
Gulf  of  Gascony,  where  the  vessel  had  been  detained  for 
some  cause  which  is  not  given  by  the  chroniclers  of  this 
memorable  epidemic.  On  August  22nd,  a  second  case,  in 
the  person  of  a  cabin-boy,  occurred,  followed  by  death  on 
the  30th.  On  August  26th  an  apprentice  was  at- 
tacked; recovery.  On  August  29th,  the  fourth  case  oc- 
curred ;  recovery.  On  September  11th,  the  captain  of  the 
vessel  was  taken  ill ;  recovery.  On  September  11th  and 
20th,  sixth  and  seventh  cases;  recovery.  On  September 
20th,  eighth  and  last  case,  followed  by  death. 

The  last  echo  of  this  epidemic  was  furnished  by  one  of 
the  men  employed  in  cleaning  and  fumigating  the  Anne- 
Marie,  who  was  taken  ill,  August  29th,  and  died  Septem- 
ber 5th. 

Dr.  Eager  brings  out  the  fact  that  the  records  of  the 
epidemic  at  Saint-Nas^aire  show  that  all  the  infected  ships 
were  stationed  down  the  wind  from  the  Anne-Marie.  The 
fact  is  established  by  the  data  of  the  meteorological  and 
maritime  observer  at  Lorient.  It  is  interesting  to  note 
that  a  ship  of  the  imperial  navy,  the  Chandernapnr,  and 
a  passenger  transport,  the  Lorientais  No.  8,  posted  near 
the  Anne-Marie,  but  up  the  wind,  were  perfectly  immune 
from  yellow  fever.  The  distance  of  anchorage  and  the 
length  of  time  passed  near  the  infected  vessel  seemed  to 


406  HISTORY    OF    YELLOW    FEVER.  i 

have  had  decided  influence  in  determining  outbreaks  of 
the  disease.  The  prevailing  temperature  did  not  appear 
to  have  any  influence.  The  daily  temperature  during  the 
epidemic  oscillated  between  the  maxima  of  21°  and  25.5° 
C,  and  the  minima  of  11.8°  and  17°  C. 

Infected  Vessels   icliich  Entered  the  Earhor  of  Saint- 
'Nazo/ire,  in  1861. 

It  is  interesting  to  note  that  the  Anne-Marie  was  not 
the  only  vessel  infected  with  yellow  fever  which  entered 
the  harbor  of  Saint-Kazaire,  in  1861.  A  reference  to  the 
maritime  annals  of  the  port,  reveals  the  fact  that  from 
July  15  (the  date  of  the  arrival  of  the  Anne-Marie)  to 
September  17,  the  following  vessels  ai'rived  from  ports 
where  yellow  fever  was  prevailing : 

July  15.  Anne-Marie.  Left  Havana,  June  13,  Had 
nine  cases  and  two  deaths  on  homeward  voyage.  Focus 
of  infection  whence  originated  the  epidemic  of  Saint- 
Kazaire. 

August  7.  Etoile  de  la  Me?-.  Left  Havana,  July  6. 
Healthy. 

August  8.     Jules.     Left  Havana,  July  3.     Healthy. 

August  13.  Nicholas-Cezard.  Left  Havana,  July  16. 
Two  cases  on  arrival ;  one  died.  A  third  case,  August  29 ; 
died  September  5. 

August  15.  Paul  Aiiguste.  Left  Havana,  July  12. 
One  death  (July  30)  at  sea. 

August  15.  Amelia.  Left  Havana,  July  12.  One 
death  at  sea. 

August  15.  Pere  Chaigneau.  Left  Havana,  July  10. 
HeaJthy. 

August  16.  Washington.  Left  Havana,  July  16. 
Healthy. 

August  18.  Jacques  Langlois.  Left  Matanzas,  July  15. 
Healthy. 

August  19.  Amelie-Eenriette.  Left  Havana,  July  12. 
One  death  at  Havana. 

August  25.     Olivier.     Left  Havana,  July  19.     Healthy. 


FRANCE SAINT  NAZAIRt 1801  407 

(September  4.  Etienne.  Left  Matanzas,  July  25. 
Healthy. 

September  4.  Enfants  Nantais.  Left  Havana,  July  21. 
Six  cases  at  Havana;  no  deaths.  I 

September  15.  Gironde.  Left  Havana,  August  9. 
Three  deaths  at  Havana,  two  at  sea.  Every  person  on 
board  sick,  with  the  exception  of  one  man,  who  had  had 
yellow  fever  two  years  before. 

September  17.  Brothers.  Left  Cardenas,  August  3. 
Healthy. 

Of  these  fifteen  vessels,  twelve  were  from  Havana,  two 
from  Matanzas,  and  one  from  Cardenas.  Of  the  twelve 
arrivals  from  Havana,  five  gave  histories  of  yellow  fever 
on  board,  and  two,  the  Anne-Marie  and  the  NicJiolas- 
Cezard,  sent  cases  to  the  lazaretto  at  Saint- Nazaire.  The 
vessels  from  Matanzas  and  Cardenas  were  healthy  and 
gave  no  history  of  yellow  fever  on  board,  either  in  Cuban 
waters  or  at  sea. 

General  Summary. 

It  will  thus  be  seen  that  two  vessels,  the  Anne-Marie 
and  the  NicJioIas-Cezard^  infected  the  port  of  Saint- 
Nazaire  in  1861.  The  total  number  of  cases  and  deaths 
were  as  follows: 

Infected  by  the  Nicholas-Cesard 13  cases,  resulting  in    2   deaths 

Infected  by  the  Anne-Marie 40  cases,  resulting  in  23   deaths 

Total  cases  and  deaths   43  25 

Aside  from  a  fatal  case  at  Montoir-de-Bretagne  (q.  v.), 
the  Saint-Nazaire  fever  was  not  carried  to  any  other  part 
oi  France. 

1862. 

'It  is  not  generally  known  that  yellow  fever  was  brought 
to  Saint-Nazaire,  in  1862,  but  according  to  Gestin,*'^  five 

•^Gestin:    In  Melier's  "Relation  de  la  Fievre  Jaune  Survenue 
at  Saint-Nazaire  «<n  1861,"  Paris,  1863,  p.  199. 


*0S  HISTORY    OF  YELLOW  FEVER. 

vessels  infected  with  the  disease  reached  that  port  between 
June  17  and  December  1. 

The  first  suspicious  vessel  to  enter  the  harbor  was  the 
French  cruiser  Montezuma,  from  Vera  Cruz,  June  17. 
There  was  no  infectious  disease  on  board,  but  the  com- 
mander reported  the  death  of  one  of  the  crew  from  yellow 
fever  while  the  warship  was  at  Vera  Cruz.  This  man  had 
surreptitiously  visited  the  shore,  where  he  contracted  the 
disease.  The  fever  was  not  communicated  to  any  other 
person  on  board,  and  when  the  Montezuma  arrived  at  her 
destination,  more  than  a  month  had  elapsed  since  the 
death  of  the  sailor  and  the  officers  and  crew  were  healthy. 

The  Albeft,  which  reached  Saint-Nazaire,  August  10, 
actually  brought  yellow  fever  to  the  port.  There  had  been 
eleven  cases  out  of  a  crew  of  eighteen,  while  the  vessel 
was  at  Havana,  followed  by  one  death  at  sea  (July  18). 
On  the  ship's  arrival,  four  cases  were  transferred  to  the 
floating  hospital  Jeanne-D'Arc,  where  they  eventually  re- 
covered.    There  was  no  diffusion  of  the  disease  ashore. 

The  JVologa,  which  arrived  from  Havana,  September  6, 
reported  having  had  four  deaths  while  in  the  Cuban  port. 
No  cases  at  sea  or  at  Saint-Nazaire. 

The  Alfred  and  Mary,  which  arrived  from  Havana,  No- 
vember 16,  gave  a  history  of  two  cases  at  the  port  of  de- 
parture.    No  other  manifestations. 

The  fifth  and  last  vessel  with  a  history  of  yellow  fever, 
entered  the  harbor  on  December  1.  There  had  been  twelve 
cases  on  board  at  Havana,  and  one  at  sea,  during  the  home- 
ward voyage.  The  crew  were  healthy  on  arrival,  and  no 
cases  erupted  while  the  vessel  was  at  Saint-Nazaire. 

1881. 

The  memorable  epidemic  of  1861,  does  not  seem  to  have 
imbued  the  authorities  of  Saint-Nazaire  with  any  extra- 
ordinary ideas  of  prudence,  for  we  see  yellow  fever  again 
at  the  doors  of  the  quaint  old  French  city,  in  1881.  That 
the  disease  did  not  invade  the  town  on  this  occasion,  is 
certainly  not  due  to  the  sagacity  of  its  health  guardians. 


FRANCE SAINT  N AZAIRE 1881.  409 

The  facts  of  the  second  importation  of  yellow  fever  to 
Saint-Nazaire,  are  as  follows  :^^ 

The  transatlantic  passenger  steamer  Yille-de-Paris,  left 
Porto-Bello,  Brazil,  on  April  30th,  1881,  and  arrived  at 
For t-de- France,  Martinique,  on  May  5th,  where  she  re- 
mained fifteen  days.  Yellow  fever  was  prevailing  in  the 
town.  While  in  the  harbor,  the  Yille-de-Paris  communi- 
cated freely  with  the  dispatch-boat  Magicien,  which  was 
also  infected.  The  steamier  left  Fort-de-France,  on  May 
20th,  with  a  crew  of  128  and  45  passengers,  among  the 
latter  being  four  convalescents  from  yellow  fever. 

On  June  2nd,  thirteen  days  after  her  departure 
from  Fort-de-France,  yellow  fever  broke  out  on  the  Yille- 
de-Paris.  *  This  case  was  an  engineer  attached  to  the 
vessel,  who  had  had  many  dealings  with  persons  con- 
nected with  the  Magicien.  The  next  day,  three  cases 
erupted.  The  vessel  arrived  at  Saint-Nazaire  on  the  4th. 
That  same  day,  a  child  of  seven  was  taken  ill. 

On  May  5th  the  vessel  was  sent  to  the  quarantine  sta- 
tion and  the  patients,  five  in  number,  were  sent  to  the 
lazaretto  at  Mindiu,  where  only  one  recovered. 

The  passengers  were  given  free  pratique  on  May  13th, 
only  eight  days  after  the  eruption  of  the  last  case,  and  the 
vessel  released  from  quarantine  on  the  20tli. 

The  imprudence  of  allowing  persons  from  a  notoriously 
infected  ship  to  circulate  freely  after  only  a  week's  deten- 
tion, caused  much  adverse  comment  and  French  nosolo- 
gists  called  attention  to  the  terrible  consequence  which 
might  have  ensued  had  even  one  of  these  persons  carried 
the  germ  in  his  system  for  a  longer  period  than  a  week. 

The  question  was  again  agitated  at  the  meeting  of  the 
Quatrienie  Gongres  International  d' Hygiene  et  dc  Demo- 
graphies held  at  Geneva,  Switzerland,  September  4-0,  1882. 
In  a  general  discussion,  in  which  Drs.  Formento  (of  New 
Orleans),  Bourru  (of  Rochefort),  da  Silva  Amado  (of 
Lisbon),  Rochard   (of  Paris),  Cabello  (of  Madrid)   and 

"Griffon  du  Bellay:  Recueil  des  Travaux  du  Comite  Con- 
sultatif  d'Hygiene  Publique  de  France,  Paris,  1883,  vol. 
11,  p.  213. 


410  HISTORY    OF    YELLOW    FEVKR. 

Layet  (of  Bordeaux)  participated,  the  danger  of  the  in- 
troduction of  the  typhus  amaril  into  France  was  forcibly 
pointed  out  and  the  authorities  censured  for  being  too  lax 
in  the  enforcement  of  preventive  measures.  Dr.  Kochard, 
in  an  inspired  address,  pointed  out  this  grave  danger. 
Following  is  a  translation  of  his  most  pungent  remarks : 

"France,  on  account  of  its  higher  altitude,  has  less  to 
fear  than  countries  where  the  disease  easily  propagates 
itself  and,  to  this  day,  when  yellow  fever  has  been  im- 
ported to  our  shores,  it  has  never  spread  beyond  the  origi- 
nal focus  of  infection.  But  will  it  always  be  thus?  It 
would  be  undue  boldness  to  answer  the  question  affirma- 
tively. There  are  certain  days  in  July  and  August  when 
the  heat  is  intense  in  the  heart  of  France,  and  notably  at 
Paris.  Let  us  suppose  that  a  vessel  infected  with  yellow 
fever  should  arrive  at  Saint-Nazaire,  and  that  strict  sani- 
tary measures  were  overlooked,  what  would  prevent  the 
disease  from  being  carried  to  Paris  by  the  next  train? 
And  then,  admitting  that  the  disease  did  reach  the  capital, 
what  terrible  havoc  it  would  cause  among  the  two  million 
souls  massed  within  its  walls."^^ 

But  these  warnings  have  been  little  heeded  by  the 
French  Government,  for,  on  reading  the  quarantine  laws 
now  in  vague,  we  notice  (Article  01)  that  pssengers  from 
infected  ships,  even  when  yellow  fever  is  actually  on  board 
on  its  arrival  in  port,  are  only  subjected  to  a  detention 
of  seven  days.  | 

The  established  incubative  period  of  yellow  fever  is  from 
two  to  seven  days;  sometimes  longer,  but  this  is  rare. 
A'lnd  how  do  we  know  that  a  certain  kind  of  mosquito  of 
the  genus  other  than  the  Sfcgomi/ia  Calopus,  capable  of 
transmitting  yellow  fever,  does  not  exist  in  Paris?  If 
such  things  be,  France  may  one  day  awake  and  see  Pro- 
fessor Pochard's  prophecy  fulfilled  and  her  proud  capital 
in  the  merciless  grasp  of  the  Yellow  Demon. 


"Rochard:    Trans.  Quatrieme  Congres  International  d'Hyglene 
et  de  Demographie  (Geneva,  1883),  vol.  1,  p.  480. 


FRANCE SAINT  NAZAIRE — 1908.  411 

1899. 

In  October,  1899,  the  French  ship  'Navarre,  from  Vera 
QvvLZ,  arrived  at  Saint-Nazaire  with  yellow  fever  on 
board.^^  The  vessel  was  remanded  to  the  quarantine  sta- 
tion.   No  other  cases  erupted. 

1908. 

The  year  1908  furnishes  the  last  link  in  the  chain  of 
yellow  fever  importations  to  the  port  of  Saint-Nazaire. 
The  facts  are  as  follows,  {TJ.  S.  Public  Health  Reparts, 
1908,  vol.  23,  pp.  1507;  1543;  1621)  : 

The  disease  was  brought  to  St.  Nazaire  by  the  French 
steamship  La  France,  which  arrived  at  that  port  Septem- 
ber 16  1908,  after  having  touched  at  Fort-de-France,  Mar- 
tinique (Sept.  10),  where  yellow  fever  was  prevailing. 

The  steamship,  upon  arrival  at  St.  Nazaire,  received 
pratique,  and  the  crew  and  all  the  passengers  landed,  the 
passengers  scattering  in  different  directions. 

A  few  days  after  the  arrival  of  the  La  France,  several 
members  of  the  crew  were  admitted  to  the  local  hospital 
as  suffering  from  paludic  fever.  After  the  death  of  three 
of  tliese,  a  necropsy  was  held  over  one  of  the  bodies,  which 
revealed  the  fact  that  he  had  died  of  yellow  fever. 

In  the  meantime  all  the  crew  of  the  Steamship  La 
France  had  been  transferred  to  the  Steamship  Versailles, 
which  sailed  October  9,  for  Guadeloupe,  Martinique,  Ven- 
ezuela, Colombia  and  Colon,  Panama. 

Up  to  October  10,  nine  cases  of  yellow  fever  had  de- 
veloped and  entered  the  hospital  at  St.  Nazaire.  Five 
died. 

On  October  20,  two  more  cases  and  an  additional  death 
had  been  added  to  the  list,  making  altogether  eleven  cases, 
out  of  which  five  proved  fatal. 

The  outbreak  was  confined  to  the  above  cases  and 
deaths. 

«Hill:    U.  S.  p.  H.  &  M.  H.  Reports,  vol.  14,  1899,  p.  2000. 


412  HISTORY    OF   YELLOW    FEVER 

TOULON. 

1862. 

The  A77iazony  a  transport  in  the  service  of  the  French 
Government,  entered  the  port  of  Toulon  in  October,  1862. 
The  vessel  having  served  as  a  yellow  fever  hospital  ship 
while  at  Vera  Cruz,  she  was  looked  upon  with  great  sus- 
picion by  the  health  authorities  and  remanded  for  obser* 
vation.^*^  The  commander  gave  a  history  of  eighty  deaths 
from  yellow  fever  while  in  Mexican  waters  and  two  addi- 
tional deaths  during  the  homeward  voyage.  The  trans- 
port was  detained  in  quarantine  until  October  29,  and 
given  free  pratique.  No  cases  erupted  on  board  while  at 
Toulon,  but  the  entrance  of  a  yellow  fever  hospital  ship 
in  a  French  port,  especially  when  the  events  which  had 
transpired  at  Saint-Nazaire  the  year  before  were  still  fresh 
in  the  minds  of  the  people,  caused  general  consternation 
throughout  the  country. 

**Gallas:    In  Melier's  "Relation  de  la  Flevre  Jaune  Survenue  a 
Saint-Nazaire  en  1861,"  p.  215. 


YELLOW    FEVER 


IN 


GREAT  BRITAIN. 


1 


YELLOW  FEVER 

IN 

GREAT     BRITAIN. 

With  the  exception  of  the  epidemic  at  Swansea  in  1865, 
imported  from  Havana  by  the  Eecla,  and  which  is  detailed 
at  length  in  this  volume,  yellow  fever  has  never  obtained 
a  foothold  in  Great  Britain.  Vessels  have  from  time  to 
time  brought  the  disease  to  the  seacoast  towns  of  the 
Empire,  and  in  a  solitary  instance  (1878)  a  death  oc- 
curred in  the  ver^^  heart  of  Lob  don;  but  the  inhabitants 
of  the  British  Isles  have  to  this  day  proved  immune  to  the 
scourge  on  their  own  soil,  the  eruptions  being  in  every  in- 
stance confined  to  the  imported  cases.  Swansea  furnishes 
the  only  example  to  the  contrary. 

The  exemption  of  Great  Britain  from  an  invasion  of 
the  Saffron  Scourge  may  not  be  as  secure  as  one  would 
think.  It  is  true  that  the  Stegomyia  Calojms  does  not 
flourish  on  English  soil,  but  the  CuJex  Calopus  does  and 
there  remains  the  possibility  that  either  this  species,  or 
a  different  species  at  this  day  established  in  the  "tight 
little  island,"  may  some  day  be  impregnated  with  the 
virus  of  the  disease  and  spread  the  contagion  far  and 
wide.  The  doctrine  of  the  mosquito  transmission  of  yel- 
low fever  is  yet  in  the  adolescent  stage  and  future  ex- 
periments may  prove  that  other  species  than  the  Ste- 
gomyia  Calopus  are  also  active  agents  in  the  dissemina- 
tion of  the  disease  under  discussion. 


416  HSSTORY    OF    YILLOW    FEVER. 

CHRONOLOGY    OF   YELLOW    FEVER    IN    GREAT 

BRITAIN. 


I 


1713. 

London.            ) 

1817. 

Falmouth. 

1843. 

Swansea. 

1845. 

Isle  of  Wight. 

1846. 

Woolwich. 

1848. 

Woolwich. 

1851. 

Swansea. 

1852. 

Southampton. 

1853. 

Southampton. 

1854. 

Cork. 

1857. 

Southampton;  Dublin,   (not  authentic) 

1860. 

Southampton. 

1864. 

Falmouth;  Southampton;  Swansea. 

1865. 

Llanelly;  Swansea.    ' 

1866. 

Southampton. 

1867. 

Southampton. 

1877. 

Salcombe. 

1878. 

London. 

By  Localities. 

Cork.     1854.  ' 

Dublin.     1857,  (not  authentic).  v 

Falmouth.     1817 ;  1864. 
Isle  of  Wight.     1845. 
Llanelly.     1865. 
London.     1713;  1878. 
]\rotherbank.     (See  Isle  of  Wight). 
Portsmouth.    |1763. 
Salcombe.     1877. 

Southampton.     1852;  1853;  1857;  1860;  1864;  1866; 
1867. 

Swansea.     1843 ;  1851 ;  1864 ;  1865. 
Woolwich.     1846 ;  1848. 


417 

LOCALITIES   IN(  GREAT   BRITAIN  WHERE   YEL- 
LOW FEVER,  HAS  BEEN  OBSERVED. 

England. 

Dover.  A  seaport  and  parliamentary  borough,  on  the 
northwest  side  of  Dover  Strait,  County  Kent,  sixty-six 
miles  southeast  of  London  and  twenty-one  miles  from 
Calais,  France.  It  is  an  important  railway  terminus,  and 
as  a  port  for  mail  and  railwa}'^  service  with  the  Conti- 
nent, has  a  large*  passenger  traffic.  Population:  1881, 
28,486;  1891,  33,418. 

Falmouth.  A  seaport,  in  Cornwall,  on  Falmouth  Bay, 
on  the  southern  side  of  the  estuary  of  the  Fall  River, 
sixty-six  miles  by  rail  southwest  of  Plymouth,  and  250 
miles  from  London.  From  1G88  to  1850,  Falmouth  was 
an  important  packet  station,  but  it  is  now  chiefly  a  port 
of  call.  It  has  a  fine  roadstead,  affording  excellent  refuge 
for  shijiping.     Population :  1891,  4,273. 

Isle  of  Wight.  An  island  in  the  English  Channel,  off 
the  south  coast  of  Hampshire,  separated  from  the  main- 
land by  The  Solent  and  Spithead. 

London.  Capital  of  the  British  Empire  and  the  largest 
city  in  the  world.  It  is  situated  in  the  southeast  of 
England,  on  both  sides  of  the  Rivei^  Thames.  It  is  difficult 
to  assign  any  exact  limits  to  London,  on  account  of  its 
straggling  form  and  numerous  suburban  extensions;  but 
it  may  be  said  to  stretch  fromi  east  to  west  about  fourteen 
miles  and  from  north  to  south  about  ten.  Population: 
1881,  3,816,483;  1900,  4,546,752;  1907,  (estimated), 
7,217,941. 

Mothcrhank.  A  shoal  off  the  south  coast  of  England, 
between  the  mainland  and  the  Isle  of  Wight. 

'NeiccaMlc-on-Tyne.  A  city  in  the  northeast  of  England, 
Northumberland  County,  on  the  left  bank  of  the  Tyne 
Hiver,  about  eight  miles  from  the  North  Sea.  It  is  an 
extensive  manufacturing  center.  Within  the  city  and 
vicinity  are  numerous  blast  furnaces  and  malleable  and 


418  HISTORY    OF    YELLOW    FEVER. 

other  iron  foundries.     Population:  1891,  186,345;  1907, 
(estimated),  264,511. 

Salcomhe.     A  town  in  Devon. 

Southampton.  An  important  seaport  near  the  English 
Channel,  in  Hampshire,  on  a  peninsula  at  the  mouth  of 
the  Itchen  Eiver,  near  t^e  head  of  Southampton  Water. 
It  is  seventy-one  miles  southwest  of  London.  The  town 
is  a  rendezvous  for  many  steam  packet  lines  and  is  much 
visited  by  ocean  steamers.  It  has  extensive  docks  and  is 
an  emigrant  station.  The  Royal  Mail  Steamers  ply  regu- 
larly between  Southampton  and  the  West  Indies.  Popu- 
lation; 1891,  65,325;  1907  (estimated),  119,745. 

Woolwich.  This  was  formerly  a  naval  port  of  England, 
County  of  Kent  on  the  Thames,  seven  miles  southeast  of 
Saint  Paul's  Cathedral,  London.  It  is  now  a  part  of  the 
metropolis.  The  chief  importance  of  the  place  lies  in  the 
fact  that  it  is  the  seat  of  the  Eoyal  Arsenal,  founded  in 
1585,  which  employs  about  12,000  men,  whose  wages  ex- 
ceed 1350,000  a  month. 

Ireland. 

Corh.  A  river-port  of  Ireland,  capital  of  the  County 
of  Cork,  137  miles  southwest  of  Dublin.  <  Population: 
1881,  80,124 ;  1891,  75,070. 

Dnhlin.  Capital  of  Ireland,  on  the  Liffey  River,  by 
which  it  is  separated  into  two  nearly  equal  parts.  Popu- 
lation: 1891,  254,709;  1907,  (estimated),  378,994. 

Wales. 

Llanelli/.  A  seaport  town  of  Wales,  an  a  creek  empty- 
ing in  Carmarthen  Bay,  fifteen  miles  of  Carmarthen. 
Population:  14,973. 

Swansea.  A  seaport  of  Wales,  County  of  Glamorgan, 
on  the  west  side  of  the  Tawe,  at  its  mouth  in  Swansea 
Bay,  Bristol  Channel.  It  is  an  important  commercial 
center  and  is  connected  with  London  bv  rail.  Population : 
1871,  51,702;  1881,  59,597;  1891,  90,349. 


419 

ENGLAND. 

DOVER. 

1878. 

iln  1878,  yellow  (fever  was  almost  brought  to  the  town 
of  Dover.  A  Norwegian  ship,  on  which  there  had  been 
three  deaths  from  tho  disease  on  the  passage  from  Rio 
de  Janeiro,  entered  th^'  port  without  being  subjected  to 
quarantine  measures.  Fortunately,  no  cases  erupted  on 
board  while  the  vessel  was  in  the  harbor.^ 

FALMOUTH. 

1817. 

The  brig  Britannia^  from  the  West  Indies,  after  having 
touched  at  Liverpool,  arrived  at  Falmouth.  She  remained 
in  that  port  six  weeks  before  beginning  to  discharge  her 
cargo,  which  consisted  principally  of  cotton.  No  sooner 
had  the  unloading  begun  than  yellow  fever  developed  on 
board.     The  disease  was  limited  to  the  crew  of  the  vessel.^ 

1864. 

A  ship  from  Sierra  Leone  brought  a  ease  of  yellow  fever 
to  Falmouth  in  1864.     The  patient  died.^ 

ISLE  OF  WIGHT. 

1845. 

In  1845,  the  ship  Eclair,  which  later  in  the  year  in- 
fected the  Cape  Verd  Island  (q.  v.),  brought  yellow  fever 
to  the  Isle  of  Wight.  A  pilot  and  a  doctor  who  had  come 
from  shore  to  thel  vessel  were  attacked,  but  recovered. 
The  outbreak  was  limited  to  these  two  cases.^ 


^  Berenger-Feraud :    Traite  Theorique  et  Pratique  de  la  Fievre 
Jaune  (Paris,  1890),  p.  158. 

*  Eager:    Bulletin  No.  8,  Yellow  Fever  Institute  (Washington, 

D.  C),  1902,  p.  32. 
'  Berenger-Feraud,  loc.  cit.,  p.  141. 

*  Berenger-Feraud,  p.  117. 


420 

LONDOX. 

1713. 

Ciirrie^  (page  61)  asserts  that  yellow  fever  was  brought 
to  Loudon  by  "a  vesseP'iu  1713,  but  that  the  disease  did 
not  spread  beyond  the  imported  cases.  The  information 
is  yery  indefinite,  not  eyen  giying  the  name  of  the  ycssel, 
the  number  of  sick  or  the  original  source  of  infection. 
A  careful  suryey  of  tliis  and  the  other  books  of  Currio 
indicates  that  this  is  the  only  place  in  which  mention  is 
made  of  yellow  feyer  in  London.  \ 

1S7S. 

The  only  authentic  case  of  yellow  feyer  eyer  obseryed 
in  London,  is  commented  upon  at  length  by  Leggatt  and 
Greenfield^  in  the  Transactions  of  the  Clinical  Society  of 
London,  for  1878. 

The  patient,  D.,  a  retired  army  officer,  was  in  the  habit 
of  spending  the  winter  months  in  a  warm  climate  an<l 
for  two  years  previous  to  his  illness  had  done  so  in  South 
America.  Leaving  England  January  9,  1878,  he  landed 
at  Rio  de  Janeiro  on  the  30th  of  the  same  month  and  then 
Avent  to  Buenos  Ayres.  He  returned  to  Rio  on  February 
21.  Yellow  feyer  was  then  epidemic  in  the  town  and 
shipping.  He  left  Rio  on  February  21,  arrived  at  Lisbon 
on  March  14,  and  at   Southampton  on  the  17th.      He 


'^Curi'ie:  A  Sketch  of  the  Rise  and  Progress  of  the  Yellow 
Fever,  and  of  the  Proceedings  of  the  Board  of  Health, 
in  Philadelphia,  in  the  Year  1799;  to  which  is  added  a 
Collection  of  Facts  and  Observations  Respecting  the 
Origin  of  the  Yellow  Fever  in  this  Country;  and  a  Re- 
view of  the  Different  Modes  of  Treating  it. 
Philadelphia:  Printed  by  Budd  and  Bartram,  No.  58  North 
Second  Street,  1800. 

'  Legatt  and  Greenfield:  "A  Fatal  Case  of  Yellow  Fever  Oc- 
curing  in  London." — Transactions  of  the  Clinical  Society 
of  London,  1878,  p.  187. 


LONDON,   ENGLAND 1878.  421 

reached  London,  March  18,  was  taken  ill  on  the  21st,  and 
died  on  the  27th. 

The  autopsy  disclosed  a  typical  case  of  yellow  fever. 

What  puzzled  the  English  doctors  who  attended  this 
case,  was  the  seemingly  long  incubation  of  the  germ  of 
yellow  fever,  about  twenty-five  days,  according  to  their 
computation.  They  calculated  the  probable  date  of  in- 
fection to  have  been  February  24,  the  day  of  D.'s  departure 
from  Eio.  The  fallacy  of  this  conclusion  is  proved  by  a 
reference  to  an  extract  from  the  diary  of  the  officer, 
published  in  the  article  from  which  this  account  is  taken. 
It  seems  that  on  February  12,  while  the  ship  on  which 
he  had  taken  passage  was  at  Buenos  Ayres,  the  assistant 
purser  died  of  yellow  fever.  The  Vessel  left  Buenos 
Ayres,  February  15  and  arrived  at  Rio  on  the  21st  and 
sailed  for  England  on  the  21th.  Two  days  later,  two  of 
the  crew,  who  had  never  left  the  vessel  since  her  departure 
from  England,  were  stricken  with  yellow  fever.  One  re- 
covered; the  other  died  on  March  5.  No  other  cases 
erupted  on  board.  ) 

From'  the  above,  it  is  certain  that  D.  did  not  contract 
the  disease  at  Eio,  but  was  infected  on  board  the  vessel 
on  which  he  was  a  passenger  a  few  days  after  the  death  of 
the  third  case  (^larch  5).  This  would  give  an  incubation 
of  nine  or  ten  days. 

NFWCASTLE-ON-TYNE. 

1S95. 

'Much  apprehension  was  caused  in  England  in  1S05 
by  the  announcement  that  the  Norwegian  ship  Mindet, 
from  IMobile,  Alaliama,  which  arrived  at  Newcastle-on- 
Tyne  in  November  of  that  year,  had  yellow  fever  on  board. 
An  investigation  by  the  health  officers  of  the  town  revealed 
the  fact  that  eleven  men  Avere  suffering  from  malarial 
fever  and  that  two  had  died  of  this  disease  on  the  pas- 
sage from  Mobile.     The  eleven  men  were  removed  to  the 


4J2  HISTORY    OF    YELLOW    FEVRR, 

Tyne  Port  floating  hospital,  as  a  precautionary  measure. 
All  recovered  J 

There  was  no  yellow  fever  in  Mobile  in  1865,  and  as  the 
Mindet  did  not  touch  at  any  port  on  the  trip  to  Xewcastle- 
on-Tyne,  the  diagnosis  of  malaria  was  undoubtedly 
correct. 

PORTSMOUTH. 

1763. 

Legallois^  says  that  the  war  vessels  returning  from 
America  in  the  fall  of  1763,  landed  at  the  Haslar  Hospital, 
near  Portsmouth,  several  seamen  sick  with  yellow  fever, 
The  hospital  being  overcrowded,  it  was  found  impossible 
to  segregate  these  patients,  but  in  spite  of  this  lack  of 
precaution,  the  disease  was  confined  to  the  imported  cases. 
The  number  of  cases  and  deaths  is  not  given. 

1827. 

La  Roche^  quoting  Niel,i*^  relates  a  case  of  fever  which 
occurred  at  Portsmouth  in  July,  1827,  during  a  very  hot 
spell  of  weather.  In  this  case,  which  was  of  very  severe 
character,  there  was  jaundice  and  other  symptoms,  which 
gave  it  somewhat  the  character  of  yellow  fever.  The 
patient  was  attacked  dru  the  night  of  the  8th ;  on  the  15th, 
he  vomited  thrice  in  the  night,  the  matter  being  black 
like  coffee  grounds.  The  stools  assumed  the  same  appear- 
ance. After  twenty  days  of  sickness,  the  patient 
recovered. 


^Campbell:    U.  S.  Public  Health  Reports  (Washington,  D.  C), 

1895,  vol.  10,  p.  1150. 
*Legallois:    Rocherches  sur  la  contagion  de  la  Fievre  Jaime 

(reprint),  Paris,  1850,  p.  20  (foot  note). 
•La  Roche:    Yellow  Fever  (Philadelphia,  1855),  vol.  1,  p.  274, 
"Neil:    London  Med.  &  Phys.  Journal,  N.  S.,  vol.  5,  p.  105, 


ENGLAND 176S.  423 

Had  this  case  occurred  in  New  Orleans  or  any  other 
locality  where  the  disease  has  been  observed  from  time 
to  time,  it  would  have  been  unhesitatingly  j)ronounced 
yellow  fever.  It  is  one  of  the  many  examples  which  goes 
to  prove  how  difficult  it  is  to  arrive  at  a  correct  diagnosis 
of  the  saffron  pest. 

SALCOMBE. 

1877. 

In  the  beginning  of  1877,  a  German  sailor  was  landed 
at  Salcombe,  Devon,  from  the  schooner  St.  Lucia,  from 
the  West  Indies,  suffering  from  fever.  IHe  was  taken  to 
the  workhouse  infirmary  at  Kingsbri'dge.  Unmistakable 
symptoms  of  yellow  fever  having  manifested  themselves, 
all  the  other  inmates  were  removed  from  the  hospital,  and 
the  Board  of  Trade  was  communicated  with.  The  patient 
recovered  and  no  other  case  resulted. 

SOUTHAMPTOM.  ' 

Yellow  Fever  Yeaes. 

1852;  1853;  1857;  1860;  1861;  1866;  1867. 

Summary  of  Importations. 

1852. 

It  is  surprising  that  Southampton,  which  has  extensive 
commercial  relations  with  the  West  Indies,  South  America 
and  the  West  Coast  of  Africa,  all  notorious  foci  of  yellow 
fever  infection,  should  not  have  been  invaded  by  the  dis- 
ease prior  to  1852.The  passenger  traffic  between  the  town 
and  the  countries  above  mentioned  is  very  active  and  as 
hardly  any  precautions  are  taken  when  a  ship  from  these 
localities  arrives  at  the  port,  unless  yellow  fever  is  present 
or  has  been  raging  on  board  during  the  voyage,  there  is 
no  doubt  in  our  mind  that  outbreaks  of  yellow  fever  have 


414  HISTORY    OF    YELLOW    FEVER. 

occurred  at  dates  anterior  to  1852  and  were  put  down  by 
the  authorities  as  "typhus"  or  "malignant  fever/'  either 
through  ignorance  of  the  symptomatology  of  the  tropical 
plague  or  through  a  wanton  desire  to  conceal  the  real 
state  of  things.  The  slogan  of  the  British  nosologists  is 
"No  Quarantine,"  as  they  hold  'that  the  ship  alone  and 
not  the  place  whence  it  comes  should  be  held  under  sus- 
picion and  though  yellow  fever  may  be  committing  fear- 
ful ravages  in  a  certain  place,  no  barrier  is  put  upon  ves- 
sels arriving  therefrom,  unless  the  vessel  itself  is  known 
to  be  infected.  Owing  to  the  swiftness  with  which  trans- 
Atlantic  vessels  make  the  voyage  from  America  these 
days,  a  ship  may  be  a  slumbering  nidus  of  infection  and 
a  detention  of  two  days,  which  is  the  usual  custom  in 
England,  is  hardly  suflflcienit  to  place  a  ban  on  the  impor- 
tation of  the  disease.  The  only  thing  which  saves  South- 
amtpon,  London  and  other  ports  of  the  Empire  from  a 
devastating  invasion  of  yellow  fever,  is  the  fact  that  the 
Stenomyia  ralojms  is  either  totally  absent  ior  is  present 
in  such  small  quantities  in  these  localities,  tliat  even  when 
importation  does  take  place,  there  is  no  agent  present  to 
disseminate  the  virus  and  the  invasion  ends  with  the 
original  cases. 

The  solitary  case  which  erupted  in  the  very  heart  of 
Southampton  in  18.52,  substantiates  the  above  assumption. 
Had  tliis  incident  happened  in  ZS'ew  Orleans,  which  is  now 
as  free  from  the  disease  as  Boston,  New  York  or  Pliila- 
delphia,  Imt  which  was  then  a  hot-l)ed  of  pestilence,  it 
would  have  created  a  focus  whence  the  poison  would  have 
been  carried  to  every  section  of  the  city.  To  the  Stc- 
gomyia  calopus,  New  Orleans  owes  the  terrible  carnage 
caused  by  yellow  fever  in  tlie  past  and  to  the  strict  quar- 
antine regulations  and  the  almost  total  annihilation  of 
the  winged  carriers  of  contagion,  does  she  owe  her  present 
freedom  from  a  disease  which  at  one  time  was  said  to  be 
endemic.  ! 


SOUTHAMPTON,  ENGLAND 1852.  425 

The  history  of  the  infection  of  Southampton  in  1852  is 
as  follows  :^^ 

On  the  morning  of  the  ISth  of  November,  1852,  the 
Royal  Mail  Steampacket  Company's  ship  La  Plata  ar- 
rived at  Southampton  from  the  West  Indies,  with  the  loss, 
from  yellow  fever,  on  the  homeward  voyage,  of  her  com- 
mander, together  with  six  of  the  crew.  She  had  left 
Southampton  on  the  18th  of  October  (exactly  one  month 
previously),  and  gone  directly  to  the  Island  of  Saint 
Thomas,  which  she  reached  in  thirteen  days;  and  remain- 
ing there  four  or  five  days,  sailed  again  on  the  4th  of 
November  for  Southampton. 

This  was  the  second  voyage  of  the  La  Plata  from 
England  to  the  West  Indies.  The  vessel  was  new  and 
the  crew,  when  she  left  Southampton  in  October,  were  in 
perfect  health.  Yellow  fever  was  then  prevailing  both  in 
the  town  of  Saint  Thomas  and  among  the  shipping  in 
the  harbor.  During  the  time  the  La  Plata  lay  in  the  West 
Indian  port,  her  officers  and  crew  communicated  freely 
with  tlie  people  on  shore  and  with  the  crew  of  some  of 
the  adjacent  ships,  ^forcover,  just  before  leaving  England, 
she  received  on  board  a  considerable  number  of  invalids 
from  the  Great  Western,  the  Thames  and  the  Esl^ — ships 
belonging  to  the  Royal  Mail  Company — as  likewise  from 
the  war-steamer  Hif/hfh/er.  All  these  invalids  were  re- 
covering from  fever  and  one  Avas  actually  ill  at  the  time 
(>i  tlie  transfer  (November  5th),  had  black  vomit  the  next 
day  and  died  on  the  day  following. 

AYithin  twelve  hours  after  the  La  Plata  steamed  from 
Saint  Thomas,  on  the  5th  of  November,  the  second  en- 
gineer fell  ill  with  yellow  fever.  The  captain  was  attacked 
on  the  8th.  The  same  dav,  the  purser  and  two  coal  trim- 
mers were  seized,  and  each  of  the  five  days  following  fur- 
nished fresh  cases  of  the  disease.  In  all,  fifteen  cases 
occurred  during  the  passage  from  the  4tli  to  the  13th  of 
November,  of  which  seven  proved  fatal. 


•Harvey:     Lancet    (London),   1853.   vol.   1,   p.   148;    Phillips; 
Ibid.,  p.  2931;  Milroy:  Ibid.,  460. 


426  HISTORY    OF    YELLOW    FEVER. 

When  the  La  Plata  arrived  at  Southaaiipton,  the  above 
particulars  were  communicated  to  the  quarantine  officer 
of  the  port,  and  the  vessel  was  placed  in  quarantine  till 
the  morning  of  the  20th,  when  she  was  released. 

The  distressing  intelligence  thus  conveyed  by  the  La 
Plata,  and  the  fact  that  yellow  fever  was  through  her 
brought  almost  to  the  doors  of  the  town,  created  intense 
excitement,  as  well  in  the  kingdom  at  large  as  at  South- 
ampton. And  this  feeling  had  scarce  began  to  subside 
when  it  was  heightened  by  the  occurrence,  in  the  town 
of  Southampton  itself,  eight  days  after  the  release  of  the 
vessel  from  quarantine,  of  an  unequivocal  case  of  yellow 
fever  affecting  and  proving  fatal  to  Mr.  Napier,  fourth 
engineer  of  the  La  Plata. 

It  was  impossible  to  be  without  misgivings  as  to  the  con- 
dition in  which  the  steamers  next  in  succession  from  the 
West  Indies  might  arrive  and  accordingly  their  advent 
".Nas  looked  forward  to  with  greatest  anxiety.  Unfor- 
tunately, the  worst  fears  were  realized.  The  Medicay, 
the  Orinoco,  the  Mar/dalcua,  and  the  Parana,  which  suc- 
cessively came  in,  all  gave  histories  of  having  suffered 
more  or  less  from  the  fever.  Not  to  go  into  details  respect- 
ing them,  it  may  be  observed  that  including  the  La  Plata, 
the  several  steamers  furnished  an  aggregate  of  about  124 
cases,  of  which  about  50  ended  fatally.  ; 

The  particulars  of  the  sickness  and  death  of  Mr.  Napier 
are  as  follows : 

The  La  Plata  arrived  at  Sontliaiupton  on  the  18th  of 
November,  1852.  Amongst  her  officers  was  Mr.  Napier, 
who  was  engaged  in  the  engineer's  department.  He  took 
lodgings  in  town,  where  he  slept  at  night.  During  the 
day  he  was  occupied  on  some  work  in  the  engine  room, 
in  the  lowest  part  of  the  vessel,  where  he  no  doubt  was 
bitten  by  the  infected  mosquitoes  who  had  retreated  to 
the  warmest  part  of  the  ship  to  escape  the  cold,  the  winter 
season  being  then  at  its  heigjlit.  'He  'SN-'as  taken  ill  at  liis 
lodgings  on  the  28th  of  November.  On  the  evening  of  the 
3rd  of  December,  he  vomited  black  matter  and  died  on 
the  morning  of  the  5th. 


I 


I 


SOUTHAMPTON,  ENGLAND 1852.  427 

When  the  news  of  this  death  reached  the  public,  South- 
ampton was  in  an  uproar  almost  bordering  on  panic  and 
all  sorts  of  wild  rumors  were  circulated.  Every  case  of 
fever  was  looked  upon  with  suspicion  and  it  only  needed 
the  eruption  of  a  second  case  to  cause  an  exodus  of  the 
population.  A  report  was  spread  that  the  woiinan  who 
had  nursed  the  unfortunate  engineer  had  been  seized  with 
yellow  fever,  but  when  the  rumor  was  sifted,  it  was  found 
that  a  woman  had  been  engaged  to  attend  to  the  patient, 
but  left  the  house  and  the  landlady  had  taken  her  place. 
She  was  not  in  good  health  when  she  began  her  minis- 
trations and  having  to  attend  the  patient  day  and  night, 
the  fatigue  incidental  to  her  arduous  task  rendered  her 
ill.  This  indisposition  was  magnified  by  the  excited  pop- 
ulace into  a  case  of  black  vomit  and  it  was  only  when 
the  health  authorities  publicly  announced  that  the  rumor 
was  false,, that  the  excitement  subsided.  One  good  trait 
of  the  English  people,  is  their  unshakable  faith  in  the  word 
of  their  health  guardians,  and  even  if  the  woman  really 
had  yellow  fever,  the  mere  fact  that  a  representative  of 
Her  Majesty  said  that  she  did  not,  was  sufficient.  There 
was  no  "going  behind  the  returns,"  as  we  do  in  America. 

The  case  of  Mr.  Napier  was  the  first  and  last  manifesta- 
tion of  yellow  fever  in  Southampton  in  1852. 

1853. 

During  1853,  yellow  fever  continued  to  rage  in  the  West 
Indies,  particularly  at  Kingston,  Jamaica,  where  the  ves- 
sels of  the  Royal  Mail  Company  continued  to  be  infected, 
as  in  1852.  According  to  the  reports  published  in  the 
Lancet,  British  Medical  Journal  and  London  Medical 
Gazette,  for  1853,  we  glean  the  fact  that  the  following 
vessels  had  yellow  fever  on  board  on  their  homeward  voy- 
age from  America : 

January .     The  Parana.    Infected  at  Saint'  Thomas. 

Thirty  cases;  four  deaths.     On  arrival  at  Southampton, 
thirteen  invalids  were  transferred  from  the  vessel  to  the 


428  HISTORY    OF    YELLOW    FEVER. 

Marine   Hospital.       All   recovered   and   no   other   cases 
oconiTed. 

May  17th.  The  Severn.  Infected  at  Rio  Janeiro  or  at 
Saint  Thomas.  Six  cases;  no  deaths.  Last  case,  May 
2nd.  Fifteen  days  having  elapsed  since  the  last  case,  ti  •■ 
vessel  was  admitted  to  pratique,  after  a  rigid  examina- 
tion.    Xo  other  cases  erupted.  I 

May  18th.  The  Orinoco.  Infected  at  Saint  Thomas. 
Fourteen  cases;  two  deaths.  One  of  the  invalids  being 
"as  yellow  as  a  guinea,"  when  the  Orinoco  reached  South- 
ampton, the  vessel  was  detained  at  quarantine  for  four 
hours,  pending  an  investigation.  A  release  was  tlien 
given,  but  the  "saffron  man"'  was  sent  to  the  quarantine 
station  and  the  yellow  flag  hoisted.  A  guard  was  sta- 
tioned to  prevent  any  possibility  of  escape,  but  the  patient 
improving  rapidly,  was  released  after  a  detention  of  two 
days.  No  other  cases  erupted  while  the  Orinoco  was  at 
Soutliampton,  but  the  vessel  was  reinfected  a  few  weeks 
aftc^rwards,  as  we  shall  see  later. 

May  30.  The  La  Plata.  Infected  at  Saint  Thomas. 
Tliis  i>;  the  steamer  which  imported  the  celebrated  case  of 
Mr.  Xapier  to  Southampton  in  1852.  On  arrival  at  the 
quarantine  station,  it  was  learned  that  there  had  been 
fourteen  cases  and  three  deaths  on  board  since  May  Ttli, 
the  date  of  the  first  case.  The  last  case  had  occurred  <»n 
the  24th,  and  the  last  death  on  the  30th,  the  day  of  her 
arrival  at  Southampton.  Immediately  after  the  conclu- 
sion of  the  investigation,  the  mails  were  landed,  but  the 
ship  was  detained  at  quarantine  and  the  facts  communi- 
cated to  the  Privy  Council  Office.  Orders  were  received 
from  London  to  release  the  liealthy  passengers  at  once, 
but  to  detain  the  ship  until  tlie  afternoon,  in  order  to  com- 
plete the  stinulated  six  days  from  the  outbreak  of  the 
last  case.  Tlie  invalids  were  eventually  transferred  to 
the  Marine  Hospital.     No  new  cases  ensued. 

vluly  17th.  The  Orinoco.  This  is  the  same  vessel 
which  had  had  fourteen  cases  and  tAvo  deaths  on  a  previous 


SOUTHAMPTON,  ENGLAND 1853.  429 

voyage,  noted  above.  On  arriving  at  quarantine,  the  fact 
was  elicited  that  the  first  case  had  appeared  on  the  day 
after  the  ship  arrived  at  Saint  Thomas,  in  the  person  of 
a  seaman.  This  evidently  does  away  with  the  assump- 
tion that  the  vessel  was  infected  at  Saint  Thomas  in  this 
instance,  as  yellow  fever  certainly  takes  more  than  tw' enty- 
four  hours  after  infection  to  manifest  itself,  l^e  that  as 
it  may,  during  the  remainder  of  her  stay  at  Saint  Thomas, 
no  less  than  thirty  cases  occurred,  confined  principally  to 
the  seamen  and  stokers.  After  leaving  Saint  Thomas, 
fifteen  fresh  cases  erupted,  among  Avhich  was  a  passenger. 
The  forepeak  of  the  steamer  was  fitted  up  and  used  as  a 
hospital  during  the  time  the  ship  was  in  the  harbor  of 
Saint  Thomas;  but  on  her  leaving,  the  heat  being  exces- 
sive from  the  closing  of  the  ports,  the  sick  were  removed 
to  the  deck,  where  awnings  were  spread.  This  was  at- 
tended by  a  diminution  of  the  sickness,  which  finally  dis- 
appeared altogether. 

The  Southampton  authorities  took  extraordinary  pre- 
cautions to  prevent  the  disease  from  spreading  to  the 
shore.  All  persons  on  board,  in  good  health,  who  made 
a  sworn  declaration  that  they  had  had,  in  their  lives, 
anything  like  yellow  fever,  were  peruutted  to  land  at 
once.  Those  who  could  not  do  so,  were  put  under  sur- 
Teilance  and  allowed  to  proceed  on  their  way  only  after 
a  rigid  examination. 

The  disease  was  not  communicated  to  the  shore. 

1857. 

The  steamship  Tamar,  which  brought  yellow  fever  to 
Lisbon,  Portugal,  in  1857  (q.  v. ),  entered  Southampton 
shortly  afterwards.^''  She  had  deaths  on  the  passage 
from  Spain  and  gave  rise  to  several  cases  of  yellow  fever 
in  the  harbor  of  Southampton. 


Eager:    Yellow  Fever  Institute  Bulletin   No.   8,  Washington, 
D.  C,  1902,  p.  33. 


430  HIITORY    OF    YELLOW    FEVCR. 

1860. 

On  April  3rd,  1860,  the  Royal  Mail  Steamer  Tyne  ar- 
rived at  Southampton  with  yellow  fever  on  board.  Eight 
cases,  with  three  deaths,  had  occurred  during  the  home- 
ward voyage.  One  of  the  passengers  was  seized  only  eight 
days  before  the  arrival  of  the  ship  at  Southampton.  Three 
of  the  patients,  in  an  extremely  debilitated  condition,  were 
sent  to  the  Marine  Hospital,  where  they  eventually  recov- 
ered.^* iNo  new  cases  manifested  themselves  while  the 
Tyne  was  at  Southampton. 

IRELAND. 

CORK. 

1851. 

A  solitary  instance  of  yellow  fever  having  been  brought 
to  Ireland  is  recorded. 

In  1854,  according  to  the  Lancet  (London),  vol.  1,  page 
90,  1851,  a  vessel  entered  the  harbor  of  Cork,  with  yellow 
fever  on  board.  Two  patients,  who  were  transferred  from 
the  ship  to  the  Marine  ITospital,  died.  This  incident 
created  much  alarm  among  the  inhabitants  of  the  town 
and  prompt  and  extraordinary  precautions  were  adopted 
to  prevent  a  spread  of  the  disease.  No  other  cases 
erupted. 

DUBLIN. 

1857. 

Cummins'*^  relates  a  case  which  came  under  his  obser- 
vation at  Dublin  in  1857,  which  presented  all  the  charac- 

" Lancet  (London),  1860,  vol.  1,  p.  386. 

"Cummins:   Case  of  Fever,  with  Unusual  Symptoms.     Dublin 
Quar.  Jl.  of  Med.  Sciences,  1858,  vol.  26,  p.  212. 


IRELAND,    1857.  431 

teristics  of  yellow  fever.  The  patient,  a  Boy  five  years 
old,  had  exhibited  symptoms  of  ill  health  for  some  months 
previous,  consisting  of  debility,  loss  of  appetite  and  shoot- 
ing pains  in  various  parts  of  the  body.  These  symptoms 
were  given  proper  attention  by  Dr.  Cummins,  but  with- 
out much  decided  or  permanent  improvement.  On  De- 
cember 2,  1857,  the  little  patient  developed  a  fever  which 
seemed  to  be  of  a  gTave  nature.  "From  day  to  day,  as  I 
watched  the  progress  of  the  symptoms,"  observes  Dr.  Cum- 
mins, "I  became  more  and^more  reminded  of  that  disease 
which  numbers  its  victims  by  thousands  within  the  trop- 
ics, but  rarely  carries  its  devastations  to  more  temperate 
regions,  and  as  yet  has  only  been  observed  in  isolated  cases 
in  this  country." 

The  Doctor  did  not  at  the  time  suspect  that  he  was 
dealing  w4tli  a  case  of  yellow  fever,  and  did  not  treat  it 
as  such,  but  remarks  that  if  the  case  had  occurred  in  any 
of  the  habitats  of  yellow  fever,  there  would  not  have 
been  a  second  opinion  about  pronouncing  it  to  be  that 
disease. 

The  patient  died  on  December  9th,  seven  days  after 
the  graver  symptoms  of  his  illness  had  manifested  them- 
selves.    Shortly  before  death,  he  had  black  vomit. 

At  the  time  of  the  above  occurrence,  yellow  fever,  having 
transgressed  its  ordinary  bounds,  had  visited  Southern 
Europe  and  was  making  fearful  ravages  in  Lisbon.  Our 
authority  does  not  give  the  probable  source  of  infection 
in  the  case  under  observation,  leaving  one  under  the 
impression  that  it  originated  in  Dublin.  Such  could  not 
possibly  happen,  however,  under  the  most  vivid  stretch  of 
the  Imagination.  If  the  case  was  one  of  yellow  fever, 
there  is  but  one  way  in  which  it  could  have  been  engen- 
dered. We  regret  our  inability  to  either  verify  or  dis- 
prove the  question  at  issue,  as  the  literature  of  the  period 
fails  to  enlis:hten  us  in  that  direction. 


WALES. 

LLANELY. 

1SC5. 

While  the  yellow,  fever  was  causing  widespread  con- 
sternatiou  at  Swansea  (q.  v.),  the  sloop  Elconorc,  Avhich 
lay  close  to  the  Hecla,  from  September  IGth  to  the  18th, 
Avas  infected  and  carried  the  disease  to  Llahely.^"  Charles 
Hayes,  John  Slocuni  and  Daniel  Stapleton,  sailors  on 
board  the  sloop,  were  attacked.  The  Eleonorc  sailed  for 
Llanely,  where  two  of  the  patients  died.^" 

SWANSEA. 

Yellow  Fever  Years. 

1843;  1851;  18G4;  18G5. 

1843. 

On  Jnly  2r)tli,  1843,  the  brig  piric,  from  Cuba,  arrived 
at  Swansea,  with  a  cargo  of  copper  ore.  Some  of  tlie 
crew  had  died  from  yellow  fever  on  the  homeward  voyage. 
Benjamin  Davies,  a  Swansea  ])ilot,  boarded  the  vessel 
on  her  arrival,  remained  on  board  that  day  at  the  ^fumbles 
Koad,  entered  the  harbor  the  following  day,  the  27th.  He 
repaired  to  his  home  as  soon  as  the  shi])  was  moored.  T\o. 
felt  indisposed,  complaining  of  violent  i)ain  in  the  head 
and  died  on  the  28th,  exhibiting  all  the  symptoms  of 
vellow  fever.^^ 


"Donnet:   Arch,  de  Med.  Navale,  1870.  vol.  14,  p.  118. 
"Buchanan:  Eighth  Report  of  the  Medical  Officer  of  the  Privy 

Council  for  1865  (London,  1866),  p.  443. 
^^  Buchanan,  loc.  cit.,  p.  443. 


SWANSEA,    WALES 1851.  4SS 


1851. 

The  bark  Henrietta,  from  Cuba,  arrived  at  Swansea  in 
the  month  of  August,  1851,  with  a  cargo  of  copper  ore. 
William  Gammon,  a  sailor,  was  employed  to  go  on  board 
as  ship-keeper. While  attending  to  his  duties,  he  was  taken 
ill,  went  home  on  August  25th,  and  died  the  next  day, 
an  unmistakable  victim  of  yellow  fever. 

A  second  case  developed  on  the  Henrietta.  When  Gam- 
mon was  first  taken  ill,  his  brother,  also  a  sailor,  not  sus- 
pecting the  mature  of  his  relative's  illness,  went  on  board 
the  vessel  to  take  his  place.  He  was  also  taken  ill,  but 
having  obtained  the  prompt  service  of  three  doctors,  as 
well  as  that  of  the  ship's  old  captain,  recovered.  His 
illness  is  said  to  have  been  yellow  fever.^^ 

No  other  cases  erupted  on  board  the  HemHetta  nor  was 
the  disease  diffused  on  shore. 


1862. 


During  the  year  18G2,  the  following  vessels  arrived  at 
Swansea  with  histories  of  yellow  fever  on  board  :^" 

The  San  Jose  lost  two  of  her  crew  from  yellow  fever  at 
Cuba. 

The  Florence,  one.  ' 

The  Cornwall,  ten,  five  in  Cuban  ports  and  five  at  sea 
on  the  homeward  voyage.    ^ 

The  Ellen,  eight,  seven  at  Havana  and  one  on  the  pas- 
sage home. 

The  Hampshire,  one. 

The  Mamgosteen,  one. 

The  Countess  of  Bective,  five. 

The  Dorsetshire,  four. 

The  Cohrero,  four. 


"iBuchanan,  loc.  cit.,  p.  443. 
"Buchanan,  loc.  cit.,  p.  444. 


4S4  HISTORY  OF    YELLOW    FEVER. 


1863. 


The  year  1863,  although  not  as  prolific  as  1862,  fur- 
nished the  following  :^i 

The  Florence  lost  one  man  at  Cuba  from  yellow  fever. 
The  Stains  Castle^  one. 

The  Cornioall,  three,  two  at  Cuba  and  one  on  the  way 
home. 

The  San  Jose,  one,  at  Cuba. 

1864. 

In  July,  1864,  the  bark  Mangosteoi,  from  Cuba,  ar- 
rived at  Swansea,  with  a  history  of  yellow  fever  on  board 
during  the  homeward  voyage.  Samuel  Dawkin,  a  ship- 
keeper,  was  placed  in  charge  of  the  vessel.  He  was  soon 
taken  ill  and  died  on  the  third  day.-- 

The  following  vessels  also  furnished  histories  of  yellow 
fever  infection  in  1864  r^ 

The  Dorsetshire,  two  at  Cuba. 

The  Mangosteen,  one,  at  sea. 

The  Pedro  Ferrer,  one,  at  Cuba. 

1865. 
The  Famous  Case  of  the  ''^Hecla.^^ 

The  year  1865  furnished  the  only  epidemic  of  yellow 
fever  which  has  ever  flourished  on  English  soil.  We  shall, 
therefore,  make  free  use  of  Dr.  Buchanan's  masterly  re- 
port of  the  incident.^^  The  facts  as  condensed  from  the 
voluminous  document  in  question,  are  as  follows : 

=*  Buchanan,  loc.  cit.,  p.  444. 
^=  Buchanan,  loc.  cit.,  p.  443. 
^'  Buchanan,  loc.  cit.,  p.  444. 
"Buchanan:  Report  on  the  Swansea  Fever,  published  in  Eighth 

Report  of  the  Medical  Officer  of  the  Privy  Council  for 

1865  (London,  1866),  p.  442,  et.  seq. 


SWANSEA,      WALES 1865.  435 

The  bark  Eecla,  a  wooden  sailing  vessel,  returning  from 
Cuba  to  Swansea  with  a  cargo  of  copper  ore,  arrived  at 
the  British  port  September  8,  1865.  The  vessel  was 
boarded  at  5  P.  M.,  by  George  Morgan,  a  Swansea  pilot, 
fifteen  miles  to  N.  E.  of  Lundy  Island  (about  twenty-five 
miles  off  Swansea)  Morgan  found  the  ship  in  charge  of  a 
Bristol  Channel  pilot,  who  gave  up  his  post  and  returned 
to  his  own  boat.  The  master  informed  Morgan  that  he 
had  a  man  sick  with  dropsy  on  board,  that  he  had  lost 
three  of  his  crew  on  the  voyage  home,  was  in  consequence 
short-handed,  and  desired  the  pilot  to  send  his  boat  ashore 
for  four  or  five  men  to  assist  him  in  coming  in.  This 
was  accordingly  done  and  the  five  men  boarded  the  Hecla. 
The  vessel  anchored  in  the  ]Mumbles  roadstead,  about  9 
P.  M.,  and  showed  a  light  through  the  night.  At  daylight 
on  Saturday,  September  9,  the  ensign  was  hoisted,  and  the 
ship's  number  shown.  iThe  steam  tug  came  up  about  6 
A.  M.,  and  towed  the  Hecla  in,  in  the  ordinary  course. 
Not  a  word  was  said  to  the  pilot  about  yellow  fever,  and 
he  had  no  idea  that  the  nxen  died  of  that  disease.  The 
last  vessel  that  had  arrived  from  Cuba,  less  than  a  fort- 
night before,  had  had  no  sickness  on  board,  and  the  pilot 
had  no  reason,  particularly  as  the  Hecla  had  a  clean  bill 
of  health,  to  believe  that  the  sickness  on  board  was  of  an 
infectious  character. 

The  Hecla  entered  Swansea  harbor  at  9  A.  M.,  on  Sep- 
tember 9,  showing  no  quarantine  flag,  and  giving  no  in- 
dication that  sickness  was  on  board.  She  was  placed  in 
the  North  Dock,  alongside  the  Cobre  Wharf,  in  the  usual 
discharging  berth.  A  good  many  people  went  on  board 
as  she  entered  the  dock.  Within  an  hour  of  the  ship's 
arrival,  two  passengers  were  landed  with  their  baggaige, 
and  the  crew  had  left  the  ship,  and  had  distributed  them- 
selves over  the  town.  Three  men  were  landed  sick;  two 
of  whom  were  recovering  from  "fever;"  one  tlie  captain) 
reported  ill  of  dropsy.  Within  three  hours  of  the  vessel's 
arrival  in  port  the  hatches  Avere  removed,  a  stage  rigged 
and  gangs  of  men  commenced  discharging  the  cargo. 
About  noon  the  sanitary  inspector  came  to  the  mayor, 


436  HISTORY    OF    YELLOW    FEVER. 

told  him  of  the  arrival  of  the  Eecla,  and  stated  to  him 
that  deaths  were  reported  to  have  occurred  on  the  vessel 
in  her  homeward  passage,  and  that  one  seaman  had  been 
landed  from  the  ship  seriously  ill.  The  mayor  went  at 
once  to  the  collector  of  customs  and  to  the  master  of  the 
Hecla,  and  learned  that  the  rumor  about  sickness  on  board 
was  true,  that  some  of  the  deaths  had  been  from  yellow 
fever,  and  that  the  sick  seaman  Avas  suspected  to  be  suf- 
fering from  the  same  disease.  Thereupon  the  mayor  re- 
quested Dr.  Paddon  to  accompany  him,  and  they  went 
together  to  Welcome  Court,  where  the  man,  James  Saun- 
ders, who  had  been  removed  from  the  Hecla,  lay  sick.  He 
had  before  been  visited  by  two  medical  men  ( Messrs.  Har- 
rington and  Thomas).  This  was  the  man  who  was  stated 
by  the  captain  to  be  ill  of  dropsy-.  Dr.  Paddon  found  him 
in  bed,  in  a  wretched  room  of  a  small  filthy  house,  dying 
of  exhaustion  from  fever,  without  any  sign  of  dropsy; 
his  body  tinged  yellow.  He  was  so  near  death  that  no 
detailed  examination  could  be  made.  The  mayor  and  Dr. 
Paddon  had  scarcely  left  the  house  when  the  people  rau 
after  them,  to  say  that  Saunders  was  dead.  Dr.  Paddon 
thereupon  certified  that  he  died  of  "fever,  probably  yellow 
fever." 

At  this  time,  soon  after  noon  on  September  9,  a  good 
deal  of  public  anxiety  existed  about  the  Hecla.  and  about 
the  possibility  of  the  disease  spreading  from  the  house  in 
Welcome  Court  or  from  the  crew.  Under  Dr.  Paddon's 
advice,  the  mayor  caused  the  following  precautions  to  be 
taken :  The  body  of  Saunders  was  put  into  a  tarred  sheet, 
and  buried  within  four  hours  of  his  death ;  the  house 
where  he  died  was  immediately  emptied,  and  disinfected 
with  limewash  and  clilori(3e  of  lime  and,  for  further  safety 
all  the  houses  in  the  court  were  similarly  treated.  ;The 
bedding  and  clothing  of  the  dead  man  were  destroyed, 
and  the  house  was  again  cleansed  and  disinfected  before 
it  was  allowed  to  be  tenanted,  a  week  after.  The  mayor 
also  set  the  police  to  find  out  the  passengers  and  crew  of 
the  Hecla,  instructed  the  sanitary  inspector  to  have  their 
clothes  and  rooms  and  persons  fumigated  with  chlorine. 


SWANSEA,  WALES 1865.  437 

But  the  maj'or  and  Dr.  Paddon  were  further  desirous 
of  dealing  with  the  Hccla  herself,  on  the  supposition  that 
she  might  be  a  source  of  infection.  The  mayor  therefore 
convened  a  meeting  of  magistrates,  to  consider  whether 
there  was  any  power  to  remove  the  vessel  from  the  dock, 
and  if  so,  whether  the  sailors  who  had  left  the  ship  could 
be  compelled,  under  their  articles,  to  take  her  out.  The 
customs  authorities  and  the  board  of  health  were  also 
applied  to.  All  agreed  that  the  vessel  ought  never  to 
have  come  into  port,  but  having  entered  and  partly  dis- 
charged her  cargo,  the  authorities  found  themselves 
powerless  to  insist  on  her  removal.  The  agents  for  the 
owners  of  the  ship  and  cargo  were  communicated  with, 
but  they  at  first  refused  to  allow  either  ship  or  cargo  to 
be  meddled  with,  arguing  that  other  ships  had  come  into 
Swansea  having  had  yellow  fever  on  board  on  their  home- 
ward passage,  that  they  had  never  been  interfered  with, 
and  that  no  ill  results  from  them  had  occurred  to  inhabi- 
tants of  the  town.  After  consultation  with  other  auhori- 
ties  of  the  town,  the  mayor  on  the  afternoon  of  the 
same  day,  September  9,  set  the  police  to  turn  people  off 
the  vessel,  and  keep  etverybody  from  going  on  board  her. 
The  unloading  was  stopped,  and  the  hatches  shut  down, 
but  not  before  some  thirty  tons  of  ore  had  been  taken  out 
and  placed  in  the  Cobre  yard.  Measures  of  purifying  the 
ship  were  now  had  recourse  to;  these  continued  until 
September  12,  and  consisted  in  washing  the  decks  and 
forecastle  with  solution  of  chloride  of  lime,  and  in  the 
copious  sprinklings  of  chloride  in  the  forecastle,  steerage, 
hold,  and  places  of  storage. 

A  man  named  Norman,  whose  case  is  recorded  by  Dr. 
Buchanan,  noticed  when  he  was  on  the  ship  on  the  9th, 
before  any  chemicals  were  used,  that  a  very  bad  odor 
came  from  the  forecastle,  whore  the  sick  people  had  been; 
and  on  Monday  (the  11th),  Dr.  Paddon  observed  even 
the  scupper  holes  filled  with  what  appeared  to  be  excre- 
ment, and  had  them  cleaned  out.  The  fumigation  of  the 
ship  was  finished  on  the  12th;  the  police  were  tlien  re- 
moved,  and  communication   with   the  vessel   permitted. 


4S8  HISTORY    OF    YKLIOW    FEVER. 

On  the  morning  of  the  13th,  she  began  to  discharge  her 
c-argo,  and  finished  unloading  on  the  20th  or  21st  of  Sep- 
teml)er,  lying  all  the  time  alongside  the  Cobre  company's 
yard  into  which  her  ore  was  taken.  The  agent  for  the 
Cobre  company  had  this  ore  sprinkled  with  disinfecting 
fluid. 

Medical  History  of  the  '"'^Hecla^'  Previous  to  Her  Ar- 
rival AT  Swansea. 

On  the  afternoon  of  the  day  when  the  Hccla  arrived,  as 
soon  as  action  had  been  taken,  inquiry  into  the  history  of 
the  vessel  and  into  the  circumstances  of  her  arrival  was 
more  accurately  made.  At  about  3  P.  M.,  the  collector 
of  cusoms  instructed  the  examining  officer  to  put  to  the 
master  the  usual  quarantine  questions.  It  must  be  pre- 
mised that  the  master  had  been  guilty  of  an  infraction  of 
the  quarantine  laws,  and  that  his  answers  were  defensive 
in  character,  and  were  not  always  consistent  with  them- 
selves. From  them  it  appears  that  the  Hecla  left  Swan- 
sea on  May  1,  and  touched"  at  no  place  until  she  arrived 
at  Cuba;  that  she  left  Cuba  on  the  2Gth  of  July  with  a 
clean  bill  of  health,  again  touching  at  no  place  in  the 
homeward  voyage.  The  master's  answers  further  state 
that  he  was  not  aware  of  any  infectious  disease  prevailing 
in  any  degree  at  the  place  from  which  he  sailed,  but  that 
he  heard  reports  of  sickness  at  Cuba.  He  states  that  two 
seamen  died  at  Cuba.  (In  a  subsequent  examination  by 
Mr.  Cullum,  of  the  customs,  the  master  stated  that  before 
sailing  from  Cuba  several  cases  of  sickness  occurred,  and 
on  July  21,  George  Wilson  died  in  the  hosspital  on  shore, 
and  Hansel  Pederson  was  left  in  the  hospital  sick). 
The  master  further  stated  that  he  had  four  officers,  ten 
seamen,  and  two  passengers  on  board  (they  had,  however, 
dispersed  at  the  time  the  examination  was  taken),  and 
that  in  the  course  of  his  homeward  voyage  he  lost  three  of 
those  on  board,  viz.,  on  August  11,  one  man,  sixteen  days 
sick;  on  August  24,  a  second,  three  days  sick;  and  on  Sep- 


SWANSEA,     WALES — 1865.  439 

tomber  1,  a  third,  forty-two  days  sick.     The  bedding  and 
pillows  of  these  men  were  thrown  overboard. 

Saunders,  who  died  on  the  day  of  the  Eecla's  arrival  at 
Swansea,  had  been  fourteen  days  sick.  Of  the  six  deaths, 
two  had  been  from  yellow  fever,  tAVO  from  intermittent. 
(In  his  statement  to  Mr.  Cullum  the  master  says  he  con- 
sidered Saunders  was  suffering  from  dropsy.  In  the  book 
of  "receipts  of  wages  and  effects  of  deceased  seamen,"  the 
cause  of  death  of  each  of  the  six  men  is  entered  as  "yellow 
fever.")  Among  other  answers  to  the  quarantine  ques- 
tions, the  master  stated  that  all  except  the  cases  now  men- 
tioned had  been  well  during  both  voyages  and  at  Cuba. 
(In  his  subsequent  statement  to  Mr.  Cullum,  however,  he 
soys  that  several  cases  of  sickness  ccurred  before  sailing 
from  Cuba,  and  that  during  the  passage  home  several  of 
the  crew,  besides  those  who  died,  were  sick). 

A  Peculiar  *^^Quarantine.^' 

Those  answers  having  been  obtained  from  the  master, 
the  collector  of  customs  forwarded  them  on  September  9, 
to  the  Commissioners  of  Customs  in  London,  and  stated 
that  "he  had  put  the  vessel  in  quarantine."  On  being 
questioned  by  Dr.  Buchanan,  on  October  3,  as  to  what 
this  statement  signified,  inasmuch  as  the  crew  were  al- 
ready dispersed,  and  the  vessel  partly  unloaded,  the  col- 
lector said  that  he  meant  that  he  had  the  quarantine 
questions  put,  and  that  the  mayor  had  prevented  com- 
munication with  the  ship,  and  had  had  her  hatches  shut; 
but  that  the  customs  authorities  had  adopted  no  pre- 
ventive measures. 

Ignorance  of  the  Law  Is  Sometimes  an  Excuse. 

Dr.  Paddon  was  desirous,  on  September  9,  tlmt  the 
Board  of  Trade  should  be  at  once  acquainted  Avith  the 
circumstances  by  telegraph,  and  their  instructions  asked. 
Finding  this  was  not  done,  he  wrote  on  September  11  to 


i' 


440  HISTORY    OF    YELLOW    FEVER. 

the  president  of  the  Board  of  Trade,  detailing  the  chief 
points  already  abstracted  here. 

On  September  15  the  Board  of  Customs  instructed  Mr. 
Cullum,  their  collector  at  Newport,  to  proceed  without 
delay  to  Swansea,  and  to  institute  a  ful  linquiry  into  the 
circumstances  connected  -^dth  the  Hecla.  The  chief  points 
elicited  in  this  inquiry  have  already  been  stated. 

The  observations  of  the  Board  of  Customs  upon  Mr. 
Cullum's  report  are,  "that  there  has  been  great  n'regu- 
larity  and  neglect  of  the  usual  precautions  on  the  part 
of  all  persons  on  board,  and  that  the  master,  the  Swansea 
pilot,  as  well  as  the  Bristol  pilot,  and  the  crew  who  landed 
from  the  vessel  have  in  strictness  rendered  themselves 
liable  to  prosecution  under  the  quarantine  laws.  They 
would,  however,  appear  to  have  acted  in  ignorance  and 
not  from  any  willful  intention  of  violating  the  law."  This 
opinion  having  been  communicated  to  the  Privy  Council, 
the  custom,s  authorities  were  informed  that  the  parties 
implicated  must  be  warned  of  their  liability  to  prosecu- 
tion, but  that  under  the  circumsances  no  prosecution 
would  take  place. 

This  is  one  of  the  few  instances  on  record  where  igno- 
rance of  the  law  has  proved  a  convenient  loophole  for  the 
guilty  to  escape.  And  yet,  we  have  always  been  led  to 
believe  from  infancy  that  the  majesty  of  the  law  is 
supreme  in  Britain,a  delusion  which  Dr.  Buchanan's  re- 
port punctures  beyond  re-inflation. 

The  Epidemic. 

After  Saunder's  interment,  and  after  the  precautions 
before  described  had  been  taken,  no  further  alarm  appears 
to  have  been  felt  about  yellow  fever.  The  Hecla  some 
days  after  unloading,  was  transferred  from  her  place  by 
the  Cobre  Wharf  into  the  Beaufort  Dock,  a  branch  of  the 
North  Dock,  surrounded  by  high  warehouses.  But  on 
September  23,  the  registrar  of  births  and  deaths  in  Swan- 
s«ea,  got  a  medical  certificate  that  a  death  had  occurred 
from  yellow  fever,  and  heard  it  reported  that  other  cases 
were  about  the  town.     That  letter,  transmitted  by  the 


I 


SWANSEA,   WALES 1865.  441 

Eegistrar  General  of  births  and  deaths  to  the  Privy  Coun- 
cil Oilice,  was  the  immediate  cause  of  the  inquiry  headed 
by  Dr.  Buchanan  being  set  on  foot.  This  eminent  scient- 
ist discovered  that  since  the  arrival  of  the  Hecla,  cases  of 
true  yellow  fever  had  occurred  among  residents  of  Swan- 
sea. The  character  and  sequence  of  the  attacks  were  only 
made  out  by  degrees;  each  is  related  separately  with  as 
much  accuracy  as  possible  in  the  supplement  to  the  ex- 
haustive report  from  which  this  account  is  taken.  The 
history  of  these  cases,  while  exceedingly  interesting,  pre- 
sents the  same  clinical  and  pathological  features  which 
are  seen  in  the  average  case  of  j-ellow  fever,  and  not  to 
make  this  chapter  too  lengthy,  are  omitted  here. 

Dr.  Buchanan  calls  attention  to  the  fact  that  during 
the  summer  of  1865,  and  at  the  time  of  this  outbreak, 
there  had  been  extremely  little  fever  of  any  sort  m  swan- 
sea.  What  did  exist  was  ordinary  typhiod,  and  there 
were  no  cases  of  this  on  the  island.  There  was  not,  and 
there  had  not  been  for  many  years,  any  instance  of  relaps- 
ing fever. 

'Between  September  15,  when  the  first  case  occurred, 
to  October  13,  when  the  last  case  became  convalescent, 
there  were  twenty-two  cases  in  which  the  diagnosis  of 
yellow  fever  could  pretty  certainly  be  mjade,  and  seven 
other  cases  in  which  the  circumstances  of  exposure  or  the 
character  of  the  attack  led  to  a  more  or  less  strong  suspi- 
cion that  the  illness  was  of  the  same  nature. 

Of  the  cases  diagnosed  yellow  fever,  fifteen  died — be- 
sides the  man  brought  by  the  Hecla — and  seven  recovered. 
Of  the  doubtful  cases,  one  died,  and  six  recovered. 

Interesting  Points  of  the  Epidemic. 

Other  ships  having  arrived  at  Swansea  from  infected 
localities  in  1865,  it  appeared  right,  before  connecting  the 
Hecla  with  the  deaths  wliich  occurred  after  her  arrival, 
to  make  quite  sure  that  no  other  vessels  which  had  entered 
the  liarbor  of  the  English  port,  coming  from  an  American 
or  West  Indian  port,  had  had  any  cases  of  yellow  fever — 


448  HISTORY    OF    YELLOW    FEVER. 

even  not  fatal — on  board.  In  answer  to  an  inquiry  on 
this  score,  the  Kegistrar  General  of  Seamen  furnished 
Dr.  Buchanan  extracts  from  the  logs  of  all  vessels  so 
arriving  within  two  months  preceding  the  Hccla  incident. 
These  extracts  showed  that  of  the  twenty-four  ships  com- 
ing from  Cuban  waters  which  discharged  their  crews  at 
Swansea  during  the  year  in  question,  only  three  gave 
histories  of  deaths  from  yellow  fever,  viz. :  The  Aur/usta 
Schneid^r^  one;  the  Victoria,  two  at  sea;  and  the  Hccla, 
whose  history  is  given  in  these  pages. 

This  information,  coming  from  such  high  authority,  led 
Dr.  Buchanan  to  the  conclusion  that  no  other  vessel  than 
the  Hecla  could  be  connected  with  the  outbreak — an  opin- 
ion which  is  no  doubt  shared  by  all  those  who  have  fol- 
lowed the  history  of  this  remarkable  epidemic. 

The  rise  and  progress  of  this  epidemic  shows  that  all 
those  attacked  either  went  on  board  the  Hccla  or  visited 
the  homes  of  the  stricken  ones.  This  proves  beyond  ques- 
tion that  a  small  colony  of  yellow  fever  mosquitoes  vras 
imported  to  Swansea  either  by  the  ship  in  question  or  by 
other  ships  coming  from  the  natural  habitat  of  the  in- 
sects. To  the  fact  that  the  winged  pests  were  not  present 
in  large  numbers,  is  due  the  escape  of  the  balance  of  the 
population  of  the  thriving  seaport  from  a  disastrous  visi- 
tation of  the  West  Indian  pestilence. 

Many  interesting  incidents  are  brought  to  light  in  Dr. 
Buchanan's  report.  For  example,  the  sloop,  EJcnuorc, 
which  remained  about  three  days  alongside  the  Hccla, 
discharging  her  cargo,  left  Swansea  for  a  neighboring  port 
(Llanely,  q.  v.),  where  she  lost  tAvo  of  a  crew  of  four,  one 
of  tliein  certainly  from  yellow  fever. 

Another  remarkable  fact  is  that  the  Bristol  and  Swan- 
sea pilots,  the  five  seamen  who  helped  to  bring  the  ship 
into  the  harbor,  the  custom-house  officers  and  men,  and 
almost  all  the  men  employed  in  discharging  the  Hccla'fi 
cargo,  escaped  an  attack  of  the  fever  (the  after-history  o,f 
most  of  them  being  known),  although  they  had  much  more 
direct  dealing  Avith  the  ship  than  the  persons  AA'ho  AA-ere 
attacked.       For  this  circumstance,  Dr.  Buchanan  states 


WOOLWICH,    ENGLAND 1846.  4-4,3 

that  no  explanation  can  be  offered.  In  this  age  of  ad- 
vanced scientific  knowledge,  however,  it  is  easy  to  account 
for  this  apparently  extraordinary  immunity.  It  can  be 
explained  in  a  few  plain  words :  They  were  not  bitten  by 
the  active  agent  of  infection,  the  nefarious  Stegomyia 
calopus.  But  iclitj  they  were  not  bitten  while  others,  less 
exposed,  were,  requires  a  modern  Edipus  to  elucidate. 
We  are  modern,  but  we  have  no  Edipian  faculties. 

WOOLWICH. 

1840. 

The  Eclair  is  accused  of  having  infected  Woolwich 
in  1846.  After  the  incident  of  1845,  the  vesel  was  brought 
to  that  port,  where  it  Avas  thoroughly  renovated  and,  to 
make  the  metamorphosis  more  complete,  the  name  Eclair 
was  stricken  from  the  marine  register  and  the  rehabili- 
tated vessel  christened  Rosamond.  But  the  infection  was 
still  dormant  in  the  hold  and  broke  out  while  the  ship 
was  being  put  in  trim  for  a  voyage  to  the  South  Atlantic 
stations.  Four  men  were  attacked  with  what  the  Second 
Report  on  Quarantined^  is  pleased  to  be  called  "typhus," 
but  which  was  no  doubt  yellow  fever.  Two  of  the  patients 
died  in  the  Woolwich  hospital.  What  gives  additional 
color  to  the  assumption  that  the  disease  was  yellow  fever, 
is  the  fact  that  in  February,  1847,  three  days  after  leaving 
Woolwich,  another  "suspicious"  case  was  observed,  fol- 
lowed in  rapid  succession  by  others  as  the  vessel  neared 
the  tropics.  When  in  the  neighborhood  of  the  Cape  Verd 
Islands,  before  any  communication  was  had  with  the  shore, 
a  sailor  died  on  board,  having  vomited  black  for  two 
days,  after  having  shown  other  marked  characteristics  of 
yellow  fever  infection.  We  can  therefore  safely  assert 
that  the  outbreak  at  Woolwich,  while  the  ship  was  being 
renovated,  was  a  typical  manifestation  of  yellow  fever. 


"  Second  Report  on  Quarantine,  1852,  p.  98. 


444  HISTORY    OF    YELLOW    FEVER, 

1848. 

The  war-steamer  Grmoler  infected  Woolwich  in  a  round- 
about way  in  1848.  The  vessel,  which  was  employed  in 
conveying  liberated  Africans  to  the  West  Indies,  left 
Sierra  Leone  on  November  12,  1847,  and  arrived  at  Trini- 
dad on  December  5.  During  the  voyage,  forty-six  deaths 
occurred  among  the  emigrants  from  dysentery  and  two 
from  "fever."  The  total  number  of  cases  of  "fever"  under 
treatment  was  seventy-five,  of  which  seventy-two  recov- 
ered. After  visiting  other  West  Indian  Islands  and  being 
accused  of  infecting  Barbadoes,  the  Groiolei'  returned  to 
Africa,  whence  she  sailed  for  Woolwich.  When  the 
hatches  were  opened  at  that  port,  two  men  who  slept 
directly  over  the  hatchway,  were  afterwards  seized  with 
fever,  possessing  all  the  characteristics  of  yellow  fever 
and,  in  the  course  of  a  few  days,  both  had  black  vomit  and 
died  in  the  Marine  Infirmary.-^  The  fact  that  they  slept 
near  the  open  hatchway  made  them  an  easy  prey  to  the 
infected  mosquitoes  which  were  lurking  in  the  ship's  hold. 
The  disease  did  not  spread  to  the  town. 

"Bryson:    Climate  and  Diseases  of  the  African   Stations,  p. 
224;   also  Milroy:    Lancet,  London,  1853,  vol.  1,  p.  461. 


HISTORY 


OF 


YELLOW    FEVER 


IN 


ITALY. 


ITALY. 

Italy  is  the  easternmost  country  in  Europe  where  yel- 
low fever  has  been  observed.  Only  on  two  occasions, 
however,  has  the  disease  made  any  progress  on  its  shores — 
Leghorn,  in  1804,  and  Torre  Annuziata,  in  1883.  The 
only  epidemic  of  any  consequence  was  that  of  Leghorn. 


CHRONOLOGY  OP  YELLOW  FEVER  IN  ITALY. 

1804.  Leghorn;  Pisa. 

1821.  Leghorn. 

1828.  Leghorn. 

1850.  Genoa. 

1868.  Naples. 

1870.  Vajrignana. 

1883.  Torre  Annunziata. 

By  Localities. 

Genoa.     1850. 

Leghorn .     1804 ;  1821 ;  1828. 

Naples.    1868. 

Pisa.     1804. 

Torre  Annunziata.     1883. 

Varignana.     1870. 

-GENOA. 

Description. 

Genoa  is  a  seaport  of  Northern  Italy,  on  the  coast  of 
the  Mediterranean,  at  the  head  of  the  Gulf  of  Genoa, 
seventy-five  miles  southeast  oft  Turin.  It  is  one  of  the 
oldest  cities  of  Europe,  its  origin  being  said  to  be  more 
remote  than  that  of  Rome.  Its  population  in  1883  was 
about  140,000;  in  1903,  222,000. 


iiS  HISTORY    OF    YELLOW    FEVER. 

Yellow  Fever  Years. 

1850;  1903.  ! 

Summary  of  Importations. 

1850. 

A  vessel  from  Pernamlnico,  Brazil,  is  accused  of  bring- 
ing yellow  fever  to  Genoa  in  1850.  No  details  are  given 
by  our  authority.^ 

1903. 

Tlie  health  authorities  of  Genoa  were  put  on  the  qui 
Vive  in  April,  1903,  by  the  report  that  the  steaiier 
Antonina,  froaii  Buenos  Ayres,  which  arrived  at  the  Ital- 
ian port  on  April  23,  was  infected  with  yellow  fever.'"* 
An  investigation  revealed  the  fact  that  a  "suspicious 
death"  had  occurred  during  the  voyage.  As  the  Antonina 
carried  743  passengers  destined  for  Genoa  and  contiguous 
ports,  precautionary  measures  were  immediately  taken  to 
prevent  a  spread  of  the  disease.  No  cases  erupted  while 
the  vessel  was  at  Genoa. 

LEGHORN. 

Description.  ' 

Leghorn  is  an  im[[3ortant  seaport  of  Western  Italy,  on 
the  Mediteranean,  twelve  miles  southwest  of  Pisa  and 
sixty-two  miles  west  of  Florence.  Leghorn  Avas  a  mere 
fishing  village  in  1121,  when  it  fell  into  the  hands  of  the 
Florentines,  and  it  continued  toi  be  a  place  of  small  im- 
portance till  the  IGth  Century,  when  the  decline  of  Pisa 
as  a  commercial  mart  gradually  gave  it  prominence  until  J 
it  now  ranks  third  among  the  chief  ports  of  Italy,  being 
excelled  only  by  Naples  and  Genoa. 

^Berenger-Feraud:    Traite  Theorique  et  Pratique  de  la  Flevre 
Jaune  (Paris,  1890),  p.  120. 
'  U.  S.  Public  Health  Reports,  1903,  vol.  15,  p.  852. 


449 


Yellow  Fever  Years. 

1804;  1821;  1828. 

Summary  op  Epidemics. 

1801. 

Keating^  claims  that  yellow  fever  was  present  at  Leg- 
horn in  1801,  and  that  "150  died  daily  for  several  months.'^ 
A  search  through  the  works  of  Palloni,^  Tomassini,^ 
Dessessartz  and  Halle,^  Guillaume  and  Gouet,"^  Ozanam,* 
Berenger-Feraud,^  Mocchi,  Pasquetti  and  Brynole,^" 
Guignon,^^  and  others  who  have  written  at  length  npon 
the  prevalence  of  the  disease  at  Leghorn,  fails  to  verify 
Keating's^  statement.  The  learned  gentlemen  evidently 
got  his  dates  mixed  or  inadvertently  substituted  Leghorn 
for  some  other  locality. 

1804. 

The  epidemic  of  yellow  fever  which  almost  devastated 
Leghorn  in  1804  was  for  a  long  time  the  subject  of  much 

'Keating:  History  of  Yellow  Fever,  1879,  p.  81. 

*  Palloni :  Observatione  Mediche  ^Sulla  Malattia  Febrile  Domin- 

ante  in  Livorno.     Livorno,  1804. 
'Tomassini:    Recherches   Pathologiques   sur  la  Fievre  Jaune, 

Paris,  1812. 
•Dessessartz  et  Halle:  Jl.  Gen.  de  Med.,  Chir,  et  Pharm.,  Paris, 

1805,  vol.  23,  pp.  3;  19. 
'Guillaume    et   Gouet:    Jl.   de   Med.,    Chir.    et    Pharm.,    Paris, 

1805,  vol.  23,  pp.  274;   331. 
'Ozanam:    Histoire    Generale,    Medicale    et    Particuliere    des 

Maladies  Epidemiques,  1835,  vol.  3. 
'  Berenger-Feraud :   Loc.  cit. 
"Mocchi,    Pasquetti    and    Drynole:     Relazione    Medica    della 

Malattia  cho  Domina  Presentimente  in  Livorno.  Livorno, 

1812. 
"Guignon:   Dissertation   sur  la  Fievre  Jaune   qui  a  Regne  a 

Livourne  en  1804.    Paris,  1810. 


450  HISTORY    OF    YELLOW   FEVEER. 

heated  discussion  as  to  diagnosis  and  source  of  infection. 
Bally ^^  incriminates  a  Jew  from  Gibraltar,  "who  surrepti- 
tiously entered  the  city;  other  authors  contend  that  the 
disease  was  of  home  origin,  while  some  place  the  onus 
on  America.  The  most  plausible  and  generally  accepted 
opinion,  however,  is  the  one  expounded  by  Ozanam,^^  who 
implicates  the  Anna  Maria  in  the  importation.  The  facts 
are  as  follows: 

A  Spanish  ship,  the  Anna  Maria,  entered  the  pJort  of 
Leghorn,  August  18,  1804.  On  a  voyage  from  Havana 
to  Cadiz  this  vessel  had  lost  the  entire  crew  from  yellow 
fever.  At  Cadiz  the  ship  was  refused  permission  to  enter 
port,  but  was  allowed  tO'  recruit  the  crew  in  quarantine. 
Through  some  irregularity  the  Anna  Maria  was  given 
clean  papers  at  Cadiz  and,  July  10,  passed  Gibraltar  and 
prjoceeded  to  Alicante,  where  she  received  free  pratique. 
The  vessel  sailed  from  Alicante  Augaist  9,  and  reached 
Leghorn  August  18.  Owing  to  the  prevalence  of  yellow 
fever  in  Spain,  special  sanitary  restrictions  had,  since 
July  17,  been  placed  on  all  vessels  arriving  at  Leghorn 
froim  Spanish  ports.  There  had  been  sickness  on  board 
the  Anna  Maria  on  the  passage  from  Alicante  to  Leghorn. 
The  declaration  of  the  captain,  supported  by  oath,  and 
the  liberal  donations  of  money  made  by  the  owner  of  the 
cargo,  appear  to  have  been  effective  in  quieting  all  appre- 
hensions at  Leghorn.^"*  The  ship  was  given  free  pratique. 
Two  sick  men  taken  from  aboard  were  carried  ashore  and 
lodged  at  an  inn  in  the  Strada  Pescheria  Vecchia.  These 
men  died  three  days  after,  and  a  few  days  later  twelve 
persons  at  the  inn  were  taken  sick.  All  the  cases  puded 
fatally.     A  Neapolitan  who  had  left  the  inn  at  the  first 


"Bally:   Typhus  d'Ameriqne   (Paris,  1814),  p.  91. 

"Ozanam:  Historire  Medicale,  GeneraJe  et  Particuliere  des 
Maladies  Epidemiques   (Paris,  1835),  vol.  3,  p.  227. 

"This  incident  goes  to  prove  that  "graft"  is  not  a  strictly 
modern  American  institution,  but  has  done  much  to 
shape  the  destiny  of  the  world  since  the  day 
Mephistopheles  handed  Adam  that  delicious  apple  in  the 
Garden  of  Eden. — G.  A. 


LEGHORN 180i.  451 

appearance  of  the  disease  was  attacked  ten  days  after  and 
died  in  another  neighborhood.  A  French  butcher  who 
took  breakfast  at  the  inn  in  the  Strada  Pescheria  Vecchia 
died  of  the  disease  in  ten  days.  Soon  after  his  wife,  the 
woman  who  owned  the  house  in  which  he  lived,  and  a 
friend,  an  oflS'cer  of  the  French  army,  died  of  the  same 
affection.  At  the  time  these  events  were  occur ing  at  the 
inn,  another  focus  was  formed  at  a  bakery  in  the  Via 
San  Antonio.  A  baker  had  brought  from  the  infected 
ship  a  quantity  of  sacks  which  were  to  be  filled  with 
biscuits.  The  bread  was  baked  in  the  night  and,  in  the 
intervals  between  ovenfuls,  the  bakers  rested  themselves 
by  lying  down  on  the  empty  bags.  iln  a  few  days  these 
men  were  stricken  with  a  strange  malady.  Suspicion 
was  directed  against  the  Anna  Maria  as  the  source  of  the 
disease,  and  sanitary  guards  were  stationed  aboard.  In 
their  turn,  the  guards  acquired  the  disease, 
and  wood  used  in  the  art  of  dyeing,  and  was  stored  in 
warehouses  in  different  part  0(f  the  city.     In  the  neigh- 

The  cargo  of  the  Anna  Maria  consisted  of  sugar,  hides 
borhood  of  these  magazines  the  disease  gained  quick  head- 
way. The  porters  who  handled  the  goods  and  the  cus- 
todians of  the  warehouses  were  taken  with  the  disease. 
Two  porters  and  one  custodian  died.  Thus,  spreading  by 
degrees,  the  malady  extended  throughout  the  city  of  Leg- 
horn. At  that  period  Leghorn  had  a  population  of  60,666, 
not  including  the  men  of  the  French  garrison.  Abofiit 
7000  fled.  The  French  soldiers  were  transferred  else- 
where. None  of  those  who  left  the  city  carried  the  dis- 
ease to  the  places  they  fled  to,  with  the  exception  of  two 
refugees  who  died  at  Pisa  ( q.  v. ) 

Authorities  widely  differ  as  to  the  total  mortality. 
Lacoste  says  that  1,900  died  during  siege  of  the  fever, 
Lacoste^^  savs  that  1,900  died  during  siege  of  the  fever, 


"Lacoste:    Dissertation  Historique  sur  la  Fievr©  Regnante  a 

Llvourne,  etc.    Livourne,  1804. 
"Coppl:  Cenni  Storici  di  Alcunne  Pestilenze.    Roma,  1832. 
"Bally:  Typhus  d'Amerique,  p.  81. 
"PallonI:  Loc.  clt. 


45 €  HISTORY    OF    -iTELLOW    FEVER. 

last  named  fij^ures  are  those  generally  accepted.     Accord- 
ing to  Palloni's  computation,  the  deaths  were  as  fodlows: 

August    7 

September    51 

October   204 

November 390 

December    3 

Total 655 

The  fever  was  at  its  height  in  the  beginning  of  Novem- 
ber, gradually  declined  after  the  15th  of  the  month,  and 
had  totally  disappeared  by  December  9th. 

1821. 

Cornilliac-^'^  claims  that  yellow  fever  was  present  in  the 
shipping  at  Leghorn  in  1821. 


1828. 

According  to  Cornilliac,-^  a  vessel  brought  yellow  fever 
to  Leghorn  in  1828.     There  was  no  spread  of  the  disease. 


NAPLES. 


Description. ' 

Naples  is  the  most  populo'iis  city  of  Italy.  It  is  situ- 
ated on  the  shores  of  the  Adriatic,  on  the  Bay  of  Naples, 
at  the  foot  of  Mount  Vesuvius,  118  miles  southeast  of 
Eome. 


"Cornilliac:       Recherches      Chronologiques,      etc.,      (Fort-de- 
France,  Martinique,  1886),  p.  228. 
"Cornilliac:  Loc.  cit.,  p.  228. 


ITALY.  453 

1868. 

Profilo-^  relates  an  interesting  case,  said  to  be  yellow 
fever,  which  was  observed  in  Naples  in  1868.  j  The 
patient,  a  gunsmith,  aged  40  years,  came  to  Naples  froan 
Torre  Annunziata.  The  onset  of  the  attack  occurred  on 
February  10,  and  he  was  admitted  to  the  Hospital  in  the 
clinical  ward  of  Prof.  Cardarelli  on  the  eighth  day  of  the 
disease,  February  18,  At  that  time,  his  skin  and  visible 
membranes  were  of  a  decided  yellow^  color.  Albumin 
was  present  in  the  urine.  Under  careful  treatment,  his 
condition  improved  and  about  two  weeks  later  he  left 
the  hospital  to  return  to  his  home  in  the  Province  of 
Parma. 

A  careful  search  through  Profilo's  article  fails  to  dis- 
close the  source  of  infection  in  this  case.  In  his  synop- 
sis of  the  symptomatology,  the  learned  gentleman  says  that 
the  diagnosis  was-  tifo  icterodes  biliosa.  'We  doubt  very 
much,  from  a  careful  digest  of  the  clinical  history  given  by 
Dr.  Profilo,  that  this  Avas  a  case  of  yellow  fever  and  for  this 
reasoe  do  not  include  it  in  our  chronology.  We  have 
given  it  a  place  in  this  volume  for  the  reason  that  it  is 
the  only  instance  where  a  case  of  yellow  fever  is  said  to 
have  been  observed  in  Naples. 

PISA. 

Descrijytion. 

Pisa  is  a  city  of  Northern  Italy,  capital  of  the  province 
of  the  same  name,  six  miles  from  the  Mediterranean  and 
forty-f/our  miles  w^est  of  Florence.  It  is  located  on  both 
banks  of  the  Arno,  liere  crossed  by  three  stone  bridges 
for  general  traffic  and  one  for  tlie  railway.  In  the  north- 
west part  of  the  city  are  the  famous  "Leaning  Tower" 
and  the  Campo  Santo,  the  most  remarkable  cemetery  in 
the  world. 


"Profile:   Un  Caso  de  Tifo  Icterode.     Morgan!   (Napoli),  1868, 
vol.  10,  p.  897. 


454  HISTORY    OF    YELLOW    FEVER. 

Yellow  Fever  Year. 

1804. 

Summary  op  Importation. 

During  the  prevalence  of  the  great  epidemic  of  yellow 
fever  at  Leghorn  in  1804,  7,000  of  its  terror-stricken  in- 
habitants fled  to  the  surrounding  country.  Of  this  vast 
number,  only  two  carried  the  infection  with  them.^^ 
These  two  were  stricken  sick  after  their  arrival  at  Pisa 
and  died  with  black  vomit  a  few  days  after  the  onset  of 
the  attack.  The  population  of  Pisa  was  thrown  into  con- 
sternation and  the  refugees  made  preparations  to  flee 
anew.  '  The  authorities,  to  stem  the  threatened  panic, 
publicly  burned  the  belongings  of  the  dead,  proclaiming 
that  such  a  course  would  prevent  the  "contagion"  from 
spreading.  No  other  cases  erupting,  confidence  was  re- 
stored and  to  this  day  the  good  people  of  Pisa,  no  doubt, 
attribute  their  escape  from  a  visitation  of  the  terrible 
pestilence  to  the  incineration  of  the  clothes  and  bedding 
of  the  two  victims  of  the  scourge. 

TOREE  ANNUNZIATA. 

Description. 

Torre  Annunziata  is  a  seaport  in  the  Province  of 
Naples,  Italy,  at  the  foot  of  Vesuvius,  on  the  Bay  of 
Naples.  1 

Yellow  Fever  Year. 
1883. 

Summary  of  Epidemic. 

The  second  epidemic  of  yellow  fever  on  Italian  soil 
took  place  at  Torre  Annunziata  in  1883,  nearly  eighty 
years  after  the  "Great  Epidemic"  of  1804.  The  terror 
which  this  visitation  of  the  Saffron  Scourge  would  have 

^Dictionaire  des  Sciences  Medicale  (Paris),  vol.  15,  p.  356. 


TORRE  ANNUNZIATA 18HS.  455 

otherwise  caused,  was  totally  overshadowed  by  the  greater 
epidemic  of  cholera  which  threatened  to  overrun  Italy  that 
year  and  which  created  such  havoc  in  Naples  the  following 
year. 

According  to  researches  made  by  Eager^^,  the  first  case 
occurred  June  19,  1883,  in  the  person  of  a  tavern  keeper, 
aged  60,  from  Ischia.  This  man  went  directly  from 
Ischia  to  Torre  Annunziata,  May  29,  to  transact  business 
as  a  wine  merchant.  His  case  was  diagnosed  as  one  of 
grave  icterus  and  he  died  July  8,  in  Via  Cisterna.  A 
few  days  later  another  man,  80  years  old,  living  in  the 
Via  del  Popolo,  two  or  three  blocks  away,  died  with  the 
same  symptoms.  The  attending  physicians  made  a  diag- 
nosis of  acute  yellow  atrophy  of  the  liver.  The  third 
ease  was  that  of  a  woman  aged  70  years,  who  died  August 
25,  after  an  illness  of  eight  days.  She  lived  in  Via  Gari- 
baldi, within  two  blocks  of  the  first  cases.  The  same 
diagnosis  of  acute  yellow  atrophy  was  made. 

Early  in  September,  several  persons  living  in  Via  Cis- 
terna were  taken  sick  about  the  same  time  and  with  the 
«ame  symptomls.  An  alarm  arose  and  strict  sanitary 
measures  were  employed.  September  6,  a  custom-house 
clerk  in  Via  Cisterna  was  taken  ill.  He  had  a  chill,  pains 
iu  the  back,  high  fever,  slow  pulse,  severe  headache  and 
black  vomit.  He  died  in  seven  days.  Cases  continued 
to  appear  in  the  same  neighborhood  until  October  13. 
There  were  in  all  thirteen  cases  and  seven  deaths.  In 
September,  a  commission  of  medical  men  from  the  Uni- 
versity of  Naples  investigated  the  disease.  Among  them 
was  Professor  Somma,  who  died  in  the  cholera  epidemic 
at  Naples  the  next  year.  Aitev  much  discussion  the 
members  of  the  commission  admitted  the  specific  nature 
of  the  malady,  but  did  not  give  it  a  name.  However, 
Proifessor  Somma,  in  a  concise  letter  written  September 
24,  1883,  to  Dr.  Gennaro  Cozzolino,  made  the  statement 
that  the  disease  prevailing  at  Torre  Annunziata  was  yel- 
low fever.     During  the  height  of  the  epidemic  the  most 


Eager:  Bull.  No.  8,  Yellow  Fever  Institute,  1902  ,p.  31 


456  HISTORY  OF  YELLOW  FEVER. 

careful  investigations  were  made;  necropsies  were  con- 
ducted by  the  most  skillful  pathologists  of  Naples;  a 
special  lazaretto  was  established,  and  the  most  stringent 
measures  of  isolation  and  disinfection  insisted  upon.  The 
disputes  between  medical  men  were  numerous  and  more 
or  less  violent.  As  a  result,  the  consensus  of  opinioai  ex- 
cluded yellow  fever.  Icteroid  typhus  and  infective  fever 
characterized  by  jaundice  were  the  diagnosis  settled  upon 
by  the  different  physicians  who  went  so  far  as  to  give  it 
a  name. 

VERIGNAXA. 

Description. 

We  have  been  unable  to  locate  the  exact  position  of 
Verignana  on  the  map  of  Italy,  but  infer  from  Allan's 
article  that  it  is  a  small  place  between  Leghorn  and 
Genoa. 

Yellow  Fever  Year. 
1870. 

Summary  of  Importation. 

According  to  Allan, -^  two  cases  of  yellow  fever  were 
observed  in  the  lazai'ctto  at  Verignana  in  1870.  The 
facts,  as  translated  from  Allan's  article,  are  as  follows : 

The  merchant  vessels  Guiseppe  and  Pirro,  both  from 
Leghorn,  went  on  a  cruise  to  BaiTelona,  Spain,  where 
several  of  the  crew  were  infected  with  yellow  fever. 

The  Guiseppe  left  five  sailors  in  the  hospital  at  Bar- 
celona and  three  more  contracted  the  disease  on  the  home- 
ward voyage.  Of  the  latter,  two  died  and  were  buried  at 
sea. 

The  Pirro  left  five  sailors  in  the  hospital  at  Barcelona ; 
an  additional  case  followed  by  death,  developed  on  the 
voyage  from  Barcelona  to  Leghorn. 

The  authorities  of  Leghorn,  recalling  the  epidemic  of 


I 


I 


**Allu:  Relazione  Finale  sui  Casi  di  Febre  Gialla  Verificatisi 
nel  Lazaretto  de  Varignano  durante  I'Autumno  1870. 
Venizio,  1871. 


ITALY.  457 

1804,  which  was  brought  ot  the  town  in  just  such  a  man- 
ner, refused  to  allow  the  vessels  to  enter  the  harbor.  The 
infected  ships  then  went  to  Verignana,  where  an  attempt 
was  made  to  .conceal  the  fact  that  yellow  fever  had  oc- 
cun'ed  on  board.  The  authorities  were  suspicious,  how- 
ever, and  the  Giiisejrpe  and  Plrro  were  detained  at  quar- 
antine and  put  under  surveillance.  Two  health  officers 
of  the  village,  detailed  on  board  the  vessels,  were  stricken 
with  yellow  fever,  one  on  October  6,  dying  on  October  8, 
and  the  other  October  7,  dying  on  the  12th. 

No  other  cases  erupting,  quarantine  was  raised 
November  10. 

CONCLUSIONS. 

The  epidemic  at  Torre  Annunziata  is  the  last  observed 
on  Italian  soil.  Since  1883,  vessels  have  come  to  the  sea- 
ports of  the  kingdom  with  histories  of  deaths  from  yellow 
fever  during  the  voyage,  but  no  case  has  erupted  on 
shore  since  1883.  And,  with  our  present  knowledge  of 
the  mode  of  transmission  of  the  disease  under  discussion, 
we  fervently  hope  none  ever  will. 


YELLOW    FEVER 


IN 


PORTUGAL. 


1 


PORTUGAL. 


With  the  exception  of  Lisbon,  which  has  suffered  much 
from  occasional  visitations  of  yellow  fever,  the  history 
of  the  disease  in  PortuGjal  is  ■  of  minor  epidemiological 
interest,  being  confined  to  seven  localities,  from  1718  to 
1880,  The  onlv  epidemic  of  consequence  was  that  of  1857, 
which  threatened  to  invade  the  entire  kingdom  and  caused 
a  mortality  of  5,652,  in  Lisbon. 

Chronology  of  Yellow  Fever  in  Portugal. 


1718. 

Peniche. 

1721. 

Ericeira. 

1723. 

Lisbon  (Great  Epidemic). 

1721. 

Lisbon. 

1850. 

Oporto. 

1851. 

Oporto. 

1856. 

Bel  em  ;  Lisbon;  Oporto. 

1857. 

Belem;    Bom    Successo;    Lisbon     (Great    Epi 

demic)  ; 

Olivaes. 

1858. 

Lisbon;  Oporto. 

1800. 

Lisbon   (in  harbor). 

1879. 

Lanceda;  Lisbon. 

1880. 

Lisbon   (in  harbor). 

By  Localities. 
Belem.     1856;  1857.  ^ 

Bom  Successo.     1857. 
Ericeira.     (1721. 

Lisbon.     1723;   1724;   1856;  1857;   1858;  1860;  1879; 
1880. 

Olivaes.     1857. 

Oporto.     1850;  1851;  1856;  1858. 

Peniche.     1718. 

BELEM. 

Descrij}tion. 
Belem  is  a  town  of  Portugal,  three  miles  south  of  Lis- 
bon, on  the  right  bank  and  near  the  mouth  of  the  Tagus. 
It  has  been  a  j^art  of  Lisbon  since  1885. 


BELEM 1856.  461 

Yellow  Fevee  Years. 
1856;  1857. 

Summary  op  Epidemics. 
1856. 

Guyon/  Eager-  and  Berenger-Feraud^  give  interesting 
accounts  of  the  epidemic  of  1856,  the  first  on  record  at 
Belem.  This  port  was  the  seat  of  the  yellow  fever  hos- 
pital during  the  epidemic  at  Oporto.  The  first  case  at 
Belem  was  observed  in  August,  in  the  person  of  the  wife 
of  a  druggist  of  the  town.  This  case  Avas  followed  by  two 
others  in  the  same  family,  and  then  by  scattered  cases 
at  considerable  interval  and,  finalh',  an  epidemic  estab- 
lished itself.  The  fever  was  mistaken  for  typhus  by  the 
local  physicians,  but  the  members  of  the  Eoyal  Commis- 
sion that  investigated  the  pestilence  found  that  at  least 
some  of  the  cases  presented  the  undoubted  characteristics 
of  yellow  fever.     There  were  100  cases  and  30  deaths. 

Lisbon  is  suspected  of  having  infected  Belem. 

1857. 

In  1857,  occurred  the  great  epidemic  of  yellow  fever 
at  Lisbon  (q.  v.)  The  disease  was  transmitted  from  Lis- 
bon to  Belem  by  a  carpenter  who  made  daily  trips  be- 
tween the  two  cities.  He  was  taken  ill  October  12.  His 
wife  w^as  stricken  on  October  14  and  died  on  the  20th. 
The  carpenter  was  transported  to  his  mother's  house. 
The  father  contracted  the  disease  and  died  on  the  28th.'' 
This "^ was  the  last  death  of  the  outbreak. 


^Guyon:   Gazette  Medicale  de  Paris,  1858,  vol.  39,  p.  451. 

*  Eager:  Bull.  No.  4,  Yellow  Fever  Inst,  Washington,  1902,  p. 

10. 
•Berenger-Feraud:   Fievre  Jaune,  etc.,   (Paris,  1890),  p.  127. 

*  Berenger-Feraud,  p.  131. 


462  HISTORY    OF    YELLOW    FEVER. 

BOM  SUCCESSO. 

1857. 

In  1857,  during  the  progress  of  the  epidemic  which 
was  ravaging  the  coast  cities  of  Portugal,  the  infection 
was  brought  from  Lisbon  to  Bom  Successo,  a  village  near 
the  capital,  by  a  child  who  had  slept  in  a  house  where 
cases  had  occurred.  On  November  11,  the  day  after  ita 
arrival,  the  child  was  attacked  by  the  fever  and  died  on 
the  19th.  The  boy's  father,  who  had  been  constantly  at 
the  little  patient's  bedside,  fell  a  victim  to  the  pest.^  We 
find  no  record  of  other  cases  at  Bom  Successo. 

ERICEIEA. 


Description. 

Ericeira  is  a  town  of  Portugal,  near  the  Atlantic, 
twenty-two  miles  northwest  of  Lisbon.  Population,  2,091, 
mostly  fishermen. 


1721. 


Ericeira  occupies  the  doubtful  honor  of  being  the  sec- 
ond place  in  Portugal  where  yellow  fever  has  been  ob- 
served. According  to  Guyon,^  who  gives  Rodrigues  de 
'Avreu  as  his  authority,  the  disease  was  imported  to  the 
town  in  1721.     No  details  are  given. 


■  Berenger-Feraud,  p.  131. 
•Guyon:  Loc.  cit. 


463 

LISBON. 

Description. 

Lisbon,  capital  of  the  Kingdom  of  Portugal,  is  on  the 
right  bank  of  the  Tagus,  near  its  mouth  in  the  Atlantic 
Ocean.  The  climate  is  healthy,  but  variable,  the  city 
being  exposed  to  heavy  rains  and  cold  winds  in  winter. 
Population,  1864,  208,376;  1878,  253,496.  In  1885,  Belem 
and  Olivaes  were  made  part  of  the  city.  '  | 

Historical  Resume. 

Lisbon  is  a  place  of  remote  antiquity.  It  was  anciently 
called  Olisipo  or  Ulyssippo,  on  account  of  its  foundation 
being  ascribed  to  Ulysses.  It  was  originally  a  Roman 
province,  but  was  conquered  by  the  Goths,  from  whom  it 
was  captured  by  the  Moors  in  716.  The  new  conquerors 
called  the  city  El-Oshbuna  and  retained  poossession  of  it 
until  1147,  when  it  was  seized  by  Alphonse  I,  of  Portugal, 
with  the  aid  of  the  English,  French  and  Flemish  cru- 
saders. In  1713,  it  was  attacked  and  partly  burned  by 
the  Castillians,  but  the  inhabitants  succeeded  in  repuls- 
ing the  invaders.  The  Castillians  again  made  an  unsuc- 
cessful effort  to  capture  the  city  in  1724.  It  was  made 
the  capital  of  the  Kingdom  by  Juan  I  in  1422,  and  was 
seized  in  1580  by  Alva  for  Philip  II  of  Spain.  It  was 
from  this  port  that  the  famous  "invincible"  Armada 
sailed  in  1588.  In  1640,  the  Duke  of  Braganza  aroused 
his  countrymen  to  shake  off  the  Spanish  yoke  and  once 
more  Lisbon  became  the  capital  of  Portugal. 

The  French  were  in  possession  of  the  city  for  ten 
months  during  1807-08.  A  series  of  military  revolts  in 
the  middle  of  the  last  century  culminated  in  almost  open 
rebellion  in  1831,  which  was  with  difficulty  put  down  by 
the  government. 

Lisbon  suffered  from  a  severe  earthquake  in  1344,  was 
devastated  by  the  plague  in  1348  and  was  almost  de- 
stroyed by  the  "Great  Earthquake"  of  1755,  which,  in  ten 


46i 


HISTORY    OF    YELLOW    FEVER. 


minutes,   killed  between   40,000   and   00,000  people  and 
damaged  property  to  the  extent  of  |100,000,000. 

The  tale  of  Lisbon's  misfortunes,  covering  a  period  of 
over  twelve  centuries,  Avas  culminated  on  February  1, 
1908,  by  the  assassination  of  King  Carlos  I  and  the  Crown 
Prince  by  anarchists  in  the  streets  of  the  ancient  metro- 
polis of  Lusitania. 

In  addition  to  the  turmoils  of  internal  dissensions  and 
inroads  by  the  Moors,  Lisbon  has  been  repeatedly  visited 
by  epidemics  from  an  early  period.  The  following  table 
gives  a  tolerably  correct  summary  of  the  many  eruptions 
of  pestilential  disease  in  the  Portugese  capital. 

Chronology  of  Epidemics  at  Lisbon  Since  1191. 


Year.;  NATURE  OF  DISEASE.       MONTH 


DURATION 


MORTALITY 


1191    Epidemic  Meningitis 

134X    Black  Death   

1384    Contagrious    Typhus 

1415    Plag-ue  

1437    Platrue  

145,s    "Pestilential  Epidemic"— 

UW    Platfue 

14r,'i    Plat'ue 

147"    Plasrue  

14JS4    Plague 

1487    Military  Sweat 

14«3    Piaerue 

1503    Pla^fue  

1505    Epidemic  Petechial  Fever 

1510    Plajfue  

1514    Military  Sweat 

1517    Plague  

1520    Piaerue 

1522    Plague 

1526  IPlaifue 

1531    Plague  

1557    Whoiipingr  Couffh 

15(j^    Plague  

1575    Typhus  

157<»    Plague   

1598    Plague  

1()00    Plague  

1631    Contagious  Typhus   

1641    "Typhus  o{  Prisons" 

1658    "Typhus  of  Camps" 

167''    Plairue 

1723  Yellow  Fever 

1724  Yellow  Fever 

1755    Tvphoid  Fever 

1810    "Typhus  of  Camps"  

1832    Cholera  

1856    Cholera   

1856  Yellow  Fever 

1857  Yellow  Fever 

1858  Yellow  Fever   

1860   Yellow  Fever 

1879  Yellow  Fever 

1880  Yellow  Fever 


January 

September  29 

August  1 

June 

No  Record  .-. 

;«Iarch 

October  

No  Record  ... 

August 

October   

February  

No  Record — 

October 

July    

No  Record — 

April 

No  Record  — 

August 

No  Record    - 

June 

April 

November  10 
October  26..  .. 
No  Record  ..  . 

May  

December  ..  .. 
No  Record  .  .. 
l»ecember  ..  .. 

Sept.  15  

Atigust  

November..  .. 

October - 

No  Record  .  .. 

Aueuat  ..  . 
September 
January  .  .. 

May  

May 

June  10 


3  Months No  Record  

3  Months   20.000,  (Pop.  60.000) 

1  Month  and  3  Days    No  Record 

No  Record —  . 

Two  Years 

Four  Montht 

No  Record    


Two  Years 

1  Year  and  2  Months 
Ni>  Record  

2  Y'ears  and  7  Months 
2  Years  and  7  Months 

2  Years 

2  Months     

No  Record 


3  Months  . 
9  Months  .. 
No  Record 


5   ^Tonths  80.000 

>  Months !No  Record 

1  Y'ear  and  4  Months  40.000  

10  Months  2.727  

August,  1602 No  Record 

No  Record " 


3  Months 
2   Months 

4  Months  ., 
10  Months.. 
No  Record  .. 


6.000     Por.  250.000) 
No  Record  


September 
December  . 
February   .. 

May    

Two  Cases  . 
One  Case  .. 


3.600 

40 

5.652  ■ 
Small 


Two  -. 
None 


LISBON — 17«3.  465 

Yellow  Fever  Years. 
1723;  1724;  1856;  1857;  1858;  18G0;  1879;  1880. 
Summary  of  Epidemics. 
1723. 

The  third  invasion  of  Portugal  by  yellow  fever  took 
place  at  Lisbon  in  1723,  during  the  reign  of  Juan  V.^ 

The  documents  relating  to  this  outbreak  are  very  rare 
and  only  meagre  details  could  be  obtained.  According 
to  Da  Cunha,^  the  first  case  was  observed  on  September 
15.  The  epidemic  lasted  three  months,  causing  a  mor- 
tality of  6,000,  out  of  a  population  of  250,000.  Amooig 
the  illustrious  dead  was  the  great  admiral,  Antonio  Este- 
vao  de  Costa  Sousa,  The  last  death  took  place  in 
November.  ( 

Da  Cunha  designates  the  disease  under  the  name  of 
Vomito  Prcto.  It  was  evidently  imported  from  the  West 
Indies.  Eager^^  claims  that  the  disease  was  imported 
from  Brazil,  but  as  there  is  no  record  whatever  of  the 
prevalence  of  yellow  fever  in  that  country  in  the 
eighteenth  century,  we  think  it  is  more  logical  to  incrimi- 
nate that  natural  hotbed  of  dissemination — the  Antilles. 

1724. 

Yellow  fever  was  again  present  in  Lisbon  in  1724. 
There  were  only  a  few  cases  and  the  mortality  was  not 
high.  It  is  to  be  regretted  that  the  authors  who  have 
written  on  this  recrudescence  of  the  disease  in  the  capital 


•  First  recorded  invasion  took  place  at  Ericeiva  (q.  v.)  in 
1721. 

*Acunha:  Discouro  e  Onservacoes  Apollineas  Sobre  as 
Doencas  que  Houve  na  Cidade  Lisboa  Occidental  ne 
Oriental  no  Otouno  de  1723.    Lisboa,  1726. 

"Eager:   Loc.  cit.,  p.  9. 


466  HISTORY  or  yellow  fever. 

of  Portugal  (Guyon/^  Avreu,^-  Leitau,^^  Sachetti," 
Salndaha^^  and  Berenger-Feraud^^)  do  not  go  into  more 
minute  details. 

1856. 

For  a  period  of  one  hundred  and  thirty-one  years — 1724 
to  1856 — no  record  can  be  found  of  the  prevalence  of  yel- 
low fever  in  Lisbon. 

In  1856,  the  disease  was  epidemic  at  Oporto,  which  is 
170  miles  north  of  Lisbon,  and  it  is  not  surprising  that  it 
should  have  manifested  itself  in  the  capital  that  year. 
The  first  cases  were  observed  at  Belem,  a  suburb  of  Lis- 
bon, towards  the  last  days  of  August.  Shortly  after, 
cases  cropped  out  here  and  there  in  Lisbon,  but  the  mal- 
ady was  not  extensive,  resulting  in  211  cases  and  40 
deaths.^^ 

The  original  source  of  infection  of  this  epidemic  was 
Brazil,  as  will  be  seen  by  reference  to  our  account  of  the 
fever  which  prevailed  at  Oporto  in  1856. 

1857. 

The  epidemic  of  1857  was  the  most  disastrous  which 
had  visited  Lisbon  since  1723  and  gave  rise  to  numerous 
elaborate  and  learned  monographs  and  treatises  on  yel- 
low  fever,   prominent  among   which   are   the   works   of 

"Guyon:  Gaz.  Med.  de  Paris,  1S5S.  p.  451. 

"Avreu:  Loc.  cit. 

"Leitao:  Medicina  Comme  Arte  (1738). 

"  Joa  Mendes  Sachetti:    Consideracoes  Medicas. 

"Salndaha:   IHuatracao  Medica,  vol.  2,  p.  483. 

"Berenger-Feraud:    Loc.  cit.,  p.  43. 

"  Lyons:  Report  of  the  Epidemic  of  Yellow  Fever  at  Lisbon  in 
1857,  p.  113.  (The  figures  given  by  Lyons  are  311  cases 
and  11  deaths,  but  as  100  cases,  followed  by  30  deaths, 
were  observed  at  Belem,  then  a  seperate  city  from 
Lisbon,  we  have  deducted  these  last  figures  from  Dr. 
Lyons'  total. — G.  A.). 


LISBON — 1857.  467 

Pinto/^  Alvarega^^  and  Lyons,^*^  and  the  Report  of  the 
Extraordinai'y  Council  of  Public  Health  of  Lisbon.^^ 
These  monographs  contain  many  odd  and  untenable  doc- 
trines, it  is  true,  but  are,  nevertheless,  historically  accur- 
ate and  can  be  fructuously  consulted  by  the  student. 

Origin,  Rise  and  Progress  of  the  Epidemic. 

Three  vessels  are  accused  of  having  brought  yellow 
fever  to  Lisbon  in  1857 — the  Tamar,  the  Gerona  and  the 
Cuidad  de  Belem.  These  three  j)est  ships  came  f!rom 
Brazil. 

In  March,  1857,  yellow  fever  developed  on  board  the 
steamship  Tamar,  from  Eio  de  Janeiro,  and  when  the 
vessel  reached  Lisbon,  the  captain  reported  having  lost 
two  men  from  the  disease  during  the  voyage.  The  vessel 
only  touched  at  Portugese  ports,  leaving  immediately  for 
England.  As  will  be  seen  by  reference  to  our  account  of 
yellow  fever  at  Southampton  in  1857,  that  port  was  in- 
fected by  the  Tamar  shortly  after  her  arrival,  thus  prov- 


**De  Sequeira  Pinto  (A.  C.) :  Relatorio  Dirigido  ao  Governo  de 
Sua   Magestade   acerca   da   Organisacao   e    Servico    dos 
Hospitaes  Provisorios  de  Febre  Amarella  Estabelecidos, 
em    1857,    n'esta    Capital    e    do    Respectivo    Movimento 
Clinico  Desenvolvido  p.or  Quadros  Estatisticos.     Lisboa, 
1S58. 
Also:   Union  Med..  Paris,  1863,  2.  s.,  xvii,  570;   585. 
By  the  same  author:  Parecer  de  Alguns  Medicos  Estrangeiros 
e   Nacionaes  Acerca   da  Anatomia  Pathologica  e   Symp- 
tomatologia  da  Febre  Amarella  em  Lisboa  no  Anno  de 
1857.     Lisboa,  1862. 

~  Lyons  (R.  D.) :  Report  on  the  Pathology,  Therapeutics,  and 
General  Aitiology  of  the  Epidemic  of  Yellow  Fever 
which  Prevailed  at  Lisbon,  during  the  Latter  Half  of  the 
Year  1857.     London,  1855. 

^  Relatorio  da  Epidemia  de  Febre  Amarella  em  Lisboa  no  anno 
de  1857.  Feito  pelo  Conselho  Extraordinario  de  Saude 
Publica  do  Reino. — Lisbao,  1859. 


468  HISTORY    OF    YELLOW    FEVER. 

iug  that  tlio  vessel  was  a  hotbed  of  pestilence.  jS^othing 
unusual  occurred  to  disturb  the  health  conditions  of 
Lisbon  after  the  departure  of  the  Tamar,  and  the  inci- 
dent was  soon  forgotten  by  the  authorities.  The  Tauiur 
again  touched  at  Lisl)on  in  September,  l)ut  no  history  of 
the  disease  having  prevailed  on  board  at  that  time  could 
be  found.  / 

According-  to  the  available  documents  and  the  accounts 
of  the  epidemic  by  the  authors  above  named,  notwith- 
standing the  prevaileince  lOf  laryngieal  attections,  bron- 
chitis, diseases  of  the  lungs  and  rheumatism  during  the 
first  three  months  of  1857,  which  were  followed  in  the 
spring  and  early  summer  by  erysipelas,  typhoid,  inter- 
mittent and  remittent  fevers,  and  also  gastric  maladies, 
the  public  health  of  Lisbon  proved  satisfactory  until  tlie 
end  of  July,  as  shown  by  this  coniclusive  fact,  that  the 
rate  of  mortality  throughout  tlie  metropolis  of  Portugal 
actually  ranged  less  than  it  had  done  during  the  analo- 
gous six  months  of  the  two  previous  years. 

Such  Vas  the  sanitary  condition  of  tlie  Portugese  cap- 
ital wlien  tlie  steamship  (jcnora,  from  ilia  de  Janeii-o, 
arrived  at  Lisbon  early  in  July,  1857,  bringing  immi- 
grants from  Brazil,  ^lany  of  these  persons  were  so  ill 
that  all  of  tliem  were  sent  at  once  to  Bel  em  to  pass  the 
period  of  quarantine  in  tlie  lazaretto.  Cases  began  to 
erupt  at  Belein  soon  after  the  arrival  of  the  (icnora.  The 
infection  eventually  reached  Lisbon,  where  the  first  une- 
quivocal case  of  yellow  fever  developed  in  a  maiU  dwelling 
in  Padaria  Street.  The  patient  died  on  the  fifth  day  of 
the  attack.  A  second  case,  affecting  a  woman,  occurred 
on  July  29,  which  likewise  terminated  fatally  on  the  fifth 
day.  The  epidemic  slowly  spread  to  other  districts,  be- 
coming more  prevalent  during  August  ajid  September, 
being  especially  severe  during  October,  about  the  middle 
of  which  month  the  malady  manifested  its  greatest  in- 
tensity. 

It  is  a  peculiar  fact  thaf  while  the  fever  was  ravajdng 
the  city  proper,  the  liealth  of  the  harbor  remained  good. 
No  cases  are  recorded  as  having  occurred  in  the  shipping 


LISBON — 18  5?.  469 

during  the  progress  of  the  epidemic  and  the  health-guards 
stationed  along  the  water  front  proved  immune  to  the 
pestilence.  This  anomalous  state  of  things  puzzled  the 
Roj^al  Commission  to  a  considerable  degTee,  and  caused 
themi  to  propagate  the  dogma  that  the  infection  had 
not  been  introduced  by  vessels  and  their  crews,  but  by 
"filthy  fomites  deposited  in  the  customs  magazines  of 
the  town" — an  opinion  which  seemed  plausible  then,  but 
which  reads  like  a  passage  from  the  Arabian  Nights  at 
the  present  day. 

The  spreading  of  the  disease  from  one  locality  to  an- 
other deserves  special  mention.  THie  Report  of  the  Port- 
ugese Board  of,  Health  informs  us  that  it  travelled  by 
slow  and  successive  steps  from  place  to  place,  generally 
from  one  street  to  another,  and  even  from  house  to  house, 
according  to  their  proximity,  and  extending  from  lower 
to  higher  parts  of  the  city ;  where,  however,  the  epidemic 
manifested  minor  intensity  than  throughout  less  elevated 
districts.  This  ])rogress  seemed  so  regular,  that  observers 
could  almost  tell  beforehand  the  course  which  the  dis- 
ease  would  pursue.  Generally  speaking,  the  epideimic 
spread  from  east  to  west ;  the  central  part  of  the  capital, 
from  being  most  populous,  suffering  in  greater  proportion 
than  localities  not  so  crowded,  while  the  suburbs  fur- 
nished much  fewer  cases,  especially  towards  the  western 
portion,  in  which  only  several  isolated  examples  appeared. 
Towards  the  sea-shore,  and  in  buildings  abutting  on  the 
quays,  the  complaint  proved  more  virulent  than  elsewhere. 

Having  become  gradually  more  extended  throughout 
August  and  September,  the  malady  exhibited  its  maxi- 
mum intensity  towards  the  third  week  of  October,  on  the 
20th  of  which  month  298  new  cases  were  recorded,  being 
the  greatest  nu'mber  ever  occurring  in  one  day.  From 
that  date  the  cases  became  daily  less  frequent,  and  on  the 
31st  only  185  fresh  attacks  came  under  notice  among  the 
entire  population  of  Lisbon.  On  the  4th  of  November, 
however,  250  new  cases  were  recorded,  thus  showing  a 
temporary  augmentation.      But  afterwards  the  number 


470  HISTORY    OF    YELLOW    FEVBR. 

of  cases  diminished  consecutively  till  the  end  of  Decem- 
ber, when  yellow  fever  ceased  entirely. 

Statistics  of  the  Epidemic. 

During  the  period  mentioned — that  is,  while  the  epi- 
demic lasted,  the  cases  registered  amounted  to  13,757  al- 
together. Of  these,  7842  were  treated  at  the  patient's 
own  domicile,  5161  in  special  hospitals,  and  the  remain- 
ing 751  in  other  establishments.  Considering  m/any  in- 
stances may  have  been  overlooked  when  yellow  fever  first 
made  its  appearance  in  the  Portugese  metropolis,  the 
Eeport  states  that  most  likely  the  total  persons  attacked 
reached  18,000 ;  which,  hence  gives  a  ratio  of  one  person 
affected  by  the  epidemic  in  every  eleven  inhabitants. 
Eespecting  the  mortalitj^,  it  is  added  that  5652  cases 
proved  fatal,  of  which  3466  died  at  the  patient's  own 
dwelling,  1932  in  special  hospitals,  and  the  remaining  251 
in  other  public  institutions.  Consequently,  the  propor- 
tion of  deaths  ranged  about  one  in  ihirty-five  of  the  total 
population;  and  if  the  number  of  attacks  be  assumed  at 
18,000,  as  the  Council  of  Health  believed,  that  would  aver- 
age one  fatal  case  to  every  318  individuals  affected. 

Married  Men  Suffered  Much. 

Some  interesting  statistical  deductions  may  be  derived 
from  the  tables  contained  in  the  lieport.  For  example, 
among  the  3466  fatal  cases  which  took  place  in  private 
domiciles,  2061  were  uuile  and  1405  fenmle  patients,  or 
146  of  the  former  to  100  of  the  latter,  tlie  period  of  life 
whicli  seemed  most  fatal  being  from  thirty  to  forty  j-ears 
of  age;  while  married  men  seem  to  have  died  in  a  much 
larger  proportion  than  married  females.  Whereas  wid- 
ows oftener  fell  victims  to  yellow  fever  than  widoAvers, 
the  proportion  being  about  double  in  both  categories;  12 
married  men  liaving  died  to  every  5  married  women,  and 
10  widows  to  everv  53  widowers. 


LISBON IStl.  471 

Mortality  mnong  Trades  and  Occupations. 

It  is  also  curious,  in  reference  to  occupations,  to  know 
thati  more  persons  died  who  worked  on  wood  than  in 
metals;  while  those  employed  on  leather  also  suffered 
considerably,  as  for  instance,  curriers  and  shoemakers. 
On  the  other  hand,  persons  engaged  in  weaving  silk  and 
cotton,  although  they  constituted  a  numerous  body  in 
Lisbon,  only  24  deaths  were  reported  against  108  among 
the  leather  workers.. 

Among  professional  men  the  mortality  was  greatly  out 
of  proportion  to  other  classes.  Thus  30  clergymen,  13 
physicians  and  16  apothecaries  died;  besides  IG  other 
medical  practitioners  who  fell  victims  in  the  hospitals  to 
yellow  fever,  or  had  retired  to  the  country  previo|US  to 
their  deaths.  If  comparisons  be  made  betwixt  persons 
belonging  to  the  liberal  or  educated  professions,  and  in- 
dustrial laborers,  the  mortality  proved  much  larger  among 
the  former  than  the  latter,  in  reference  to  their  relative 
numbers;  436  of  the  former  category  having  died,  or 
one-eighth  of  the  entire  amount  recorded,  which,  much 
exceeds  the  ratio  of  those  engaged  in  handicrafts. 

Mortality  hi  Hospitals. 

'The  Report  gives  a  detailed  account  of  the  movement  of 
patients  attacked  with  yellow  fever,  who  were  received 
into  the  several  hospitals  when  that  malady  existed  in 
Lisbon.  The  total  number  treated  in  these  institutions 
amounted  to  5161;  of  whom  4043  were  males  and  1118 
females — 7  of  the  former  to  2  of  the  latter  sex ;  the  recov- 
eries being  3229,  comprising  2400  males  and  730  females; 
while  1932  died,  or  1544  of'  the  former  sex  to  388  of  the 
latter.  According  to  such  data,  it  therefore  appears  the 
average  mortality  ranged  as  one  death  in  every  267  ad- 
missions; or  in  five  cases  treated,  about  two  died.  The 
proportion  of  male  patients  received  was  at  least  three 
men  to  one  woman ;  the  fatal  cases  being,  however,  com- 
paratively, nearly  analogous.     In.  both  sexes  a  very  large 


47  J  HISTORY    OF    YELLOW    FIVER. 

proportion  of  the  deaths  recorded  took  place  in  persons 
varying  from  puberty  to  thirty  years  of  age;  3003  fatal 
cases  of  the  entire  number  previously  stated  having  oc- 
curred among  patients  at  that  period  of  life;  Avhile  only 
31  instances  were  reported  in  children  at  or  under  their 
tenth  year.  The  largest  number  of  deaths  occurred  in 
bachelors;  next  the  married,  and  lastly  widowers;  while 
among  female  patients,  fewer  single  women  becajne  vic- 
tims than  in  any  other  class  of  that  sex. 

The  movement  of  patients  in  the  military  hospitals  who 
were  attacked  by  the  prevailing  epidemic,  next  occupies 
the  Board  of  Health's  attention.  According  to  their 
report,  626  men  and  officers  were  received  into  these  es- 
tablisliments  during  October,  November  and  December, 
of  whom  503  Avere  cured  and  123  died;  thus  showing  a 
much  smaller  mortality  than  among  the  civil  population. 
It  is,  however,  worthy  of  remiark  that  the  disease  proved 
more  fatal  to  officers  than  to  common  soldiers.  Thus, 
out  of,  8  officers  admitted,  6  died,  whereas,  among  501 
rank  and  file,  the  deaths  were  91,  or  two  in  every  eleven 
admissions,  which  therefore  makes  a  remarkable  differ- 
ence. It  is  also  further  interesting  to  mention  that, 
among  the  626  fatal  cases  recorded  in  military  hospital?*, 
only  34  were  married  men  and  1  widowers — hence,  co- 
inciding with  the  remark  made  in  reference  to  civilians 
attacked  by  yellow  fever — viz.,  that  bachelors  oftener  died 
than  married  men —  while  422  were  persons  from  twenty 
to  thirty  years  of  age.  ' 

The  MUitarij  and  Municipal  Guards. 

Again,  as  the  garrison  of  Lisbon  and  Beleni  then 
amounted  to  5230  men,  and  the  total  deaths  being  626, 
about  one-eighth  of  the  entire  number  thus  fell  victims 
to  the  epidemic,  whereby  the  proportionate  mortality  ex- 
ceeded that  noticed  amouij  the  general  population.  The 
municipal  guard  also  suffered  considerably,  since  out.  of 
a  force  comprising  1161  men,  126  were  attacked,  of  whom 
39  died.     The  horse-patrols  of  this  body  were,  however, 


LISBON — 1857.  473 

less  severely  affected  than  the  infantry;  while  patients 
treated  ai  their  own  dwellings  exhibited  a  smaller  com- 
parative mortality  to  those  sent  to  the  hospital. 

Mortality  in-  the  Shipping. 

On  board  the  ships  of  war  at  anchor  in  the  Tagus, 
exactly  57  individuals  were  attacked,  of  whom  only  five 
died,  which  formed,  therefore,  a  small  mortality.  In 
mercantile  ships,  the  disease  also  made  very  little  havoc— 
this  immunity  of  the  marine  population  being  especially 
manifested  among  those  guards  who  did  duty  on  board 
of  ships,  and  still  more  marked  in  a  detachment  compris- 
ing 120  men  stationed  at  Belem,  of  whojin  not  one  became 
indisposed.  The  very  reverse  was  specially  noticed  re- 
specting persons  employed  in  the  arsenal,  291  cases  of 
yellow  fever  having  been  registered  in  that  establishment, 
of  whom  106  proved  fatal,  the  most  of  these  having  been 
constantly  employed  o;n  shore,  although  a  few  occasionally 
worked  on  board  of  ships. 

1858. 

In  January,  1858,  at  a  time  when  the  inhabita.nts  of 
Lisbon  had  scarcely  recovered  from  the  terrible  experi- 
ences which  had  overshadowed  their  native  land,  a  few 
scattered  cases  of  yelloAv  fever  were  observed  in  localities 
where  the  disease  had  been  especially  malignant  the  year 
before.  Prompt  sanitary  measures  were  taken  and  by 
the  middle  of  of  February,  the  incipient  epidomic  had 
been  stamped  out.--  The  number  of  cases  is  not  stated, 
but  eleven  deaths  are  recorded  during  the  period  men- 
tioned. Grave  fears  were  entertained  bv  the  government, 
it  being  predicted  that  the  disease  would  again  manifest 
itself  during  the  summer  months,  but  apart  from  the  fact 
that  the  steamship  Dni.v  A  mia,  from  TJio  de  Janeiro,  after 
being  subjected  to  a  month's  quarantine  at  LisV)on,  car- 

"  Berenger-Feraud,  p.  133. 


474  HISTORY    OF    YELLOW    FEVER. 

ried  yellow  fever  to  Ponta-Delgado,  in  the  Azores  (q.  v.)^^ 
nothing:  untoward  happened  to  disturb  the  health  condi- 
tions of  the  caiHtal. 

18C0. 

In  the  beginning:  of  May,  1860,  the  Royal  Mail  steamer 
Tijne  touched  at  Lisbon  on  her  way  to  Southampton. 
Yellow  fever  was  prevailing  on  board  and  seventy-six  pas- 
sengers, destined  for  Lisbon,  were  prohibited  from  land- 
ing by  the  health  authorities.  They  were  all  huddled  in 
the  lazaretto,  but  no  cases  developing  were  allowed  to 
proceed  on  their  way  after  a  few  days'  detention. 

1879. 

Rio  de  Janeiro  again  contaminated  Lisbon  in  1879. 

The  English  ship  Imogene  left  Rio  de  Janeiro  in  the 
beginning  of  ^lay,  1879,  and  arrived  at  Lisbon  on  the 
7th  of  the  month,  with  forty-two  passengers  and  a  crew 
of  eighteen.  The  captain  reported  that  nine  passengers 
and  three  sailors  had  died  of  yellow  fever  during  the 
voyage.  The  vessel  was  sent  to  the  quarantine  station 
and  thoroughly  disinfected.  Two  of  the  workmen  em- 
ployed in  the  disinfection  of  the  vessel  were  attacked  by 
the  disease.  These  two  cases  were  immediately  isolated 
by  the  authorities  and  their  lodgings  fumigated  and  quar- 
antined.    The  infection  did  not  spread.-^ 

1880. 

The  history  of  yellow  fever  in  Lisbon  closes  with  a 
"suspicious  case"  in  the  beginning  of  June,  1880.  The 
patient  was  attacked  on  June  10th,  went  through  a  severe 
spell  of  the  disease,  and  v.as  discharged  cured  on  the 

^  See  page  357  of  this  volume. 
"Lancet   (London),   1860,   vol.   1,   p.   386;    Berenger-Feraud,   p. 

136. 
"  Berenger-Feraud,  p.  168. 


OPORTO — 1850.  475 

30th  of  the  same  month.     The  source  of  infection  is  not 
given  by  o;ur  authority.^^ 

OLIVAES. 

1857. 

The  great  epidemic  which  devastated  Lisbon  in  1857, 
spread  to  Olivaes,  then  a  separate  city  of  23,000  inhabi- 
tants, but  since  1883,  a  part  of  Lisbon.  Tliere  is  a  record 
of  120  cases,  60  being  fugitives  from  Lisbon.  Our  author- 
ity (Eager,  loc.  hit.,  p.  10)  does  not  give  the  number  of 
deaths. 

OPORTO. 

Description. 

Oporto  is  the  second  largest  city  in  Portugal,  on  the 
right  bank  and  about  two  miles  from  the  mouth  of  the 
Douro,  170  miles  north  of  Lisbon.  The  appearance  of 
the  city  on  a  first  approach  is  very  prepossessing,  but 
in  reality  most  of  the  streets  are  narrow,  crooked  and 
filthy,  and  the  houses  irregularlj-  constructed.  The  prin- 
cipal trade  is  in  wine,  white  and  red,  but  chiefly  the  laitter 
(Port  Wine,  so  named  from  this  town).  Oporto  was  at 
one  time  the  capital  of  Portugal.  It  was  at  this  place 
that  Wellington  routed  the  French  in  1810,  after  the  re- 
markable passage  of  the  Do'itro.  It  was  originally  the 
Portus  Cale  of  the  Romans  and  was  the  stronghold  of  the 
Christians  against  the  ferocious  Moors  in  the  early  days 
of  the  Church  of  Rome.  Population :  1878,  105,838 ;  1890, 
139,856. 

Yellow  Fever  Years. 

1850;  1851;  1856;  1857;  1858;  1859. 

Summary  of  Epidemics. 

1850. 

There  is  no  record  of  yellow  fever  having  prevailed  at 
Oporto  previous  to  1850,  when  two  vessels  from  Brazil 
brought  the  disease  to  the  ancient  capital  of  Portugal. 

=°Firmo  Ferrara  des  Santos:   Jl.  Soc.  Science  Med.  de  Lisboa, 
1881,  vol.  45,  p.  136. 


476  HISTORY    OP'    YELLOW    FEVER. 

In  July  of  the  year  above  mentioned,  the  ship  Duarte 
IV  entered  the  harbor  of  Oporto.  No  history  of  yellow 
fever  on  board  was  given  by  the  captain,  but  five  custom- 
house employes  of  the  town  who  had  been  on  board  were 
taken  ill  a  few  days  afterward  and  three  died.  The  dis- 
ease was  diagnosed  as  yellow  fever,  but  the  facts  were 
witliheld  from  the  public,  for  fear  of  creating  a  panic. 
The  incident  would  undoubtedly  have  been  unnoticed  by 
the  population  had  not  a  second  infection  taken  place. 
The  new  focus  was  created  by  the  Tentaklora,  a]so\  fr/om 
Kio  de  Janeiro,  which  arrived  at  Oporto  during  Septem- 
ber, having  lost  five  men  from  yellow  fever  during  the 
voyage.  Customhouse  inspectors  who  had  been  sent  by 
the  health  authorities  tc  investigate  the  health  condi- 
tions on  the  vessel  caught  the  disease  and  contaminated 
their  fellowmen.  Scattered  cases  cropped  out  through- 
out the  town,  but  fortunately  the  cool  season  stopped  the 
progress  of  the  fever  on  October  19,  after  fifty  deaths  had 
resulted  from  the  epidemic.  The  number  of  cases  is  not 
stated  by  our  authority.-^ 

1851. 

The  Tcntadara  and  Duarte  IV,  both  from  Eio  de 
Janeiro,  again  infected  Oporto  in  1851.  A  third  ship, 
the  ^auta  Cm;:,  from  Brazil,  also  imix)rted  the  disease 
intq  the  town  that  year. 

The  Tcntadora,  which  entered  the  port  in  August,  had 
had  five  deaths  from  yellow  fever  during  the  voyage. 
Several  customhouse  employes  who  went  on  board  the 
ship  were  taken  sick  and  died  of  the  dreaded  disease.  As 
in  the  year  1850,  the  infectioii  did  not  spread  from  these 
initial  cases,  and  the  town  would  ])robably  have  escaped 
an  invasion  of  the  pest  if  proper  precautions  had  been 
taken  by  the  health  autliorities  when  the  next  ship  ar- 
rived fro<m  Brazil.  Bigorous  sanitary  measures  were 
neglected,  however,  and  a  repetition  of  the  disasters  wliich 

-'  Berenger-Feraud,  p.  120. 


OPORTO — 1851.  477 

overran  Portugal  iu  the  past  was  oul^-  prevented  by  the 
advent  of  the  cool  season,  which  put  a  quietus  to  the 
activities  of  the  Calopae. 

In  an  account  given  by  Eager,-^  it  seems  that  the 
Ducirte  IV  arrived  at  Oporta  on  September  10,  having 
had  deaths  aboard  from  yellow  fever  during  the  voyage. 
The  vessel  spent  twelve  days  in  quarantine.  After  being 
given  pratique,  two  custom-house  men  posted  aboard  to 
guard  the  ship  were  attacked  with  the  disease  and  died. 
A  few  days  later,  three  laborers  employed  in  removing 
'  the  cargo  from  the  hold,  and  several  other  ]jerson  who 
had  been  on  the  vessel,  were  taken  ill  with  the  same 
malady.  The  disease  afterwards  spread  in  the  quarters 
known  as  Miragaia  ad  Massarellos  and  altogether  seven- 
teen persons  died  in  consecpience. 

While  this  incipient  epidemic  was  gradually  spreading, 
there  arrived  from  Brazil  another  Aessel,  the  ^^(l)^f(l  Crnz\ 
The  same  malady  attacked  the  custom-house  employees, 
the  stevedores  and  other  persons  whoi  in  one  way  or  an- 
other had  had  direct  relation  with  the  infected  ship. 
The  popular  alarm  occasioned  by  these  frequent  appear- 
ances of  fatal  cases  resulted  in  the  appointment  of  a  sani- 
tary commissioqi  for  the  study  of  the  mater  and  the  recom- 
mendation of  measures  of  betterment.  Notwithstanding 
the  vigorous  means  adopted  to  this  end,  cases  continued 
to  occur.  The  infection  spread  to  tw»  British  vessels 
anchored  down  the  wind  from  the  pest  ship  ^'^aiita  Cniz: 
The  British  vessels  were  supposed  to  be  quite  isolated 
from  the  Hanta  Cniz.  Soon  other  cases  appeared  on  two 
Pf)rtugese  vessels  anchored  to  leeward  of  the  British  ves- 
sels.    Several  of  the  men  of  the  Portugese  vessels  died. 

The  epidemic  which  was  of  short  duration,  came  to  an 
end  on  October  19,  resulting  in  100  cases  and  40  deaths. 

1856. 

^  The  third  invasion  of  Oporto  by  yellow  fever  took  place 

=*  Eager:   Bull.  No.  4,  Yellow  Fever  Inst.,  Wash.,  1902,  p.  9. 


478  HISTORY    OF    YELLOW    FiVER. 

in  1856,  under  identical  conditions  as  in  1850  and  1851. 
Verily,  the  Lusitamians  do*  not  profit  by  experience. 

The  kingdom,  which  had  been  ravaged  by  cholera  since 
1853,  and  Avhich  lost  3,275  of  her  inhabitants  from  that 
disease  between  October,  1855,  and  November,  1856,  was 
hardly  prepared  for  the  invasion  of  a  second  foreign  pesti- 
lence and  the  appearance  of  yellow  fever  at  Opqrto  in 
1856  caused  widespread  terror. 

According  to  Eager  and  Lyons,^^  early  in  July,  some 
vessels  arrived  from  Brazil,  where  yellow  fever  prevailed. 
July  12,  the  first  cases  appeared,  and,  as  before  the  first 
persons  affected  were  custoim-house  employees,  stevedores 
and  those  in  contact  with  the  suspicious  vessels.  Again 
a  focus  of  infection  was  established  in  the  Miragaia  and 
Massarellos  quarters.  There  Avere  also  cases  of  yellow 
fever  among  the  soldiers  of  the  municipal  garrison,  but  a 
marked  difference  was  noted,  both  in  the  intensity  of  the 
symptoms  and  in  the  issue  of  the  disease  between  the 
cases  falling  ill  on  boai-d  ship  and  those  resulting  from 
communication  with  infected  foci  on  land.  The  first  cases 
were  congregated  in  a  special  hospital,  and  of  these,  six- 
•teen  ot  of  twenty-one  died.  !0n  the  other  hand,  only  ten 
deaths  took  place  among  the  twenty-seven  soldiers  at- 
ta/cked.  Energetic  measures  were  taken  by  the  autliori- 
ties  of  the  port.  Certain  of  the  vessels,  being  evidently 
deemed  infected  beyond  hope  of  cleansing,  were  sunk  at 
sea. 

The  first  case  was  observed  July  12  and  the  last  Octo- 
ber 2.  A  total  oif  120  cases  and  63  deaths  resulted  from 
the  outbreak. 

1857. 

Tlie  Teufadorn.  wliich,  it  will  bo  remembered  was  one 
of  the  causes  of  the  epidemics  ofi  1851  and  1852  at  Oporto, 
again  brought  yellow  fever  to  that  port  in  1857. 


Eager:  Loc.  cit.,  p.  10. 


OPORTO — 1857.  479 

Almost  simultaneously  with  the  sitting  of  the  Quaran- 
tine Congress  at  Paris  in  1857,  and  while  the  terrible 
ravages  of  the  epidemic  which  was  then  decimating  Lis- 
bon, were  being  discussed  and  ways  and  means  devised 
to  stop  its  awesome  progress,  Europe  was  startled  to 
learn  that  Oporto*,  after  successfully  warding  off  the  in- 
vasion from  the  capital  of  the  Kingdom,  had  been  infected 
by  importation  from  a  foreign  country.  Fortunately,  the 
importation  took  place  at  the  beginning  of  the  cool  season 
and  did  not  spread.     The  facts  are  as  follows:  , 

The  Tentadora  arrived  at  Oporto,  from  Brazil,  about 
the  beginning  of  September,  1857.  Several  of  her  crew 
had  died  from  yellow  fever  during  the  passage.  It  is 
said  that  one  of  the  crew  was  missed  while  the  vessel  was 
on  her  way  to  Oporto  and  that,  on  the  caa'go  being  dis- 
charged, his  body  was  found  in  a  state  of  decomposition 
in  the  ballast  in  the  hoild.  Three  persons  from  Oporto 
who  boarded  the  vessel  soon  after  her  arrival,  were  at- 
tacked with  the  fever  and  died.  The  fourth  case  to  erupt 
on  shore  was  that  of  a  store-keeper.  This  man  had  not 
been  on  board  the  Tantadora,  but  had  received  in  his  store 
casks  from  the  infected  vessel. ^^ 

The  outbreak  was  confined  to  the  cases  above  noted, 
while  unfortunate  Lisbon,  only  170  miles  to  the  south, 
and  which  iiad  been  infected  in  a  similar  manner,  lost 
5,652  souls. ^^ 

1S58. 

A  few  cases  in  the  liarbor  in  1858  proved  to  be  tlie  last 
echoi  of  the  history  of  yellow  fever  in  Oporto.^-  The  sick 
were  promptly  isolated  and  the  infection  did  not  spread. 
As  fifty  years  have  elopsed  since,  we  trust  that  tlie  health 
authorities  of  the  former  capital  of  Lusitania,  grown  wise 
by  past  experiences,  will  continue  to  keep  the  foreign  pest- 
ilence away  from  the  shores  oif  the  little  Kingdom. 


^"Editorial:  Medical  Times  and  Gazette'  (London),  1857,  vol. 
'^See  page  467  of  this  volume  for  a  description  of  the  Libson 

epidemic  of  1S57. 
Berenger-Feraud,  loo.  cit.,  p.  135;  Eager,  loc.  cit.,  p.  1?. 


480  HISTORY    OK    YELLOW    FEVER. 

PENICHE. 

Description. 

Peniche  is  a  fortified  town  of  Portugal,  on  the  Atlantic 
and  south  side  of  the  peninsular  of  Peniche.  Population, 
2,903. 

Yellow  Fever  Year. 

1718. 

'  Summary  op  Outbreak. 

According  to  Rodrigues  de  Avreu,  quoted  by  Berenger- 
Feraud  (loc.  cit.,  page  42),  the  first  appearance  of  yellow 
fever  in  Portugal  took  place  at  Peniche  in  1718,  seven 
years  before  the  great  epidemic  of  Lisbon.  As  no  details 
are  given,  we  infer  that  the  outbreak  was  limited  to  a 
few  cases,  probably  in  the  shipping. 


HISTORY  OF 


YELLOW    FEVER 


IN 


SPAIN. 


SPAIN. 

Spain  has  been  a  nidus  of  i)estileutial  disease  from  time 
immemorial.  xVs  far  back  as  tlie  year  1100  B.  C,  an  epi- 
demic devastated  tliat  country.  It  is  recorded  that  this 
was  followed  by  twent^^-five  years  of  drought  without  in- 
terruption; springs  were  dried  up,  rivers  became  ford- 
able,  their  waters  becoming  almost  stagnant;  there  was 
neither  pasture  for  beast  nor  fi'uit  for  man.  'So  gi'eat 
was  the  barrenness,  that  there  was  scarcely  any  green 
things  to  be  found,  except  some  olive  trees  on  the  banks 
of  the  Ebro  and  the  Guadalquivir.  Such,  says  th(^  his- 
torians of  the  period,  was  the  melancholy  state  of  ancient 
Spain — ^'full  of  dreadful  mortalities,  plagues  and  miseries 
of  e\erj  description,  which  with  immigration  to  other 
lands,  nearly  depopulated  our  countr}." 

In  the  year  476  B.  C,  and  the  succeeding  years,  there 
prevailed  in  Spain,  from  time  to  time,  a  series  of  iDcsti- 
lences  and  other  minor  diseases  by  which  a  multitude  of 
people  perished.  The  Carthagenians,  to  appease  the 
anger  of  the  gods,  to  whom  they  attributed  these  fatal 
visitatios,  offered  human  sacrifices,  and  made  incisions 
in  their  arms,  legs  and  on  other  parts  of  their  bodies; 
they  also  immlolated  cattle  of  all  kinds,  according  to  the 
severity  of  the  pestilence. 

Ancient  records  speak  of  pestilential  diseases  in  Spain 
in  the  years  427,  383,  237,  B.  C. 

During  the  Christian  Era,  fearful  epidemics  have  rav- 
aged Spain ;  but  as  our  aim  is  simply  to  give  a  narration 
of  the  progress  of  yellow  fever  in  that  country,  we  will 
not  dwell  upon  them,  referring  the  reader  for  fuller  de- 
tails to  that  part  of  this  Avork  which  treats  of  the  ravages 
of  pestilential  disease  in  Europe.  Suffice  it  to  say  that, 
at  the  present  day,  Spain  is  one  of  the  healthiest  countries 
in  Europe  and  the  favorite  objective  point  of  the  tourist 
in  quest  of  the  romantic  and  beautiful. 


484  HISTORY    OK    YELLOW    FEVER. 

Spain  has  suffered  more  from  visitations  of  yellow 
fever  than  all  the  other  countries  ofi  Europe  combined. 
At  one  time  (1800  to,  1830)  the  disease  seemed  to  have 
taken  up  its  permanent  abode  within  the  confines  of  the 
Kingdom.  The  last  general  epidemic  took  place  in  1821, 
although  in  1870  cases  Avere  observed  in  several  localities 
and  fears  were  entertained  that  the  great  epidemics  of  the 
beginning  of  the  century  would  be  duplicated.  Prompt 
sanitary  measures  were  resorted  tQ  and  the  progress  of 
the  pestilence  checked. 

A  reference  to  the  year  1800  in  our  chronological  table 
will  show  the  ap])alliug  list  of  mortalities  from  yellow 
fever  in  Spain  that  year.  Forty-six  localities  Avere  in- 
A^adt^  by  the  saffron  scourge,  causing  a  mprtalitA'  of  oxer 
62,000.  In  1804,  when  thirty-eight  localities  Avere  visited 
Avith  a  combined  population  of  al)Out  428,000,  the  death 
roll  reached  nearly  53,000,  or  one  death  for  each  eight 
inhabitants. 

« 

LOCALITIES  IN  SPAIN  WHERE  YELLOW  FEVER 
HAS  BEEN  OBSERVED. 

In  Andahi.'^ia. 

Af/tiihir  fir  la  Front  era.  A  toAvu  tAventy-two  miles 
southeast  of  CordoAa.     Population,  12,300. 

Alcala  de  Ins  Gaznles.  On  the  slope  of  the  Rouda 
]\rouutains,  thirty-seven  miles  cast  by  south  of  Cadiz. 
Population,  5,510. 

Alcala  de  Guadaj/ra.  A  toAvn  seA-en  miles  east  of  Seville; 
situated  on  a  hill.     Population,  7,341. 

Alf/eziras.  On  the  nortliAvest  coast  of  the  Bay  of  Gib- 
raltar, and  opposite  the  latter  town:  little  eleA'ate<l  aboA-e 
the  level  of  the  sea;  behind  it  are  high  ranges  of  moun- 
tains.    Population,  14,220. 

Alhaurin  rl  Grande.  On  an  eminence,  tAventy  miles 
west  from  ]\ralaga.     Population,  0,78L 

Atmeria.  On  the  Mediterranean,  104  miles  east  of 
Malaga.     Population   (1908),  46,806. 


SPAIN LOCALITIES    aFFECTED.  485 

Antequera.  In  a  plain  between  Granada  and  Seville, 
twenty-eight  miles  west  of  Malaga ;  it  is  built  partl}^  on  a 
rising  ground;  streets  straight  and  wide.  Population, 
27,201. 

Arahal.  ,Twenty-two  miles  southeast  of  Seville.  Pop- 
ulation, 9,287. 

Arcos  de  la  Frontera.  Situated  on  a  very  high  rock, 
thirty  miles  north  of  Cadiz.     Population,  15,378. 

Ayamipnte.  At  the  mouth  of  the  Guadiana,  near  the 
frontiers  of  Portugal,  in  a  sterile  countr}',  eighty  miles 
from  Seville.     Population,  5,972. 

Bcnaocaz.  Sixty  miles  northeast  of  Cadiz.  Population, 
1,960. 

Bornos.     Twenty  miles  fromi  Cadiz.     Population,  4,530. 

Cadi:::.  On  the  Isla  de  Leon,  at  the  extremiiy  of  a  nar- 
row neck  of  land,  extending  about  six  and  one-half  miles 
into  the  sea,  sixty  miles  northwest  of  Gibraltar  and  sixty- 
four  miles  south  of  Seville.     Population  (1908) ,  69,382. 

Cannona.  Eighteen  miles  northeast  of  Seville,  on  a 
hill.     Population,  20,074. 

Catalan  Bay.     A  small  fishing  village  near  Gibraltar. 

Chiclana.     Twelve  miles  southeast  of  Cadiz. 

Carlota.  Seventeen  miles  southwest  of  Cordova.  Pop- 
ulation, 1,350. 

Chipiona.  On  a  rock  on  the  coast,  near  the  uiouth  of 
the  Guadalquivir,  four  miles  from  San  Lucar  and  nine 
miles  Irom  Cadiz,     Population,  500. 

Coua.  Six  miles  south  of  Seville,  on  the  Guadalquivir, 
Population,  3,756. 

Cordova.  In  a  plain  near  the  Sierra  ^Morena,  on  the 
river  Guadalquivir ;  distant  from  the  sea,  seventy  miles  ^n 
a  direct  line,  aud  eighty-six  miles  northeast  of  Seville. 
Population,  55,614. 

Cortes  de  la  Frontera.  Forty-eight  miles  southwest  of 
Malaga.     Population,  4,330. 

Dos  Hcnnanas.  Six  miles  southeast  of  Seville.  Popu- 
lation, 3,498. 

Eclja.  In  a  plain  on  tlie  western  bank  of  the  Xenil, 
eighteen  miles  before  its  junction  witli  the  Guadalquivir, 


486  HISTORY    OF    YELLOW     FEVER. 

in  a  fertile  country,  and  eighty-two  miles  from  Seville. 
Population,  27,210.' 

El  Borge.  A  small  town  near  Malaga.  Population, 
1,200. 

El  Palo.    'A  yillage  about  three  miles  east  ofl  Malaga. 

Espejo.  Twenty-flye  miles  southeast  of  Cordoya,  in  a 
plain  on  the  riyer  Guadajoz.     Population,  5,120. 

Espera.  Thirty-foiu'  miles  northeast  of  Cadiz.  Popu- 
lation, 1,822. 

Estcpa.  Fifty-four  miles  from  Seyille.  Population, 
8,133. 

Gibraltar.     A  fortified  town  and  rock  at  the  south  ex- 
tremity of  Andalusia,  belonging  to  Great  Britain.     Popu-" 
lation,  (exclusiye  of  garrison),  19,859. 

Granada.  Beautifully  situated  on  two  spurs  of  the 
Sierra  Nevada  mountains,  at  an  elevation  of  927  feet  aboye 
the  sea  level,  forty-eight  miles  from  Malaga  and  about 
thirty-one  miles  in  a  direct  line  from  the  sea.  Population, 
76,005. 

Huclra.  On  an  inlet  of  the  Atlantic,  forty-nine  miles 
southwest  of  Seyille.     Population  (1908),  21,000. 

Isla  de  Leon.  On  the  east  side  of  the  island  of  the  same 
name,  seyen  miles  southeast  of  Cadiz.     Population,  18,202. 

La  RamMa.  A  town  in  the  Province  of  and  fourteen 
miles  south  of  Cordova.     Population,  5,920. 

Lchrlja.  Twenty-nine  miles  southwest  of  S(n'ille,  in  a 
plain  six  miles  from  the  riyer  Guadalcpiiyir.  Population, 
10,328. 

Los  Barrios.  A  small  village,  situated  in  the  moun- 
tains, about  fourteen  miles  west  of  Gibraltar,  on  the  road 
to  Cadiz.     . 

Los  Palacios.  Twelve  miles  south  of  Sciville.  (Popu- 
lation, 1,835. 

Maircra  del  Alcor.  Thirteen  miks  east  of  Seville.  Pop- 
ulation, 4,100. 

Malar/a.  At  the  base  of  a  range  of/  hills,  sixty-ftye  miles 
ea.st  of  Gibraltar.     Population   (1908),  135,000. 


SPAIN LOCALITIES    AFFECTED.  487 

Medina  Sidonia.  THventy-two  miles  southeast  of  Cadiz, 
and  twelve  miles  from  the  sea.  An  old  town,  built  on  a 
high  hill.     Population,  9,703. 

Montilla.  Eighteen  miles  southeast  of  Cordova;  situ- 
ated partly  on  a  hill.     Population,  15,000. 

Moron-de-la-Frontera.  Thirty-two  miles  northeast  of 
Seville,  at  the  foot  of  the  eliain  of  mountains,  called  Sierra 
de  Konda.     Population,  12,846. 

Paferna  de  la  Ribcra.  Twenty- tliire©  miles  east  of 
Cadiz,  at  the  foot  of  the  Xerez  Mountains.  Population, 
1,500. 

Puerto  Real.  In  Cadiz  Bay,  six  miles  from  that  city. 
Population,  0,511. 

Ronda.  Situated  in  the  midst  of  a  range  of  mountains 
of  that  name,  at  a  very  great  elevation  above  the  sea; 
distant  from  Gibraltar,  forty-two  miles  north.  Popula- 
tion, 19,331. 

Rota.  On  the  coast,  three  miles  from  Puerto  Santa 
Maria,  and  six  miles  from  Cadiz.     Poi)ulation,  G,972. 

San  Fern av do.  On  the  Isla  de  Leon,  near  Cadiz.  Pop- 
ulation, 18,202.      (Also  known  as  Isla  de  Leon). 

San  Lncar  de  Barameda.  At  the  mouth  of  the  river 
Guadalquivir,  eighteen  miles  north  of  Cadiz.  Population, 
18,130. 

San  Roque.  Fifty-six  miles  southeast  of  Cadiz,  and 
seven  miles  northwest  of  Gibraltar.     Population,  00,458. 

SeriUe.  On  the  river  Guadalquivir;  situated  in  an  ex- 
tensive plain,  seven-two  miles  north  northeast  of  Cadiz. 
Population  (1908),  148,315. 

Uhrique.  Forty-six.  miles  northeast  of  Cadiz.  Popu- 
lation, 4,876. 

TJtrera.  Sixteen  miles  southeast  of  Seville;  situated 
between  two  hills.     Population,  12,441. 

Yejer  de  la  Frmitera.  Twenty-seven  southeast  of  Cadiz, 
on  a  very  high  but  cultivated  hill,  at  a  short  distance  from 
the  sea,  opposite  Cape  Trafalgar.     Population,  7,662. 

Velez  Malaga.  Situated  at  about  fourteen  miles  to  the 
east  of  ]\ralaga,  on  the  slope  of  a  hill,  two  miles  from  the 
sea,  on  the  river  Velez.     Population,  12,523. 


488  HISOORV    OF    YELLOW    FEVER. 

Vera.  Thirty-nine  miles  from  Almeria,  about  three 
mile  from  the  Meditei'ranean,  in  a  plain.  Population, 
6,017. 

Villa  Franca  de  la  Marisma.  Fifteen  miles  south  of 
Seville.     Population,  4,268. 

Villa  Martin.  Forty-three  miles  southeast  of  Seville, 
on  the  river  Guadaleta.     Population,  1,000. 

Xerez  de  la  Frontera.  Sixteen  miles  north  northeast  of 
Cadiz,  on  a  hill  in  a  fertile  country.     Population,  64,523. 

Ximena  de  la  Frontera.  Forty-six  miles  north  of  Cadiz, 
about  twenty  miles  from  Gibraltar,  on  a  hill.  Population, 
6,577. 

In  Aragon. 

Fraga.  Fifty-five  miles  southeast  of  Huesca.  Popu- 
lation, 6,  695. 

Mequinenza.  Sixty  miles  southeast  of  Huesca,  on  the 
Ebro  and  Segra;  distant'from  the  sea  in  a  direct  line  forty 
miles.     Population,  2,890. 

Nonaspe.  A  village  near  Mequinenza,  on  the  small 
river  Nonaspe.     Population,  1,000. 

Balearic  Islands. 

Palma.  Capital  of  the  Island  of  Majorca,  130  miles 
south  of  Barcelona.     Population,  58,224. 

Poj-t  Mahon.  Capital  of  the  Island  of  Mii.orca,  situ- 
ated on  its  south  side.  Its  port  is  one  of  the  best  and 
most  commodious  on  the  Mediterranean,  i  Population, 
18,588. 

In  Catalonia. 

Asco.  A  small  town  on  the  right  bank  of  the  Ebro, 
partly  on  a  hill,  thirty-nine  miles  from  Tortosa.  Popu- 
lation, 1,300. 

Barcelona.  In  a  plain  on  an  extensive  T>ay,  having  on 
its  western  side  a  high  mountain.  It  is  312  miles  east 
northeast  of  Madrid.  ^  Population  (1908),  600,000. 


/ 

SPAIN LOCALITIES    AFFECTED.  489 

Barcelonetta.  A  suburb  of  Barcelona,  and  on  the  same 
bay,  distant  fronn  the  latter  city,  a  quarter'  of  a  mile. 

Canet-deMar.  Twenty-six  miles  northeast  of  Barcelona. 
Population,  3,301. 

Jesus.     A  village  opposite  Tortosa. 

Malgrat.  Thirty-seven  miles  northeast  of  Barcelona. 
Population,  3,287.' 

Glot.  Twenty-one  miles  northeast  of  Gerona.  Popu- 
lation, 9,984. 

Regens.     lA  village  five  miles  from;  Tortosa. 

Roquito.     On  the  Ebro,  opposite  Tortosa. 

Salou.     Eight  miles  southwest  of  Tarragona. 

Sitgcs.     Eighteen  miles  southwest  of  Barcelona. 

Tan'agona.  At  the  mouth  of  the  Francoli,  on  a  lofty 
rock,  fifty-two  miles  from  Barcelona.     Population,  18,923, 

Tortosa.  On  the  left  bank  of  the  Ebro,  twenty-two 
miles  from  the  sea  and  forty-three  miles  southwest  of  Tar- 
ragona.    Population,  24,702. 

In  Guipiizcoo. 

Passajes.  On  the  Bay  of  Biscay,  three  miles  east  of 
San  Sebastian.     Population,  921. 

In  Mnrcia. 

Arclienn.  Fourteen  miles  northwest  of  INIurcia,  in  a 
plain  at  the  foot  of  a  range  of  mountains,  near  river 
Segura.     Population,  1,766. 

Carfagena.  On  a,  bay  of  the  ^NFediterraneau,  twenty- 
seven  miles  southeast  ofi  Murcia.     Population,  75,908. 

Cieza.  Twenty-six  miles  northwest  of  Murcia.  Popu- 
lation, 8,000.  I 

Jumilla.  In  Province  of  Carthagena,  thirty-seven  miles 
northwest  of  Murcia,  at  the  foot  of  a  hill,  forty  miles  from 
the  sea  and  sixty-five  miles  northwest  of  Cartagena. 
Population,  9,013." 

Lorca.  Forty-two  miles  southwest  of  ^lurcia.  Popu- 
lation, 48,138. 


490  HISTORY    OF    YELLOW    FEVER. 

Mazarron.  Twenty  miles  west  of  Cairtagena.  Popu- 
lation, 3,745. 

MoJina.  Six  miles  from  Miircia,  and  tliirty-five  miles 
from  Malaga,  in  a  plain,  on  the  river  Segura.  Popula- 
tion,. 2,469. 

Murcia.  On  the  river  Segura,  north  of  Cartagena. 
Population,  91,805. 

Ojos.  Fifteen  miles  north  o^  Mureia,  in  a  narrow  val- 
ley on  the  river  Segura.     Populat'on,  300. 

Palmar.     Three  miles  south  of  Murcia. 

Ricot.  Twenty-seven  miles  north  of  Murcia,  in  a  plain 
at  the  foot  of  a  range  of  mountains,  and  one  and  a  half 
miles  from  river  Segura.     Popuhition,  1,098. 

Saj-ria.     Near  Barcelona.     Population,  3,752. 

Totana.  Ten  miles  northwest  of  Lorca.  Population, 
3,315. 

Villa  Nueva  del  Ariscal.  Seven  miles  fi^om  Seville. 
Population,  1,651. 

In  Ncio  Castile. 

Madrid.  Capital  of  Spain,  in  New  Castile,  in  the  cen- 
ter of  the  Pcniusula,  on  tlie  ^lenzauares  River.  Popula- 
tion (1887),  470,283;  (1908),  556,663. 

Villaseca  de  la  Sagra.  Twelve  miles  northeast  of 
Toledo.     Population,  'l,369. 

Ill  Old  Castile. 
San  Andero. 

In  Pontevadra. 

Vic/o.  Thirteen  uiiles  south  southwest  of  Pontevadra. 
A  lazaretto  is  maintained  at  this  port.     Population,  8,21  i. 

In  Valencia. 

Alcantarilla.  Five  miles  from  Murcia.  Population, 
4,089. 


SPAIN LOCALITIES    AFFECTED.  491 

Alicante.  In  a  fertile  coiintirj^,  on  tlie  sea-co'aist,  at  the 
foot  of  a  hill,  800  feet  high.     Population,  42,500. 

Gimrda/mm\  Twenty-one  miles  southwest  of  Alicante, 
at  the  mouth  of  the  river  Segura.     Population,  2,696. 

Orihucla.  In  a  plain,  near  a  range  of  mountains,  on 
river  Segura,  thirty-two  miles  from  Alicante,  and  distant 
from  the  sea,  fourteen  miles.     Population,  25,208. 

Palmar.     Three  miles  south  of^  Murcia. 

Penacerrada.  A  small  village,  three  miles  from  Ali- 
cante, consisting,  at  the  time  of  epidemic,  of  forty-two 
families  or  158  inhabitants. 

San  Juan.  A  small  village  in  the  neighborhood  of 
Alicante. 

Sans.     A  short  distance  north  of  Barcelona. 

Taharra.  A  small  island  in  the  jNIediterranean,  five 
miles  south  of  Alicante.     Population,  500. 

Valencia.  In  a  fine  plain  on  the  Guadalaviar,  about 
two  miles  from  the  sea  and  190  miles  east  southeast  of 
Madrid.     Population,  143,861. 

CHRONOLOGY    OF    YELLOW    FEVER    IN    SPAIN, 
FROM  1649  TO  1890. 

1649.  Gibraltar,  Seville.  (First  appearance  of  ycllom 
fever  in  Spain). 

1696.     Castille;  Navarre. 

Immunity.     Forty-Siijc  Years. 

1700.  Cadiz. 

Immunity.     Three  Years. 

1701.  Cadiz. 

1702.  Cadiz. 

1703.  Cadiz. 

Immiiniti/.     One  Year. 
1705.     Cadiz. 

Immunity.     Tiventy-One  Years. 
1727.     Gibraltar. 


I 


492  HISTORY    OF    YELLOW    FEVER. 

I  mm  unit  I/.     Two  Years. 

1730.  Cadiz. 

1731.  Cadiz. 

Immnniiij.     Tico  Years. 
1734.     Cadiz. 

Immunity.     One  Year. 
1736.     Cadiz. 

Immunity.     Three  Years. 

1740.  Cadiz. 

1741.  Cadiz;  Malaga. 

Immunity.     Two  Years. 

1744.  Cadiz;  Palnia. 

1745.  Cadiz. 
1740.  Cadiz. 
1747^1     Port  Mahon. 

1748.  Port  Mahon. 

1749.  Pal  ma. 

Immunity.     Three  Years. 
1753.     Cadiz, 

Immunity,     ^^eren  Years. 
17(51.     Cadiz. 

Immunity.     One   Year. 

1703.  Cadiz. 

1704.  Cadiz. 

1705.  Cadiz. 

Immunity,     Fourteen  Years. 
1780.     Cadiz. 

Lujuunity.     Three  Years. 
1784.     Cadiz. 

Tnimunily.     Fire  Years. 

1700.  Cadiz. 

1701.  :Malaoa. 
1792.     Cadiz. 

Inimunitj/.     k^i.r  Years. 

1798.     Gibraltar. 

Im)nunity.     One   Year. 

1800.  AJoala  de  los  (iazulos;  Aralial ;  Arcos;  Avriata; 
Ayamonte;  Benaocoz;  Rornos;  Cadiz;  Caneta  la  Eeal; 
Carmoua;  Chiclana;  Cordova;  Conil;  Cortes  de  la  Fran- 


SPAIN CHRONOLOGY,      1  649   TO    1890.  493 

tera;  Coria;  Dos  Herma^iias;  Ecija;  El  Arahal;  Espreza- 
lena;  Estepa;  Gibraltar;  Hiielva;  Isla  de  Leon;  La 
Cabezas;  Lebrija;  Los  Palacios;  Maireno;  Medina  Sidonia; 
Montejuge;  Moron  de  la  Frontera;  Olivera;  Paterna  de 
la  Eiviera;  Puerto  de  Santa  Maria;  Puerto  Real;  Rota; 
Ronda ;  San  Lucar  de  Barameda ;  Santa  Caridad ;  Sarria ; 
Seville ;  Tribujena ;  Ubrique ;  Uterera ;  Vejer ;  Villamartin ; 
Villaluneja;  Xeres  de  la  Front eii'a. 

Total  localities  infected  in  1800,  forty-seven. 

1801.  Cadiz;  ^Medina  Sidonia;  Seville. 

1802.  Cadiz ;  Carnioua ;  Cliuriauna  ;  Cordova ;  Malaga ; 
Medina  Sidonia. 

1803.  Algerziras;  Alicante;  Antequera;  Barcelona; 
Barcelonette;  Cadiz;  Coiunna;  Espera;  Gibraltar;  la 
Rambla;  Malaga;  Montilla;  Palma;  Ronda. 

1801.  Alcada  de  los  Pahderas;  Algerziras;  Alhaurin- 
el-Grande;  Alicante;  Antequera;  Arcos  de  la  Frontera; 
Avamonte;  Balearic  Islands  (Majorca);  Cadiz;  Car- 
tagena; Churriana;  Coin;  Cordova;  Ecija;  El  Borge;  El 
Palo;  Espejo;  Espera;  Gibraltar;  Granada;  Guardamar; 
La  Rambla;  Los  Barrios;  Malaga;  Mijas;  ;Montilla; 
iMoron  de  la  Frontera;  Murcia ;  Palma;  Paterna  de  la 
Ribera;  Pena-Serrada ;  Puerto  de  Santa  Maria;  Ronda; 
San  Juan;  San  Roque;  Torre- ]Molino ;  Velez-Malaga; 
Vera;  Villamartin;  Xeres  de  la  Frontera;  Ximines  de  la 
Frontera. 

Total  localities  infected  in  1801,  forty-one. 

Irtvmnnity.     Two  Years. 

1807.  Cadiz. 

1808.  Cadiz.     Xeres  de  la  Frontera. 

Immunity.     Our  Year. 

1810.  Alberca;  Barcelona;  Cartagena;  Cadiz;  Gib- 
raltar; Seville. 

1811.  Alicante;  Alcantarilla ;  Cadiz;  Cartagena;  Gib- 
raltar; Isla  de  Leon;  Jumila;  Lebrija;  Lebrillo;  Tx)rsa; 
Medina-Sidonia;  Murcia;  Tobarra;  Totana;  Ziesar. 


494  HISTORY    OF    YELLOW    FEVER. 

Total  localities  infected  in  1811,  fifteen. 

1812.  Cadiz;  Cartagena;  Cieza;  Jumilla;  Murcia. 

1813.  Cadiz;  Catalan  Bay;  Gibraltar;  Malaga;  Me- 
dina-Sidonia ;  San  Andero. 

1814.  Cadiz;  Catalan  Bay;  Gibraltar. 

Immwiity.     Ttco  Years. 

1817.  Cadiz. 

1818.  Gib-altar. 

1819.  Barcelona  ;  Cadiz ;  Chiclana ;  Isla  de  Leon ;  Port 
Mahon;  Puerto  de  Santa  Maria;  Puerto  Eeal;  San  Lucar 
de'  Bairameda;  Seville;  Xeres  de  la  Frontera, 

Total  localities  infected  in  1819,  eleven. 

1820.  Cadiz;  Alcala  de  los  Gazules;  La  Carlotta; 
Malaga;  Puerto  de  Santa  Maria ;  Mequinenza ;  Xeres  de  la 
Frontera. 

1821.  Agiiilas;  Asco;  Badalona;  Barcelona;  Bar- 
celonette;  Cauet  de  Mar;  Fraga;  Jesus;  Las  Arguilas; 
Lebrija;  Xonaspe;  Malaga;  Malgrat;  Mequinenza;  Monte 
Alegi'e;  Olot;  Pal  ma;  Pedrara;  Port  Mahon;  Puerto  de 
Santa  Maria;  Roquetas;  Bota;  Salou;  San  Gervaiso;  San 
Lucar  de  Barameda;  Sans;  Sarria;  Seville;  Sitges;  Tor- 
tosa ;  Villa  Secca ;  Xeres  de  la  Frontera. 

Total  localities  infected  in  1821.  thirtv-two. 


1822. 

Corn  una ;  Gibraltar. 

1823. 

Loyola ;  Passajes. 

1821. 

Giinaltar. 

1825. 

Gilii-altar. 

182G. 

Gibi-altar. 

Tnimuuifi/.     One  Year. 

1828. 

Catalan  Bay  Gibraltar. 

1829. 

Gibraltar. 

Immunity.     Ttcenty-eiglit  Years. 
1858.     Ferrol ;  Vigo. 


SPAIN CHRONOLOGY,     1649  TO    1890.  495 

Immunity.     Eight  Years. 
1867.     Madrid. 

Immunity.     Two  Years. 
1870.     Alicante;    Barcelona;    Madrid;    Palma;    Port 
Mahon;  Tortosa;  Valencia. 

Immunity.     Seven  Years. 

1878.  Madi'id. 

1879.  Pedroches. 

Immunity.     Three  Years. 
1883.     Barcelona. 

Immunity.     Five  Years. 

1889.  Vigo. 

1890.  Malaga.  (Last  appearance  of  yellow  fever  in 
Spain). 

Chronology  of  Yellow  Fever  in  Spain^  by  Localities. 

1649  TO  1890. 

A  star  (*)  placed  after  a  name  means  that  authorities 
consulted  do  not  state  the  year  of  the  prevalence  of  the 
disease. 

Aguilar  de  la  Frontera.* 

Aguila,s.     1821. 

Alaurinego.     1804. 

Albania,* 

Alberca.     1810. 

Alcala  de  Gnadayra.* 

Alcala  de  los  Gazules.     1800 ;  1820. 

-^Icala  de  los  Panaderos.     1804. 

lAlcantarilla.     1811. 

Alcaria.* 

Algeziras.     1803 ;  1804. 

Alhaurin-el-Grande.     1804. 

Alicante.     1803 ;  1804  ;  1 811 ;  1 870. 

Almeria.* 

Antequera.     1803;  1804. 


1744;  1745;  1746;  1753 
1784;  1790;  1792;  1800 
1808;  1810;  1811;  1812 


496  HISTORY  OF  YELLOW   FEYER. 

Aralial.     1800. 

jArchena.* 

Arcos  de  la  Frontera.     1800;  1804. 

Asco.     1821. 

Awiata.     1800. 

ATamonte,  1800 ;  1804. 

Badalona.     1821. 

Barcelona.     1808 ;  1810 ;  1819 ;  1821 ;  1870 ;  1883 

Barcelonette.     1803;  1821. 

Barrio  de  Perchel.     1803 ;  1804. 

Benaocaz.     18001 

Bornos.     1800. 

Cadiz.  1700;  1701;  1702;  1703;  1705;  1730;  1731 
1733;  1734;  1730;  1740;  1741 
17G1;  1763;  1764;  1765;  1780 
1801;  1802;  1803;  1804;  1807 
1813;  1814;  1817;  1819;  1820;  1821 

Canet-de-Mar.  1821. 

Caneta-la-Real.     1800. 

Carmona.     1800;  1802. 

Carraca.     1800. 

Carrana.* 

Cartao-ena.     1753;  1804;  1810;  1811;  1812 

Castillo.     1696. 

Catalan  Bay.     1813 ;  1814 ;  1828. 

Chielana.     1800;  1819. 

Chipiona.* 

Churriana.     1802 ;  1804. 

Cieza.     1811;  1812. 

Coin.     1804. 

Conil.     1800. 

Cordova.     1800 ;  1802 ;  1804. 

Coria.     1800. 

Cortes  de  la  Frontera.     1800. 

Coninna.     1803;  1822. 

Dos  Hermanos.     1800. 

Ecija.     1800;  1804. 

El  Arahal.     1800. 

El  Borge.     1804. 

Elche.* 


SPAIN CHRONOLOGY,    BY  LOCALITIES.  497 

El  Palo.     1804. 

Eprezalena.     1800. 

Escala.* 

Espejo.  1803;  1804. 

Espera.  1800 ;  1804. 

Estepa.  •  1800. 

Ferrol.  1858. 

Fraga.  1821. 

Gibraltar.  1649;  1727;  1798;  1800;  1803;  1804;  1810; 
1811;  1814;  1818;  1822;  1824;  1825;  1826;  1828;  1829. 

Granada.  1804. 

Giiardamar.  1804. 

Hiielva.  1800. 

Isla  de  Leon.  1800 ;  1811 ;  1819. 

Jesus.  1821. 

Jumilla.     1811 ;  1812. 

La  Caltezas  de  San  Juan.     1800. 

La  Cai'lotta.     1800 ;  1820. 

La  Eambla.     1803 ;  1804. 

Las-Aguilaa     1821. 

Lebrixa.     1800;  1811;  182L 

Los  Palacios.     1800. 

Lorsa.     1811. 

Los  Barrios.     1804.  « 

Loyola.     1823. 

Madrid.  1867 ;  1870 ;  1878. 

Mairena  del  Alcor.  1800. 

Malgrat.  1821. 

Malaga.  1741;  1791;  1802;  1803;  1804;  1813;  1820; 
1821;  1890. 

Mazarron.* 

Medina-Sidonia.     1800;  1801;  1802;  1811;  1813. 

Mequinenza.     1821. 

INIijas.     1804. 

(Molina.* 

Monte  Alegi'e.     1821. 

Montejugue.     1800. 

Montiila.     1803;  1804. 

Moron  de  la  Frontera.     1800 ;  1804. 

Mnrcia.     1804;  1811;  1812. 


i98 


HISTORY    OF     YELLOW     FEVER. 


Navarre.     1696. 

Noiiaspe.     1821. 

Ojos.* 

Olivera.     1800. 

Olot.     1821. 

Oriliiiela.* 

Palma.  1714 ;  1719 ;  1803 ;  1801 ;  1819 ;  1821 ;  1870. 

Palmar.* 

Pasajes.     1823. 

Paterna  de  la  libera.     1800 ;  1804. 

Penacerrada.     1804. 

Pedrara.     1821. 

Pedrochos.     1879. 

Port  Mahon.     1747 ;  1748 ;  1819 ;  1821 ;  1870. 

Puerto  de  Santa  Maria.     1800 ;  1804  ;  1819 ;  1820 ;  1821. 

Puerto  Real.     1800;  1819. 

Ricote.* 

Ronda.  1800;  1803;  1804. 

Roquetas.  1821. 

Rota.  1800;  1804;  1821. 

Saint  EloT.* 

.Salon.  1821. 

San  Andero.     1813. 

San  Gervaiso.     1821. 

San  Juan.     1804. 

San  Lucar  de  Barameda.     1800 ;  1819 ;  1821. 

San  Ro(ine.     1804. 

Sans.     1821. 

Santa  Caridad.     1800. 

Sarria.     1800;  1821. 

Seville.     1649 ;  1800 ;  1801 ;  1810 ;  1819  ;  1821. 

Sit^res.     1821. 

Tabarca.     1804. 

Tarrajiona.* 

To1»arra.     1811. 

Tortosa.     1821 ;  1870. 

Totana.     1811;  1812. 

Torrenela.* 

Torre-:\Iolino.     1804. 

Ubrique.     1800. 


SPAIN.  499 

Utrera.     1800. 

Valencia.     1870. 

Vejer  de  la  Frontera.     1800. 

Velez  Malaga.     1804. 

Vera.     1804. 

Vig-o.     1858 ;  1889. 

Villafranea.* 

Villamartin.     1800;  1804. 

Villalunueva  del  Ariscal.     1800. 

Villa  Seea.     1821. 

Xeres  de  la  Frontera.  1800 ;  1804 ;  1808 ;  1819 ;  1820 ; 
1821. 

Ximines  de  la  Frontera.     1804. 

Yelar.* 

Ziera.* 

Total  number  of  cities  in  Spain  in  which  yellow  fever 
has  been  observed  from  1649  to  1890,  a  period  of  two  hun- 
dred and  foriy-one  years,  144. 


SUMMARY   OF   EPIDEMICS. 
AGUILAS. 

1821. 

The  little  potrt  of  Aguilas,  in  Murcia,  on  the  Mediter- 
ranean, was  infected  by  the  brig  Saint-Joseph,  from 
Malaga,  in  1821.  It  had  then  a  population  of  700.  Vesr 
sels  from  Cadiz  also  brought  yellow  fever  cases  to  the 
town.     There  were  75  cases  and  25  deaths,^ 


♦iChervln:    Examen  de    rAdministration    en    Matiere    Santaire. 

Paris,  1827,  p..  91. 
•Fellowes:    Reports   of  the   Pestilential   Disorder  of  Andalusia, 

etc.,   (London,  1815),  pp.  181,  185. 


500  HISTORY    OF    YELLOW    FEVKR. 

ALBERCA. 

1810. 

Refugees  from  Mureia,  four  miles  distant,  infected  Ai- 
berca  in  1810.     There  was  no  diffusion  of  tiie  disease.* 

ALCALA  DE  LOS  GAZULES. 

1800. 

Alcala  de  los  Gazules,  situated  on  the  slope  of  the  Ronda 
Mountains,  thirty-seven  miles  southeast  of  Cadiz,  was 
contaminated  by  refugees  from  the  the  last  named  locality 
in  1800,  and  lost  817  of  its  inhabitants.- 

1820. 

The  second  and  last  appearance  of  yellow  fever  at  Alcala 
de  los  Gazules  took  place  in  1820.  A  native  of  the  town 
went  on  a  visit  to  Xeres  de  la  Frontera,  contracted  the 
malady  and  died  on  his  return  to  Alcala.  The  infection 
did  not  spread.^ 

ALCALA  DE  LOS  PANDEROS. 

1804. 

The  inhabitants  of  the  village  of  Alcala  de  los  Panderos, 
located  al)Out  four  miles  from  Seville,  proved  remarkably 
immune  from  yellow  fever  during  the  great  epidemic  of 

*Bonneau    and    Sulpicy:    Recherches   sur    la    iContagion    de    la 

Fievre  Jaune,  Paris,  1823,  p.  364. 
-La  Roche:  Yellow  Fever,  etc.  (Phila.,  1855),  p.  534. 
Alfonso  da  Maria:    Memoria  Sobre  la  Epidemia  de  Andalusia, 

p.  122. 
'Jackson:    Remarks  on  the  Epidemic  Yellow  Fever  which  has 

appeared   at   Intervals   on    the    South    Coasts    of    Spain 

(London,  1821),  p.  41  (foot  note). 


SPAIN.  501 

1804.  The  place,  which  takes  its  name  from  the  occupa- 
tion of  its  inhabitants,  who  are  mostly  bakers,  and  fur- 
nished nearly  all  the  bread  consumed  in  Seville  at  the 
time,  was  in  daily  cumniunication  with  the  latter  place, 
where,  out  of  a  remaining  population  of  80,000,  over 
76,000  are  said  to  have  been  attacked  by  j-ellow  fever; 
yet,  in  spite  of  this,  only  twenty-four  persons  had  the  dis- 
ease in  the  village,  eighteen  of  which  died.^  In  every  in- 
stance, those  attacked  had  communicated  with  Seville. 
Aside  from  these,  not  a  single  case  erupted  in  the  village. 
Jackson,  Fellowes,  Berthe  and  others  who  have  written  at 
length  on  the  epidemics  of  Spain,  ascribe  this  remarkable 
immunity  to  the  fact  that  aromatic  herbs  were  burned  in 
the  ovens  of  the  innumerable  bakeries  in  the  village,  claim- 
ing that  this  purified  the  atmosphere  and  rendered  the 
"miasmata"  inocuous.  The  logical  explanation  in  these 
days  of  enlightment,  is  that  the  fumes  of  the  "aromatic 
herbs"  were  distasteful  to  the  nostrils  of  the  yellow  fever 
mosquitoes  and  kept  them  away  from  the  locality. 

ALCANTAEILLA. 
1811. 

'AJcantarilla  ("the  little  bridge")  was  contaminated  bv 
refugees  from  Murcia,  in  1811.  The  outbreak  was  not  ex- 
tensive and  the  mortality  was  small.® 

ALGERZIEAS. 

1803. 

In  1803,  smugglers  brought  yellow  fever  from  Gibraltar 
to  Algerziras.     Only  a  few  cases  resulted.® 

*  Bancroft:    An   Essay   on    the    Disease    Called    Yellow    Fever 

(London,  1811).  p.  460. 
"  Berenger-Feraud:    Traite  Theoriqiie   et  Pratique  de  la  Fievre 

Jaune,  Paris,  1890,  p.  84. 
®  Berenger-Feraud,  p.  74. 


502  HISTORY    OF    YELLOW    FEVER. 


1804. 
In  1804,  Algerziras  had  a  popiilatiou  of  about  14,000. 
Yellow  fever,  which  was  widespread  in  Spain  that  year, 
soon  niade  its  appearance  in  the  town,  but  was  confined  to 
one  or  two  streets.     The  mortality  was  snuill." 

ALHAURIN-EL-GRANDE. 

1804. 

A  few  cases  of  yellow  fever,  all  imported,  were  observed 
at  Alhaurin  in  1804,  principally  in  persons  communicat- 
ing- with  Malaga.  The  disease  did  not  obtain  a  foot.iold 
in  the  village.^ 

ALICANTE. 

1803. 
Government  officials  patrolling  the  coast  are  accused  of 
having  brought  yellow  fever  to  Alicante  in  1803.  Other 
authorities  attribute  the  outbrcaFc  of  the  disease  to  a  bale 
of  cotton  goods  from  (Jibraltar,  wliich  had  l)een  surre])ti- 
tiously  taken  into  Alicante  and  hidden  in  the  residence 
of  the  port  commissioner.  The  latter  was  the  first  victim 
of  the  outbreak,  which  was  not  extensive  and  resulted  in 
oinly  a  few  cases  and  deaths.^ 

1804. 

Tlie  ill-.starred  inhabitants  of  Alicante  were  less  fortu- 
nate in  1804.  The  first  case  of  yellow  fever  was  observed 
August  0.  The  town,  which  had  a  ])(>i)ulati(!n  of  13,057, 
had  taken  great  precautions  to  pi'evcnt  an  importation  of 
the  disease,  and  when  the  news  spread  that  the  pestilence) 
was  in  their  midst,  the  inhabitants  became  terror-stricken 


I 


'  Fellowes.  p.  101    (foot  note). 
^Fellowes,  pp.  181;  182. 
"  Berenger-Feraud,  p.  74. 


SPAIN ALICANTE.  *  503 

and  all  who  could  do  so  soiii>lit  fancied  security  in  fliglit. 
It  is  of  record  that  2,110  Hcd  to  the  neighboring  country, 
leaving  11,817  within  the  focus  of  the  disease.  Out  of 
this  number,  there  resulted  (1,971  attacks,  of  which  2,472 
proved  fatal.  It  is  a  notable  fact  that  the  disease  was 
more  fatal  to  men  than  women,  1,552  of  the  former  suc- 
cumbing, while  the  fatalities  among  the  latter  amounted 
to  920.  The  disease  manifested  its  greatest  intensity  on 
October  9,  gradually  subsiding  after  that  date  and  becom- 
ing extinct  on  December  13.^*' 

1811. 

Alicante  was  infected  by  Gibraltar  in  1811.  Only  a 
few  cases  were  observed. ^^ 

1870. 

During  the  outbreak  of  yellow  fever  which  devastated 
Barcelona  in  1870,  some  cases  were  imported  into  'Ali- 
cante. 

The  virulence  of  the  ejiidemic  and  the  rapidity  with 
which  it  spread,  brought  back  to  the  minds  of  the  terror- 
stricken  inhabitants,  the  horrors  of  the  pestilences  which 
had  laid  waste  the  flourishing  cities  of  Andalusia,  in  the 
beginning  of  the  century.  Alicante  had  a  jxipulation  of 
25,000  in  1870.  When  news  of  the  eruption  of  the  first 
case  (September  13)  became  public,  and  the  first  death 
was  recorded  (Septem^ber  14).  the  alarm  was  general, 
and  in  less  than  a  week,  12,500  or  half  the  population 
fled. 


^"  Summarized  from  the  works  of: 

Moreau  de  Jonnes:    Monographie  HistoTique  et  Medicale  de  la 
Fievre  Jaune  des  Antilles,  Paris,  1820,  p.  341. 

Bally:  Typhus  d  Amerique  ou  Fievre  Jaune,  Paris,  1814,  p.  90, 

La  Roche,  loc.  cit.,  p.  536. 

Fellowes,  loc.  cit.,  p.  478. 

Chervin:   Second  Report  on  Quarantine,  London,  1852,  p.  203. 
'^  Berenger-Feraud,  p.  84. 


504  HISTORY    OF    YELLOW    FEVER. 

The  epidemic  raged  most  fiercely  between  October  20 
and  NoTember  15.  After  the  last  named  date,  it  grad- 
ually subsided  and  became  extinct  on  December  13,  when 
the  last  death  took  place. 

Following  is  the  summary  of  cases  and  deaths,  taken 
from  the  interesting  report  of  Bergez  y  Dufoo,-^^  after 
divesting  it  of  the  sonorous  verbiage  and  onerous  details 
which  ever  chai'acterize  the  writings  of  the  Castillians : 

Cases.  Deaths. 

Men 3,857     Men 1,082 

Women 1,012     Women 228 

Children 484      Children 70 


5,353  1,380 

Of  the  70  mortal  cases  among  children,  44  were  boys 
and  26  girls. 


ANTEQUERA. 

The  first  appearance  of  yellow  fever  at  Antequera  took 
place  in  1803.  The  infection  came  from  Malaga.  The 
outbreak  was  unimportant.^^ 

1804. 

In  1804,  yellow  fever  appeared  at  Antequera  on  August 
2.  It  was  brought  to  that  place  by  Joseph  Delgado,  a 
journeyman  tailor,  who,  in  dread  of  the  malady  which  had 
begun  its  ravages  at  Malaga,  fled  to  his  father's  house  at 
Antequera.  He  left  :Nralaga  on  the  23rd  of  July,  was 
taken  ill  on  the  27th,  and  died  on  the  2nd  of  August.  His 
mother  was  attacked  on  the  15th  of  tlio  same  mouth,  and 
died  on  the  24th.       One  of  his  brothers  sickened  on  the 

"Bergez  y  Dufoo:  Siglo  Medica  (Madrid),  1871,  vol.  18,  pp.  280, 

311.  327,  437. 
"  Berenger-Feraud,  p.  74. 


SPAIN — ANTEQUERa.  505 

17th,  and  died  ou  the  21st.  Two  sisters  were  taken  ill 
on  the  18th,  one  died  on  the  22nd;  the  other  recovered. 
Another  brother,  a  youth  about  11  jears,  was  attacked 
on  the  19th ;  he  recovered.  The  fiather  of  this  unfortunate 
family,  aged  75,  was  taken  ill  on  the  28th  of  August,  and 
died  on  the  2nd  of  September ;  and,  finally,  the  renuiining 
brother,  aged  2G,  was  attacked  on  the  30th  of  August,  and 
died  on  the  4th  of  September. 

Another  refugee  from  Malaga  created  a  new  focus  of 
infection  at  Antequera  almost  simultaneously  with  the 
importation  of  Delgado.  A  lady  by  the  name  of  Munoz 
fled  from  Malaga  and  sought  refuge  among"  friends  at 
Antequera.  Slie  arrived  obout  the  end  of  July,  was  taken 
ill  on  the  1st  of  August,  and  died  on  the  7th.  The  servant 
who  attended  her  and  six  of  the  family  where  she  lodged 
fell  victims  tO'  the  disease. 

A  third  focus  was  created  by  a  wonum  named  Rosario, 
who  arrived  at  Antequera  from  jNIalaga  on  the  7th  of 
August,  already  indisposed.  She  died  on  the  12th.  The 
master  of  the  house  where  she  lodged  was  taken  ill  on  the 
19th  of  August,  and  died  on  the  25th.  His  wife  was 
attacked  on  the  23rd,  and  died  on  the  27th. ^^ 

From  these  three  foci,  the  infection  spread  Avith  incredi- 
ble swiftness  and  the  entire  city  was  soon  under  its  in- 
fluence. 

In  the  beginning  of  October,  the  death-rate  \\'as  between 
thirty  and  forty  daily.  The  populace,  who  looked  upon 
the  pestilence  with  superstitious  terror,  sought  to  arrest 
its  progress  by  religious  demonstrations.  On  the  evening 
of  October  12th,  thev  formed  into  a  solemn  procession  and 
marched  through  the  streets  until  three  o'clock  in  the 
morning,  singing  hymns  and  bearing  aloffi^  a  picture  of 
Our  Lady  of  the  Rosary.^^  The  folly  of  a  multitude^  parad- 
ing the  streets  of  an  infected  city  soon  made  itself  evident, 


"Jackson,  loc.  cit.,  p.  19. 

♦During  the   terrible  epidemic   which   ravaged   Cadiz   in   ISOO   a 

similar  demonstration  was  made  by  the  fanatical  populace. 

See  page  530  of  this  volume. 
"Bally,  p.  436. 


506  HISTORY    OF    YELLOW    FEVER. 

for  on  the  fourth  day  following  the  demonstration,  the 
deaths  increased  from  forty. to  eighty  each  day. 

The  last  death  took  place  November  G.  Out  of  a  popu- 
lation of  14,577,  there  were  2,490  deaths,  divided  as  fol- 
lows: Males,  1,850;  females,  l,090.i« 

Since  1804,  yellow  fever  has  never  been  observed  at 
Antequera. 

ARAHAL. 

During  the  widespread  epidemic  of  1800,  a  few  hundred 
cases  were  imported  to  Arahal,  twenty-two  miles  from 
Seville,  resulting  in  180  deaths. 

ARCOS  DE  LA  FROXTERA. 

1800. 

Arcos  de  la  Frontera  was  infected  by  Cadiz  in  1800,  and 
lost  G31  of  her  inhabitants.^^ 

1804. 

Tn  1804,  Arcos  de  la  Frontei'a  had  a  ])o])iilation  of  0,894. 
The  first  case  of  yellow  fever  was  observe;!  on  August  1?>, 
and  between  that  date  and  December  8,  Avhen  the  last 
death  took  ])lace,  184  victims  paid  tribute  to  the  pestil- 
ence.    Of  this  nuuiber,  ll.'>  were  mah  s  and  71  females. ^'-^ 

1821. 

Asco,  a  small  town  on  the  Ebro,  tliirtv-uiiie  miles  from 
Tortosa,  was  infected  in  a  peculiar  manner  in  1821.     It 


"•Fellowes,  p.  478. 
'^  La  Roche,  vol.  1.  p    534. 
'"La  Roche,  vol.  1,  j).  478 
'^  Fellowes.  p.   478. 


SPAIN.  507 

appears  that  a  man  from  Tortosa  was  visiting  friends  in 
Asco,  when  he  was  informed  that  his  wife  had  been  taken 
suddenly  ill.  Impatient  to  return  home,  he  borrowed  a 
horse  from  his  host,  promising  to  send  back  the  animaJ 
the  following  dny.  On  arriving  at  his  destination,  the 
unfortunate  Tortosan  was  stricken  with  the  malady  which 
was  then  prevailing  in  his  native  town  (yellow  fever), 
and  died  in  a  few  days.  The  party  at  Asco  to  whom  the 
horse  belonged,  not  hearing  any  tidings  of  his  property, 
sent  his  servant  for  the  animal.  The  latter,  on  reaching 
Tortosa,  was  told  of  the  death  of  his  master's  friend  and 
given  permission  to  take  back  the  animal.  On  his  return 
to  Asco,  he  was  stricken  with  yellow  fever,  communicated 
the  disease  to  his  master,  who  in  turn  infected  the  balance 
of  the  family,  and  from  this  focus,  radiated  an  epidemic 
which  threatened  to  encompass  the  town.  The  inhabi- 
tants fled  to  the  neighboring  country.  This;  checked  for  a 
time  the  progress  of  the  malady,  and  Asco  was  congratu- 
lating itself  uj)on  having  escajjcd  with  only  a  few  cases 
and  deaths,  while  Tortosa  and  Barcelona  were  being  de- 
populated, when  the  infection  broke  out  anew.  An  in- 
vestigation by  the  health  authorities  to  discover  the  source 
of  the  secondary  infection,  as  Asco  had  estaldished  a  strict 
quarantine  against  places  where  the  malady  was  then  pre- 
vailing, revealed  that  four  thieves  had  l)roken  into  a  house 
where  yellow  fever  had  been  most  murderous,  and  had 
ransacked  it  from  top  to  l)ottom  of  everything  vaiualtle. 
These  f;)ur  law  breakers  paid  dearly  for  their  dejjredation, 
for  they  were  shortly  after  stricken  with  yellow  fever  and 
died.  Froiu  this  soui'ce  radiated  the  second  outbreak. 
Apother  general  exodus  of  tlic  iiopiilation  took  ])lace.  The 
commissary  of  Asco  caused  every  dog  in  the  town  to  be 
killed  (for  reasons  not  ex]>1ained  by  the  chroniclers  of  the 
period),  opened  wide  the  doors  and  windows  of  every  habi- 
tation for  six  consecutive  days,  and  forbade  the  inhabi- 
tants to  return  until  the  epidemic  was  com])letely  stam])ed 
our.  Tliese  energetic  measun^s  saved  Asco  from  de- 
population.-^ 


'■"Bally,  FrancoJs  and  Pariset,  p.  59. 


508  HISTORY    OF    YELLOW    FEVER. 

AVEIATA. 

1800. 

A  few  cases  of  yellow  fever  were  observed  at  Avriata 
in  1800.  There  is  no  record  of  any  other  invasion  pre- 
vious to  or  after  that  date.^^ 

A  YA  MONTE. 

1800. 

Ayamonte  is  one  of  the  few  places  in  Spain  Avhere  yel- 
low fever  has  been  observed  only  infrequently.  Fellowes 
claims  that  it  suffered  to  some  extent  in  1800,  but  does  not 
give  any  details.-^ 

1804. 

Chervin-^  pokes  fun  at  Pariset  because  the  latter  sol- 
emnly asserts  in  his  work  published  in  1820,-^  that  yellow 
fever  was  introduced  into  Ayamonte  in  1804  by  means  of 
cheese  and  crackers-^  smuggled  into  the  town  from  Gib- 
raltar by  a  fisherman.  As  yellow  fever  was  quite  severe 
at  Gibraltar  in  1804,  and  it  was  proved  that  the  lone  fish- 
erman had  communicated  in  the  open  sea  with  a  Aessel 
coming  from  the  infected  port,  there  is  no  doubt  in  the 
world  that  he  contaminated  Ayamonte,  for  he  died  of  the 
disease  on  his  return  home;  but  we  side  with  Chervin  in 
exonerating  the  cheese  and  crackers.  Cheese  sometimes 
(especially  in  summer)  contains  animal culae,  but  it  has 
never  been  known  to  harbor  the  larvae  of  the  winged  dis- 
seminators of  yellow  fever. 


^'Rougeau:   Theses  de  Paris,  1827,  No.  119. 
--  Fellowes,  p.  444. 

^Chervin:   Examen  Critique,  etc.,  p.  18. 
-'Pariset:   Observations  3ur  la  Fievre  Jaune,  p, 
=3  *    *    *    .<^^j  moyen  du  fromage  et  dii  biscuit." 


Sl'AIN.  509 

The  unfortunate  fisherman  communicated  the  disease 
to  his  family,  who  all  fell  victims  to  the  pestilence.  The 
fever  invaded  the  three  streets  contiguous  to  the  fisher- 
man's home,  but  did  not  spread  to  other  quarters  of  the 
town.  The  number  of  cases  and  deaths  is  not  given  by  our 
authorities.-^ 

BADALONA. 

1821. 

A  Avorkman  living  at  Badalona,  six  miles  from  Barce- 
lona, contracted  yellow  fevei'  at  the  latter  place,  and  Avas 
transported  to  his  home,  where  he  expired  the  following 
day.  The  authorities  of  Badalona  had  the  body  trans- 
ported outside  the  town  limits,  and  threatened  to  shoot 
any  one  who  should  harbor  refugees  from  infected  places. 
These  stringent  measures  saved  the  village  from  con- 
tamination.* 

BALEARIC    ISLANDS. 

Yellow  Fever  Years. 

1744 ;  1747 ;  1748 ;  1749 ;  1803 ;  1804 ;  1819 ;  1821 ;  1870. 

Summary  of  Epidemics. 

1744. 

Palma. 

Berenger-Feraud^"  and  Pariset-^  give  vague  accounts  of 
an  outbreak  of  yellow  fever  on  tlu^  Island  of  :Majorca  in 
1744.  Whence  the  fever  was  imported  or  what  ravages  it 
caused,  is  left  to  conjecture. 

-'"Fellowes;   Chervin;   Bally,  Francois'  and  Pariset. 

*  Bonneau  and  Sulpicy:  Recherches  siir  la  Contagion  de  la  Fievre 

Jaune.     Paris,  1S23,  p.  306. 
"  Berenger-Feraud,  p.   48. 
^  Pariset,  p.  123. 


510  HISTORY    OF    YELLOW     FEVER. 

1747. 
Port  Malion. 

According  to  Cleghorn,^  the  second  appearance  of  yel- 
low, fever  in  the  Balearic  Islands  took  place  on  the  Island 
of  Minorca  in  1747. 

Xo  particulars  of  any  historical  value  are  given  con- 
cerning this  importation. 

1748. 

Fort  Million . 

It  is  recorded  that  the  disease  was  present  at  Minorca 
in  1748.30 

No  authentic  data  concerning  this  invasion  are  ob- 
tainable. 

1749. 

Palm  a. 

The  fourth  invasion  of  the  Balearic  Islands  took  place 
at  Majorca  in  1749,  according  to  Cleghorn.'^^ 

The  literature  on  the  subject  is  as  unsatisfactory  as  in 
the  preceding  outbreaks. 

1803. 

Palma. 

A  vessel  ft'om  Alicante  brought  vellow  fever  to  Palma 
in  1803.32 

The  outbreak  was  unimportant. 


^'Cleghorn:  Observations  on  the  Epidemic  Diseases  of  Minorca, 

from    the   Year     1744     to     1749     (London,     1779).       Also: 

Berenger-Feraud. 
^  Moreau  de  Jonnes,  p.  336. 
='  Eager,  p.  16. 
^=  Berenger-Feraud,  p.  74. 


SPAIN BALEARIC  ISLANDS.  511 

1804. 

Pahna. 

The  state  of  the  public  health  at  Palma  was  excellent  iu 
1804,  wlien  a  Tessel  arrived  from  Alicante,  having  on  board 
a  Majorcan  who  was  convalescing  from  an  attack  of  yel- 
low fever,  and  a  family  destined  for  the  Island  of  Minorca, 
The  latter  took  lodgings  at  Palma,  intending  to  leave  for 
their  native  town  in  a  day  or  so.  On  the  same  day  of 
tlieir  arrival,  the  mother  of  the  family  was  taken  ill  with 
yellow  fever.  The  following  day,  the  husband  and  child 
were  attacked.  The  unfortunates  were  immediately  sent 
to  the  pest-house,  but  some  soldiers  who  frequented  the 
Uivern  where  the  stricken  family  had  taken  lodgings,  con- 
tracted the  disease  and  brought  the  infection  to  the  town 
barracks,  where  several  cases  were  observed.  The  dis- 
ease did  not  spread  through  the  town.^^ 

1819. 

Po7't  Mahon. 

In  1819,  yellow  fever  ravaged  the  cities  on  the  south 
coasts  of  Spain.  The  infection  was  originally  brought  by 
the  ship  Asia,  from  Vera  Cruz  and  Havana,  to  the  Isla  de 
Leon,  and  infected  Cadiz.  The  Asia  was  sent  to  the  quar- 
antine station  at  Port  Mahon,  where  three  inhabitants  of 
the  town  contracted  the  disease  and  died.  The  outbreak 
was  limited  to  these  three  cases. "^"^ 

1821. 
Palma. 

In  1821,  another  great  epidemic  wave  of  yelb)w  fever 
desolated  the  sea  coast  cities  of  Southern  Sj^ain. 

*^  Berenger-Feraud,  p.  79. 

"Begin:    Journal    de    Medecine    Milltaire,    1820,    p.    346.      Also: 
Berenger-Feraud,  p.  89. 


512  HISTORY    OF     YELLOW     FEVER. 

On  xViigust  C,  1821,  a  vessc4  left  Barcelona,  where  "a 
suspicious  fever'-  was  beginuiug  to  cause  much  public  un- 
rest, and  arrived  at  Palma  two  days  later.  Among  the  pas- 
sengers was  a  merchant  of  Palma,  who  lived  in  the  La  Paz 
Quarter.  On  his  arrival  home,  the  merchant  was  taken 
ill  with  yellow  fever.  He  was  nursed  by  his  wife  and  his 
little  daughter  and  recovered.  Tlie  girl  was  soon  attacked 
and  died  with  black  vomit  on  the  fifth  day.  The  women 
who  prepared  the  girl  for  burial  were  mostly  all  attacked 
and  died.  The  merchant's  wife  was  next  attacked.  She 
was  transported  to  a  house  in  San  Pedro  Street,  Avliere 
she  recovered.  The  two  adjoining  houses  were  con- 
taminated. 

The  merchant  was  visited  during  his  illness  by  two 
friends,  Poulet  and  Uoig  and  by  two  female  relatives, 
]\Iunera  and  Femina.  These  four  persons  were  soon  after 
taken  ill  with  mellow  fever  and  died.  Poulet's  wife  and 
all  her  children  next  fell  victims  to  the  disease.  A  man 
named  I\enz,  who  lived  in  a  small  room  in  the  house  of 
the  ]Munera  woman,  soon  succumbed  to  the  fever.  The 
man  Roig,  Avho  died  of  the  fever,  contaminated  his  clerk, 
]Mulet  and  five  or  six  persons  who  roomed  in  his  house. 
^y\wu  ^Mulct's  wife  felt  the  first  febrile  symptoms,  she  fled 
Avith  her  children  and  a  servant  to  a  remote  quarter  of 
the  town,  wliich  was  free  from  sickness  at  the  time.  She 
soon  died  of  tlie  disease  and  was  followed  by  lier  children 
and  the  servant  who  had  accom])anied  her. 

Such  was  the  pre-epidemic  situation  in  Palma,  when 
the  authorities  finally  awoke  from  their  lethargy. 

Up  to  Sei)tember  10,  the  malady  had  been  confined  to 
the  two  districts — La  Paz  cyr  Puyg  de  San  Pedro  and  the 
Boleria,  but  cases  began  to  crop  out  so  rapidly,  that 
tlie  authorities  decided  to  take  urgent  measures  to  check 
the  inroads  of  the  fever.  Xews  of  the  contem])lated  move 
on  the  part  of  the  authorities  reached  the  inhabitants  of 
the  infected  districts,  and  fearing  that  they  would  be 
surrounded  by  an  impenetrable  sanitary  cordon,  entire 
fjimilies  fled  in  the  middle  of  the  night  to  relatives  or 
friends  all  over  the  city.  This  wholesale  migration  acted 
like  a  firebrand  in  spreading  the  fever,  and  the  epidemic 
was  soon  bevond  control. 


SPAIN BALEARIC    ISLANDS 


513 


Panic  seized  the  inhabitants. 

It  was  now  a  question  of  everyone  for  himself.  Fathers 
deserted  their  families,  mothers  their  babes,  and  inde- 
scribable terror  prevailed  in  the  town.  On  September  15, 
the  superior  authorities,  civil  and  military,  fled  to  the 
village  of  Yaldemosa,  about  twelve  miles  from  Palma. 
The  citizens,  following  their  example,  made  a  precipitate 
retreat  to  the  country  beyond  the  walls  of  the  pest-ridden 
city.  The  migration  was  so  considerable  that  of  36,000, 
only  12,000  remained,  21,000  fleeing  from  the  terrible  pest- 
ilence. The  government  found  it  necessary  to  raifee  funds, 
secure  means  of  maintenance  and  build  huts  in  the  open 
country,  and  two  encampments  Avere  formed  at  the  foot 
of  Mount  Belver,  about  two  miles  from  Palma.  It  is  a 
remarkable  fact,  out  of  this  multitude  fleeing  from  a  nest 
of  pestilence,  not  a  single  case  erupted,  save  in  those  who 
already  had  the  disease  when  they  joined  in  the  frenzied 
exodus.^^ 

There  were  altogether  7,100  cases  in  Palma,  of^  which 
5,311  died. 

Port  Mahon. 

During  the  epidemic  which  ravaged  the  seacoast  towns 
of  Spain  in  1821,  forty-three  vessels  were  quarantined  at 
Port  Mahon,  beginning  with  the  Javeque  Constitucion, 
from  Barcelona,  August  13,  1821,  and  ending  with  the 
Luacl  Santo  Cristo  del  Grau,  October  21,  1821. 

Among  the  total  of  196  cases  of  yellow  fever,  122  died. 
Owing  to  the  vigilance  of  the  health  authorities,  the  dis- 
ease did  not  spread  to  the  inhabitants  of  Port  Mahon. 

Among  the  49  attendants  at  the  Lazaret  Nacional  at 
Port  Mahon,  10  wei-e  attacked  with  yellow  fever,  five  of 
whom  died.  These  cases  and  deaths  are  included  in  the 
above  total. 

"  Bally,  Francois  and  Pariset,  p.  63. 

'•Junta    Superior   de    Sanidad   de    dicha   Isla   de    Minorca,   etc., 
Mahon,  1821. 


51i  HISTORY    OF     YELOW   FFVKR. 

1S70. 
Palma. 

For  nearly  fifty  years  after  the  sinister  epidemic  of 
1821,  yellow  fever  was  kept  out  of  Palma.  •  In  1870  a  few 
cases  were  imported  to  that  town  from  the  south  coast 
of  Spain,  where  the  disease  had  been  originally  brought 
to  Barcelona  in  August  by  the  ship  La  Mariu,  from 
Havana,  Prompt  sanitary  measures  were  resorted  to,  and 
the  outbreak  at  Palma  was  confined  to  a  few  cases.^^ 

We  have  seached  diligently  through  files  of*  Spanish 
journals  for  a  history  of  the  prevalence  of  the  disease 
at  Palma,  in  1870,  but  the  results  have  been  negative. 
On  page  630  of  El  Sif/lo  Medico  for  1871,  is  a  reference 
to  an  article  entitled  "Historia  de  la  Fiehre  AmariUa  que 
se  Padecia  en  Palma  de  Mallorca  en  1870,"  but,  with  the 
characteristic  haziness  which  generally  pervades  the  lit- 
erature of  the  Castillians  when  it  comes  to  facts  and 
figures,  the  ai»ticle  conveyed  nothing  tangible. 

Port  Ulalwii. 

We  were  more  fortunate  in  gathering  information  con- 
cerning the  prevalence  of  yellow  fever  at  Port  Mahon  in 
1870.  The  infection  did  not  spread  to  the  shore,  but  was 
confined  solely  to  ships  in  the  quarantine  basin. 

According  to  El  Siglo  Medico  for  1871,  vol.  18,  pages 
233,  2G0,  310  and  406,  the  flollowing  infected  ships  were 
quarantined  at  the  lazaretto  during  the  epidemic  of  1870: 

1.  Steamship  Menorca,  from  Barcelona,  September  15. 
Carried  three  women  ill  with  yellow  fever,  who  were  re- 
moved to  lazaretto.     Two  died. 

2.  Bark  Dunamargnesa.  Arrived  from  Barcelona, 
September  17.  Three  of  the  crew  were  afflicted  on  the 
way  from  Barcelona..  On  arrival,  a  third  case  died.  On 
September  21,  a  patient  was  cai'ried  to  the  lazaretto  from 

*^  Berenger-Feraud,  p.  145. 


SPAIN PORT    MAHON,     1870.  515 

this  vessel,  and  died  on  the  28th.       On  September  28, 
one  of  the  health-guards  was  attacked  and  died. 

3.  Steamship  Union  arrived  from  Barcelona,  Septem- 
ber 23.  Two  passengers  were  found  to  be  indisposed,  and 
were  sent  to  the  lazaretto.  Both  died,  one  the  same  day 
and  the  other  six  days  later.  Another  fatal  attack  on 
the  24th.     Another  case  on  the  26th,  followed  by  recovery. 

4.  Steamship  Mallorca,  from  Barcelona,  September 
24.  Among  six  passengers,  one  had  yellow  fever  and  died 
on  the  fourth  day. 

5.  Brigantine  Nicevo  Copernico,  from  Barcelona,  Sep- 
tember 28.     Two  cases  sent  to  lazaretto.     One  died. 

6.  Polacre  Grieza  EvangeUsta,  from  Barcelona,  Sep- 
tember 25.  Three  attacks  during  voyage.  One  died  at 
sea.     Other  two  sent  to  lazaretto ;  both  died. 

7.  Warship  Lepanto,  ftpom  Barcelona,  September  23. 
On  October  4,  gunner's  mate  attacked;  on  the  5th,  6th 
and  7th,  two  sailors  and  a  cabo  de  canon  were  attacked. 
All  recovered. 

8.  Ship  San  Juan,  October  2.  First  case  October  4; 
carried  to  lazaretto  where  he  died  several  hours  later. 
On  October  5,  a  second  case;  recovery. 

9.  Gunboat  Licjera,  from  Barcelona,  October  16.  On 
the  22nd,  disembarked  a  case  of  yellow  fever ;  recovery. 

10.  Brigantine  Jnanita,  from  Barcelona,  October  8. 
On  the  11th,  one  case  sent  to  lazaretto;  recovery. 

General  summary: 

First  case,  September  15;  last,  October  22. 

First  death,  September  17;  last,  October  4. 

Total  cases,  22;  total  deaths,  12. 

With  the  exception  of  the  health-guard  who  was  in- 
fected on  the  Dunamarguesa,  not  a  single  inhabitant  of 
Port  Mahon  contracted  the  disease. 

Since  1870,  the  Balearic  Islands  have  been  free  from 
yellow  fever. 


516  HISTORY    OF    YELLOW    FEVnjR. 

BARCELONA. 

Yellow  Fever  Yeaks. 

i 
1803;  1810;  1819;  1821  (Great  Epidemic)  ;  1870;  1883. 

Su^kiMARY  OF  Epidemics. 

1803. 

The  first  authentic  importation  of  yellow  f^^ver  to  Bar- 
celona took  place  in  1803.  While  the  fever  was  raging  at 
Malaga,  cases  began  to  erupt  in  the  harbor  of  Barcelona. 
Five  soldiers,  who  had  been  placed  on  duty  on  board 
vessels,  were  attacked  and  died.  Their  colonel  next  fell 
a  victim  to  the  malady.  The  cases,  which  were  confined 
to  the  shijiping,  amounted  to  73,  of  which  30  proved 
fatal.ss 

1810. 

Yellow  fever  is  said  to  have  been  present  at  Barcelona 
in  1810.  We  Imve  been  unable  to  obtain  any  details  con- 
cerning this  alleged  outbreak.  The  Medico-  CJiirurgical 
Journal  and  Review  (1821,  vol.  2,  p.  19,),  claims  that  yel- 
low^ fever  "raged"  at  Barcelona  during-  the  year  under  ob- 
servation, but  efforts  to  corroborate  this  statement  have 
been  fruitless.  Cadiz,  Gibraltar,  Seville  and  Carthagena 
suffered  from  the  saffron  scourge  that  year,  and  a  few 
cases  were  probably  brought  to  Barcelona  or  erupted  on 
vessels  in  the  harbor;  but  there  certainly  was  no  epidemic  ' 
in  the  ancient  capital  of  Catalonia  in  1810.  If  there  had 
been,  Berenger-Feraud,  Audouard,  Bally,  Pariset,  Eager 
and  others  who  have  written  interestingly  of  the  epidemics 
which  ravaged  Spain  in  the  beginning  of  the  last  century, 
would  certainly  have  made  note  of  the  occurrence. 


Bally,  p.  84.     Bally,  Francois  and  Pariset,  p.  461. 


SPAIN BARCELONA.  5  J? 

1819. 

A  solitary  case  of  yellow  fever  was  observed  in  Barce- 
lona in  1819,  according  to  Robert.^^  Our  authority  does 
not  go  into  details,  but  states  that  the  case  erupted  in 
July,  and  proved  fatal  in  a  few  days.  There  was  no 
diffusion. 

1821. 

The  epidemic  of  1821  was  appalling  and  has  gone  into 
history  as  one  of  the  most  murderous  on  record. 

The  population  of  Barcelona  in  1821  was  150,000.  When 
the  true  nature  of  the  "mysterious  disorder"  which  was 
causing  widespread  anxiety  to  the  inhabitants  of  the 
ancient  city  became  known,  80,000  fled  precipitately  to 
all  points  of  the  compass.  Qf  the  70,000  who  remained, 
nearly  every  one  was  attacked  and  between  16,000  and 
20,000  died,  according  to  the  estimates  of  various  au- 
thorities.* 

The  Pcst-^^Jiips  from  Havana, 

The  dismal  history  of  this  epidemic,  as  condensed  from 
the  works  of  O'Halloran,^^  Audouard,^!  Bally,  Francois 
and  Pariset,*-  Eager^^  and  Berenger-Feraud,^^  is  as 
follows : 

The  following  vessels  are  accused  of  having  brought 
yellow  fever  to  Barcelona  in  1821 : 

'"Robert:  Guide  Sanitaire,  vol.  1,  p.  88. 

*  La  Roche  (Vol.  1,,  p.  536)  says  that  these  figures  are  exagger- 

ated and  places  the  cases  at  14,000  and  the  deaths  at  9,730. 
*>  O'Halloran:    Remarks  on  the  Yellow  Fever  on  the  South  and 

East  Coasts  of  Spain  (London,  1823),  pp.  22  et  seq. 
"Audouard:  Relation  Historique  et  Medicale  de  la  Fievre  Jaune 

qui  a  Regne  a  Barcelone  en  1821.     Paris,  1821. 
"Bally,  Francois  and   Pariset:    Histoire   Medicale   de   la  Fievre 

Jaune  (Paris,  1823).  p.p.  4  et  seq. 
«  Eager:  Bull.  No.  5,  Yellow  Fever  Inst,  1902,  p.  22. 

*  Bally,  Francois  and  Pariset:  p.  613. 

**  Academia  de  Medcina  y  Cirurgia  de  Barcelona:  Memoria  soibre 
la  Epidemia   de   Febre   Amarilla   Sufrida   a   Barcelona   en 

1870.  Borcelona,  1872,  page  148. 

Also:    Berenger-Feraud,  p.  91;   Roux,  Marseilles  Medicale, 

1871,  vol.  8,  p.  194. 


518  HISTORY    OF    YELLOW    FEVER. 

1.  The  brig  Talla  Piedra 

2.  The  brig  Nuestra  Senora  del  Carmen. 

3.  The  brig  Gi^an  Turco. 

4.  The  Spanish  frigate  La  Libertad. 

The  above  named  vessels  sailed  from  Havana  on  April 
28,  1821,  and  were  part  of  a  fleet  consisting  of  fifty-two 
sails,  destined  for  the  following  ports :  thirteen  for  Cadiz, 
twenty  for  Barcelona,  six  for  Comma,  three  for  Santan- 
der,  four  for  Malaga,  one  for  Vigo,  one  for  Ferrol,  one  for 
Bilboa,  one  for  Palma,  one  for  Lisbon  and  one  for  Bahia> 

A  cursory  glance  into  the  history  of  these  four  pest- 
ships  proves  interesting. 

The  Talla  Piedra  touched  at  Cartagena  on  June  12, 
arriving  at  Barcelona  on  the  19th  of  the  same  month. 
She  was  given  pratique  after  having  performed  eight  days' 
quarantine. 

The  Nuestra  Senora  del  Carmeiv  arrived  at  Cartagena 
on  June  16,  obtained  pratique  and  disembarked  her  sec- 
ond pilot.  She  arrived  at  Alicante  June  19,  where  she 
unloaded  part  of  her  cargo  and  embarked  a  passenger. 
The  Carmen  finally  cast  anchor  in  the  harbor  of  Barcelona 
on  July  11,  This  vessel  had  three  cases  of  yellow  fever  dur- 
ing the  voyage  from  Havana  to  Alicante,  one  of  which 
proved  fatal.  The  passenger  who  had  boarded  the  ship 
at  Alicante,  was  ill  when  the  ship  arrived  at  Barcelona, 
but  eluded  the  vigilence  of  the  authorities  by  sitting  on 
deck  "all  dressed  up"  when  the  vessel  entered  the  port. 
He  died  a  few  days  after  landing,  of  a  malady  which  pre- 
sented "strange  and  suspicious  symptoms."  This  was  no 
doubt  the  first  case  of  yellow  fever  at  Barcelona  in  1821, 
but  the  man  who  had  been  taken  on  board  through  charity 
and  had  no  parents  or  influence,  was  buried  by  the  city 
without  any  inquiries  being  made  about  his  previous  per- 
sonal history. 

The  Gran  Turco  reached  Cadiz  on  June  5,  where  she 
obtained  pratique,  disembarked  twenty-four  passengers 
and  took  on  l)oard  four  others  and  three  sailors.  She 
then  set  sail  for  Barcelona,  where  she  arrived  June  29. 
The  Gran  Turco  had  formerly  been  a  slave-ship.     During 


SPAIN BARCELONIA,     1821.  519 

the  voyage  from  Havana,  there  had  been  some  deaths  from 
yellow  fever  on  board. 

The  frigate  La  Lihertad  arrived  at  Malaga  on  June  8, 
obtained  pratique  and  disembarked  part  of  her  cargo ;  she 
then  sailed  for  Cartagena,  where  she  also  landed  some 
freight,  a  passenger  and  a  sailor,  after  which  she  left  for 
Barcelona,  where  she  arrived  June  28. 

Which  of  these  four  vessels  contaminated  Barcelona,  or 
whether  they  each  played  a  role  in  bringing  the  disease 
from  Havana,  has  never  been  satisfactorily  elucidated  to 
this  day;  but  that  the  onus  fell  on  the  quartette,  there 
is  not  the  slightest  doubt. 

The  First  Seeds  of  the  Epidemic. 

The  state  of  the  public  health  was  excellent  at  Barce- 
lona. ^  Great  preparations  were  being  made  by  the  civil 
and  military  authorities,  as  well  as  the  general  public, 
for  a  great  festival  to  be  held  July  12,  to  celebrate  the 
anniversary  of  the  promulgation  of  constitutional  law  in 
Spain.  Owing  to  bad  weather  on  the  selected  date,  which 
would  have  marred  the  eclat  of  the  celebration  in  the 
harbor,  where  elaborate  manouevres  were  to  be  held,  the 
feast  was  postponed  until  the  following  Sunday,  July  15. 
On  that  day,  the  sky  was  cloudless  and  the  weather  splen- 
did, and  the  populace  congregated  on  the  quays  to  witness 
the  nautical  sports.  There  were  then  about  twenty  ships 
from  Havana  and  Vera  Cruz  in  the  harbor,  and  they  took 
part  in  the  celebration.  Captain  Sagredas,  cammanding 
the  Gran  Turco,  gave  a  reception  on  board  his  ship.  His 
wife,  their  children,  his  brother-in-law,  sister-in-law  and 
many  other  persons,  altogether  forty,  attended.  After 
spending  a  couple  of  days  aboard  the  Gran  Tnrco,  the 
captain's  family  went  to  Barcelonetta,  near  Barcelona, 
where  they  lived.  In  a  few  days,  every  member  of  this 
family  sickened  "of  a  strange  malady,"  and  all  died.  Of 
the  forty  persons  wlio  had  visited  the  G?-aii  Turco,  thirty- 
five  died,  with  pronounced  symptoms  of  yellow  fever. 

Many  persons  visited  the  Talla  Piedra  during  the  pro- 
gress of  the  festival.     In  a  few  days,  they  were  all  taken 


520  HISTORY    OF  VELLOW  FEVER. 

ill  with  the  same  "strange  malady,"  and  the  majority 
died. 

The  French  brig  Josephine  was  riding  at  anchor  close 
to  the  above  named  vessels.  The  crew  was  taken  ill  with 
yellow  fever,  and  only  a  few  survived.  The  Saint-Joseph, 
from  Naples,  also  moored  near  the  infected  vessels,  was 
contaminated  and  lost  most  of  her  crew. 

The  captain  of  the  Josephine,  when  he  saw  th^  havoc 
wrought  on  board  his  ship,  took  lodgings  in  Barcelona. 
Eight  days  afterwards,  this  lodging  house  was  infected, 
and  the  landlady,  her  husband,  their  children  and  the 
servants  were  attacked  in  rapid  succession. 

Shortly  after  the  death  of  captain  Sagredas'  family  and 
the  fatal  cases  in  the  lodging  house  above  mentioned,  cases 
of  the  same  "strange  and  suspicious  malady"  began  to 
crop  out  here  and  there  in  Barcelona  and  neighboring 
villages  on  the  sea-shore,  mainly  among  those  who  had 
communicated  with  the  infected  ships  or  who  had  visited 
the  houses  where  cases  had  erupted.  While  the  disease 
was  slowly  gaining  ground,  the  "eminent  physicians"  of 
Barcelona  were  in  daily  conclave,  wrangling  over  the  sit- 
uation and  refusing  point-blank  to  admit  that  they  were 
face  to  face  with  an  invasion  of  yellow  fever.  It  was  only 
after  the  malady  had  invaded  nearly  every  quarter  of  the 
town  that  the  authorities  saw  that  they  had  been  blunder- 
ing and  began  the  institution  of  sanitary  measures  to  stop 
the  progress  of  the  "mysterious  malady."  But  it  was  too 
late — the  demon  of  pestilence  was  unchained  and  Barce- 
lona was  destined  to  pay  a  terrible  penalty  for  the  criminal 
negligence  of  those  sworn  to  safe-guard  her  interests. 

On  August  5,  the  health  authorities  began  sending  the 
sick  to  isolation  hospitals,  but  this  had  little  effect  in 
arresting  the  progress  of  the  malady,  for  the  people, 
deluded  by  the  manifestos  of  the  Spanish  physicians  deny- 
tliat  the  "mysterious  malady"  was  yellow  fever,  openly 
defied  the  law  and  violently  opposed  interference  with 
their  business  and  pleasure. 


I 


SPAIN — BARCELONA,       1821.  521 

'  Panic  and  Flight. 

On  August  12,  the  situation  became  so  grave,  that  the 
number  of  isolation  hospitals  were  increased,  and  per- 
emptory instructions  given  that  the  places  of  amuse- 
ment be  closed  and  public  assemblages  prohibited.  The 
populace  violently  opposed  these  measures,  and  riots  were 
of  daily  occurrence.  The  local  medical  society  sustained 
public  opinion,  denying  that  the  disease  was  yelloAv  fever. 
Under  this  state  of  things,  the  pestilence,  unchecked  by 
concerted  preventive  measures,  was  soon  beyond  control, 
and  the  deaths  became  daily  more  frequent  and  the  malady 
more  aggressive  and  widespread. 

On  August  16,  the  public  finally  awoke  to  the  real  situ- 
ation and  a  panic  ensued.  In  the  space  of)  a  few  days, 
half  the  population  of  the  town  had  fled. 

An  example  of  the  fearful  mortality  may  be  deduced 
from  the  fact  that  out  of  853  male  and  886  female  patients 
treated  at  the  Seminary  Hospital  between  September  13 
and  November  25,  640  of  the  former  and  622  of  the  latter 
died. 

Between  August  16  and  the  first  days  of  October,  the 
ravages  of  the  epidemic  were  terrible.  In  the  beginning 
of  October,  400  deaths  were  daily  recorded.  At  the  end 
of  the  month,  the  situation  improved  and  by  the  middle 
of  November,  health  conditions  were  nearly  normal.  On 
November  25,  the  last  case  erupted,  but  it  was  not  until 
December  18  that  the  authorities  relaxed  their  vigilance 
and  withdrew  the  sanitary  cordon  which  had  completely 
shut  out  communication  between  Barcelona  and  the  out- 
side world. 

Thus  came  to  an  end  one  of  the  most  awesome  epidemics 
of  yellow  fever  on  record,  which  has  been  unsurpassed 
for  its  fierceness  and  appalling  mortality  (21,483*  out  of  a 
remaining  population  of  70,000),  and  which  could  have 
been  controlled  in  its  incipiency,  but  for  the  ignoTance  of 
the  people  and  the  shameful  wrangles  and  pig-headedness 
of  the  physicians  who  controlled  the  destinies  of  the  un- 
fortunate city. 


522  HISTORY    OF    YELLOW    FEVER. 

1870. 

/ 

For  forty-nine  years,  Barcelona  enjoyed  a  total  im- 
munity from  yellow  fever. 

Early  in  August,  1870,  the  ship  Maria  arrived  at  Barce- 
lona from  Havana.  There  had  been  two  deaths  on  board 
during  the  voyage.  In  spite  of  this,  the  vessel  was  given 
free  pratique,  without  being  required  to  undergo  the  neces- 
sary sanitary  formalities.  The  physicians  of  the  port  and 
the  secretary  of  the  sanitary  office,  who  visited  the  vessel 
and  gave  her  a  clean  bill  of  health  without  making  strict 
inquiries,  were  taken  ill  with  yellow  fever  a  few  days 
after  their  return  home  and  died.  ^Members  of  their  fam- 
ilies were  next  stricken,  and  the  disease  by  this  means 
spread  through  the  city.  During  the  months  of  August 
and  September,  the  malady  became  epidemic  and  a  gen- 
eral exodus  of  the  population  took  place.  Toward  the  end 
of  October,  the  daily  mortality  varied  from  twenty-five  to 
forty. 

The  epidemic  came  to  an  end  in  the  early  days  of  Novem- 
ber, resulting  in  2,510  cases.  Of  these,  1,250  died,  or  49.8 
per  cent. 

The  disease  extended  to  Valencia,  Alicante,  Palma  and 
Madrid.  The  total  mortalitv  in  Spain  that  vcar  amounted 
to  2,658.44 

18S3. 

The  last  appearance  of  yellow  fever  in  Barcelona  took 
place  in  1883.  In  October  of  that  year,  the  A^V»  Jo.sr, 
from  Havana,  arrived  at  the  port.  Two  men  employed 
in  discharging  guano  from  the  vessel  were  taken  ill  with 
yellow  fever  and  died.^^  The  cool  season  undoubtedly 
saved  Barcelona  from  an  invasion  of  the  Antillean  pest- 
ilence. 

BARCELONETTE. 

1803. 

A  few  cases  of  yellow  fever  were  observed  in  Barcelo- 

*^  Berenger-Feraud,  p.   189. 


SPAIN BARCELONA.  52S 

nette  in  1803,  imported  from  vessels  in  the  harbor.     There 
was  no  spread  of  the  disease.     {Pariset,  p.  38). 

1821. 

The  seeds  of  the  great  epidemic  which  desolated  Bar- 
celona in  1821,  were  sown  at  Barcelonette,  a  suburb  of  the 
first  named  city.  The  little  burg  was  infected  on  July  16, 
l)y  parties  who  had  been  on  board  the  ship  Gran  Turco, 
and  the  first  death  took  place  July  26.  The  history  of  this 
epidemic  is  so  closely  associated  with  that  of  Barcelona, 
that  a  reference  to  the  preceding  pages  will  suffice  to  place 
tlie  reader  in  touch  with  the  distressing  events  which 
shrouded  Spain  in  gloom  during  the  year  under 
consideration.^^ 

BAEKIOS. 

1801. 

Barrios,  near  Algerziras,  was  infected  in  1804  by  sol- 
diers forming  part  of  an  escort  which  had  left  Cadiz  with 
a  consignment  of  money."*^  On  the  night  of  September  11, 
the  cavalrymen  stopped  at  the  village  inn,  where  one  of 
their  members  was  taken  ill  and  died  on  the  morning  of 
the  13th.  The  yellowness  of  the  cadavre  excited  the  sus- 
picions of  the  authorities,  and  steps  were  at  once  taken 
to  prevent  a  spread  of  the  disease.  The  stegomyiae  were 
already  infected,  however,  and  within  two  weeks  six  cases, 
followed  by  death,  erupted  in  the  immediate  neighborhood 
of  the  lodging-house.     No  other  cases  were  observed. 

BENAOCAZ.  ; 

1800. 

During  the  general  epidemic  of  1800,  a  few  oases  were 
observed  at  Benaocaz.     The  outbreak  was  unimportant.*'* 

*"  Audouard,  loc.  cit,  gives    a    comprehensive    and    interesting 

account  of  this  epidemic. 
"  Bally,  p.  444. 
*'Rougeau:  Theses  de  Paris,  1827,  No.  19. 


5 14  HISTORY    Ot     YELLOW    FEVER. 

BOENOS. 

1800. 

The  epidemic  of  1800  spread  to  Bornos.  The  number  of 
cases  is  not  stated,  but  the  mortality  amounted  to  17.^^ 

CADIZ. 

Historical  Resume. 

Cadiz  is  one  of  the  most  ancient  cities  of  Spain.  It  was 
founded  by  the  Phenicians,  and  early  became  of  great  com- 
mercial importance.  It  is  situated  at  the  extremity  of  a 
tongue  of  land  which  juts  out  from  the  Isla  de  Leon,  is 
well  built,  well  paved,  and  for  a  Spanish  city,  very  clean. 
Cadiz,  in  common  with  other  cities  of  Spain,  has  off-  " 
been  the  scene  of  exciting  political  disturbances  and,  in 
the  past,  has  been  besieged,  taken  and  sacked  by  the 
Romans,  the  English  and  the  French.  Its  present  popu- 
lation is  estimated  at  09,322. 

TJie  Epidemics  of  Cadiz. 

According  to  Fellowes,^^  the  first  great  sickness  of 
Cadiz  of  which  there  is  any  account,  appeared  in  the  year 
14()G.  In  1507,  an  equally  fatal  malady  prevailed  there. 
The  disorder,  on  both  occasions,  was  supposed  to  be  the 
plague,  although  the  word  pcsfc.  used  bv  Spanish  authors, 
is  applied  to  infectious  disorders  in  general. 

Of  the  sickness  which  broke  out  in  Cadiz  in  1582,  little 
can  be  ascertained.  It  is  said  to  have  ceased  through  the 
intercession  of  St.  Tioque,  to  whom  the  city  dedicated  a 
chapel. 

In  1049,  the  plague  was  introduced  into  Cadiz,  and 
lasted  three  years,  causing  a  mortality  of  over  14,000. 

In  1661,  the  plague  again  appeared. 

"  La  Roche,  vol.  1,  p.  534. 
">  Fellowes,  p.  22. 


SPAIN — CADIZ.  525 

From  1661  to  1700,  when  el  vomito  negro  (black  vomit) 
first  made  its  appearance  in  Cadiz,  there  is  no  (record  of 
any  extraordinary  change  in  the  state  of  the  public  healtli 
in  that  historic  city. 

Cadiz,  being  the  weatermost  port  of  Spain  and  directly 
in  the  path  of  an  extensive  trans-Atlantic  commerce,  is 
more  exposed  to  infection  from  the  West  Indies  and  South 
America  than  any  other  city  on  the  Iberian  Peninsula. 
Since  1700,  when  the  first  authentic  importation  of  yellow 
fever  took  place,  the  city  has  suffered  from  thirty-nine 
visitations  of  the'  disease.  Five  of  these  outbreaks  ( 1730, 
1731,  1800,  1804  and  1819)  were  attended  with  fearflul 
mortality. 

Yellow  Fever  Years. 


1784 
1803 
1812 


1700;  1701;  1702;  1703;  1705;  1730  (Great  Epidemic) 
1731  (Great  Epidemic);  1734;  1736;  1740;  1741:  1744 
1745;  1746;  1753;  1761;  1763;  1764;  1765;  1780 
1790;  1792;  1800  (Great  Epidemic);  1801;  1802 
1804  (Great  Epidemic);  1807;  1808;  1810;  1811 
1814;  1817;  1819  (Great  Epidemic)  ;  1820;  1821. 

Summary  of  Epidemics. 

1700. 

Vessels  from  the  West  Indies  are  said  to  have  brought 
yellow  fever  to  Cadiz  in  1700.^^  Beyond  this  mere  state- 
ment, no  other  information  is  of  record  concerning  this 
importation. 

1701. 

A  few  cases  of  yellow  fever  were  imported  to  Cadiz  in 
1701.     There  was  no  diffusion  of  the  malady.^^ 


"  Berenger-Feraiid,  p.  38. 

"-Arejula:  Archives  de  Medeoine  Navale,  vol.  7,  p.  251. 


526  HISTORY  OF    YELLOW    FEVER. 

1702. 

Unofficial  reports  allege  that  yellow  fever  was  present 
in  Cadiz  in  1702.^^  These  probably  refer  to  cases  in  the 
harbor,  as  we  could  find  no  record  of  the  prevalence  of  the 
malady  in  the  town  that  year. 

17U8. 

"Ships  from  America"  are  said  to  have  infected  the  har- 
bor of  Cadiz  in  1703.  We  could  find  no  authentic  docu- 
ments to  substantiate  this  allegation. 

1705. 

According  to  Father  Labat,^"*  the  vessel  on  which  he 
was  a  passenger  was  quarantined  at  Cadiz  in  1705,  owing 
to  the  fact  that  a  ship  previously  arrived  from  the  West 
Indies  had  brought  yellow  fever  to  the  town.  The  rev- 
erend chronicler  does  not  state  whether  the  disease  was 
still  prevalent  when  he  arrived. 

1730. 

The  epidemic  of  1730  is  the  first  of  which  any  authentic 
record  exists.  All  previous  outbreaks  of  yellow  fever 
which  are  said  to  have  prevailed  in  Cadiz  lack  sub- 
stantiation. 

The  squadron  of  Admiral  Pintado,  contaminated  at  the 
West  Indies,  brought  the  fever  into  Cadiz  in  1730.  The 
mortality  was  high,  but  no  details  are  given  by  our 
authority.^^ 

1731. 

Fellowes  (page  23)  states  that  yellow  fever  "prevailed 
with  equal  fury"  in  the  year  1731.  Two  symptoms  were 
particularly  noted  as  being  most  fatal  in  this  disorder, 

''^Berenger-Feraud,  p.  39. 

"Labat:   Nouveau  Voyage  aux  lies  d'Amerique,  Paris,  1742. 

"  Berenger-Feraud,  p.  44;  Fellowes,  p.  23. 


SPAIN CADIZ.  527 

viz.,  spots  of  a  livid  yellow  or  dark  color,  and  were  the 
certain  forerunners  of  the  black  vomit.  The  Spanish 
physicians  wer6  of  the  opinion  that  the  malady  was  of!  a 
pestilential  nature,  and  they  advised  the  magistrates  to 
take  the  necessary  precautions.  The  Court  was  then  at 
Seville,  and  Don  Josef  Cervi,  physician  to  Carlos  III  (at 
that  time  Duke  of  Parma  and  Placentia),  was  directed 
to  send  a  practitoner  from  Seville  to  examine  into  thel 
origin  and  character  of  the  disorder  which  was  raging  in 
Cadiz.  For  some  unexplained  reason,  the  result  of  this 
investigation  was  never  published  and  the  full  extent  of 
the  epidemic  which  devastated  Cadiz  in  1731  is  left  to 
conjecture. 

1733. 

Spanish  tradition^^  asserts  that  yellow  fever  was  pres- 
ent in  Cadiz  during  the  year  1733.  No  authentic  docu- 
ments have  been  found  giving  any  detailed  description  of 
this  outbreak,  but  the  prevalence  does  not  appear  to  have 
been  extensive. 

1734. 

A  mild  epidemic  of  yellow  fever  prevailed  in  Cadiz  in 
1734.  Authors  are  divided  as  to  whether  this  outbreak 
was  due  to  new  importation  from  the  West  Indies  or  the 
sea  coast  towns  of  Atmerica  or  a  repullulation  of  the  germs 
of  the  previous  yeair.^'^ 

1736. 

A  few  cases  were  observed  in  1736.^® 

1740. 

Another  mild  manifestation  in  1740.^'^ 


'"Bally,,  p.  42;  Eager,  p..  15. 

"  Berenger-Feraud,  p.  45. 

''  Berenger-Feraud,  p.  45. 

°°  Bally,  p.  44;  Berenger-Feraud,  p.  47. 


5i8  HISTORY    OF    YELLOW    FEVER. 

1741. 

Yellow  fever  prevailed  at  Cadiz  in  1741.®^  That  same 
year,  nearly  10,000  persons  died  from  the  disease  in 
Malaga. 

■  1744. 

Cadiz  was  again  afflicted  in  1744,  the  infection  being 
brought  by  vessels  from  the  West  Indies.  The  outbreak 
was  of  moderate  iutensity.^^ 

1745. 

In  1745,  another  mild  manifestation.^- 

1746. 
A  vessel  from  Cuba  infected  Cadiz  in  1746.^^ 

1753. 

The  squadron  of  Admiral  Don  Pedro  de  la  Cerda 
brought  fever  from  tlie  West  Indies  to  Cadiz  in  1753.  The 
outbreak  was  not  extensive.^^ 

1761. 

A  few  cases  were  observed  in  1761,  according  to 
Tariset.^^ 

1763. 

The  outbreak  of  1763  was  quite  severe,  and  was 
importeil  by  "a  vessel  from  America."  There  had  been 
several  deaths  from  yellow  fever  on  board  during  the 
voyage,  but   the   captain   concealed   this   fact   from   the 

""  Berenger-Feraud,  p.  47. 

"  Eager,  p.  16. 

"-  Berenger-Ferraud,  p.  49. 

"'Eager,  p.  16;   Berenger-Feraud,  p.  49. 

"Eager,  p.  16. 

""^Pariset:    Histoire   Medicale   de   la   Fievre   Jaiine   Observee   en 


SPAIN CADIZ.  519 

authorities  and  the  vessel  was  admitted  tO'  pratique  im- 
mediately upon  her  arrival.  Shortly  aftei".  cases  broke 
out  in  a  tavern  where  sailors  from  this  vessel  had  Iodised, 
and  thence  spread  to  the  adjoininf>-  houses,  occupied  by 
the  poorer  classes.  The  progress  of  the  malady  was  slow, 
but  it  finally  spread  to  other  quarters  of  the  town  and 
caused  much  mortality.  Ships  near  the  sliore  suffered, 
but  those  anchored  a  mile  or  more  from  the  wharves  were 
not  infected. ^^ 

1764. 

In  the  month  of  September  1764,  the  traditional  "ship 
from  America"  brought  yelloAV  fever  to  Cadiz.  Chroniclers 
disagree  as  to  the  extent  of  the  epidemic,  but  Lind,^^  a 
recognized  authority,  states  that  it  was  very  fatal,  a  hun- 
dred deaths  being  recorded  in  a  single  day. 

1765. 

In  the  month  of  April,  1765,  two  persons  visited  a  room 
where  cases  had  occurred  Ihe  year  before  and  ransacked 
some  old  clothes  which  had  been  left  undisturbed  in  a 
closet  since  the  death  of  the  occupants  of  the  house.  The 
couple  were  shortly  after  taken  ill  and  died  with  the 
characteristic  symptoms  of  yellow  fever.  The  malady 
did  not  spread.^^ 

1780. 

A  few  cases  were  observed  in  1780.*^^ 


""  Berenger-Feraud,  p.  53. 

"Lind:  Diseases  Incidental  to  Europeans  in  Hot  Climates  (First 

American  Edition,  1811),  p.  91. 

"'  Berenger-Feraud,  p.   54. 

°"Hirsch:    Deutsche    Vierteljahrsschrift    fur    Offentl.      Gesdhts.- 

Pfleg.,  vol.  4,  pajrt  3,  pp.  353-377.    Also:   Berenger-Feraud, 

p.  57. 


530  HISTORY    OF    YELLOW    FEVER. 

1784. 
Sporadic  cases  were  observed  in  1784.'^ 

1790. 
Scattered  cases  erupted  in  1790.'^ 

1792. 
A  few  cases  are  recorded  for  1792."^ 

1800. 


We  now  come  to  a  recital  of  the  greatest  epidemic  of 
yellow  fever  which  has  ever  invaded  Cadiz,  and  which, 
radiating  into  neiohboring  localities,  plunged  Spain  in 
mourning.  In  Cadiz  alone,  one-sixth  of  the  population 
perished  in  the  space  of  little  more  than  three  months. 


Havana^  the  Eternal  Source  of  Infection. 
Assordina*  to   the  various   authors   who  have  written 


'"Robert,  Guide  Sanitaire,  vol.  1,  p.  88. 

Berenger-Feraud,  p.  58. 

Pariset,  p.  104. 
'^Robert,  vol.  1,  p.  88;  Pariset,  p.  104. 
'-  Robert,  vol.  1,  p.  88. 

Berenger-Feraud,  p.  60. 

Pariset,  p.  104. 


SPAIN CADIZ,    1800.  531 

on  the  subject,'^'^  the  importation  of  the  disease  is  attri- 
buted to  the  bri<^  Dolphin,  which  sailed  from  Havana  at 
the  end  of  May,  1800,  arrived  at  Charleston,  S.  C,  on  the 
30th  of  the  same  mionth,  whence  she  sailed  on  June  11, 
after  embarking  three  sailors,  finally  arriving  at  Cadiz 
on  July  6. 

When  the  vessel  arrived  at  Cadiz,  the  captain  reported 
that  three  of  the  crew  had  died  from  yellow  fever  during 
the  voj-age  across  the  Atlantic.  He  was  refused  pratique 
and  the  vessel  remanded  for  observation.  On  July  15, 
after  ten  days  of  apparently  rigid  isolation,  and  twenty 
days  after  the  last  death,  the  health  of  all  on  board  being 
reported  perfect,  the  vessel  was  permitted  to  disembark 
her  passengers  and  discharge  her  cargo. 

Two  other  vessels  are  also  suspected  of  having  infected 
Cadiz: 

"See  the  following  works: 
Bally,  Typhus  d'Amerique,  p.  70. 
Bancroft,  Essay  on  Yellow  Fever,  p.  439. 
Beienger-Feraud,  p.  68. 
Berthe:    Precis   Historique    de    la    Maladie    qui    a    Regne    en 

Andaloucie  en  1800.     Paris,  1801. 
Eager:   Bull.  No.  5,  Yellow  Fever  Inst.,  p.  16. 
Fellowes,  p.  37, 
Ameller:    Descripcion   de   la  Enfermedad   Epidemica  que   tuva 

Principio  en  la  Ciudad  de  Cadiz,  etc.,  'Cadiz,  1800. 
Arejula:  Breve  Descripcion  de  la  Fiebre  Amarilla,  etc.    Madrid, 

1806. 
Assalini:    Remarks  on   the  Yellow  Fever  of  Cadiz,   etc.     New 

York,  1806. 
EdiQburgh  Medical  Journal,  1815,  vol.  11,  p.p.  389,  390. 
Halle:  Jl.  de  Med.,  Chir.,  Phar.,  etc.,  Paris,  1801,  vol.  1,  p.  291. 
Dictionaire  des  Sciences  Medicales,  Vol.  15,  p.  347. 
Jackson,  p.  16. 
O'Halloran,  p.  17. 
La  Roche,  vol.  1,  pp.  534;  536. 

Pascalis:    Medical  Repository,  New  York,  1808,  vol.  11,  p.  131. 
Schousboc;    Jl.    d.    Pract.    Arzuk.    und   Wundarzuk.    (Jena   und 

Berlin)  1801,  vol.  11,  p,  84. 
Supplement  to  Madrid  Gazette,  Tuesday,  October  28,  1800. 
Peaez:  Theses  de  Paris,  1825,  No.  127,  p.  13. 
Various  official  Spanish  documents. 


53J  HISTOUV    OF     YELLOW     FEVER. 

The  Agiiila,  which  sailed  from  Havana  May  28,  1800, 
stopped  at  San  Lncar  de  Baranieda  (Spain),  during  the 
last  days  of  June,  Avhere  the  crew  dispersed  and  other 
men  were  shipped,  and  reached  Cadiz  June  30,  six  days 
after  the  arrival  of  the  Dolphin. 

The  ship  Jupiter,  which  cleared  from  Vera  Cruz,  Feb- 
ruary 4,  1800,  and  arrived  at  Cadiz  March  28.  A  few 
days  after  her  departure  from  Vera  Cruz,  one  of  the 
officers  fell  ill  and  died  in  a  few  days.  Then,  one  after 
another,  all  hands  on  board  were  taken  sick.  The  condi- 
tion of  the  ship  was  at  one  time  so  des]ierate  that  the 
captain  was  at  one  time  undecided  whether  to  proceed 
on  the  voyage  or  return  to  Havana.  The  crew,  however, 
made  an  uneventful  recovery  and  the  vessel  continued  on 
her  way. 

Eager  {loc.  fit.,  p.  10),  states  that  in  addition  to  the 
three  vessels  which  fell  under  direct  suspicion,  a  large 
number  of  A'essels  were  continually  entering  the  port  from 
trans- Atlantic  ports,  and  that  by  order  of  the  King,  dated 
February  1,  1800,  it  was  absolutely  prohibited  to  suluuit 
to  quarantine  any  vessel  coming  from  America.  Thus  all 
safeguards  were  for  a  time  removed. 

The  Wages  of  Offieidl  Vorniplion. 

The  reason  why  the  Dolphin  is  principally  incriminated 
in  the  infection  of  Cadiz,  is  due  to  the  folowing  facts, 
narrated  by  Fellowes  (p.  38)  :  The  Board  of  Health  of 
Cadiz  was  at  the  period  under  discussion,  merely  a  nom- 
inal establishment;  health  officers  were,  howeve7%  ap- 
pointed, who  took  the  duty  by  turns  weekly.  At  the  time 
the  DfAphuv  arrived  in  the  harbor,  a  man  named  Vallialta 
was  the  Dipiitado  dc  i^-^auidad,  or  meml)er  of  Health  Board, 
was  on  duty.  When  the  Dolphin  was  ]»ut  under  observa- 
tion, it  was  currently  reported  in  Cadiz  that  money  had 
been  paid  to  this  pei'son,  which  bribe  induced  him  not 
only  to  give  the  ship  ])ratique  sooner  than  the  time  re- 
quired, but  to  connive  at  the  communication  which  took 
place  with  persons  from   shore,   and  particularly  with 


SPAIN CADIZ,    1800.  533 

smugglers  and  others  living  in   Sopranis   and   Boqueta 
streets. 

The  Pre-Epidemic  Cases. 

The  first  cases  were  observed  early  in  Augaist,  in  the 
persons  of  two  health  guards  who  had  been  on  board  the 
Dolphin,  and  who  were  taken  ill  on  returning  to  their 
lodgings  in  the  Barrio  de  Santa  Maria,  One  died;  the 
other  recovered. 

Whether  imported  by  the  Jupiter,  Aguila  or  the  Dol- 
phin, or  by  the  nondescript  craft  which  entered  tlie  har- 
bor of  Cadiz  in  1800,  there  is  no  disputing  the  fact  that 
the  fever  was  brought  from  abroad,  as  yellow  fever  has 
never  originated  on  Spanish  soil.  It  is  also  of  record  that 
the  state  of  the  public  health  of  Cadiz  was  excellent  up 
to  the  beginning  of  August,  when  a  certain  species  of 
fever  made  its  appearance  in  the  Barrio  de  Santa  ]Maria, 
which  from  the  violence  and  singularity  of  its  symptoms 
and  the  uncommon  rapidity  Avitli  which  its  course  was 
terminated,  attracted  the  attention  of  the  practitioners 
of  the  ancient  metropolis  of  Spain, 

While  Doctor's  Wrangled^  Cases  Multiplied. 

The  malady,  although  at  first  confined  to  two  streets — 
Boqueta  and  Sopranis — in  the  Barrio  de  Santa  INfaria, 
inhabited  by  sailors  and  customhouse  employes,  continued 
daily  to  gain  ground  and,  in  whatever  house  it  appeared, 
every  person  in  the  family  was  attacked.  The  frequent 
deaths  alarmed  the  magistrates,  Avho,  anxious  to  check 
the  evil,  assembled  all  the  practitioners  of  the  town,  to 
deliberate  On  the  measures  of  precautions  to  be  taken; 
but  upon  this,  as  upon  other  similar'  occasions  noted  in 
this  history,  useless  discussion  arose,  each  individual 
thinking  it  incumbent  upon  himself  to  do  all  the  talking 
and  advance  all  the  theories,  with  the  result  that  general 
confusion  arose  and  the  deliberations  led  to  nothing.  The 
prevailing  disorder  was  attributed  to  all  the  causes  which 
have  ever  been  assigned  for  the  production  of  fever  and 


53  ♦  HISTORY    OF    YELLOW    FIVER. 

nKiDT  names  were  <iiven  to  it,  such  as  svnochal,  putrid, 
bilious,  ephemeral,  etc. ;  in  fact,  exerj  designation  except 
the  correct  one — yellow  fever. 

While  the  physicians  and  health  authorities  of  Cadiz 
were  wrangling  as  to  its  diagnosis,  the  "mysterious  fever" 
was  daily  gaining  ground;  by  the  middle  of  August,  the 
number  of  deaths  amounted  to  twenty  or  thirty  a  day. 

The  Follies  of  Superstition  and  Ignorance. 

On  August  20,  the  news  were  spread  through  the  Barrio 
de  Santa  Maria,  that  Villialta,  the  man  accused  of  haA'- 
ing  permitted  unlawful  communications  between  the  Dol- 
phin and  the  inhabitants  of  Cadiz,  had  cauglit  the  dis- 
ease and,  filled  with  remorse  at  the  effects  which  he 
foresaw  were  likely  to  result  from  his  misconduct,  refused 
all  medical  assistance  vind  expired  in  gTeat  agony.  This 
circumstance  aroused  the  suspicion  in  the  public  mind 
that  the  reigning  malady  was  not  the  common  endemic 
of  Cadiz,  which  is  observed  nearly  every  year,  and  oc- 
casioned so  much  alarm  amongst  the  inliabitants  of  that 
quarter  of  the  town,  that  on  August  23  a  mob  assembled 
before  the  house  of  the  fijindico  Person rro  (or  head  of 
the  municipality)  and  sujjplicated  him  to  permit  them  to 
form  a  procession  through  the  streets,  bearing  aloft  the 
image  of  Our  Savior  (N-nestro  Padre  Jesus),  as  a  means 
of  arresting  the  progiess  of  the  malady.  Tlie  lower 
classes  of  Spain  are  naturally  ignorant  and  superstitious, 
and  such  was  the  terror  of  this  fanatic  people,  that  they 
considered  tliemselves  the  objects  of  offended  Heaven  and 
imagined  that  by  following  the  Cross  with  humility,  they 
Avould  effectually  appease  the  anger  of  the  Deity.  The 
magistrate,  dreading  this  assemblage  of  pei'sons  in  a  part 
of  the  town  where  the  disorder  Avas  spreading,  in  vain  en- 
deavored to  quiet  their  apprehensions,  but  all  reasoning 
was  ineffectual,  and  the  procession  took  place,  passing 

"A  similar  procession  was  held  at  Antequera  during  the 
epidemic  of  1804,  and  was  also  followed  by  dire  con- 
?equence;.     See  page  505  of  this  volume. 


SPAIN CADIZ,    1800.  535 

through  Sopranis  and  Boqueta  streets,  and  thence  to  other 
quarters  of  the  city,  where  -.the  malady  had  not  yetj 
spread."* 

The  Avorst  fears  of  the  magistrate  were  soon  realized. 
In  a  few  days,  cases  of  the  fever  erupted  in  Barrios  of 
San  Antonio,  and  on  August  27,  the  pestilence  was  wide- 
spread.    On  that  day  157  deaths  were  reported. 

The  i^anic  was  uoav  at  its  height  and  it  is  recorded  that 
13,992  persons  fled  from  the' pest-cursed  city. 

Desolation. 

Cadiz  was  now  a  vast  charnel  house.  It  was  ordered 
that  the  dead  should  be  conveyed  away  in  carts  and  buried 
outside  the  town ;  the  ringing  of  bells  was  prohibited  and 
every  measure  adopted  to  tranquilize  the  minds  of  the 
people, ~  but  the  dread  of  this  awful  calamity  was  so 
strongly  impressed  on  every  individual,  that  it  seemed 
only  to  increase  the  aptitude  to  take  the  disease,  and  many 
instances  are  recorded  of  deaths  acelerated  soleh'  by  the 
terror  thus  induced. 

By  the  middle  of  September,  the  deaths  amounted  to 
200  daily.  All  those  who  could  do  so,  had  fled  from  the 
city.  The  streets  Avere  deserted,  the  shops,  drug-store 
and  public  places  closed,  and  the  air  became  so  vitiated, 
that  its  noxious  state  affected  even  animals  and  birds. 
Dogs,  cats,  cattle,  etc.,  were  attacked  by  some  disease  or 
other,  and  died  by  the  thousands ;  canary  birds  died  with 
blood  issuing  from  their  bills  and  even  the  pugnacious 
sparrow  migrated  to  purer  atmospheres. 

The  unfortunate  inhabitants  of  Cadiz  might  have 
mournfully  applied  to  themselves  the  f^)ll()wing  lines 
taken  from  Boucher's  immortal  poem  describing  the  rav- 
ages of  the  plague  of  Marseilles : 

"Cliaque  instant  voyait  hors  dcs  inuraillcs, 
S'ai^ancer  tout  rcmpli  Ic  chiir  dcs  fiuicraUJes; 
Sans  parens,  sans  amis,  sans  pretre,  sans  flambeau, 
Nulle  voix  ne  suivant  se  mohile  tmnheau" 


5S6  HISTORY    OF    YELLOW    FKVER. 

Ajtnid  this  scene  of  desolation,  the  most  perfect  order 
prevailed  among  those  who  had  remained  in  the  city. 
Althouiih  several  leadiuo-  members  of  the  municipal  gov- 
ernment had  been  early  carried  off  by  the  fever,  the  popu- 
lace behaved  admirably,  and  none  of  the  disgraceful 
scenes  took  place  AVhich  had  occurred  in  other  towns  of 
the  Kingdom  during  the  periods  of  public  calamity. 

A  Rift  in  the  Clouds. 

At  the  time  under  observation,  England  and  France 
were  engaged  in  one  of  their  periodical  disiigTeements. 
Spain  had  allied  itself  with  France  against  the  common 
enemy  and  Johnny  Bull  sent  a  fleet  to  blockade  the  ports 
of  the  doughty  Ca.stillians.  Early  in  October  the  British 
fleet  under  Lord  Keith  appeared  before  Cadiz;  and  this 
novel  and  startling  sight  produced  an  extraordinary  ef- 
fect upon  the  minds  of  the  populace.  The  fear  of  an 
attack  roused  this  courageous  people  to  individual  ex- 
ertions for  their  defense,  and  they  swarmed  from  their 
closed  infected  houses  to  repel  the  invading  force.  The 
transition  from  a  melancholy  contemplation  of  the  spectre 
of  pestilence  to  a  state  of  belligerency  against  a  hated 
enemy,  combined  with  the  inception  of  the  cool  season, 
seemed  to  have  a  magical  effect  upon  the  health  condi- 
tions of  the  city.  From  that  date,  the  disease  gradually 
decreased,  and  by  October  30,  only  357  cases  were  under 
treatment  and  the  mortality  was  unimportant. 

On  November  12,  the  pestilence  came  at  an  end  and  the 
city  was  oflftcially  declared  in  a  state  of  health  by  the 
celebration  of  the  Tc  Deiim. 

Total  Cases  and  Deaths. 

Authorities  differ  as  to  the  exact  proportions  of  cases 
and  deaths.  The  mortality  from  yellow  fever  has  been 
prodigious  in  nearly  epidemic  that  has  invaded  Spain; 
but  the  precise  number  of  deaths  has  never  been  abso- 
lutely correct,   owing   to   the  natural   demoralized   con- 


SPAIN CADIZ.  537 

dition  of  affairs  and  the  difficulty  of  obtaining  au- 
thentic data.  Jackson  (lor.  cit.,  p.  137),  states  that  it 
may  be  said  Avith  safety  that  the  mortality  was  not  in 
reality  less  than  one-half  of  those  who  were  attacked. 
The  generally  accepted  figures,  so  far  as  the  epidemic  of 
1800  is  concerned,  are  as  follows,  {La  Roche,  vol.  1,  p. 
534)  : 

Cases,  48,520;  deaths,  10,946. 

Arejula  (loc.  cit.,  p.  256),  says  that  it  is  a  sorrowful 
fact  that  all  the  localities  in  Spain  where  the  disease 
obtained  a  foothold,  owed  their  misfortunes  to  the  inhabi- 
tants of  Cadiz,  who  fled  to  them,  not  with  any  intention 
of  introducing  the  disorder,  but  to  save  their  lives  by 
talving  refuge  in  places  where  no  disease  whatever  pre- 
vailed at  the  time.  Thus  it  happened  that  the  seeds  of 
this  pestilence  were  scattered  in  the  neighboring  towns, 
such  as  Puerto  de  Santa  Maria,  Isla  de  Leon,  Puerto 
Real,  San  Lucar  and  others,  causing  a  total  mortality  of 
61.363  in  the  Kingdom.'^^ 

1801. 

Another  outbreak,  but  not  as  mortal  as  that  of  the 
previous  year,  prevailed  in  Cadiz  in  1801.  Tlie  disease 
was  observed  principally  in  a  newly-arrived  regiment,  and 
its  spread  was  not  very  extensive.''^^ 

1802. 

In  the  year  1802,  five  hundred  cases  were  observed  in 
Cadiz.  These  cases  all  came  from  ships  in  the  harbor, 
and  were  transported  to  the  hospital  of  San  Juan  de 
Dios  by  order  of  Admiral  Gravina.  The  malady  did  not 
spread  to  the  inhabitants.'^^ 

"The   detailed   mortality   in  the   principal   cities   and   towns   in 

Spain  during  the  epidemic  of  1800,  will  be  found  in  our 

chronological  tables   for  that  year. 
'"  Periodico  de  la  Sociedad  Medico-Quirirgica  de  Cadiz,  1822,  p. 

23;    Eerenger-Feraud.  p.  70;    O'Halloran,  p.  177. 
"Dariste:    Recherches  Pratiques    sur    la    Fievre    Jaune     (Paris, 

1825).  p.  61. 


538  HISTORY  OF  YELLOW    FEYER. 

1803. 

In  1803,  according  to  Eager,  yellow  fever  spread  widely 
in  Cadiz  and  resulted  in  great  loss  of  life."^  The  number 
of  fatalities  is  not  stated. 

1804 

Cadiz  was  infected  by  refugees  from  Malaga  in  1804, 
and  suffered  cruelly.  The  first  case  was  observed  August 
28,  and  from  that  date  until  November  5,  when  the  epi- 
demic came  to  an  end,  5,000  cases  were  recorded,  of  which 
2,892  proved  fatal  (2,692  males  and  200  females). ^^ 

1807. 

After  three  years  of  respite,  Cadiz  again  found  herself 
threatened  with  an  invasion  of  yellow  fever.  The  out- 
break was  confined  to  the  French  squadron  ni  the  Bay 
of  Cadiz,  and  did  not  spread  to  the  shore.^^ 

1808. 

A  few  cases  were  imported  to  Cadiz  in  1808,  but  the 
developments  were  unimportant.^^ 

1810. 

In  August,  1810,  yellow  fever  was  introduced  into 
Cadiz  by  smugglers,  and  .soon  attained  the  proportions 
of  an  epidemic.  Our  autthorities  {Berenger-Feraud,  p- 
83  and  Eager,  p.  21)  do  not  give  any  details. 


"Eager,  p.  18. 

"La  Roche,' vol.  1,  p.  536:   Fellowes,  p.  479. 

*"  Second  Report  on  Quarantine  (London,  1852),  p.  202. 

"  Eager,  p.  20. 


SPAIN CADIZ.  539 

1811. 

Santa  Cruz  de  Teneriffe,  which  had  been  contaminated 
by  Cadiz  in  1810,  infected  that  city  in  1811.  The  out- 
break was  not  general. ^- 

1812. 

Keating"^"^  claims  that  yellow  fever  was  epidemic  in 
Cadiz  in  1812,  but  we  have  not  been  able  to  substantiate 
the  statement.-    Onlj  a  few  imported  cases  were  observed. 

1813. 

In  1813  Cadiz  was  in  a  flourishing  condition  once  more 
and  had  a  population  of  130,000.  During  the  last  days 
of  July,  the  warshi]>  Saint-Pierre^  from  Vera  Cruz,  having 
the  vice-roy  of  Mexico  on  board,  entered  the  harbor.  There 
was  no  history  of  yellow  fever  on  board,  and  the  illus- 
trious passenger  was  received  with  open  arms  by  the  in- 
habitants, and  the  crew  allowed  the  fredom  of  the  town. 
Shortly  afterwards,  cases  of  yellow  fever  began  to  appear 
in  the  richest  and  most  fashionable  part  of  the  city,  the 
first  to  be  attacked  being  the  nephew  of  the  viceroy,  who 
died  a  few  days  after  the  onset.  From  this  focus,  the 
disease  radiated  to  other  quarters  of  the  town,  finally 
becoming  violently  epidemic.  We  have  been  unal)le  to 
discover  the  number  of  cases,  but  the  mortality  is  said  to 
liave  been  4,000.^^ 

1814. 

IMany  cases  were  observed  in  Cadiz  in  1814.  Keating 
claims  that  the  disease  was  e])idemic,  but  no  aulheutic 
records  can  be  found  to  substantiate  the  report.^^ 


^  Berenger-Feraud,  p.  84. 
^^  Keating:   History  of  Yellow  Fever,  p.  83. 
"Berenger-Feraud,  p.  85;   Keating,  p.  83. 
'^•"■Berenger-Feraud,  p.  85;  Keating,  p.  83. 


540  HISTORY    OF    YELLOW    FEVER. 

1817. 

The  famous  Spanish  phTsician,  Arejula,  is  quoted  by 
Pariset  and  Eobert^*^  as  saving  that  his  little  daughter 
died  of  yellow  fever  in  the  month  of  August,  1817.  This 
would  tend  to  indicate  that  the  disease  was  prevalent 
that  year  in  Cadiz,  but  no  mention  is  made  in  any  of  the 
works  we  have  consulted,  nor  in  public  documents,  of  any 
other  case.  Apart  from  the  statement  accredited  to  him 
by  Pariset,  Arejula  himself  is  silent  on  the  subject.  Ber- 
enger-Feraud  leans  to  the  belief  that  the  case  spoken  of 
by  Arejula  was  probably  one  of  malignant  icterus  and 
not  yellow  fever. 

The  frequent  application  of  the  word  vomifo  prcta  at 
that  period  to  any  dark  fluid  ejected  from  the  stomach, 
tended  no  doubt  to  create  obscurity  as  to  the  character 
of  diseases;  and  in  Spain,  medical  men,  for  want  of  a 
better  name,  sometimes  employed  the  word  firhre  dudoso- 
(fever  of  a  doubtful  nature)  when  speaking  of  an  epi- 
demic characterized  by  febrile  manifestations  and  black 
vomit. 

1819. 

The  great  epidemic  of  yellow  fever  which  devastated 
Cadiz  in  1810  lias  only  been  equaled  in  intensity  and  mor- 
tality by  that  of  1800.  As  on  previous  occasions,  unend- 
ing acrimonious  discussions  aro^e  as  to  its  origin,  and 
scores  of  contradictory  theories  were  formulated.  Public 
opinion  even  went  so  far  as  to  accuse  the  warship  ^an 
Juliono,  from  Calcutta,  of  having  imported  the  pestil- 
ence; but  as  the  vessel  had  been  on  duty  at  the  Philip- 
pines previous  to  arriving  at  Calcutta,  this  contention 
was  easily  punctured.  What  placed  the  San-Jiiliano  un- 
der sus]ucion,  was  the  fact  that  the  vessel  had  scarcely 
begun  to  load  a  cargo  of  cannon  powder  at  Tsla  de  Leon, 
when  suspected  cases  of  yellow  fever  appeared  among  the 
persons  employed  on  board.  The  disease  also  broke  out 
in  the  quarter  of  the  city  called  Barrio  del  Christo,  where 


I 


Pariset,  p.  104;  Robert,  vol.  1,  p.  88. 


SPAIN CADIZ,     18  19.  541 

the  baggage  of  the  crew  of  the  San-Jiiliano  had  been 
deposited. 

The  ship  Asia,  which  arrived  in  the  port  from  Vera 
Cruz  and  Havana  at  about  the  same  time,  Avas  also  ac- 
cused of  having  infected  Cadiz.  This  accusation  seems 
to  us  to  have  been  well-founded,  for  several  deaths  from 
yellow  fever  had  taken  place  on  board  while  the  Asia 
was  in  mid-ocean,  and  the  health  conditions  of  the  ves- 
sel appeared  so  unsatisfactory  that  she  was  refused  pra- 
tique, and  the  captain  ordered  to  proceed  to  the  quaran- 
tine station  at  Port  Mahon  for  further  observation.  The 
fears  of  the  liealtli  autliorities  of  Cadiz  seem  to  have  been 
well  grounded,  for  three  individuals  employed  in  dis- 
charging the  cargo  at  Port  Mahon  contracted  the  malady 
and  died. 

It  is  therefore  evident  that  the  Asia  could  easily  have 
contaminated  the  ^au -Julia no  before  being  sent  to  Port 
INIalion.  It  is  also  of  record  that  passengers  from  the 
Asia  "escaped"  during  the  night  while  the  vessel  was  in 
the  harbor  of  Cadiz,  and  went  to  their  homes  in  the 
Barrio  del  CJirisfo,  the  locality  where  the  first  cases  were 
observed.  Merchandise  Avas  also  smuggled  on  shore  wliile 
the  guards  were  "looking  the  other  way." 

When  news  spread  tlmt  cases  of^  yellow  fever  had 
broken  out  in  the  BajTio  del  Christo,  the  inhabitants  w^ere 
greatly  alarmed,  and  at  the  instigation  of  a  public  demon- 
stration, the  commandant  of  the  city  sent  his  chief  san- 
itary officer,  Dr.  Flores,  to  Isla  de  Leon  where  the  orig- 
ioal  cases  had  been  observed,  to  study  the  disease  and 
report  on  its  nature.  Dr.  Flores,  convinced  from  his  in- 
vestigations that  the  disease  was  yellow  fever,  declared 
that  rigorous  measures  alone  could  avert  a  disaster.  But 
his  counsels  were  not  listened  to.  On  the  contrary,  he 
was  accused  of  high  treason  and  held  for  trial  before 
a  tribunal  of  war.  The  commanding  general  assured  the 
alarmed  population  that  yellow  fever  did  not  exist  on  the 
Isla  de  Leon,  and  boastingiy  added  the  ratlier  unintel- 
ligible information,  that  should  it  enter  the  city  of  Cadiz, 
he  was  prepared  to  meet  it  with  the  point  of  his  sword. 


542  HISTORY    OF    YELLOW     FEVER. 

Notwithstanding  all  assurances  to  the  contrary,  the  un-' 
heeded  warning  of  the  unfortunate  Flores  came  true.     The 
scourge  struck  with  frightful  force,  and  among  the  first 
to  run  away  from  the  city  was  the  bombastic  general. 

The  population  of  Cadiz  in  1819  was  only  72,000,  war 
with  France  and  the  unceasing  drain  upon  the  Spanish 
cities  to  maintain  peace  in  the  colonial  possessions  of  the 
Kingdom  haying  reduced  the  male  population  about  one- 
half.  The  yirulence  of  the  feyer  may  be  deduced  from 
the  fact  that  out  of  this  small  population,  there  resulted 
48,000  cases,  of  which  5,000  proyed  mortal.^''' 

1820. 

The  following  year  (1820)  a  few  sporadic  cases  were 
obseryed.  We  can  find  no  record  of  fresh  importation, 
and  the  first  cases  no  doubt  owed  their  origin  to  the  re- 
awakening of  infected  mosquitoes  which  had  remained 
inactiye  during  the  cool  season. 

The  first  case  was  a  Frenchman,  who  returned  from 
IMadrid  in  February,  and  who  took  lodgings  in  a  sitiall 
room  where,  during  the  preceding  epidemic,  two  persons 
had  died  of  yellow  feyer  and  one  had  been  yery  ill.  At 
the  end  of  May,  the  new-comer  was  attacked  with  the 
diagnostic  symptoms  of  yellow  feyer. 

The  second  case  was  the  ordinario  of  the  Bishop  of 
Cadiz,  who  slept  in  a  dark,  ill-yentillated  room,  where  in 
the  foregoing  year,  his  predecessor  had  died  of  yellow 
feyer. 

Our  source  of  information^^  does  state  whether  these 
cases  proyed  fatal  or  not. 

We  infer  from  Dr.  O'llalloran's  report  that  the  out- 
break was  not  extensiye.  Whether  the  escape  of  Cadiz 
from  an  inyasion  of  yellow  feyer  can  be  attributed  to  the 

*' Berenger-Feraud,  p.  89;  Eager,  p.  21;  La  Roche,  vol.  1,  p.  536. 
«'  O'Halloran,  p.  177  (foot  note) ;  Periodico  de  la  Sociedad  Medico- 

Quirirgical  de  Madrid,  1822,  p.  23. 
*  See  histories  of  the  epidemic  which  ravaged  these  localities, 

under  the  proper  chapters  in  this  volume. 


SPAIN CADIZ,  5i3 

inactivity  of  the  Calopac  or  to  the  probability  that  the 
wiclesrpead  epidemic  of  the  previous  year  had  left  no  non- 
immune material,  we  cannot  say.  It  is  one  of  these  in- 
scrutable problems  which  often  confronts  the  searcher 
after  knowledge,  and  which  no  amount  of  reflection  can 
elucidate. 

1821. 

The  frightful  epidemic  of  1821  is  one  of  the  darkest 
pages  in  the  history  of  Spain,  and  nearly  depopulated 
Barcelona,  Tortosa,  Malaga,  Asco,  Palma  and  other  thriv- 
ing cities  of  the  Kingdom.  .Cadiz,  however,  escaped  the 
full  force  of  the  pestilential  wave.  There  were  cases  and 
deaths  here  and  there,  but  the  attacks  were  so  limited  that 
they  scarcely  deserve  the  denomination  of  an  epidemic.**'"^ 

The  origin  of  the  case^  observed  in  Cadiz  in  1821  is 
shrouded  in  mystery.  All  that  is  known,  is  that  the  first 
persons  who  suffered,  lived  in  that  part  of  the  town  in» 
habited  by  smugglers  and  the  poorer  classes,  and  that 
the  first  cases  erupted  in  the  dwellings  of  smugglers  who 
had  "recently  arrived  from  the  Bay."  From  this  last 
observation,  it  may  be  logically  surmised  that  the  infec- 
tion was  contracted  on  ship-board. 

Conotusioii^-lS21  to  1909. 

There  is  no  record  of  yellow  fever  having  been  imported 
to  Cadiz  since  1821.  The  awesome  fierceness  of  the  epi- 
demic of  1821  in  Spain,  and  the  havoc  produced  in  the 
wealth  and  life  of  the  richest  industrial  section  of  the 
peninsula  by  frequently  repeated  and  devastating  pestil- 
ences, attracted  the  attention  of  other  nations.  There 
were  accusations  of  negligence  in  the  enforcement  of  san- 
itary regulations.  This  led  the  Spanisli  government  to 
adopt  extraordinary  precautions  for  the  prevention  of 
future  disasters  of  this  character.     The  leading  academies 

"' O'Halloran,  pp.  70;   164. 


544  HISTORY    OF    YEIXOW    FEVER. 

and  societies  of  medicine  in  the  Kingdom  were  interpel- 
lated as  to  whether  yellow  fever  could  be  considered  of 
American  origin  and  of  an  infectious  and  contagious 
nature.  The  physicians  of  Spain,  like  those  of  every 
other  nation  on  the  globe,  when  a  question  is  brought  up 
for  final  decision,  could  not  agree  Avhen  it  came  to  a  vote, 
but  the  majority  were  convinced  of  the  exotic  nature  of 
the  disease,  and  that  it  was  "infectious  and  contagious." 
As  a  consequence,  stringent  provisions  of  maritime  sanita- 
tion were  devised  and  put  into  effect,  and  save  the  epi- 
demic of  El  Passajes  in  1823  and  that  of  Gibraltar  in 
1828,  yellow  fever  ceased  to  obtain  a  foothold  in  Spain 
after  the  disaster  of  1821. 


CANETA  DE  MAR. 

1821. 

Although  only  twenty-six  miles  north  of  Barcelona,  on 
the  Mediterranean,  Caneta  de  Mar  experienced  but  a 
single  invasion  of  yellow  fever.  The  facts  are  as  follows:^*' 

During  the  last  days  of  August,  1821,  a  young  car- 
penter of  Caneta  de  ]\rar,  while  seeking  employment  in 
Barcelona,  was  hired  to  do  some  work  on  board  the  ship 
Talla-Piedra.  (This  vessel,  it  will  be  remembered,  in- 
fected Barcelona  that  year  and  caused  a  terrible  epi- 
demic). ITe  Avas  shortly  afterward  taken  ill  and  returned 
home,  where  he  arrived  on  September  5.  On  the  lOtli, 
he  was  a  corpse.  His  mother  was  attacked  on  the  12th 
and  died  on  the  15th.  The  house  was  hermetically  closed 
by  the  authorities,  and  no  one  allowed  to  enter  it  until 
the  advent  of  the  cold  weather,  when  it  was  thoroughly 
aerated  before  any  one  was  permitted  to  inhabit  it. 

No  other  case  erupted  in  the  village. 


Ba]ly,  Francois  and  Pariset,  pp.  51;   57. 


SPAIN,  545 

CANETA-LA-REAL. 

1800. 

< 

Refugees  from  infected  localities  contaminated  Caneta- 
la-Real  in  1800.     Only  a  few  cases  were  observed.^^ 

1800 

CARMONA. 

The  population  of  Carmona  snffered  cruelly  during  the 
epidemic  of  1800,  according  to  Chervin.^^ 

The  number  of  cases  and  deaths  is  not  stated. 

1802. 

A  few  yelloAV  fever  patients  escaped  from  the  public 
hospit<als  of  Cadiz  in  1802,,  and  sought  refuge  among 
friends  in  Carmona.  Most  of  the  refugees  died,  but  did 
not  contaminate  the  inhabitants  of  Carmona.  {Pariset, 
p.  79). 

CARRACA. 

1800. 

The  disastrous  epidemic  of  1800  invaded  Carraca  and 
claimed  515  victims.®^     The  number  of  cases  is  not  given. 

CARRANA. 

Several  writers  mention  the  fact  that  yellow  fever  pre- 
vailed at  Carrana  during  the  epidemic  period  in  Spain 
(1800-1822),  but  do  not  state  the  year. 


•-Rougeau:   Theses  de  Paris,  1827,  No.  119. 
"-Chervin:  Examen  Critique,  etc.,  p.  56, 
"La  Roche,  vol.  1,  p.  534. 


5t6  HISTORY    OF    YELLOW    FEVER. 

CARTAGENA. 

Yellow  Fever  Years. 

1753;  1804;  1810;  1811;  1812. 

Summary  of  Epidemics. 

1753. 

"Ships  of  war  from  America"  are  said  to  have  brought 
yellow  fever  to  Cartegena  in  1753.  There  was  no  exten- 
sive spread  of  the  disease.^"* 

1804. 

For  over  fifty  years,  we  hear  of  no  importation  of  yel- 
low fever  to  Cartagena.  In  1804,  smugglers  communi- 
cating with  a  vessel  on  which  deaths  had  occurred  from 
the  disease  and  which  was  still  in  quarantine,  brought 
the  infection  on  shore.  The  first  victim  was  the  daughter 
of  the  Swedish  consul,  in  whose  house  the  smugglers  had 
secreted  goods  surreptitiously  taken  from  the  vessel  above 
mentioned.  A  nun  who  had  visited  the  young  girl  in 
question  and  who  had  been  given  handkerchiefs  to  hem 
(these  goods  having  also  been  smuggled  from  the  same 
vessel),  was  t<aken  ill  with  yellow  fever  and  died.  Seven 
other  nuns  living  in  the  same  convent  rapidly  succumbed 
to  the  disease  and  the  balance  fled,  the  majority  carrying 
the  germs  of  the  fever  with  them,  and  dying  in  the  places 
where  they  sought  refuge.  The  disease  soon  made  its 
appearance  along  the  principal  street  of  the  toAvn,  mn- 
ning  its  course  from  house  to  house,  until  it  finally  in- 
vaded every  quarter  of  the  town. 

The  population  of  Cartagena  in  1804  was  33,222.  ,From 
September  5,  when  the  first  case  was  observed,  to  Jan- 
uary 23,  1805,  the  date  of  the  extinction  of  the  epidemic, 

"  Eager,  p.  16. 


I 


SPAIN CARTAGENA.  547 

11,445  persons  fell  victims   to   the  pestilence,   of  which 
7,630  were  males  and  3,815  females.^^ 

1810. 

Yellow  fever  appeared  for  the  third  time  in  the  history 
of  Cartagena  in  1810.  Its  ravages  were  considerable,  but 
no  authcQtic  statifJtics  are  obtainable.^^ 

1811. 

YelloAv  fever  reappeared  in  1811.  The  war  with  France 
militated  against  the  enforcement  of  preventive  measures 
and  the  disease  soon  became  epidemic  and  spread  to  ad- 
joining cities  and  towus.^^ 

1812. 

The  outbreak  of  1812  was  not  extensive,  lot  pfoved 
very  fatal.  It  prevailed  principally  among  the  British 
troops  stationed  in  the  city.  The  first  unequivocal  case 
was  that  of  Major-General  Ross,  who  died  with  black 
vomit  on  September  26,  at  Galleras,  a  fort  situated  at  the 
summit  of  a  hill  on  the  west  side  of  the  town.  The  in- 
fection rapidly  spread  to  the  balance  of  the  troops,  and 
by  October,  over  100  cases  were  under  treatment.  On  Oc- 
tober 5,  about  seventy  of  the  worst  cases  were  (ransported 
on  board  an  improvised  hospital  ship.  Three  died  the 
evening  they  arrived  on  board,  two  the  day  following, 
and,  in  the  course  of  a  few  days,  twenty  more  fatalities 
were  recorded.     From  October  5  to  December  21,  when 


»'  Ba],ly,  p.  447 

Fellowe:;.  p.  478. 

La  Roche,  vol.  1.  p.  359. 

Mimaiit:   Memcire  siir  la  Nature  des  Maladies  Endemiques  it, 
Cartagene  (Paris,  1819),  p.  47. 
°«  Eager,  p.  21;   Berenger-Feraiid,  p.  S3;   Mimaut,  loc.  cit. 
»' Berenger-Feraud,  p.  84;  Eager,  p.  21;   Mimaut,  loc.  cit. 


348  HISTORY    OF    YELLOW    FEVER. 

the  epidemic  became  extinct,  all  the  ''bad  cases"  were 
transported  to  this  vessel.     The  mortality  was  heavy.^^ 

Of  the  prevalence  of  the  fever  among  the  inhabitants 
of  Cartagena  during  this  epidemic,  the  records  are  very 
unsatisfactory-  and  no  authentic  dafta  could  be  found  as 
to  the  total  number  of  cases  and  deaths.  It  is,  therefore, 
to  be  presumed  that  the  malady  was  confined  chiefly  to 
the  invading  army. 

CATALAN  BAY. 

1813. 

The  little  village  of  Catalan  Bay  (known  also  by  the 
name  of  La  Caleta,  and  inhabited  i^rincipally  by  fisher- 
men and  washerwomen)  is  located  a  few  miles  east  of 
Gibraltar.  A  single  case  of  yellow  fever  was  ol>served 
there  in  1813,  in  the  person  of  Antonio  Perez,  aged  28, 
who  had  gone  to  Gibraltar  on  business.  On  his  return 
home,  he  was  taken  ill,  but  the  fact  was  concealed  from 
the  inspector.  He  recovered  Avithout  contaminating  any 
other  inhabitant  of  the  village.^^ 

1814. 

In  1814,  during  the  prevalence  of  yellow  fever  at  Gib- 
raltar, twelve  of  the  inhabitants  of  Catalan  Bay,  who  had 
visited  the  former  place,  were  taken  ill  on  their  return 
home.  Most  of  those  attacked  concealed  their  illness  from 
the  inspector,  from  fear  of  being  sent  to  the  Lazaretto, 
and  the  majority  died  while  pursuing  their  avocations — 
some  in  the  streets  and  some  in  their  fishing-smacks. 
Only  those  who  had  communicated  with  Gibraltar  con- 
tracted the  disease.^^^ 


""Proudfoot:  Dul)lin  Hospital  Reports,  1818,  vol.  2,  p.  254.  Also 
Berenger-Feraud,  p.  85;  Eager,  p.  21;  Mlmaut,  loc.  cit. 

'"  Documens  Recueillis  par  MM.  Chervin,  Louis  et  Trousseau. 
Paris,  1830,  vol.  2,  pp.  62;  116. 

>~  Ibid.,  p.  120. 


SPAIN.  549 

1828. 

The  virulent  epidemic  of  yellow  fever  which  made 
1,677  victims  in  Gibraltar  in  1828,  was  introduced  into 
Catalan  Bay  by  a  water-carrier,  whose  occupation  com- 
pelled him  to  make  daily  pilgrimages  to  the  city.  This 
man,  taken  sick  about  September  18.  died  on  the  23rd. 
His  family  consisted  of  his  wife  and  four  children.  Two 
of  the  children  were  next  attacked,  then  the  mother  and 
then  the  remaining  children.  All  but  one  boy  followed 
the  unfortunate  water-carrier  to  the  grave. 

From  this  focus,  the  disease  radiated  in  every  direction, 

and   hardly   an   inhabitant   of    the   hamlet   escaped   an 
attack.ioi 

CHICLANA. 

1800. 

Like  the  balance  of  the  towns  in  Southern  Spain,  Chic- 
lana  was  invaded  by  the  "yellow  pestilence"  in  1800. 
Out  of  a  population  of  10,000,  1,328  died.  ( La  Roche, 
vol.  1,  /).  534). 

1819. 

The  widespread  epidemic  of  1819  spread  to  Chiclana 
and  caused  much  mortality.     {Berenger-Feraud,  p.  90). 

CHIPIONA. 

At  some  time  or  other,  during  the  epidemics  which 
desolated  Spain  from:  1800  to  1828,  Chipiona  suffered 
from  yellow  fever,  but  the  authors  we  have  consulted  do 
not  state  the  exact  date.  (See  the  vague  and  unsatis- 
factory accounts  given  by  Chervin,  Pariset,  Bally  and 
other  ancients  who  have  discussed  at  length  the  great 
epidemics  of  yellow  fever  in  Spain). 


Ibid.,  p.  2;  Berenger-Feraud,  p.  106. 


550  HISTORY    OF    YELLOW    FEVER. 

CHURRIANA. 

1800. 

Churriana,  suburb  of  jNIalaga  was,  in  1800,  a  separate 
communitY,  inhabited  principally  by  bakers,  who  sup- 
plied the  metropolis  with  bread.  Only  one  ease  was  ob- 
served in  the  village  that  year,  in  the  person  of  the  wife 
of  a  baker,  who  recovered.^*^^ 

1804 

In  1804,  yellow  fever  committed  fearful  ravages  in 
Malaga.^^^  Thirty-two  inhabitants  of  Churriana,  who 
had  brought  bread  and  other  provisions  to  Malaga,  re- 
turned home  with  the,  disease  in  their  sj'stem  and  died. 
The  disease  did  not  spread,  only  those  who  had  communi- 
cated with  the  seat  of  infection  falling  victims  to  the 
pestilence.^^^ 

CIEZA. 

{See  Zieza). 
COIN. 

1801. 

Refugees  from  Malaga  infected  Coin  in  1804.  The  dis- 
ease did  not  spread  to  the  inhabitants  of  tlie  village,  being 
confined  to  the  imported  cases. ^*^'' 


"*-  Chervin,  Examen  Critique,  p.  52. 
""  See  Malaga,  year  1S04. 
'"^Dariste,  p.  62;  Fellowe^,  pp.  181;  185. 
''"Fellowes,  p.  181. 


SPAIN.  551 

CONIL. 

1800-1821. 

Chervin^*'^  states  that  between  the  years  1800  and  1821, 
inclusive,  172  persons  affected  with  yellow  fever  came  to 
Conil  from  Cadiz  and  other  infected  localities,  but  in  no 
instance  w^as  the  infection  transmitted  to  the  residents 
of  the  village.    pMost  of  the  cases  proved  fatal. 

CORDOVA. 

1800. 

fA  few  fugitives  from  Cadiz  were  treated  in  an  isolated 
section,  of  the  Cordova  general  hospital  in  1800.  There 
was  no  spread  of  the  malady.^^^ 

1802. 

In  1802,  five  hundred  cases  of  yellow  fever  were  sent 
from  vessels  in  the  harbor  to  the  public  hospital  of  Cadiz. 
A  few  patients  escaped  to  Cordova  and  other  localities. 
There  was  no  diffusion  of  the  malady.^^^ 

1804. 

The  only  epidemic  of  yellow  fever  in  Cordova,  of  which 
there  is  any  record,  took  place  in  1804.  The  population 
was  then  40,000.  The  first  ca.^se  came  from  Malaga  and 
erupted  September  28.  From  that  period  until  November 
14,  the  date  of  the  last  case,  there  were  400  deaths,  of 
which  180  were  males  and  220  females.^o^  It  is  worthy 
of    note    that    this    is    one    of    the    few    epidemics    of 

'"'Chervin:   Examen  'Critique,  ;».  54;   Rougeau,  Theses  de  PaTls, 

1S27,  Xo.  119. 
'"^  Bally,  p.  74. 
"'  Pariset,  p.  79. 
^"'Fellowes,  p.  47S;   Chervin,  Examen  Critique,  p.  3. 


55i  HISTORY    OF    YELLOW    FEVER. 

yellow  fever  in  Spain  in  which  the  mortality  was  greater 
among  women  than  men. 

CORIA. 

1800. 

Coria,  six  miles  south  of  Seville,  was  contaminated  by 
the  latter  in  1800.     Mortality,  450.iio 

CORTES  DE  LX  FRONTERA. 

/    1800. 

During  the  general  epidemic  of  1800,  refugees  from  in- 
fected points  brought  yellow  fever  to  Cortes  de  la  Fron- 
tera.     The  infection  did  not  spread  to  the  inhabitants  of 


the  village.^^^ 


CORUNNA. 


1803;  1822. 


Corrunna,  the  northwesternmost  port  of  Spain,  was 
threatened  with  invasions  of  yellow  fever  in  1803  and 
1822.  Energetic  sanitary  measures  were  immediately 
taken  in  both  instances  and  the  disease  confined  to  im- 
ported cases.     (Pariset,  p.  96). 

DOS  HERMANAS. 

1800. 

Seville  contaminated  Dos  Hermanas  in  1800.  The  mor- 
tality amounted  to  70,  all  refugees.^^^ 


'  La  Roche,  vol.  1,  p.  534. 
Rougeau,  Theses  de  Paris,  1827,  No.  119. 
La  Roche,  vol.  1,  p.  534. 


f 


I 


SPAIN ECIJA.  55S 

EOIJA. 
1800. 

Ecija,  fifty-two  miles  northeast  of  Seville,  on  the  Genii 
River,  is  a  point  of  much  interest  to  the  tonrist,  on  ac- 
count of  its  ancient  Roman  ruins  and  fine  sheltered  prom- 
enades, but  it  is  so  hot  as  to  be  called  "the  frying  pan 
of  Andalusia." 

Ecija  has  been  invaded  by  yellow  fever  on  three  occa- 
sions only,  two  epidemics  (1800  and  1804)  and  one  im- 
portation (1802).  The  present  population  of  the  town 
(about  30,000)  does  not  show  that  much  projiress  has 
been  made  in  this  direction,  as  there  were  10,000  souls 
within  its  walls  in  1800. 

Ecija  was  contaminated  by  Seville  in  1800.  Profiting' 
by  the  terrible  experiences  of  that  unfortunate  city  of 
Cadiz,  stringent  sanitary  measures  were  instituted,  and 
the  disease  limited  to  400  cases,  of  which  100  died.^^^ 

1802. 

According  to  Pariset  (page  TO),  a  few  cases  of  yellow 
fever  were  observed  in  Ecija  in  1802.  The  disease  was- 
confined  to  the  importations. 

1804. 

In  1804,  the  population  of  Ecija  was  about  the  same  as 
in  1800.  On  October  8,  the  first  unequivocal  case  of  yel- 
low fever  was  reported,  and  by  the  31st  of  the  month,  the 
epidemic  was  widespread.  The  fever  raged  until  Decem- 
ber 20,  resulting  in  5,000  cases,  of  which  3,802  proved 
fatal.  This  is  another  of  the  few  examples  where  the 
mortality  was  higher  among  women  than  men,  the  figures 
being  2,122  for  the  former,  against  1,380  for  the  latter."* 


Bally,  p.  75;  La  Roche,  vol.  1,  p.  536. 

La  Roche,  vol.  1,  p.  536:    Fellowes,  p.  478;    Chervin,  Examen. 
etc.,  p.  S. 


554  HISTORY     OF     YELLOW     FEVER. 

EL  ARAHAL. 

{See  Arahal). 
•      EL  BORGE. 

1804. 

The  village  of  El  Borge  was  contaminated  in  1804  bv 
persons  fleeing  from  Malaga,  and  lost  the  greater  part  of 
its  population.^^^  The  number  of  cases  and  deaths  is  not 
stated. 

EL  PALO. 

1804. 

El  Palo,  infected  by  ^Nfalaga  in  1804,  suffered  cruelly 
from  yellow  fever.  "All  of  the  inhabitants  were  attacked 
with  the  epidemic,  and  it  occasioned  great  destruction 
among  them."^^^ 

EL  PASSAJES. 

(See  Passajcs). 

EPREZALENA. 

1800. 

In  common  with  other  towns  within  the  rnrlius  of  in- 
fection, Esprazah'ua  Avas  invaded  by  the  Saffron  Scourge 
in  1800.     The  mortality  was  inconsequential. ^^^ 


"•Fellowes,  p.  186. 
"•"•  Fellowes,  p.  186. 
'"  Rougeau,  loc.  cit. 


SPAIN ESPEJO  555 

ESPEJO. 

1803. 

Refugees  from  Malaga  brought  j'ellow  fever  to  Espejo 
in  1803.     The  outbreak  was  not  extensive.^^^ 

1801. 

The  terrible  yellow  fever  epidemic  of  the  year  1804, 
which  prevailed  at  various  sea  coast  towns  of  Spain,  is 
said  to  have  made  its  way  into  Espejo  in  the  following 
manner  :^^® 

John  Cordoba,  a  muleteer,  arrived  from  Malaga  about 
five  in  the  evening  of  the  27th  of  August,  much  indis- 
posed. He  sent  for  one  of  the  physicians  of  the  place, 
who  finding  the  case  to  be  alarming,  reported  the  circum- 
stances to  the  health  authorities.  Cordoba  was  himself 
impressed  with  the  idea  that  he  was  infected  with  the 
plague  or  epidemic.  He  had  brushed,  in  passing  through 
the  streets,  one  of  the  carts  employed  to  can-y  the  dead 
to  the  grave.  His  imagination  was  struck ;  and,  conceiv- 
ing that  touch  was  sufficient  to  communicate  the  mal- 
ady, he  believed  the  incident  alluded  to,  to  be  the  actual 
cause  of  the  indisposition  which  he  then  felt.  Various 
persons  from  the  adjoining  houses  visited  Cordoba  in  his 
illness,  some  in  friendship,  others  to  purchase  things 
which  he  liad  brought  from  ]\ralaga  for  sale. 

When  news  of  Cordoba's  illness  reached  the  author- 
ities, the  patient  was  at  once  carried  to  the  open  country, 

"'Berenger-Feraud,  p.  75. 

"'Jackson:  Yellow  Fever  on  the  South  Coasts  of  Spain,  p.  23; 
Fellowes,  p..  47S;  Ballly,  p.  90;  Eager,  p.  20. 

*  Fellowes  gives  the  following  figures:  Males,  100;  females,  268. 
This  would  give  a  total  of  368.  Both  Fellowes  and  Bally 
state  that  the  total  deaths  were  329.  It  is  a  noteworthy 
fact  that  the  mortality  among  men  has  in  nearly  every 
instance  been  greater  than  among  women  during  the 
epidemics  of  Andalusia  and  we  have  taken  the  liberty  of 
adding  the  missing  figures  to  the  male  column. 


I 


556  HISTORY    OF    YELLOW    FEVER. 


and  the  remaining-  goods,  he  had  brought  from  Malaga 
destroyed.  But  it  was  too  late.  The  seeds  of  infection 
were  already  sown.  All  those  who  had  visited  the  mule- 
teer during  his  illness,  were  taken  ill  with  yellow  fever 
and  a  majority  died.  The  disease  manifested  itself  at 
first  to  the  portion  of  the  city  frequented  by  the  friends 
of  Cordoba.  A  rigorous  cordon  was  instituted  and  thus 
the  other  sections  of  the  city  were  spared. 

Espejo  had  a  population  of  4,901  in  1804.  From  August 
27  to  November  25,  the  date  of  the  last  death,  there  were 
329  fatalities  fromj  the  fever.  Of  this  number,  161  were 
males  and  168  females. 

ESPERA. 

1800. 

In  1800,  yellow  fever  invaded  Espera  and  caused  a  mor- 
talitv  of  442.  The  infection  undoubtedlv  came  from 
Cadiz.120 

1804. 

The  population  of  Espera  in  1804  was  2,084.  The  first 
rase  of  yellow  fever  was  observed  September  25 ;  the  last, 
December  3.  During  the  course  of  the  epidemic,  there 
were  439  deaths,  of  which  280  were  males  and  159 
females.^-^ 

ESTEPA. 

1800. 

A  single  instance  of  yelloAv  fever  having  invaded  Estepa 
is  recorded.  JDuring  the  general  epidemic  of  1800,  ref- 
ugees fled  to  this  village.  In  spite  of  the  fact  that  the 
scourge  was  committing  fearful  ravages  in  nearly  every 
city  and  town  in  Andalusia,  only  two  persons  died  of  the 
disease  in  Estepa.      {La  Rochr.  vol.  1,  p.  5.34). 

'="  La  Roche,  vol.  1,  p.  534. 
'='  Fellowes,  p.  478. 


SPAtN.  557 

FEEROL. 

1858. 

Ferrol,  twelve  miles  northeast  of  Corunna,  was  con- 
fronted with  a  small  epidemic  of  yellow  fever  in  1858. 
On  July  80  of  that  year,  the  warship  Isabel  II  entered 
the  port.  She  had  originally  sailed  from  Havana  in  the 
last  days  of  jNfay,  and  had  sto])ped  at  Gijon,  a  port  in 
the  Bay  of  Biscay,  before  coming-  to  Ferrol.  On  July 
81,  the  day  after  her  arrival,  a  sailor  named  Pablo  Bor- 
rell,  who  had  been  ailing  for  several  days,  Avas  transferred 
from  the  vessel  to  the  military  hospital,  where  he  died 
of  yellow  fever  on  August  1.  On  August  S,  three  more 
sailors  from  the  Isnhcl  II  died  from  the  same  disease 
at  the  hospital.  Nine  cases  in  all  were  admitted  to 
the  hospital.  Our  souice  of  information  does  not  state 
whether  or  not  there  were  any  further  fatalities.  The 
disease  did  not  spread  to  the  inhabitants  of  Ferrol.^-- 

FRAGA. 

1821. 

Refugees  \\ith  the  poison  of  yellow  fever  in  their  system 
fled  to  Fraga  in  1804,  and  a  majority  died.  The  inhabi- 
tants of  the  village  were  not   contaminated.^-^ 

GIBRALTAR. 

Yellow  Fever  Years. 

1G49;  1727;  1798;  1800;  1803;  1804;  1810;  1811;  1813; 
1814;  1818;  1822;  1824;  1825;  1826;  1828;  1829. 


Capriles:    S':glo  Medico,  Madrid,  1858,  vol.  5,  p.  284;    Vizalde; 

Ibid,  pp.  263,  282. 
Bally,  Francois  and  Pariset,  p.  62. 


558  HISTORY    OF    YELLOW    FEVER. 

Historical  Resume. 

Gibraltar,  known  to  the  Greeks  as  Calpe,  was  first  for- 
tified as  a  strategic  point  by  the  Saracen  leader,  Tarik 
Ibu  Zeiad,  in  711-712,  from  whom  it  was  thenceforward 
called  Gebel-al-Tarik,  the  rock  of  Tarik.  It  was  ulti- 
mately taken  by  the  Spaniards  from  the  Moors  in  1462, 
fortified  in  the  European  style,  and  so  much  strengthened 
that  the  engineers  of  the  seventeenth  century  considered 
it  impregnable.  It  was  taken,  however,  after  a  vigorous 
bombardment  in  1701  by  a  combined  English  and  Dutch 
force  under  Sir  George  Rooke  and  Prince  George  of 
Darmstadt,  and  was  secured  to  Britain  by  tlie  Peace  of 
Utrecht  in  1713.  Since  then  it  has  remained  in  British 
hands,  notwithstanding  many  desperate  efforts  on  the  part 
of  Spain  and  France  to  retake  it. 

Vast  sums  of  money  and  an  immense  amount  of  labor 
have  been  spent  by  England  in  fortifying  this  celebrated 
stronghold,  which,  in  case  of  war,  would  form  one  of  the 
most  important  points  of  support  for  naval  operations. 
Numerous  caverns  and  galeries,  extending  two  to  three 
miles  in  length,  and  of  sufficient  width  for  carriages,  have 
been  cut  in  the  solid  rock,  with  port-holes  at  intervals  of 
every  twelve  yards,  bearing  upon  the  neutral  ground 
w^hich  separates  the  fortress  from  the  mainland  and  the 
Bay  of  Gibraltar,  and  mounted  with  more  than  1,000 
guns,  some  of  them  of  the  largest  size.  The  regular  gar- 
rison in  time  of  peace  is  5,000. 

Summary  of  Epidemics. 

1649. 

Historians  assert  that  yellow  fever  had  never  been  ob- 
served at  Gibraltar  prior  to  1803,  but  ancient  documents 
and  Spanish  tradition  give  vague,  but  undoubtedly  au- 
thentic accounts  of  the  prevalence  of  the  disease  among  the 
Spanish  garrison,  as  far  back  as  the  middle  of  the  seven- 
teenth century. 


SPAIN GIBRALTAR.  559 

According  to  the  Second  Report  on'  Quarantine,  pub- 
lished by  the  General  Board  of  Health  of  Great  Britain 
in  1852  {page  153),  a  Dr.  Morillo,  who  had  been  employed 
at  Marabella  and  other  towns  in  Andalusia  during  a  pes- 
tilential outbreak  (the  nature  of  which  is  not  stated), 
went  also  to  Gibraltar,  to  investigate  an  epidemic,  which, 
according  to  an  old  history  of  Gibraltar  by  Ayola,  proved 
so  fatal,  that  the  people,  losing  all  confidence  in  human 
means,  instituted  processions  to  the  neighboring  hermit- 
age of  San  Eoque,  which  were  kept  up  annually  in  the 
month  of  August,  till  the  surrender  of  the  garrison  to 
the  British  in  1704. 

Although  we  have  been  unable  to  find  any  record  of 
Dr.  Morillo's  report  (if  any  was  ever  made),  we  have 
no  doubt  that  this  epidemic  was  one  of  yellow  fever. 

1727. 

There  is  a  record  that  the  garrison  at  Gibraltar  lost 
500  men  by  fever  in  1727,  twenty-three  years  after  the 
fortress  had  been  taken  by  the  British.  The  character  of 
the  disease  is  not  described,  but  the  excessive  mortality 
leaves  no  doubt  that  it  was  yellow  fever. ^-* 

1798. 

Another  outbreak  of  yellow  fever  on  this  celebrated 
rock,  not  mentioned  in  the  various  works  on  epidemiology 
we  have  consulted,  is  said  to  have  taken  place  in  1798. 
This  information  is  contained  in  a  letter  written  Staif- 
Surgeon  Hill,  of  the  British  Army,  dated  June  13,  1832, 
and  published  in  the  Second  Report  on  Quarantine. 

It  appears  from  said  letter  that  the  48t]i  Regiment 
having  returned  fronii  the  West  Indies  a  complete  skele- 
ton, were  completed  by  recruits  from  the  different  sup- 
plementary corps  to  the  number  of  1,100  strong,  with 
which  it  immediately  embarked  on  board  the  Calcutta 
Indiaman,  September  1,  1798,  at  Lymington,  England, 
and  arrived  at  Gibraltar  the  following  month  (October)  ; 

"*  (Second  Report  on  Quarantine,  p.  153. 


560  HISTORY    OF    YELLOW    FEVER. 

previously  to  the  regiment  embarking  tliere  had  been  a 
detachment  on  board,  and  two  or  three  eases  of  small-pox 
occurred;  the  ship  had  been  fumigated  and  whitewashed, 
but,  nevertheless,  a  few  cases  of  small-pox  were  debarked 
at  Gibraltar  on  the  arrival  of  the  regiment  at  that 
fortress;  in  all  other  respects  the  mien  were  iiealthy,  al- 
though much  crowded  on  board  ship,  and  such  was  the 
state  of  equipment  that  the  men  appeared  in  their  dif- 
ferent county  militia  uniforms,  not  having  had  time  to  fit 
on  the  proper  uniform  clothing  prior  to  leaving  England. 

Soon  after  the  arrival  of  the  corps  at  Gibraltar,  several 
cases  of  yellow  or  bilious  remittent  fever  made  their  ap- 
pearance, which  increased  rapidly  and  proved  highly  fatal. 
Dr.  Harness,  physician  to  Lord  St.  Vincent's  fleet  de- 
clared the  fever  was  precisely  the  same  he  had  seen  in  the 
West  Indies,  and  requiring  the  same  treatment. 

The  young  recruits  were  the  only  sufferers,  not  an  of- 
ficer lieing  attacked.  ,  Most  of  the  latter  had  lately  re- 
turned from  the  West  Indies,  but  among  the  subalterns 
there  were  several  that  had  never  before  been  out  of 
England. 

The  total  mortality  amounted  to  100.  The  number  of 
cases  is  not  stated. ^^^ 

The  fact  that  the  48th  Tlegiment  came  from  tlie  West 
Indies,  a  notorious  hot-bed  of  yellow  fever,  and  the  high 
rate  of  mortality,  leaves  no  hesitation  in  our  mind  that 
the  disease  under  discussion  was  yellow  fever. 

1800. 

In  Trotter's  Medicina  Kautica,  it  is  stated  that  257 
deaths  from  "fever"  took  place  at  Gibraltar  in  1800, 
among  the  military.^-^ 

Although  the  word  "yellow  fever"  is  not  mentioned  by 
this  authority,  the  fact  that  this  disease  was  general  in 
Spain  in  1800,  and  that  the  average  yearly  mortality  dur- 
ing non-epidemic  periods  among  the  military  had  been 
only  thirty-eight,  is  conclusive  proof  that  the  Antillean 
Pestilence  prevailed  at  Gibraltar  that  year. 

*"  Second  Report,  etc.,  pp.  153;  206, 
'^  Second  Report,  etc.,  p.  153. 


SPAIN GIBRALTAR.  561 

1803. 

We  now  come  to  the  first  authentic  invasion  of  Gib- 
raltar by  yellow  fever.  During  the  summer  months 
( l)resumal)ly  August),  smugglers  brought  the  disease  to 
to  the  town.     Only  a  few  sporadic  cases  resulted.^-^ 

1804. 

A  reference  to  our  chronology  will  show  that  yellow 
fever  was  widespread  in  Andalusian  in  1804.  A  rigorous 
cordon  was  placed  in  the  environs  of  Gibraltar,  but  smug- 
glers from  Cadiz  and  iMalaga  succeeded  in  eluding  the 
vigilance  of  the  coast-guards,  and  stole  into  the  place. 
That  they  carried  something  more  harmful  to  public  in- 
terests than  contraband  goods  is  obvious  from  the  sequel. 
Some  of  them  developed  yellow  fever  in  the  midst  of  the 
healthy  population  of  Gibraltar  and  died,  diffusing  the 
infection  among  the  inhabitants.^-^ 

The  population  of  Gibraltar  in  1804  (both  civil  and 
military)  was  15,000.  When, the  epidemic  came  to  an  end, 
5,733  fatalities  had  occurred,  4,864  among  the  civilians 
and  869  among  the  military.^-^ 

1810. 

Sporadic  cases  appeared  in  1810,  causing  a  mortality 
of  seventeen  among  the  civilians  and  six  among  the 
soldiers.^^^ 

1811. 

Gibraltar  was  infected  by  Cadiz  in  1811.  Beyond  the 
mere  mention  of  this  fact,  our  authority^^^  gives  no  in- 
formation of  any  value. 

"'  Berenger-Feraud,  p.  74. 

"*  Eager,  p.  19. 

""Second  Report  on  Quarantine,  p.  158. 

""Second  Report  on  Quarantine,  p.  158. 

'"  Berenger-Feraud,  p.  84. 


562  HISTORY    OF    YKLLOW    FEVER. 

1813. 

The  warship  St.  Pierre  brought  yellow  fever  to  Cadiz 
in  1813.  On  August  11  of  that  year  a  vessel  called  the 
FoHtiue  arrived  at  Gibraltar  from  Cadiz.  One  of  the 
crew  being  ill,  Avas  sent  to  the  Catholic  Hospital,  and 
died  on  the  19th  of  the  same  month,  with  every  symptom 
of  yellow  fever.  Nothing  untoward  happened  until  the 
end  of  the  month,  when  a  Frenchman,  a  native  of  Paris, 
residing  in  Government  Street,  near  City  Hall  Lane,  was 
taken  ill  with  the  same  symptoms  as  the  first  case,  and 
died  on  September  3.  It  afterwards  developed  that  this 
man  had  been  a  passenger  on  board  the  Fortune,  and  had 
landed  the  same  day  as  the  sailor  who  died  on  August  19th. 

Between  the  3rd  and  11th  days  of  September,  nine  per- 
sons died  of  yellow  fever  in  the  same  neighborhood.  The 
disease  spread  to  other  streets  and  the  entire  town  was 
soon  infected. 

The  total  number  of  cases  and  deaths  was  as  follows: 

Cases.  Deaths. 

At  Lazaaretto 635  281 

In  town 684  218 

At  Military  Hospital   .  . .  .1,470  384 


2,789  883 

Among  the  deaths  at  the  Military  Hospital,  were 
twenty-four  officers,  fifty-eight  soldiers'  wives  and  six 
children. ^^^ 

1814. 

The  epidemic  of  1814  lasted  from  August  to  November, 
and  claimed  the  following  victims. ^^^ 

Civilians 132 

Soldiers 114 


246 


'"Gilipin:   Medico-Chirurgical  Transactions,  London,  1814,  vol.  5, 

pp.  328,  338. 
"'Second  Report  on  Quarantine,  p.  159. 


SPAIN GIBRALTAR.  563 

1818. 

In  the  month  of  August,  1818,  a  solitary  case  of  yellow 
fever,  followed  by  recovery,  was  observed  at  Gibraltar.^^* 

1822. 

Two  cases  of  yellow  fever  are  recorded  for  the  year 
1822.     They  were  observed  in  September.^^^ 

1824. 

Gillkrest,  surgeon  of  the  43rd  Light  Infantry,  reports 
having  attended  two  cases  of  yellow  fever  at  Gibraltar  in 
1824.*  One  of  the  cases  was  that  of  a  private,  whom  the 
doctor  attended,  until,  in  the  course  of  his  ministrations, 
he  was  himself  taken  ill,  furnishing  the  second  case.^^** 


"*Amiel:   Second  Report  on  Quarantine,  p.  266. 

^^  Amiel,  loc.  cit. 

*  As  the  main  abject  of  the  researches  made  .by  the  compilers 
of  the  Second  Reiport  on  Quarantine  was  to  uphold  the 
theory  that  yellow  fever  was  not  always  imported  to 
Gibraltar,  but  could  originate  on  Spanish  soil  when  certain 
climatic  and  atmospheric  conditions  were  present,  the 
eminent  physicians  who  conducted  the  examinations  em- 
bodied in  the  Report  evidently  took  advantage  of  every 
honest  opportunity  to  amass  evidence  to  fortify  their 
pretensions.  We  theirefore  think  that  the  evidence  they 
gathered  regarding  the  prevalence  of  sporadic  cases  in 
certain  years  genuine,  nothwithstanding  adverse  criticism 
by  numerous  authors.  Of  course,  the  opinion  that  the 
disease  originated  on  Spanish  soil  is  absurd,  our.  present 
day  knowledge  leading  to  the  belief  that  the  sporadic 
cases  noted  in  this  history  owed  theiir  origin  simply  to 
the  renewed  activity  of  infected  Calopae.  Why  the 
disease  did  not  propagate  in  those  special  instances,  is 
one  of  these  mysteries  which  Nature  veils  from  human 
ken  and  which  no  amount  of  reasoning,  however  deep  or 
methodical,  can  satisfactorily  explain. 

"'Gillkrest:  Second  Report  on  Quarantine,  p.  266. 


504  HISTORY  OK  YELLOW    FEVER. 

Dr.  Gillkrost  was  attended  by  Dr.  Arejiila,  pliysieian  to 
the  Kiug  of  Spain,  who  lias  written  learnedly  on  the 
epidemics  of  Andalusia. 

1825. 

In  November,  1825,  two  sporadic  cases  of  yellow  fever 
are  said  to  have  erupted  in  Gibraltar.  This  is  the  first 
time  on  record  where  fellow  fever  showed  itself  so  late 
in  the  year  in  this  locality.  Our  informant  does  not  fur- 
nish any  details. 

182G. 

Three  cases,  a  soldier  and  two  civilians,  were  observed 
in  1826.     One  of  the  civilians  died.^^^ 

1828. 

A  severe  visitation  of  yellow  fever  ravaged  Gibraltar 
in  1828.  The  history  of  tliis  epidemic  is  related  at  length 
by  Messrs.  Chervin,  Louis  and  Trousseau,  in  a  work  re- 
markable for  the  vast  amount  of  documentary  evidence 
which  these  gentlemen  amassed,  but  which  is  unfortun- 
ately so  unwisely  classified,  that  it  tfckes  a  vast  amount 
of  dessication  to  separate  the  wheat  from  the  chaff,  and 
therefore  gi'eatly  detracts  from  the  imi^ortance  of  the 
work  as  one  of  ready  reference.  After  laboriously  going 
over  the  542  documents,  covering  two  volumes  of  412 
pages  each,  one  is  finally  able  to  condense  the  following 
information : 

The  Swedish  ship  Di/c/den,  left  Havana  :May  12,  1828, 
with  a  crew  of  16.  The  vessel  reached  Gibraltar  June 
28.  Two  sailors  had  died  from  yellow  f(n'er  during  the 
voyage,  one  on  May  27  and  the  other  June  1.     The  Dygdcn 

"'  Amlel,  loc.  cit. 

'•"Browne  and  Gillice:  Second  Report  on  Quarantine,  p.  266. 

'•"Documens  Recueillls  par  MM.  Chervin,  Louis  et  Trousseau, 
■MembeTS  de  la  Commission  Francalse  Envoyee  a  Gibraltar 
pour  Observer  I'Epidemie  de  1828;  et  par  M.  le  Dr.  Barry, 
Medecin  des  Armees  Anglaises.    2  vols.,  Paris  1830. 


SPAIN GIBRALTAR.  565 

was  deemed  so  unsanitary  that  pratique  Avas  refused  the 
captain,  and  the  vessel  ordered  to  quarantine.  Avhere  she 
remained  forty  dnjH.  Althou<>:h  presumahly  under  strict 
surveillance,  it  was  onlj^  on  Jul^^  27,  or  29  days  after  her 
arrival,  that  health-guards  were  sent  on  board.  The  ship 
was  released  from  quarantine  August  8. 

The  first  cases  of  yelloAv  fever  on  shore  erupted  August 
29,  in  the  house  of  a  man  hamed  Testa,  one  of  the  guards 
sent  on  board  the  Dycfdcn  on  July  27.  Much  stress  is 
laid  on  this  fact  by  the  historians  of  this  epidemic,  and 
Testa  is  accused  of  having  infected  his  sister,  who  was  the 
first  person  to  die  of  the  disease,  but  as  Testa  himself  did 
not  have  the  malady  at  the  time  and  the  germs  are  not 
spread  by  contact,  infected  mosquitoes  were  no  doubt 
introduced  into  the  premises,  probably  in  smuggled  goods, 
and  thus  a  focus  Avas  created.  Of  course,  our  astute 
friends  of  over  a  century  ago  had  no  idea  of  the  mos- 
quito transmission  of  yelloAv  fever,  and  the  fact  that  Testa 
had  been  on  board  the  Di/gden  and  his  sister  was  the  first 
person  stricken,  was  strong  enough  evidence  to  place  the 
burden  of  contagion  on  the  shoulders  of  the  unfortunate 
health-guard. 

Another  vessel,  the  Met  a,  is  also  accused  of  having  con- 
taminated the  town  in  1828.  This  ship  left  Havana  at 
about  the  same  date  as  the  Di/r/dcn,  and  arrived  at  Gib- 
raltar at  the  end  of  June,  having  lost  two  men  from  yel- 
low fever  during  the  voyage.  She  was  submitted  to  a 
quaranatine  of  twenty-one  days.  Contraband  goods  found 
their  way  on  shore,  and  the  vessel  was  also  visited  by 
washerwomen  from  Gibraltar  and  the  neighboring  vil- 
lage of  Catalan  Bay,  who  took  the  soiled  linen  of  the 
sailors  to  their  homes.  Most  of  the  washerwomen  con- 
tracted yellow  fever  and  died.  The  chroniclers  of  the 
period  attributed  their  death  to  the  fact  that  among  the 
clotlies  taken  by  them  from  the  Meta,  were  some  which 
had  belonged  to  the  sailors  who  had  died  during  the  voy- 
age, and  which  were  still  soiled  with  black  vomit. 

Whether  contaminated  by  the  Dyfjdcn,  or  the  Meta,  or 
by  both,  it  is  plain,  from  a  summary  of  the  evidence,  that 
Havana  was  the  original  source  of  infection.     Such  has 


5G6  HISTORY    OK    YELLOW    EEYER. 

generally  been  the  case  in  nearly  every  epidemic  of  yel- 
low fever  in  Spain. 

The  last  death  occurred  December  25.  With  the  ex- 
ception of  the  disastrous  epidemic  of  1804,  that  of  1828 
proved  to  be  the  worst  that  Gibraltar  ever  experienced. 
There  were  5,543  cases,  of  which  1,677  proved  fatal.  The 
mortality  among  the  civil  population  amounted  to  1,170, 
while  the  military,  out  of  a  population  of  3,781,  lost  507. 

1829. 

A  few  cases  and  deaths  are  recorded  for  the  month  of 
January,  1829,  being  the  "tail  end"  of  the  epidemic  of 
the  year  previous.  The  last  death  occurred  on  the  14th 
of  the  month. 

Since  1829,  yellow  fever  has  not  been  observed  at 
Gibraltar. 

GRAXADA. 

1804. 

The  beautiful  aud  historic  city  of  Granada  was  visited 
by  yellow  fever  once  in  its  history.  On  August  25,  1804, 
the  first  case  was  observed,  and  the  disease  slowly  pro- 
pagated itself,  resulting  in  a  total  of  30G  deaths,  out  of 
a  population  of  54,902.  The  mortality  among  the  males 
was  185 ;  females,  121.  The  epidemic  exerted  its  greatest 
intensity  on  October  10,  and  became  extinct  on  the  28th 
of  the  same  month. ^^^ 

GUARDAMAR. 

1804. 

Yellow  fever  was  brought  to  Guardamar  by  refugees 
from  Alicante  and  other  infected  places  in  1804,  but  did 
not  spread  to  the  inhabitants.     Out  of  a  population  of 

'"Second  Report  on  Quarantine,  p.  159. 
'"Fellowes,  p.  478. 


SPAIN GUARDAMAR. 


567 


2,464,  not  a  single  case  occurred  among  the  inhabitants. 
Only  fourteen  deaths  are  recorded,  the  first,  September 
21,  and  the  last,  November  16.  The  mortality  among  the 
men  was  eight;  women,  Q}"^-  The  absence  or  inactivity 
of  the  Calopae  no  doubt  saved  Guardamar  from  a  dis- 
astrous epidemic. 

HUELVA. 

1800. 

A  few  cases  of  yellow  fever  were  brought  bj  refugees 
to  Huelva  in  1800,  according  to  Rougeau.^^^  The  devel- 
opments must  have  been  unimportant,  as  we  find  no  de- 
tailed history  of  the  incident  in  any  works  on  epidem- 
iology. 

ISLA  DE  LEON. 

Isla  de  Leon  (also  know  as  San  Fernando)  is  only  seven 
miles  from  Cadiz,  and  it  is  surprising  that  yellow  fever 
has  not  been  observed  there  more  frequently  than  on  the 
three  occasions  mentioned  in  this  history. 

1800. 

In  1800,  Isla  de  Leon  was  infected  by  refugees  from 
Cadiz.  The  town  had  then  a  population  of  32,000.  In 
less  than  three  months,  5,033  of  its  inhabitants  fell  vic- 
tims to  the  terrible  pestilence.^^'* 

1811. 
In  1811  yellow  fever  was  imported  to  Isla  de  Leon  by 
a  vessel  from  Santa  Cruz  de  Teneriffe,  and  claimed  many 
victims.^^^     From  this  focus,  the  disease  spread  to  Cadiz, 
Gibraltar  and  Alicante. 

"Tellowes,  p.  478, 

"'Rougeau:   Theses  de  Paris,  1827,  No.  119. 

*"La  Roche,  vol.  1.  p.  534. 

""  Berenger-Feraud,  p.  84. 


568  HISTORY    OK    YELLOW    FEVER. 

1819. 

The  steamship  Asia,  from  Vera  Cruz  and  Havana,  in- 
fected Isla  de  Leon  in  1819.^^^  From  this  focus,  the 
neighboring  city  of  Cadiz  wae  contaminated  and  experi- 
enced one  of  the  miost  dismal  epidemics  in  its  history. 

JESUS. 

1821. 

Fugitives  from  Tortosa  brought  yellow  fever  to  the  vil- 
lage of  Jesus,  on  the  Ebro,  opposite  that  city,  in  1821. 
A  man  named  Cordoba  and  his  dauaghter,  -who  had  com- 
municated with  Tortosa,  contracted  the  disease  and  died, 
without  contaminating  other  inhabitants  of  Jesus.  Dur- 
ing the  progTCss  of  the  epidemic  at  Tortosa,  several  per- 
sons who  had  fled  to  the  village  died,  but  in  no  instance 
did  the  malady  spread.^^" 

JUMILLA. 

1811. 

A  few  cases  of  yellow  fever  were  observed  at  Jumilla, 
thirty-seven  miles  northwest  of  Murcia,  in  1811,  There 
was  no  spread  of  the  disease.^*® 

1812. 

The  battle  of  Salamanca  (July  22,  1812),  which  stopped 
the  progress  of  the  victorious  French  army  through  Spain, 
compelled  General  Marmon  to  abandon  his  plans  of  fur- 
ther conquest  and  retrace  his  steps.     During  the  month 


>" Begin:    Journal  de  Medecine  Militaire,  1820,  vol.  7,  p.  346. 

Also:   Berenger-Feraud,  p.  89. 
'"O'Halloran,  p.  121. 
"'  Bally,  Francois  and  Pariset,  p.  560. 


SPAIN-r-JUMILLA.  5C9 

of  September,  1812,  a  portion  of  this  once  splendid  corps 
traversed  the  Kino:dom  of  Mureia.  A  division  arrived 
on  October  1,  at  Zieza,  a  small  town  on  the  Se<;iira, 
where  yellow  fever  was  epidemic,  having  been  imported 
by  two  individuals  from  Cartagena  during  the  early  days 
of  September.  Nearly  all  the  inhabitants  of  Zieza  had 
fled  from  the  threatened  pestilence,  and  the  troops  finding 
only  deserted  houses  and  rottening  corpses,  pressed  north- 
ward. Two  days  later,  the  soldiers  arrived  at  Jumilla, 
which  had  already'  been  contaminated  by  Zieza,  but  where 
conditions  were  better,  and  decided  to  rest  from  their 
fatigues.  A  few  days  later  (October  8),  a  soldier  was 
taken  ill  with  the  prevailing  fever  and  died  in  forty-eight 
liours.  From  that  date  to  the  28th  of  the  moi^th,  the  dis- 
ease spread  through  the  camp  and  claimed  about  100  vic- 
tims. The  segregation  of  the  soldiers  finally  i)ut  an  end 
to  the  epidemic. ^^^ 

LA  CARLOTA. 

1800. 

The  beautiful  little  town  of  La  Carlota,  seventeen  miles 
southwest  of  Cordova,  had  a  population  of  733  in  1800. 
Refugees  from  Cadiz  brought  yellow  fever  to  the  place 
that  year.  When  the  first  cases  erupted,  all  those  who 
could  do  so  fled,  the  remaining  population  being  473. 
Out  of  this  small  number,  there  resulted  195  cases,  122 
of  which  proved  fatal. ^^^ 

This  is  the  only  authentic  record  of  the  appearance  of 
yellow  fever  at  La  Carlotta. 

LA  RAMBLA. 

1803. 

La  Rambla,  which  had  been  spared  during  the  wide- 
spread epidemic  of  1800,  was  contaminated  by  refugees 

'"Pessou:   Journal  de  Medecine  Militaire,  181,  vol.  5.  p.  304. 
""•Bally,  p.  74. 


570  HISTORY    OF    YELLOW    FEVER. 

from  Malaga  in  1803,  and  suffered  severely.^^^     Our  au- 
thority fails  to  give  any  details. 

1804. 

In  1801  yellow  fever  was  introduced  into  La  Eambla 
from  Malaga  in  the  following  manner  :^^- 

A  man  by  the  name  of  Nieto,  who  had  been  at  Malaga 
on  business,  was  prompted  by  morbid  curiosity  to  follow 
and  touch  a  burying-cart  containing  the  corpse  of  a  person 
that  had  died  of  yellow  fever.  ;Of  course,  the  mere  fact 
that  he  did  this  was  certainly  not  sufficient  to  infect  him, 
but  the  incident  is  mentioned  to  illustrate  the  peculiar 
views  of  contagion  held  by  the  physicians  of  the  period. 

Even  Jackson,  who  lived  in  an  atmosphere  of  rabid 
contagionists  and  infectionists,  ridicules  the  idea.  "It 
is  known  by  experience,"  observes  the  doctor,  "that  neither 
burying-carts  nor  dead  bodies  possess  the  material  of  con- 
tagion in  a  condition  to  communicate  the  infection  to 
others;  the  whole  has  the  air  of  a  story,  the  blanks  of 
which  are  filled  up  by  fiction — tlie  facility  of  doing  which 
seems  to  be  characteristic  of  the  Spanish  nation. "^^^ 

In  whatever  manner  Nieto  contracted  the  disease,  it  is 
certain  that  he  brought  it  to  La  Rambla.  He  went  to 
bed  immediately  on  liis  arrival  liome,  on  the  day  in  ques- 
tion, lie  was  not  seriously  ill  and  recovered.  A  youth 
named  de  Castro  who  lived  near  Nieto,  and  who  visited 
him  during  his  illness,  was  taken  ill  on  the  9th  of  Sep- 
temlxT  and  died  on  the  Ifith.  A  young  woman,  Maria 
Marina  Doblas,  a  cousin  of  Nieto,  who  lived  in  a  house 
contiguous  to  his,  came  to  see  him  during  his  illness  and 
was  attacked  by  the  disease.  Christobal  Doblas,  who  oc- 
cupied the  same  house  with  Maria,  was  taken  ill  about 
the  same  time  as  the  woman,  and  died  on  the  19th  of 
September.  Garcia  Luque,  bridegToonii  of  ]\raria,  was 
taken  ill  about  the  same  time  as  his  wife,  and  also  died 

"'Berenger-Feraud,  p.  74. 

'"Arejula:    Breve   Descripcion   de  la   Fiebre   Amarilla   Padecida 

en  Cadiz,  etc.,  p.  286. 
'^'Jackson,  p.  21. 


SPAIN LA    RAMBLA.  ■  571 

on  the  19th.  Garcia  Luque  lived  in  a  distant  part  of  the 
town  where  there  was  as  yet  no  siclvness,  and  no  doubt 
contracted  the  malady  when  he  came  to  live  with  his 
father-in-law.  Luqhe's  mother  was  attacked  about  a 
month  after  the  death  of  her  son. 

La  Rambla  had  a  population  of  6,000  in  1800.  The 
disease  made  sIoav  progress,  and  finally  came  to  an  end 
in  the  early  days  of  October,  Only  seventy  cases,  of  which 
thirty-seven  proved  fatal,  are  recorded. 

LAS  AGUILAS. 

(See  Aguilas). 

LAS  CAVEZAS  DE  SAN  JUAN. 

1800. 

Yellow  fever  invaded  Las  Cavezas  de  San  Juan  in  1800 
and,  according  to  La  Roche,^^*  caused  a  mortality  of  994. 

LAS  PALACIOS. 

1800. 

Las  Palacious  experienced  a.  solitary  invasion  of  yellow 
fever.  According-  to  La  Roche,  192  fatalities  resulted  in 
1800.     No  other  details  are  given. ^^^ 

LEBRIXA. 

1800. 

In  the  year  1800  the  people  of  Lebrixa  suffered  from 
yellow  fever,  in  consequence  of  being  infected  by  a  cavalry 
regiment  from  Alcantara,  which,  proceeding  from  places 
where  the  malady  was  prevailing,  passed  a  night  in  the 


La  Roche,  vol.  1,  p.  534. 
La  Roche,  vol.  1,  p.  534. 


57^  HISTORY    OF    YELLOW    FEYER. 

town  and  left  some  sick.  The  fever  spread  after  the  de- 
parture of  the  regiment  and  attacked  progressively  the 
inhabitants,  causing  such  havoc  that  ^'numbers  of  them 
could  not  obtain  professional  aid  or  attendance  for  this 
malignant  and  fatal  disease."  {O'HaaJoran,  p.  153). 
According  to  La  Eoche,  2,100  persons  were  carried  oft"  by 
the  epidemic.^°^ 

1811. 

A  few  ca^es  were  observed  in  1811.  The  local  Board 
of  Health  inaugurated  strict  i«anitary  measures  and  in- 
creased its  vigilance,  cutting  off  every  comuiunication 
with  infected  localities,  and  the  disease  was  confined  to 
the  imported  cases.-^^^ 

1821. 

The  first  case  of  yellow  fever  in  Lebrixa  in  1821,  ap- 
peared in  the  person  of  Simon  Riega,  who  resided  in  the 
Posada  Xueva  de  la  Constitucion.  He  fell  ill  on  the  15th 
of  September,  and  died  on  the  18th.  Eieto's  family,  con- 
sisting of  eight  persons,  were  not  attacked,  although  they 
communicated  freely  with  the  sick  man. 

Two  men  wlio  had  come  from  Xeres  de  la  Fron- 
tera,  where  the  fever  was  epidemic,  and  Avho  stopped  at 
a  liouse  in  the  Posada  Xueva,  are  suspected  of  having 
imported  the  malady.* 

The  second  case  occurred  at  a  distance  of  five  hundred 
yards  from  the  former,  in  the  person  of  Maria  Cataliua, 
a  girl  sixteen  years  of  age,  who  resided  in  the  Calle  Xueva. 
Slie  l)ecame  indisposed  on  Septeuiber  15,  and  died  on  the 
21st.  Tlio  girl  had  no  communicatiou  with  Piega  or  his 
family.  Ten  persons  living  in  the  t-^ame  house  with  ^laria 
proved  immune  to  the  infection. 


'•'■'La  Roche,  vol.  1,  p.  534. 

'■'Robert,   Guide    Sanitaire.   vol.    1,   p.    284;    Berenger-Feraud.  P- 
84;  Bally,  Francois  and  Pr.riaet,  p.  559. 


SPAIN — LEBRIXA.  51 S 

A  man  named  La  Paz,  residing  in  Calle  la  Pena,  fur- 
nished the  tliird  caf>e.  He  was  taken  ill  Septeml)er  16, 
and  died  on  the  23rd.  He  resided  250  yards  from  Iviega's 
place.  No  one  in  the  La  Paz  household  was  affected,  with 
the  exception  of  a  child,  Avho  contracted  the  disease  two 
months  afterwards,  at  a  time  when  the  malady  was  almost 
extinct. 

A  youth  named  de  Salas,  aged  eighteen,  furnished  the 
fourth  case.  He  resided  in  the  Bario  Xucao  Secundo, 
about  250  yards  distant  from  the  nearest  house  in  which 
the  cases  previously  n®ted  occurred.  He  was  taken  ill 
Septemher  20,  and  died  on  the  28th. 

Two  weeks  after  the  deatli  of  de  Sales,  the  fifth  case 
was  recorded,  in  the  person  of  a  hoy,  who  lived  in  the  same 
neighborhood,  and  who  died  thirty-six  hours  after  the 
onset. 

The  above  first  live  cases,  taken  from  O'Halloran's^^'* 
work,  are  given  to  show  that  the  original  focus  was 
within  a  comparatively  restricted  area,  and  undoubtedly 
owed  its  infection  to  the  two  voyagers  from  Xeres  de  la 
I'rontera.* 

From  tliis  focus,  the  disease  slowly  spread  through  the 
town.  Contrary  to  the  usual  dilatory  tactics  of  the  Cas- 
tillian,  tlie  Lebrixa  Board  of  Health  acted  quickly  and 
energetically,  and  caused  all  the  healthy  inhabitants  who 
could  do  so  to  emigrate  to  the  country,  by  this  means  pre- 
venting a  repitition  of  the  disaster  of  1800.  From  the 
most  authentic  sources,  there  were  only  500  cases,  of  which 
150  died. 

LORCA. 

1811. 

Ivorca,  forty-two  miles  southwest  of  ]\rurcia,  was  in- 
fected in  1811.     The  disease  did  not  spread. ^^^ 

'■•' O'Halloran:  Remarks  en  the  Yellow  Fever,  etc.,  p.  151. 

•  The  Spanli'h  authorities  claim  that  these  men  came  from 
Puerto  de  Santa  Maria,  but  authentic  researches  made  by 
Br.  O'Halloran  elicited  the  information  that  they  were 
from  Xeres  de  la  Frontcra.    (O'Halloran,  p.  155,  foot  note.) 

""  Bally,  Francois  and  Pariset,  p.  5G0. 


374  HISTORY    OF    YELLOW    FEVER. 

LOS  HUMEROS. 

{A  siihiirh  of  Seville,  which  see) 
LOYOLA. 

1823. 

LoTola,  the  birth-place  of  the  founder  of  the  Order  of 
Jesuits,  was  threatened  with  an  invasion  of  yellow  fever 
in  1823.  In  August  of  that  year,  the  ship  Doniasteria, 
from  Havana,  arrived  at  Pasajes  and  was  visited  by  many 
inhabitants  of  the  Basque  town.  Among  the  visitors  were 
two  persons,  husband  and  wife,  who  had  stopped  at  Pas- 
ajes on  their  way  to  a  pilgrimage  to  Loyola.  After  visit- 
ing the  ship,  they  continued  to  their  destination,  where 
they  were  taken  ill  shortly  after  their  arrival,  and  died 
of  yellow  fever  a  few  days  afterwards.  Although  much 
apprehesion  was  felt  by  the  inhabitants  of  the  quaint  old 
Spanish  town,  the  infection  did  not  spread  beyond  these 
two  cases. 

'A  reference  to  Pasajes,  in  tliis  volume,  will  show  that 
the  Doniastcra  infected  that  locality  in  1823,  result- 
ing in  101  cases  and  10  deaths. 

MADRID. 

Description. 

Madrid,  the  capital  of  Spain,  is  in  the  center  of  the 
Peninsula,  on  the  Manzanares.  Situated  on  a  high 
plateau,  2,400  feet  above  sea-level,  wind-swept  from  the 
snowy  Guadarrama,  with  unhealthy  extremes  of  temper- 
ature, the  city  has  no  advantages  except  the  fanciful  geo- 
graphical merit  of  being  the  center  of  Spain.  Railways 
connect  it  with  the  principal  cities  of  the  Kingdom. 
Population:  1887,  470,283;  1908   (estimated),  556,663. 


SPAIN MADRID.  575 

Yellow  Fever  Years. 
1867;  1870;  1878. 

Summary  of  Importations. 

1867. 

Yellow  fever  has  never  obtained  a  foothold  in  Madrid. 
Even  during  the  calamitous  disorders  of  the  beginning 
of  the  last  century,  when  Andalusia  was  nearly  depopu- 
lated and  cases  were  imported  to  nearly  every  city  of  the 
Kingdom,  although  Madrid  received  its  quota  of  fugitives,, 
not  a  solitary  case  manifested  itself  in  the  capital. 

The  first  case  of  yellow  fever  in  the  history  of  ^'^adrid 
was  observed  in  1867.  In  December  of  that  year,  a  man 
who  had  been  to  the  Canaries,  arrived  at  Cadiz  on  the 
steamship  Clara.  Deaths  from  yellow  fever  had  occurred 
on  board  the  vessel.  The  man  went  from  Cadiz  to  i\^adrid 
and  was  taken  ill  in  his  lodgings  on  December  8,  and 
died  on  the  7th.  The  autopsy  revealed  typical  lesions  of 
yellow  fever.^^^ 

1870. 

The  captain  of  the  merchant  vessel  Torcuato  came  from 
Barcelona  to  Madrid  on  September  29,  1870,  and  was 
taken  ill  with  yellow  fever  immediately  on  his  arrival. 
He  recovered.  Our  authority^^'^  does  not  state  whether 
other  cases  occurred  in  INIadrid  or  not,  and  as  a  search 
through  the  Spanish  medical  press  of  1870  and  subse- 
quent years  fails  to  throw  any  light  on  the  subject,  it  is 
to  be  presumed  that  there  were  none.  Eager  (loc.  cit.,  p. 
24),  says  that  "a  few  cases"  were  observed,  but  we  have 
been  unable  to  verify  the  statement. 

""De   PedTO:    Un   Caso   de   Fiebre   Amarilla   an   Madrid.     Siglo 

Medico,  Madrid,  1868,  vol.  15,  p.  20'. 
"*  De   Pedro:    Un  Eraigrante  de  Barcelona    en    Madrid;     Fiebre 

Amarilla.     Siglo  Medico,  Madrid,  1870,  vol.  17,  p.  676. 


576  HISTORY    OF    YELLOW     FEVER. 

.1878. 

In  September  and  October,  1878,  many  Spanisli  soldiers 
returned  from  Cuba.  They  disembarked  at  Santander,  a 
seaport  on  the  Bay  of  Biscay,  207  miles  north  of  Madrid, 
and  the  majority  went  by  rail  to  the  capital.  Among  the 
soldiers  were  a  great  number  whose  term  of  service  had 
expired  and  who,  having  no  families,  took  up  bachelor 
quarters  in  Calle  Tetuan,  in  a  mean,  filthy  dweling,  where 
they  slept  fifteen  or  twenty  in  the  same  room.  Among 
these  liccncmdas  Avere  nmny  who  had  yellow  fever  in 
Cuba,  and  also  some  who  had  never  contracted  the 
disease. 

On  September  15,  a  youth  of  fifteen,  who  lived  in  Calle 
Tetuan,  was  taken  ill  with  peculiar  symi)tvnns  which 
baffled  the  attending  physician.  Four  members  of  the 
youth's  family  were  soon  attacked  with  the  same  myste- 
rious disease,  and  when  two  other  persons  in  the  same 
house  were  taken  ill,  considerable  alarm  was  created  and 
an  investigation  by  the  health  authorities  revealed  the 
fact  that  these  cases  were  genuine  nmnifestations  of  yel- 
low fever.  Prompt  measures  were  immediately  taken, 
but  the  malady  spread  to  the  adjoining  houses  in  Calle 
Tetuan,  making  slow,  but  steady  progress,  only  subsiding 
with  the  advent  of  cold  weather.  The  last  case  was  ob- 
served October  15.  There  were  in  all  fifty  cases,  of  which 
thirty-five  proved  fatal. ^^^ 

MAIRENA  DEL  ALCOR. 

1800. 

A  f^w  cases  of  yellow  fever  were  imported  to  Merina 
del  Alcor  in  1800,  principally  from  Seville,  thirteen  miles 
distant.     Only  nine  fatalities  are  recorded.^^^ 


""Guichet:      MeiHoires     de     Medecine     Militarie,     1878.       Also: 

Berenger-Feraud,  p.  158;  Eager,  p.  24. 
*  La  Roche,  vol.  1,  p.  534. 


577 


MALAGA. 

Description. 

The  ancient  and  historic  city  of  Malaga,  said  to  have 
been  founded  by  the  Carthagenians,  is  situated  on  a  bay 
of  the  Mediterranean,  sixty-five  miles  east  of  Gibraltar. 
It  is  of  much  commercial  importance.  Population  (1908), 
135,000. 

The  Epidemics  of  Malaga, 

We  shall  premise  the  history  of  yellow  fever  in  Malaga 
by  a  summary  of  the  several  pestilential  diseases  which 
have  ravaged  the  famous  Spanish  city  since  1487,  the  year 
of  the  expulsion  of  the  Moors  from  the  Kingdom.  Pre- 
vious to  1487,  no  records  were  kept. 

In  an  old  Spanish  work  published  by  Cecilio  Garcia 
de  la  Lena,^^^  a  learned  priest  of  Malaga,  the  history  of 
every  epidemic  which  invaded  his  native  town  from  1493 
to  1750  is  given.  The  ecclesiastic  designates  these  pesti' 
lential  visitations  by  the  common  name  of  plague,  no  mat- 
ter what  the  etiology  of  the  disease  could  have  been. 

1493.  First  epidemiic  of  which  there  is  any  record. 
Great  mortality.     No  details  given. 

1522.  Plague  caused  excessive  ravages.  The  details 
are  too  vague  to  recognize  anything  but  the  great 
mortality. 

1580.  This  ei>idemic  is  designated  by  the  name  el 
catarro  by  the  good  Padre.  About  eighty  persons  died 
daily.  A  torrential  rain,  on  October  10,  stopped  its 
ravages. 

"'Cecilio  Garcia  de  la  Lena:    Conversaciones  Historicas  Mala- 
guenas,  1789-1793. 


578  HISTORY    OF    YELLOW    FEVER. 

15S2-1583.  This  epidemic  was  caused  by  tlie  introduc- 
tion of  old  clothes  brought  by  strangers  coming  from 
"countries  across  the  sea."  What  countries,  the  learned 
historian  does  not  say.  The  malady  was  attended  by 
bubos. 

1597.  The  "Fifth  Plague"  to  harass  Malaga  broke  out 
in  1597,  and  lasted  three  years.  As  in  1582-3,  it  was  in- 
troduced "by  sea."  Nearly  the  entire  population  of  the 
town  perished. 

1G20.  Plague  again  introduced  into  Malaga  "by  per- 
sons coming  from  the  sea."  The  mortality  was  such,  that 
the  government  was  compelled  to  send  families  from  other 
towns  to  re-people  the  stricken  city. 

1637.  Padre  de  la  Lena  goes  into  more  details  con- 
cerning the  "Seventh  Plague,"  which  was  brought  to 
Malaga  by  a  vessel  "on  its  way  to  Leghorn."  iHe  does 
not  state  whence  the  ship  originally  sailed.  While  in  the 
harbor,  an  inhabitant  of  Malaga  went  on  board  the  vessel, 
where  he  remained  all  night.  When  he  returned  home 
next  morning,  he  was  taken  sick  and  died  shortly  after- 
wards. His  whole  family  shared  the  same  fate.  The 
doctor  who  had  treated  these  unfortunates,  warned  the 
people  that  they  had  died  of  plague,  but  his  admonitions 
were  disregarded,  and  the  neighbors  invaded  the  house 
and  took  possession  of  the  clothes  and  furniture.  By 
this  means,  the  disease  was  communicated  to  neighboring 
streets  and  spread  rapidly  through  the  town,  and  even 
to  neighboring  villages.  From  the  beginning  of  April  to 
the  end  of  May,  the  entire  city  was  infected.  Entire 
streets  were  improvised  into  hospitals,  and  the  public 
parks  were  transformed  into  huge  furnaces,  where  the 
clothing  of  the  dead  was  burned  night  and  day.  The 
epidemic  only  stopped  for  want  of  material,  about  Sep- 
tember 1.  The  mortality  is  variously  estimated  by  dif- 
ferent authors  at  twelve  thousand,  seventeen  thousand  and 
twenty-five  thousand. 

1G48-1649.  Famine  and  the  influx  of  strangers  into 
Malaga  are  given  as  predisposing  causes  of  the  plague 


SPAIN MALAGA.  579 

of  1648-9.  The  mortality  was  not  great  in  1G48,  but  it  is 
said  that  40,000  people  died  in  1649.* 

1674.  A  pestilential  disease,  called  el  catarro,  caused 
much  mortality  in  1674.     No  details  are  given. 

1678-1679.  The  plague  of  1678-9  was  brought  from 
Oran  and  Carthage  (Africa)  by  strangers  bringing  in  old 
clothes  and  chattel.  Although  the  epidemic  lasted  tAvo 
years,  our  author  states  that  "we  are  happy  in  the  thought 
tha  only  8,000  jtersons  perished,  notwithstanding  the  fact 
that  the  city  was  very  populous." 

1719.  The  epidemic  of  1719  had  its  origin  in  Africa. 
The  malady  broke  out  among  the  troops  which  had  been 
sent  to  defend  Ceuta,  Morocco,  from  the  Moors.  Many 
of  the  sick  soldiers  were  tranferred  to  Malaga,  and  com- 
municated the  contagion  to  the  inhabitants.  The  epi- 
demic, whose  principal  characteristics  were  malignant 
fevers  {tahardillos) ,  lasted  several  months  and  caused 
much  mortality. 

1738.  This  epidemic  is  also  designated  tahardillos,  and 
is  said  to  have  been  engendered  by  the  great  famine  of 
1734,  the  most  cruel  of  the  epoch.  More  than  forty  per- 
sons died  daily.     The  total  mortality  is  not  stated. 

1741.  Although  designated  by  the  name  "plague"  by 
Padre  de  la  Lena,  the  epidemic  of  1741  was  nothing  else 
but  yellow  fever,  the  details  of  wliich  will  be  found  in 
our  relation  of  the  eruptions  of  that  disease  in  Malaga, 

1750-1751.  This  epidemic,  also  characterized  by  the 
name  tabardillos,  caused  6,000  deaths.  Its  origin  is  not 
given. 

According  to  de  la  Lena,  no  pestilential  diseases  were 
observed  in  jMalaga  from  1751  to  1793,  the  year  of  the 
publication  of  his  monograph. 

Diego  Blanco  Salgado,  a  distinguished  Spanish  physi- 
cian, sent  by  the  King  to  study  this  epidemic,  also  wrote 
on  the  subject. 


*  Rodrigo  Enriques  and  Jaun   Serrano  de  Vargas  Ykrena  have 
also  written  histories  of  this  plague. 


580  HISTORY    OF    YELLOW    FEVER. 

Yellow  Fever  Years. 
1741;  1791;  1802;  1803;  1801;  1813;  1820;  1821;  1890. 
Summary  of  Epidemics. 

1741. 

A  French  squadron  coming  from  Martinique  touched 
at  Malaga  in  1741.  Yellow  fever  Avas  prevailing  on  board 
the  vessels,  but  the  commander  concealed  this  fact  from 
the  port  authorities,  and  the  officers  and  crews  had  un- 
interrupted communication  with  the  town.  The  disease 
soon  broke  out  in  Santo-Domingo  street,  in  a  locality 
which  had  been  much  frequented  by  the  French  marines. 
Thence  it  spread  rapidly  through  the  town  and  even  in- 
vaded its  suburbs.  The  epidemic  Ihsted  three  months 
and,  according  to  Barea,^^*  more  than  10,000  persons 
died.  Eubio,  however,  claims  that  only  3,000  died,*  but 
the  majority  of  chroniclers  assert  that  the  figures  given 
by  Barea  are  approximately  correct. 

1791. 

Robert  {Guide  Sanitaire,  vol.  1,  p.  271"),  claims  that 
]\ralaga  suffered  from  yellow  fever  in  1791,  and  that 
10,000  persons  perished.* We  have  looked  through  the  writ- 
ing of  Bally,  Ozanam,  Eager,  Berenger-Feraud  and  old 
Spanish  documents  and  works  on  epidemiology,  but  can 
not  substantiate  this  statement.  Even  Gendrin,  in  his 
elaborate  monograph  on  the  epidemics  of  Spain,  published 

'°*  Barea:   Conversaciones  Malaguenas,  p.  51. 
Rexano:  Chrisis  Epidemica,  1742,  Section  20. 
Cecilio  Garcia  de  la  Lena,  loo.  cit. 

Gendrin:  Journal  General  de  Medecine,  1824,  vol.  88,  p.  293. 
Chervin:  Examen  Critique,  etc.,  1828,  p.  26. 

*  This  historian's  exact  language  is  as  follows: 
"Pericieron,  segun  el  mas  rigcroso  escrutino,  tres  mil  personas, 

pocos  mas  o  memos." — Rubio,  Analysis  Medica,  etc.,  p.  20. 

•  "♦    *    *    Malaga,  qui,  en  1791,  vit  introduire  dans  ses  murs  une 

affreuse  contagion,  et  compta  dix  mille  victimes." 


SPAIN MALAGA.  581 

originally  in  tlie  Journal  General  de  Medicme  for  1824 
(vols.  88  and  89,  pp.  289  and  10,  respectively),  is  silent 
on  the  subject.  A  few  sporadic  cases,  which  escaped  the 
attention  of  other  observers,  probably  occurred;  but  the 
excessive  mortality  mentioned  by  Eobert  as  having  taken 
place  in  1791,  is  undoubtedly  a  chronological  hiatus. 

1802. 
In  1802,  yellow  fever  was  imported  to  Cadiz,  and  thence 
spread  to  other  cities  on  the  south  coast  of  Spain.     A  few 
sporadic  cases  were  observed  in  Malaga.^^^ 

1803. 

The  mild  visitation  of  1802  was  but  a  premonition  of 
the  terrible  epidemic  which  was  destined  to  afflict  Malaga 
the  following  year. 

Likely,  nearly  all  the  disastrous  visitations  of  yellow 
fever  which  desolated  the  southern  cities  of  Spain  during 
the  first  quarter  of  the  last  century,  the  origin  of  the 
Malaga  disorder  of  1803  is  shrouded  in  obscurity.  The 
details  which  follow  are  culled  from  the  most  reliable 
authorities  on  the  subject.^®^ 

'**  Eager,  p.  17;  Berenger-Feraud,  p.  72. 
*°* Summarized  from: 

Guendrin:    Journal  General  de   Medecine,  Pari\  1S24,   vol.   88, 

pp.  289  et  seq. 
Alfonso  da  Maria:    Memoria  Sobre  la  Epidemia  de  Andalusia 

de  1880  al  1819.     Cadiz,  1820,  p.  122. 
Fellowes:   Reports  of  the  Pestilential  'Disorders  of  Andalusia, 

p.  157. 
Mendoza:   Historia  de  las  Epidemias  Padecidas  en  Malaga  en 

los  anes  de  1803  y  1804.    Malaga,  1813. 
Arejula:    Breve   Descrijjcion   de   la  Fiebre   Amarilla   Padecida 

en  Cadiz  y  Pueblcs  Comercanos  en  1800,  en  Medina  Sidonia 

en  1801,  en  Malaga  en  1803,  etc.     Madrid,  1806. 
Eager:   Bulletin  No.  5,  Yellow  Fever  Institute,  p.  17. 
Berenger-Feraud,  p.  73. 
La  Roche,  vol.  1,  p.  536. 

Bancroft:  Essay  on  Yellow  Fever,  pp.  468;  471. 
Bancroft:   Sequal  to  an  Essay  on  Yellow  Fever,  p.  309. 
Keating:    History  of  Yellow  Fever,  p.  81. 
Bally:   Typhus  d'  Amerique,  p.  81. 


582  HISTORY    OF    YELLOW    FCVKR. 

The  Suspected  Carriers  of  Infection. 

The  historians  of  this  epidemic  accuse  the  following 
vessels  of  having  infected  Malaga  in  1803: 

1.  The  Joven  Nicolas,  a  Dutch  store-ship,  sailed  from 
Smyrna  on  the  14th  of  March,  1803,  and  arrived  at  Malaga 
on  the  22nd  of  May,  after  a  passage  of  seventy  days,  and 
having  during  that  period  touched  at  different  ports. 

2.  The  French  brig  Desai^x,  chartered  by  the  French 
Government  to  convey  trooljiis)  tio  St.  Domingo,  sailed 
from  Marseilles  on  the  26th  of  April,  1803,  with  171  men, 
chiefly  deserters,  prisoners  and  convicts.  Almost  the 
whole  of  them  had  been  forced  on  board,  and  were  taken 
from  forts  St.  John  and  St.  Nicolas  (at  Marseilles),  in 
which  the  jail  fever  at  that  time  prevailed.  Fourteen  of 
these  unfortunates  were  convalescents  and  had  lately  been 
discharged  from  the  hospital.  This  vessel  entered  Malaga 
on  the  ITtli  of  INIay,  having  lost  during  the  voyage  thirteen 
men ;  thirty-six  on  board  whilst  under  strict  quarantine 
in  the  bay,  and  three  in  the  fort  of  Gibralfaro,  which  over- 
looks the  town  of  Malaga. 

3.  The  French  brig  VTJnion,  also  chartered  by  the 
French  Government,  sailed  from  Marsaille  on  the  5th  of 
May  of  the  same  year,  with  150  men  of  a  similar  descrip- 
tion, besides  twelve  sailors;  they  had  been  embarked  from 
Fort  St.  Nicholas,  at  Marseilles,  where  the  jail  fever  pre- 
vailed; and  this  vessel  entered  the  harbor  of  Malaga  on 
the  3rd  of  June,  1803.  During  the  passage,  seven  men 
died,  and  eight  on  board  in  the  bay.  Total  deaths,  sixty- 
seven.  This  was  the  French  account,  but  they  lost  many 
more,  who,  as  reported,  had  drowned  themselves  or  de- 
serted. On  the  18th  of  August,  1803,  the  remainder  of 
the  people  were  permitted  to  disembark,  and  they  were 
conveyed  at  night  to  the  Moorish  Castle  of  Gibralfaro. 

On  the  7th  of  September,  1803,  the  two  brigs  were  ad- 
mitted to  pratique, 

4.  The  Spanish  ship  Proridcncia,  belonging  to  ^Nfanes- 
cau  and  Co.,  Malaga,  from  Monte  Video,  and  laden  with 
cocoa,  hides  and  tallow;  she  entered  the  bay  of  Malaga 


SPAIN MALAGA.  58S 

on  the  9th  of  June,  1803,  and  was  admitted  to  pratique 
a  few  days  after  her  arrival. 

The  Celebrated  Case  of  Felix  Munoz. 

It  was  generally  asserted  and  believed  by  Arejula,  that 
the  first  man  who  died  of  the  epidemic  in  Malaga  was 
Felix  Munoz,  a  noted  smuggler.  On  or  about  the  14th  of 
July,  he  was  known  to  have  gone  on  board  the  Joven 
Nicolas,  whence  he  brought  away  samples  of  cotton  and 
tobacco,  and  he  himself  confessed  to  the  physician  who 
attended  him,  that  from  the  moment  he  left  the  ship,  he 
felt  ill. 

In  fact  this  man  on  his  return  home,  took  to  his  bed 
and  died  on  the  fifth  or  sixth  day  of  his  illness. 

This  circumstance  produced  at  the- time  great  constern- 
ation in  Malaga;  immediately  after  his  death,  his  wife 
and  all  his  family  fled  into  the  country  and  did  not  re- 
turn until  late  the  following  year^^  _Hence,  Arejula  con- 
cIuHes  that  as  no  one  entered  the  house,  the  disorder  of 
Ayhich  Munoz  died,  did  not  spread,  and  the  alarm  subsid- 
ing, no  further  nottce  was  taken. 

Prom  this  period  there  was  an  interval  of  thirty-five  or 
thirty-six  days  until  the  sickness  broke  out  in  the  Ver- 
duras  family,  which  is  regarded  as  the  source  of  the 
epidemic. 

As  the  J  oven  Nicolas  came  from  Smyrna,  where  yellow 
fever  has  never  prevailed — as  least,  within  recorded  times 
■ — we  fail  to  see  how  Munoz  could  have  contracted  the 
disease  by  simply  visiting  tlie  ship  in  the  interest  of  his 
nefarious  business.  If  he  died  of  yellow  fever — in  our 
humble  opinion  a  remote  possibility — he  contracted  it 
elsewhere. 

TJie  Real  Origin  of  tJie  Epidemic. 

Out  of  the  mass  of  discussions,  denunciations,  recrimi- 
nations and  dissensions,  Avhich  even  the  courts  failed  to 
untangle,  the  following  facts  are  called: 


584  HISTORY    OF    YELLOW    FEVER. 

The  disorder  which  broke  out  in  Malaga  in  1803,  com- 
menced in  the  house  of  Christopher  Verduras,  living  in 
the  district  of  Perchel,  on  the  west  side  of  the  Guad- 
almedina. 

Verduras  was  a  caulker  by  trade,  but  a  noted  smuggler, 
and  a  person  who  was  likely  from  his  character  to  do  any- 
thing for  gain.  It  was  generally  reported  in  Malaga  that 
this  man  about  the  latter  end  of  August,  had  brought  a 
person  from  one  of  the  vessels  in  the  bay — some  say  it 
was  an  American  vessel,  others  a  Dutch  ship — and  se- 
cretly conveyed  him  to  his  house.  This  person  was  then 
suffering  from  a  disease  of  which  he  soon  after  died.  It 
was  afterwards  discovered  that  the  body  was  buried  pri- 
vately in  the  neighboring  church  of  St.  Peter,  in  the  mid- 
dle of  the  night. 

Arejula  states  that  the  interment  took  place  with  the 
connivance  of  the  curate  of  St.  Peters.  The  priest  was 
himself  taken  ill  and  died  of  the  disease,  together  with 
the  physician  who  attended  him.  These  two  were  sus- 
pected of  having  been  interested  in  the  smuggling  trans- 
actions that  were  going  on  iu'  the  Venduras  household. 
If  such  were  the  case,  retribution  came  unmercifully,  for 
every  person  connected  with  the  curate's  house,  was  taken 
ill  and  died;  even  the  sacristan  and  his  wife,  as  well  as 
the  monagnillo,  or  altar-boy. 

"The  facts  were  well  known  at  the  time,"  says  Arejula, 
"and  it  was  affirmed  by  all  the  inhabitants  of  the  district 
De  Perchel  that  those  who  had  entered  the  Church  of  St. 
Peters  to  hear  mass  on  St.  Michael's  day,  were  taken  ill, 
and  a  great  part  of  the  congregation  died." 

Fellowes  says  that,  on  this  account,  the  people  con- 
ceived so  great  a  horror  of  this  edifice,  that  it  became 
necessary  to  shut  it  up,  and  it  continued  cl'osed  until 
December  18,  1805,  when  Dr.  Arejula,  accompanied  by 
several  physicians  of  INIalaga,  fumigated  it  with  oxygen- 
ated muriatic  acid  and  other  germicides. 

On  the  26th  of  August,  Michael  Verduras,  the  son  of 
Christopher,  was  taken  ill  in  the  same  house,  and  from  the 
report  of  the  physicans  who  attended  him,  there  is  no 


SPAIN MALAGA.  585 

doubt  of  his  having  died  of  yellow  fever.  In  two  or  three 
days  after  Michael  had  fallen  sick,  two  other  men,  friends 
of  his,  and  caulkers  by  trade,  who  worked  with  him,  were 
also  attacked  with  the  fever.  One  of  them  died ;  the  other, 
Lucas  Perez,  recovered. 

Shortly  after  the  death  of  Michael  Verduras,  which 
took  place  on  September  3,  his  mother  and  two  sisters 
sickened  with  the  same  symptoms.  Christopher  Ver- 
duras died  on  the  15th  of  September.  His  daughter  and 
another  son,  Antonio  were  also  attacked  and  died  on 
the  19th. 

Whilst  the  fever  was  running  through  the  Verduras 
family,  Dr.  Del  Pino,  who  had  treated  all  the  members  of 
the  family,  was  called  to  visit  a  young  man,  a  sailor,  19  or 
20  years  of  age,  who  lived  in  a  house  immediately  op- 
posite to  that  of  Verduras,  and  was  the  friend  and  com- 
panion of  Michael,  His  symptoms  were  similar.  About 
the  same  time  Pascual,  a  baker,  who  lived  in  a  house  ad- 
joining to  Verduras,  was  attacked  with  the  disorder,  and 
the  similarity  of  symptoms  was  so  remarkable,  that  Dr. 
Del  Pino  called  a  consultation,  in  which  it  was  deter- 
mined that  a  report  should  immediately  be  made  to  the 
Governor  of  Malaga,  of  a  very  alarming  disease  having 
made  its  appearance,  and  the  two  physicians  accordingly 
declared  that  they  had  seen  several  sick  persons  laboring 
under  some  alarming  symptoms,  such  as  were  unusual 
in  the  place.  The  Governor  received  this  report,  and 
transmitted  it  to  the  Board  of  Health,  but  no  notice  was 
taken  of  the  matter. 

The  disorder,  however,  continued  to  spread  gradually, 
not  only  in  the  narrow  lanes  and  streets  of  the  district 
de  Perchel,  where  Verduras  had  lived,  but  it  afterwards 
extended  to  other  suburbs,  and  to  the  adjoining  districts 
of  the  Trinidad,  Capuchins  and  Alto,  which  are  at  some 
distance  from  the  Perchel.  The  spread  of  the  infection 
to  these  localities  was  said  to  have  been  caused  by  the 
fact  that  many  persons  living  there,  principally  laborers 
and  workmen,  joined  early  in  the  morning  to  liear  mass 
in  the  church  of  the  Corventico  with  those  of  Perchel. 
because  the  services  were  held  earlier  in  that  district. 


386  HISTORY  or  yellow  fever. 

"It  must  be  observed,"  says  Fellowes,  "that  in  Catholic 
countries,  especially  in  Spain,  the  lower  orders  chiefly 
are  very  attentive  to  their  religious  duties,  by  going  early 
to  church  to  hear  mass,  previous  to  their  entering  upon 
the  duties  of  the  day." 

From  this  source,  and  in  this  manner,  the  disorder  was 
undoubtedly  propagated  from  the  suburb  of  Perchel  to 
other  parts  of  the  town. 

Fellowes,  who  made  personal  investigations  concerning 
the  rise  and  progress  of  this  epidemic,  visited  Malaga  in 
March,  1806.  From  the  result  of  his  inquiries  among 
all  the  survivors  of  the  different  families,  it  appeared  that 
the  disorder  spread  on  the  following  order: 

1.  Verduras. 

2.  Pedro  de  Torre. 

3.  Gabriel  Vasquez. 

4.  Blaize  Martin. 

5.  Francisco  Ferrari. 

Martin's  house,  directly  opposite  Verduras,  was  the 
third  attacked,  and  had  eleven  cases,  of  which  five  died. 

Ferrari  lost  his  wife,  two  sons,  a  daughter  and  a 
nephew — all  livin_g  in  the  same  house. 

From  these  foci,  the  pestilence  gradually  advanced,  un- 
til the  entire  city  was  invaded.  Consternatiou  was  now 
general;  terror  multiplied  the  dangers.  Of  the  48,015 
inhabitants  that  ^Malaga  numbered  at  the  begiuning  of  the 
epidemic,  thousands  fled,  soAving  the  seeds  of  pestilence 
througliout  southern  Spain.* 

Tlie  following  statistics,  compiled  by  Guedrin  from  doc- 
uments furnished  by  the  Spanish  Government  at  the  time 
of  his  investigations,  is  taken  from  the  Journal  General 
de  Mrilicinr  for  1824,  (vol.  ^,  p.  308),  and  may  be  con- 
sidered authentic : 


*  Algerzlras,    Alicante,    Antequera,     Barcelona,     Cadiz,    Espera, 

Gibraltar,  La  Rambla,  Montilla  and   Palma  owe   their  in- 
fection in  1803  to  Malaga. 

*  In  his  "Sequel  to  an  Es^ay  on  Yellow  Fever,"  p.  319,  Bancroft 

refers  to  Fellowes'  criticism  of  his  error,  but  makes  no 
explanation. 


SPAIN. MALAGA. 


587 


Tableau  of  the  Malaga  Epidemic  of  1803. 


Population  of  Malasra. 


Males  Females 


Citizens 20.142 

Hospitals 75 

744 


Suburbs. 
On  Ships 

Military ...       |  6.068 
Totals  by  sex  27,029 


24.093 

23 

472 

Unknown 

128 
24.716 


Grand  Totals 


51,745 


No.  who  Fled 


Males, Females  Males  FemaleSiMales  Females 


1.624  I     1,972 

Oj  0 

132  j  2 

Unknown 

I 

C  1  0 


1.756       1.794 
3,730 


'o.  Remain'g  I       CASES 


18.518  '    22.121 

75  '  23 

612  :  470 

Unknown 

6.068  ;  128 


25.273  j     22,742 
48,015 


5,257 
4.864 


5,600 
£63 


Unknown 
Troops  were 
segregated 


261,    6.25t) 
16,517 


DEATHS 


Males  Females 


2,722 

1.379 

60 

04 


2,289 

312 

28 

0 


No  Cases  or 
Deaths 


4.255  I    2,629 
6,884 


From  this  table,  it  will  be  seen  that  out  of  a  population 
of  51,745  souls,  3,730  fled  and  6,196  were  segregated,  leav- 
ing 41,819  exposed  to  the  fury  of  the  pestilence.  Of  this 
remainder,  16,517  (or  2  out  of  55)  contracted  the  disease, 
and  6,884  (or  41  for  every  100)  died. 

The  epidemic  was  officially  declared  extinct  on  Decem- 
ber 20,  having  lasted  two  months  and  twenty  days. 


1804. 


The  epidemic  of  1804  was  still  more  disastrous  than 
that  of  the  previous  year.  Its  origin  is  obscure,  but  as 
no  fresh  importation  could  be  proven,  the  recurrence  of 
the  malady  Avas  no  doubt  due  to  the  renewed  activity  of 
the  St€f/onM/iae  Calopac,  which  had  remained  quiescent 
during  the  winter  and  spring. 

Stegowyiae  Calopae  have  a  habit  of  hiding  in  old  clothes 
hanging  in  closets,  or  hibernating  in  draperies,  curtains, 
etc.,  and  are  capable  of  retaining  the  virus  in  Mieir  system 
for  months.  INfanson  (Tropical  Diseases,  1907,  p.  213), 
says  that  the  usual  period  is  fifty-seven  days,  but  in- 
stances are  of  record  Avliere  mosquitoes  which  had  fed  on 
blood  of  yellow  fever  patients,  survived  for  five  months 
or  more.     In  this  connection,  the  recrudesence  of  the  epi- 


588  HISTORY     OF    YELLOW    FEVER. 

demic  of  Malaga  can  easily  he  explained.  The  first  epi- 
demic ended  Decemher  20,  1<S03.  From  that  date  until 
June  29,  when  the  initial  case  of  the  second  and  greater 
epidemic  erupted,  is  a  trifle  more  than  six  months. 
Sporadic  cases  of  mild  yellow  fever  probably  occurred 
previous  to  June  29,  but  their  mildness  prevented  the  true 
nature  of  the  disease  from  being  recog-nized,  and  it  was 
only  when  the  virulent  manifestations  in  Pozos  Dulces 
street  threw  the  populace  into  consternation,  that  the  real 
situation  was  thoroughly  understood. 

The  historians  of  this  great  epidemic  are  many.  We 
have  summarized  the  following  account  from  the  most 
reliable.i^'^ 

The  first  case  of  unequivocal  yellow  fever  in  Malaga  in 
1S04  erupted  on  June  29,  at  Xo.  12  Pozos  Dulcas  street, 
where  two  natives,  Rinz  and  Ximenes  died.  As  soon  as 
the  news  became  public,  a  wild  panic  ensued  and  the  in- 
habitants, recalling  the  horrors  of  the  preceding  year,  fled 
in  swarms.  On  July  1,  all  but  those  who  were  too  poor 
to  get  away  had  sought  fancied  security  in  flight,  and  in 
their  mad  rush  spread  the  pestilence  broadcast  throughout 
Andalusia. 

Bancroft,  in  his  Essay  on  YcUow  Fever  (p.  468),  falls 
into  a  serious  error  when  speaking  of  the  epidemic  of 
1804.  He  claims  that  it  first  appeared  in  the  Barrio  de 
Perchel,  as  in  1803.  FcJloircs  (page  177)  and  Geudrin 
{Jmimal  de  Medicine.  1824,  vol.  84,  p.  314),  conclusively 
prove  that  the  disease  broke  out  in  Pozos  Dulces  street  in 
1804,  in  an  opposite  part  of  the  town.  This  is  confirmed 
by  Mendoza's  work  on  the  subject  and  other  historians, 
who  declare  that  the  Barrio  de  Perchel,  the  ft)cus  of  the 
disaster  of  1803,  was  not  affected  in  1804  until  the  begin- 

^'"Gendrin,  loc.  cit.,  vol.  88,  p.  312, 
Arejula,  loc.  cit. 
La  Roche,  vol.  1,  p.  536. 
Fellowes,  p.  478. 
Bally,  p.  85. 

Bancroft,  Sequel,  p.  320. 

Medical  Repository  (N.  Y.),  1805,  vol.  8,  p.  430. 
Berenger-Feraud,  p.  76. 


SPAIN MALAGA.  589 

niug  of  September,  more  than  two  months  after  the  first 
deaths  at  No.  12  Pozos  Dulces  street.* 

But  we  have  no  concern  ^^ith  the  polemic  quarrels  of 
the  pros  and  cons  of  contagions  who  spent  the  best  years 
of  their  lives  in  trying  to  prove  each  other  falsifiers  and 
charlatans.  Let  us  return  to  our  mutton.  Between  the 
29th  of  June  and  the  23rd  of  July,  fifteen  fatal  cases  oc- 
curred in  Pqzos  Dulces  street,  in  eight  different  houses, 
but  little  distant  from  each  other.  During  that  interval, 
only  one  fatal  case  had  been  observed  in  the  city  proper, 
and  this  was  in  Los  Marmoles  street,  directly  across  the 
river  from  Pozos  Dulce  street.  Bj  the  end  of  July,  the 
total  mortality  had  reached  129.  In  the  beginning  of 
August  the  fever  appeared  almost  simultaneously  in  many 
parts  of  the  city,  followed  by  a  heavy  mortality,  the 
deaths  being  as  many  as  fifty  a  day.  The  epidemic  then 
seemed  to  subside,  and  by  A'ugust  11,  the  deaths  had  con- 
siderably diminished.  On  the  14th,  the  conditions  had 
so  improved  that  the  physicians-  of  the  place  subscribed 
the  following  opinion  before  a  magistrate,  which  was 
promulgated  throughout  the  city: 

"We,  the  undersigned  physicians,  certify  that  no  epi- 
demical disease  prevails  at  Malaga  at  present.  It  is  a 
sort  of  (ifjiic  or  malignant  fever,  similar  to  that  which 
rages  in  many  other  parts  of  Spain;  and  it  has  of  late 
so  much  subsided,  that  out  of  twenty  people  taken  ill, 
only  five  died ;  whilst,  on  its  first  appearance,  fifteen  died 
out  of  twenty.  We  hope  that  by  the  use  of  gentle  medi- 
cines and  by  taking  the  necessary  precautions  of  fumigat- 
ing the  houses  where  the  disease  has  existed,  it  will  soon 
disappear." 

The  subsidence  of  the  disease  was  but  the  lull  before 
the  storm.  The  proclamation  had  hardly  been  posted, 
than  new  foci  erupted  everywhere,  and  the  death-rate  be- 
came appalling,  1,040  fatalities  being  recorded  for  the 
month  of  August  alone,     i 

The  epidemic  reached  its  greatest  intensity  September 
7,  when  300  deaths  occurred.  The  mortalitT  continued 
to  be  excessive  during  September.  In  October,  the  disease 
slowly  subsided,  finally  becoming  extinct  on  the  28th  of 


590  HISTORY    OF    YKLLOVr    FEVER. 

November,  having  raged  five  months  and  one  day. 

Even  as  late  as  December,  the  afflicted  town  was  like  a 
vast  necropolis.  The  following  account  is  extracted  from 
a  letter  dated  December  3,  1804,  written  by  an  inhabitant 
of  Malaga,  and  published  in  the  New  York  Medical  Re- 
pository,  vol.  8,  1805,  p.  431 : 

''It  is  impossible  to  form  a  just  idea  of  the  aspect  ex- 
hibited by  our  unfortunate  city.  It  resembles  a  desert. 
The  mortality  here  has  in  some  measure  ceased,  it  is  true, 
for  want  of  victims.  Seven  thousand  persons  only  have 
escaped  its  attack ;  twenty-six  thousand  have  fallen  a  sac- 
rifice to  it. 

"The  effects  of  this  great  disaster  are  remarked  in  every, 
thing  that  surrounds  us.  The  grapes  liave  rotted  on  the 
vines  for  want  of  hands  to  gather  them.  On  all  sides  we 
hear  the  cry  of  Bread !  Bread !  The  plague  is  everywhere 
succeeded  by  famine. 

"In  most  parts  where  the  epidemic  has  prevailed,  the 
following  observations  have  been  made :  It  was  less  fatal 
to  females  than  to  males,  and  it  appears  that  it  had  no 
influence  on  old  women,  for  they  continually  assisted  the 
sick  without  being  attacked  by  it.  Persons  of  a  delicate 
constitution  were  also  less  subject  to  its  fatal  effects 
than  those  of  robust  constitution.  In  regard  to  the 
negroes  it  scarcely  produced  any  effect  on  them." 

With  the  exception  of  the  statement  that  26,000  per- 
sons died,  an  exaggeration  which  is  pardonable,  owing  to 
the  desolation  whicli  surrounded  the  writer,  the  above 
letter  may  be  taken  as  a  faithful  pen  picture  of  the 
situation. 

The  Aicesome  Mortality. 

The  total  population  of  :Mala£ra  in  1804  was  44.020,  of 
which  23,100  were  males  and  20,830  of  the  gentler  sex. 
At  the  beginning  of  the  epidemic,  4,548  fled,  leaving 
30.472  exposed  to  the  influence  of  the  pestilence. 

There  were  altogether  18,787  cases,  of  which  8,989  were 
men,  and  9,798  women.  Of  this  number,  7,476  men  and 
4,010  women  perished,  a  total  mortality  of  11,486. 


SPAIN MALAGA. 


591 


Twenty  doctors  and  nine  pharmacists  died.  At  one 
time,  there  was  only  one  physician  in  the  entire  city  able 
to  minister  to  the  sick,  the  others  being  either  dead  or 
sick  with  the  fever.  The  practitioner  who  escaped  an 
attack  had  had  yellow  fever  in  1803. 

If  the  reader  has  attentively  followed  the  dismal  history 
of  the  epidemics  which  devastated  Malaga,  he  will  no 
donbt  be  strnck  by  the  difference  in  population  between 
the  years  of  1803  and  1801.  This  is  readily  accounted  for 
by  the  fact,  that  on  December  20,  1803,  the  population 
had  been  diminished  by  6,881,  and  that  deaths  from  va- 
rious causes  must  have  caused  a  still  greater  decrease  up 
to  July  1,  1801.  It  is  obvious  that  six  months  and  ten 
days  is  too  short  a  period  to  permit  any  material  increase 
under  the  fundamental  laws  of  Nature. 

Comparative  Mortality  heticecn  1803  and  1801. 

The  difference  in  the  mortality  according  to  age  and 
sex  during  the  sinister  epidemics  of  1803  and  1804,  is  thus 
given  by  Gendrin  (loc.  cit.,  vol.  88,  p.  321)  :     • 


1S03. 

1804. 

Males 

Females 

Total 

Males 

Females 

Total 

Urrlpr  '0  years  

3=i5 
422 

2  « 

348 

641 

77<» 

.^86 
7^9 

461 

711 

1,007 

Bet.  11  and  20  years... 

4  SO 

"     21     '•    30        "   .... 

?09 

431 

940 

95S 

757 

1  715 

"     31     "    4n        "  ... 

183 

407 

S90 

708 

657 

1.3fi5 

•  (     41      <i    50         " 

411 

3  0 

227 

518 

404 

9il 

"     51      ••     60 

•257 

198 

4 '5 

314 

2o« 

^70 

"     61      "    70 

125 

114 

•210 

187 

152 

339 

"     71      "    80 

ss 

44 

1"7 

1<4 

90 

194 

"     81      "    9r> 

16 

32 

3S 

48 

26 

74 

"     91     "  100 

8 

7 

15 

17 

13 

HO 

4  2ftf> 

2,fii» 

6.8«4 

7  470 

4.<Ut' 

11.486 

It  will  be  seen  from  the  above  resume  that  the  mortality 
was  abnormally  great  among  young  persons,  2,351  under 
30  years  of  age  being  carried  away  in  1803,  and  4,202  in 
1804. 


592  HISTORY    OF    YELLOW    FEVER. 

1813. 

In  1813,  a  ship  from  Gibraltar,  where  yellow  fever  was 
prevailin*2:,  brought  malady  to  the  port  of  Malaga,  in- 
fecting all  those  who  had  any  communication  with  it. 
Being  on  the  alert,  the  disease  was  at  once  recognized  by 
the  Superior  Board  of  Health,  and  energetic  measures 
instituted.  All  the  sick  were  transported  to  the  lazaretto, 
and  the  houses  they  occupied  were  closed  and  guarded. 
A  mortality  of  twenty-seven  is  recorded.^*"^ 

1820. 

In  1820  a  family  affected  with  yellow  fever,  left  Xeres 
de  la  Frontera  and  came  to  Malaga.  The  nature  of  their 
illness  was  at  once  discovered  by  the  authorities,  and 
they  were  removed  to  the  lazaretto,  together  with  all 
those  who  had  communicated  with  them.  There  was  no 
extension  of  the  disease.^^® 

1821. 

The  appalling  epidemics  of  1803  and  1801  seem  to  have 
exhausted  the  non-immune  material  in  Malaga,  for  though 
we  read  of  yellow  fever  having  been  observed  at  Cadiz  in 
1807  and  1808,  and  nearly  every  year  from  1811  to  1821, 
as  well  as  in  seventeen  cities  and  towns  of  Andalusia  in 
1811,  Melaga  kept  the  yellow  pestilence  away  from  its 
doors  for  sixteen  years.  In  1821,  however,  much  appre- 
hension was  felt  for  the  safety  of  the  city,  the  disease  hav- 
ing l)een   introduced  under  the  following  conditions:^"* 

Between  June  7  and  22,  1821,  twelve  ships  forming 
part  of  a  convoy  which  had  sailed  from  Havana  April  28, 
eutered  the  port  of  ]\ralaga.  There  was  much  sickness  on 
board  these  vessels  during  the  voyage  across  the  Atlantic, 
especially  on  board  the  San  Antonio  and  the  JAheral,  the 

"'Gendrin,  loc.  cit,  vol.  88,  p.  328. 
""Gendrin,  loc.  clt.,  vol.  88,  p.  328. 

"'Gendrin,  loc.  cit.,  vol.  89,  p.  10;   Bally,  Francois  and  Pariset, 
p.  112. 


SPAIN MALAGA.  593 

latter  having  lost  her  captain  at  sea.  The  frigate  Lib- 
ertad,  which  formed  part  of  the  convoy,  was  accused  of 
having  sent  some  sick  sailors  and  a  few  cases  of  mer- 
chandise on  shore.  All  these  vessels  carried  suspicious 
clearance  papers,  but  they  were,  nevertheless,  admitted 
to  pratique  after  only  a  short  quarantine.  Some  were 
admitted  even  without  going  through  this  formality. 

The  Danish  schooner  Initium,  from  Barcelona,  which 
arrived  at  Malaga  on  August  1,  is  the  only  vessel  directly 
accused  of  having  infected  the  port.  During  the  six  days 
the  vessel  took  to  make  the  voyage  from  Barcelona,  out 
of  a  crew  of  six  and  one  passenger,  four  cases  of  yellow 
fever,  of  which  one  proved  fatal,  had  occurred  on  board. 
On  arrival,  the  three  cases  were  transported  to  the  laz- 
aretto of  Los  Angeles,  on  the  outskirts  of  the  city,  where 
two  died.  In  spite  of  its  flagrant  unsanitary  condition, 
the  Initium  was  given  free  pratique  on  August  11.  Two 
Swedish  sailors,  who  went  on  board  that  day,  were 
stricken  shortly  afterward  and  sent  to  the  lazaretto,  where 
they  died.  This  last  incident  was  not  made  known  to  the 
board  of  health. 

Rumors  began  to  circulate  that  a  strange  malady  was 
causing  much  mortality  among  the  vessels  in  port.  On 
August  21  and  22,  a  delegation  from  the  Superior  Board 
of  Health  began  an  investigation  and  discovered  that  five 
vessels,  moored  on  both  sides  of  the  Initium,  had  had  sus- 
picious cases  of  fever.  While  the  committee  was  urging 
immediate  measures  and  the  board  of  health  was  demur- 
ring, the  Danish  consul  appeared  on  the  scene  and  re- 
ported that  two  undoubted  cases  of  yellow  fever  were  at 
that  moment  on  board  another  ship  of  his  nation,  and 
requesting  that  "something  be  done"  in  tho  premises. 
This  spurred  the  nonchalant  members  of  the  board  of 
health  into  action,  and  they  went  to  extremes.  All  ves- 
sels, whether  infected  or  not,  were  ordered  to  quarantine, 
the  port  was  closed  and  communication  between  the  Mal- 
aganese  and  "any  vessel  in  port"  positively  prohibited. 
The  authorities  even  went  so  far  as  to  send  to  the  laz- 
aretto an  entire  family,  at  whose  house  one  of  the  sailors 
of  the  Initium  had  taken  lodgings.     Although  not  a  single 


594  HISTORY    OF    YELLOW    FEVER. 

case  had  developed  in  this  house,  it  was  hernietically 
closed. 

This  sudden  frenzy  of  precautionary  measures  threw 
the  population  of  Malaga  into  consternation.  They  im- 
agined the  pestilence  already  in  their  midst,  and  an  in- 
describable terror  took  possession  of  them.  Thousands 
fled,  abandoning  relatives  and  business,  and  seeking 
refuge  wherever  they  could.  The  exodus  is  said  to  have 
been  more  considerable  than  during  the  the  epidemics  of 
1803  and  1804.  After  a  few  days,  the  public  health  con- 
tinuing good,  calm  was  restored  and  the  majority  of  those 
who  had  fled  returned. 

In  the  beginning  of  September,  it  being  the  season  when 
the  produce  of  the  surrounding  country  finds  its  way  into 
the  markets  of  the  town,  nothing  untoward  having  taken 
place  in  the  status  of  the  public  health,  the  port  was 
re-opened  to  facilitate  the  handling  of  the  increasing  com- 
merce, and  the  segregated  vessels  again  permitted  to  an- 
chor at  the  wharves.  Quarantine  regulations  were  re- 
laxed and  uninterrupted  communication  had  with  the 
nondescript  craft  in  the  harlior. 

It  was  this  lack  of  precaution  which  paved  the  way  for 
the  entrance  of  the  pestilence  into  the  city. 

How  the  fever  finally  invaded  the  town,  is  difficult  to 
surmise  from  the  publications  of  the  period.  It  may  be 
that  the  infection  was  diffused  by  persons  communicat- 
ing with  the  Initium,  for  the  first  cases  were  observed  in 
the  districts  of  Alcazaba  and  Alcazabilla,  inhabited  prin- 
cipally by  sailors  and  the  poorer  classes.  The  brig 
fiouveroin  Congres,  which  arrived  from  Havana  in  Au- 
gust, with  an  unclean  bill  of  health,  and  which  had  suf- 
fered from  yellow  fever  during  the  voyage,  is  also  in- 
criminated. It  is  said  that  the  captain  of  this  vessel  and 
his  crew  came  ashore  as  soon  as  the  vessel  was  released 
from  quarantine,  and  that  the  captain's  family,  residing 
in  Alcazabilla,  were  first  to  contract  the  malady. 

By  whatever  means  the  disease  was  introduced,  the 
first  case  presentimr  unmistakable  symptoms  of  yellow 
fever  manifested  itself  on  September  6,  in  the  son  of  Jose 
Rodriguez,  a  caulker,  residing  in  the  Alcazaba  district, 


SPAIN MALAGA.  595 

whose  parent  had  been  employed  on  one  of  the  vessels 
in  port.  The  boy,  aged  11,  died  on  the  9th,  but  the  father, 
taken  ill  almost  simultaneously,  recovered.  The  histo- 
rians of  this  epidemic  accuse  the  elder  Rodriguez  of  hav- 
ing brought  the  infection  ashore,  but  as  he  was  taken  ill 
after  his  son,  such  a  contention  certainly  secmiS  absurd 
in  this  age  of  known  mosquito  transmission  of  the  dis- 
ease. Personal  contact  and  fomites  were  then  held  re- 
sponsible for  the  spread  of  yellow  fever;  but  now,  things 
are  different.  How  the  little  fellow  contracted  the  mal- 
ady, is  a  problem  which  cannot  be  satisfactorily  solved 
at  this  late  day,  unless  Ave  take  it  for  granted  that,  like 
all  children  of  his  age,  he  played  about  the  streets  in  his 
neighborhood,  already  infected  by  persons  from  the  ships 
in  the  harbor,  and  was  bitten  by  Calopae,  with  the  sad 
result  above  narrated. 

On  September  12,  three  days  after  the  death  of  young 
Rodriguez,  a  doctor  reported  that  he  had  seen  in  Cober- 
tizo  del  Corte  street  a  suspicious  case  of  illness,  followed 
by  death  on  the  fourth  day.  This  patient  had  come  from 
the  Alcazaba  district.  The  health  authorities  started  an 
immediate  investigation  and  declared  that  the  man  had 
died  of  a  "suspicious  contagious  disease,"  and  quarantined 
the  house  where  he  had  passed  away.  ;  They  went  fur- 
ther and  quarantined  the  residence  of  the  governor  of 
Alcazaba,  whence  the  suspicious  case  originally  came, 
and  caused  the  official's  family  to  be  forthwith  transported 
to  the  lazaretto.  The  governor,  who  was  ill,  died  on  the 
26th.  The  authorities  ordered  that  his  house  be  hermet- 
ically closed  and  guarded,  although  it  was  plain  to  every- 
body that  the  poor  man  had  not  died  of  yellow  fever,  but 
of  an  ailment  totally  foreign  to  that  disease. 

The  public,  already  on  the  qui  vive,  were  thrown  into 
indescribable  consternation  by  these  rigorous  measures. 
The  terror  became  so  great,  that  the  inhabitants  fled  in 
multitudes,  some  even  running  through  the  streets  and 
seeking  refuge  in  the  country,  as  if  an  invading  army  were 
pursuing  them. 

On  September  27,  in  the  middle  of  the  night,  the  physi- 
cians of  Malaga  were  called  together  by  order  of  the 


596  HISTORY    OF    YELLOW     FEVER. 

Superior  Board  of  Health,  to  arrive  at  some  decision,  as 
to  the  real  character  of  the  malady  which  was  creating 
so  much  alarm.  After  considerable  wrangling,  a  mani- 
festo was  issued  to  the  public,  of  which  the  following 
is  the  gist: 

"The  undersigned  physicians  and  surgeons  declare  that 
the  general  state  of  the  public  health  is  good ;  but,  in  par- 
ticular instances,  cases  of  a  malignant  malady  present- 
ing the  symptoms  of  yellow  fever,  have  been  observed. 
There  actually  exists  three  such  cases,  against  which 
common  prudence  and  a  regard  for  the  public  health  de- 
mand that  measures  of  non-communication  be  adopted."* 

This  was  signed  by  thirty  of  the  most  prominent  physi- 
cians of  Malaga. 

On  September  27,  Dr.  Mendoza  (whose  elaborate  work 
on  this  and  other  epidemics  of  Malaga,  are  regarded  as 
authorities),  suggested  that  the  district  of  Alcazaba, 
where  the  disease  was  concentrated,  be  isolated,  arguing 
that  this  would  be  an  easy  matter,  as  the  infected  quarter 
Avas  connected  with  the  city  proper  by  two  gates  only. 
Dissensions  among  the  members  of  the  Superior  Board  of 
Health  as  to  the  propriety  of  such  a  measure  prevented 
same  from  being  adopted,  and  many  inhabitants  of  Al- 
cazaba, fearing  to  be  cooped  up  at  any  moment  within 
the  ancient  Moorish  citadel,  fled  to  various  parts  of  the 
city  and  thus  spread  the  infection. 

Whether  the  Calopae  were  unusually  inactive  in  Malaga 
in  1821,  or  causes  which  cannot  be  explained  intervened, 
the  disease  did  not  spread  rapidly  nor  does  it  appear  to 
liave  been  very  deadly.  Cases  continued  to  crop  out  here 
and  there  during  October  and  November,  and  by  the  end 
of  the  latter  month,  cold  weather  put  an  end  to  the  activ- 
ities of  the  few  straggling  Calopae,  and  the  epidemic  was 
at  an  end.  On  December  2,  Malaga  was  officially  de- 
clared free  from  fever,  and  all  quarantines  raised. 


SPAIN MALAGA.  597 

The  number  of  cases  is  not  given,  but  the  mortality  was 
as  follows: 

Sex. 

Month.                   Males.       Females.  Total. 

August 5                0  5 

September 17                3  20 

October 56              33  89 

November 67              39  106 

December 15                7  22 

Totals 160  82  242 

In  the  above  table  are  comprised  deaths  in  the  city 
proper,  in  the  shipping  and  at  the  lazaretto. 

1890. 

The  Case  of  the  Herman  Cortes. 

Malaga  narrowly  escaped  an  invasion  of  yellow  fever 
in  1890.     The  circumstances  were  as  follows  :^^^ 

The  steamship  Herman  Cortes  sailed  from  Havana 
April  28,  1890,  and  anchored  at  Malaga  May  20.  In  ac- 
cordance with  an  old  custom,  the  boys  of  the  musical 
band  from  the  Asylum  San  Bartolome,  boarded  the  ship, 
entertained  the  passengers  and  spent  several  hours  "feast- 
ing and  making  merry."  On  May  23,  the  ship  departed 
for  Barcelona. 

On  May  25,  one  of  the  boys  was  taken  sick  with  yellow 
fever  and  died  four  days  later.  On  June  1,  a  second  be- 
came ill  and  died  on  the  3rd.  A  third  was  attacked  on 
the  11th  and  died  twenty  hours  later.  On  the  15th  and 
16th,  two  more  cases  appeared;  both  recovered. 

According  to  the  authorities  cited,  these  are  all  the 
cases  that  occurred  at  Malaga.  The  Herman  Cortes  came 
fromi  New  Orleans  via  Havana,  laden  with  cotton,  etc. 
Most  of  the  cargo  was  unloaded  at  Malaga  and  stored  in 


"'Caro:  Boletin  de  Medecine  Naval,  Madrid,  1890,  vol.  13,  p.  190. 
Ibid:  Independencia  Medico,  Barcelona,  1889-90,  vol.  21,  p.  461. 
U.  S.  Public  Health  Reports,  1891,  vol,  5,  pp.  286;  299. 


598  HISTORY    OF    YELLOW    FETER. 

factories  and  other  establishments  in  the  town,  but  no  ill 
effects  resulted.  There  was  no  yellow  fever  in  New  Or- 
leans in  1890.  There  had  been  yellow  fever  in  Havana 
up  to  three  days  prior  to  the  arrival  of  the  ship,  but  no 
cases  occurred  on  board  of  the  vessel  either  before  ar- 
riving at  Malaga  or  after  leaving  that  port. 

Infected  mosquitoes  were  undoubtedly  taken  on  board 
with  the  cargo  at  Havana,  and  the  weather  being  still  too 
cool  for  them  to  venture  in  the  open,  they  remained  in 
the  hold  until  Malaga  was  reached,  when  the  opening  of 
the  hatches  gave  them  an  opportunity  to  sally  forth  and 
feed  on  the  unfortunate  orphans  who  had  come  on  board 
to  welcome  their  friends.  It  is  a  noteworthy  fact  that  all 
the  boys  affected  had  been  among  the  number  who  visited 
the  ship.  It  is  also  worthy  of  note  that  all  the  boys  were 
not  affected,  and  that  the  passengers  and  crew  of  the 
Herman  Co7'tes  escaped  contamination.  This  is  one  of 
the  extraordinary  freaks  of  Nature  which  no  human  in- 
genuity can  solve,  and  which  conjecture  only  renders  more 
mysterious  and  inexplicable. 

Summary. 

First  case,  May  25 ;  first  death.  May  29 ;  last  case,  June 
16 ;  last  death,  June  12.  Total  cases,  5,  of  which  3  proved 
fatal. 

MALGRAT. 

1821. 

MalgTat,  thirty-seven  miles  northeast  of  Barcelona,  was 
infected  by  persons  fleeing  from  the  latter  city  in  1821.-^'^^ 
There  was  no  diffusion  of  the  disease. 


"=  Corn'lliac:  Recherches  Chronologiques,  suir  I'Origin  et  la 
Propagation  de  la  Fievre  Jaune,  etc.,  Fort-de-France,  1886, 
p.  408. 


SPAIN.  59!) 

MAZAREON. 

1804. 

Mazarron,  twenty  miles  west  of  Cartagena,  was  infected 
by  fugitives  from  that  city  in  1804.Tlie  disease  was  con- 
fined to  the  imported  cases. 

MEDINA-SIDONIA. 

Yellow  Fever  Years. 

1800;  1801;  1802;  1811;  1813. 

Summary  of  Epidemics. 

1800. 

Previous  to  1800,  yellow  fever  had  never  been  observed 
in  Medina-Sidonia.  Fugitives  from  Cadiz  infected  the 
town  that  year,  but  the  disease  was  not  extensive,  being 
confined  solely  to  the  imported  cases.  This  was  fortunate 
for  tlie  inhabitants  of  Medina-Sidonia,  for  out  of  51  cases 
reported  by  the  health  authorities,  46  ended  fatally.^"^^ 

1801. 

As  no  importation  can  be  traced  regarding  the  epidemic 
of  1801,  it  is  natural  to  lay  the  blame  to  a  revival  of  per- 
nicious activity  on  the  part  of  the  Stegomijiae  Calopae, 
infected  the  year  previous. 

The  historians  of  this  epidemic  claim  that  the  infection 
was  due  to  the  opening  of  a  house  where  fugitives  from 
Cadiz  had  died  in  1800,  and  which  had  remained  closed 
until  the  middle  of  1801.  Viewed  in  the  light  of  1909, 
this  statement  serves  to  strengthen  the  mosquito  theory. 

"'  Periodico   de   la   Sociedad  Medico-Qurirgica   de   Cadiz,   vol.   3 
(Appendix),  p.  49. 
(La  Roche,  p.  534,  quoting  Alfonso  da  Maria,  p.  123,  says  that 
the  deaths  were  136.) 


600  HISTORY    OF    YELLOW    FEVER. 

The  first  case  erupted  on  August  3,  followed  by  death 
on  the  6th.  The  father  of  this  case,  taken  ill  on  the  5th, 
died  on  the  9th.  Another  person  in  the  same  house  waa 
attacked  on  the  29th,  and  died  September  2.  The  malady 
then  spread  rapidly  and  was  especially  severe  in  San 
Francisco,  Loba,  Santa  Catalina,  Cigarra  and  Sucia 
Streets.  The  epidemic  came  to  an  end  on  November  6, 
resulting  in  821  fatalities.^"* 

1802. 

A  few  cases  of  yellow  fever  were  observed  at  Medina- 
Sidonia  in  1802.     No  reliable  details  are  obtainable.^'^ 

1811. 

Cadiz  infected  INledina-Sidonia  in  1811.  Only  a  few 
cases  were  observed.^"®  I 

1813. 

Sporadic  cases  appeared  in  1813.  The  invasion  does 
not  seem  to  have  been  extensive. ^^'^ 

MEQUINENZA. 

1821. 

Mequinenza,  a  small  town  on  the  Ebro,  was  only  invaded 
once  by  yellow  fever,  under  the  following  conditions  -.^"^^ 

"*  Rally,  p.  76. 

Robert,  vol.  1,  p.  272. 

Pariset,  pp.  95;  96. 

Chervin:   Examen  Critique,  p.  80. 

Bancroft:    Essay  on  Yellow  Fever,  p.  462    (note.) 

Bancroft:  Sequel,  p.  309.  • 
"' Moreau  de  Jonnes:   Monographie  Historique,  etc.,  p.  341. 
""  Berenger-Feraud,  p.  84. 
'"  Berenger-Feraud,  pp.  85;  86. 
'"Bally,  Francois  and  Pariset,  p.  61. 

Robert,  Guide  Sanitaire,  vol.  1,  p.  272. 

O'Halloran,  p.  45. 


SPAIN.  601 

In  August,  1821,  a  boat  left  Tortosa,  where  yellow  fever 
was  epidemic,  and  reached  Mequinenza  on  the  28th  of 
the  same  month.  One  of  the  passengers,  on  reaching 
Mequinenza,  was  taken  ill  and  was  transported  to  his 
home  in  the  town,  where  he  died  of  yellow  fever  on  the 
30th.  Of  nine  persons  who  composed  his  family,  seven 
contracted  the  disease  and  died.  The  malady  spread  to 
the  inhabitants  and  caused  much  mortality. 

MIJAS. 

1804. 

Mijas,  fifteen  miles  southwest  of  Malaga,  was  infected 
by  fugitives  from  that  city  in  1804.  The  disease  did  not 
spread  to  the  inhabitants.^'^^ 

MONTE    ALEGRE. 

1821. 

A  family  consisting  of  father,  mother  and  two  children, 
fleeing  from  Barcelona,  arrived  at  Monte  Alegre,  October 
30,  1821.  The  father,  taken  ill  on  his  arrival,  died  on 
November  3 ;  the  mother  followed  on  the  21st.  One  of  the 
children  was  also  affected;  the  other  escaped  an  attack. 
The  disease  did  not  spread  beyond  these  cases.* 

MONTEJUGUE. 

1800. 

Refugees  from  infected  localities  contaminated  Monte- 
jugue  in  1800.  The  disease  did  not  spread  to  the  in- 
habitants.^^^ 


"'Salamanca:    Observaciones  Medica  sobre  la  Fiebre  Amarilla, 

etc..  Malaga,  1804,  p.  5. 
*  Bally  Francois  and  Pariset,  p.  99. 
'^"Rougeau,  loc.  cit. 


00s  HISTORY    OF    YELLOW    FEVER. 

MONTILLA. 

1803. 

A  few  cases  of  yellow  fever,  refugees  from  Malaga  and 
other  infected  points,  were  observed  in  Montilla  in  1803. 
The  inhabitants  escaped  the  infection.^^^ 

1804. 

In  1804,  Montilla  had  a  population  of  4,000.*  It  was 
contaminated  in  the  following  manner  :^^^ 

A  monk  Avho  had  recently  arrived  from  Malaga, 
was  taken  sick  at  Montilla,  August  11,  and  died  in  five 
days.  Other  cases  followed  that  of  the  padre.  The  houses 
where  the  deaths  had  occurred  were  closed  and  all  persons 
having  contact  with  the  cases  were  isolated.  September  4, 
another  monk,  a  fugitive  from  Malaga,  was  attacked  with 
yellow  fever  and  died  in  a  few  days.  A  muleteer  return- 
ing from  Malaga  fell  victim  to  the  same  fate.  From  these 
foci,  the  disease  extended  to  a  large  portion  of  the  com- 
munity, but  owing,  it  appears,  to  the  energy  of  the  san- 
itary authorities,  did  not  work  such  havoc  as  elsewhere. 
December  15,  the  city  was  declared  free  from  yellow  fever. 

The  mortality  was  as  follows :  Males,  616 ;  females,  451 ; 
a  total  of  1,067'. 


"*  Berenger-Feraud,  p.  74. 

*  Chervin   (Examen  Critique,  p.  5)   says  that  the  population  of 
Montilla  in    1804   was    14,000,   and  not   4,000;    but   as   the 
majority  of  chroniclers   place   the  number    at    4,000    and 
taking  into  consideration  the  fact  that  the  present  popula- 
tion of  Montilla  is  only  15,000,  we  incline  to  the  belief  that 
Chervin  was  misinformed. 
»=  Eager,  p.  20. 
Fellowes,  p.  478. 
Bally,  p.  90 

CheTvin,  Examen  Critique,  p.  5. 
Pariset,  p.  86. 
Jackson,  p.  22. 


( 


SPAIN.  60S 

MORA. 

1821. 

In  1821,  an  inhabitant  of  Mora,  a  toT\Ti  on  the  Ebro, 
30  miles  west  of  Tarragona,  communicated  with  Tortosa, 
where  yellow  fever  was  prevailing. He  was  taken  ill  with 
the  disease  on  his  return  home  and  died  in  a  few  days. 
The  infection  did  not  spread,  being  confined  to  this  sol- 
itary case.* 

MOEON  DE  LA  FRONTERA. 

Moron  de  la  Frontera,  32  miles  from  Seville,  was  visited 
twice  by  yellow  fever  and,  in  each  instance,  the  mortality 
was  heavy. 

1800. 

The  great  epidemic  wave  of  yellow  fever  which  passed 
over  Spain  in  1800,  also  reached  Moron  de  la  Frontera. 
A  mortality  of  1,854  is  recorded.^^^ 

1804. 

In  1804,  the  first  case  in  Moron  de  la  Frontera  was  ob- 
served September  15.  The  epidemic  lasted  until  Decem- 
ber 12.  Out  of  a  population  of  11,000,  there  were  2,000 
deaths.     Of  these,  1,300  were  men  and  700  women.^^* 

MURCIA. 

1804. 

The  ancient  Moorish  city  of  ^Murcia,  30  miles  northwest 
of  Cartagena,  was  infected  by  fugitives  from  the  latter 
place  in  1804.     There  was  no  diffusion  of  the  disease.^^^ 

*  Rapport  III  a  1'  Academie  Royale  de  Medecine  de  Paris  (Paris, 

1828),  p.  86. 
"*  Alfonso  da  Maria,  p.  122;   La  Roche,  vol.  1,  p.  534. 
'"Fellowes,  p.  478;  Bally,  p.  90. 
"^  Bally,  p.  90. 


604  HISTORY    OK    YELLOW    FEVER. 

1810. 

Sporadic  cases  were  observed  in  1810.  The  inhabitants 
did  not  sufifer.* 

1811. 

Cases  were  also  imiported  into  Murcia  in  1811.  There 
was  no  spread  of  the  malady.^^^ 

1812. 

A  few  sporadic  cases,  fugitives  from  infected  localities. 

NONASPE. 

1821. 

Fugitives  brought  yellow  fever  to  Nonaspe  in  1821. 
There  was  no  spread  of  the  disease.^^^ 

OJOS. 

1821. 

During  the  series  of  epidemics  of  yellow  fever  in  Spain 
from  1800  to  1821,  sporadic  cases,  all  refugees,  were  ob- 
served at  Ojos.  The  chroniclers  of  the  period  do  not 
specify  the  vear. 

OLIVERA.  : 

1800. 

A  few  cases  of  yellow  fever  found  their  way  into  Olivera 
in  1800,  but  the  infection  did  not  spread  to  the  in- 
habitants.^^^ 


*  Bonneau  and  Sulpicy,  p.  363. 

'**  Berenger-Feraud,  p.  84;   Bally,  Francois  and  Pariset,  p.  559. 
"'  Bally,  Francois  and  Pariset,  p.  62. 
"*  Rougeau,  loc.  cit. 


SPAIN.  605 

OLOT. 

1821. 

A  mattress-maker  residing  at  Olot,*  who  made  dally 
trips  to  Barcelona  in  the  interest  of  his  business,  was 
taken  ill  on  his  return  home,  on  October  26,  1821,  and 
expired  shortly  afterwards.  His  son,  who  ministered  to 
him  during  his  illness,  Avas  not  affected.  The  man's  house 
was  rigidl}'  quarantined  and  no  other  case  resulted. ■'^*^''* 

PALMA. 

(See  Balearic  Islands). 

PALMAl?. 

Refugees  died  at  Palmar  during  the  series  of  yellow 
fever  epidemics  in  Spain  in  the  beginning  of  the  last 
century,  but  the  exact  date  is  not  given  by  our  authority. -^^^ 

PASAJES. 

1823. 

In  1823,  yellow  fever  was  introduced  into  Pasajes  (also 
known  as  El  Pasajes  and  Port  du  Passage)  under  the 
following  conditions  :^^^ 


*  Chervin,  Pariset,  BerengernFeraud  and  other  chroniclers  call 
this   place   "Xlot,"   instead  of  "Olot."     On  a  map   of  the 
environs  of  Barcelona,  the  locality  is  designated  as  "Olot." 
"'Pariset:   Histoire  Medicale  de  la  Fievre  Jaune,  etc.,  p.  86.. 
Chervin:  Examen  des  Principes  de  I'Administration  en  Matiere 
Sanitaire,  p.  51. 
""  Second  Report  on  Quarantine,  p.  209. 

'"Audouard:    Revue   Medicale   Francaise   et   Etrangere    (Paris), 
1824,  vol.  3,  p.  224. 
Jourdain:    Journal  General  de  Medecine,  1824,  vol.  86,  p.  176. 
iMontes:   Decadas  de  Med.  y  Cirug.  Pract.  (Madrid),  1827,  vol. 

14,  p.  321. 
Boisseau:  Physiological  Pyretology.    Philadelphia,  1832,  p.  335. 
Berenger-Feraud,  p.  101. 


606  HISTORy    OF    YELLOW    FEVER. 

The  ship  Donastiera,  sailed  from  Havana,  where  yellow 
fever  was  prevailing,  at  the  end  of  J^une,  1823,  with  a 
crew  of  fifteen  and  live  passengers.  The  vessel  had  pre- 
viously been  engaged  in  the  slave  trade  between  Africa 
and  Havana. 

Ten  days  after  leaving  Havana,  one  of  the  crew  died, 
the  symptoms  being  ''of  a  suspicous  nature.''  The  vessel 
reached  Corunna,  Spain,  thirty-five  days  after  her  de- 
parture from  Havana,  and  was  subjected  to  ten  days' 
quarantine,  after  which  it  left  for  Santander,  where  it 
remained  six  days,  finally  reaching  Pasajes  on  August  2. 
No  quarantine  was  interposed.  The  crew  was  discharged 
and  the  cargo  disembarked  betAveen  the  6th  and  10th, 
and  stored  in  warehouses  in  the  burgs  of  Saint-Jean  and 
Saint-Pierre,  which  together  form  the  town  of  Pasejes. 
The  population  was  then,  3,200  of  which  2,000  were  at 
Saint-Jean  and  1,200  at  Saint-Pierre. 

On  August  15,  nine  days  after  the  Opening  of  the 
hatches,  a  customhouse  employe  who  had  been  stationed 
on  board  the  Donastiera  was  taken  ill  and  died  on  the 
17th,  with  symptoms  of  yellow  fever. 

On  August  20,  a  carpenter  who  had  been  employed  in 
making  repairs  to  the  vessel,  was  attacked  and  died  on 
the  22nd.  From  the  last  date  until  September  1,  six 
workmen  engaged  in  removing  rotten  timbers  from  the 
hold  of  the  vessel,  and  a  huckster  and  two  boatmen  who 
had  gone  on  board,  were  successively  taken  ill  and  died, 
making  a  total  of  eleven  deaths  in  two  weeks.  The  char- 
acteristic symptoms  of  yellow  fever  and  the  appearance 
of  black  vomit  in  nearly  all  the  cases,  left  no  doubt  as  to 
the  true  character  of  the  disease. 

Pasejas  is  situated  on  the  Bay  of  Biscay,  near  the 
Frencli  frontier,  and  yellow  fever  had  never  been  observed 
there  before.  When  the  real  state  of  affairs  became  pub- 
lic, the  population  recalling  the  horrors  of  the  Barcelona 
epidemic  of  1812,  were  thrown  into  consternation  border- 
ing on  terror,  and  by  September  5th,  1,620  had  fled  pell- 
mell  wlierever  the.v  could. 

On  September  12,  a  strict  military  sanitary  cordon  was 
established  around  the  infected  localities,  but  in  spite  of 


SPAIN.  607 

these  precautions,  the  disease  continued  to  spread.  On 
September  16,  yielding  to  popular  clamor,  the  Donastiera 
was  burned  to  the  water's  edge  and  her  cargo,  which  had 
been  stored  in  warehouses  in  the  town,  guarded  by  the 
military. 

The  last  case  erupted  September  25,  but  the  sanitary 
cordon  was  not  removed  until  October  23,  when  the  in- 
habitants were  permitted  to  return  to  their  homes.  But 
the  goods  from  the  Donasteria,  which  had  been  sequestered 
shortly  after  the  outbreak  of  the  epidemic,  Avere  not  al- 
lowed to  be  placed  on  sale  until  January,  1824. 

There  were  101  cases,  of  which  40  (25  men  and  15 
women)  proved  fatal. 

This  epidemic  was  the  subject  of  much  acHmonious 
discussions  between  the  chroniclers  of  the  period. 

PAiTERNA  DE  LA  RIBIEEA. 

1800. 

Yellow  fever  invaded  Paterna  de  la  Ribiera  in  1800,  re- 
sulting in  86  deaths. ^^^ 

1804. 

In  1804,  Paterna  de  la  Ribiera  had  a  population  of 
1,140.  Yellow  fever  appeared  in  the  town  on  August  30, 
and  lasted  until  December  8,  causing  a  mortality  of  117, 
of  which  72  were  men  and  45  women. ^^^ 

PEDRARA. 

1821. 

Refugees  from  Seville  died  at  Padrara  during  the  epi- 
demic of  1821.  The  infection  did  not  spread  to  the  in- 
habitants.1^4 

"=La  Roche,  vol.  1,  p.  534. 

"'Fellowes,  p.  478;  Bally,  p.  90. 

*"*  Bally,  Francois  and  Pariset,  p.  99. 


608  HISTORY    OF    YELLOW    FEVER. 

PEDROCHES. 

1879. 

The  bark  Imogen,  from  Rio  de  Janeiro,  arrived  at 
Pedroehes  June  7,  1879,  with  a  crew  of  fifteen  and  forty- 
one  passengers.  Twelve  cases  of  yellow  fever,  all  fatal, 
had  occurred  on  board  during  the  voyage  across  the  At- 
lantic. While  the  ship  was  in  the  quarantine  basin  at 
Pedroehes,  a  case  erupted  on  June  18,  followed  by  two 
others.  Our  authority  does  not  state  whether  these  cases 
were  fatal  or  not.  There  was  no  diffusion  of  the  in- 
fection.-^^^ 

PENACERRADA. 

1804. 

Penacerrada,  a  village  of  100  inhabitants,  was  invaded 
by  yellow  fever  on  September  28,  1901.  From  that  date 
until  November  16,  there  were  11  deaths,  of  which  9  were 
men  and  5  women.* 

PORT    MAHON. 

(See  Balearic  Islands). 

PUERTO  DE  SANTA  MARIA. 

1800. 

Puerto  de  Santa  Maria  was  infected  by  Cadiz  in  1804. 
It  had  then  a  population  of  20,000,  out  of  which  3,493 
died  from  the  pestilence.^^® 


"'Branco:  Correjo  Med.  de  Lisboa,  1879,  vol.  8,  p.  149. 
*Fellowes,  p.  478;  Bally,  pp.  90;  449. 
>"  Bally,  p.  75. 

Alfonzo  da  Maria,  p.  122.       . 


SPAIN PUERTO  DE  SANTA  MARIA.  fl09 

1804. 

Four  persons  from  Cadiz  fled  to  Puerto  de  Santa  Maria 
in  1804,  and  were  taken  ill  with  yellow  fever  shortly  after 
their  arrival.  They  infected  the  inhabitants,  but  the 
epidemic  does  not  seem  to  have  been  severe,  as  the  total 
number  of  cases  and  deaths  is  not  given.^^^ 

1819. 

A  fugitive  from  Isla  de  Leon  brought  yellow  fever  to 
Puerto  de  Santa  Maria  in  1819.  The  developments  were 
unimportant.^®^ 

1821. 

Several  persons,  who  contracted  yellow  fever  in  Cadiz 
and  Xeres  de  la  Frontera,  were  taken  ill  and  died  at 
Puerto  de  Santa  Maria  in  1820.  The  inhabitants  of  the 
town  were  not  affected.^®® 

1821. 

Yellow  fever  invaded  Puerto  de  Santa  Maria  in  1821, 
but  the  attacks  were  so  limited  as  scarcely  to  deserve  the 
denomination  of  an  epidemic.    Details  are  not  available.^"^ 

PUERTO  REAL. 

1800. 

In  1880,  Puerto  Real  had  a  population  of  1,000.  Ac- 
cording to  Alfonzo  de  Maria,  the  first  case  manifested 
itself  on  August  11,  in  the  person  of  a  youth,  who  died 
on  the  seventh  day  of  the  onset.     His  case  was  diagnosed 


'■"Bally,  p.  90;  Bally,  Francois  and  Pariset,  p.  80. 
"'  Berenger-Feraud,  p.  90. 

•»»  Robert:  Guide  Sanitaire,  vol.  1,  p.  272;   O'Halloran,  p.  138. 
=«"  O'Halloran,  p.  70. 


610  HISTORY    OF    YELLOW    FEVER. 

by  the  authorities  as  "ardent  fever,  caused  by  insolation."* 
Perez,  Pariset  and  others,  claim  that  the  first  case  was 
that  of  a  carpenter  who  had  been  on  board  the  corvette 
Dauphin,  from  Havana,  who  was  taken  ill  August  21  and 
died  on  the  27th. 

From  these  two  foci,  the  disease  spread  far  and  wide, 
resulting  in  the  death  of  1,621  persons.^*^^ 

1819. 

A  few  cases  were  observed  in  1819.  Some  authorities 
place  the  mortality  at  10,  while  others  claim  that  the 
disease  was  more  widespread.  Authentic  details  are 
lacking.^*^^ 

REGENS. 

1821. 

Regens,  situated  five  miles  from  Tortosa,  must  have 
been  free  from  Stegomyaie  Calopae  in  1821,  for,  according 
to  O'Holloran,  not  a  single  case  erupted  in  the  village, 
although  many  refugees  from  Tortosa  who  took  up  their 
abode  there,  died  of  yellow  fever.  Some  of  the  inhabitants 
who  communicated  with  the  infected  city  was  stricken, 
but  those  who  remained  aloof  enjoyed  total  immunity 
from  the  disease.^^^  ' 

RICOTE. 

At  some  time  or  other,  during  the  first  years  of  the 
last  century,  yellow  fever  was  brought  to  Ricote  by 
refugees.  The  works  we  have  consulted  fail  to  specify  the 
date. 


*  "*   *   *   la  fiefbre  de  ardiente  por  insolacion." 
"'Alfonzo  da  Maria,  loc.  cit. ;   La  Roche,  vol.  1,  p.  534;   Chervin, 

Examen  Critique,  etc..  p.  34;  Robert,  p.  279;  Pariset,  p.  92; 

Perez,  Theses  de  Paris,  No.  127  (1825),  p.  15. 
"'Chervin,  Examen  Critique,  p.  47. 
"' O'Halloran,  p.  122, 


SPAIN.  611 

RONDA. 

1800. 

In  1800,  Eonda  was  infected  by  refugees  from  near-by 
localities.  The  outbreak  was  confined  to  a  limited  area, 
resulting  in  20  cases,  of  which  19  proved  fatal.-*^* 

1803. 

A  few  cases  were  also  observed  in  1803.  No  details  are 
obtainable.^^^ 

1804. 

The  first  person  whose  case  gave  suspicion  of  the  exist- 
ence of  yellow  at  Eonda  in  1804,  was  Maria  de  Eio.  She 
was  attacked  on  July  27,  and  died  on  August  4;  the 
disease  was  denominated  "black  erysipelas"  by  the  medi- 
cal attendant.  She  vomited  black  matter  before  death; 
and  is  said  toi  have  recollected  that  two  persons  from 
Malaga  lodged  at  her  house  some  time  previous.  The 
woman  was  ignorant  of  their  character,  or  the  state  of 
their  health  at  the  time. 

Francisco  Euiz,  another  inhabitant  of  Eonda,  was  taken 
ill  on  September  4,  and  died  on  the  7th.  He  became  in- 
disposed in  four  or  five  hours  after  his  return  from 
Malaga ;  he  was  deeply  jaundiced,  and  matter  which  he 
vomited  was  of  a  black  color.  Besides  Euiz,  a  lady  ar- 
rived from  Malaga,  on  the  19th  of  August,  at  the  house 
of  her  mother  and  was  taken  ill  with  yellow  fever  shortly 
afterwards. 

From  these  foci,  the  disease  pursued  a  slow  course  until 
the  first  days  of  October  resulting  in  about  50  deaths.^^^ 


***Chervin:   Examen  Critique,  p.  88. 
«« Ibid. 

'^Jackson,  loc.  cit.,  p.  23;  Chervin,  Examen  Critique,  p.  88;  Bally, 
Francois  and  Pariset,  p.  78;  Eageir,  p.  20. 


612  HISTORY    OF    YELLOW    FEVER. 

ROQUETAS. 

1821. 

Eoquetas,  a  hamlet  on  the  Ebro,  opposite  Tortosa,  was 
contaminated  by  refugees  from  that  citj  in  1821.  The  first 
victims  were  two  women,  named  De  Juari.  After  these, 
the  village  barber  was  stricken  and  then  the  mayor.  The 
infection  did  not  spread  to  the  inhabitants,  being  confined 
to  these  four  imported  cases.^^^ 

ROTA. 

1800. 

Rota,  which  had  6,000  souls  in  1800,  was  contaminated 
that  year  by  refugees  from  Cadiz  and  Isla  de  Leon.  ■Many 
fled,  but  the  disease  seems  to  have  been  imbued  with  un- 
usual virulency,  for  out  of  the  small  remaining  popula- 
tion, there  were  1,116  deaths.^*^^ 

1804. 

Yellow  fever  invaded  Rota  in  1801,  but  no  reliable  de- 
tails are  obtainable.  Perez  gives  a  resume  of  twenty-three 
autopsies,  but  does  not  touch  upon  the  historical  phase 
of  the  epidemic. ^^^ 

SAINT    ELOY. 

During  the  first  years  of  the  nineteenth  century,  yellow 
fever  was  imported  to  Saint  Eloy.  No  details  or  dates 
given  by  the  authorities  we  have  consulted.^^^ 


"•^  O'Halloran,  p.  21. 

=^'La  Roche,  vol.  1,  p.  534;  Alfonzo  da  Maria,  p.  122. 

"^  Perez:  Journal  General  de  Medecine,  1820,  vol.  71,  p.  3. 

*"•  Second  Report  on  Quarantine,  p.  209. 


SPAIN,  61S 

SAN   ANDERO. 
1813. 

In  the  autumn  of  1813,  being  the  close  of  the  Peninsular 
War,  sporadic  cases  of  yellow  fever  appeared  in  the  depot 
barrack  in  San  Andero,  in  Spain,  and  after  the  Christmas 
holidays,  became  numerous.  The  troops  were  removed  to 
a  healthy  situation,  and  the  epidemic  was  soon  under 
control. 

Out  of  about  700  persons  who  were  exposed  to  the  in- 
fection, 50  were  attacked  and  11  died.^^^ 

Our  authority  does  not  attempt  to  give  the  source  of 
infection,  but  as  yellow  fever  ravaged  several  cities  of 
southern  Spain  in  1813  (Cadiz,  Gibraltar  and  Medina- 
Sidonia)  and  the  events  of  the  Peninsular  War  rendered 
rigid  quarantines  impracticable,  we  can  safely  incrimi- 
nate one  of  the  above  named  foci  in  this  importation. 

SALOU. 

1821. 

On  July  28,  1821,  the  N^testra  Senora  de  Begoma  ar- 
rived at  Salon  from  Barcelona,  where  yellow  fever  was 
prevailing.  Owing  to  the  high  tide,  the  crew  was  unable 
to  land.  This  was  fortunate  for  the  inhabitants  of  the 
village,  for  the  captain  of  the  little  craft  was  taken  ill 
with  yellow  fever  during  the  night  and  died  the  following 
morning.  The  boat  was  immediately  quarantined  by  the 
health  authorities.  A  sailor,  taken  ill  on  the  day  of  the 
captain's  death,  died  on  August  2.  The  disease  was  not 
communicated  to  the  inhabitants  of  Salou.^^^ 


"^Second  Report  on  Quarantine,  p.  235. 

"-Chervin:   Examen  des  Principes  de  rAdministration  Sanitaire, 
p.  57. 


614  HISTORY    OF    YELLOW    FEVER. 

SAN    GERVAISO. 

1821. 

A  refugee  from  Barcelona  died  of  yellow  fever  at  San 
Gervaiso  in  1821.  Only  a  few  cases  resulted  from  this 
infection.^^^ 

SAN    JUAN    DEL   PUERTO. 

1804. 

Yellow  fever  was  introduced  into  San  Juan  ( which  had 
then  a  population  of  3,476)  by  refugees  from  neighbor- 
ing cities  on  September  17,  1804.  The  epidemic  lasted 
until  December  17,  resulting  in  219  deaths,  of  which  136 
were  men  and  83  women. ^^* 

SAN    LUCAR    DE    BARA:\rED.\. 

1800. 

San  Lucar  de  Barameda,  which  had  a  population  of 
18,000  in  1800,  lost  2,303  from  yellow  fever  that  year.^^^ 

1819. 

'In  1819,  sporadic  cases  were  observed.  No  authentic 
details  are  obtainable.^^® 

1821. 

The  last  appearance  of  yellow  fever  in  San  Lucar  de 
Barameda  took  place  in  1821,  when  a  few  cases,  probably 
refugees,  caused  some  apprehension.  There  was  no  dif- 
fesion  of  the  disease.-^^ 


"'O'Halloran,  p.  88;  Bally,  Francois  and  Pariset,  p.  434;  Chervin, 

Examen  Critique,  p.  200. 
="*Fellowes,  p.  478. 

^^''La  Roche,  vol.  1,  p.  534;  Bally,  p.  75. 

""  Medico-Chirurgical  Journal  and  Review,  1821,  vol.  2,  p.  439. 
^"Robert,  loc.  cit.,  vol.  1,  p.  272. 


SPAIN.  615 

SAN    EOQUE. 

1804. 

In  1804,  a  resident  of  San  Roque  went  to  Algeziras, 
where  yellow  fever  was  prevailing-,  to  see  his  son,  who  was 
ill.  On  his  return  home,  he  was  taken  ill  and  infected 
five  persons  living  in  his  immediate  neighborhood.  From 
these  foci,  the  disease  spread  throughout  the  town,^^^ 

I 

SANS. 

1821. 

A  resident  of  Sans  went  to  Barcelona  on  business  dur- 
ing the  epidemic  which  devastated  the  latter  city  in  1821. 
He  remained  but  a  few  hours.  On  his  return  home,  he 
was  taken  ill  and  died  in  a  few  days.  His  wife,  who 
nursed  him,  also  contracted  the  malady  and  died.  It  was 
afterward  proved  that  this  man's  wife  often  accompanied 
him  to  Barcelona,  and  it  was  no  doubt  on  one  of  these 
trips  that  she  was  infected,  as  none  of  the  five  children 
of  the  couple,  nor  their  servants  or  friends  who  visited 
them,  were  attacked.  No  other  inhabitant  of  Sans  con- 
tracted the  maladj'.-^^ 

SARRIA. 

1652. 

Was  it  yellow  fever  which  ravaged  Sarria  in  1652? 

In  1652,  a  pestilence  "of  an  unknown  character"  raged 
in  Bai'celona  and  was  brought  by  refugees  to  Sarria. 
This  epidemic  is  commented  upon  by  Rochoux.*  The 
little  suburban  village  was  almost  depopulated.  To  com- 
memorate their  escape  from  the  scourge,  Ihe  survivors 
erected  a  singular  monument  in  the  gardens  of  the  Capu- 

*  Berenger-Feraud,  p.  78. 

"^Chervin:  Examen  des  Principes,  etc.,  p.  47. 
Bally,  Francois  and  Pariset,  p.  50. 
Pariset:   Histoire  Medicale  de  la  Flevre  Jaune,  pp.  50;   107. 

*  Rochoux:     Recherches     sur    les    Differentes    Maladies    qu'on 

Appelle  Fievre  Jaune.    Paris,  1828,  p.  75. 


616  HISTORY    OF    YELLOW    F£VER. 

cins  at  Sarria.  This  monument,  even  to  this  day,  is  an 
object  of  curious  pilgrimage  to  the  tourist  and  the  inhabi- 
tants of  Barcelona  and  neighboring  villages.  The  alle- 
gorical figures  are  of  terra  cotta  and  represent  a  proces- 
sion in  solemn  march,  the  largest  personages  being  quar- 
ter life-size,  others  much  smaller.  The  processionists  are 
grouped  around  a  church.  In  their  midst  is  a  personage 
who  appears  to  have  been  suddenly  stricken  with  the 
scourge.  All  about  him  are  people  either  dying  or  dead. 
The  moribund  are  being  attended  to  in  their  last  moments 
by  surpliced  friars.  A  peculiar  feature  of  this  group  is 
that  all  the  personages  have  bleeding  sores,  either  on 
the  sides,  the  nape  of  the  neck,  the  arms  or  legs.  Two 
of  the  stricken  ones  are  vomiting.  One  of  the  latter, 
U'Jiose  features  are  painted  yellow,  is  ejecting  hlaelc  matter 
from  the  stomach,  while  the  other,  whose  distended 
cheeks  show  that  his  mouth  is  full,  has  placed  a  hand 
over  the  oriface,  as  if  in  a  vain  effort  to  stop  the  escape 
of  the  fluid.  A  monk  supports  his  head  with  one  hand 
while  with  the  other  he  offers  him  a  draught  out  of  a 
cup  containing  a  beverage  which  he  seems  to  coax  him 
to  take. 

Kear  this  remarkable  group  is  a  small  two-story  edifice, 
covered  with  a  shroud,  which  is  open  on  one  side. 
Through  this  opening  can  be  seen  eleven  skeletons  habited 
in  monkish  garments^ — three  in  the  first  story,  four  in 
the  second  and  four  in  the  basement.  At  the  base  of  this 
mausoleum,  is  the  following  scription,  written  in  the 
picturesque  language  of  Catalonia: 

NOMS  DELS  ONSE  RELIGIOUS 

QUE    MORIREX    DE   PESTA,, 

EX  LO  ANY  1G52, 

ASSISTIN  EX  LO  SPIRITUAL  Y  TETINIPORAL  AL  POBLB 

DE   SARRIA   ESSEXT  AFFLIGIT  DE  TAL  COXTAGI ; 

Y  SON   ENTERRATS  BAIX  EST  PANTAON.* 


*  Translation: 
"Names  of  the  eleven  religious  who  died  of  the  pest  in  1852, 
while   bringing  spiritual   and  temporal   assistance   to   the" 
inhabitants  of  Sarraia,  afflicted  with  this  contagion;   they 
rest  beneath  this  pantheon." 


SPAIN SARRIA.  617 

Although  Spanish  archives  are  silent  as  to  the  real 
character  of  this  pestilential  visitation,  the  pantheon 
above  noted  certainly-  leads  to  the  suspicion  that  a  malady 
bearing  two  of  the  pronounced  characteristics  of  yellow 
fever — black  vomit  and  jaundice — devastated  Barcelona 
and  Sarria  in  1652.  The  running  sores,  however,  pre- 
clude the  diagnosis  of  yellow  fever.  But  it  does  not  fol- 
low that  these  latter  symptoms  were  really  present.  The 
exalted  temperament  of  the  Catalonians  may  have  imbued 
the  artist  (or  artists)  who  moulded  this  remarkable  group 
with  ultra  extravagant  ideals,  and  induced  him  to  add 
the  running  sores  to  the  other  SA^nptoms  for  effect.  The 
Spaniards  are  proverbially  fond  of  CQUps  dc  theatres,  and 
do  not  hesitate  to  give  their  imaginations  free  rein  to 
effect  a  soul  stirring  climax,  even  at  the  sacrifice  of  truth. 
As  the  real  diagnosis  of  this  epidemic  has  never  been 
satisfactoryily  established,  we  do  not  include  it  in  our 
chronology,  but  simply  give  it  a  niche  in  this  volume  as 
one  of  the  "curiosities"  of  epidemiology. 


1800. 
P^'ive  persons,  fleeing  from  Barcelona,  died  from  yellow 
fever  at  Sarria  in  1800.     The  inhabitants  were  not  con- 

I  -IT   oia 


1800. 

IS,  fleeing  frc 
ia  in  1800. 
taminated.-^'^ 

1821. 

A  doctor  of  Sarria,  on  the  eve  of  being  married,  went 
to  Barcelona  with  liis  fiancee  on  September  7,  1821.  The 
couple  spent  the  day  in  going  from  shop  to  shop  making- 
purchases.  They  were  married  the  following  day  and 
took  up  their  residence  in  Sarria.  On  the  9th,  the  day 
after  the  ceremony,  the  bride  was  taken  ill  with  yellow 
fever  and  died  on  the  13th.  The  husband,  stricken  on 
the  11th,  died  on  the  20th.  There  were  altogether  18 
deaths  in  tlie  village,  all  in  persons  who  had  been  to 
Barcelona.  Those  who  remained  at  home  did  not  con- 
tract the  malady.^2^ 

"'La  Roche,  vol.  1,  p.  534. 

"°  Chervil! :  Examen  des  Principes  de  rAdministration,  etc.,  p.  48. 
Bally,  Francois  and  Pariset,  pp.  50;    57. 


618  History  of  yellow  fevbr. 

SEVILLE. 

Historical  Resume. 

Seville,  the  Romula  of  Julius  Caesar,  is  one  of  the  most 
ancient  cities  of  Spain,  and  has  been  made  famous  in 
song'  and  story  from  the  time  it  was  the  capital  of  a 
Mohammedan  emirate  to  the  age  of  de  Musset.  Even  to 
this  day,  a  glamour  of  romance  pervades  this  historic 
place,  whose  old  Moorish  houses,  Gothic  cathedral  and 
famous  aqueduct,  are  the  only  vestiges  of  an  old-time 
splendor,  when  it  boasted  of  a  population  of  600,000  souls. 
Its  decadence  began  with  the  capture  of  the  city  by  Fer- 
dinand III  in  1248,  when  300,000  Moors  fled  froim  the 
sabres  of  the  cruel  Castillians.  The  discovery  of  Amer- 
ica gave  Seville  renewed  energy  and  for  a  time  it  was 
again  flourishing,  but  the  superior  advantages  of  the  port 
of  Cadiz  induced  the  government  to  order  tlie  galleons  to 
be  stationed  at  the  latter  place,  and  the  decline  of  the 
ancient  metropolis  of  Andalusia  was  rapid  from  that  date. 
In  1800,  the  population  was  only  80,5G8.  During  the  one 
hundred  and  eight  years  which  have  elapsed  since,  the 
increase  lias  been  slow,  the  estimated  population  of  the 
town  in  1908  being  118,315. 

Yet.low  Fevi-]r  Years. 
1649   (not  authentic)  ;  1800;  1801;  1819;  1821. 

Summary  of  Epidemics. 

1649. 

According  to  Spanish  tradition,  yellow  fever  was  ob- 
served in  Seville  as  early  as  1649,  but  authentic  documents 
are  lacking  to  substantiate  this  statement.  According  to 
the  most  reliable  authorities  we  have  consulted,  yellow 
fever  had  never  invaded  the  ancient  Moorish  city  previous 
to  1800.  But  there  is  a  strong  possibility,  nevertheless, 
that  the  disease  was  imported  to  the  Spanish  coast  prior 
to  that  date.  Before  it  was  superseded  by  Cadiz,  the  port 
of  Seville  was  the  principal  shipping  and  receiving  point 
for  the  extensive  commerce  between  Spain  and  her  colo- 


SPAIN SEVILLE.  619 

nial  possessions  in  the  New  World,  and  it  is  natural  to 
surmise  that  the  dreaded  Antillean  pestilence  was  im- 
ported within  its  walls,  but,  owing  to  its  mildness  or  its 
sporadic  nature,  was  unnoticed  by  the  historians  of  the 
period,  whose  tjime  was  more  occupied  in  watching  and 
recording  court  intrigues  than  in  making  history. 

The  only  modern  author  who  refers,  in  a  roundabout 
way,  to  the  Seville  epidemic  of  1649,  is  O'Halloran,  in  a 
small  monograph  published  in  1821  (Yellow  Fever  in 
Andalusia  in  1820,  p.  165),  in  which  he  gives  Lind  as  his 
authority.  A  perusal  of  the  works  of  the  famous  English 
physician  fails  to  throw  any  satisfactory  light  on  the 
subject. 

1800. 

The  first  epidemic  of  yellow  fever  in  Seville  of  which 
there  is  authentic  record,  took  place  in  1800.  The  origi- 
nal cases  were  observed  August  23,  in  the  suburb  of 
Triana,  which  is  separated  from  the  city  proper  by  the 
Guadalquivir  Eiver,  and  inhabited  principally  by  bull- 
fighters, seamen  and  smugglers.  Smugglers  from  Cadiz 
are  said  to  have  infected  Triana.  Communication  between 
both  banks  of  the  river  being  uninterrupted,  the  infection 
was  soon  brought  to  the  suburb  of  Los  Humeros,,  opposite 
Triana,  also  inhabited  by  seamen  and  the  working  classes, 
whence  it  was  propagated  throughout  the  town. 

Seville  had  then  a  population  of  80,568.  As  is  always 
the  case  when  compiling  statistics  showing  the  ravages 
of  great  epidemics,  authorities  differ  as  to  the  total  num- 
ber of  cases  and  deaths.--^  The  majority,  however,  unite 
in  placing  the  cases  at  76,488  and  the  deaths  at  14,685. 

^^^La  Roche,  vol.  1  ,pp.  534;  536;   538. 
Bally:    Typhus  d'Amerique,  p.  72. 
Caisergues:    Memoire   sur   la   Contagion    de   la   Fievre   Jaune. 

Paris,  1817,  pp.  190;   214. 
Fellowes:   Pestilential  Disorder  of  Andalusia,  p.  421. 
Arejula,  p..  434. 
Alfonzo  da  Maria,  p.  122. 
Berthe:    Precis   Historique   de   la    Maladie    qui    a    Renee    en 

Andalousie  en  1800.     Paris,  1800..  p.  64. 


620  HISTORY    OF    YELLOW    FIVER. 

Fellowes  (p.  421)  gives  the  following  tableau  of  deaths: 

From  August  23  to  the  end  of  the  month 165 

In  September 2,10G 

In  October 9,236 

In  November 1,223 

Dates  not  specified 1,955 

Total  deaths  from  August  23  to  November  30.  .11,685 

La  Eoche  (p.  538),  iii  commenting  on  the  above  mor- 
tality, states  that  when  we  read  the  statement  here  re- 
corded, authentic  as  it  appears  to  be,  we  can  with  dif- 
ficulty divest  ourselves  of  the  idea  of  error  having  crept 
in  somewhere.  ^'Xot  that  I  feel  disposed  to  swell  the 
mortality  to  20,000,  as  was  done  by  Dumeril  (Humboldt, 
779),  and  thereby  diminish  the  ratio  of  recoveries;  but  I 
am  inclined  to  regard  it  as  probable  that  the  number  of 
those  stricken  down  with  the  real  malignant  yellow  fever 
did  not  reach  the  amount  mentioned.-'  The  idea  of  an 
epidemic  evtending  its  baneful  influence  to  all  but  4,000 
in  a  population  of  80,000,  La  Roche  finds  difficult  <o 
reconcile  with  the  facts  known  respecting  the  diffusion  of 
the  same  disease  elsewhere.  He  thinks  it  is  more  natural 
to  presume  that  in  the  number  of  cases  recorded,  are  in- 
cluded many  of  the  other  and  milder  complaints.  Should 
this  be  true,  the  proportion  of  deaths  to  recoveries  would 
be  larger  than  stated;  while  the  number  of  cases  might 
still  be  very  large  in  proportion  to  the  population.  To 
this  opinion,  he  is  the  niore  inclined,  because,  so  far  as 
he  could  ascertain,  the  Spanish  physicians,  of  those  times 
at  least,  were  not  noted  for  accuracy  in  matters  of  diag- 
nosis, and  their  success  in  the  treatment  of  the  disease 
had  not  usually  been  such  as  to  induce  the  belief  that  they 
would  lose  but  1  in  5.21  during  a  wide-spreading  and 
highly  malignant  epidemic. 


SPAIN SEVILLE.  621 

1801. 

In  1801,  yellow  fever  reappeared  in  Seville.  The  malady 
affected  principally  those  who  had  fled  the  preceding  year. 
There  were  in  all  1,100  cases,  of  which  660  proved  fatal. ^^^ 

1819. 

The  epidemic  of  1819  broke  out  in  the  quarter  of  Santa 
Cruz,  where  it  was  brought  by  a  woman  who  had  fled 
from  Cadiz,  and  who  died  on  September  18  in  the  home 
of  a  friend  in  Baraba  Street.  The  friend  contracted  the 
malady  and  in  his  turn  contaminated  those  who  visited 
him.  By  this  means,  the  fever  was  disseminated  through- 
out the  quarter,  where  it  raged  until  November  21,  re- 
sulting in  546  cases  and  217  deaths,  out  of  a  population 
of  1,650.  The  disease  was  confined  exclusively  to  the 
Santa  Cruz  quarter.—^ 

1821. 

A  few  cases  were  observed  in  1821.  The  developments 
were  unimportant.^^* 

SITGES. 

1821. 

Sitges  is  located  on  the  Mediterranean,  eighteen  miles 
from  Barcelona.  On  August  1,  1821,  a  woman  who  had 
been  in  the  latter  place  returned  to  her  home  in  Sitges 
and  was  taken  ill  with  yellow  fever.  She  died  on  the  5th. 
Three  persons  who  had  nursed  her  were  immediately  dis- 
patched to  the  country  by  the  health  authorities,  but  none 

'^=  Bally,  p.  77;  Berenger-Feraud,  p.  71;  Keating,  p.  81. 

-"La  Roche,  vol.  1,  p.  536,  and  vol.  2,  p.  387;  Berenger-Feraud, 
p.  90;  Chervin,  Examen  Critique,  p.  11;  Cotens,  Decad.  de 
Med.  et  de  Cirug.  Prac  (Madrid),  1828,  vol.  4,  p.  68. 

"*  O'Halloran,  p.  70. 


642  HISTORY    OF    YELLOW    FEVER. 

of  them  contracted  the  disease.     Xo  other  case  occurred 
in  the  town.--^ 

TABAECA. 
1804. 

The  diminutive  island  of  Tabarca,  in  the  Mediterranean, 
five  miles  south  of  AJicante,  was  infected  by  yellow  fever 
from  the  latter  place  in  1804.     The  mortality  was  small.^^** 

TOBAEKA. 

1811. 

Yellow  fever  was  carried  as  far  as  Tbbarra,  in  Murcia, 
in  1811.     There  was  no  extensive  spread  of  the  disease.^^^ 

TOEEE   DEL  MAE. 

1804. 

Fugitives  from  Malaga  died  from  yellow  fever  at  Torre 
del  Mar  in  1804.  The  inhabitants  of  the  village  were  not 
affected.^^^ 

TOEEE    MOLINO. 

1804. 

Persons  who  had  communicated  with  jNIalaga  died  from 
yellow  fever  at  Torre  Molino  in  1804.  The  villagers  who 
remained  at  home  were  not  affected.^^^ 


*^  Chervin,    Examen    des    Principes    de   rAdministration,   p.   58; 

Berenger-Feraud,  p.  94. 
==«  Bally,  pp.  90;   449. 

="  Bally  Francois  and  Pariset,  p.  560;  Berenger-Feraud,  p.  84. 
==^  Bally,  p.  87. 
=^Fellowes,  pp.  181;  182. 


SPAIN TORTOSA.  62S 

TORTOSA. 

Historical  Resume. 

The  picturesque  city  of  Tortosa,  in  Catalonia,  on  the 
Ebro,  22  miles  from  its  mouth,  and  63  miles  southwest  of 
Tarragona,  occupies  a  romantic  niche  in  history.  Origi- 
nally a  Moorish  stronghold,  it  was  wrested  from  the  in- 
fields by  Louis  le  Debonaire  in  811,  but  was  recaptured 
by  the  Moors  and  became  a  nest  of  pirates.  Eugenius  III 
proclaimed  a  crusade  against  the  place,  and  it  was  re- 
taken by  the  Christians  in  1148.  In  1149,  the  Moors 
made  a  desperate  effort  to  regain  possession  of  the  city, 
but  were  frustrated,  partly  through  the  bravery  of  the 
women.  In  1798,  the  French  invaded  the  city.  Popula- 
tion, 24,702. 

Summary  of  Epidemics. 
1821. 

In  1821,  for  the  first  time  in  its  history,  Tortosa  was 
invaded  by  the  Saffron  Scourge  and  suffered  one  of  the 
most  destructive  epidemics  on  record.  The  population 
was  then  15,000,  of  which  10,000  fled  when  the  real  nature 
of  the  malady  became  known  to  the  inhabitants. 

The  facts  of  this  epidemic  are  as  follows  :^^° 

The  first  case  developed  in  the  person  of  a  soap 
dealer  named  Curto,  who  had  communicated  with  Bar- 
celona on  August  1,  and  arrived  at  Tortosa  on  the  4th. 
He  was  taken  ill  on  the  Gth,  in  the  soap  manufactory  in 
the  Calle  de  Cerced  and  died  on  the  11th  in  the  country, 
where  he  had  been  transported  by  the  health  authorities. 

The  second  case  was  that  of  a  sailor  named  Puich,  who 
belonged  to  the  brig  Ventura.  This  vessel  sailed  from 
San  Feliu  de  Guixols,   Spain,   early  in  July,   and  was 


^O'Halloran,  p.  110;  Chervin,  Examen  des  Principes,  etc.,  p.  66; 
Bally,  Francois  and  Pariset,  p.  34. 


624  HISTORY  OF  YELLOW    FEVER. 

detained  fifteen  days  in  the  Ebro  Kiver,  for  want  of  water 
to  float  her  to  the  citj*  There  was  no  epidemic  disease 
at  the  port  of  departure  and  it  is  said  that  Piiich  held 
no  communication  with  Curto.  He  was,  tlierefore,  in- 
fected at  Tortosa.  He  was  taken  ill  on  August  11.  He 
was  visited  on  the  13tli  by  two  physicians  of  Tortosa, 
who  unhesitatingly  pronounced  his  disease  to  be  yellow 
fever.  When  black  vomiting  and  other  unequivocal  symp- 
toms of  the  Antillean  pestilence  made  their  appearance, 
the  unfortunate  sailor  was  forcibly  taken  from  his  bed 
at  eight  o'clock  at  night,  compelled  to  dress  himself,  and 
with  a  rope  around  his  neck  (for  the  emissaries  of  the 
health  authorities  were  afraid  to  touch  him),  was  dragged 
by  four  armed  soldiers  to  a  lazaretto  in  the  country,  at 
which  he  arrived  after  a  march  of  three  hours.  The  laz- 
aretto, being  unoccupied,  was  forced  open,  and  the  un- 
happy and  helpless  victim,  without  assistance  or  even 
water  to  allay  his  thirst,  was  left  to  his  fate  for  the 
remainder  of  the  night,  without  even  a  bed  on  which  to 
repose.     He  died  on  the  15th. 

The  third  case  was  that  of  a  sailor  who  had  arrived 
with  the  soap-maker,  Curto,  from  Barcelona,  who  died 
a  fcAV  days  after  the  onset  of  the  nialad}'. 

Cases  then  appeared  in  various  parts  of  the  city,  mak- 
ing slow  progress,  until  August  29,  when  thirty  persons 
were  suddenly  seized  with  the  symptoms  of  the  dreadful 
scourge,  all  of  whom  died  within  a  short  time  after  being 
attacked. 

Panic,  terror  and  despair  seized  the  populace.  Of  the 
15,000  persons  which  constituted  the  population  of  Tor- 
tosa, 10,000  fled.  It  was  well  that  this  wholesale  exodus 
took  place,  for  of  the  5,000  who  remained,  2,356  perished. 

The  epidemic  came  to  an  end  about  the  middle  of 
October. 


*  "Hacia  15  dias  que  se  hallaba  en  el  rio." — ^^Oflicial  Report  of 
Tortosa  Board  of  Health. 


SPAIN.  625 

1870. 

For  almost  half  a  century,  yellow  fever  was  kept  out 
of  Tortosa.  That  year  occurred  the  memorable  epidemic 
of  Barcelona,  and  the  disease  was  imported  from  the 
latter  place  to  the  former,  on  September  17.  From  that 
date  until  November  30,  when  the  last  case  was  observed, 
sporadic  cases  erupted  here  and  there,  but  at  no  time  was 
the  disease  epidemic.  There  were  in  all  41  cases,  of  which 
32  proved  fatal.  Of  those  attacked,  23  were  men  and 
18  women;  of  those  who  died.  20  were  men  and  12 
women. -"^^ 

TOTANA. 

1811. 

In  1811,  yellow  fever  was  imported  to  Cadiz  from  the 
Canary  Islands,  and  thence  to  the  neighboring  cities  in 
Southern  Spain.  A  few  cases  were  observed  at  Totana, 
but  the  disease  did  not  spread  to  the  inhabitants. ^^^ 

TRIANA. 

(A  Suburb  of  Seville,  which  see). 
TEIBUJENA. 

1800. 

During  the  general  epidemic  of  yellow  ever  which 
devastated  Spain  in  1800,  Tribujeua  was  invaded  by  the 
pestilence  and  lost  68  inhabitants.^^^ 


=''Ferandez  y  Domingo:  Siglo  Medica,  1873,  vol.  20,  p.  261. 
=^=  Bally,  Francois  and  Pariset,  p.  559;   Berenger-Feraud,  p.  84, 
^"^  La  Roche,  vol.  1,  p.  534. 


626 


HISTORY    OF    YELLOW    EEYER. 

TURRIANO. 


1804. 


Turianno,  Avliere  nearly  all  the  bread  consumed  in 
Malaga  was  baked  in  the  beginning  of  the  last  century, 
had  uninterrupted  communication  with  that  citj  during 
the  great  epidemic  of  1804,  but  none  of  the  inhabitants  who 
remained  at  home  contracted  the  disease.  Most  of  the 
persons  who  brought  and  delivered  the  bread  at  Malaga, 
contracted  yellow  fever  and  died  on  their  return  to  their 
native  town,  but  in  no  instance  did  they  infect  others.^^^ 

A  similar  state  of  affairs  prevailed  at  Alcala  de  los 
Panaderos,  near  Turriano,  where  were  also  located  numer- 
ous bakeries  which  supplied  Seville  with  the  "staff  of 
life."  The  chroniclers  of  the  period  attributed  this  sing- 
ular immunity  to  have  resulted  from  the  burning  of 
aromatic  herbs  in  the  bakers'  ovens,  but  it  is  useless  to 
observe  that  had  all  the  spices  of  the  Molacca  Islands 
been  incinerated,  Turriano  Avould  not  have  escaped  in- 
fection if  the  Stegomyia  Calopus  had  established  itself 
within  .the  precincts  of  the  town. 

UBRIQUE. 

1800. 

The  epidemic  of  1800  also  invaded  Ubrique,  46  miles 
northeast  of  Cadiz.  Only  a  few  cases,  all  refugees  from 
the  latter  place,  were  observed.^^^ 

UTRERA. 

1800. 

A  regiment  of  infantry  from  Cadiz  infected  Utrera  in 
1800,  resulting  in  1,689  deaths.^^^ 

^*  Bancroft:  Essay  on  Yellow  Fever,  p.  460. 
-■"Rougeau,  Theses  de  Paris,  1827,  No.  119. 
='"  La  Roche,  vol.  1,  p.  534;  Chervin,  Examen  Critique,  p.  54. 


SPAIN.  627 

VALENCIA. 

1870. 

A  sailor  arrived  at  Valencia  from  Barcelona,  where 
yellow  fever  was  prevailing,  in  the  latter  part  of  Sep- 
tember, 1870.  He  took  lodgings  at  No.  3  Calle  B.uj  Dom 
Pedro,  where  he  developed  the  disease.  On  October  1, 
other  sailors  who  had  come  from  Barcelona  took  lodgings 
at  No.  23  of  the  same  street,  and  were  taken  ill  with  yel- 
low fever.  Quarantine  against  Barcelona  was  then  es- 
tablished and  no  other  cases  appeared.  The  inhabitants 
of  Valencia  were  not  affected. -^^ 

VEJER  DE  LA  FEONTERA. 

1800. 

In  1800,  refugees  from  Cadiz  died  of  yellow  fever  at 
Vejer  de  la  Frontera,  There  was  no  diffusion  of  the 
disease.-^^ 

VELEZ  MALAGA. 

1804. 

Velez  Malaga,  14  miles  east  of  Malaga,  was  infected  by 
refugees  from,  the  latter  place  in  1804.  Out  of  a  popu- 
lation of  12,700,  there  were  5,245  deaths  from  yellow 
fever,  of  which  3,496  were  men  and  1,749  women.  The 
first  case  was  observed  August  20 ;  the  last,  December  4. 
The  greatest  mortality  took  place  on  September  24.^^^ 


-"'Siglo  Medica,   1871,   vol.   18,   p.    630;    Deutsch   Klinik,   Berlin, 

vol.  23,  p.  117. 
^*Rougeau,  loc.  cit.;    Chervin,  Examen  Critique,  p.  49;   Pariset, 

Obs.  sur  la  Fievre  Jaune,  pp.  67;   76. 
^'^^  Fellawes,  p.  478;  Bally,  pp.  88;   90;   Berenger-Feiraud,  p.  76. 


628  HISTORY    OF    YELLOW    FEYER. 

VERA. 

1804. 

On  September  IT,  1804,  the  wife  of  a  marine  officer 
arrived  at  Vera  from  Cartagena,  where  yellow  fever  was 
committing  fearful  ravages,  and  was  taken  ill  on  the 
20th  of  the  same  month.  Almost  all  the  members  of  the 
household  contracted  the  malady  and  died.  The  neigh- 
boring houses  were  soon  contaminated,  but  rigid  measures 
were  instituted  by  the  health  authorities  and  the  infected 
quarter  completely  isolated.  The  infection  was  thus  re- 
stricted to  the  original  focus,  resulting  in  208  deaths  out 
of  a  population  of  4,000.  Of  the  fatal  cases.  111  were 
men  and  97  women.  The  epidemic  came  to  an  end  on 
January  4,  1805.-^<> 

1811. 

Vera  was  infected  by  a  man  who  arrived  from  Seville 
in  the  latter  part  of  1821,  and  who  died  of  yellow  fever 
on  the  same  day.  From  this  focus,  the  malady  diffused 
itself  throughout  the  town.-^^ 

VIGO. 

185G. 

Yellow  fever  was  imported  into  Vigo  in  April,  1856. 
The  first  cases  appeared  among  the  prisoners  at  the  penal 
institution.  Sotelo,  the  officer  in  charge,  states  that  he 
carefully  studied  the  cases,  but  gives  only  a  resume  of 
the  clinical  features  of  the  disease.  The  epidemic  lasted 
for  "more  than  nine  months,"  the  last  death  occurring 
in  January,  1857.  There  were  833  cases,  of  which  106 
proved  fatal.^*^ 

=*»Fellowes,  p.   478;    Bally,   p.    90;     Eager,    loc.    cit.;     Berenger- 

Feraud,  p.  77. 
="  Bally,  p.  97   (foot-note). 
="  Sotelo:  Sieglo  Medlca,  1858,  vol.  5,  p.  100. 


SPAIN.  629 

1889. 

On  September  7,  1889,  cases  of  "alleged"  yellow  began 
to  be  officially  observed  in  the  town,  although  it  is  said 
that  the  disease  had  been  sporadically  present  for  some 
time  previously.,  The  origin  of  this  outbreak  has  never 
clearly  established  and  many  doubt  that  this  was  actually 
an  epidemic  of  yellow  fever.  The  Portugese  assert  that 
it  was,  while  the  Spanish  government  as  vehemently  de- 
clared it  was  not.  About  1,000  persons  in  Vigo  and  the 
neighboring  coast  villages  were  attacked,  and  about  10  or 
12  per  cent,  of  these  died.  Northerly  winds  and  the  cool 
weather  caused  the  fever  to  subside,  and  it  had  entirely 
disappeared  before  the  end  of  September. -^^ 

A  search  through  Spanish  papers  and  official  docu- 
ments of  the  period  fails  to  throw  any  satisfactory  light 
on  the  subject.  We  looked  carefully  for  records  of  the 
alleged  epidemic  which  the  IT.  S.  Consular  representa- 
tive claims  to  have  ravaged  Vigo  and  "neighboring  sea- 
coast  towns,"  but  find  nothing  authentic.  It  is  doubtful 
whether  even  the  bulletin  given  out  by  the  United  States 
Public  Health  authorities  is  authentic.  It  was  probably 
merely  a  statement  made  on  hearsay,  as  we  can  find  no 
corroboration  of  same. 

VILLA  MARTIN. 

1800. 

A  solitary  case  of  yellow  fever,  resulting  in  death,  was 
observed  in  Villamartin  in  1800.  It  was  probably  im- 
ported from  Seville,  43  miles  distant.^** 

1804. 

In  1804,  Villamartin  had  a  population  of  1,880.  The 
first  case  was  observed  October  5.  From  that  date  until 
December  25,  1G8  deaths  are  recorded,  of  which  93  were 
men  and  75  women. ^^^ 


*«U.  S.  Public  Health  Reports,  vol.  4,  1889,  pp.  286;  370. 
^La  Roche,  vol.  1,  p.  534. 
='«Fellowes,  p.  478. 


630  HISTORY    OF    YELLOW    FEVER. 

VILLANUEYA  DEL  ARISCAL. 

1800. 

A  few  cases  of  yelloAv  fever,  undoubtedly  imported  from 
Seville,  occurred  in  Vilalunueva  del  Ariscal  in  1800.  The 
population  of  the  town  was  not  affected.-^*^ 

VILLASECA  DE  LA  SAGRA. 

1821. 

Villaseca  de  la  Sagra  was  infected  by  refugees  in  1821. 
The  disease  did  not  spread.-^^ 

XERES  DE  LA  FRONTERA. 

Historical  Resume. 

Xeres  de  la  Frontera  (commonly  called  Xeres  or 
Jerez),  is  a  famous  town  of  Andalusia,  16  miles  by  rail 
northeast  of  Cadiz,  The  Asta  Rcc/ia  of  the  Romans,  it 
owes  its  modern  name  to  the  ]Moors,  who  fought  a  seven 
days'  battle  near  the  town  in  711,  in  which  they  defeated 
Roderic,  the  last  of  the  Goths.  The  present  fame  of 
Xeres  rests  upon  the  delicious  wine  known  as  sherry, 
which  it  exports  in  enormous  quantities  to  all  parts  of  the 
world. 

Yellow  Fever  Years. 

1800;   1804;   1808;   1813;   1819;  1820;   1821. 

Summary  of  Epidemics. 

1800. 

Fugitives  from  Cadiz  introduced  yellow  fever  into 
Xeres  de  la  Frontera  about  the  middle  of  August,  1800. 


Rougeau,  loc.  cit. 
Berenger-Feraud,  p.  94. 


SPAIN.  631 

The  first  death  took  place  August  25.  From  that  date 
until  the  close  of  the  epidemic,  out  of  a  population  of 
42,000,  there  resulted  32,000  cases,,  of  which  14,000 
proved  fatal.-^^ 

1804. 

In  1804,  fugitives  from  Cadiz  died  from  yellow  fever 
at  Xeres.  From  September  23  to  December  1,  there  were 
71  deaths,  of  which  63  were  males  and  8  females.  The 
inhabitants  of  the  town  were  not  affected.^^^ 

1808. 

An  individual  from  Cadiz  died  from  yellow  fever  at 
Xeres  in  1808.  Itigorous  prophylatic  measures  were  taken 
to  protect  the  large  prison,  and  were  successful  until 
near  the  decline  of  the  outbreak.  At  that  point  some 
prisoners  slipped  away,  but  were  captured  and  returned 
to  their  cells.  They  brought  back  yellow  fever  with  them, 
and  so  terrible  was  its  effect  within  the  prison  walls 
that  only  a  few  of  the  convicts  escaped  death.  {Eager, 
loc.  cit.,  p.  21). 

1813. 

In  1813,  five  individuals  from  Cadiz  died  from  yellow 
fever  in  Xeres.     There  was  no  diffusion  of  the  disease.^^" 

1819. 

A  gypsy  and  her  daughter,  originally  from  Isla  de 
Leon,  are  accused  of  having  brought  yellow  fever  to  Xeres 

^*^  Bally,  p.  75.  "^ 

La  Roche,  vol.  1,  pp.  534;    536. 

Chervin,  Examen  'Critique,  p.  57. 

Proudfoot,  Edinburgh  Medical  Journal,  vol,  28,  p.  295. 

Caisergues,  loc.  cit.,  p.  214. 

■Pariset,  Preces  Historique,  p..  163. 
="Fellowes,  p.  478;  Bally,  p.  90. 
^Cheirvin,  Examen  Critique,  p.  70. 


632  HISTORY    OF    YELLOW    FEVER. 

in  1819.  Clierviu  {Examen  Critique,  p.  68)  denies  this, 
but  the  official  report  of  the  Xeres  health  authorities  as- 
sert that  such  was  the  case,*  an  opinion  also  shared  by 
Berenger-Feraud  (p.  901).  Whether  the  Bohemians  were 
guilty  or  not,  it  is,  nevertheless,  true  that  the  first  cases 
were  observed  in  the  persons  of  two  soldiers  who  had 
taken  lodgings  at  the  house  of  the  women  located  in  the 
Calle  de  Pavia,  and  who  died  shortly  afterwards.  From 
this  focus,  te  disease  spread  to  other  quarters  of  the  town, 
but  the  advent  of  the  cool  season  prevented  a  general 
diffusion  of  the  malady.  Out  of  a  population  of  45,000, 
there  were  1,262  cases,  of  which  408  proved  fatal.^^^ 

i820. 

On  August  10,  1820,  a  woman  arrived  at  Xeres  de  la 
Frontera  from  Cadiz,  where  yellow  fever  was  prevailing, 
and  hired  herself  as  a  servant  to  a  woman  named  Rameiro 
in  the  Calle  Torneria.  Feeling  indisposed  she  only  re- 
mained two  days  at  this  house  and  repaired  to  the  abode 
of  an  old  friend  in  the  Calle  de  Arcos.  She  remained 
there  two  days,  when  she  was  removed  to  the  hospital  de 
la  Sangre,  where  she  shortly  afterwards  died. 

On  the  14th,  15th  and  16th  of  the  same  month  (August), 
eight  persons  living  in  the  house  in  Calle  de  Arcos  and 
two  in  the  house  of  the  Eameiro  woman,  were  attacked 
by  "a  mysterious  disease."     Five  of  these  patients  died. 

The  official  records  state  that  there  were  201  cases,  of 
which  102  proved  fatal,  but  Jackson  {Remark's  on  the 
Epidemic  Yellow,  etc.,  p.  137),  states  that  the  mortality 


*  En  la  Calle  de  Pavia  se  hospodo  una  gitana  procedente  de  la 
ciudad    de   San-Fernando   con   una   bija   que   trais   la   en- 
fermedad,  de  la  qui  murio  a  pocos  dias,  y  la  communico. 
=»•  La  Roche,  vol.  1,  p.  536. 
Berenger-Feraud,  p.  90. 
Pariset,  Observations,  p.  66. 
Chervin,  Examen  Critique,  p.  67. 

Bonneau    and    Sulpicy:    Recherches    sur    la    Contagion    de   la 
Fievre  Jaune.     Paris,  1823,  p.  302. 


SPAIN.  6S3 

was  iu  reality  much  higher,  for  only  those  who  were 
buried  without  the  corporate  limits  of  the  town  were 
included  in  te  dead  list.  Private  hurial  was  obtained  for 
many,  and  such  were  not  registered  as  yellow  fever 
deaths.-^- 

1821. 

.  The  first  case  of  yellow  fever  in  Xeres  in  1821,  erupted 
in  the  person  of  a  man  living  in  the  Plaza  de  la  Con- 
stitucion,  who  was  attacked  on  August  13  and  died  August 
20.     There  is  no  authentic  record  w  hence  the  man  came. 

The  second  case,  a  child  four  years  old,  was  observed  in 
Porvera  Street  a  month  later,  September  13,  and  died 
on  the  18th.     The  source  of  infection  could  not  be  traced. 

The  third  case,  that  of  a  young  girl,  erupted  on  Sep- 
tember 15,  in  a  house  a  few  yards  distant  from  the  sec- 
ond case.  The  patient  recovered.  In  this  particular  in- 
stance, the  infection  was  traced  to  Puerto  de  Santa  Maria, 
where  yellow^  fever  was  epidemic,  where  the  girl  had  re- 
mained two  days  before  coming  to  Xeres. 

From  these  foci,  the  disease  spread  to  other  quarters 
of  the  town.  Our  authorities  do  not  give  the  total  number 
of  cases  and  deaths,  from  which  fact  we  infer  that  the 
malady  did  not  attain  the  proportions  of  an  epidemlc.^^^ 

XIMENA   DE   LA   FUONTEKA. 

1804. 

Ximena  de  la  Frontera,  46  miles  east  of  Cadiz,  was  in- 
fected by  fugitives  from  the  latter  place,  on  October 
27,  1804.  The  last  case  was  observed  December  30. 
Out  of  a  population  of  7,500,  there  were  only  fifty  deaths 

"-  Periodico  de  la  Sociedad  Quirurgica  de  Cadiz,  1822,  p.  24. 

La  Roche,  vol.  1,  p.  536. 

Jackson,  p.  137. 

O'Hallorran:    Yellow  Fever  in  Andalusia  in  1820,  p.  153. 
^'O'Halloran,  p,  70. 

Ferran:   Annales  de  Medecine  Physiologique,  Paris,  1825,  vol. 
7,  p.  298. 


634  HISTORY    OF    YELLOW     FEVER. 

(29  men  and  21  women),  Avhicli  natnrallj  leads  to  the 
l>elief  that  the  disease  was  not  communicated  to  the  in- 
habitants of  the  town,  but  was  confined  solely  to 
refugee.-''^ 

YECLA. 

1812. 

In  1812,  after  the  battle  of  Salamanca,  the  French 
army  which  occupied  Andalusia  retreated  through  the 
Kingdom  of  Valencia.  The  fourth  division  of  this  corps 
reached  the  Kingdom  of  Murcia,  where  yellow  fever  was 
prevailing,  about  the  1st  of  October.  They  passed  through 
the  town  of  Ziczar  (which  was  also  infected),  and  camped 
on  the  outskirts,  where  they  remained  about  two  days. 
They  reached  Jumilla  where  yellow  fever  was  also 
present,  but  did  not  enter  the  town,  on  account  of  its 
unhealtliin(\ss.  Continuing  their  march,  the  soldiers 
finally  reached  Yecla,  14  miles  north  of  jNIurcia,  on  the 
Jumilla  Eiver,  where  they  concluded  to  camp.  Some  of 
the  soldiers  were  soon  taken  ill  and  tlie  disease  diagnosed 
as  yellow  fever  by  the  army  surgeon.  A  baker  attached 
to  the  division  died  on  the  9th.  This  case  was  rapidly 
followed  by  others.  Between  October  8  and  15,  about  one 
hundred  deaths  occurred.  The  nmlady  tlien  gradually 
subsided  and  became  extinct  by  the  latter  part  of 
October.255 

ZIEZA. 

1811. 

Zieza  (or  Ciezar),  erroneously  called  Zuzar  by  Beren- 
ger-Feraud,  was  infected  by  refugees  during  the  epidemic 
wave  of  yellow  fever  wliicli  passed  over  soutliern  Spain 
in  1811.     No  details  are  given  by  our  authority.^^^ 

^  Fellowes,  p.  478. 

Bally,  Francois  and  Pariset,  p.  79. 
^Peyson:   Journal  General  de  Medecine,  1820,  vol.   71,  p.  343. 
*°*  Berenger-Feraud,  p.  83. 


SPAIN.  635 

1812. 

Two  refugees  from  Cartagena  brought  yellow  fever  to 
Zieza  in  the  beginning  of  September,  1812.  Almost  the 
entire  population  fled  to  the  country,  but  there  were  still 
some  sick  left  when  the  French  army  passed  through  the 
town  on  October  1.  They  found  the  place  deserted,  with 
unburied  corpses  in  many  of  the  houses.  The  troops  did 
not  stop  at  this  place,  but  they  were,  nevertheless,  infected 
and  carried  the  disease  to  Yecla  (q.  v.),  where  many  of 
the  soldiers  perished  from  the  prevailing  sickness.-^'^ 


-^''  Berenger-Feraud,  p.  S5;  Peyson,  loc.  cit.,  p.  343. 


HISTORY 


OF 


YELLOW  FEVER 


IN 


NORTH  AMERICA. 


639 


Proofs  that  Yellow  Fever  Is  ax  American  Product 

AND  Was  Unknown  to  Europeans  Before  the 

Time  of  Columbus. 

The  historv  of  yellow  fever  in  America  dates  from  the 
second  voyage  of  Columbus,  1493.  Before  that  time  the 
disease  was  presumably  unknown  to  the  civilized  world. 
Traditional  accounts  given  by  the  Aztecs  and  other  Indian 
tribes  of  the  countries  and  islands  washed  by  the  Gulf 
of  Mexico,  state  that  a  disease  possessing-  all  the 
cliaracteristics  of  yeUow  fever  committed  fearful  rav- 
ages among  the  tribesmen  long  before  the  discovery  of 
America,  being  known  under  the  name  of  Cocolitzle  and 
Matlazahuatl  by  the  aborigines.  We  have  not  the  slight- 
est doubt  of  the  identity  of  this  affliction  with  the  malady 
now  known  as  yellow  fever,  as  the  pest  was  unknown 
to  Europeans  before  the  colonization  of  the  New  World; 
but  Science,  after  over  four  hundred  years  of  investi- 
gation, has  failed  to  establish  a  connecting  link  between 
the  two  diseases. 

Finlay  makes  a  valuable  contribution  to  the  literature 
on  the  subject  of  American  origin  of  yellow  fever  in  the 
Clhnatologist*  in  which,  after  reviewing  what  others 
have  said  about  the  origin  of  the  disease,  and  giving  his 
own  views,  goes  on  to  show  that  yellow  fever  was  known 
to  the  American  Indians  before  the  discovery  of  America. 
Dr.  Finlay's  conclusions  are  based  upon  his  interpreta- 
tion of  a  philological  study  on  the  the  names  of  "America" 
and  "Yucatan,"  by  the  Bishop  of  Yucatan,  Dr.  Crescencis 
Carillo  y  Ancona.  While  reading  this  scholarly  work. 
Dr.  Finlay  came  across  a  quotation  from  the  "Chumayel 
manuscript,"  which  reads  as  follows : 

"There  ivas  hlack  vomit,  which  hegau  to  occasion  deaths 
among  us  in  1648." 

This  statement  immediately  suggested  the  idea  that 
among  the  Indian   manuscripts  of   Yucatan,   might   be 


640  HISTORY    OK    YELLOW     FEVER. 

foiuid  the  evidence  that  was  wanted  to  prove  that  yellow 
fever  was  not  unknown  to  the  American  Indians  before 
the  advent  of  Columbus.  Accordingly,  the  matter  was 
submitted  to  the  learned  Bishop  himself,  acquainting  him 
with  the  state  of  the  question  and  begging  for  information 
on  the  following  points : 

Whether  among  the  Maya  documents  that  he  had  ex- 
amined in  the  course  of  his  other  researches,  any  data 
had  been  met  confirmatory  of  Dr.  Finlay's  conjectures, 
or  tlirowing  light  on  the  subject  of  the  epidemics  called 
cocolitzley  which,  according  to  Herrera  (Decada  4,  Ub. 
9,  Cap.  6),  used  to  attack  the  Mexican  Indians  on  the 
coast  of  New  Spain  before  the  arrival  of  the  Spaniards. 

In  answer  to  this  request,  the  Rev.  Bishop  Avrote  a 
most  interesting  and  instrucive  letter,  containing  a  full 
discussion  of  the  subject  and  valuable  data  not  to  be 
found  in  the  literature  of  the  period.  Dr.  Finlay's  article 
in  tile  CliimttoIo(/ist  was  inspired  by  this  important  com- 
munication, which  is  here  reproduced,  and  we  hold  that 
it  has  such  an  important  bearing  upon  the  question  under 
discussion,  that  we  summarize  it  in  these  ])ages. 

After  proving,  upon  the  best  testimony,  that  Yucatan, 
until  the  year  1(148,  liad  been  pronounced  by  all  the 
Spa.nish  writers  a  most  salul)rious  country,  exempt  from 
the  diseases  that  prevailed  in  other  places,  no  epidemic 
of  any  kind  having  been  observed  in  it  from  the  com- 
mencement of  the  Spanish  colonization  in  1517  until 
1648,  the  Rev.  Bishop  Carrillo  concludes  that  the  dis- 
eas(^  called  rocolifzle  by  the  ^Mexicans,  and  which  pre- 
vailed annually  at  Vera  Cruz  before  the  Spanish  invasion, 
did  not  habitually  manifest  itself  in  Yucatan.  Regard- 
ing the  disease,  he  calls  attention  to  the  circumstance 
that,  from  Herrera's  own  account,  it  is  easily  seen  that  a 
distinction  was  made  by  the  IMexicans  between  the  local 
endemic,  properly  designated  under  the  nam(^  of  cocolitdc, 
and  a  broader  application  of  the  same  term,  qualified 
by  some  expletive  such  as  "general"  or  "universal"  when- 
ever it  was  used  to  designate  other  epidemic  invasions 
that  extended  over  the  whole  country,  as  subsequently 


NORTH    AMERICA  641 

happened  with  small-pox.  The  local  endemic,  the 
cocolitzle  proper,  existed  at  Vera  Cruz,  "some  years  more 
violent  than  others;"  and  the  reason  why  the  Spaniards 
found  so  large  a  population  on  that  coast  was  that,  on 
occasions  when  the  cocolitzle  had  been  particularly  severe, 
Montezuma  used  to  send  8000  families  from  the  interior 
to  repeople  the  coast,  exempting  them  from  taxes  during 
a  term  of  years  and  granting  them  other  privileges.  This 
cocolitzle  may,  therefore,  have  been  yellow  fever,  but  at 
any  rate  it  did  not  occur  at  Yucatan  between  the  years 
1517  and  1748.  He  next  goes  on  to  prove  the  epidemic 
of  1648,  alluded  to  as  "black  vomit"  in  the  "Chumayel 
manuscript,"  was  in  reality  yelloAV  yever;  and  does  so 
very  effectively  by  reproducing  a  most  remarkable 
description  of  the  epidemic  by  an  eye-witness,  the  Yuca- 
tan historian.  Pray  Diego  Lopez  de  Cogolludo,  who  was 
himself  attacked  by  the  disease.  This  account  is  so 
graphic,  so  rich  in  sagacious  remarks,  and  so  acucrate 
in  its  clinical  details,  that  it  well  deserves  to  be  given 
here.     Tt  runs  thus  : 

"1648.  Shortly  after  the  commencement  of  the  solar 
year,  in  the  month  of  March,  the  sun  appeared  for  sev- 
eral days  to  be  eclipsed,  the  air  being  so  thick  that  it  had 
the  appearance  of  a  mist  or  condensed  smoke.  This  was 
so  general  that  every  part  of  the  land,  from  Cozumel  to 
Tobasco,  offered  the  same  unwliolef^ome  condition.*  *  * 
In  the  city  of  Merida,  especially  towards  evening,  when 
the  winds  generally  set  from  the  sea,  a  bad  smell  was 
brought  with  it  that  could  scarcely  lie  borne,  and  pene- 
trated everywhere.  The  cause  of  this  smell  was  un- 
known until  a  Spanish  vessel  happened  to  run  aground 
over  an  immense  heap  of  dead  fish  near  the  shore.  It 
was  from  these  fish,  which  were  being  waslied  ashore  by 
the  tide,  that  the  smell  had  proceeded,  extending  as  far 
as  the  city,  and  even  beyond.  In  April  and  IMay  some 
sudden  deaths  occurred,  which  caused  alarm  in  the  city 
of  Merida.  At  the  beginning  of  June  the  scourge  of  the 
peste  commenced  in  the  town  of  Campeche,  and  in  a 
few  days  became  so  severe  that  the  place  was  completely 


6i2  HISTORY    OF    YELLOW    FEVER. 

ravaged.  *  *  *  The  roads  to  Campeche  were  guarded 
for  fear  that  the  contagion  should  spread;  but  if  the  Lord 
guards  not  the  city  what  shall  human  efforts  avail !  With 
this  fear  of  Divine  justice  the  month  of  July  passed,  until 
towards  the  end  a  few  persons  began  to  sicken,  dying 
very  soon;  but  the  disease  was  not  considered  epidemic 
until  the  month  of  August,  With  such  violence  and 
rapidity  were  the  people  attacked,  big  and  small,  rich 
and  poor,  that  in  less  than  eight  days  the  whole  popula- 
tion were  sick  at  the  same  time,  and  many  citizens  of 
the  highest  rank  and  authority  died.  *  *  *  While 
the  city  was  thus  afflicted  hy  this  calamity,  never  before 
seen  since  tliis  country  was  conquered  hij  the  Spanish 
nation,  permission  was  asked  that  the  image  of  Our  Lady 
of  Itzamal  might  be  brought.  *  *  *  Very  great  was 
the  tribulation,  such  a  calamity  having  never  been  experi- 
enced before.  *  *  *  In  other  countries  epidemics  oc- 
cur as  a  common  evil  which  attacks  uniformally  all  the 
people,  but  such  was  not  the  case  in  Yucatan,  which 
caused  greater  confusion.  It  u-as  impossible  to  say  what 
the  disease  kms,  for  the  physicians  did  not  recognize  it. 
In  most  of  the  cases  the  patients  were  taken  with  a  most) 
severe  and  intense  headache,  and  pains  in  all  the  bones 
of  their  bodies,  so  violent  that  their  limbs  felt  as  if  torn 
asunder  or  squeezed  in  a  press.  A  few  moments  after 
the  pains  came  on  a  very  intense  fever  which  in  most 
instances  produced  delirium,  though  not  in  all.  This  was 
followed  by  vomiting  of  blood,  as  if  putrefied,  and  of  such 
cases  very  few  survived.  Some  were  attacked  with  dis- 
charges from  the  bowels  of  a  bilious  humor,  which 
being  corrupt  occasioned  dysentery  without  vomiting, 
while  others  again  made  violent  efforts  to  vomit  without 
being  able  to  discharge  anything,  and  many  suffered  the 
fever  and  pains  in  the  bones  without  any  of  the  other 
symptoms.  *  *  *  In  the  majority  the  fever  seemed 
to  remit  completely  on  the  third  day;  they  would  say  that 
they  felt  no  pains  whatever,  the  delirium  would  cease,  the 
patients  conversing  in  their  full  senses,  but  they  were 
unable  to  eat  or  drink  anything;  they  would  continue 


NORTH     AMERICA.  643 

this  for  one  or  several  daj^s,  and  wliile  still  talking  and 
saying  they  were  quite  well,  they  expired.     A  great  num- 
ber did  not  pass  the  third  day,  the  majority  died  on  the 
fifth,  and  very  few  i:eached  the  seventh,  excepting  those 
who  survived,  and  these  were  mostly  advanced  in  years. 
The  most  robust  and  healthy  of  the  young  men  were  most 
violently  attacked  and  died  soonest.     *     *     *     Although 
a  great  many  women  were  taken  sick,  the  disease  Avas  less 
severe  in  them  than  in  men.     *     *     *     Some  cases  oc- 
curred in  which  the  patient  passed  the  fever  in  a  sleep, 
until  they  recovered,  having  no  one  to  administer  remedies 
to  them.     In  houses  of  large  families  there  Avere  scarcely 
any  one  to  attend  to  the  sick  or  to  fetch  the  sacraments 
for  them.     This  spiritual  difficulty  was  remedied  by  the 
charity  of  the  priests,  both  secular  and  regular,  who  went 
about  the  street  by  day  and  night  carrying  with  them  the 
Holy  Viaticum  and  the  Holy  Oils,  and  visited  the  houses 
to  administer  the  same  to  such  as  required  them.     *     *     * 
When  the  laity  began  to  improve,  the  disease  broke  out 
among  the  priests.     Of  eight  members  of  the  Jesuits  col- 
lege, six  died.    *     *     *     Of  our  own  Order  (Franciscans) 
twenty  died  in  the  city.     Almost  all  the  heads  of  insti- 
tutions and  persons  of  highest  ranks,  both  ecclesiastics 
and  seculars,  were  carried  away  by  the  epidemic.     *     *     * 
While  it  lasted  in  its  full  intensity  among  the  Spaniards, 
the  Indians  were  not  attacked,  excepting  those  who  lived 
with  the  former,  or  A\'ho,  having  visited  the  city,  left  it 
already  touched  by  the  disease;  most  of  these  died  in 
their  villages,  but  did  not  communicate  their  illness  to 
those  who  attended  them.     This  emboldened  the  Indians 
to  declare  that  the  scourge  was  a  punishment  of  God, 
and  that  only  the  people  of  cities  and  town  Avere  attacked 
for  their  ill-treatment  to  the  Indians.     *     *     *      /V  deceit- 
ful Indian  spread  the  report  that  all  the  Spaniards  in 
Yucatan  Avould  die,  and  the  Indians  Avould  be  left  by 
themselves.     *     *     *     Finally,   this   man   was   taken   up 
and  the  rumor  ceased.     *     *     *     Soon,  however,  did  our 
Lord  undeceive  the  Indians  of  their  presumption,  for  a 
few  days  after  the  aboA'e  occurrence  the  illness  broke  out 
in  many  of  the  Indian  villages,  causing  fearful  havoc,  as 


644  HISTORY    OF    YELLOW    FEVER. 

was  to  be  expefted,  coiisideriiig-  their  want  of  comfort 
or  medicine.  *  *  *  ^lie  disease  continued  over  the 
wh(de  country  during  the  space  of  two  years.  *  *  * 
Few  tliat  lived  in  this  hind  or  visited  it  in  the  course  of 
those  two  years  escaped  being  sick,  and  it  rarely  hap- 
pened that  a-ny  one  died  of  a  second  attack  after  having 
recovered  from  the  first.  All  remained  pale  as  ghosts, 
without  hair,  many  lost  their,  eyebrows,  and  all  were  so 
jDulled  down  that  even  after  two  days'  fever  with  mod- 
erate pains  (such  as  happened  to  myself),  it  was  many 
days  before  they  could  recover  their  strength.  *  *  * 
In  the  year  of  1050,  on  our  way  to  visit  the  province  of 
Guatemala  *  *  *  having  to  pass  through  an  exten- 
sive pine  wood  * ,  *  *  we  observed  that  since  the  year 
of  1(U8,  in  Avhicli  the  epidemic  had  commenced,  some 
pestilential  air  or  other  noxious  influence  had  dried  up 
all  the  full  grown  pine-trees,  *  *  *  only  the  young 
ones  remained  with  life.  I  then  reflected  that  of  the 
young  children  who  were  attacked  h\  the  pcste  in  Yucatan 
only  a  few  had  died,  as  compared  with  the  adults." 
{Cof/olhido-Hisioria  dc  Yucatan,  Libro,  XII,  Capitulo 
XII;  XIII;  XIV). 

The  Rev.  Bishop,  after  this  quotation,  states  that  the 
Spanish  historian  finding  himself  at  a  loss  to  classify  or 
to  name  the  curious  nuilady  which,  after  the  lapse  of  over 
a  century,  affected  the  Spaniards  of  Yucatan,  found  him- 
self consti'aincMl  to  give  a  minnte  account  of  its  symptoms 
and  circumstances;  whereas,  the  "Chumayel  manuscript'' 
only  needs  one  sigle  word,  both  graphic  and  appropriate, 
in  order  to  record  the  occurrence  of  the  epidemic,  by  its 
sjtecial  name,  in  the  corresponding  chronological  note 
which  it  has  been  his  good  fortune  to  give  to  the  learned 
world  in  the  fac-simile  that  accompanies  his  PJiilolor/ical 
^tiidy  on  the  names  of  America  and  Yucatan — TcJici 
xekik  hoppci  cimil  toon  1048  anos — which  means:  There 
was  black  vomit,  which  began  to  cause  death  among  us  in 
the  year  1048. 

Even  without  knowing  the  Maya  language,  read  care- 
full  v  that  line  of  text  and  observe  the  second  word,  rcJdk. 


NORTH    AMERICA.  645 

111  the  Dictionary  of  Don  Jnaii  Pio  Verez,  you  will  find 
it  rendered  by  roiiiito  pricio,  roiiiifai-  sanf/rc  (black  vomit, 
to  vomit  blood).  The  words  that  follow  means:  ''And 
we  ourselves  began  to  die — -'■  referring  to  the  Indians ;  for 
Avhicli  reason  Cogolludo  has  said  that  at  the  commence- 
ment of  the  epidemic,  only  the  b^paniards  were  attacked, 
but  subsequently  the  Indians  also  began  to  suffer. 

This  philological  demonstration  must  be  continued  in 
the  Bishop's  own  words : 

"Nothwithstanding  that  from  this  statement  alone  of 
the  CJnoiiaijrl  manu.scr'ipt,  I  infer  that  the  roiiiito  negro 
was  known  to  the  indigenous  historians,  though  new  to 
the  Spaniards  of  Yucatan,  this  would  only  constitute  a 
conjecture,  more  or  less  grounded ;  whereas,  what  is  re- 
quired, as  you  say,  is  a  decisive  fact.  This  brings  us  to 
the  essential  and  culminating  point  of  the  present  letter." 

"The  Majfa  uiauuscripts  that  I  possess,  like  alt  the 
sacred  books  of  the  ancient  Yucatec-os  or  ChiJam-hakim 
books,  as  they  are  vulgarly  known,  have  precisely  for  their 
principal  object  the  recording  of  chronological  notes  con- 
cerning their  feasts  to  their  gods,  wars,  pestilences, 
famines  and  invasions  by  the  Spaniards.  They  are  chron- 
icles and  calendars.  I  therefore  proceeded  to  examine 
them  more  particularly  in  such  parts  as  concord  with 
the  Chumai/cl  regarding  the  seventeenth  century  and  the 
occurrence  of  the  great  epidemic,  and  find  the  following 
conclusive  statement  in  the  Tzinuii  mcnui.script  (which  I 
have  so  named  because  it  proceeds  from  the  Tzimin 
Indians  (Tzimincah),  between  the  folios  16  (verso) 
and  17: 

"In  English:  'In  the  4th  ahau  (year  of  the  Mayas), 
at  the  expiration  of  a  katun  (their  century)  which  is 
counted  towards  the  well  of  Chichenitza,  at  the  placing 
of  the  stone  katan,  arrival  of  Kuk,  arrival  of  Yaxum 
(nn/tJiolof/icat  and  hisiorical  characters  irho  (/arc  their 
names  to  the  epochs)  arrival  of  Kantenal,  OCCURRED 
THE  ARRIVAL  OF  BLACK  VO:\riT  FOR  THE 
FOURTH  TIME,  arrival  of  Kukulcan,  after  the  Ytzaes, 
at  the  fourth  placing  and  signification  of  the  katun.' 


646  HISTORY    OF    YELLOW    FEVER. 

"This  statement  throws  much  light  on  that  of  the 
Chmnayel,  for,  in  speaking  of  the  same  epidemic  cor- 
responding to  the  year  1648,  it  says  most  positively  that 
it  was  the  fourth  time  that  it  had  visited  this  country;  and 
considering  that  since  the  discovery  in  1517  until  the  said 
year  of  1618,  in  which  the  epidemic  broke  out,  it  had 
never  been  seen  by  the  Spaniards,  it  must  follow  that 
the  three  previous  invasions  had  occurred  before  the 
discovery." 

The  Rev.  Bishop  goes  on  to  say  that  so  true  is  this,  that 
the  same  historians  he  has  quoted  before  to  prove  the 
constant  healthiness  of  the  climate  of  the  Yucatan  penin- 
sula, and  that  i)i  it  tcere  not  experienced  the  disease  that 
occurred  in  other  lands — all  are  equally  agreed  in  stating 
that  great  epidemics  had  been  suffered  in  Yucatan  before 
the  discovery,  thereby  conrming  the  words  in  the  Tziman 
manuscript. 

The  Rev.  Fray  Don  Diego  de  Lauda,  who,  it  must  be 
remembered,  was  a  missionary  in  Yucatan  during  the  first 
epoch  after  the  discovery,  expressed  himself  in  the  follow- 
ing terms: 

"Various  calamities  were  experienced  in  Yucatan  in 
the  century  before  the  conquest,  hurricanes,  pestilences, 
wars,  etc.  ♦  ♦  *  There  came  all  over  the  land  certain 
pestilential  fevers,  which  lasted  twenty-four  hours,  and 
after  the  patients  would  smell  and  break  out  full  of 
worms,  and  from  this  pestilence  a  great  number  died,  and 
a  great  ])art  of  the  croi)s  could  not  be  gathered  ;  that  after 
the  epidemic  liad  ceased  they  had  a  period  of  sixteen  good 
years,  during  which  their  quarrels  and  dissensions  were 
renewed,  so  that  one  hundred  and  fifty  thousand  men 
were  killed  in  wars,  after  which  they  were  ([uieted,  made 
peace  and  rested  during  twenty  years,  and  when  they 
were  attacked  hi/  a  pestilence  of  large  boils,  Avhich  rotted 
their  bodies  with  great  fetidness,  so  that  their  liml)S  would 
drop  off  in  pieces  in  the  course  of  four  or  five  years." 
(Landa,  Relacion  de  las  co^as  de  Yucatan.  Ann  de 
1566). 

The  same  account  is  given  by  Herera  {Decada  IV,  Libro 


NORTH     AMERICA.  64? 

X^  Cap.,  Ill)  and  other  historians,  and  it  must  be  par- 
ticularly remembered  that  the  Eev.  Bishop  Landa  had 
at  his  disposal  a  great  number  of  Maija  manuscripts, 
painted  skins,  and  other  historical  relics  of  the  Yucatan 
people;  a  notorious  fact,  which  is  attested  both  by  his 
important  work,  just  quoted,  and  by  the  accusation 
brought  up  against  him  of  having  burned  such  documents 
in  the  auto  da  fc  that  took  place  in  Man. 

The  author  holds,  therefore,  as  sufficiently  proven  and 
for  a  certain  and  unquestionable  fact,  that  the  Indians 
of  Yucatan  suffered  from  the  vomito  negro  as  an  epidemic, 
before  the  advent  of  Columbu.s,  and  consequently  yellow 
fever  is  a  disease  properly  belonging  to  America. 

There  is  another  statement,  though  only  of  an  accessory 
character,  is  the  Maya  manuscript,  which  the  Kev.  Bishop 
found  in  the  Prescription  Books  of  the  Indians,  of  which 
he  possessed  several  ancient  copies,  in  the  Maya  language. 
In  almost  all  these  books,  the  following  prescriptions 
appears : 

.  /'^U  cacal  xekih  ti  unic,  mu  hach  ehaci,  maix  Jdki  hay  u 
kah  yhacna,''  which  means:  'medicine  for  the  vomiting  of 
blood  for  the  persons  who  discharge  it;  not  properly  of 
a  red  color,  nor  resembling  red  blood,  but  like  a  liquid 
mixed  with  soot." 

If  one  will  notice  the  last  word,  yhacna,  and  consult 
the  dictionary  of  Don  Juan  Pio  Peres,  he  will  find  that 
it  is  rendered  by  Hollin  which  in  Spanish  signifies  "a 
black  substance,  thick  and  oily,  which  the  smoke  leaves 
in  chimneys."  ^o  that  kik  hay  n  kah  y  hacna  means' 
"black  vomit,  like  an  infusion  of  soot."  Thanks,  there- 
fore, to  this  unexpected  application  of  the  Rev.  Bishop 
Carrillo's  extensive  philological  and  bibliographical  learn- 
ing, the  vexed  question  of  the  origin  of  yellow  fever  and 
the  true  nature  of  the  early  epidemics  experienced  by  the 
Spaniards,  on  their  arrival  to  these  parts  of  America,  ever 
since  the  days  of  Columbus,  may  be  considered  as  defin- 
itely settled. 

Dr.  Pinlay  states  that  notwithstanding  that  the  chrono- 
logical system  of  the  Mayas  and  the  concordance  of  their 


648  HISTORY    OF    YELLOW    FEVER. 

dates  with  our  Christian  era  are  but  imperfectly  under- 
stood, tlie  learned  bishop,  in  a  subsequent  letter,  informed 
him  that  he  had  other  grounds  for  his  assertion  and  aliso- 
lute  conviction  that  the  epidemic  of  black  vomit,  referred 
to  in  the  Tzimm  manuscript,  is  the  same  that  we  find 
recorded  in  the  CJnnuai/rl  under  the  date  of  1048.  "He 
wrote  Dr.  Finla.y  that  althoufih  the  quotation  from  the 
Tzimin  manuscript  does  not  contain  the  date  (expressed 
in  vears  of  the  Christian  era),  the  book  commences  its 
clironological  notes  with  the  year  ''1593,"  so  written,  in 
the  hand  of  the  Indian  author  and  with  the  same  figures 
that  we  now  use  (folio  1,  line  2).  If  we  follow  the  text', 
l)age  after  page,  and  without  omiting  a  single  word,  it  is 
observed  that  no  invasion  of  "vomiting  of  blood"  is  re- 
corded until  folio  17  is  reached;  here  the  author  for  the 
first  time  mentions  such  an  invasion,  adverting  that  it 
was  the  fourth  that  had  occurred.  Now,  tliat  it  is  a 
proven  fact  that  after  the  year  1593,  and  even  since  the 
discovery  of  Yucatan  in  1517,  no  epidemic  of  hlach  vomit 
had  occurred  until  1648,  to  this  same  year  must  cor- 
respond the  fourth  epidemic  mentioned  in  the  Tzimin 
manuscript,  and  the  three  previous  ones  must  have  taken 
place  before  the  year  1593,  at  which  time  chronological 
record  begins. 

If  the  Tzimin  text  does  allude  to  "black  vomit"  or 
yellow  fever,  before  the  invasion  which  the  author  quali- 
fies as  the  fourth,  he  does  so  not  in  a  historical  sense, 
but  as  a  calamity  to  be  dreaded  in  evil  times.  It  must 
be  remembered  that  these  CJiiJam  hclam  books  are  cal- 
endars, which  not  only  contain  chronological  and  his- 
torical notes,  but  also  predictions  that  in  a  prophetic 
style  had  been  made  in  their  ancient  times.  This  one, 
for  instance,  is  a  literal  translation  from  the  same  Tzimin 
nmiiKScript : 

"At  the  end  of  the  2nd  ahan  *  *  *  \t  will  happen 
that  the  i)eople  will  have  to  seek  laboriously  ffvr  food  as 
far  as  the  shores  of  the  sea,  eating  the  young  leaves  of 
plants,  and  with  setting  of  the  Jcatiim,  days  will  come 
•when  great  vomiting  of  hlood  will  afflict  the  people,  and 


NORTH     AMERICA.  6W 

all  joy  will  cease;  then,  in  order  to  find  food,  it  will  be 
necessary  to  solye  enigmas  that  will  be  proposed;  and 
after  those  troubles  are  passed,  after  the  katiim^  days  of 
consolation  will  come." 

The  fact  that  the  Indians  introduced  in  their  prognos- 
tics of  eyil  days  the  threat  of  rouiifiiif/  of  hlood,  concludes 
Dr.  Finlay,  is  another  proof  that  the  disease  had  been 
well  known  to  them  since  a  long  time,  and  precisely  under 
its  epidemic  form,  not  as  the  endemic  that  it  has  now 
become. 

It  is  thus  paramount,  from  Dr.  Finlay's  important 
work,  that  yellow  feyer  is  an  American  product,  was  un- 
known to  Europeans  preyious  to  the  discoyery  of  America 
by  Columbus,  and  that  Mexico,  Central  America  and  the 
West  Indies  may  be  considered  as  the  original  cradle  of 
the  awesome  scourge. 


650 

CANADA 

History  of  Yellow  in  Canada. 

Canada  enjoys  the  distinction  of  being  the  northern- 
most part  of  the  American  Continent  where  yellow  fever 
has  been  observed.  It  is  true  that  only  sporadic  im- 
ported cases  of  the  disease  have  appeared  within  its 
domain,  but  had  the  Htegomy'm  Calopus  been  present  at 
the  time  of  these  isolated  manifestations,  there  is  no  doubt 
that  a  different  story  would  have  been  told  in  these  pages. 

In  most  works  on  epidemiology,  Quebec,  which  is  in  lat- 
itude 40°  49"  6'"',  is  given  as  the  northernmost  point  in 
America  where  yellow  fever  has  ever  been  imported. 
Such  was,  until  very  recently,  also  our  belief,  as  will  be 
seen  by  referring  to  page  G3  of  this  volume,  where  we  give 
Quebec  as  the  most  northern  port  in  the  Western  Hemi- 
sphere where  yellow  fever  has  made  its  appearance.* 
While  "nosing  about''  musty  times  and  cobwebby  docu- 
ments, we  came  across  an  old  work  by  the  distinguished 
French  naval  surgeon  Keraudren,  published  in  1823. 
This  valuable  contribution  to  epidemiology  is  entitled 
De  la  Ficvrc  Jaune  Oh^errcc  au.r  AniiUcs  ct  sur  Ics  Yais- 
seaux,  Considcree  PrincipaJcmcnt  Sous  le  Rapport  de  sa 
Tran.wiissio7i.  Kreaudren,  who  was  then  Physician-in- 
Chief  of  the  French  Navy  and  Inspector  General  of  the 
Health  Department  of  the  Navy,  gives  an  interesting 
account  of  the  outbreak  of  yellow  on  board  the  Tarn, 
which  became  infected  at  Martinique  in  1819.  At  that 
period,  whenever  practicable,  as  soon  as  the  terrible  dis- 
ease manifested  itself  on  board  a  ship  attached  to  the 
French  squadron,  orders  were  at  once  recei\ed  to  set  sail 
for  a  colder  clime,  the  point  of  refuge  being  generally 
either  New  Foundland  or  the  islands  of  Saint  Pierre  and 
Miquelon,  which  lie  off  the  south  coast  of  the  former. 
Keraudren  states  that,  thanks  to  this  wise  precaution, 
the  lives  of  many  seamen  were  saved,  for,  as  the  infected 
vessel  approached  the  northern  seas,  the  disease  gradually 
abated,  generally  ceasing  altogether  before  reaching  its 


CANADA.  e/il 

destination.  A  sojourn  of  a  few  weeks  was  then  sufficient 
to  purify  the  ship. 

Kreaudren  informs  us  (loc.  cit.,  page  18),  that  the 
Tarn^  of  the  French  West  Indian  Squadron,  left  Marti- 
nique July  15,  1819.  Two  days  later,  a  sailor  was 
stricken  with  yellow  fever  and  died  the  following  day. 
On  July  28  while  in  33°  34'  north  latitude,  four  seamen 
were  taken  sick  with  yellow  fever,  followed  the  next  day 
by  six  others.  Two  of  these  patients  died,  one  on  the 
fourth  and  the  other  on  the  fifth  day  after  being  attacked. 
Two  died  while  the  Tarn  was  actually  in  the  harbor  of 
Saint-Pierre,  one  on  the  seventh  and  the  other  on  the 
tenth  day  after  the  onset  of  the  malady. 

Saint-Pierre-de-Miquelon  which  is  in  latitude  47°  30', 
is  therefore  the  most  northern  point  in  America  Avhere 
yellow  fever  has  ever  been  observed.  The  disease  was 
not  communicated  to  the  shore  nor  to  the  other  vessels 
in  the  harbor,  but  had  the  same  conditions  which  pre- 
vailed at  Martinique,, the  original  point  of  infection,  ex- 
isted at  Saint-Pierre-de-Miquelon,  the  importation  Avould 
undoubtedly  have  been  followed  by  disastrous  results. 
This  point  is  incontestably  upheld  by  the  fact  that,  al- 
though yellow  fever  ceased  entirely  while  vessels  infected 
in  the  AVest  Indies  or  other  southern  latitudes  were  in 
the  harbors  of  Saint-Piere,  iNIiquelon  or  New  Foundland, 
many  instances  are  recorded  where  the  disease  reappeared 
with  renewed  energy  when  these  same  vessels  returned  to 
to  the  southern  seas,  before  any  communication  what- 
ever with  the  shore.  This  phenomenon  is  attributed  by 
Keraudren  to  the  torrid  heat  of  the  southern  latitudes; 
we,  basking  in  the  lime-light  of  the  twentieth  century 
knowledge,  phlegmatically  attribute  it  to  the  re-awaken- 
ing of  the  ^tcffomijia  Calopus,  whose  sphere  of  misdi- 
rected usefulness  had  been  nullified  by  the  rigors  of  a 
boreal  clime. 

We  have  found  it  amusing,  when  analyzing  the  theories 
of  the  thousands  of  learned  epidemiologists  of  the  past  who 
have  written  ah  lihifiini  about  the  transfission  of  yellow 
fever,  to  observe  how  nicely  their  views  dovetail  into  the 
mosquito  theory  of  the  glorious  twentieth  century.     lAc- 


652  HISTORY    OF    YELLOW    FEVKR. 

cording  to  what  they  consider  incontestable  proof  that 
the  disease,  in  such  and  such  an  instance  had  been  trans- 
mitted by  the  wind,  foul  odors,  old  clothes,  personal  con- 
tact, casks  of  sugar  and  other  odds  and  ends,  the  ear- 
marks of  the  calopus  can  be  distinguished  without  the 
aid  of  a  microscope  and  what  was  deemed  impenetrable 
darkness  suddenly  becomes  unclouded  daylight. 
Verily,  times  do  change.     • 

CHKOXOLOGY  OF  YELLOW  FEVEE  IX  CANADA. 


1805. 

Quebec. 

1812. 

Quebec. 

1819. 

Saint-Pierre  and  Miquelon. 

1801. 

Halifax. 

1801. 

Quebec. 

1878. 

Halifax. 

1880. 

Prince  Edward  Island. 

By  Localities. 

Halifax.     1861;  1878. 
Quebec.     1804;  1812;  1864. 
Prince  Edward  Island.     1880. 
•^^aint-Piere  and  Miquelon.     1819. 

NOVA  SCOTIA. 

HALIFAX. 

Yellow  FEyER  Years. 

1842;  1861;  1878. 

Summary  of  Importations. 

1842. 

The  Case  of  Ihe  ToJage.^ 

The  British  ship,  Tohifje,  was  commissioned  at  Chat- 
ham, England,  August  2,  1841,  and  sailed  for  the  West 
Indies  on  January  2,  1842,  calling  on  her  way  at  ]\radeira 
and   Bermuda,   and   remaining  some  time  at  the  latter 


i 


CANADA.  653 

place  to  refit.  She  anchDred  at  Port  Roj^al,  Jamaica,  on 
Marcli  3,  1842,  and  remained  there  until  the  2Gth  of 
April ;  she  then  sailed  for  Santa  Martha  and  Carthagena, 
Colombia,  and  returned  to  Port  Royal  on  the  12th  of  May. 
On  the  19th  she  again  took  her  departure  for  Colombia, 
where  she  arrived  on  the  23rd,  and  where  she  stopped 
eight  days  at  Chagres,  revisiting  afterwards  Carthagena 
and  Santa  Martha.     This  cruise  occupied  nearly  a  month. 

In  the  month  of  March,  April  and  May,  1842,  a  few 
cases  of  fever  occurred  which  were  of  a  mild  character, 
and  yielded  readily  to  the  customary  remedies.  These, 
however,  proved  the  precurors  of  an  alarming  outbreak 
of  yellow  fever,  which  commenced  on  the  18th  day 
of  May,  and  continued  to  spread,  at  fiist  slowly,  but  after- 
wards rapidly  and  extensively  amongst  the  officers  and 
crew. 

Two  cases,  which  terminated  fatally,  with  yellow  suf- 
fusion and  black  vomit,  occurred  on  the  25th  of  June,  at 
Port  Royal.  There  were  then  17  cases  on  the  sick  list, 
exclusive  of  four  at  sick  quarters.  An  immediate  change 
to  a  cooler  climate  Avas  thought  advisable,  not  only  for 
the  recovery  of  those  already  seized,  but  absolutely  neces- 
sary to  arrest  further  progress  of  the  disease.  Orders 
were,  therefore,  given  to  sail  on  the  following  moi;ning 
for  Halifax,  Nova  Scotia,  proceeding  via  the  Florida 
Channel. 

In  spite  of  the  ship  having  gore  to  a  higher  latitude, 
the  disease  advanced  with  increased  force ;  numerous  fresh 
cases  were  added  daily  to  the  sick-list,  and  continued  to 
be  so  even  for  some  time  after  her  arrival  ^t  Halifax,  and 
did  not  completely  cease  until  "all  hands"  were  landed 
on  Navy  Island. 

It  is  difficult  to  come  to  a  perfectly  satisfactory  conclu- 
sion as  to  when  the  fever  originally  broke  out  on  the 
Vohiffp,  but  it  is  evident  that  the  primary  infection  was 
Chagres,  Carthagena  or  Santa  ^lartha,  where  the  fever 
first  seriously  presented  itself,  and  where  the  disease 
is  endemic.  1 


654  HISTORY    OF    YELLOW    FEVER. 

It  will  be  perceived  that  the  fever  had  gone  on  un- 
checked for  nearly  three  months.  The  cases  at  Halifax 
were  as  virulent  as  those  which  took  place  at  sea. 

That  the  infected  ^tegomyin  Calopus  never  left  the 
vessel,  is  proved  by  the  fact  that  two  officers  who  came 
on  board  to  assist  in  nursing  the  sick,  were  taken  ill 
within  four  days,  and  that  two  visitors  who  were  only 
on  board  an  hour  or  two,  having  been  exposed  to  the  same 
cause  which  operated  on  the  two  officers,  were  also 
stricken. 

Outside  of  these  four  cases,  no  other  inhabitant  of  Hali- 
fax contracted  the  disease. 

1861. 

In  the  summer  of  1861 — a  very  sickly  yellow  fever 
year — manj^  ships  of  war  of  the  British  West  Indian 
Squadron  arrived  at  the  port  of  Halifax,  Nova  Scotia, 
with  cases  of  yellow  fever  on  board.  Some  of  the  ships 
had  suffered  very  disastrously  during  the  voyage.  The 
history  of  these  importantion  is  as  follows:^ 

The  Case-  of  the  Firebrand. 

The  ship  Firebrand  arrived  at  Halifax  from  Jamaica, 
on  July  4,  1861,  after  a  passage  of  twelve  days.  There 
were  then  seventy-nine  of  the  crew  on  the  sick  list — all 
fever  cases.  Ten  deaths  had  occurred  during  the  voyage 
from  Port  Roya|.  IMany  of  the  sick  were  moribund.  All 
the  sick  Avere  at  once  transferred  to  a  hulk  moored  oft 
tlie  naval  hospital,  and  the  convalescents  and  others  sent 
to  a  storehouse  in  the  dockyard.  There  were  fifteen  con- 
valescents, tliirty  convalescing  and  thirty-four  seriously 
ill  at  the  time. 

Several  fresli  cases  occurred  subsequently,  and  two 
were  fatal,  with  black  vomit.  Besides  these  deaths  in  the 
hospital  on  shore,  sixteen  took  place  amongst  the  sick 
in  the  hulk.  From  the  commencement  of  the  disease,  the 
Firebrand  lost  forty-nine  of  her  crew  out  of  one  hundred 
and  seven  attacked.     ^ 


CANADA.  655 

The  Case  of  the  Spiteful. 

The  Spiteful  arrived  at  Halifax  on  August  16,  1861, 
from  the  Bahamas,  which  she  had  left  seven  days  before. 
Eleven  deaths  had  occurred  on  the  passage,  and  forty-six 
cases  were  on  the  sick  list  on  arrival ;  two  died  that  night. 
The  sick  were  at  once  sent  to  the  hulk,  and  the  conval- 
escent and  the  well  to  the  dockyard.  Some  of  these 
sickened  with  the  fever  on  shore,  and  were  then  trans- 
ferred to  the  hulk.  Altogether  thirty-three  sick  were 
treated  at  Halifax,  and  of  these,  twelve  died.  The  Spiteful 
lost  in  all  thirty-six  of  her  crew,  out  of  eighty-eight 
attacked. 

TJie  Case  of  the  Racer. 

The  Racer  arrived  at  Halifax  from  Nassau  on  Septem- 
ber 3,  1861.  During  the  passage,  nineteen  cases  and  five 
deaths  occurred.  Several  fresh  attacks  took  place  after 
arrival.  The  total  number  of  attacks  among  the  crew  of 
this  ship  was  sixty-one,  of  which  twenty  proved  fatal. 

•'  The  Case  of  the  Jason. 

The  Jason  reached  Halifax  on  September  2,  1861,  from 
the  Gulf  of  Mexico,  which  she  had  left  sixteen  days  before 
in  consequence  of  fever  having  broken  out  on  board. 
During  the  voyage  forty-six  fresh  cases  and  ten  deaths 
took  place.  On  arrival  at  Halifax,  all  the  sick  were  sent 
to  a  building  in  the  dock.vard.  A  good  many  fresh  attacks 
occurred  after  arrival  The  total  number  of  attacks  among 
the  crew  was  seventy-nine,  and  seventeen  proved  fatal. 

Recapitulation  of  Cases  at  Halifex  in  1861. 

Firebrand 28  16 

Spiteful 33  12 

Racer 42  5 

Jason  ?  ? 

103  33 


656  HISTORY    OF    YELLOW    FEVER. 

Five  vessels  in  all  havin<>-  an  aj>gTe*ijate  crew  of  855, 
were  found  to  be  infected  with  yellow  fever  on  their 
arrival  at  Halifax  in  1861.  Of  this  number,  499  were 
attacked  and  102  died.  It  is  interestinj*-  to  note  that  not 
a  solitary  case  of  jelloAV  fever  occurred  among  any  of 
the  people  about  the  dockyard  at  Halifax,  or  in  any  other 
inhabitant  of  the  town.  This  proves  that  the  ^tcgomyia 
Calopus  did  not  migrate  to  the  shore. 

1878. 

In  1878,  H.  M.  S.  Bullfinch,  from  the  West  Indies,  had 
a  large  number  of  yellow  fever  cases  while  in  the  harbor 
of  Halifax.  The  mortality  was  lieavy.-^  The  outbreak 
was  confined  to  the  original  source  of  infection. 

PRINCE   EDWARD  ISLAND.  . 

Charlottetown. 

1880. 

"A  vessel  from  the  West  Indies"  had  two  cases  of  yel- 
low fever  while  in  the  harbor  of  Charlottetown,  in  the 
month  of  June,  1880.  Two  deaths  resulted  from  the  out- 
break.^ 

QUEBEC. 

Yellow  Fever  Years. 

1805;  1812;  18G4. 

Summary  of  iMroRXATioxs. 

■  1805. 

One  of  the  most  noteworthy  outbreaks  of  yellow  fever 
in  Canada,  took  place  at  (Quebec  in  1805.  Whence  the 
infection  came,  authorities  are  silent,  but  they  all  agree 
that  it  was  a  genuine  manifestation  of  the  disease. 
Quebec  then  carried  on  a  considerable  trade  with  the  AA'^est 
Indies  and  was  probably  contaminated  by  some  of  the 
not  over-clean  vessels  plying  between  the  two  localities. 


657 


What  makes  the  incident  still  more  remarkable,  is  the 
fact  that  the  fever  was  confined  solely  to  the  59th  Regi- 
ment, not  a  single  inhabitant  of  the  quaint  French  town 
contracting  the  disease.  There  were  in  all  55  cases,  of 
which  6  proved  fatal. ^ 

In' the  same  old  medical  journal  where  we  gathered  the 
above  facts,*^  is  the  relation,  of  a  strange  epidemic  which 
ravaged  Montreal  in  1799,  and  which,  it  is  claimed,  came 
from  Quebec.  In  the  fall  of  that  year,  the  Asia,  a  large 
troop  ship,  arrived  at  Quebec  from  the  Cove  of  Cork, 
having  the  41st  Eegiment  and  two  companies  of  the  6th 
on  board.  The  transport  was  crowded,  and  not  over- 
clean,  and  some  recruits  from  a  prison  ship  were 
suspected  of  having  introduced  the  fever  on  board.  Im- 
mediately on  the  Asia's  arrival  at  Quebec,  the  men  were 
transferred  from  the  ship  to  bateaux  and  sent  up  the 
river  to  31ontreal.  Scarcely  were  they  settled  in  quar- 
ters, when  a  "malignant  putrid  fever"  broke  out.  Num- 
bers of  the  men  and  many  inhabitants  died.  Entire 
families  fled  from  the  town,  and  the  impression  the  pes- 
tilential fever  made  on  the  people  was  so  forcible,  that 
for  two  3'ears  afterwards  the  inhabitants  of  Montreal 
shunned  the  approach  of  a  soldier. 


1812. 


Rerenger-Fcraud'''  states  that  yellow  fever  was  observed 
at  Quebec  in  1812.  The  learned  epidemiologist  gives  no 
further  details,  and  the  logical  conclusion  is  that  it  was 
probably  a  solitary  case  on  board  the  proverbial  "vessel 
from  the  West  Indies."  Had  the  disease  obtained  a  foot- 
hold on  shore,  such  men  as  Bally,  Chervin,  Laroche,  Man- 
son,  Clemow,  Sternberg,  Gorgas,  Finlay  and  scores  of 
others  who  have  written  at  length  on  the  history  of  yellow 
fever,  would  certainly  not  have  allowed  such  a  notable 
incident  to  remain  unnoticed. 


658  HISTORY    OF    YELLOW    FEVER. 

18G4. 

The  third  and  last  appearance  of  yellow  fever  at 
Quebec  took  j^lace  in  18C4.  In  August  of  that  year,  the 
ship  Montgomery  from  Nassau,  one  of  the  Baham-a  Islands 
(West  Indies),  arrived  at  the  Canadian  port.  Yellow 
dever  was  epidemic  at  Nassau  when  the  ship  sailed,  and 
there  had  been  several  deaths  from  the  disease  during 
the  voyage.  On  August  15,  a  man  by  the  name  of  Mac- 
Clusty,  who  lived  in  a  house  opposite  the  wharf  where  the 
Montgomery  was  moored,  was  taken  ill  with  yellow  fever 
and  died  on  the  19th.     The  infection  did  not  spread.^ 

It  is  not  stated  whether  or  not  MacClusty  visited  the 
Montgomery,  but  as  he  contracted  the  fever  and  no  other 
case  manifested  itself,  either  on  the  vessel  or  at  Quebec, 
the  natural  inference  is  that  he  did. 

Saint-Pierre   and   Miquelon. 

Description. 

Saint-Pierre  and  Miquelon  is  a  French  colony,  off  the 
southeast  of  New  Foundland,  composed  of  the  islands 
of  that  name  and  the  islands  of  Langley  and  Isle-au- 
Chien.  The  importance  of  Saint-Pierre  lies  in  the  fact 
that  it  is  the  western  terminus  of  three  Atlantic  cables. 
Population  of  the  colony,  4,748,  of  which  3,743  reside  on 
Saint-Pierre,  77G  on  Miquelon  and  Langley,  and  499  on 
Isle-au-Chien. 

Saint-Pierre-de-Miquelon,  so  called  to  distinguish  the 
town  from  Saint-Pierre,  ^Martinique,  is  the  capital  of  the 
colony.  It  is  on  tlie  southeast  side  of  the  island  of  Saint- 
Pierre,  is  compactly  built  of  stone  and  has  a  good  harbor. 
Population,  3,187,  or  almost  the  entire  population  of  the 
island. 

Summary  of  I:\iportatiox.'  • 

1819. 

Tlie  Tarn,  attached  to  the  French  West  Indian 
Squadron,  left  Martinique  W.  I.,  on  July  19,  1819.     Two 


CANADA.  659 

days  later,  a  sailor  was  stricken  with  yellow  fever  and 
died  the  following  day.  jOn  July  26,  four  cases  erupted 
among  the  sailors,  followed  the  next  day  by  six  additional 
cases.  In  the  meantime,  the  Tarn  reached  Saint-Pierre- 
de-Miquelon  with  many  of  her  crew  down  with  the  fever. 
Two  died  while  the  vessel  was  in  the  hai'bor,  one  on  the 
seventh  and  the  other  on  the  tenth  day  of  the  attack.  The 
disease  then  subsided  without  infecting  the  town.^ 

Bibliography  op  Yellow  Fever  in  Canada. 

1.  Birthwhistle :     Lancet   (London),  1846,  vol.  1,  p.  8. 

2.  Slavter:     Transactions    Epidemiological    Society    of 

"^  London  (1860-66),  1863,  vol.  1,  p.  354. 
Ibid.     Medical  Circular,  London,  1862,  vol.  31,  p.  85. 
Ibid.     Lancet  (London),  1862,  vol.  2,  p.  91. 
Milroy:     Trans.  Ep.  Soc.  London,  1862,  p.  90. 
Berenger-Feraud :     Gazette     des     Hopitaux,     Paris, 
1884,  vol.  57,  p.  803. 

3.  Keating:     History  of  Yellow  Fever,  p.  94. 

4.  National  Board  of  Health  Bulletin,  1879-80,  vol.  1, 

p.  428.  '     • 

5.  Walshe:     Medical    and    Physical    Journal,    London, 

;    1806,  vol.  15,  446. 

6.  Ibid.,  p.  449 

7.  Berenger-Feraud:     Traite  Theorique  et  Pratique  de 

la  Fievre  Jaune,  Paris,  1890,  p.  84. 

8.  Berenger-Feraud,  loc.  cit,  p.  140. 

9.  Keraudren:     De  Ifi  Fievre  Jaune  Observee  aux  An- 

tilles et  sur  les  Vaisseaux  du  Roi,  etc.    ,Paris, 
1823,  p.  18. 


660 

CENTRAL  AMERICA. 

History  of  Yellow  Fever  in  Central  America. 

Contrary  to  general  expectations,  Central  America 
presents  a  sterile  field  for  the  study  of  yellow  fever  from 
a  point  of  widespread  prevalence.  Although  within  a 
stone's  throw  from  the  West  Indies,  whence  yellow  fever 
radiated  in  the  past  to  the  four  points  of  the  compass, 
it  has  been  remarkably  free  from  the  disease.  Save  for 
a  fringe  of  coast-line  bordering  on  the  Atlantic,  it  can 
be  said  that  the  Central  American  States  have  enjoyed 
comparative  freedom  from  invasions  of  the  yellow  scourge 
and  one  can,  in  almost  every  outbreak,  place  the  onus  on 
importation.  AVhat  renders  the  situation  still  more 
perplexing,  is  that  both  to  the  north  and  south  of  the 
bellicose  little  republics  which  compose  •  the  Central 
American  dis-Union,  yellow  fever  is  almost  endemic,  Mex- 
ico, the  Isthmus  of  Panama  and  Venezuela  having  been 
notorious  foci  of  the  American  Pestilence  since  the  days 
of  the  buccaneers. 

/How  can  this  almost  total  exemption  be  accounted  for? 
Surely  not  by  the  absence  of  the  usual  causes  favorable 
to  the  propagation  of  yellow  fever,  for  we  find  them  all 
in  Central  America,  even  tlie  pestiferous  Stegomyia, 
Culopus.  Yet  tlie  Latin  republics  have  had  only  two 
widespread  epidemics  in  the  past  four  hundred  years. 
The  yellow  fever  outltrenk  of  187S  was  almost  a  pandemic, 
a  case  being  impoited  even  to  Loudon,  England;  yet  there 
is  no  record  of  any  invasion  of  the  Central  American 
States  that  year.  Again,  during  the  widespread  epidemic 
of  1897,  Avhen  the  ^Fississippi  Valley  was  invaded  as  far 
north  as  Cairo,  and  eases  were  imported  to  New  York, 
Philadelphia,  San  Francisco,  Baltimore  and  other  local- 
ities hostile  to  yellow  fever  propagation,  only  a  few 
isolated  cases  were  observed  in  Salvador  and  Nicaragua, 
the  balance  of  the  States  escaping  infection  altogether. 
In  1905,  however,  Honduras,  Guatemala  and  Nicaragua 
were  pretty  widely  infected,  while  Costa  Rica  and  Sal- 
vador escaped  contamination. 


\ 


CENTRAL    AMERICA.  661 

CHRONOLOGY  OF  YELLOW  FEVER  IN  CENTRAL 

AMERICA. 

1596.     Locality  not  nieutioned. 

No  Authentic  Details  Avaikible  between  1596  and  1803. 

1803.     HONDURAS. 
No  details. 

1839.     GENERAL. 
No  details. 

1850.     HONDURAS. 
No  details. 

1860.     HONDURAS. 
No  details. 

1860.     BRITISH  HONDURAS. 
Belize. 

1868.  NICARAGUA. 

No  details. 
"         SALVADOR. 

San  Salvador. 

1869.  NICARAGUA. 

No  details. 

1870.  NICARAGUA. 

No  details. 

"         SALVADOR. 

■  No  details. 

1883.     COSTA  RICA. 
San  Jose. 

1887.     GUATEINIALA. 
Livingston. 


i 


662 


1890. 

ii 

1891. 

1892. 


1893. 


1894. 


1895. 


1897 


HISTORY    OF     YELOW    FFVER. 

BKITISH  HONDURAS. 

Belize. 
COSTA  RICA. 

Port  Limon. 

COSTA  RICA. 
Punta  Arenas. 

COSTA  RICA. 

Alajiiela. 
Heredia. 
Ltvingston. 
Port  Limon. 

GUATEMALA. 

Livinjiston. 
HONDURAS. 
Ceiba. 

HONDURAS. 

No  details. 
NICARAGUA. 

General,  but  epidemic  in  : 

Granada. 

Manag^ua. 
SALVADOR. 

General,  l)nt  ei)idemic  in : 

La  Libertad. 

San  Salvador. 

guate:\iala. 

Champirico. 
SALVADOR. 
Acajntla. 
La  Libertad. 
San  Salvador. 

NICARAGUA. 
Corinto. 
Leon. 
Managua. 


I 


4 


CENTRAL     AMERIPA.  663 


"         SALVADOR. 

San  Salvador. 

1898.  COSTA  RICA. 

Port  Limon. 
"         SALVADOR. 

San  Salvador. 

1899.  COSTA  RICA. 

Alajuela. 
Heredia. 
Port  Limon. 
Punta  Arenas. 
"         SALVADOR. 

San  Salvador. 

1900.  COSTA  RICA. 

Alajuela. 
Port  Limon. 
Punta  Arenas. 
San  Juan. 
San  Jose. 
"         SALVADOR. 

San  Salvador. 

1901.  COSTA  RICA. 

Alajuela. 
Jacunapa. 
Liberia. 
Port  Limon. 
"         SALVADOR. 
San  Jose. 

1902.  COSTA  RICA. 

Port  Limon. 

1903.  COSTA  RICA. 

Matina. 
Port  Limon. 
San  Jose. 
Zent. 


664  HISTORY    OF  YELLOW  FEVER. 

"         KICARAGUA. 
Blueflelds. 

1904.  COSTA  RICA. 

Alajuela. 
Port  Limon. 

1905.  BRITISH  HONDURAS. 

Belize. 
"         GUATEMALA. 

Gualan. 
Livino;ston. 
Tucura. 
Zacapa. 
"         HONDURAS. 
Ceiba. 

Cliamelicon. 
Cienaguita. 
Cholona. 
Puerto  Cortez. 

"         NICARAGUA.  :r,, 

Leon. 

IManao-ua.  j 

San  Francisco.  * 

San  Pedro. 

1906.     COSTA  RICA.  | 

Port  Limon. 

San  Jnan. 
"         HONDURAS. 

Cf'iha. 

Choloma. 

El  Pariso. 

Pimenta. 

Puerto  Cortez. 

San  Pedro. 
"         CTUATE:\rALA. 

Gualan. 
"         NICARAGUA. 

Manaaua. 


CEMTRAL    ANERICA. 


66  J 


1907.     COSTA  RICA. 
San  Jose. 
San  Mateo. 

"         GUATEMALA. 
Gualan. 

Puerto  Barrios. 
Zacapa. 

"         NICARAGUA. 
Managua. 

1908.     GUATEMALA. 
Chiquimula. 
Zacapa. 


666 


BRITISH    HONDURAS. 

British  Honduras  (also  known  as  Balize  or  Belize),  a 
British  Colony  of  Central  America,  borders  on  the  Bay 
of  Hunduras,  an  arm  of  the  Gulf  of  Mexico,  and  lies 
between  Mexico  and  Guatemala.  Capital,  Belize,  on  the 
Bay  of  Honduras,  which  has  a  population  of  about  6,000, 
mostly  blacks. 

SUMMARY  OF  EPIDEMICS. 
Belize. 

The  history  of  yellow  fever  in  Belize  can  be  summed  up 
in  a  very  few  words.  The  only  white  people  in  the  town 
are  English  officers  and  traders  and  a  few  Americans. 
The  balance  of  the  population  are  negroes,  who  are  pro- 
verbially immune  from  yellow  fever  and  which  accounts 
for  the  few  outbreaks  of  the  fever  recorded  in  this  history. 


1860. 


In  the  middle  of  July,  1860,  yellow  fever  broke  out  in 
Belize,  and  in  a  short  time  decimated  the  white  popula- 
tion, especially  new-comers.  The  negroes  and  acclimated 
Avliites  nearly  all  escaped,  as  did  also  the  troops.  The 
latter,  with  the  exception  of  the  officers,  were  black.  An 
army  assistant  sergeant  died.  No  statistics  are  given  by 
our  authority.^ 


1890. 


Yellow  fever  broke  out  among  the  British  colonists  at 
Belize  in  February,  1890.  The  first  death  occurred  on 
February  17.  There  were  altogether  five  cases,  of  which 
four  proved  fatal.  The  last  case  erupted  May  23,  and 
the  last  death  took  place  June  1." 


CENTRAL     AMERICA.  667 

1905. 

From  June  20,  when  the  first  case  was  reported,  to 
S^ovember  30,  1905,  there  were  five  cases  of  yellow  fever 
in  Belize,  of  which  three  proved  fatal.  The  victims  were 
Englishmen. ^ 


668 

COSTA  RICA. 

Description. 

Costa  Eica  (rich  coast)  the  most  southern  republic  of 
Central  America,  lies  between  the  Caribbean  Sea  and  the 
Pacific  Ocean  and  is  bounded  on  the  north  by  Nicaragua 
and  on  the  south  by  Panama.  Capital,  San  Jose.  Punta 
Arenas,  on  the  Pacific  and  Port  Limon  on  the  Caribbean, 
are  its  j)rincipal  ports.^ 

SUMMARY  OF  EPIDEMICS. 

Alajuela. 

1892. 

Alajuela,  3,000  feet  above  the  sea-level,  was  thought 
for  a  long  time  to  be  immune  from  invasions  of  yelloV 
fever,  owing  to  its  elevation.  In  1892,  however,  the  dis- 
ease was  imported  to  the  town.  The  infection  was  not 
widespread.  The  number  of  cases  and  deatlis  is  not  given 
by  our  authority.^ 

1899. 

In  1899,  Alajuela  had  a  population  of  about  10,000. 
In  the  middle  of  August,  a  man  arrived  from  Punta 
Arenas,  where  there  had  been  sporadic  cases  of  yellow 
fever  for  some  time  previous  to  his  departure.  He  was 
taken  ill  with  yellow  fever  shortly  after  arriving  at 
Alajuela.  From  August  4  to  September  24,  60  cases  re- 
sulted, of  which  21  proved  fatal. ^  Another  authority 
states  that  there  were  100  deaths,  but  does  not  give  the 
number  of  cases.^ 

1901. 

A  solitary  case  of  yellow  fever  was  observed  in  Alajuela 
on  June  7,  1901.     The  patient  died."^ 


CENTRAL     AMERICA.  669 

1904. 

Yellow  fever  siuddenly  made  its  appearance  at  Alajiiela 
about  the  middle  of  April,  1904.  From  the  18th  to  the 
24th  of  the  month,  there  were  11  cases,  of  which  (3  died.'* 
The  outbreak  subsided  as  suddenly  as  it  had  begun. 

HEREDIA. 

1892. 

Yellow  fever  "prevailed"  in  Heredia  (six  miles  from 
San  Jose)  in  1892,  but  to  what  extent,  our  source  of  in- 
formation^ does  not  state. 

1899. 

A  solitary  case  was  imported  to  Heredia  from  Alajuela 
in  1899.  The  ultimate  fate  of  this  case  is  left  to  con- 
jecture.^'^ 

LIBERIA. 

1901. 

Liberia,  a  city  of  about  0,000  inhabitants,  located  in 
the  "hot  lands"  near  the  Pacitic  Coast,  was  invaded  by 
yellow  fever  for  the  only  time  in  its  history  in  1901.  The 
number  of  cases  is  not  stated,  but  06  deaths  were  recorded 
between  March  21  and  August  15.  As  the  white  popu- 
lation of  Liberia  is  very  sparse  and  the  natives  of  Central 
America  are  seldom  attacked  by  yellow  fever,  this  mor- 
tality may  certainly  be  considered  excessive.^^ 

MATINA. 

The  village  of  Matina,  10  miles  from  Limon,  on  the 
Matina  River,  had  2  cases  of  yellow  fever  in  1903.  The 
infection  probably  came  from  Port  Limon. ^^ 


670  HISTORY  OF    YELLOW    FEVER. 

POET  LIMON. 

Port  Limon  is  on  the  east  coast  of  Costa  Eica,  on  the 
Caribbean  Sea.  It  has  a  good  harbor  and  is  the  eastern 
terminus  of  the  Costa  Eica  Eailway.  It  is  surrounded 
by  dense  forests  and  does  an  extensive  exporting  trade 
in  fruit,  coffee,  rubber,  sai*saparilla  and  skins.  Popula- 
tion, 5,000. 

Port  Limon  is  not  an  endemic  focus  of  yellow  fever, 
the  disease  always  having  been  imported  in  every  recorded 
instance.  Of  late  years,  however,  or,  to  be  more  precise, 
since  1900,  yellow  fever  has  been  present  almost  every 
year  in  the  port.  In  1901,  the  infection  was  widespread, 
thirty-two  foci  being  created  within  the  corporate  limits 
of  the  town,  resulting  in  63  cases  and  17  deaths.  In  1903, 
another  widespread  epidemic  took  place.  As  three-fourths 
of  the  population  of  Port  Limon  are  negroes — a  race  com- 
monly immune  from  attacks  of  yellow  fever — and  the 
whites  generally  flee  whenever  an  outbreak  of  yellow  fever 
assumes  a  malignant  phase — there  is  certainly  ground 
for  alarm  that  the  disease  may  become  endemic.  Only 
the  modern  measures  intelligently  directed  against  the 
inroads  of  the  yellow  plague — the  screening  of  first  cases 
and  the  total  extermination  of  the  Stcf/onii/ia  C(tlo>pus — 
can  save  the  beautiful  metropolis  of  Centi'al  America  from 
becoming,  like  her  South  American  neighbors,  the  en- 
demic home  of  a  disease  which  modern  science  has  proved 
can  be  eradicated  from  a  community.  The  brilliant  vic- 
tories achieved  in  Havana,  New  Orleans  and  Panama  are 
monumental  examples  of  what  Avell-directed  preventive 
measures  can  accomjilish.  The  same  thing  can  be  done 
in  Central  America. 

Summary  of  Epidemics. 

1890. 

Although  yellow  fever  undoubtedly  prevailed  at  Port 
Limon  in  former  years,  no  authentic  record  can  be  found 
previous  to  1890.     In  December  of  that  year,  2  cases  were 


CENSRAL     AMERICA.  67  i 

observed,  but  whether  they  proved  fatal  or  not,  is  not 
stated.^^ 

1893. 

Sporadic  cases  of  yellow  fever  broke  out  in  Port  Limon 
at  the  end  of  May,  1893.  An  old  man,  an  employe  of  the 
customhouse,  a  native  unacclimated  to  Limon,  died  of 
the  fever  on  the  28th.  On  the  report  of  this  death,  there 
was  a  general  exodus  of  the  white  residents  into  the  in- 
terior, most  of  them  migrating  to  San  Jose.  By  means 
of  this  partial  depopulation,  only  acclimated  negroes  re- 
maining, the  progress  of  the  outbreak  was  checked.^^ 

1898. 

From  June  14  to  September  1,  1898,  there  were  six 
deaths  from  yellow  fever  in  Port  Limon.^^ 

1899. 

From  August  18  to  August  29,  1899,  2  cases  and  1 
death.16 

1900. 

l"*he  first  case  in  1900  was  in  the  person  of  a  Costa 
Rican,  aged  76,  wlio  was  taken  ill  on  April  19,  loss  than 
three  days  after  his  arrival  from  the  interior  of  the 
country,  and  is  presumed  to  have  been  infected  at  Punta 
Arenas,     The  patient  died  on  the  20th. 

The  steamship  Holstcin  arrived  at  Port  Limon  from 
Mobile,  Alabama,  August  10.  Two  days  later  the  captain 
of  the  vessel  died  of  yellow  fever.  There  Avas  no  yellow 
fever  at  Mobile  in  1900,  so  the  vessel  was  evidently  in- 
fested at  another  port  of  call. 

On  August  21  a  case  of  yellow  fever  eru])ted  on  board 
the  steamship  Ciinard,  from  Colon,  and  was  transferred 
to  the  quarantine  station.     The  patient  died  on  the  23rd. 

Between  October  31  and  November  4,  a  case  of  yellow 
fever  developed  on  shore  and  a  case  was  reported  on  board 


672  HISTORY    OF    YELLOW    FEVkR. 

the  steamship  Adler,  from  Bocas  del  Tora,  Colombia.    The 
patients  recovered. 

liesiime  for  lUOO  :     Total  cases,  5 ;  total  deaths,  2^^ 

1901. 

A  small  epidemic  of  jellow  fever  j^revailed  at  Port 
Limou  in  lOOL^^ 

The  first  case  was  reported  on  March  31,  in  the  person 
of  a  Canadian  who  had  been  in  Port  Limon  one  month. 
Recovery.  The  second  case,  an  Enij;lishman,  who  had 
been  in  the  town  about  a  year,  was  taken  ill  June  9. 
AA'hile  a  resident  of  Port  Limon,  the  patient  had  been 
employed  on  the  railroad  near  Alajnela,  where  yellow 
fever  was  prevailing,  and  evidently  contracted  the  disease 
there.     He  recovered. 

The  third  case,  which  marked  the  real  beginning  of  the 
e])idemic,  erupted  in  the  person  of  an  Anu'rican,  of  En- 
glish parentage,  who  had  been  in  Port  Limon  only  a  few 
months.  He  was  admitted  to  the  Hospital  of  the  United 
Fruit  Company  on  July  1,  suffering  from  yellow  fever. 
He  recovered.  A  sister  of  the  above  case,  who  lived  in 
the  same  house  in  which  he  spent  the  first  two  days  of  his 
illness,  was  taken  ill  on  the  eighteenth  day  from  the  initial 
chill  of  her  brother,  and  had  a  typical,  though  mild  fever. 
She  had  had  no  further  communication  with  the  patient 
from  the  time  of  his  removal  to  the  hospital,  and  her 
case  is  o.ne  of  the  thousands  illustrations  of  the  truth  of 
the  mosquito  theory  of  tlie  transmission  of  yellow  fever. 

From  this  focus,  the  fever  gradually  extended  through- 
out the  town.  From  July  1  to  October  12,  there  were 
altogether  01  cases,  of  which  17  proved  fatal.  Adding  to 
this  tlie  cases  observed  on  March  31  and  June  9,  gives  a 
total  of  63  cases  for  1901. 

Yellow   Fever   in    Port   L'lninti   D.iiriiif/    llie    Quarantine 
Season  of  1901. 

The  following  comprehensive  summary  of  this  remark- 
able  out])reak,   made  by   Dr.   Goodman,   then   Aissistant 


CENTRAL    AMERICA.  673 

United  States  Marine  Hospital  Surgeon  at  Port  Limon, 
will  be  found  interesting  and  instructive:^'^ 

During  the  quarantine  season  of  1901 — that  is,  from 
April  1  to  November  1,  there  were  63  cases  of  yellow 
fever  in  Port  Limon,  Costa  Rica,  to  my  personal  knowl- 
edge. Of  these,  45  contracted  the  disease  in  Port  Limon, 
and  18  came  or  were  brought  from  stations  on  the  rail- 
road, distant  2  to  30  miles.  These  cases  occurred  by 
months  as  follows:  April,  1  case;  May,  none;  June,  2; 
July,  5;  August,  26;  September,  25;  October,  4.  About 
September  15  the  heavy  and  continued  rains  set  in  and 
the  mortality  rate  from  all  diseases  was  very  much  les- 
sened. For  instance,  there  were  from  all  causes,  39  (Jeaths 
from  August  15  to  September  15,  and  only  19  from  Sep- 
tember 15  to  October  15. 

Of  these  45  cases  of  yellow  fever,  originating  in  Port 
Limon,  20  were  natives  and  25  Americans  and  Europeans. 
The  disease  appeared  in  22  houses  or  foci,  a  brief  history 
or  description  of  which  follows : 

Focus  I, — A  second-class-  hotel,  block  No.  43,  1  one- 
story  building,  close  to  the  ground,  in  a  badly  drained 
lot;  thence  we  had  case  No.  1,  April  1,  1901,  Englishman; 
case  No.  3,  June  16,  1901,  p:nglishman;  case  No.  30, 
August  28, 1901,  American ;  case  No.  59,  October  28,  1901, 
American ;  case  No.  60,  October  3,  1901,  American. 

Focus  11. — In  the  extreme  western  end  of  the  town, 
7  1/2  blocks,  or  about  750  yards,  froui  Focus  I,  on  a  hill 
surrounded  by  slirubbery;  rain  water,  caught  in  barrels 
and  in  a  tank,  is  used  for  drinking;  it  is  a  one-story 
dwelling  house,  and  here  we  had  case  No  2,  June  12, 
American;  case  No.  33,  August  29,  native,  wife  of  an 
Amei'ican. 

Focus  III. — One  hundred  and  twenty-five  yards  north 
of  Focus  II,  higher  up  the  hill;  dense  foliage  close  to 
the  house;  rain  water  used  and  mosquitoes  plentiful; 
communication  between  Foci  II  and  III  by  no  means 
easy,  owing  to  undergrowth  and  the  steep  hillside;  here 
we  had  case  No.  4,  July  4,  American ;  case  No.  5,  July  18, 
American;  case  No.  9,  August  1,  American. 


674 


HISTORY    OF     YELLOW     KfcVER. 


Focus  IV. — Two  hundred  and  sixty  yards  south  of 
Focus  I,  a  two-story  house  on  the  railroad  iu  a  low,  badly 
drained  spot,  mosquitoes  plentiful ;  here  we  had  case  No. 
0,  August  1,  native;  case  No.  11,  August  5,  native;  case 
Xo.  10,  August  15,  native;  case  No.  35,  September  1, 
native. 

Focus  V. — In  the  middle  of  block  17,  60  yards  west  of 
the  ])ark,  120  yards  NE.  of  Focus  IV,  and  250  yards 
south  of  Focus  I,  one  of  several  rooms  in  a  long  row, 
partitions  going  up  only  partly  to  the  top.  Case  No.  12, 
August  8,  native.  No  attempt  at  disinfection  was  made 
at  this  house,  it  being  impossible  from  its  construction. 
The  roo  mwas  thrown  open  and  strong  winds  and  bright 
sunlight  allowed  to  pass  through. 

Focus  VI. — City  jail,  between  seawall  and  i)ark,  160 
yards  SE.  of  Focus  Y,  220  yards  S.  of  E.  of  Focus  IV. 
The  rst  floor  used  for  prisoners,  the  second  is  sleeping 
rooms  for  the  policemen.  Case  No.  13,  August  9,  native; 
case  No.  47,  September  20,  native. 

Focus  VTI. — One  hundred  yards  southeast  of  Focus  I, 
and  in  the  same  block;  offices  on  the  ground -floor,  sleep- 
ing rooms  above.  Case  No.  7,  August  8,  American;  case 
No.  28,  August  23,  American. 

Focus  VIII. — The  United  Fruit  Company's  Hospital, 
1()  wliich  most  of  the  yellow  fever  patients  were  carried 
and  put  into  wards  isolated  and  provided  with  screened 
doors  and  windows;  only  1  case  originated  here,  that  of 
a  white  nurse;  all  other  nurses  were  negroes.  Case  No. 
51,  August  7,  Englishman. 

Focus  IX. — In  block  35,  15  yards  south  of  Focus  III ; 
a  two-story  house  on  the  hill,  sui-rouuded  1>y  shrubbery; 
cistern  water  used;  the  house  bad  been  vacant  for  months 
until  occupied  by  this  patiipint  a  few  days  prior  to  her 
illness.     Case  No.  18,  August  10,  Englishman. 

Focus  X. — Southeast  half  of  the  (hand  Hotel,  a  three- 
story  building,  one  room  deep,  300  feet  long;  attached 
to  this  southeast  end  is  the  hospital  of  the  Costa  Rica 
Eailroad.  All  cases  occurring  in  this  building,  whether 
from  Foci  X,  XVITI  or  XX,  were  in  tlie  second-story, 


f 


CENTRAL  AMERICA.  675 

.  where  mosquitoes  were  troublesome  at  times.  On  the 
third  floor  the  very  strono-  zreezes  kept  the  rooms  free  of 
them.  Case  No.  20,  August  16,  Englishman;  case  No.  22, 
August  17,  Englishman;  ease  No.  44,  September  12, 
American;  case  No.  62,  October  4,  Ajnerican. 

Focus  XI. — Custom-house;  second  floor  used  as  resi- 
dence; 80  yards  east  of  Focus  VI.  Case  No.  21,  August 
16,  native;  case  No.  58,  September  28,  native. 

Foci  XII  and  XIII . — Thirty  yards  south  of  Focus  I 
and  about  60  yards  west  of  Focus  VII,  all  in  the  same 
block;  Focus  XII  downstairs  and  to  the  rear,  Focus  XIII 
upstairs  and  to  the  front.  Case  No.  26,  August  20,  natice ; 
case  No.  27,  August  20,  native. 

Focus  XIV. — Twenty-five  3^ards  north  of  Focus  V. 
Case  No.  29,  August  24,  native. 

Focus  XV. — twenty  yards  south  of  Focus  VIII.  Case 
No.  37,  September  3,  native. 

Focus  XVI. — Forty  yards  northeast  of  Focus  XIV. 
Case  No.  31,  Auguf'>t  31,  native;  case  No.  34,  September  2, 
native. 

Focus  A'TV/.— Sixty  yards  E.  of  Focus  XVI,  120  yards 
NW.  of  Focus  X.  Case  No.  38,  September  9,  native ;  case 
'^o.  39,  September  9,  native. 

Focus  AF///.— Twenty  yards  SE.  of  Focus  X.  Case 
No.  7,  August  1,  native ;  case  No.  40,  September  6,  English- 
man. 

Focus  XIX. — One  hundred  and  twenty  yards  N.  of 
Focus  IX.  Case  No.  42,  September  9,  American;  case 
No.  43,  September  11,  American.  . 

Focus  W.— Northwest  half  of  Grand  Hotel,  tliis  with 
Foci  X  and  XVIII  may  ])roperly  be  considered  as  one 
Imilding.  Case  No.  53,  September  27,  American;  case 
No.  61,  October  4,  American. 

Focus  XXI. — One  hundred  and  twenty  yards  N.  of 
Focus  XIX  and  100  yards  W.  of  Foci  I  and  XII.  Case 
54,  September  24,  native. 

Focus  XXII. — One  hundi-ed  and  twenty  yards  N.  of 
Focus  VIII.     Case  No.  57,  September  30,  German. 

In  drawing  deductions  from  the  above  facts  the  follow- 
ine:  should  be  borne  in  mind : 


676 


HISTORY    OF     YELLOW    FEVER. 


Strong  westeru  and  southwestern  land  breezes  prevail 
at  night,  and  eastern  or  sea  breezes  during  the  day — 
much  personal  intercomniunication  between  the  natives  is 
pi'obable,  but  ])etAveen  tlieni  and  Americans  it  is  at  most 
very  limited. 

AVitli  few  exceptions  the  i)atients  were  removed  on  the 
first  or  second  day  of  illness  to  the  isolated  yellow  fever 
wards  of  the  liospital,  and  disinfection  of  the  vacated 
rooms  done. 

The  iiopulatiou  of  Port  Limon  is  about  4,000,  made  up 
of,  say,  3,000  Jamaican  negroes,  who  seemed  to  be  im- 
mune, and  1,000  Americans,  Europeans  and  natives  of 
Si)anish  ancestry.  31any  of  the  inhabitants  who  could 
give  no  cause  for  immunity  escaped  the  disease. 

Those  ph^^sicians  having  the  largest  practice  and  the 
quarantine  ofncials  i)rovisionlly,  at  least,  accepted  the 
mosquitoes  as  a  means  of  propagation  of  yelb.w  fever 
and  advised  the  general  use  of  mos(iuito  netting. 

1902. 


Tlie  year  11102  witn(ss(Ml  anctliei'  stubb(.rn  outbreak  of 
yellow  fever  at  Tort  Lim(yn. 

According  to  Acting  Assistant  Surgeon  ('arson, -'^  cases 
began  showing  themselves  as  early  as  March,  but  were 
not  reported  as  sudi.  Tlie  first  case  to  receive  official 
recognition  was  tliat  of  a  native  laborer,  aged  about  25, 
wlio  had  been  sick  two  days  without  medical  attention, 
and  wlio  was  admitted  to  tlie  United  Fruit  Company's 
h(>s])ital  on  April  14,  whei('  the  nature  of  his  illness  was 
at  once  recognized  as  yellow  fever.     Death  on  the  10th. 

Between  April  16  and  23,  three  more  cases  were  ad- 
mitted into  the  hos])ital.      All  recovered. 

Week  ending  ]\fay  1  :  ()ue  case,  brouiilit  from  Cairo 
Junction,  about  40  miles  bv  rail  from  Port  Limon;  not 
recognized  as  yellow  fever  until  aftei'  admission  into  the 
h(;s])ital. 

July  5,  one  death,  an  imported  case  from  the  Zent  Dis- 
trict, 20  miles  from  Limon,  on  the  Tosta  TJica  Eailroad. 


CENTRAL  AMERICA.  677 

I 

July  10,  two  cases  were  admitted  into  the  United  Fruit 
Company's  hospital,  brought,  respectively,  from  Zent 
Junction  and  Guasimo,  20  and  51  miles  by  rail  from  Port 
Linion. 

July  17,  two  new  cases. 

July  22,  one  death  at  hospital. 

August  8,  one  death  at  hospital.  Imported  from  Cairo 
Junction. 

August  22,  one  case,  from  Zent  Junction,  admitted  to 
hospital. 

September  7,  two  cases,  originating  at  Port  Limon. 

Three  new  cases  were  admitted  to  the  hospital  on  Octo- 
ber 6  and  7,  one  Italian  and  two  Costa  Eicans. 

October  6  to  30,  4  cases  and  3  deaths. 

Cases  broke  out  sporadically  as  late  as  December,  the 
last  case  being  reported  on  the  6th.  Altogether,  from 
July  1  to  December  0,  there  were  27  cases,  of  which  14 
died. 

1903. 

In  1903,  yellow  fever  broke  out  in  April.  Among  the 
first  to  be  attacked  was  Dr.  Allan  Jumel,  of  New  Orleans, 
then  Inspector  of  the  Louisiana  State  Board  of  Health  at 
Port  Limon,  who  made  an  uneventful  recovery.  The  first 
death  occurred  on  April  17,  in  the  person  of  an  employe 
of  the  Costa  Rican  Railroad.  From  that  date,  the  fever 
gained  rapid  headway,  the  type  becoming  graver  and  less 
amenable  to  preventive  treatment.  The  epidemic  came 
to  an  end  on  October  29,  Avith  the  following  record: 
Cases,  99;  deaths,  50. 


21 


1904. 

As  early  as  INIarch,  a  case  of  yellow  fever  was  treated 
at  tlie  United  Fruit  Company's  iiospital.  Nothing  unto- 
ward happened  until  the  end  of  ^May,  when  three  cases 
were  reported  on  the  2Sth.  One  was  imported  from  a 
banana  farm  near  Port  Limon;  the  others  originated  in 
town.     All  recovered. 


678  HISTORY    OF    YELLOW    FETER. 

Xo  cases  reportod  until  July  9,  when  an  American  mis- 
sionry,  who  had  lived  for  some  months  in  Port  Limon, 
was  attacked.     Kecoverv. 

For  week  ending  July  16,  one  case,  a  Spanish- American 
woman,  a  resident  of  Port  Limon  who  had  been  two 
months  in  Port  Limon. 

Week  ending  October  15,  one  case,  imported  from 
Seqnires,  36  miles  from  Limon.     Recovery. 

Total  for  1904:  Cases,  7;  deaths,  1.22"^ 

1905. 

An  American,  who  had  been  for  a  few  months  resident 
in  and  about  Port  Limon,  with  a  positive  history  of  hav- 
ing been  in  the  town  since  the  morning  of  June  16,  was 
found  in  a  public  park  very  sick  on  the  19rh,  and  taken 
to  the  hospital.  Sporadic  cases  were  observed  from  that 
date  until  October  12,  a  total  of  6  cases,  of  which  2 
proved  fatal,  being  recorded.--^ 

PUNTA  AEEXAS. 

Only  vague  information  can  be  had  concerning  the 
history  of  yellow  fever  in  Punta  Arenas.  The  disease  was 
present  in  the  town  in  1892,  1899  and  1900,  but  to  what 
extent  is  not  stated.-^ 

SAX   JOSE. 

1883. 

During  the  widespread  epidemic  of  yellow  fever  in 
Mexico  and  Central  America  in  1883,  a  fcAv  cases  were 
observed  at  San  Jose.^-^ 

1900. 

In  the  early  days  of  August,  1900,  a  Costa  Eican  came 
to  San  Jose  from  Port  Limon,  where  yellow  fever  was 


CENTRAL   AMERICA.  679 

prevailing. He  was  taken  ill  on  the  Gtli  and  died  on  the 
9th,  with  black  vomit.-^  This  was  the  only  case  in  San 
Jose  in  1900. 

1901. 

In  August,  1901,.  a  few  cases  of  yellow  fever  were  im- 
ported to  San  Jose  from  Port  Limon.  The  infection  did 
not  spread.-" 

1903. 

Three  years  later,  another  case  was  imported  to  San 
Jose  from  Port  Limon.  Dr.  Bentel,  a  chemist  in  the  em- 
ploy of  the  Costa  Eican  government  came  to  Port  Limon 
from  the  capital,  on  official  business  in  1903.  On  May  27, 
he  was  taken  ill  and  returned  to  San  Jose,  where  he  died 
on  the  30th.  Another  case  Avas  brought  to  the  town  in 
August  3,  and  died  two  days  later.  There  was  no  dif- 
fusion of  the  malady.-^ 

1906. 

Two  cases  of  vellow  fever  Avere  imported  to  San  Jose 
in  1906.29 

1907. 

A  physician  contracted  yellow  fever  in  the  banana  dis- 
trict, about  45  miles  from  Port  Limon,  in  September, 
1907,  and  went  to  San  Jose  for  treatment.  The  report 
does  not  state  what  ultimately  became  of  the  case.^*^ 

SAN    JUAN. 

1900. 

A  case  of  yellow  fever  was  imported  to  San  Juan  in 
May,  1900.     The  patient  recovered.*^^ 


1 


680 


HISTORV    OF     YELLOW    FEVER. 


ze:nt. 


1903. 

There  were  4  deaths  from  yellow  fever  at  Zeut  Junction 
iu  1903.  There  must  have  been  a  widespread  infection  in 
the  village,  as  several  cases  were  imported  therefrom  to 
Port  Limon  and  the  surrounding-  country. 


681 

GUATEMALA. 

Guatemala  lies  south  of  Mexico  aud  borders  on  the 
Pacific,  and  has  a  small  coast  line  on  the  Bay  of  Hon- 
ruras.  Capital,  Guatemala.  Puerto  Barrios  on  the  Bay 
of  Honduras,  is  the  principal  port. 

The  history  of  yellow  fever  in  Guatemala  can  he  told 
in  a  very  few  words.  The  following  summary  is  made 
from  the  records  of  the  United  States  Marine  Hospital 
Service : 

CHAMPERICO. 

1895. 

Yellow  fever  reported  "present. "^^    No  details  available. 

CHIQUIMULA. 

1007. 

A  few  cases  of  yellow  fever  reported.^* 

1008. 

Population,  6,000.  A  few  cai-:es  of  yellow  fever,  im- 
ported from  Zacapa."'"" 

GUALAX. 

1005. 

A  severe  epidemic  of  yellow  fever  ravaged  Gualan,  SO 
miles  from  Puerto  Barrios,  in  1005.  The  number  of  cases 
is  not  given,  but  the  stimatcd  numlier  of  deaths,  from 
Augiist  20  to  November  9,  is  placed  at  200.  No  exact 
statisitics  could  be  obtained.'''^ 

Tlie  first  cases  of  yellow  fever  in  the  history  of  the  town, 
came  under  observation  in  August,  1005.  The  cases  in  the 
railroad  hospital  were  kept  under  bars,  and  every  pre- 


682  HISTORY    OF    YELLOW    FEVER. 

caution  used  to  prevent  the  spread  of  the  infection,  no 
standinji:  water  beinji-  aHowed  around  the  buildings;  but 
in  the  town  itself  nothing  Avas  done. 

1906.  : 

August  24,  two  cases;  one  died.  Sporadic  cases  ob- 
served during  the  year^^ 

1907. 
Between  Mav  15  and  21,  three  cases;  one  died.^^ 
LIVINGSTON. 

1887.  • 

August  7,  four  cases ;  August  27,  "several  cases."'*'** 

1889. 
July  28,  one  case,  followed  by  death.  No  developments.^" 

1892. 

Yellow  fever  broke  out  in  ^lay  and  "raged  most  malig- 
nantly."    No  statistics  given. "^^ 

1905. 

Y('lb;w  fever  was  epidemic  in  many  cities  of  Guatemala 
in  1005.  A  total  of  27  cases,  of  which  12  died,  is  re- 
corded for  Livingston. ^- 

PUERTO    BARRIOS. 

1907. 

Diligent  research  has  failed  to  find  any  Jiistory  of  yel- 
low fever  so  far  as  Puerto  Barrios  is  concerned,  previous 


CENTRAL    AMERICA.  683 

to  1907.  On  June  27,  a  solitary  case  was  reported,  in  the 
person  of  a  Spanish  officer  in  charge  of  the  cnratel.  Orig- 
inal source  of  infection  not  stated.^^ 

TUCAEA. 

1905. 

Tucara  suffered  from  yellow  fever  during:  the  epidemic 
of  1905.  The  first  case  was  reported  August  7.  Statistics 
are  not  given.^'* 

ZUCAPA. 

1905. 

The  Guatemalan  yellow  fever  epidemic  of  1905  was 
quite  extensive  in  Zucapa,  a  town  of  about  6,000  inhabi- 
tants, in  the  interior,  100  miles  by  rail  from  Puerto 
Barrios. 

The  disease  made  its  appearance  in  Zacapa  the  latter 
part  of  June.  The  infection  was  introduced  from  Liv- 
ingston through  natives  who  were  permitted  to  return 
to  their  homes  in  Zacapa  after  the  outbreak  of  the  fever 
in  Livingston.  The  fever  was  not  recognized  as  yellow 
fever  until  Augiist,  by  which  time  the  infection  was  thor- 
oughly disseminated  throughout  the  town,  there  being 
hardly  a  house  in  tlie  place  which  had  not  had  a  case. 
No  reliable  information  as  to  the  number  of  cases  or 
deaths  could  be  ol)tained,  but  reliable  reports  estimate  the 
number  of  deaths  at  about  700.*^  At  the  time  of  the  out- 
break a  great  number  of  people  left  and  went  to  the 
mountains,  leaving  only  about  3,500  in  the  place  during 
the  height  of  the  fever.  '  This  is  the  first  time  yellow  fever 
has  ever  appeared  in  Zacapa. 

1907. 

The  second  appearance  of  yellow  fever  in  Zacapa  took 
place  in  1907.  On  May  16,  a  case  was  imported  from 
Gualan.     In  the  latter  part  of  May,  the  disease  was  re- 


684  HISTORY    OF    YELLOW    KEVER. 

ported  epidemic,  with  about  two  deaths  daily.  No  reli- 
abh^  statistics  could  be  obtained.  Sporadic  cases  were 
observed  as  late  as  November.^^ 


685 

HONDURAS. 

Hondui'as,  one  of  the  Central  American  Republics,  lies 
between  Kicaragiia  and  San  Salvador  and  the  Pacific 
Ocean  and  the  Caribbean  Sea.     Capital,  Te,i>ucigalpa. 

Although  discovered  by  Columbus  on  liis  fourth  voy- 
age (1502),  and  in  close  proximity  to  the  West  Indies, 
it  is  only  within  very  recent  years  that  yellow  fever  has 
been  observed  in  Honduras.  Berenger-Feraud^"  speaks 
of  a  "severe  epidemic"  in  that  country'  in  1803,  imported 
by  the  ship  Hihhcr,  but  gives  no  details.  The  same 
autliority  (page  119)  says  that  Honduras  was  ''contami- 
nated" in  1850,  but  in  what  manner  and  to  what  ext(mt, 
is  left  to  the  inuigination.  With  the  exception  of  1905, 
no  general  epidemic  of  yellow  fever  has  ever  been  observed 
in  Honduras. 

CEIBA. 

1905. 

From  August  1  to  24,  1905,  there  were  six  cases  of- 
yellow  fever  in  Cc  iba,  of  which  three  proved  fatal.  One 
of  the  cases  was  imported  by  the  steamship  Nicaragic, 
from  Kew  Orb^ans.  Last  death,  August  22.  Tlie  out- 
break was  not  very  extensive."*'^ 

190G. 

Yellow  fever  was  reported  "present"  in  Ceiba  from  July 
21  to  29 ;  no  details  given.'*^ 

CHAMELICON. 

1905. 

From  June  18  to  October  10,  1905,  there  Avere  143  cases 
of  vellow  fev(n'  in  Chamelicon;  49  dicd.^^ 


68G  HISTORV    OF    YELLOW     FEVER. 

CHOLONA. 
1905;  190G. 

Cholona,  which  has  a  population  of  about  4,000,  has 
been  visited  twice  by  yellow  fever — 1905  and  190G. 

In  1905,  from  June  18  to  December  12,  150  cases  were 
observed;  59  died.^^ 

In  1906,  from  April  6  to  April  19,  there  were  7  cases; 
1  died.^2 

CIENAGUITA. 

1905. 

^farch  21  to  September  T,  20  cases;  5  deaths.^^ 

EL    PAR  I  SO. 

1906.  I 

Present  between  June  15  and  June  19.  Xo  record  of 
cases;  1  death.'^^ 

XACAOME. 

1894.  ^ 

April  8  to  28,  5  deaths ;  number  of  cases  not  reported. ^^ 

PIMENTA. 

1906.' 

!Mav  23,  20  cases  r('])ort('d,  which  proves  thai:  the  town 
must  have  been  infected  for  some  time  previously.  From 
that  date  to  June  6,  a  total  of  85  cases  and  20  fjeaths  is 
recorded.  The  e])idemic  lasted  until  October,  but  com- 
plete statistics  are  not  obtainable.^^ 


CENTRAL  AMERICA.  687 

PUERTO    CORTEZ. 
1905. 

Imported  cases  of  yellow  fever  may  have  been  observed 
at  Puerto  Cortez  previous  to  1905,  but  no  authentic 
records  could  be  found  bearing  on  the  subject. 

The  only  epidemic  which  has  ever  visited  the  port,  took 
place  in  1905,  and  is  thus  described  in  the  United  States 
Public  Health  Reports  :^^ 

The  first  case  to  come  under  observation  was  reported 
May  25.  The  patient  a  young  man  was  taken  sick  sud- 
denly with  a  chill  in  the  night,  violent  pains  in  the  back 
and  head,  vomiting  and  delirium.  On  the  third  day  urinal 
examination  showed  15  per  cent,  albumen.  He  died  on 
the  eighth  day,  in  convulsions.  This  was  a  typical  case 
throughout. 

The  next  case  was  an  old  man  at  a  hotel.  He  had  all 
the  symptoms.  Was  taken  ill  suddenly ;  on  the  third  day 
all)umen  showing  as  much  as  4  per  cent.  He  died  on  the 
sixth  day  in  coma. 

The  next  patient  was  a  custom-house  inspector,  who 
was  taken  ill  with  the  same  symptoms  and  about  the  same 
time  as  the  second  case.  On  the  fifth  day  albumen  showed 
25  per  cent. ;  temperature,  102 ;  pulse,  46 ;  died  in  coma. 

Another  case  was  that  of  a  native  l)oy,  reported  by  the 
Government  surgeon  at  al)out  the  same  time.  He  also 
died.  All  had  ])lack  vomit,  except  the  old  man  at  the 
hotel,  h'our  other  cases  were  taken  sick  about  the  same 
time  and  recovered.  The  first,  a  woman  boarding  at  the 
hotel,  was  taken  violently  ill  with  a  chill  in  the  night, 
with  vomiting,  viohMit  ])ains  in  the  l)ack,  limbs,  head  and 
delirium.  On  the  third  day  albumen  from  10  to  15  per 
cent.  This  case  recovered.  The  daughter  of  this  patient 
was  attacked  in  the  same  way,  with  the  same  train  of 
symptoms,  during  her  mother's  convelescence.  Aubumen 
about  10  per  cent.;  urine  cleared  up  on  the  fith  day;  went 
on  to  recovery. 

An  Italian' at  the  hotel  was  attacked  about  the  same 


688  HISTORY    OF    YELLOW    FEVER. 

time.     His  was  a  typical  case.     Albumen,  25  per  cent. ; 
l)iilse  went  as  low  as  40,  with  a  slow  convalescence. 

The  eighth  case  was  that  of  the  surgeon  of  the  United 
Fruit  Company  and  is  .of  much  interest,  showing  the 
enormous  quantity  of  sulphate  of  quinine  a  jierson  of  long 
experience  in  the  Tropics  can  stand  without  injury-  in  yel- 
low fever.  This  patient  had  lived  in  the  Tropics  about 
fifteen  years,  having  spent  five  years  of  his  life  at  Limon, 
going  through  three  epidemics  there  without  contracting 
the  disease.  He  considered  himself  immune.  On  May 
30  he  was  taken  violently  ill  with  all  the  train  of  symp- 
toms of  yellow  fever.  Two  days  before  this  he  complained 
of  feeling  very  badly,  but  still  remained  at  work,  and 
said  he  supposed  he  was  going  to  have  a  sharp  spell  of 
remittent  fever,  as  he  had  not  had  an  attack  for  a  long 
time.  He  began  taking  large  does  of  sulphate  of  quinine 
to  reduce  the  temperature,  but  he  comj^lained  he  could 
not  bring  his  temperature  to  normal  and  lower  than 
101  1/2,  and  during  the  two  days  before  he  was  taken 
ill,  he  told  me  that  he  took  280  grains  of  sulphate  of 
quinine  and  1  ounce  of  Warburg's  tincture  to  reduce  his 
tem]i(^rature.  On  Thuri-day  night  he  had  the  preliminary 
chill,  temperature  going  to  104  1/2,  and  from  that  time 
on  during  his  illness  he  never  showed  the  bad  effects  of 
the  quinine,  altliough  he  had  a  very  serious  attack  of 
yellow  fever  and  at  one  time  the  urine  test  showed  25  per 
cent,  albumen. 

Of  the  first  eight  cases  of  the  epidemic,  four  recovered 
and  four  died. 

From  the  date  of  the  breaking  out  of  the  epidemic  (May 
25)  to  June  18,  10  additonal  cases  were  reported,  of  which 
4  died\ 

The  epidemic  came  to  an  end  on  December  12,  with  a 
record  of  148  cases,  of  which  50  died. 

190(1. 

On  :\Iarch  7,  1900,  a  case  of  yellow  fever  was  reported 
in  Puerto  Cortez.     It  was  a  mild  case  and  the  patient 


CENTRAL    AMERICA.  689 

made  an  uneventful  recovery.       No  other  eases  are  re- 
corded.''^ 

SAN    PEDEO. 

1905. 

San  Pedro,  35  miles  from  Puerto  Cortez,  experienced 
its  first  extensive  epidemic  of  yellow  fever  in  1905.  From 
June  18  to  December  12,  there  Avere  625  cases,  of  which 
153  proved  fatal. ^'^ 

1906. 

March  18  to  March  24.  Yellow  fever  present.  No 
statistics.^^ 


690 

NICARAGUA. 

Desc?'iption. 

Nicaragua  lies  between  Honduras  and  Costa  Eica  and 
extends  from  the  Caribbean  Sea  to  the  Pacifis  Ocean. 
Principal  cities:  Bluefields,  Leon,  Granada,  Nicaragua 
and  Managua,  the  capital. 

Berenger-Feraud  says  that  yellow  fever  was  imported 
to  Nicaragua  in  1868  by  voyagers  from  infected  localities, 
but  gives  no  details,  merely  mentioning  this  fact  and  stat- 
ing that  "several  localities''  were  affected. ^^ 

According  to  Lawson,  the  disease  was  also  present  in 
Nicaragua  in  1869.^- 

Cornilliac  notes  the  fact  that  many  localities  were  af- 
fected in  1870.63 

BLUEFIELDS. 

1903. 

Bluefields  is  on  the  Caribbean  coast  of  Nicaragua,  and 
has  a  population  of  about  3,000.  Yellow  fever  has 
rarely  been  observed  at  this  port,  and  in  every  instance  it 
was  imported.  Statistics  are  meager  and  unreliable  con- 
cerning the  i)revalence  of  the  disease  at  Bluefields,  the 
only  authentic  case  on  record  being  in  1903,  when  the 
Schooner  Sunbeam,  from  Limon,  brought  a  case  to  the 
town  on  ]May  8.  Proper  sanitary  measures  were  insti- 
tuted and  there  was  no  spread.''* 

CORINTO. 

1897. 

Corinto,  like  other  ports  on  the  Pacific  coast  of  Nica- 
ragua, has  been  almost  immune  from  yellow  fever.  The 
only  instance  when  the  disease  made  any  headway  in  this 
port  was  in  1897,  when  it  was  introduced  by  vessels  com- 


CENTRAL   AMERICA.  691 

ing  from  infected  Mexican  and  South  American  ports. 
Reliable  statistics  as  to  the  extent  of  this  outbreak  are 
lacking.®^ 

GRANADA. 

1894. 

Granada  has  a  population  of  15,000  and  is  on  the  north- 
west shore  of  Lake  Nicaragua,  about  30  miles  from  the 
city  of  Nicaragua.  Yellow  fever  prevailed  to  a  limited 
extent  in  this  place  in  1894.     No  statistics  obtainable.^^ 

JUCUNAPA. 

1901. 

A  case  of  yellow  fever  was  brought  to  Jucunapa  in 
1901.  As  soon  as  the  inhabitants  became  aware  of  the 
state  of  affairs,  they  fled  to  various  parts  of  the  republic, 
leaving  the  town  practically  deserted.  Only  one  case  is 
recorded.  ^^ 

LEON. 

1897. 

Leon  lies  between  Lake  iManagua  and  the  Pacific  Ocean 
and  has  a  population  of  25,000.  Yellow  fever  was  brought 
to  Leon  by  refugees  in  August,  1897,  and  prevailed  epi- 
demically to  the  end  of  September,  according  to  official 
reports.     No  statistics  could  be  obtained.^^ 

1905. 


Yellow  fever  prevailed  for  the  second  time  in  the  his- 
tory of  Leon  in  1905.  Like  other  epidemics  of  this  kind 
in  Central  America,  details  are  lacking. ^^ 


69 i  HISTORY  OF  YELLOW    FEVER. 

MANAGUA. 

The  history  of  yellow  fever  as  it  concerns  Managua 
may  be  briefly  summarized  as  follows,  as  no  details  are 
obtainable  i''^^ 

1894.     Present. 

1897.     Present. 

1905.  Thirty  cases;  number  of  deaths  not  stated. 

1906.  Present. 

1907.  Present. 

SAN   FRANCISCO. 

1905. 

The  extensive  yellow  fever  epidemic  of  1905  invaded  San 
Francisco,  a  small  town  near  the  Pacific  coast,  during  the 
last  days  of  August.  The  number  of  cases  is  not  given; 
deaths,  2.'^ 


695 

SALVADOR. 

Salvador  is  bounded  on  the  north  by  Honduras  and 
Guatemala,  east  by  Xicarajiua  and  south  hj  the  Pacific 
Ocean.     Capital,  San  Salvador. 

Salvador  has  suffered  less  from  yellow  fever  than  the 
other  countries  of  Central  America.  The  outbreaks  so  far 
as  could  be  collected  from  the  scant  literature  on  the  sub- 
ject, were  as  follows: 

ACAJITLA. 

189G.  Yellow  fever  reported  as  prevailing  extensively. 
No  statistics. "- 

LA    LIBERTAD. 

1894.     Yellow  fever  "present." '^ 

1^96.  Yellow  fever  reported  as  "making  rapid  pro- 
gress."    No  statistics.'^** 

SAN    SALVADOR. 

The  city  of  San  Salvador  is  one  of  the  oldest  in  Central 
America,  having  been  founded  by  the  Spanish  in  1523.  It 
is  105  miles  southeast  from  Guatemala,  near  the  Pacific 
Ocean.  San  Salvador  was  moved  from  its  original  site 
near  the  base  of  the  volcano  of  the  same  name  in  1854, 
on  account  of  the  prevalence  of  destructive  earthquakes, 
but  it  has  since  twice  been  partially  destroyed  by  these 
mysterious  convulsions  of  nature.  Before  the  last  earth- 
quake (1873)  the  population  was  40,000;  it  is  now  about 
half  that  figure. 

1868. 

The  first  record  of  yellow  fever  having  prevailed  in 
San  Salvador  is  given  by  Guzman,  who  states  that  401 
cases  were  treated  at  the  Casa  Amarilla  (yellow  fever 
hospital)  in  18G8.  Of  these  cases,  296  were  males  and 
85  females.  The  mortality  was  132  (85  males  and  47 
females.     The  source  of  infection  is  not  given."^^ 


694  HJSTORY    OF    YELLOW    FEVER. 

1870. 

Cornilliac  states  that  yc41ow  fever  was  observed  in  San 
Salvador  in  1870.     No  statisties.'^^ 

1894. 

After  a  lapse  of  24  years,  vellow  fever  again  made  its 
appearance  in  San  Salvador.  The  first  person  attacked 
was  one  of  the  mail-service  boys,  who  caught  the  infec- 
tion at  La  Libertad.  Bevond  the  statement  that  the  mor- 
tality was  60  per  cent.,  no  other  information  is  given  by 
our  authority."'^ 

1896. 

Yellow  fever  was  reported  "present''  in  San  Salvador 
in  October  19,  1906.     Further  details  not  obtainable.''^ 


189 


Yellow  fever  broke  out  with  much  virulence  in  July 
and  raged  until  December.  Cases  and  deaths  were  as 
follows : 

July 38  cases.  11  deaths. 

August   54  cases.  16  deaths. 

September   34  cases.  12  deaths. 


Total  for  three  months.  .    126  39 

The  epidemic  decimated  the  foreign  population. 
Among  the  prominent  victims  were  the  Russian  Princess 
Dolgorouky,  who  had  come  to  San  Salvador  to  give  con- 
certs, and  ^Ir.  Baker,  the  manager  of  the  London  Bank. 
The  American  Colony  did  not  suffer  much. 

The  epidemic  came  to  an  end  in  December.  Complete 
statistics  not  given.''''^ 

1898. 

Yellow  fever  again  broke  out  in  San  Salvador  in  1898. 
Following  statistics  are  furnished  by  the  United  States 
Marine  Hospital  Service.®^ 


CENTRAL  AMERICA.  695 

To  June  4,  total  of  34  cases  and  8  deaths. 
From  that  date  to  August  7,  38  new  cases,  of  which 
8  proved  fatal. 

Total,  72  cases ;  16  deaths. 

1899. 

June  30  to  August  1,  a  total  of  3  cases  and  1  death  is 
reported.^^ 

1900. 

Yellow  fever  broke  out  as  early  as  February;  five 
deaths  being  reported  between  the  Xlth  of  that  month 
and  March  3.  Between  .the  last  mentioned  date  and 
April  11,  there  were  38  new  cases.  After  this,  the  epi- 
demic subsided,  only  3  new  cases  and  1  death  being  re- 
ported to  August  1.  Sporadic  cases  were  subsequently 
observed,  but  no  complete  statistics  are  obtainable.^^ 

1901. 

In  1901  the  fever  broke  out  during  the  last  week  of 
March,  and  from  that  time  to  the  end  of  June,  10  cases 
and  6  deaths  were  reported.  As  in  other  outbreaks  of  the 
disease,  it  is  impossible  to  give  exact  statistics.  In  every 
eruption  of  yellow  fever  in  Central  America,  the  policy 
of  concealment  is  adhered  to  by  the  authorities,  and  it  is 
only  by  constant  vigilance  that  the  representatives  of 
foreign  governments  are  able  to  arrive  at  the  truth. ^^ 

That  yellow  fever  prevailed  to  a  considerable  extent  in 
San  Salvador  in  1901,  is  evidenced  by  the  fact  that  a 
certain  college  in  that  city  was  ordered  closed  by  the 
government;  five  cases  and  one  death  having  occurred 
among  the  students. 

1907. 

Yellow  fever  was  reported  epidemic  in  the  Republic 
of  Salvador  in  January,  1907.^^  No  further  information 
is  furnished,  but  the  outbreak  could  not  have  been  very 


696  HISTORY    OF    YELLOW    FEVER. 

severe,  for  even  the  most  guarded  policy  of  concealment 
could  not  have  kept  the  facts  from  the  public  during  the 
two  vears  which  have  elapsed  since  the  first  news  were 
telegraphed  to  the  United  States  Marine  Hospital  Service 
at  Washington. 

SANTIAGO  DE  MARIA.  * 

1901. 
Refugees  from  Jucunapa  infected  Santiago  de  Maria  in 
1901,  for  the  first  time  in  its  history.     No  statistics. ^^ 

BIBLIOGRAPHY   OF  YELLOW   FEVER   IN   CENTRAL  AMERICA. 

GENERAL. 

Brumby  (W.  M.)  Our  Commercial  Relations  with  Central  America, 
with  reference  to  Yellow  Fever.  Texas  State  Journal  of  Medicine, 
1906,  vol.  2,  p.  86. 

Gibbs  (B.  F.) :  The  calenturia,  congestive  fever  of  Nicaragua,  in  its 
relations  to  yellow  fever.  Med.  &  Surg.  Reporter,  Phila.,  1868,  vol. 
19,  pp.  391,  413. 

Santos  Fernandez  (J.) :  La  Fiebre  Amarilla  es  el  obstaculo  mas 
grande'  que  encuentra  la  civilization  de  le  America  Latina.  Cron.  Med. 
Quir.  de  la  Habana,  1896,  vol.  22,  p.  347. 

BRITISH  HONDURAS. 

1.  Lawson:  Transactions  Epidemiolosical  Society  of  London,  1860, 
vol  1,  p.  IBS. 

2.  Goldwaite:  Correspondence  Relative  to  the  Insanitary  Conditions 
at  Belize  in  1890.     Colonial  Office,  London,  1891,  p.  16. 

3.  U.  S.  Public  Health  Reports  (Washington,  D.  C),  1905,  vol.  20, 
p.  2770. 

Boyce,  (R.):  Report  to  the  Government  of  British  Honduras  upon 
the  Outbreak  of  Yellow  Fever  in  that  colony  in  1905.     1906. 

Ross  (R.)  and  Breinl  (A.):  Yellow  Fever  in  Belize.  British  Medical 
Journal,  vol.  2,  for  1906,  p.  1604. 

Eyles  (C.  H.):  Yellow  fever  in  Belize.  Brit.  M.  J.  (London),  1907, 
vol.  1,  p.  113. 

COSTA  RICA. 

4.  U.  S.  Public  Health  Reports,  1892,  vol.  7,  p.  129. 

5.  Ibid,  1899,  vol.  14,  pp.  1389;   2366. 


CENTRAL      AMERICA.  697 

6.  Recueil  des  Travaux  du  Comite  Consultatif  d'Hygiene  Publique 
de  France,  Paris,  1903,  p.  334. 

7.  U.  S.  Public  Health  Reports,  vol.  16,  pp.  1415,  1594. 

8.  Ibid.,  1904,  vol.  19,  pp.  858,  1304. 

9.  Ibid.,  1892,  vol.  7,  p.  129. 

10.  Ibid.,  1899,  vol.  14,  py.  1389,  2366. 

11.  Recueil  des  Travaux,  etc.,  (loc.  cit.)  for  1901,  Paris,  1903,  p.  334. 
Also:  U.  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2309. 

12.  U.  S.  Public  Health  Reports,  1903,  vol.  18,  p..  2309. 

13.  Ibid.,  1891,  vol.  6,  p.  138   (foot-note  d.) 

14.  Ibid.,  1893,  vol.  8,  pp.  441,  452,  453,  517. 

15.  Ibid.,  1898,  vol.  13,  p.  157. 

16.  Ibid.,  1899,  vol.  14,  p.  2366. 

17.  Ibid.,  1900,  vol.  15,  pp.  1072,  2089,  2164,  2227,  2826,  3176. 

18.  Ibid.,  1901,  vol.  16,  pp.  772,  847,  906,  1416,  1481,  1641,  1878,  1949, 
2003,  2059,  2121,  2225,  2383,  3083. 

19.  Goodman:  U.  S.  Public  Health  Reports,  1902,  vol.  17,  p.  135. 

20.  U.  S.  Public  Health  Reports,  1902,  vol.  17,  pp.  953,  1079,  1143, 
1745,  1796,  1842,  2067,  2112,  2230,  2468,  2622,. 

21.  Ibid.,  1903,  vol.  18,  pp.  1037,  2309. 

22.  Ibid.,  1904,  vol.  19,  p.p.  858,  1232,  1571,  1428,  1578.  2690, 

23.  Ibid.,  1906,  vol.  21,  pp.  758,  782,  1132,  1542. 

24.  Ibid.,  1892,  vol.  7,  p.  139;  1899,  vcl.  14,  pp.  1389  and  2366;  1900, 
vol.  15,  p.  938. 

25.  Medical  News,  N.  Y.,  1883,  vol.  43,  p.  419. 

26.  U.  S.  Public  Health  Reports,  1901,  vol.  16,  p.  1948. 

27.  Recueil  des  Travaux  du  Comite  Consultatif  d'Hygiene  Publique 
de  France,  etc.,  1901  (Paris,  1903),  p.  334. 

28.  U.  S.  Public  Health  Reports,  1903,  vol.  18,  pp.  975,  2309. 

29.  Ibid.,  1907,   vol.  22,  p.  904. 

30.  Ibid.,  1907,  vol.  22,  p.  1444. 

31.  Ibid.,  1900,  vol.  15,  p.  1617. 

32.  Ibid.,  1903,  vol.  18,  p.  2309. 

Gruver:  Case  of  yellow  fever  on  steamship  Westgate.  U.  S.  Public 
Health  Reports,  Wash.,  1903,  vol.  18,  p.  1310. 

Merry  (W.  L..) :  Yellow  Fever  at  Alajuela,  3,000  ft.  above  Sea  Level, 
and  Heredia.  Pub.  Health  Reports  U.  S.  Mar.  Hosp.  Serv.,  Wash  , 
1899,  vol.  14,  p.  1389. 

GAUTEMALA. 

33.  U.  S.  Public  Health  Reports,  1895,  vol.  10,  p.  612. 

34.  Ibid.,  1908,  vol.  23,  p.  45. 

35.  Ibid.,  1908,  pp.  45,  157,  534. 


698 


HISTORY    OF    YELLOW    FEVER. 


36.  Ibid.,  1905,  vol.  20,  p.  2770. 

37.  Ibid.,  1906,  vol.  21,  p.  1075. 

38.  Ibid.,  1907,  vol.  22,  pp.  765,  807,  904. 

39.  Ibid.,  1887,  vol.  2,  pp.  145,  162. 

40.  Ibid.,  1889,  vol.  4,  p.  240. 

41.  Ibid.,  1892,  vol.  7,  pp.  243,  283. 

42.  Ibid.,  1905,  vol.  20.  p.  2631. 

43.  Ibid.,   1907,  vol.   22,   pp.   92t»,   972,   1939.     . 

44.  Ibid.,  1905,  vol.  20,  pp.  2035,  2770. 

45.  Ibid.,  1905,  vol.  20,  p.  2631. 

46.  Ibid.,  1907,  vol.  22,  p.  807;  Ibid.,  1908,  vol.  23,  p.  45. 


4. 


HONDURAS. 

47.  Berenger-Feraud:    Traite    Theorique    e't  Pratique    de    la   Fievre 
Jaune  (Paris,  1890),  p.  73. 

48.  U.  S.  Public  Health  Reports,  1905,  vol.  20,  p.  1911. 

49.  Ibid.,  1906,  vol.  21,  p.  1553. 

50.  Ibid.,  1905,  vol.  20,  p.  2770. 

51.  Ibid.,  1905,  vol.  20,  p.  2770. 

52.  Ibid.,  1906,  vol.  21,  pp.   392,  452,  741. 

53.  Ibid.,  1905,  vol.  20,  p.  2770. 

54.  Ibid.,  1906,  vol.  21,  p.  741. 

55.  Ann.  Rep.  Sup.  Surg.-Gen.  (U.  S.),  1894,  p.  293. 

56.  U.  S.  Public  Health  Reports,  1906,  vol.  21,  pp.  659,  692,  762,  763, 
874,  1553. 

57.  Ibid.,  1905,  vol.  20,  pp.  1350,  2169,  2770. 

58.  Ibid.,  1906,  vol.   21,  pp.  302,  741,  989. 

59.  Ibid.,  1905,  vol.  20,  pp.  1536,  1912,  2770. 

60.  Ibid.,  1906,  vol.  21,  p.  741. 

Carter:   History  of  outbreak  of  yellow  fever  at  Puerto  Cortez.     Pub. 
Health  Rep.  U.  S.-  Mar.  Hosp.  Serv.,  Wash.,  1905,  vol.  20,  p.  1350. 

NICARAGUA. 


61.  Berenger-Feraud,  loc.  cit.,  p.  144. 

62.  Lawson:    Trans.   Epidemiological   Society  of  London,   vol.   3,   p. 
321. 

63.  Cornilliac:  Recherches  Chronologiques,  etc.,  p.  428. 

64.  U.  S.  Public  Health  Reports,  1903,  vol.  18,  p.  1037. 

65.  Ibid.,  1897,  vol.  12,  pp.  1124,  1434. 

66.  Annual  Report  Superv.  Surg.-Gen.   (U.  S.),  1894,  p.  293. 

67.  U.  S.  Public  Health  Reports,  1901,  vol.  16,  p.  1724. 

68.  Ibid.,  1897,  vol.  12,  p.  1434. 


I 


CENTRAL  AMERICA.  fi99 

69.  Ibid.,  1905,  vol.  20,  p.  2770. 

70.  Annual  Report  Sup.  Surg.-Gen.,  1894,  p.  293;  U.  S.  Public  Health 
Reports,  1897,  p.  1434;  Ibid.,  1905,  p.  2770;  Ibid.,  1906,  pp.  742,  1553; 
Ibid.,  1907,  p.  1938. 

71.  Ibid.,  1905,  vol.  20,  p.  2770. 

72.  Ibid.,  1896,  vol.  11,  p.  1062. 

73.  Ann.  Rep.  Sup.  Surgeon-General,  1894,  p.  293. 

74.  U.  S.  Public  Health  Rep.orts,  1896,  vol.  11,  p.  1062. 

75.  Guzman:   Theses  de  Paris,  1869,  No.  229,  pp.  85-102. 

76.  Cornilliac:   Recherches  Chronologiques.,  etc.,  p.  428. 

77.  Annual  Report  Supervising  Surgeon-General  (U.  S.),  1894,  p. 
293.  Also:  U.  S.  Publx  Health  Reports,  1897,  vol.  12,  p.  1183. 

78.  U.  S.  Public  Health  Reports,  1896,  vol.  11,  p.  1062;  also,  1897,  p. 
1183. 

79.  Ibid.,  1897,  vol.  12,  pp.  1183,  1358,  1434. 

80.  Ibid.,  1898,  vol.  13,  p.  1572. 

81.  Ibid.,  1899,  vol.  14,  p.  2367. 

82.  Ibid.,  1900,  vol.  15,  pp.  1682,  2387. 

83.  Ibid.,  1901,  vol.  16,  pp.  1504,  1724,  3084. 

84.  Ibid.,  1907,  vol.  22,  pp.  62,  1057. 

85.  Ibid.,  1901,  vol.  16,  p.  1724. 


700 

MEXICO. 

History  of  Yellow   Fever  in  Mexco. 

Mexico  presents  an  interesting  and  prolific  field  for  the 
study  of  yellow  feyer. 

■  Yellow  feyer  {the  romito  jiricto)  of  the  early  Spanish 
colonists,  has  preyailed  from  time  immemorial  between 
the  mouth  of  the  Rio  Antigua  and  the  present  port  of 
Vera  Cruz.  The  Abbe  Chayiiiero,  whose  History  of 
Mexico  is  a  classic,  affirms  that  the  disease  under  dis- 
cussion appeared  for  the  first  tiiiie  in  Mexico  in  1725.  It 
is  a  matter  of  history,  howeyer,  that  long  before  the 
arriyal  of  Cortez  and  his  murderous  band  of  pillagers, 
there  preyailed  periodically  in  ''Xew  Spain"  an  epidem- 
ical disease  called  by  the  natiyes  MatlazahuafL  which  was 
no  doubt  the  same  as  the  yellow  feyer  of  the  present  day. 

Endemic  Foci  of  YeUoic  Fever  in  Mexico. 

In  a  paper  read  l)efore  the  American  Public  Health 
Association,  at  its  Annual  Conyention  in  1893,  Dr. 
Eduardo  Liceaga,  of  Mexico,  giyes  a  minute  and  elaborate 
history  of  the  rayages  of  yellow  feyer  in  ^lexico.  The 
learned  scientist  coyers  eyery  point  so  fully  and  admir- 
ably, that  we  take  the  liberty  of  appropriating  his  thunder 
in  making  this  summary. 

Dr.  Liceaga  states  that  inyestigations  which  haye  been 
undertaken  by  historians  haye  neyer  been  able  clearly 
to  determine  whether  the  yellow  feyer  originated  in  Vera 
Cruz,  or  was  imported  from  other  parts.  Many  authors 
are  inclined  to  adopt  the  latter  o])inion,  and  especially 
Dr.  Charles  Heinemann,  a  distinguished  TKn'man  physi- 
cian, who  for  many  years  practised  his  profession  in  that 
port,  and  from  whose  interesting  works  Dr.  Liceaga  took 
many  of  the  data  for  his  i)aper.  Howeyer  this  may  be, 
the  fact  is  that  Vera  Cruz,  for  more  than  Iwo  centuries, 
has  been  the  most  important  hot-bed  of  yellow  feyer  in 
the  whole  coast.  From  this  point  the  troops  started  in 
1843,  and  introduced  the  disease  for  the  first  time  in  the 


MEXICO.  ^  701 

port  of  Tampico.  The  epidemics  which  ravaged  the  same 
port  in  the  years  1847-48,  and  in  1803-04,  owe  their  origin 
to  the  same  circumstances.  In  the  same  way,  the  disease 
was  carried  to  Tuxpan  in  the  year  1803,  and  to  Jicaltepee 
in  the  years  1801  and  1808. 

In  Vera  Cruz  the  greater  part  of  the  epidemics  take 
place  in  the  summer  time,  between  March  and  October; 
but  on  some  occasions,  as  in  the  years  1807-08,  and  in 
1877-78,  the  epidemics  raged  through  the  winter. 

According  to  Dr.  Heinemann,  the  port  of  Alvarado,  sit- 
uated eighteen  leagues  to  the  southeast  of  Vera  Cruz,  and 
near  the  mouth  of  the  River  Papaloapam,  is  another  cen- 
ter of  the  disease. 

Tlacotalpam  is  a  city  situated  on  the  left  bank  of  the 
same  river,  and  at  a  distance  of  twenty-five  miles  from 
Alvarado.  It  is  also  considered  as  a  cradle  of  yellow 
fever. 

Laguna  is  the  principal  town  on  the  Island  of  Carmen, 
and  derives  its  importance  from  the  exportation  of  dye- 
woods.  This  is  another  permanent  center  of  the  disease, 
which  causes  numerous  victims,  every  year,  among  the 
foreign  sailors. 

Campeche  is  the  capital  of  the  state  of  the  same  name, 
in  the  peninsula  of  Yucatan,  and  is  another  source  of 
yellow  fever  at  those  times  when  federal  troops  are  sta- 
tioned here,  proceeding  from  the  more  elevated  parts  of 
the  country,  or  from  abroad.  This  happened  in  the  year 
1805,  when  two  companies  of  Austrian  troops  lost  the 
greater  part  of  their  numbers  through  yellow  fever. 

The  City  of  Merida,  capital  of  the  State  of  Yucatan, 
which  covers  the  northern  part  of  the  peninsula  of  the 
same  name,  as  well  as  the  districts  comprised  within  that 
state  under  the  name  of  Unucma,  Trogreso,  Temax,  Tizi- 
min  and  Valladolid  are  considered  as  centers  of  yellow 
fever  by  Dr.  Jose  Talomeque,  a  distinguished  physician 
of  Merida,  and  who  declares  that  the  disease  in  that  place 
finds  its  greatest  development  amongst  the  foreigners  who 
have  not  already  had  it,  the  natives  of  the  elevated  table- 
lands in  the  central  part  of  the  republic,  and  the  Indians 
from  the  other  towns  of  the  same  state. 


I 

702  HISTORY    or    YELLOW    FEVBR.  * 

To  the  districts  of  the  states  of  Yucatan  above  men- 
tioDed,  Dr.  Domingo  Orvananos,  in  his  recent  work,  adds 
the  districts  of  Motul  and  Mazcanu  as  being  centers  of 
yellow  fever. 

The  preceding  lines  will  have  demonstrated  that  in  the 
Gulf  of  Mexico,  and  out  of  a  length  of  2,580  kilometres 
of  coast,  only  that  small  part  belonging  to  the  canton  of 
Vera  Cruz,  to  the  district  of  Frontera,  to  Campeche,  and 
the  northern  coast  of  the  peninsula  of  Yucatan,  can  be 
considered  as  centers  of  yellow  fever,  as  they  are  in  con- 
stant communication,  by  sea,  with  each  other,  and  with 
the  Island  of  Cuba.  It  is  to  be  noted  that  these  last 
mentioned  localities  are  onl}"  separated  from  Cuba  by  a 
narrow  strait,  and  that  it  is  natural  to  suppose  that  the 
disease  was  originally  imported  from  that  island. 

In  contrast  to  the  narrow  limits  of  the  centers  of  in- 
fection, we  can  present  the  enormous  coast  line  of  the 
Gulf,  and  of  the  Pacific,  where  yellow  fever  prevails  only 
transported  from  those  places  in  which  the  disease  pre- 
vails in  an  endemic  form. 

Along  the  Pacific  Coast.  - 

The  port  of  [Matamoros,  situated  opposite  Browns- 
ville, United  States,  has  suffered  from  epidemics  of 
yellow  fever  in  the  years  1858,  1863  and  1867. 

Altamira  went  through  its  first  epidemic  of  black  vomit 
in  the  month  of  October,  1821,  shortly  after  the  arrival 
in  that  port  of  a  vessel  from  Havana.  More  than  fifteen 
hundred  persons,  both  native  and  foreign,  succumbed  dur- 
ing the  ravages  of  the  epidemic. 

Tampico,  situated  on  the  left  bank  of  the  river  Panuco, 
was  visited,  as  previously  mentioned,  by  its  first  epidemic 
of  yellow  fever  in  the  year  1843,  twenty  years  after  its 
foundation. 

Tuxpan,  on  the  left  bank  of  the  river  of  the  same  name, 
was  visited  by  an  epidemic  in  the  year  1838,  which  was 
not  repeated  until  the  year  1863,  and  was  then  imported 
by  vessels  arriving  from  Vera  Cruz.  It  attacked  the 
natives  of  the  locality,  the  Mexicans  newly  arrived  from 


MEXICO.  703 

the  table-land  and  foreign  sailors,  and  it  afterwards 
spread  to  the  villages  of  Jieo  and  Huauchinango. 

Papantla  and  Misantla  were  visited  by  an  epidemic  of 
yellow  fever  of  the  most  deadly  character,  which  was  im- 
ported by  the  troops  passing  through  those  districts  dur- 
ing the  revolution  of  1876. 

Naulta  was  visited  by  the  epidemic  in  1859 ;  Jicaltepec, 
in  the  years  1861  and  1868. 

Trusting  to  the  information  given  by  Dr.  Heinemann, 
below  is  given  a  list  of  the  following  towns  in  which  yel- 
low fever  has  never  appeared  within  the  memory  of  man : 

Santecomapan,  La  Barilla,  Cupilgiiillo,  Dos  Bocas, 
Chiltepec,  San  Pedro  y  San  Pablo,  Barro  del  Rio  Palizeda 
and  Champoton.  According  to  many  other  numerous  and 
reliable  reports,  the  foreign  sailors  in  these  ports  have 
hitherto  escaped  the  disease,  in  spite  of  the  hard  work 
they  have  to  perform  under  a  burning  sun,  receiving  and 
stowing  the  goods  with  which  the  ships  are  loaded. 

Coatzacoalcos  and  Minatitlan  were  invaded  by  the  epi- 
demic in  September,  1892,  imported  by  persons  who  had 
arrived  from  Vera  Cruz  in  the  steamer  Mai). 

Frontera  has  from  time  to  time  been  visited  by  mild 
epidemics,  which  have  attacked  both  natives  and  for- 
eigners. 

San  Juan  Bautista  de  Tabasco  had  never  been  visited 
by  yellow  fever  until  the  year  1877,  when  it  was  imported 
by  the  troops  under  the  command  of  General  Euriquez, 
coming  from  Campeche,  and  touching  in  Frontera. 

The  disease  attacked  the  inhabitants  of  this  town,  with- 
out distinction  of  race,  and  afterwards  spread  to  INIicalte- 
pec,  Huimanguillo,  San  Antonio,  Cardenas,  Nacayuca, 
Jalapa,  Pichucalco.  Doctor  Castanares,  who  has  lived  in 
that  locality,  believes  that  the  Mexicans  who  are  natives 
of  the  old  country,  and  those  of  the  neighboring  State 
of  Chiapas,  are  the  first  to  be  attacked  by  the  epidemic, 
while  it  respects  the  natives  of  the  State  of  Tabasco. 

During  tlie  construction  of  the  Vera  Cruz-Mexico  Bail- 
road,  and  as  the  works  advanced,  the  disease  presented 
itself  in  all  the  stations  excepting  that  of  Tejeria, 
although  it  is  only  situated  at  a  distance  of  fifteen  kilo- 


704  HISTORY    OK    YELLOW    FEVER. 

metres  from  Vera  Cruz.  This  station  preserves  its  im- 
munity to  this  day,  while  in  La  Soledad,  El  Camaron, 
Paso  del  Macho  and  Atojae,  a  few  eases  of  yellow  fever 
are  observed  almost  every  year. 

But  the  city  situated  on  this  road  in  which  the  epidemic 
has  presented  itself  on  several  occasions,  and  where  it  has 
carried  off  the  largest  number  of  victims,  is  Cordova. 
Situated  at  a  distance  of  105  kilometres  from  Vera  Cruz, 
and  at  an  altitude  of  827  metres  above  the  sea  level.  It 
has  undergone  epidemics  imported  from  that  port,  in  the 
years  1866-67,  1876-77,  1880-81  and  1892-93. 

In  the  year  1876,  more  than  two  thousand  persons  per- 
ished in  the  epidemic,  which  spread  to  many  of  the  neigh- 
boring towns  and  villages. 

Following  the  ways  of  communication  by  the  road  from 
Vera  Cruz  to  Jalapa,  the  epidemic  was  carried  to  the 
towns  of  San  Juan  and  Paso  de  Ovejas,  but  did  not  reach 
Jalapa,  Avhich  is  almost  at  the  same  distance  from  Vera 
Cruz  as  Cordova,  but  at  an  elevation  of  3,960  feet  above 
the  sea  level.  This  is  the  highest  point  in  Avhich  the  yel- 
low fever  has,  up  to  the  present  date,  been  found  sus- 
ceptible of  development. 

The  extensive  coast  of  the  Pacific  had  always  enjoyed 
an  immunity  from  this  epidemic,  with  the  exception  of 
short  stretches  belonging  to  the  States  of  Michoacan, 
Oaxaca  and  Chiapas,  which  on  two  distinct  occasions  had 
been  visited  by  yellow  fever. 

In  the  localities  mentioned  below,  all  memory  had  dis- 
ap])eared  of  an  epidemic  of  this  class,  if  they  ever  had 
known  such  a  thing,  so  that  when  it  presented  itvSelf  in 
Mazatlan,  the  local  physicians  did  not  recognize  it,  believ- 
ing that  it  was  not  a  disease  special  to  that  climate. 
Nevertheless,  in  August,  1883,  the  I'acific  mail  steamer, 
San  Jnaiiy  arrived  with  sick  people  on  board,  who  im- 
ported yellow  fever  in  INIazatlan.  The  epidemic  spread 
with  such  rapidity  that  within  five  days,  three  thousand 
persons  were  attacked  with  the  disease.  From  ]\razatlan 
it  extended  to  Guaymas,  San  Bias,  Acapulco,  Manzanille 
and  other  places.     Among  these  latter,  I  would  especially 


MEXICO.  705 

mention  Culiacan  and  llcrmosillo  on  acconut  of  tlie  dis- 
tance at  which  they  are  situated  from  the  coast.  The  epi- 
demic ceased  in  the  month  of  October,  in  the  same  year, 
and  has  never  been  repeated. 

General  Retrospeet.  i 

From  the  preceding  remarks,  it  will  be  seen  that  the 
immense  coast  of  the  repnl)lic  washed  by  the  two  oceans, 
is  always  liable  to  be  invaded  b}'  epidemics  of  yellow  fever 
when  it  is  imported. 

^Matamorcs  was  visited  by  epidemics  in  the  years  1858, 
1863  and  1807. 

As  Ave  have  already  seen,  the  epidemic  appeared  in  Alta- 
mira  during  the  year  1821,  after  the  arrival  of  a  vessel 
from  Havana. 

The  first  epidemic  was  carried  to  Tampico  in  the  year 
1813,  by  troops  from  Vera  Cruz. 

To  the  same  circumstance  we  attribute  the  great  rav- 
ages among  the  American  troops  in  1847-18,  who  gar- 
risoned that  town  during  the  war. 

The  epidemic  was  also  imported  into  Tampico  during 
the  years  18G3-G1,  by  two  battalions  of  the  French  army. 
The  great  epidemic  that  ravaged  Tampico  in  September, 
1878,  was  imported  from  New  Orleans. 

In  June,  1879,  yellow  fever  was  again  imported  to 
Tam]jico,  and  caused  an  ei)idemic  which  lasted  until  the 
month  of  December. 

From  that  date  no  new  epidemic  has  appeared  in  Tam- 
pico, although  is(tlated  cases  have  been  observed  in  per- 
sons who  carried  the  disease  with  them  from  Vera  Cruz. 

Tuxpan  was  visited  by  an  epidemic  in  the  year  1838. 
Dr.  Ordozgoiti  does  not  state  how  the  (•])idemic  was 
brrmght  to  the  town,  but  he  dearly  declares  that  the 
epidemic  of  1863  Avas  imported  from  ships  arriving  from 
Vera  Cruz.  ^Fuleteers  carried  the  disease  as  far  as  Jico 
and  Huauchinango.  Troops  arriving  at  Tuxpan  from 
Vera  Cruz  introduced  the  epidemic  in  the  years  1877 
and  1878. 


"Oli  HISTORY     OF     VELI-LW     FEVER 


Papantla :  A  detadniiriif  uf  trccps  i)assiiii»-  through 
this  town  iu  the  year  187(>,  brought  an  epideuiie  of  yellow 
fever  with  them  which  dev(  loped  the  most  deadly  char- 
acteristics. 

Nautla :     An  epidemic  took  jjlace  here  in  the  year  1859. 

Jicaltepec :  An  epidemic  appeared  iu  this  town  iu  the 
year  1861,  which  was  limited  to  the  right  bank  of  the  river 
Xautla.  It  was  also  visit(d  by  an  epidemic  in  the  year 
18(>8. 

(.'oatzacoalcos :  The  yellow  fever  was  carried  to  this 
port  in  the  mouth  of  September,  1892,  by  some  sick  men 
on  board  the  steamer  M<ij/,  from  Vera  Cruz. 

3Iiuatitlau:  The  disease  was  carried  to  this  port  at 
the  same  time  and  under  the  circumstances  as  the  one  last 
mentioned. 

Frontera :  From  time  to  time  mild  epidemics  are  ob- 
seived  in  this  town,  the  disease  affecting  both  foreigners 
and  natives  alike. 

San  Juan  Bautista :  An  epidemic  raged  iu  the  year 
1877,  having  been  imported  by  ^Mexican  troops  which  had 
touched  at  Frontera  on  tlieir  way  from  Campeche.  From 
San  Juan  Bautista  th.e  epideuiic  spread  to  ^Nlicaltepec, 
Huimai'guillo,  San  Antonio,  Cardenas,  Xacayuca,  Jalapa 
and  l*ichucalco. 

Dr.  Castanares,  who  ])racticed  his  profession  for  twenty- 
three  years  iu  Tabasco,  says  that  the  epidemics  only 
appear  in  that  state  when  there  occurs  a  great  croAvding 
of  people  under  unliealthy  conditions,  as  for  instance,  in 
a  military  encampu'ent.  Dr.  Castanares  believes  that  the 
(])idemic  attacks  with  greater  facility  the  natives  of  the 
n(  ighl'oring  State  of  Chia])as.  According  to  Dr.  Orvan- 
anos,  e])idemics  of  yellow  fever  have  visited  the  State  of 
Yucatan  in  the  years  1855,  1857,  1881-82  and  1883,  and 
have  also  aiipeared  in  the  State  of  Vera  Cruz  in  the 
years  1803,  1872,  1873,  1875,  1878  and  1879.  and  in  Cam- 
peche iu  the  year  1805.  Tlu^  author  does  not  give  any 
d(  taib-  as  to  the  nianner  in  which  the  ei)idemics  developed 
thems(^lves. 

Dr.  Orvaranos  speaks  of  epidemics  havina"  apjjeared  in 
the  State  (  f  :\richoacan,  during  the  years  1813,  1814  and 


MEXICO.  707 

18G0,  but  this  can  only  have  taken  place  along  a  short 
stretch  of  coast,  as  no  record  can  be  found  of  these  epi- 
demics. The  same  remark  apjjlies  to  the  state  of  Oaxaca 
durinu  the  years  1850  and  1857. 

The  Ocucral  Epidemic  of  1883. 

The  epidemic  which  spread  during  the  year  1883  along 
the  entire  coast  of  the  Tacitic,  is  of  the  greatest  interest. 
If  any  previous  epidemics  had  ever  appeared,  the  memory 
of  them  was  so  comfjletely  lost,  that  when  the  first  cases 
of  yellow  fever  preh^ented  themselves  in  the  port  of  ^Nlaz- 
atlan,  the  physicians  did  not  recognize  them,  founding 
their  doul)ts  on  the  fact  that  this  disease  had  never  been 
on  the  west  coast  of  ^Mexico.  Audther  great  point  of  in- 
terest presented  by  this  special  eiiidemic,  is  found  by  fol- 
lowing up  the  wav  in  which  the  disease  was  introduced, 
that  is  to  say,  Dr.  Traslow  maintains  that  the  yellow 
fever  mux  have  been  imported,  frcm  the  year  1882,  by  the 
steamers  of  the  Pacific  mail,  which  brought  yellow  fever 
patients  from  Panama,  who  did  not  land.  He  proves  this 
assertion  by  letters  from  persons  who  had  traveled  in  the 
steamer  CoJiiiia,  on.  board  of  which  tlie  caittain  and  six 
stewards  fell  sick. 

The  same  did  not  happen  in  August,  1883.  In  that 
morith  the  steann  r  i<(ni  Jikni,  belonging  to  the  same  com- 
pany, reached  ^lazatlan  with  tliii  ty-three  sick  peo])le  on 
board,  coming  fi(  ni  Panama.  Some  of  them  laitdcd,  and 
the  consequent  (^])ideniic  FjU'ead  with  such  force  that,  as 
before  said,  more  than  thrc(^  thousand  people  were  at- 
tacked in  the  port  within  tin  first  live  days,  while  twenty- 
hvo  died  in  one  day.  The  e](idemic  rapidly  extended  it- 
self to  other  ports  (tn  that  coast,  and  visited  the  ports  of 
La  Paz,  Ouaymas,  Altata,  San  Bias,  :\ranza!iillo,  San- 
tiago, Acaponeta,  Puerto  Angel,  Salina  Truz,  T<n'ala, 
Soconusco,  Tapaciiula  and  San  Benito  and  in  tlie  interior 
at  Ilermossillo  and  Tuliacan.  A  very  important  fact  to 
lie  borne  in  mind  if^,  that  in  all  the  territory  included  be- 
tw((Mi  the  Yaqui  and  "Slayo  Pivers,  which  is  inhabited  by 
Ya(iui   Indians,  the  ('i)i(lcmic  did   not  i)nt    in  an  appear- 


708  HISTORY     OF    YELLOW    FEVER. 

iuuc  Tliis  was  due  to  the  eiioriiitic  attitude  assumed  by 
the  ehief  of  the  tribe,  who  piv^hibited  all  eonimunieatiou 
with  the  outside  world,  either  bv  sea  or  laud,  uuder  pen- 
alty of  death. 

HISTOIJY    OF   YELLOW   FEVER    IX    MEXICO,   BY 
LOCALITIES. 

ACAPULCO. 

1853.  Yellow  fever  was  imported  to  Aeai)uleo  by  a 
veh-sel  coming  from  (iuayafjuil,  Ecuador,  in  1853,  for  the 
first  tiuie  in  its  history.     xVbout  sixty  eases  resulted. 

1883.  Thirty  years' later  (1883),' refugees  from  :\Iaz- 
atlan  infected  Acapnlco.  The  disease  prevailed  (piite 
exteusively. 

1887.  in  April,  1887,  a  case  of  yellow  fever  was 
brought  to  Acajiulco  and  died  on  the  17th.  Source  of  in- 
fection not  stated.     There  was  no  spread. 

1895.  A  vessel  fiom  Panama  brought  a  case  of  yellow 
fever  to  Acapnlco  on  S(^])tember  8th.     Death  on  the  15th. 

181)().  Three  cases  in  181)0  completes  the  history  cf  yel- 
low fever  in  Acapnlco. 

ACAYUCAX. 

1902.  A  case  of  yellow  fever  was  brought  to  Acayuacan 
from  Vera  Cruz  in  P>()2.     The  patient  recovered. 

ALTATA. 

Altai  a  was  infected  by  refugees  from  :Mazatlan  in  1883. 
The  disease  prevailed  epidemically.  The  number  of  cases 
could  not  be  asccM'taincd,  but  the  d(  atlis  were  1,98L  Of 
150  soldiers  stationed  in  the  town,  148  had  the  fever;  47 
died. 

ALT  A:\IEPv  A. 

1821.  Altamera,  which  ^^as  an  important  port  previous 
to  the  foundation  of  Tampico  (1824),  is  now  a  place  of 
minor  im])ortance,  the  new  city  having  taken  away  its 


MEXICO.  709 

coniinereial  presti<;v.  Yellow  fever  was  observed  for  tlio 
fi'rst  time  in  Altainera  in  1821.  The  infection  was  bronjj,ht 
from  Havana  in  October,  and  an  extensive  epidemic  re- 
sulted.    The  mortality  was  1500. 

1903.  Yellow  fever  broke  out  in  July.  The  outbreak 
was  neither  severe  nor  extensive. 

ALVAI^DO. 

1902.  Three  cases  of  yellow  fever  were  observed  in 
Alvarado  in  1902.     The  infection  came  from  Vera  Cruz. 

AMALCO. 

1899.     Sporadic  cases. 

ATAI. 

1883.  Atai,  in  Sonora,  near  the  borders  of  Arizona, 
suffered  to  a,  considerable  extent  from  yellow  fever  in 
1883.  No  statistics  are  oiven,  but  it  is  stated  that  there 
were  "several  thousand  cases,"  ard  that  the  moitality 
went  into  the  hundreds. 

CAMARGA. 

1882.  The  villaiic  of  famaroa,  three  miles  from  I\io 
Grande  TMty,  which  bad  a  po])uiation  of  300  in  1882,  vras 
infected  in  SeptemlxM-,  by  refui-ees  frctm  Matamoras.  The 
virulent  nature  of  the  fever  may  be  judged  from  the  fact 
that  out  of  this  small  ])opulation,  there  were  225  cases, 
of  which  33  died. 

ca:\[peche. 

1865.  Yellow  fever  was  e])id(  niic  in  1805.  No  reliable 
details  are  available. 

1883.  Yellow  fever  Avas  carried  to  Gampeche  "  by  a 
Norweo-ian  vessi^l"  in  1883.  Beyond  this  statement,  no 
other  information  is  niven. 


10 


HIST()R^      OF    VELl.OW      KEVKR. 


CARDENAS. 

1S77.     Cardenas   Avas   infected   bv  rcfngees  from   San 
Jnan  in  1877.     Developments  Avere  unimportant. 
1903.     In  July,  1  fatal   case. 

CHILPANZIXGO. 


1853.  Refugees  from  Acapulco  carried  yellow  fever  to 
Chilpauzingo,  capital  of  the  State  of  Guerrero,  in  1853. 
No  details  obtainable. 

1896,  At  the  end  of  August,  189G,  and  without  any 
antecedents  whatever',  two  cases  of  a  disease,  which  at 
once  spread  itself  and  which  at  first  was  diagnosed  under 
the  name  of  yellow  fever,  simultaneously  appeared  in 
different  places,  remote  from  each  othcT,  in  Chilpauzingo. 
The  malady  assumed  a  most  alarming  character,  in  view 
of  the  limited  extent  of  the  town  and  the  small  number 
of  its  inhabitants,  and  because  it  indistinctly  attacked 
jjersons  belonging  to  all  social  classes. 

The  Mexican  Board  of  Health  immediately  ordereel  Dr. 
Vglesias,  an  authority  on  yellow  fever,  to  proceed  at  once 
to  Chilijanzingo  for  the  purpose  of  making  an  exact  eliag- 
nosis  of  the  disease.  After  a  careful  investigation,  the 
doctor  reported  that  the  epidemic  in  (piestion  was  a  man- 
ifestation of  grave  paludism;  but  as  the  military  physi- 
cian then  resident  in  the  town  was  of  a  contrary  opinion, 
it  was  decided  that  Dr.  ^fejia,  Professor  of  Clinics  in 
the  National  School  of  ]\[edicine,  ^Mexico,  v^^hould  join  Dr. 
Yglesias  for  the  pur])ose  of  making  a  study  of  the  epi- 
demic. Dr.  Mejia  was  accompanied  by  Drs.  Reristain 
and  Loeza,  who  took  with  them  the  necessary  instruments 
for  a  microscopical  study  of  the  blood  of  the  fever  patients, 
and  for  the  forwarding  of  the  blood  under  ilie  conditions 
that  would  facilitate  cultiyation  under  proper  means  in 
the  laboi-atory  of  the  Board  of  TTealth  in  Ihe  City  of 
Mexico. 

Tlie  Commission  presenteel  three  reports,  in  which  it 
was  shown  that  the  epidemic  in  question  was  produced 
bv  the  hematozoria  of  Laveran. 


MEXICO  7  1  1 

1899.  A  few  sporadic  cases  of  yellow  fever  observed  in 
September. 

CILAS. 

1903.  Yellow  fever  was  imported  to  Cilas  iu  1903  for 
the  first  time  in  its  history  and  raged  for  two  months — 
Angust  25  to  October  21.  '  A  total  of  118  cases,  of  which 
50  died,  is  recorded. 

CINCHArA. 

1899.  Yellow  fever  broke  out  in  August.  Only 
sporadic  cases  were  observed. 

CLINIDAS. 

1903.  Yellow  fever  claimed  00  victims  in  Clinidas  in 
1903.     Tlie  number  of  cases  not  stated. 

COATZACOALCOS. 

1892.  The  steamship  Maj/,  from  Vera  Trn/,  brought 
yellow  fever  to  Coatzaccalcos  in  1892.  Only  a  few  cases 
resulted. 

1900.  Sporadic  cases  in  ]\ray. 

1902.  Refugees  from  Vera  Cruz  infected  Coatzaccalcos 
in  1902.  Forty-two  cases  are  recorded;  deaths  not  stated. 

1903.  Six  cases;  3  deaths. 

1904.  Six  cases;  1  death. 

1905.  Six  cases ;  2  deaths. 

COLINA. 

1SS4. 

Yellow  fever  suddenlv  broke  out  in  Colina  in  August, 
1884.  How  tlie  disease  originated,  autlieniic  informalion 
is  lacking;  but  that  it  was  imported  there  is  no  doul)t, 
as  tliis  tluMvimx  ^Mexican  town  had  never  suffered   from 


7  I  -  HISTORY    OK    YELLOW     FEVKR. 

a  visitation  of  tlu^  disease  Ix-for'.'.  T];e  infection  probablv 
came  from  ]\[anzjinillo,  fifty  miles  distant,  on  tlie  Pacific 
coast. 

AVhen  tlie  30,000  inhabitants  of  Colina  realized  that 
they  were  face  to  face  Avitli  an  epidemic  of  the  dreaded 
romito,  terror  and  consternation  seized  them.  Inside  of 
a  week,  10,000  had  fled  to  the  surrounding  country,  where, 
unfortunately,  the  spread  of  the  infection  helped  to 
swell  the  frightful  mortality  which  characterized  the  ^lex- 
ican  epidemic  of  1884.  In  two  months,  more  than  1,000 
died  in  Colina  alone,  among  whom  were  some  of  its  bes't 
citizens — the  chief  justice  of  the  "superior  tribuna  de 
justicia,-'  a  lawyer  of  some  national  reputation  and  his 
wife,  the  federal  district  attorney,  a  colonel  of  the  federal 
troops,  his  son  and  daughter  and  scores  of  other  promi- 
nent people.  The  houses  were  closed,  the  city  deserted, 
the  streets  lifeless  (save  for  the  lumbering  funeral  carts) 
and  business  paralyzed.  At  one  time,  the  new  cases  were 
in  the  hundreds  and  the  mortality  from  15  to  20  every 
twenty- four  hours. 

Complete  statistics  could  not  be  obtained,  but  as  the 
mortality  is  said  to  have  been  about  1,000,  there  certainly 
must  have  been  at  least  10,000  cases,  as  hardly  a  house- 
hold escaped  invasion.  And,  even  to  this  day,  the  inhabi- 
tants of  tlie  l)eautiful  mountain  city,  speak  with  a  shudder 
of  tlie  ''great  e])ideinic,'  and  mourn  the  los>s  of  some  dear 
relative  who  fell  victim  to  its  baneful  influence. 


CAEACO. 


188e3. 


The  City  of  Caraco,  in  the  State  of  Jalisco,  suffered 
greatly  during  the  epidemic  of  1884.  Statistics,  which 
also  include  the  neiuhboring  town  of  Gualian,  place  the 
number  of  cases  at  3,000,  with  a  mortality  of  521  within 
the  space  of  three  months. 


MEXICO.  7  IS 

CONCOKDIA. 

Concordia,  in  Linaloa,  suffered  severely,  an  average  of 
tliree  cases  daily  being-  recorded  during  the  height  of  the 
epidemic,  a  period  of  three  months.  Complete  statistics 
not  obtainable. 

CORDOVA. 

Cordova  is  GG  miles  west  of  Vera  Cruz,  and  has  about 
5,000  inhabitants.  This  history  of  the  epidemics  of  yel- 
low fever  which  have  from  time  to  time  decimated  the 
town  is  taken  from  the  elaborate  paper  read  by  Dr.  Men- 
dizabal,  of  Vera  Cruz,  at  the  189G  meeting  of  the  Amer- 
ican Public  Health  Association  and  brought  up  to  date 
by  the  compiler  of  this  work.  It  is  to  be  regTetted  that 
no  statistics  are  given  showing  the  cases  and  deaths  in 
these  epidemics. 

The  City  of  Cordova  is  situated  on  the  boundary  of  the 
yellow  fever  zone,  near  the  railway  which  connects  Vera 
Cruz  with  the  City  of  ^lexico,  and  on  the  margin  of  the 
old  high  road. 

The  city  was  founded  in  the  seventeenth  century,  and 
there  is  no  record  or  knowledge  of  any  epidemic  of  yellow 
fever  during  that  century. 

The  epidemics  of  yelloAv  fever  in  Cordova  liave  nearly 
always  commenced  in  the  autumn,  very  seldom  before  the 
end  of  the  summer.  It  has  n(^ver  lieen  geuerated  there, 
the  infection  having  always  been  imported  from  Vera 
Cruz. 

1772. 

The  first  epidemic  of  which  the  date  is  recorded  was  in 
July,  in  the  year  1772,  and  lasted  three  months. 

1795. 

It  reappeared  in  tlie  autumn  of  the  year  1795,  in  whicli 
year  five  thousand  persons  were  attacked,  of  whom  six- 
hundred  died. 


714  HISTOm      OF    YELLOW     FEVER. 

1796-1800. 

DiiriiiU-  the  years  1796,  '97  and  '98,  some  isolated  cases 
contiuiied  to  occur,  but  the  epidemic  faded  in  the  years 
1799  and  1800,  beini?  a  total  durinj;'  the  eighteenth  century 
of  two  great  epidemics  and  four  small  ones. 

1801-1860. 

During  1801  and  1802,  the  epidemic  which  existed  at 
the  end  of  the  previous  century  continued  under  the  form 
of  a  small  epidemic,  which  in  1803  took  the  character  of  a 
large  epidemic,  soon  subsiding  into  small  epidemics,  which 
ap]ieared  at  irregular  intervals  in  the  years  1805,  1809, 
1813  and  1818,  '21,  '21,  '51  and  '60. 

1865-1867. 

In  the  year  1865,  in  the  month  of  June,  there  was  a 
great  ej)id(*mic,  which  ceased  during  the  winter  and  re- 
appeared in  the  summer  of  the  year  '66,  and  faded  in  the 
autumn  of  the  same  year.     Sporadic  cases  in  1867. 

The  frequency  and  gravity  of  the  e])idemics  date  from 
the  year  '65,  which  was  the  period  of  the  i)rincipal  work 
for  the  construction  of  the  Mexican  Railroad  from  Vera 
Cruz  to  the  City  of  Mexico. 

The  frequent  and  severe  outbreaks  at  this  epoch  are 
easily  explained  when  we  consider  the  conditions  existing 
in  Cordova  at  that  time;  viz.:  an  accumulation  of  un- 
acclimatized  persons  living  under  the  worst  possible  con- 
ditions of  hygiene;  the  rapid  and  frequent  communica- 
tions with  Vera  Cruz;  the  neglect  of  all  precautions, 
especially  in  not  isolating  the  sick  persons  immediately  on 
their  arrival,  each  of  whom  became  a  center  of  infection. 

These  circumstances  combined,  formed  elements  of 
combustion  f>f  the  worst  form;  all  the  (usuing  misery,  the 
result  of  neglect  of  timely  precaution,  might  have  been 
avoided  by  stopping  the  lodgment  of  that  spark,  or  suf- 
focating it  at  its  birth. 


MEXICO.  *  715 

1875-1882. 

The  same  circumstances  were  observed  diirino-  the  years 
'75  and  '70,  and  the  years  '81  and  '82.  Total  for  the 
nineteenth  century  seven  great  and  sixteen  small 
epidemics. 

1893-1896. 

Sporadic  cases  were  observed  in  1893  and  1896. 

1899. 

This  is  the  first  instance  in  which  reliable  statistics 
were  obtained.  The  epidemic  broke  out  in  May.  Be- 
ginuinp;  with  the  10th  of  May,  the  following  number  of 
cases  was  reported : 

May 8  cases.  September 197  cases. 

June 37  "  October 132      " 

July 90  "  November  . 39      " 

August 220  "  December   7      " 

Total  730 

The  mortality  was  350,  making  a  death-rate  of  48  1/2 
per  cent.  Eleven  per  cent,  of  the  inhabitants  were 
attacked. 

1902. 

Limited  outbreak,  a  total  of  13  cases  being  recorded. 

1905. 
Five  cases;  1  death. 

1906. 

Sporadic  cases  in  January. 

COKKTENTES. 

1883. 
Limited  outbreak. 


71G  HISTORY    OF    YELLOW     KEVER. 

COK^MALOAP.^:\r. 

1890.     Aiif>ust  21,  1  imported  ease;  recovery. 
1902.     April   11,   1   case,    imported  from  Vera   Cruz; 
recovery. 

COSALA. 

1883.     Sporadic  cases. 

CULICAX. 

1883.  Infected  by  refugees  from  Matauzas,  in  Sep- 
tember. The  mortality  was  three  daily  to  October  1, 
after  which  date  it  Aveut  as  high  as  nine  daily  for  a  Avhile. 
Complete  statistics  not  obtainable. 

DOFIA    CECILIA. 

1003.  Between  July  15  and  November  4,  two  cases  of 
yellow  fever  were  imported  to  Dofia  Cecilia.  There  was 
no  spread  of  the  disease. 

EL    HIGO. 
1003.     August  15.     Sporadic  cases. 

EQUADOR. 

1853.  Ecjuador  was  infected  by  Acapulco  in  1853.  The 
outbreak  was  not  extensive. 

FROXTEKA. 

1805.  A  fatal  case  of  yellow  fever  was  observed  in 
Frontera  in  1805.  It  was  imported  from  the  surrounding 
country. 

1002.     One  case,  imported  from  Tabasco. 


MEXICO.  7  I  7 

GUALIAN. 

1883.  Gnalian  suifered  considerably  from  yellow  fever 
in  1883.  The  total  number  of  eases  and  deaths  could  not 
be  ascertained,  but  the  fornun*  were  considerable  and  the 
latter  went  into  the  hundreds.  The  garrison,  which  con- 
sisted of  GOO  soldiers,  was  nearly  decimated,  150  falling 
victims  to  the  pestilence.  An  opera  company  of  31  mem- 
bers lost  25.     Out  of  eight  doctors,  two  died. 

GUAYMAS. 

1883.  Cxuaynias  was  infected  l)y  refugees  from  jNIaz- 
atlan  in  1883  and  suffered  the  first  yellow  fever  visitation 
in  its  history.  The  epidemic  was  so  severe,  that  many 
perished  fr<im  want  of  attendance,  the  dead  being  buried 
by  the  carload  by  Indians.  The  fever  was  particularly 
fatal  to  Americans  in  the  employ  of  the  railroad  company. 

1884.  Eecrudescense  of  the  epidemic. 

1885.  Sj)oradic  cases  observed. 

1891.     Yellow  fever  reported  as  epidemic  in  August. 
1895.     Y\']low  fever  reported  present  on  May  20. 

GUEREERA. 

3882.     One  case;  recovery.     Imported. 

GUirniroRi. 

1902.     One  case.     Imported. 

IIERMOSILLO. 

1883.  The  extensive  eiudemic  of  1883  reached  Her- 
mosillo  in  August  and  lasted  until  the  l)eginning  of 
November.  At  times  the  mortality  mounted  up  to  twenty 
daily. 


78  HISTORY     OF     YE.  LOW     FEVS.R. 

HIDALGO. 

1890.     Sp<;ra(lie  cases  in  Aii,<iiist. 

HUACHINANGO. 

1863.     Sporadic  cases.     Imported. 

HUIMAXGUILLO. 

1877.     Infected  by  San  Juan.     Sporadic  cases. 

IXCALLAX. 

Ixcallan,  which  had  then  a  population  of  13,000  suf- 
fered for  the  first  time  in  18S3.  During  the  height  of  the 
epidemic,  33  cases  were  reported  daily.  The  mortality  is 
not  stated. 

JALAPA. 

1877.  Yellow  fevfr  imported  from  San  Juan.  Limited 
outltr.'.al^. 

181)1).     Five  deaths  in  August.     Importv'd. 
11)02.     Infected  hy  Yvrn  Cruz;  27  deaths. 

JICALTEPEC. 

1801.  Infected  Ity  V(  ra  ('n:z.  Epidemic  confined  f^ 
riglit  ])ank  of  the  Xaulta  liiyer. 

1808.     Infected  by  Vera  Cruz.     Limited  epidemic. 

.Tiro. 

1803.     Jico  was  infected  by  muleteers  from  Tuxpan  in 
1803.     Limited  outbreak. 

JIMIXEZ. 

1898.     Sporadic  cases  in  Septcmlier.     Imported. 


MEXICO.  719 

JOLTIPAN. 

1904.     Sporadic   cases.     Imported. 
JUCHITAX. 

1899.  Sporadic  cases.     Imported. 

LAGUXA  DEL  CARMEN. 

1894.  Sporadic  cases. 

1900.  Several  cases  and  one  death  in  ^Nlarcli. 

1902.  Dne  case;  imported  from  CampecJie. 

1908.  Five  cases  and  three  deaths  iu  3Iay,  on  barlv 
JjCiiihit,  from  Tncacas,  Venezuela.  The  disease  did  not 
spread  to  the  town. 

LA   JUNTA. 

1899.     Sporadic  cases. 

LAMPASAS. 

1903.  Five  deaths  from  yellow  fever  hetwcdi  October 
1  and  Decemlier  31. 

1904.  Sporadic  cases;  impcjrted. 

LA    l^VZ. 

1883.  The  oreat  yellow  fev(>r  e])idemic  of  1883,  which 
c(iniuittcd  lavajLies  cii  the  I'acilic  ('oast  of  :Mexico,  was 
hrouo-ht  to  Lea  Paz,  a  town  of  about  2,000  inhabitants,  in 
Lower  California.  About  1,000  cases  resulted.  The  type 
of  the  disease  was  r.ot  very  severe,  only  71  deaths  bein.c: 
recorded. 

1895.  La  Paz  was  visited  by  yellow  fever  for  the  sec- 
ond and  last  time  in  its  history  in  1895.  The  outbreak 
was  limited  to  3  cases,  all  importe<l  from  ^lazatlan. 


720  HISTORY     OF    YELLOW     FEVER. 

LAS    AXi:.[AS. 

Yellow  fever  has  beeu  observed  in  Las  Animas  on  one 
or  two  oecasions,  but  the  exact  date  could  not  be  as- 
certained. 

LIXAEES. 

1903.  Linares  is  situated  in  the  State  of  Xueva  Leon, 
35  miles  southeast  of  Monterey,  and  has  a  population  of 
6,000.  Yellow  fever  was  imjiorted  to  this  town  in  1903, 
and  from  August  until  the  end  of  the  epidemic  (Decem- 
ber), there  were  2,011  cases,  of  which  366  died. 

1904.  Sporadic  cases. 

:\rAXZAXILLO. 

1883.  MaDzaiiillo,  whii  h  liad  a  population  of  76,000  in 
1883,  was  visited  by  a  disastrous  epidemic  of  yellow  fever 
that  year.  Xo  reliable  statistics  could  be  obtained.  In- 
fection came  from  Mazatlan, 

1884.  Sporadic  cases. 
1896.  Spo-radic  cases. 
1902.     One  ca.^e;  imported. 

1907.     One  case,  on  steamship  Saii  Juan. 

:\rATA:\ioi{AS. 

Malamoras  is  situated  on  the  \V\o  Grande,  opposite 
Brownsville,  Texas,  40  miles  from  the  Oiulf  of  :\rexico,  and 
has  a  population  of  about  25,000.  Owing  to  its  close 
business  relations  Yvilh  Rrownsville,  whenever  yellow 
fever  i)revailed  in  ^latanioras,  it  was  invariably  brought 
to  the  Ameriran  city. 

St':\im.vuy  of  Epidemics. 

1853.  In  1853  ^latamoras  had  a  population  of  6,500. 
Yellow  fever  was  introduced  into  the  town  on  September 
22  and  raged  epidemically  until  the  end  of  the  year.     No 


MEXICO.  721 

statistics  were  kept  of  the  number  of  cases,  but  the  mor- 
talitT  is  recorded  at  322.     Source  of  infection  not  stated. 

Infection  carried  to  Brownsville,  Texas,  (deaths,  50). 

1858.  ]Mild  epidemic.  Xo  statistics.  Brownsville  in- 
fected (deaths,  41). 

1863.     ]Mild  epidemic.     No  statistics. 

1867.     ]Mild  epidemic.     No  statistics. 

1882.  Severe  epidemic.  No  statistics.  Brownsville 
infected  (1,072  cases;  63  deaths). 

MAZATLAN. 

Mazatlan  is  an  important  commercial  port  of  Mexico,  in 
Cinaloa,  on  the  Gulf  of  California,  and  has  a  population 
of  about  15,000  souls.  Previous  to  1883,  in  common  with 
other  localities  on  the  Pacific  Coast,  Mazatlan  had  never 
experienced  vellow  fever. 

Summary  of  Epidemics. 

3883.  The  steamship  k^aii  Juan,  from  Panama,  brought 
yellow  fever  to  Mazatlan  in  August.  The  Italian  Opera 
Company,  which  was  to  open  the  season,  had  just  landed. 
Paralta,  the  prima  donna,  and  seventeen  members  of  her 
company,  contracted  the  disease  and  died  at  the  Hotel 
Iturbide.  The  epidemic  lasted  until  December,  causing 
500  deaths. 

1884.  Bea])pearance  of  yellow  fever,  but  not  extensive. 

1885.  In  July  and  August,  sporadic  cases. 
1895.     Sporadic  cases  in  September. 

1897.  September  26  to  October  2,  sporadic  cases;  9 
deaths. 

MEBIDA. 

Merida,  capital  of  the  State  of  Yucatan,  has  a  popula- 
tion of  al)out  50,000.  It  is  26  miles  south  of  Progreso, 
with  which  it  is  connected  bv  rail. 


722  HISTORY    OF    YELLOW    FEVER. 

Summary  of  Epiih:mi('s. 

1880.     One  case,  iiup<;ited;  ckatli,  January  31. 

1887.  Mar  11  to  August  2,  six  deaths. 

1888.  January  20,  one  death. 

181)0.  Twelve  ea^es  reported  in  June;  total  cases  and 
deaths  not  stated. 

1891.  Two  cases  in  January. 

1891.  One  death. 

1895.  Three  cases;  no  deaths. 

1898.  Seyen  deaths. 

1899.  One  death,  week  ending  July  1. 

1900.  Seyen  cases  and  four  deaths  in  July. 

1901.  June  11  to  September  28;  sixteen  deaths. 

1902.  Nineteen  cases;  eight  deaths. 

1903.  January  1  to  Decemher  5,  211  cases;  85  deaths. 

1904.  June  13  to  December  3,  119  cases,  of  which  39 
died,  distributed  as  followed: 

Nationality                                Cases.  Deaths. 

:Nrexicai'  . .' 44  19 

Italian fi  4 

Sjianisb   50  13 

Turk 12  2 

English   1  0 

American    3  ,0 

Porto  Rican 1  0 

French 1  0 

Greek 1  1 

Total   119  39 

1905.  January  to  Decemher,  nine  cases,  of  ^vhich  five 
died.  Th(^  case  in  December  was  imported  from  Vera 
Cruz  on  tlie  23rd,  and  established  a  focus  from  which 
other  cases  d(  yeloped  later. 

1900.  January  10,  the  first  case  occurred  and  was 
traced  to  tlie  focus  of  December  23,  1905.  Cases  and 
deaths  were  as  follows: 


I 


MEXICO  723 

Month.                                           Cases.  Deaths. 

Jauuar}^ 3  3 

February 3  0 

^larch   2  1 

April   1  1 

May 5  3 

Juue  to  December   107  63 

Total   121  71 

1907.  Two  cases  aud  one  death  in  March. 

1908.  August  23  to  December  26,  69  cases ;  25  deaths. 

1909.  January  1  to  March  6,  15  cases;  8  deaths.  {At 
the  tiiiic  of  (joiiHj  to  prcsS;,  April  15,  tlw  epidemic  teas 
still  ill'  pro(/rcss). 

CITY    OF    MEXICO. 

The  City  of  Mexico,  7,160  feet  above  the  level  of  the 
s(>a,  is  the  highest  point  in  the  world  where  yellow  fever 
lias  been  observed.  The  disease  has  never  originated  in 
the  phice,  but  in  every  instance  was  brought  either  from 
Vera  Cruz  or  towns  adjacent  to  that  seaport,  and  was 
confined  to  the  imported  cases.  This  is  fortunate, 
for  Mexico  has  nearly  half  a  million  souls,  all  non- 
immunes, and  the  importation  of  a  few  Htegomyia  Calopae 
simultaneously  with  cases  of  yellow  fever,  wonld  result 
in  an  e])idemic  wliose  ravages  would  undoubtedly  be 
appalling. 

Can  the  Yelloir  Fever  Mosquito  Tlirire  in  }fciico  City? 

Can  the  S1c(/oiiii/i(i  Calopus,  once  introduced  in  the 
City  of  "Mexico,  whei(>  it  is  now  a  stranger,  be  acclima- 
tized? This  menu  ntons  question  has  been  agitating  the 
scientists  of  the  entiic  civilized  world  since  the  adoption 
of  the  :Mos(iuito  Doctiine  of  the  transmission  of  Yellow 
I'ever. 

Drs.  Fernando  Lopez,  of  Mexico  City,  and  Xarcisso  del 
IJio,  of  V(-ra  fMuz,  made  special  studies  in  this  direction, 


724  HISTORY    OF     YELLOW     FEVER. 

aiul  gave  the  result  of  tiicir  labors  iu  an  elaborate  paper 
read  by  Dr.  Lcpez  at  the  Havana  Meeting  of  the  American 
Public  Health  Association  in  1905.  The  statistics  pre- 
sented prove  that  the  Sfcfjonii/ia  Calopus  race  of  mos- 
quitoes have  thrived  in  altitudes  hitherto  thought  to  he 
antagonistic  to  its  existence  since  the  construction 
of  railroads  throughout  the  Republic  and  that  though 
until  lately  it  was  admitted  that  these  insects  could  not 
be  found  except  in  some  ])laces  on  the  coast,  the  facility 
and  rapidity  of  communication  have  acclimated  them  in 
places  more  or  less  distant  and  in  more  or  less  elevated 
alitudes,  thus  enlarging  the  Yellow  Fever  Zone. 

That  the  spread  of  yellow  fever  to  localities  in  Mexico 
where  it  was  hitherto  unknown,  can  be  placed  at  the 
doors  of  the  railroads,  is  made  clear  by  the  following 
deductions  arrived  at  by  these  eminent  scientists: 

Along  the  Mexican  Railroad,  it  has  been  observed  that, 
from  time  to  time,  yellow  fever  was  spreading,  first 
to  Cordova,  which  has  an  altitude  of  2,481  feet  above 
the  sra  level.  It  did  net  pass  the  limits  of  that  station 
until  1890,  when  an  eiudcMuic  broke  out  in  Orizal)a,  3,684: 
feet  above  the  sea  level. 

Along  the  Interoceanic  Railroad,  it  has  been  observed 
that  the  ^tef/ojni/ia  Calopus  has  been  aacclimating  itself 
from  station  to  station,  until  it  reached  Carrizal  station, 
with  an  altitude  of  2,481  feet  above  the  sea  level. 
Similar  cases  have  been  noted  in  the  states  of  Tamaulipas 
and  Xuevo  Leon,  where  the  traffic  of  the  railroads  have 
facilitated  the  enlarging  of  the  Yellow  Fever  Zone. 

Having  come  to  an  agreement  with  Dr.  del  Rio,  Dr. 
I^;])ez  formed  the  following  program  for  a  careful  study 
of  the  (piestion : 

1st.  To  investigate  if  tlie  Slc(/(jnii/ia  lai-vje  brcnight  to 
Mexico  City  Avould  liatcli  into  mosquitoes,  and  in  case 
they  shoubl,  to  see  if  lliese  would  live,  if  they  would  bite 
and  i'epi-o<luce. 

2nd.  To  investigate  if  the  adult  nu)squito  brought 
from  Yera  ("vuz  to  :Me\ico  City  Avill  live,  bite  and  re- 
produce. 


CITY  OF  MEXICO.  725 

3rd.  To  investigate  if  tlie  mosquitoes  infected  with 
YclloAV  fever  l)itin<>  a  person  in  ^Mexico  City,  wlio  was  non- 
immune will  produce  the  disease,  if  it  presents  the  same 
characteristics  which  it  does  on  the  coast,  and  if  an 
immunity  may  be  found. 

In  order  to  solve  the  first  part  of  the  problem,  Dr.  del 
Kio  sent  Dr.  Lopez  from  Vera  Cruz  a  flask  containing  a 
multitude  of  ^tcqouiii'ia  larva^,  which  were  received  in 
Mexico  City  on  June  24,  1905;  the  larvie,  were  collected 
from  a  deposit  of  water  in  a  house  in  Vera  Cruz,  and  were 
preserved  in  the  same  water. 

The  larvie  were  placed  in  a  flue  wire  cage  50  cm.  in 
height,  30  cm.  in  length  and  40  cm.  wide,  having  an  iron 
sheeting  floor  and  roof.  In  one  side  of  the  cage  there  was 
an  opening  over  which  was  sewed  a  cloth  bag  through 
which  the  hand  might  be  put  into  the  cage  without  fear 
of  lettijig  the  mosquitoes  escape. 

The  cage  was  placed  in  an  ample,  well  ventilated  room 
where  there  was  sufficient  light. 

The  mosquitoes  which  began  to  hatch  out  in  great  num- 
bers were  fed  on  bananas,  the  juice  of  which  they  greedily 
sucked  out.  When  there  were  quite  a  number  of  mos- 
quitoes four  or  five  days  old,  Dr.  Lopez  put  his  hand  into 
the  cage  through  the  opening  already  mentioned,  and 
with  no  little  surprise  saw  that  the  fenmles  rushed  to  it 
and,  raising  their  bills,  bit  him  greedily.  This  was  some- 
thing the  doct((r  was  not  ])repar'cd  to  expect,  owing  to 
Ihe  statenuMits  which  have  hvvw  admitted  heretofore,  that 
the  ^tcf/ouii/id  loses  its  power  of  biting  when  it  is  found 
in  an  altitude  of  more  than  0,000  feet  above  the  sea  level, 
and  Mexico  City  is  morc^  than  7,300  feet  high.  AVatching 
the  mosquito,  the  doctor  could  easily  see  that  its  abdomen 
wa.s  filled  with  blood,  after  which  it  Avould  retire. 

The  sting  was  painful,  forming  a  pimj^le  which  lasted 
from  five  to  six  days  and  produced  an  insupportable  itch- 
ing. Dr.  Lopez  repeated  this  experiment  various  times, 
always  obtaining  the  same  results. 

In  order  that  the  mosquitoes  might  reproduce.  Dr. 
Lopez  pnt  a  bowl   of  water  which   containcnl  some  little 


'16  HISTORY     OF     YELLOW     KEVER. 


pebbles  barely  coiniiiu'  up  (uit  of  the  top  of  the  water 
into  the  cauc  He  did  this  with  the  object  that  the 
females  which  had  sucked  the  blood  might  find  a  place 
to  deposit  their  eggs.  A  few  days  later,  he  was  convinced 
that  tliis  liad  liai)pened;  for  using  a  lens,  he  could  see 
a  certain  number  of  isolated  eggs  upon  the  surface  of  the 
water,  whicli  were  of  a  blackish  color.  Then  he  took  out 
the  bowl  containing  the  eggs  and  put  it  in  another  cage, 
in  order  to  observe  them  better;  in  ten  days,  the  eggs 
had  been  converted  into  lai'vje,  whicli  hatched  into 
nios(iuitoes,  thus  constituting  the  second  generation  of 
>itc(ioniijia  bred  and  hatched  in  Mexico  City. 

Only  a  few  mosquitoes  Avere  ol)tained  in  this  way,  for 
an  unlocked  for  accident  overturned  the  r(M-eptacle  in 
which  the  doctor  had  placed  the  larva^,  unfortunately 
causing  the  death  of  all  that  remained.  These  mosquitoes, 
ewen  when  the  investigator  had  put  them  in  conditions 
which  he  thought  favorable  for  their  repr<;ducti(:n,  di(d 
without  leaving  any  young.  They  retained  the  power  of 
biting  as  long  as  they  lived. 

On  the  8th  tlay  of  August  of  the  same  year  (1005),  two 
other  flasks  containing  larvae  arrived  from  Vera  Cruz, 
having  been  sent  by  Dr.  del  Kio.  That  Dr.  Lope^z  might 
cbange  somewhat  the  conditions  of  the  former  ex])erinu  nt, 
he  put  these  larva?  in  wooden  cages  covered  with  tarltau. 
Xvvy  soon  the  mosquitoes  began  to  hatch,  and  as  soon  as 
(acli  (lie  was  hatched  they  were  passed  over  into  a  new 
(age  of  the  same  kind,  in  order  to  observe  them  minutely. 
Three  days  after  they  were  hatched  they  began  to  bite. 
]>r.  Lctpez  had  Then  observed  friendly  struggles  between 
the  females  and  the  males. 

On  the  first  day  of  September,  the  ex])ei-imenter  ob- 
served that  there  were  already  many  groups  of  egg's,  which 
transfcrmed  into  larvje  and  the  lattei-  into  moscpiitoes, 
n.otwitbstandinii-  the  fact  that  tlie  tenijxratuie  had 
descended  to  15  degrees  centigrade  in  the  room  in  whicli 
he  placed  them  fer  observation.  He  preserved  many 
larvje  until  the  middle  of  December,  the  date  in  which 
lliis  was  wilt  (en.      From  tliis  last  generaticni  n<!  eggs  were 


CITY  OF   MEXICO.  7'S.7 

secured,  wliicli  was  probabW  due  to  the  fact  that  winter 
had  set  iu. 

Tlie  temperature  and  the  degree  of  dampness  of  the 
air  in  the  room  in  which  the  mosquitoes  were,  was  from 
the  beginning  of  the  experiments  taken  regnlarlv,  and 
was  found  to  vary  between  15  and  21  degrees  centigrade 
for  the  former ;  the  latter  between  50  and  TO  degrees. 

Having  for  his  object  the  study  of  isolated  mosquitoes, 
specimens  were  placed  in  proof  tubes,  closing  the  entrance 
with  a  simple  gauzj  material  every  day.  At  different 
hours  of  the  day,  the  doctor  applied  the  inouth  of  the 
tube  to  his  bared  arm,  to  observe  the  mosquito  while  it 
was  biting.  With  this  system  he  saw  that  the  mosquitoes 
bite  the  same  at  night  as  in  the  day,  and  that  they  do 
not  do  it  except  every  three  or  four  days.  The  mosquitoes 
remained  alive  inside  the  tubes  from  21  to  28  days. 

The  doctor  also  made  experiments  to  determine  how 
long  the  larva?  and  pupa^  will  live  without  breathing  at- 
mospheric air.  He  placed  some  larva^  in  trial  tubes, 
which  were  completely  filled  Avith  water  and  stopped  them 
with  a  rublier,  without  leaving  on  the  infiide  the  least 
Inibble  of  atmospheric  air.  The  others  were  closed  with 
tarltan  and  inverted  it  in  a  vessel  of  wator  so  that  the 
atmospheric  pressure  would  always  keep  it  full  without 
])ermitting  a  bubble  of  air  on  the  inside;  the  tarltan  kept 
the  larva^  from  coming  out.  ^Multiplying  these  experi- 
ments, Dr.  Lopez  was  able  to  ol)serve  that  the  larvae  lived 
a  longer  or  less  time  in  ju'oportion  to  theii'  age,  varying 
from  12  to  50  hours.  The  pupa'  averaged  from  10  minutes 
to  an  hour. 

In  all  of  these  ex])eriments,  Dr.  Loi)ez  ol)served  the  fol- 
lowing very  curious  plienonienon  in  the  lar\-a'  pupa':  As 
soon  as  the  larva  was  shut  up  in  the  tube,  it  would  go 
to  the  to])  and  not  finding  any  air  to  breathe,  it  would 
descend  shiwlv,  ciirling  itself  up  until  it  formed  a  com- 
plete circle;  it  would  rub  the  extremity  of  its  breathing 
tube  with  the  lufts  of  filaments  which  it  has  on  its  mouth, 
with  snch  violence  that  one  wonld  snjuiose  that  it  Avas 
trvinii-  to  r'^move  some  ol»stacle  from  it,  after  this  it  would 


728  HISTORY    OF     YELLOW     KEVER. 

mako  repeated  trials,  eontiuiiing  this  operation  until  its 
death. 

Owing-  to  its  form  and  brisk  movements,  the  pupa3  was 
still  more  interesting.  As  soon  as  it  reached  the  top  of 
the  tube  in  which  it  was  enclosed  and  found  no  air  to 
breathe,  it  descended  slowly,  curving  its  body  backwards 
and  with  the  two  flaps  at  the  end  of  the  abdomen  eagerly 
brushed  its  breathing  tubes.  It  repeats  these  struggles 
with  less  and  less  energy  until  its  death. 

These  experiments  which  Dr.  Lopez  described  to  the 
American  Public  Health  Association,  prove  that  the 
Stef/omyia  Calopus  Avas  able  to  live,  bite  and  breed  for  at 
least  two  generations  in  Mexico  Citj^,  notwithstanding  the 
fact  that  the  aforesaid  city  has  an  altitude  of  more  than 
7,300  feet  above  the  sea  level. 

The  other  two  points  remain  yet  to  be  solved. 

SianiARY  OF  I:mportatioxs  of  Yellow  Fever  to  the 
City  of  Mexico. 

1883.     One  case;  death. 

1808.  Between  October  10  and  10,  sporadic  cases;  1 
death.     There  was  no  spread  of  the  disease. 

1890.     One  case;  death. 

1900.  May  7  to  November  23,  four  deaths  from  im- 
ported cases. 

1903.     August  10  to  October  4,  four  deaths. 

1905.  One  case,  week  ending  December  2,  one  case; 
death. 

MICALTEPEC. 

1877.  Infected  by  refugees  from  San  Juan;  limited 
epidemic. 

MIER. 

1882.  Infected  in  September  by  refugees  from  Mata- 
moras;  28  deaths. 


MEXICO.  729 

MINATILTAN. 

1S92.     A  solitary  case,  imported  by  the  steamship  Mat/, 
from  Vera  Cruz.     No  developments. 

MISANTLA. 

187G.     Sporadic  cases,  brought  into  the  town  by  troops 
frojn  Vera  Cruz.     No  developments. 

MONCLAVA. 


1903.  Yellow  fever  was  l)i'oui>ht  to  Monclava  from 
Monterey  in  the  l^eiiinnino-  of  November.  The  only  thing 
which  saved  the  town  from  a  disastrous  epidemic  was  the 
absence  of  the  Stegomyia  Calojms,  and  the  fact  the  win- 
ter season  had  already  set  in  and  the  few  imported 
Stegomyla  did  not  survive.  ]Nronclava  is  1,970  feet  above 
the  level  of  the  sea,  and  the  nights  are  generally  cold, 
even  in  summer.  There  were  in  all  0  cases,  of  which  4 
died,  the  last  on  November  19,  with  black  vomit.  On  the 
last  date,  ice  was  half  an  inch  thick  in  the  town. 

1904.  Sporadic  cases.     No  developments. 


MONTEREY 


Although  ]\[onterey  was  settled  by  the  Spaniards  in 
1568,  yellow  fever  has  been  observed  in  the  city  on  three 
occasions  only,  being  im])ort('d  in  each  instance.  Situated 
700  miles  from  the  City  of  Mexico,  at  an  altitude  of  1,()30 
feet,  it  is  outside  of  the  Yellow  Fever  Zone;  but  railroads 
and  the  rapidity  of  modern  travel  may  in  time  cause  the 
^tcf/omyia  Ca1o\pi(ft  to  l)ecome  a  permanent  denizen  of  the 
place,  and  cause  INfonterev  to  align  itself  with  Vera  Cruz 
and  other  endemic  foci  of  the  Mexican  Kepublic. 


730  HISTORY  OF   YELLOW    FEYER. 

Summary  of  Epidkmics. 

1898. 

Yellow  fever  broke  out  in  Monterey  duriug  the  last 

week  of  July,  and  lasted  until  December.  The  cases  and 
death  were  as  follows : 

Cases.  Deaths. 

To  October  25 40  0 

November  1 0  4 

'•          2 11  S 

"          5 1  5 

6 0  3 

"          8 0  2 

"        25  to  December  10  3 

Total   52  25 

The  source  of  infection  is  riot  stated. 

1903. 

Monterey  was  infected   by  i"efu<iees  from  Linares  in 
July  1903.     There  were  about  500  cases.     Xo  authentic 
statistics  as  to  tlie  mortality  could  be  obtained. 
1901.     Sporadic  cases. 

:\roTrL. 

1903.     One  case,  September  G. 

MOXTZORONGO. 
1903.     Sporadic  cases  in  July. 
NAULTA. 

1859.     Sporadi?  cases. 


MEXICO.  731 

KICAYUCA. 

1877.     Infectod  by  San  Juan.     Limited  outbreak. 
NUEVA    LAEEDO. 

1903.  Septeml)er  15  to  November  28 :  Sixty-six  ca^jes; 
21)  deaths. 

1904.  Sporadic  cases. 

ocus. 

1895.     Sporadic  cases. 

OMEALCA. 

1905.  October  8  to  November  4:  Sixteen  cases;  7 
cleat  lis. 

ORIZABA. 

Orizaba  lias  a  population  of  about  25,000  and  is  70  miles 
southeast  of  Vera  Cruz. 

1883. 

Sporadic  cases,  imported  from  Vera  Cruz. 

1899. 

Previous  to  1899,  yellow  fever  had  never  been  observed 
epidemically  in  Orizaba.  The  sudden  apjiearance  of  the 
disease  in  the  year  above  mentioned  was  caused  by  im- 
]iortation,  but  whether  from  Vera  Cruz,  Cordova  or  Coat- 
zacoalcos,  has  not  been  satisfactorily  determined  to  this 
day.  The  ^fexican  government  sent  a  Commis.sion  to 
Orizaba,  headed  by  Dr.  Xarcisso  del  l\io,  in  order  to  study 
the  causes  of  the  disease  and  ascertain  whether  the 
^Irc/onir/ia  (UiJopiifi  existed  in  Orizaba,  or  if  the  im- 
munity which  until  that  year  had  prevailed  in  that  local- 
ity was  due  to  the  fact  that  the  insects  in  question  can 
not  live  there  or  reproduce  themselves  at  the  height  at 
whicli  the  citv  is  located. 


73?  HISTORY    OF     YELLOW     P^EVKR. 

AVlien  Dr.  del  Ivio  arrived  at  Orizaba,  he  was  informed 
that  tlie  first  case  Avas  that  of  an  nn^known  man,  who 
entered  the  hospital  in  a  dying  condition,  wliere  he  died 
a  few  moments  after  his  arrival.  The  symptoms  of  the 
fever  which  had  cansed  the  death  of  the  patient  being 
very  suspicious,  an  autopsy  was  made,  all  the  character- 
istics, traces  and  features  of  yellow  fever  Avere  found; 
but  it  was  not  known  where  the  unfortunate  had  con- 
tracted the  disease,  nor  the  place  whence  he  came — nobody 
knew  liim.  This  case  was  undoubtedly  the  origin  of  the 
ethers  which  followed  shortly  afterwards,  but  the  medium 
of  transmission  from  the  first  case  to  the  others  was  never 
determined. 

At  the  time  of  Dr.  del  Iiico's  arrival,  he  was  informed 
by  the  Mayor  that  12  cases  had  already  occurred  in  the 
town,  of  which  10  had  died,  and  that  there  still  remained 
a  woman  at  the  hospital  and  another  convalescent  jiatient 
in  anotlier  part  of  the  city. 

Dr.  del  Rio  visited  the  woman  at  the  hospital.  She  had 
been  attacked  four  days  previously,  and  her  illness  was 
an  acute  case  of  yellow  fever.  She  had  not  been  outside 
of  the  city  limits,  so  it  was  clear  that  the  infection  was 
local.  Two  cases  were  also  discovered  in  the  central  part 
of  the  city,  in  another  district  where  the  other  cases  had 
been  observed.  The  patients  were  husltand  and  wife. 
The  woman  recovered,  but  the  husband  died. 

Here  Avas  unmistakable  proof  that  the  Yellow  Fever 
Moscjuito  was  present  in  Orizaba.  To  assure  himself  of 
this  fact,  Dr.  del  Rio,  accompanied  by  Dr.  Labardini,  a 
member  of  the  local  Board  of  Health,  and  sanitary  agents 
appointed  by  the  Chief  of  Police,  visited  the  houses  where 
there  had  lieen  some  cases  of  the  disease. 

In  all  of  thse  houses, "the  doctor  found  larA'a?  of  the 
^tcfiomyia  Calopiis,  and  in  one  instance  two  mosquitoes 
of  this  kind  entirely  dev('l(,])ed.  These  two  mosquitoes 
furnislu'd  llie  ex]»lanation  of  the  Iavo  cases  Avhich  were 
noted  in  the  central  part  if  the  city,  quite  distinct  from 
the  original  focus,  namely,  the  married  couple,  already 
referred  to,  and  concerning  which  the  following  data  was 
secured : 


MEXICO.  7SS 

The  husband  was  a  coachman  who  had  charge  of  carry- 
ing- to  the  hospital  in  his  carriage  a  siclv  woman  Avho  lived 
in  the  infected  district,  and  whom  he  had  to  carry  in  his 
arms,  because  her  condition  was  so  serious  that  she  could 
not  walk.  The  room  which  said  patient  had  occupied  was 
disinfected  by  means  of  sprinkling  bichloride  of  mercury, 
and  it  was  in  said  room  that  Avas  found  the  specimen  of 
the  t^tcgoinyia  Calopiis  entirely  devoloped,  it  being  very 
probable  that  the  coachman  was  bitten  there  by  one  of 
the  infected  mosquitoes. 

The  Commission  concluded  that  two  conclusions  were 
generally  acceptable,  viz. :  Either  the  first  case  came 
from  Vera  Cruz,  Cordova  or  Coatzacoalcos,  and  from  said 
case  were  infected  the  mos(putoes  found  at  Orizaba,  there- 
by propagating  the  epidemic,  or  the  mosquitoes  already 
infcM-ted  at  Vera  Cruz  were  carried  by  rail  to  Orizaba, 
where^  the  first  patient  contracted  the  disease  from  the 
mosquitoes  which  arrived  in  the  manner  already  described. 

The  last  theory  is  most  acceptable  and  it  is  to  be  won- 
dered at  that  the  disease  has  not  appeared  more  fre- 
quently at  Orizaba,  owing  to  the  facility  of  communica- 
tion between  that  city  and  Vera  Cruz. 

Dr.  del  Rio  does  not  give  any  statistics  regarding  the 
cases  and  deaths,  but  acocrding  to  the  records  of  the 
United  States  Marine  Hospital  Service,  the  mortality  was 
as  follows: 

May  1  to  September  30   77 

October  1  to  Novend)er  8    36 

Total 113 

This  Avas  the  only  extensive  epidemic  of  yelloAV  feA'cr 
Avliicli  has  ever  A'isited  Orizaba. 

1902. 

YelloAV  fcAcr  Avas  im])orted  to  Orizaba  in  1002,  either 
from  C(;r(l()va,  Vera  Cruz  or  Tehiumtepec.  It  spread  to 
the  neigliboring  villaiics  and  lasted  from  the  end  of 
August  to  the  beginning  of  November,  resulting  in  700 


734  HISTORY    OF    YELLOW    FEVER. 

cases  and  280  deaths.     There  were  IS  cases  in  Orizaba. 
Number  of  deatlis  not  given. 

An  examination  by  the  authorities  revealed  the  fact 
that  Sicgoiiiijid  Calopae  were  found  in  abouudant  quan- 
tities in  all  the  localities  visited  by  the  fever. 

1903. 

From  May  17  to  July  0,  twelve  cases  of  yellow  fever 
were  observed  in  Orizaba.  Eleven  of  these  cases  Avere 
traced  directh'  to  Vera  Cruz.  Number  of  deaths,  if  any, 
not  stated. 

1905. 

October  9  to  December  9,  live  cases;  1  death. 

1900. 

One  case  in  January;  death. 

PAPAXTLA. 

1870.     Sporadic  cases. 

1895.     Cases  in  Anmust;  imported  from  Vera  Cruz. 

PARAJE    NUEVO. 

1907.     May  1,  one  case;  death. 

PASO   DE   OVIJAS. 

1870.     Spcn-adic  cases. 

pixcnrcALco. 

1877.     Iiifcclcd  by  San  Juan;  lin)ited  outbreak. 

PRESIDIO. 
1883.     Limited  epidemic. 


MEXICO.  735 

TEOGRESO. 

Progreso  is  an  important  port  in  the  State  of  Yucatan, 
2G  miles  by  rail  from  Merida,  the  Capital.  It  is  a  regular 
port  of  sail  for  American  and  British  steamships. 

Yellow  fever  has  never  prevailed  epidemically  in  Pro' 
greso,  the  few  manifestations  of  the  disease  in  that  port 
having  been  as  follows : 

1899.  Two  cases  and  one  death  in  July. 

1900.  June  9  to  September  30 :  Nine  deaths ;  number 
of  cases  not  stated. 

1901.  July  23  to  October  G :  5  cases ;  3  deatlis.  Two 
of  these  cases  were  from  the  steamship  Matliilde,  from 
Tampico  via  Vera  Cruz. 

1902.  Three  cases;  deaths  not  stated. 

1903.  January  1  to  November  7:  Nineteen  cases;  5 
deaths. 

1904.  April  28  to  December  8 :  Sixteen  cases ;  3  deaths. 
1900.     August  4   to   November:     Sporadic   cases;   im- 
ported. 

PUEBLO-VEJO. 

1865.     Six  cases;  focus  of  infection,  Tampico. 

PUEIITO    ANGEL. 
1883.     Infected  by  :Mazatlan;  limiv^xl  outbreak. 

QUANTANA    BOO. 

1903.     One  case,  September  25;  death.     Imported. 
190G.     Sporadic  cases. 

REATA. 

1903.     One   case,   November  2G;   imported. 


736  HISTORY    OF    YELLOW    FEVER. 

KEYXOSA. 

1859.  The  town  of  Uoyiio^a,  on  the  Kio  Grande,  forty 
miles  above  Matamoras,  suffered  from  yellow  fever  in 
1859,  but  beyond  the  statement  that  "over  130  had  died," 
no  further  information  could  be  obtained. 

KOSAKIO. 

1883.  During  the  great  epidemic  of  1883.  Rosario 
was  infected  by  refugees  from  ^lazatlan.  Statistics  in- 
complete. 

1885.     A  case  occurred  in  July. 

1002.     Fourteen  cases;  deaths  not  stated. 

1903.  August  9  to  November  28  :  Twenty- three  cases ; 
eleven  deaths. 

1904.  April  3  to  June  4:     Two  cases;  death. 

SAI.IXA   CRUZ. 

1883.     Infected  by  [Nlazatlan;  limited  outbreak. 
1900.     :March    18:       One   case,    imported   from    Santa 
Lucretia. 

SAN  ANTONIO. 

1877.     Infected  l>y  San  Juan.     Limited  outbreak. 

SAN  BENITO. 

1883.  Refugees  fi-cin  Mazatlan  infected  San  Benito 
in  SeptemVier,  1883.  .  Sporadic  cases  occurred  until  the 
beginning  of  November. 

SAN    BLAS. 

1883.  Yellow  fever  reached  San  Bias,  the  first  part 
soutli  of  Mazatlan,  by  a  small  schooner  carrying  fleeing 
people  from  the  larger  town.  A  case  appeared,  than  the 
usual  explosion  took  place — and  the  disease  was  epidemic. 
The  first  case  erupted  September  23;  the  last  in  November. 


MEXICO.  737 

During  the  epidemic,  so  great  was  the  terror  of  the 
inhabitants,  that  the  sick  were  abandoned  by  their  rela- 
tives and  died  unattended.  Bodies  remained  unburied 
for  days.  All  those  who  could  do  so,  fled  to  the  interior, 
spreading  the  pestilence  wherever  favorable  conditions 
presented  themselves.  As  the  same  thing  invariably  hap- 
pened in  every  afflicted  town  on  the  Pacific  Coast  of 
Mexico  during  the  outbreak  of  1883,  it  will  readily  be  seen 
why  the  epidemic  became  so  widespread,  and  its  progress 
so  difficult  to  check. 

SAN    FERNANDO. 

1898.  Yellow  fever  reported  present  in  September ;  no 
statistics. 

SAN  GEROMINO. 

1902.     One  case;  imported. 

SAN  IGNACIO. 
1883.     Sporadics  cases;  imported. 

SAN  JUAN  BAUTISTA. 

1876.  Sporadic  cases;  imported. 

1877.  Infected  by  Campeche;  limited  outbreak. 

1899.  Sporadic  cases  in  August. 

1902.  Eiglit  cases;  imported. 

SAN  LORENZO. 
1899.     Sporadic  cases  in  August;  imported. 
SAN    LUIS    POTOSI. 

1903.  Sporadic  cases  in  July;  imported. 


738  HISTORY    OF    YELLOW    FXVCR. 

SANTA  CEUZ  DE  LOS  ROSALES. 

190G.  One  case  iu  ]\raroli,  imported  from  Santa 
Lucretia. 

SANTA  LUCKETIA. 

1906.  Sporadic  cases;  source  of  infection  not  stated. 
Seyeral  villages  in  the  neighborhood  were  infected  from 
this  focus. 

SANTIAGO    ACAPEMETA. 

1883.     Infected  by  refguees  from  Mazatlan ;  limited  out- 

SOCONUSCO. 

1883.  Infected  b}^  refugees  from  Mazatlan;  limited 
outbreak. 

1905.     Six  cases  and  three  deaths  iu  October ;  imported. 

TAMPICO. 

Tampico  is  an  important  commercial  port  of  eastern 
^Mexico,  in  the  State  of  Tamaulipas,  215  miles  northwest 
of  Vera  Cruz,  on  the  south  shore  of  the  Lake  of  Tampico. 
Population,  about  12,000.  It  was  founded  by  Santa 
Anna  in  1823,  who  gave  it  the  name  of  Santa  Anna  de 
Tamaulipas.  After  the  downfall  of  Santa  Anna,  the 
name  of  the  town  was  changed  to  Tampico  Pueblo  Nuevo, 
but  it  is  popularly  known  as  Tami)ico. 

Tampico  is  said  by  some  writers  to  be  one  of  the  en- 
demic foci  (,f  yellow  fever  in  ^lexico,  but  such  is  not  the 
case,  as  in  nearly  every  instance  when  the  disease  appeared 
in  the  locality,  it  could  either  be  traced  to  importantion 
or  a  recrudescence  of  a.  previous  outbreak. 

Sl'MMAUY   OF   EriDEMICS. 

183G. 

Although  Liceaga  (Am.  Piih.  Ifrallli  .l.s.s-;?.  Report. 'i, 
1893,  p.  i23)  asserts  that  yellow  fever  first  appeared  in 


MEXICO TAMPICO.  739 

Tampico  in  1843,  Goupilleau,  of  Tampico,  in  his  elaborate 
work  {Remarqucs  ct  Observations  sur  la  Fievre  Jaime  du 
MeoL'iquc),  giA^es  histories  of  eases  as  early  as  1836. 
Tampico  had  then  a  population  of  5,000,  of  which  1,250 
were  Europeans  and  the  balance  native  Mexicans  (In- 
dians). How  the  fever  was  brought  to  the  town,  our 
authorit}'  does  not  state.  Six  cases  and  one  death  oc- 
curred in  July,  after  which  there  was  a  lull,  the  epidemic 
reappearing  in  September.  The  fever  was  particularly 
fatal  to  the  European  population  and  especially  to  those 
who  had  lived  for  many  years  in  Havana  and  other  West 
Indian  localities.  This  is  one  of  the  most  remarkable 
phases  of  the  epidemic,  as  the  newcomers,  having  pre- 
viously lived  within  the  endemic  yellow  fever  centers, 
should  have  been  less  susceptible  to  the  influences  of  the 
disease.  Humnoldt  {Political  Essay  on  the  Kingdom  of 
New  &pain)  comments  on  this  pecularity  as  regards  Vera 
Cruz,  having  noted  that  residents  of  Havana  who  settle 
in  the  Mexican  city,  and  who  had  never  experienced  yel- 
low fever  in  their  natal  place,  generally  contract  the  dis- 
ease in  their  new  abode.  The  same  thing  happens  to 
natives  of  Vera  Cruz  who  migrate  to  Havana.  This  proves 
that  immunity  is  confined  solely  to  one's  native  place. 

1843. 

Yellow  fever  was  introduced  in  Tampico  by  troops  from 
Vera  Cruz  in  1843.  The  extent  of  the  outbrealv  Is  not 
stated. 

1847. 

Troops  from  Vera  Cruz  again  introduced  the  disease  in 
1847.  The  war  between  JNIexico  and  the  United  States 
was  tlien  in  progress  and  the  American  soldiers  who  oc- 
cupied Tampico  suffered  greatly. 

1848. 
Vera  Cruz  again  infected  Tampico.     As  in  the  previous 
year,  the  American  troops  were  the  greatest  sufferers. 


7*0  HISTORY    OF    YELLOW    FEVER. 

Sporadic  cases. 

1863. 

Two  battalions  of  the  French  army  brought  the  disease 
from  Vera  Cruz.     The  outbrealv  was  not  severe. 

1804. 

Infection  from  Vera  Cruz.     No  statistics. 

18G5. 

Tlio  French  Army  arrived  at  Tampico  from  Vera  Cruz 
in  August.  The  following  day  yellow  fever  broke  out 
among  the  soldiers  and  the  epidemic  spread  through  the 
town.  The  disease  disappeared  after  tlie  withdrawal  of 
the  troox)s. 

1878. 

New  Orleans  is  accused  of  having  infected  Tampico  in 
1878.  The  epidemic  was  extensive,  about  1,000  deaths 
being  recorded. 

1870. 

No  source  of  infecti(Mi  cau  be  traced.  The  fever  broke 
out  in  June  and  lasted  until  December.  The  outbreak 
was  not  as  widespread  as  in  1878. 

1898. 

The  fever  appeared  in  Jiilv  and  lasted  until  the  begin- 
ning of  December,   l-'ollowiug  is  a  resume  of  the  mortality: 

To  July  24 '. 7 

Week  ending  July  31 0 

August  to  Se])tember  1 122 

September  2  to  October  2 61 

October  3  to  October  23 21 

October  24  to  November  30 10 

Total  mortalitv 230 


MEXICO,  741 

Number  of  cases  net  stated. 

1899.  April  20  to  October  2:  Seveuteeu  cases;  three 
deaths. 

1901.  July  26  to  August  22 :  Two  cases ;  one  death. 
One  case  imported  from  Progreso;  the  other  from  Vera 
Cruz. 

1902.  Mortality :  November,  52 ;  December,  60 ;  total, 
112. 

1903.  Mortality  :  January,  10.  Subsidence  until  May, 
when  the  disease  again  made  its  appearance  and  lasted 
until  October.  Last  death,  October  21.  Total  deaths, 
259. 

1904. 

First  case  was  observed  in  the  beginning  of  May.  Four 
cases  are  recorded  for  the  year. 

TAMUIN. 

1903.     Sporadic  cases  in  August;  imported. 

TAPACHULA. 

1883.     Infected  by  Mazatlan ;  limited  outbreak. 
1895.     Sporadic  cases;  imported. 

TEPEC. 

1883.     Limited  outbreak  ;  imported. 

TEIIUANTEPEC. 

1883.  Tehuantepoc  has  12,000  inhabitants  and  is  one 
of  the  oldest  towns  in  IMoxico.  It  certainly  is  dilapidated 
looking,  and  its  antiquity  is  undoubted,  but  considering 
that  it  has  survived  wars,  Hoods  and  earthquakes  innum- 
erable, and  has  lived  through  epidemics  of  cholera,  small- 
pox, beri1)eri  and  yellow  fever,  it  is  really  wonderful  that 
it  is  still  in  existence. 


742  HISTORY    OF    YELLOW    FEVER. 

Tehiiautepec  is  situated  on  the  river  bearing  the  same 
name  about  12  miles  from  the  Pacific  Ocean,  and  is  bnilt 
of  adobe  and  cane  houses  with  tik'd  and  thatched,  roofs. 
It  is  clustered  on  the  hillside,  and  is  naturally  "vvell 
drained.  It  was  built  without  regard  to  street  formation 
and  before  sewers  and  waterAvorks  were  known.  The 
water  supply  is  obtained  from  a  few  wells,  but  the  major- 
ity of  the  inhabitants  bring  their  water  from  the  river  in 
jars  and  barrels.  The  majority  of  the  population  are 
women,  and  Avitli  the  exception  of  a  few  foreigners  and 
some  Mexicans,  the  population  is  composed  of  Tehuan- 
tepec  Indians. 

In  Decend)er,  1882,  an  epidemic  of  Asiatic  cholera  oc- 
curred, and  1)3'  ]March  of  the  following  year  297  deaths 
were  recorded.  An  epidemic  of  yellow  fever  followed  the 
cholera,  and  when  it  ended,  the  town  was  about  depopu- 
lated. From  an  old  resident  who  lived  through  both  epi- 
demics it  was  learned  that  the  mortality  statistics  were 
not  kept  at  the  time,  and  that  the  mortality  in  Tehuan- 
tepec  and  vicinitY^  must  have  been  in  the  thousands,  judg- 
ing from  the  information  that  he  received  at  the  time. 

1S91).     Sjtoradic  cases. 
VMH).     Scattered  cases. 

1902.  Eight  cases. 

190:^.     August  9  to  Novend)er  28:     Ten  deaths. 

1904.  January  1  to  December  17:  Sixty-six  cases;  53 
deaths. 

1905.  June  24  to  December  2:     Five  case;  2  deaths. 
190(;.     Infected  by  Santa  Lucretia  in  March;  sporadic 

cases. 

TERAN. 

1903.  Sporadic  cases  in  August. 

TEXISTOPEC. 

1904.  Scattered  cases;  imported. 


MEXICO.  743 

TEZONAPA. 

1905.  October  1  to  December  9:  Twelve  cases;  4 
deaths. 

TIERRA  BLANCA. 

1903.     Sporadic  cases  iu  July;  imported. 

190G.  October  22  to  November  18:  .  Eight  cases:  2 
deaths. 

1900.  August  11  to  September  22:  Two  cases;  1 
death.     Tmx)orted  from'  Santa  Lucretia. 

TAPONA. 

1S99.     Sporadic  cases;  imported. 
1900.     Oue  case ;  imported. 

TLACOLTIPAN. 

1877.     Sporadic  cases;  imported. 

1883.     Limited  outbreak;  cases  imported. 

TPISLAN. 

1853.     Infected  by  Acapulco;  limited  outbreak. 

TONALA. 

1883.     Infected  by  ^Mazatlan;  limited  outbreak. 
1902.     One  imported  case. 

TUXPAK. 

Tuxpan  is  situated  on  the  north  bank  of  the  Tuxpan 
River,  al)out  seven  miles  from  its  mouth,  one  hundred 
and  ten  miles  north  of  Vera  Cruz,  and  about  the  same  dis- 
tance south  of  Tampico.  The  town  is  only  about  fifteen 
feet  above  the  sea  level  of  the  Gulf,  and  has  a  population 
of  12,000. 


744 


HISTORY    Or     YELLOW    FEVER. 


Mild  epidemic. 

Infected  by  troops  from  Vera  Cruz;  mild  out- 


<      Summary  of  Epidemics. 

1838.     Sporadic  cases;  imported. 

1863.  Infected  by  troops  from  Vera  Cruz.  The  French 
Army  suffered  greatly  from  the  disease. 

1873.     Severe  epidemic;  no  details. 

1875.  Infected  by  troops  from  Vera  Cruz ;  limited  out- 
break. 

1877. 

1878. 
break. 

1880.  Infected  by  Tampico;  limited  outbreak,  being 
confined  to  imported  cases. 

1892.  A  traveler  arrived  at  Tuxpan  from  Papantla  on 
August  10.  He  was  taken  ill  shortly  afterward  and  died 
of  yellow  fever.     There  was  no  spread  of  the  disease. 

1899.     July  30  to  November  8,  sixty-nine  deaths. 

1902.     One  case,  from  Vera  Cruz. 

1907.     One  case,  January  23;  death.     Imported. 

TUXTEPEC. 


1877. 

1905. 
deatlis. 

1900. 
deaths. 


Infected  by  Tlacotalpan;  limited  outbreak. 
October  8  to  December  9  :     Thirty-two  cases;  21 

August  20  to  October  6:     Seventeen  cases;  13 
VALLADOLID. 


1901. 
190.-]. 
1900. 
death. 


September  25-28:     Four  deaths. 

August  9  to  Septemlter  20  :     Sporadic  cases. 

August  25  to  September  1:     Three  cases;  one 

VERA    CEUZ. 


Vera  Cruz,  the  chief  seaport  of  Mexico,  is  situated  on 
the  Gulf  of  ]\rexico,  in  a  sandy,  marshy,  unhealthy  place, 
185  miles  east  of  Mexico  City.  Tlie  fact  that  after  four 
hundred  years  of  strenuous  existence.  Vera  Cruz  is  a  city 


MEXICO VERA   CRUZ.  745 

of  only  32,000  inliabitants,  iiotwitlistandiiii»:  its  coniinand- 
ing  position  on  the  great  American  Inland  Sea,  is  snfflci- 
ent  proof  of  tlie  unfitness  of  the  locality  as  a  place  of 
abode  for  the  average  human  being.  Although  founded 
by  Cortez  in  1520,  the  site  of  the  City  of  Vera  Cruz  was 
occupied  by  the  Spaniards  as  early  as  1509,  during  which 
year  the  unfortunate  settlers  were  decimated  by  the  first 
epidemic  of  yellow  fever  to  attack  Europeans  on  Conti- 
nental America. 

Yellow  fever  has  prevailed  in  Vera  Cruz  almost  every 
year  since  its  occupation  by  the  Spaniards,  and  the  place 
rnay  be  unhesitatingly  considered  as  one  of  the  most 
fruitions  foci  in  America.  Even  at  the  time  this  report 
is  being  prepared  for  the  printer  (April  8,  1909),  the 
disease  has  attained  epidemiohigical  proportions  in  the 
insalubrious  ]Mexican  city — and  this,  too,  in  the  face  of 
the  fact  that  everybody  in  Vera  Cruz  ought  to  have  had 
yellow  fever  by  this  time.  But  strangers  are  constantly 
arriving — especially  native  Indians  from  the  interior — 
feeding  tlie  fires  of  pestilence,  and  finding  untimely 
sepulture  in  that  unfriendly  soil.  And  thus  will  it  be  un- 
til time  is  no  more — unless  the  Mosquito  Doctrine 
triumphs  over  indolence  and  stubbornness,  and  removes 
the  only  stumlding  block  to  the  future  greatness  of  the 
"rich  city  of  the  true  cross.-'* 

CHRONOLOGY  OF  YELLOW  FEVER  IN  VERA  CRUZ 

FOR  A  PERIOD  OF  FOUR  HUNDRED  YEARS, 

1509  TO  1909. 

1509.  According  to  Parker,  Beyer  and  Pothier  (Report 
of  Workitif/  Part]!  No.  1^  YfJIotr  Fcrer  Tnsfitiitr,  Wa.^h- 
iufjtoii,  D.  C,  1903),  tlie  earliest  record  that  can  be  found 
showing  the  presence  of  yellow  fever  in  Vera  Cruz  was 
in  1509,  when  Diego  de  Nicues  occu])ied  the  place,  then 
called  New  Sjjain.  During  the  first  days  of  the  colony,  400 
of  the  settlers  died  from  a  "pestilential  disease;"  shortly 
afterward,  200  more.     At  the  end  of  fifteen  months,  there 


746  HISTORY    OF    YELLOW    FEVER. 

remained  odIv  GO  survivors.  I'^rom  descriptions  oiyen  by 
early  writers,  tliere  can  be  no  doubt  that  this  was  yellow 
fever. 

1510  to  1698.  A  search  through  the  works  of  his- 
torians who  have  written  on  tlie  epidfuiics  of  ^Mexico, 
fai^s  to  reveal  any  autlu^ntic  reference  regarding  the  ap- 
pearance of  yellow  fever  in  Vera  Cruz  from  1510  to  1698. 
The  disease  was  undoulttedly  present,  as,  even  to  this  day, 
the  infection  is  kept  virulent  and  constant  In'  the  presence 
of  native  Indians,  who  came  from  the  mountains  and 
adjoining-  villages.  Parker,  Pothier  and  Beyer  (loc.  cit.) 
state  that  while  many  foreigners  and  the  better  class  of 
Mexicans  from  the  ticrras  templadas  die  annually  of  yel- 
low fever  in  Vera  Cruz,  it  is  the  unacclimated  natives 
above  mentioned  who  come  from  the  mountains  to  work 
on  the  harl)or  improvements  or  to  sell  their  wares  that 
makes  the  death-rate  of  Vera  Cruz  excessive. 

The  Indians  certainly  came  to  Vera  Cruz  during  the 
silent  years  above  noted,  and  it  is  the  natural  inference 
to  conclude  that  they  died  of  yellow  fever,  just  as  their 
descendants  do  at  the  present  age. 

1699.  First  appearance  of  yellow  fever  in  Vera  Cruz, 
according  to  Berenger-Feraud  {Ficvrc  Jaunc,  etc.,  Paris, 
1890,  p.  37).     No  details. 

1700  to  1724.     Another  hiatus. 

1725.  Most  authors  date  the  tirst  appearance  of  yellow 
fever  in  A^era  Cruz  from  1725,  prominent  among  whom 
being  tlie  Abbe  Clavigero,  historian  of  note,  who  mentions 
the  fact  in  his  Hisfori/  of  Mr.i'ico.  But  llumlxddt,  Ber- 
enger-I>raud  and  other  w('ll-])osted  chroniclers,  assert 
that  the  eminent  ecclesiastic  is  mistaken,  for,  long  before 
the  Seventeenth  Century,  the  pestilential  disease  known 
as  vomito  prieto  by  the  Spaniards,  showed  itself  many 
times  in  the  locality.  No  records  are  available,  however, 
tradition  and  unofficial  documents  being  the  only  beacons 
to  guide  us  tbi'ough  the  darkness  of  that  period. 

1726  to  1739.     Present,  but  no  record. 

1740.     Severe  epidemic.      (Berenger-Feraud). 

1741  to  1743.     Present,  but  no  record. 


MEXICO VERA    CRUZ.  7*7 

1744.     Severe  epidemic.      (Feraiid). 
1745  to  17G1.     Present,  but  no  record. 
1702.     Severe     epidemic.        [Hionholdt;     Moreau     de 
Jonncs). 

1763.  'No  record. 

1764.  Epidemic. 

1765  to  1773.  Xo  record. 

1774.  Epidemic. 

1775  to  1792.  No  record. 

1703;  1794;  1795;  1796;  1797;  1798;  1799;  1800;  1801; 
1802;  1803;  1804;  1805.  Epidemics  of  more  or  less 
intensity. 

1806  to  1808.  No  record. 

1809;  1810;  1811;  1812;  1813.  Epidemics  of  more  or 
less  intensity. 

1814.  No  record. 

1815.  Epidemic. 

1816.  No.  record. 

1817 ;  1818 ;  1819.     Epidemic  period. 

1820.     No  record. 

1821 ;  1822 ;  1823.     Epidemic  period. 

1824.     No  record. 

1825;  1826;  1827;  1828.     Epidemic  period. 

1828.  No  record, 

1829.  Epidemic. 

1830.  No  record. 

1831.  Epidemic. 

1832  to  1835.     No  record. 

1836 ;  1837.     Epidemic. 

1838.     No  record. 

1840;  1841;  1842.     Epidemic. 

1843.     No  record. 

1844;  1845;  1846;  1847.     Epidemic. 

1848  to  1849.     No  record. 

1850.     Epidemic. 

1851  to  1852.     No  record. 

1853;  1854.     Epidemic. 

1855  to  1856.     No  record. 

1857.     Epidemic. 


748 


HISTORY    OF    YELLOW     FEVER. 


1858,     No  record. 

1850;  1860.     Epidemic. 

18(51.     Xo  record. 

1802;  18G3;  18(U ;  1865.     Epidemic 

From  1866  to  the  present  day,  more  defiuite  information 
could  be  obtained,  the  mortality  by  months  from  1866  to 
1900  being-  as  follows: 


Months. 


Years. 


=  S  ,  .?  !  _• 


1866 !  0 

1867 1  18 

1868. '  7 

1869 1  0 

1870 i  I) 

1871 3  i  0 

1872 2  2 

1873 i  1  0 

1874 ;  1  I  2 

1875 7  2 

1876 0  1 

1877  i  0  1 

1878 16  5 

1879 1  6  i  4 

1880 2  0 

1881 1  2S  '  21 

1882 I  1  i  I 

1883 [  5  :  3 

a884 1  3  2 

1«85 1  6  5 

1886 1  7  3 

1887 0  0 

1888 0  ■» 

1889 0  0 

1890 0  0 

1891 1  I  4 

1892 1  0  ;  2 

1893 5  '  I 

1894 .  0  0 

1895 5  1 

1896 0  0 

1897 1  0  I  0 

1898 !  0  0 

1899 y  5 

Total 13;!  75 


Ei. 

S 

0 

2 

4 

16 

r> 

7 

0 

0 

II 

0 

1 

a 

< 

'2 

c 

3 

X 

<-> 

3 

< 

Si 

a 

u 
Q. 

u 

O 
u 
O 

12 

a 

0 

21 

% 

3 
o 

CI 

<s 

20 

9t  a> 
IPS 

11 

26 

40 

54 

48 

20 

254 

54  1  64 

12 

8 

32 

38 

17 

11 

8 

212 

30  !  40 

16 

26 

20 

21 

9 

2 

3 

187 

2 

0 

0 

1 

1 

■> 

1 

2 

0 

0 

0 

0 

0 

0 

0 

1 

3 

5 

2 

11 

6 

29 

113 

71 

17 

10 

15 

2 

4 

271 

5 

14 

45 

53 

39 

29 

11 

5 

6 

215 

3 

1 

19 

58 

59 

41 

20 

10 

7 

222 

0 

2 

3 

11 

24 

7 

12 

11 

6 

79 

11   29 

93 

118 

105 

41 

13 

2 

0 

425 

0  1  0 

2 

4 

7 

9 

6 

1 

3 

34 

0  1  4 

7 

51 

144 

164 

77 

50 

27 

528 

1 

7 

58 

113 

no 

62 

45 

24 

7 

448 

1 

1 

1 

2 

I 

3 

0 

0 

0 

21 

0 

0 

0 

1 

3 

10 

42 

92 

103 

254 

29 

94 

235 

181 

39 

22 

25 

17 

3 

723 

1 

5 

11 

7 

14 

8 

3 

5 

12 

.  72 

16 

90 

261 

200 

67 

39 

31 

21 

7 

747 

0 

3 

2 

4 

3 

17 

41 

39 

19 

136 

5 

21 

25 

84 

84 

48 

19 

14 

9 

328 

12 

H 

31 

19 

26 

25 

37 

13 

10 

208 

0 

0 

1 

0 

0 

1 

1 

0 

0 

4 

0 

0 

0 

0 

0 

1 

2 

0 

0 

3 

1 

0 

0 

0 

0 

0 

0 

1 

0 

2 

0 

0 

1 

1 

5 

0 

6 

9 

19 

41 

3 

10 

39 

40 

19 

13 

18 

20 

10 

.  179 

7 

20 

41 

75 

53 

27 

13 

10 

10 

260 

8 

17 

32 

29 

8 

9 

11 

5 

0 

131 

« 

39 

55 

44 

38 

15 

5 

3 

3 

210 

2 

12 

23 

40 

36 

17 

3 

3 

0 

143 

0 

0 

0 

0 

0 

0 

0 

0 

0 

0 

0 

0 

0 

0 

0 

0 

1 

1 

0 

2 

0 

0 

0 

0 

9 

21 

39 

32 

23 

127 

8  101 

246 

90 

68 

31 

14 

5 

7 

670 

"' 

647 

1.442 

1,390 

1,079 

759 

557 

136 

328 

7.150 

1900.  No  yellow  fever. 

1901.  E])idemic;  102  deaths. 

1902.  Sevcie  epidemic:     721  cases;  271  deaths. 

1903.  Bevere  epidemic:     January  to  December,  1,123 
cases ;  357  deaths. 

1904.  Only  one  death. 

1905.  Sporadic  cases ;  10  deaths. 


MEXICO.  749 

190G.  January  1  to  December  8:  Twenty-one  cases; 
10  deaths.  Three  of  these  cases  Avere  imported  from 
Yucatan  and  7  from  Quiutana. 

1907.  February  9  to  March  22:  Two  cases;  1  death. 
One  case  was  imported  from  Paraje  Nuevo.  One  new 
case,  September  1.     Total :     Cases,  3 ;  deaths,  1. 

1908.  July  7  to  December  5:  Thirty-four  cases;  18 
deaths. 

1909.  Epidemic. 

VICTORIA. 

Victoria,  or  Nueya  Santander,  is  the  capital  of  the 
State  of  Tamaulipas,  120  miles  northwest  of  Tampico. 
It  has  suffered  ATry  little  from  yellow  fever.  The  few 
instances  AA'ere  as  folloAvs : 

1899.     Sporadic  cases  in  October ;  imported. 

1903.  Three  cases  and  one  death  in  Auoust ;  imported. 

1904.  Infected  by  Tampico.  December  6  to  19: 
Four  cases;  tAvo  deaths. 

XUMPICH. 

1908.  -NoA^ember  1  to  November  30:  Two  cases; 
imported. 

YUKI. 

1883.  Yuki,  in  Sonora,  near  the  Arizona  border,  was 
invaded  for  the  first  and  only  time  by  yelloAV  fever  during 
the  epidemic  of  1883.  The  mortality  is  said  to  haA^e  been 
heavy,  considering  the  smallness  of  the  place,  but  no 
statistics  Avere  kept. 

ZONGOLICA. 

1903.     Five  cases  in  July;  imported. 

ZUCATULA. 

1883.  Zucatula,  on  the  Pacific  coast,  suffered  from  yel- 
loAV  fever  for  the  first  and  only  time  in  1883.  No  statistics 
are  available. 


750  HIiTORY    OF    YELLOW    FEVKR. 

BIBLIOGRAPHY   OF  YELLOW    FEVER    IN    MEXICO. 

ACAPULCO. 

Humboldt:  Report  Sanitary  Commission  of  New  Orleans,  1853,  p.  126 

Main:  Medical  News,  New  York,  1883,  vol.  43,  pp.  419,  556,  671,  699. 

Ibid.,  1884,  vol.  44,  pp.  44,  55. 

Liceaga:   Trans.  Am.  Pub..  Health  Association,  1883,  vol.  19,  p.  120. 

Ibid,  1896,  vol.  21,  p.  166. 

Ibid,  1897,  vol.  22,  p.  165. 

U.  S.  Public  Health  Reports,  1887,  p.  69. 

U.  S.  Public  Health  Reports,  1895,  vol.  10,  p.  1147. 

Ibid.,  1896,  VOL  11,  p.  1200. 

ACAYUGA. 

Liceaga:   Trans.  Am.  Pub.  Health  Assn.,  1902,  vol.  28,  p.  258. 

ALTATA. 

Main:  Medical  News,  1883,  vol.  43,  pp.  475,  556. 

Liceaga:  Td-ans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  p.  128. 

ALTAMERA. 

Gourgues:  Journal  de  Medecine  de  Paris,  1883,  vol.  5,  p.  228. 
Liceaga:  Trans.  A.  P.  H.  Assn.,  1893,  vol.  19,  pp.  125,  126. 
U.  S.  Public  Health  Report.s,  1903,  vol.  18,  p.  2309. 

ALVARADO. 

Liceaga:  Trans.  A.  P.  H.  Assn.,  1902,  vol.  28,  p.  258. 
U.  S.  Public  Health  Reports,  1889,  p.  2367. 

ATAI. 
Main:  Medical  News,  1893,  vol.  43,  p.  529. 

CAMARGO. 

U.  S.  Public  Health  Repoics,  1883,  pp.  327,  328. 

CAMPECHE. 

Liceaga:   Trans.  U.  P.  H.  Assn.,  1883,  vol.  19,  p.  124. 
Medical  Record:   1883,  vol.  24,  p.  322. 


MEXICO.  751 


CARDENAS. 


Liceaga:   Trans.  A.  P.  H.  Assn.,  1893,  vol.  19,  pp.  125,  127. 
U..  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2309. 

CHILPANZIGO. 

Humboldt:    Rep.ort  Sanitary  Commission  N.  O.,  1853,  p.  127. 
U.  S.  Public  Health  Reports,  1890,  p.  2367. 

CITAS. 

U.  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2309. 

CINCHAPA. 

U.  S.  Public  Health  Reports,  1899,  p,  2366. 

COATZACOALCOS. 

Covananos:   Trans.  A.  P.  H.  Assn.,  1893,  vol.  19,  p.  105. 

Liceaga:   Ibid.,  1893,  pp.  125,  127. 

Ibid.,  1904,  vol.  28,  p.  258. 

Ibid.,  1905,  vol.  30,  p.  214. 

U.  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2309. 

Ibid.,  1905,  p.  2770. 

COLINA. 

Mahlo:   Ann.  Report  Sup.   S-G.,  1884,  p.  265. 

CORACO. 

Main:  Medical  News,  1883,  vol.  43,  p.  501. 

CONCORDIA., 

Main:   Medical  News,  1883,  vol.  43,  p.p.  419,  501. 

CORDOVA. 

Liceaga:  Trans.  A.  P.  H.  Assn.,  1893,  vol.  19,  p.  126. 

Ibid.,  1902,  vol.  28,  p.  258. 

Berenger-Feraud :   p.  151. 

Liceaga:   .Journal  .\m.   P.  H.  Assn.,  1897,  vol.  22,  p.  165. 

U.  S.  Public  Health  Reports,  1900,  vol.  15,  p.  815. 

Ibid.,  1905,  p.  2770. 


752  HISTORY    OK    YELLOW    EEYER. 

Ibid.,  1906,  vol.  21,  p.  741. 

Mendizabal  (G.) :  Contribution  to  the  study  of  yellow  fever  in  rela- 
tion to  epidemics  in  Cordova.  Am.  Pub.  Health  Assn.  Rep.,  1896, 
Concord,  1897,  22,  167. 

COSMALOAPAN. 

U.  S.  Public  Health  Reports,  1899,  p.  2366. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1902,  vol.  28,  p.  258. 

COSALA. 

Liceaga:   Jl.  Am.  Pub.  Health  Assn.,  1883,  vol.  20,  p.  228. 

CULIACAX. 

Main:   Medical  News,  1883,  vol.  43,  pp.  501,  529. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  126,  120. 

Preslow  (L) :  Apuntes  sobre  la  Fiebre  Amarilla,  que  reino  en  Culia- 
can,  desde  Agosto  ultimo  hasta  enero  15  del  corriente  anno.  8°. 
Culiacan,  1884. 

DOFIA  CECILIA. 

U.  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2309. 

EL  HICO. 

U.  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2309. 

EQUADOR. 

Humboldt:   Report  Sanitary  Commission,  1853,  p.  127. 

FROXTERA. 

Liceaga:  Journal  Am.  Pub.  Health  Assn.,  vol.  21,  p.  165. 
Liceaga:   Trans.  Am.  Pub.  Health  Assn.,  1902,  vol.  28,  p.  258. 

GUILLICAX. 

Main:  Medical  News,  1883,  vol.  43,  p.  501. 

GUAYMAS. 

Main:  Medical  Xews,  1883,  vol.  43,  pp.  336;  419;   475;   529;   530;  566. 
Eighth  Biennial  Report  Cal.  Board  of  Health.  1884,  vol.  6,  p.  231. 
Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  126,  128. 


MEXICO.  753 

U.  S.  Public  Health  Reports,  1891,  vol.  6,  p.  370. 

Ibid.,  1895,  vol.  10,  p.  1147. 

iMix  (A.  A.) :  The  Mexican  Epidemic  of  1883,  as  it  Appeared  in 
Guaymas.   Pacific,  Med.  &  Surg.  Jl.,  San  Fran.,  1883-4,  vol.  26,  p.  241. 

Pesqueira  (E.) :  Noticla  Sinoptica  de  una  Epidemia  de  Fiebre 
Amarilla  en  la  Capital  de  Sonora  (Guaymas).  Voz  de  Hipocrates, 
Mexico,  1883,  vol.  1,  p.  313. 

Yellow  Fever  in  Sonora  (Guaymas).  Pacific  Med.  &  Surg.  Jl.,  San. 
Fran.,  1884-5,  vol.  27,  p.  118. 

GUERRERA. 

Annual  Report  S.^.,  1883,  p.  286. 

GUICHICORE. 
Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1902,  vol.  28,  p.  258. 

HERMOSILLO. 

Main:   Medical  News,  1883,  vol.   43,  pp.  419,  475,  529,   556;    1884,  p. 
44,  45. 
Liceaga:   Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  126,  129. 

HIDALGO. 
U.  S.  Public  Health  Reports,  vol.  99,  p.  2667. 

HUACHIRARCO. 

Liceaga:   Trans.  Am.  Pub.  Health  Assn.,  1893,  p.  125. 

HUIMOGUILLO. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  pp.  125,  127. 

IXCALLAN. 

■Medical  News:  1883,  vol.  43,  p.  529. 

JALAPA. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  p.  127. 
Ibid.,  1902,  vol.  28,  p.  258. 

JICALTEPEC. 

Gourgues:  Journal  de  Medecine  de  Paris,  1883,  vol.  5,  p.  232. 
Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  123,  125, 127. 


75 1  HISTORY    OF    YILLOW    FKVKR. 

JICO. 
Gourgues:  Journal  de  Medecine  de  Paris,  18S3,  vol.  5,  p.  231. 

JIMINEZ. 
U.  S.  Public  Health  Reports,  1898. 

JULTIPAN. 
Liceaga:  Am.  Pub.  Health  Assn.,  1905,  vol.  33,  p.  214. 

LAGUNA  DEL  CARMEN. 

Ann.  Rep  S.-C,  1894,  p.  293. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1902,  vol.  28,  p.  258. 

LAGUNA  DE  TERMINOS. 

U.  S.  Public  Health  Reports,  1908,  vol.  23,  pp.  759,  798,  889,  933. 

LA  JUNTA. 

XJ.  S.  Public  Health  Reports,  1899,  p.  1404. 

LAMPANSAS. 

U.  S.  Public  Health  Reports,  1904,  vol.  19,  p.  2690. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1905,  vol.  30,  p.  214, 

LA  PAZ. 

Main:   Medical  News,  1883,  vol.  43,  pp.  501,  529,  530,  556. 
Eighth  Biennial  Report  State  Board  Health  Cal.,  1884-6,  p.  230. 
Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1S93,  vol.  19,  p.  128. 

LOS  ANIMOS. 
Liceaga:   Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  p.  126. 

LINARES. 

U.  S.  Public  Health  Reports,  1903.  vol.  18,  p.  2309. 
Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1905,  vol.  30,  p.  214. 

MANZANILLO. 

Mahlo:  Ann.  Rep.  Sup.  Surgeon  General  (U.  S.),  1884,  p.  265. 
Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp..  126,  128. 
Ibid.,  1902,  vol.  28,  p.  258. 


MEXICO.  755 

Main:   Medical  News,  1883,  vol.  43,  pp.  501,  529,  671,  699. 
Ibid.,  1884,  pp.  44,  45.. 

Liceaga:  Journal  Am.  Pub.  Health  Assn.,  1897,  vol.  22,  p.  165. 
U.  S.  Piiblic  Health  Reports,  1907,  vol.  22,  pp.  1295,  1038. 

MATAMORAS. 

Berenger-Feraud,  pp.  134,  184. 

Caraza  (R.) :  Contribucion  al  Estudio  de  la  Geografia  Medica  de  la 
Bepublica  Mexicana;  Epidemia  de  Fiebre  Amarilla  en  Matamoras  el 
anno  de  1882.  Gac.  de  Hosp.  Mil.,  Guadalajara,  1885-6,  i,  no. 4,  3;  no.  5, 
3;  no.  8,  1. 

Lafon:   Journal  de  Medecine  de  Paris,  1883,  vol.  5,  p.  228. 

Lafon  (Antonio) :  Report  of  the  Yellow  Fever  in  the  City  of  Mata 
moras,  from  September,  1853,  to  January  1854.  See  Report  of  the 
Sanitary  Commission  of  New  Orleans,  1854. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  125,  126. 

MAZATLAN. 

Eighth  Biennial  Report  State  Board  Health  Cal.,  1884,  vol.  6,  p.  230. 
iMain:   Medical  News,  1883,  vol.  43,  pp.  336,  419,  501,  529,  530,  556. 
LJceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  126,  128. 
Ibid.,  1905,  vol.  30,  p.  214. 

U.  S.,  Public  Health  Reports,  1895,  vol.  10,  p.  1147. 
Ibid.,  1897,  p.  1434. 

McHatton  (N.  H.) :  Epidemic  at  Mazatlan.  San  Francisco  West. 
Lancet,  1884,  vol.  13,  p.  112. 

MATZRORGO. 

U.  S.  Public  Health  Reports,  1903,  vol,  18,  p.  2309. 

MERIDA. 

National  Board  of  Health  Bulletin,  vol.  1,  1879-80,  p.  288. 

U.  S.  Public  Health  Reports:    1887,  pp.  112,  129,  141,  166. 

Ibid.,  1888,  p.  31. 

Ibid.,  1892,  pp.  263,  285,  322. 

Ibid.,  1895,  p.  1572. 

Ibid.,  1900,  p.  3176. 

Ibid.,  1901,  p.  1504. 

Ibid.,  1902,  p.  3880. 

Ibid.,  1903,  p.  2309. 

Ibid.,  1905,  p.  2770. 


756  HISTORY  or  yellow  fever. 

Ibid.,  1906,  vol.  21,  pp.  363,  455,  557,  625,  661,  764,  788,  925,  961,  994, 
1054,  1110,  1195,  1300,  1336. 

Ibid.,  1907,  pp.  65,  905.  M 

Ibid.,  1908,  p.  1894.                                                                             ,  M 

Ibid.,  1909  (see  tables).  1 

Ann.  Rep.  Sur.-Gen.,  U.  S.,  1894,  p.  293.  ^ 

Liceaga:  Journal  Am.  Pub.  Health  As::n.,  vol.  21,  p    165.  ; 

■i' 

MEXICO  CITY.  X 

Medical  News:   1883,  vol.  43,  p.  363. 

U.  S.  Public  Health  Reports,  1898,  p.  1422.  - 

Annual  Report  Supervising  Suregon-General,  1899,  p.  394. 

U.  S.  Public  Health  Reports,  1900,  p.  3176. 

Ibid.,  1903,  vol.  18,  pp.  1037,  2309. 

Ibid.,  1905,  p.  2770. 

MICALTEPEC. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  p.  125,  127. 

MIER. 

U.  S.  Public  Health  Reports,  1883,  pp.  286,  283. 

MINATILLAN. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  125,  127. 

MISANTLA. 

Gourgues:  Journal  de  Medecine  de  Paris,  1883,  vol.  5,  P.  232. 
Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  p.  125. 

MONCLOVA. 

U.  S.  Public  Health  Reports,  1903,  vol.  IS,  p.  2309. 
Liceaga:   Trans.  Am.  Pub.'  Health  Assn.,  1905,  pp.  30,  214. 

MONTEREY. 

U.  S.  Public  Health  Reports,  1898. 

Ibid..  1903,  vol.  18,  p.  2309. 

Liceaga:   Trans.  Am.  Pub.  Health  Assn.,  1905,  vol.  30,  p.  214. 

Martinez  (A.):  Relacion  de  la  epidemia  de  fiebre  amarilla,  desar- 
rollada  en  Monterey  en  Octubre  y  Noviembre  de  1898.  Gac.  med 
Mexico,  1899,  xxxvi  271-284. 


MEXICO.  757 

MOTUL. 

U.  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2309. 

NAULTA. 

Gourgues:  Journal  de  Medecine  de  Paris,  1883,  vol.  5,  p.  232. 
Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  125,  127. 

NICAYUCA. 

Trans.  A.  P.  H.  A.,  1893,  vol.  19,  pp.  125,  127. 

NEUVA   LAREDO. 

U.  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2309. 

Liceaga:  Trans.  Am.  Pub.  Health  Reports,  1905,  vol.  30,  p.  214. 

OCUS. 

U.  S.  Public  Health  Reports,  1895,  vol.  10,  p.  612. 

OMEALCA. 

U.  S.  Public  Health  Reports,  1905. 

ORIZABA. 

Main:   Medical  News,  1883,  vol.  43,  p.  699. 

Del  Rio  (N.): Reports  on  the  Orizaba  (Mexico)  Epidemics.  Trans, 
American  Pub.  Health  Assn.,  1905,  vol.  28,  p.  262. 

Kermorgant  (A.) :  Sur  une  Epidemic  de  Fievre  Jaune  qui  a  Regne 
a  Orizaba  (Mexique). — Ann.  d'Hyg.  et  de  Med.  Coloniales,  1904,  vol.  6, 
p.  423.  p.  423. 

Mendizabal  (G.):  La  segunda  epidemia  de  fiebre  amarilla  en 
Orizaba.   Gac.  Med.  Mexico,  1903,  2.  s.,  vol.  3,  p.  233. 

Schoenfeld:  Annales  d'Hygiene  et  de  Medecine  Coloniales,  1903,  vol. 
6,  p.  423. 

Liceaga:   Trans.  Am.  Pub.  Health  Assn.,  1902,  vol.  28,  p.  258. 

U.  S.  Public  Health  Reports,  1899,  p.  2365. 

Ibid.,  1905,  vol.  21,  p.  742. 

Ibid.,  1906,  p.  741. 

Yellow  Fever  at  Orizaba  in  September,  1902,  transmission  by 
mosquitoes.  Pub  Health  Rep.  U.  S.  Mar.  Hosp.  Scrv.,  Wash.,  1903, 
vol.  18,  p.  224. 


758  HISTORY    or    YELLOW    FEVHR. 

PAPAXTLA. 

Gourgues:  Journal  de  Medecine  de  Paris,  1883,  vol.  5,  p.  232. 
Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  ]25,  127. 
Liceaga:    Journal    Am.    Pub.    Health    Assn.,    1895,    vol.    — ,    p.    228 
(History.) 
Ibid.,  Journal  Am.  Pub.  Health  Assn.,  1897,  vol.  22,  p.  163. 

PARAJE  NUEVO. 

U.  S.  Public  Health  Reports,  1907,  \ol.  22,  pp.  405,  905. 

PASO  DE  OVIJAS. 

Liceaga:   Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  p.  126. 

PIXCHUCALCO. 

Liceaga:    Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  125,   127. 
(History). 

PRESIDIO. 

Main:   Medical  Xews,  1883,  vol.  43,  p.  501. 

Hargrave   (E.  J.):   Report  of  my  own  case  of  yellow  fever,  in  Pro- 
gress, Yucatan.     Charlotte  (X.  C.)  Med.  Jl.,  1903,  vol.  22,  p.  4. 

PROGRESO. 

U.  S.  Public  Health  Reports,  1900,  pp.  1682,  3177. 

Ibid.,  1901,  p.  3084. 

Ibid.,  1903,  p.  2310. 

Ibid.,  1909,  ppl  1304,  2690. 

Trans.  Am.  Pub.  Health  Assn.,  1902,  vcl.  28,  p.  258, 

PUEBLA. 

Trans.  Am.  Pub.  Health  Assn.,  1893. 

PUEBLO   VEJO. 

Jaspard:  Archives  de  Medecine  Xav.  1,  1854,  vol.  2,  p.  111. 
Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  p.  128. 

QUIXTAXA  ROO. 

IT.  S.  Public  Health  Reports,  1906,  vol.  21,  p.  742. 


MEXICO.  759 

REATA. 

U.  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2310. 

REYNOSA. 

N.  O.  Med.  &  Surg.  Journal,  1859,  vol.  16,  p.  752. 
Annual  Report  Sur.-Gen.  U,.  S.,  1883,  p.  327. 

ROSARIO. 
ElgWh  Biennial  Report  California  Board  Health,  1884-6,  p.  230. 

SALINA  CRUZ. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  p.  128. 

Ibid.,  1902,  vol.  28,  p.  258. 

Ibid.,  1905,  vol.  30,  p.  214. 

U.  S.  Public  Health  Report,  1903,  vol.,  18,  p.  2310. 

[hid.,  1904,  vol.  19,  p.  1304. 

Ibid.,  1906,  vol.  21,  p.  742. 

SAN  ANTONIO. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  125,  127. 

SAN  BONITO. 

Eighth  Biennial  Report  California  Board  Health,  1884-6,  p.  231. 
Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1903,  vol.  19,  p.  129. 

SAN  BLA3. 

Main:   Medical  News,  1883,  vol.  43,  p.  419. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol  19,  pp.  126,  128. 

SAN  FERNANDO. 
U.  S.  Public  Health  Reports,  1898,  p.  1116. 

SAN  GERONIMO. 
Liceaga:  Am.  Pub.  Health  Assn.,  1902,  vol.  28,  p.  258. 

SAN  IGNACIO. 
Liceaga:  Journal  Am.  Pub.  Health  Assn.,  1895,  vol.  20,  p.  228. 


I 

760  HISTORY    OF    YELLOW    FKVKR.  ^  ' 

SAN   JUAN. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  125,  126, 127. 

U.  S.  Public  Health  Reports,  1899,  p.  2366. 

Ibid.,  Trans,  Am.  Pub.  Health  Assn.,  1902,  vol.  28,  p.  258. 

SAN  LUIS  POTOSI. 

U.  S.  Public  Health  Reports,  1903.  vol.  18,  p.  2310. 

SANTA  CRUZ. 

U.  S.  Public  Health  Reports,  vol.  21,  pp.  741,  961,  1027. 

SANTA  LUCRETIA. 

U.  S.  Public  Health  Reports,  1906,  vol.  21,  p.  742. 

SANTIAGO  ACAPONETA. 

Main:  Medical  Record,  1883,  vol.  43,  p.  529. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  p.  128. 

SOCONUSCO. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  p.  128. 
U.  S.  Public  Health  Reports,  1905,  p.  2770. 

TALLERES. 

U.  S.  Public  Health  Reports,  vol.  19,  p.  1304. 

TABASCO. 

Castaneres  (A.) :  A  few  general  remarks  regarding  yellow  fever  in 
the  State  of  Tabasco.  Am.  Pub.  Health  Assn.  Rep.  1892,  concord, 
1893,  vol.  18,  p.  217. 

""^"^  TAMPICO. 

Goupilleau:  Remarques  et  Observations  sur  la  Fievre  Jaune  du 
Mexique.     In  Bull,  de  1'  Acad,  de  Medecine  Paris,  1838,  vol.  3,  p.  305. 

Liceaga:  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  pp.  123,  126,  127. 

Ibid.,  1902,  vol.  28,  p.  258. 

Gourgues:  Jo'rnal  de  Medecine  de  Paris,  p.  230. 

Berenger-F.'  .tud,  p.  140. 

Jaspard  (  P.  H.) :  Trois  mois  de  fievre  jaune  a  Tampico;  considera- 
tions Theoriyues  et  pratiques.    4°.    Montpellier,  1865. 


MEXICO.  761 

Jaspard:  Archives  de  Medeclne  Nav.  Paris,  1864,  vol.  2,  p.  109. 

Cassard:    National  Board  Health  Bulletin,  1879-80,  vol.  1,  p.  149. 

U.  S.  Public  Health  Reports,  1899,  pp.  1011,  2367. 

Ibid.,  1901,  p.  3084. 

Ibid.,  1903,  p.  2310. 

Ibid.,  1904,  p.  2690. 

Kermorgant  (A.):  Notes  sur  la  fievre  jaune  a  Tampico.  Ann.  d'Hyg. 
et  de  Med.  Colon.,  Par.,  1904,  vol.  7,  p.  534. 

Epidemiologie:  Particularites  d'etiologie  et  de  marche  presentees 
par  Tepidemie  de  fievre  jaune  qui  a  sevi  a  Tampico  sur  le  2e  regiment 
d'infanterie  de  marine.    Arch,  de  med  nav..  Par.,  1864,  vol.  2,  p.  109. 

TAMUIN. 

U..  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2310. 

TAPACHULA. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1893,  vol.  19,  p.  129. 
U.  S.  Public  Health  Reports,  1895,  vol.  10,  p.  612. 

TAPONA. 

U.  S.  Public  Health  Reports,  1899,  p.  2367. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1902,  vol.  28,  p.  258. 

TEPEC. 

Main:  Medical  News,  1883,  vol.  43,  p.  529. 

TEHUANTEPEC. 

U.  S.  Public  Health  Reports,  1900,  p.  1520. 

Ibid.,  1899,  p.  1039. 

Ibid.,  1900,   p.   1517. 

Ibid.,  1903,  p.  2310. 

Ibid.,  1904,  p.  2690. 

Liceaga:  Am.  Pub.  Health  Assn.,  1902,  vol.  28,  p.  258. 

Ibid.,  1905,  p.  2770. 

Ibid.,  1906,  vol.  21,  p.  742. 

TERAN. 
U.  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2310. 

TEXISTEPEC. 
Liceaga:   Trans.  Am.  Pub.  Health  Assn.,  1905,  vol.  30,  p.  215. 


762  HISTORY  OF  YELLOW    FEVER. 

TEZONAPA. 

U.  S.  Public  Health  Reports,  1905,  p.  2770. 

TIERRA  BLANCA. 

U.  S.  Public  Health  Reports,  1903,  vol.  18,  pp.  2310,  2770. 
Ibid.,  1906,  vol.  21,  pp.  961,  1553. 

TLACOTALPAX. 

Gourgues:  Journal  de  Medecine  de  Paris,  1883,  vol.  5,  p.  234. 
JVIedical  Record,  1883,  vol.  24,  p.  322. 

TISPLAN. 

Humboldt:  Report  Sanitary  Commission,  1853,  p.  127. 

TOXOLA. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1883,  vol.  19,  p.  128. 
Ibid.,  1902,  vol.  28,  p.  258. 

TUXPAN. 

T^iceaga:  Trans.  Am.  Pub.  Health  As3n.,  1893,  vol.  19,  pp.  123, 125, 127. 

Ibid.,  1902,  vol.  28,  p.  258. 

Berenger-Feraud,  p.  140. 

Boyd:   National  Board  of  Health  Bulletin,  1879-80,  vol.  1,  p,  309. 

Gourgues:  Journal  de  Medecine  de  Paris,  1883,  vol.  5,  p.  233. 

U.  S.  Public  Health  Reports:  1896,  p.  1200. 

Ibid.,  1899,  p.  2366. 

Ibid.,  1907,  p.  905. 

TUXTEPEC. 

TJ.  S.  Public  Health  Reports,  190  6,voL  21,  p.  1553. 
Gourgues:  Journal  de  Medecine  de  Paris,  1SS3,  vol.  5,  p.  234. 
Ibid.,  1905,  p.  2770. 

VALLADOLID. 

U.  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2310. 
Ibid.,  1906,  vol.  21,  p.  1553. 

VERA  CRUZ. 

Alvarado  (I.):  Fiebre  amarilla  (en  Veracruz).    Gac.  med.  de  Mexico, 


MRXICO.  763 

1878,  xiii,  433-452.  Ibid.,  Apuntes  para  la  historia  de  la  fiebre  amarilla 
que  reina  en  Veracruz.     Ibid.,  1879,  xiv,  45-68. 

Bernard  (J.) :  Etude  sur  la  fievre  jaune  d'apres  des  notes  recueillies 
a  la  Vera-Cruz  (Mexique)  pendant  les  annes  1862-1863-1864.  4°  Mont- 
pellier,  1868. 

Buez:  Note  sur  I'epidemie  de  fievre  jaune  de  1862,  a  la  Vera-Cruz. 
Bull..  Acad,  de  Med.,  Par.,  1861-2,  xxvii,  960-962. 

Chabert  (J.  L.):  Reflecsiones  medicas,  y  observaciones  sobre  la 
fiebre  amarilla.  Hechas  en  Veracruz  de  orden  del  supremo  gobierno 
de  la  Federacion  Mexicana.  Trad,  al  espanol  por  C.  Liceaga.  S°. 
[Mexico,  1827.] 

Crouillebois.  L'epidemie  de  fievre  jaune,  en  1862,  a  la  Vera-Cruz. 
Rec.  de  mem.  de  med mil.,  Par.,  1863,  3.  s.,  x,  401-461. 

Del  Rio  (N.) :  Informe  que  el  subscripto,  jefe  del  service  sanitario 
especial  contra  la  fiebre  amarilla  en  Veracruz,  *  *  *  qi^  agosto  de 
1904,  Bol.  d.  Sons.  sup.  de  salub.    Mexico,  1905,  3.  ep.  vol.  10,  p.  281. 

Fuzier:  Resume  d'etudes  sur  la  fievre  jaune  observee  a  la  Vera-Cruz 
pendant  les  epidemies  qui  se  sont  succedees  de  1862  a  1867.  8°.  Paris, 
1877. 

Fuzier:  Co-incidence  de  la  fievre  jaune  a  Vera-Cruz  avec  des  fievres 
intermittentes.     Ibid,  ix,  38-41. 

Kermorgant:  Mortalite  a  Vera  Cruz  Pendant  le  Deuxieme  Semestre, 
1902.— Ann.  d'Hyg.  et  de  Med.    Coloniales,  1903,  vol.  6,  p.  427. 

Liceaga:  Trans.  Am.  Pub.  Health  Assn.,  1902,  vol.  28,  p.  259. 

Ibid.,  1905,  vol.  30,  p.  214. 

Mainegra  (R.  J.):  Yellow  fever  epidemic  at  Vera  Cruz.  Rep.  Superv. 
Surg.-Gen.  ,Mar.  Hosp.,  Wash,  1883-4,  p.  241. 

Legris  (M.  H.):  Queiques  mots  sur  l'epidemie  de  fievre  jaune  de 
1862  a  Vera-Cruz.     4°.    Paris,  1864. 

Naphegyi  (Gabor) :  Remarks  on  the  Military  Hospitals  at  Vera  Cruz, 
and  the  diseases  admitted  in  1853-4,  especially  Yellow  Fever  and 
Vomito.     New  York  Journal  of  Medicine,  May,  1855. 

Porter  (J.  B.) :  Treatment  of  the  Vera  Cruz  yellow  fever  in  1847. 
Am.  J.  M.  Sc,  Phila.,  1853,  n.  s.,  xxvi,  312-333. 

Parker,  Beyer  and  Pothier:  Report  on  working  party  No,  2,  Yellow 
Fever  Institute.  Experimental  studies  in  yellow  fever  and  malaria  at 
Vera  Cruz,  Mexico.  Wash.,  1904,  Govt.  Print.  Oflice,  101,  p.  2  pi.  2  ch. 
8°.  Forms  Bull.  No.  14,  of  Yellow  Fever  Institute.  Treas.  Dept.  U.  S., 
Pub.  Health  &  Mar.  Hosp.  Service. 

Rosenau,  M.  J.  and  Parker,  H.  B.:  Experimental  Studies  in  Yellow 
Fever  and  Malaria  at  Vera  Cruz,  Mexico.  Yellow  Fever  Institute, 
Bulletin  No.  14,  1905. 

Bouffier:  Considerations  sur  les  epidemics  de  fievre  jaune  et  les 
maladies  de  la  Vera-Cruz    (Mexique)    pendant  la  premiere   moitie   du 


764  HISTORY    OK    YELLOW    FEVER. 

dix-neuvieme  siecle  d'apres  les  registres  de  riiospice  civil  Saint- 
Sebastien.    Arch,  de  nied.  nav.,  Par.,  1865,  iii,  289,  520.     Also,  Reprint. 

Ruiz:  Un  caso  notable  de  fiebre  amarilla.  Voz  de  Hipocrates, 
Mexico,  1883,  i,  2. 

Saunier  (J.  B.):  Investigaciones  sobre  la  fiebre  amarilla  o  vomito 
de  Vera  Cruz.    8°.    Puebla,  1866. 

Schmidtlein    (A.) :    Das  gelbe  Fiebre  in  Vera-Cruz  1865.     Deutsches 

Consult  also: 

Berenger-Feraud:  Traite  Theorique  et  Pratique  de  la  Fievre  Jaune, 
Paris,  1890.  (Chronologie.) 

Annual  Reports  Surgeon-General  U.  S.  Army,  from  First  Volume  to 
date. 

U.  S.  Public  Health  Reports,  Vols.  1,  1886,  to  date. 

VICTORIA. 

U.  S.  Public  Health  Reports,  1899,  p.  2367. 

Ibid.,  1903,  vol.  18,  p.  2310. 

Ibid.,  1904,  p.  1304. 

Liceaga:   Trans.  Am.  Pub.  Health  Assn.,  1905,  vol.  30,  p.  214. 

XUMPICH. 

U.  S.  Public  Health  Reports,  1908,  p.  1894. 

YUKI. 

Main:  .Medical  News,  1883,  vol.  43,  p.  529. 

ZONGONICA. 

Arch.  f.  kiln.  Med.  Leipz.,  1868..  iv,  50-109.     Also,  Reprint. 

U.  S.  Public  Health  Reports,  1903,  vol.  18,  p.  2310. 

ZUCATUL.\. 

Main:   Medical  News,  1883,  vol.  43,  p.  419. 

YUCATAN. 

Thompson:  Yellow  Fever  in  Yucatan.  V.  S.  Marine  Hospital  Service 
Public  Health  Report,  vol.  18,  p.  1315  (1903). 

GENERAL. 

Dutrouleau:  La  Fievre  Jaune  au  Mexique.  Gaz.  Heb.  de  Paris,  1862, 
vol.  9,  p.  457. 


MEXICO.  765 

Fleury  (J.) :  Vues  hygieniques  relatives  a  son  epidemie  de  fievre 
jaune  au  Mexique.  Union  med.  de  la  Gironde,  Bordeaux,  1862,  vii, 
pp.  589-596. 

Goupilleau:  Remarques  et  observations  sur  la  flevre  jaune  au 
Mexique.     [Rap.  de  Chervin.]    Bull.  Acad,  de  med.,  Par.,  1838-9,  iii,  305. 

Gourgues  (O.):  De  I'Endemicite  de  la  Fievre  Jaune  sur  les  Cotes 
Orientales  de  la  Republique  Mexicaine.  J.  de  Med.  de  Paris,  1883, 
vol.  5,  pp.  225,  257.  Also:  Bull.  Soc.  de  Med.  Prat,  de  Paris  (1883) 
1884,  p.  99.. 

Heinemann  (C):  Beitrage  zur  Kenntniss  des  gelben  Fiebers  an  der 
Ostkuste  Mexiko's.  Arch.  f.  path.  Anat,  etc.,  Berl.,  1879,  Ixxviii,  139- 
189.     Also,  Reprint. 

Heinemann  (C.) :  Estudios  sobre  le  fiebre  amarilla  (vomito)  en  la 
costa  oriental  de  la  Republica  Mejicana.  Cron.  med.-quir.  de  la 
Habana,  1882,  viii,  353,  411,  474,  518,  566.  Ibid.,  Neue  Beitrage  zur 
Kenntniss  des  gelben  Fiebers  an  der  Ostkuste  Mexico's.  Ach.  f.  path. 
Anat.   [etc.],  Berl.,  1888,  cxii,  449-463. 

Heinemann  (C):  Estudios  de  la  Fievre  Amarilla  (Vomito)  en  la 
Costa  Oriental  de  la  Republica  Mejicana.  Cron.  Med.  Quir.  de  la 
Habana,  1882,  vol.  8,  pp.  353,  411,  474,  518,  566. 

Humboldt  (W.) :  Extract  from  a  Communication  addressed  to  tlie 
Sanitary  Commission  cf  New  Orleans,  on  the  Fever  in  Mexico.  See 
Sanitary  Report,  New  Orleans,  1854. 

Humboldt:  Political  Essay  on  the  Kingdom  of  New  Spain 

Jimenez  (M.  F.):  Fiebre  amarilla  tomada  en  Vera  Cruz  y  desenvuelta 
en  Mexico.    Gac.  Med.,  Mexico,  1866,  ii,  313-317. 

Liceaga  (E.) :  Contributions  to  the  Study  of  Yellow  Fever  from  a 
Medico-Geographical  point  of  view.  (Mexico)  Am.  Pub.  Health  Assn. 
Rep.  (1893),  Concord,  1894,  vol.  19,  p.  112;  (1897)  189S,  vol.  23,  p.  442; 
vol.  24,  p..  135,  (Discussion)  328.  Also:  (Abstr.)  Med.  &  Surg.  Reporter, 
Phila.,  1893,  vol.  69,  p.  701. 

Liceaga  (E.):  Report  on  Yellow  Fever  in  the  Republic  of  Mexico 
from  October  31,  1901,  to  September  30,  1902.  Am.  Pub.  Health  Assn., 
Rep.  1902,  Columbus,  1903,  vol.  28,  p.  258. 

Liceaga  (E.):  Yellow  Fever  in  Mexico.  Am.  Pub.  Health  Assn.  Re- 
ports, 1903,  vol.  28,  p.  258;  1905,  vol.  30,  p.  214;  1906,  vol.  31,  p.  284; 
1907,  vol.  32,  pt.  1,  p.  38. 

Liceaga  (E):  La  fiebre  amarilla  en  Mexico.  Cron.  Med.  Quir  de  la 
Habana,  1905,  vol.  31,  p.  6. 

Liceaga  (E.):  Contribucion  al  Estudio  de  la  Fiebre  Amarilla  bajo 
el  punto  de  vista  de  su  Geografia  Medica  y  su  Proifilaxia  en  la  Repub- 
lica Mexicana.     8°.     Mexico,  1894: 


1 


7G6  HISTORY    OF    YELLOW    FEVER. 

Mejia  (D):  Mexico:  Investigation  of  Suspected  Yellow  Fever  on 
Pacific  Coast.  Pub.  Health  Rep.,  U.  S.  Marine  Hosp.  Serv.,  Wash., 
1897,  vol.  12,  p.   290. 

Mendizabal  (G.) :  Considerations  upon  the  endemical  character  of 
yellow  fever  upon  the  coast  of  the  Gulf  of  Mexico.  Am.  Pub.  Health 
Assn.     Rep.  1891,  Concord,  1892,  vol.  xvii,  193-198. 

Mitchell  (B.  R.) :  Yellow  fever  in  Mexico.  Med.  Exam.,  Phila.,  1848, 
n.  s.,  iv,  285-291. 

Neue:  Beitrage  zur  Kenntmiss  des  gelben  Diebers  an  der  Ostkuste 
Mexico's.     Arch.  f.  Path.  Anat.  (etc.),  Berl.  1888,  vol.  112,  p.  449. 

The  Ravages  of  yellow  fever  in  Mexico  and  Panama.  Med.  News, 
Phila.,  1883,  xliii,  419. 

Ruez  (A.) :  La  fievre  jaune  au  Mexique  en  1862.  Gas  hebd.  de  med., 
Paris,  1862,  ix,  738;  801. 

Ruiz  y  Sandoval  (G.) :  Fiebre  Amarilla  Epidemica  a  lo  largo  del 
Rio  Bravo  y  del  Litoral  del  Pacifico  en  los  ano  1882-1883.  Voz  de 
Hipocrates,  Mexico,  1884,  vol.  2,  p.  278,  286. 

Santos  Fernandez  (J.) :  Yellow  Fever  is  the  Great  Obstacle  which 
is  encountered  by  the  Civilization  of  Spanish  America.  Translated  by 
W.  Thompson.     8°.     Mexico,  1896. 

Thomas  (L.):  Une  Epimedie  Mexicaine  au  Xviii  Siecle.,  le  Cocolisti 
ou  matlazahuatl  des  Indiens.  In  his  Lecture  sur  I'Hist.  de  la  Med..  8°. 
Par.,  1885,  p.  1. 

Yellow  fever  in  Sonora.  [Guaymas.]  Pacific  M.  &  S.  J.,  San  Fran., 
1884-5,  xxvii,  118-120. 


767 


UNITED   STATES. 

HISTORY  OF  YELLOW   FEVER  IN  THE   UNITED 
STATES,  BY  LOCALITIES,  FROM  16C8  TO  1909. 

General  Nummary. 

Yellow  fever  has  never  been  known  to  originate  de  novo 
in  the  United  States  of  America.  Previous  to  1668,  it 
was  unknown  in  this  country.  It  was  imported  from 
Havana  to  New  York  that  year  and  caused  much  mor- 
tality. Twenty-three  years  later  (1691)  Boston  was  in- 
fected by  the  West  Indies,  and  in  1693  Philadelphia  and 
Charleston  experienced  their  first  visitations  of  the  dis- 
ease, the  infection  in  both  instances  being-  carried  from 
the  West  Indies. 

In  December,  1193,  fourteen  months  after  the  discovery 
of  America,  while  on  his  second  vo^^age,  Columbus  landed 
on  the  island  of  San  Domingo  and  founded  the  town  of 
Ysabella.  This  was  the  first  settlement  by  Europeans  in 
the  Western  Hemisphere.  That  same  month,  the  little 
band  of  adventurers  was  attacked  by  a  pestilential  dis- 
ease whose  symptoms  were  now  to  medical  science,  and 
which  was  no  doubt  the  malady  now  knoAvn  as  yellow 
fever.  This  pestilence  lasted  three  years,  mowing  down 
the  Spaniards  as  fast  as  they  arrived  from  tlie  Old  World. 
Ysabella  Avas  finally  abandoned  in  1496,  on  account  of  its 
insalubriety  and  never  rebuilt. 

Oviedo,  Gomara  and  Ilerrera,  chroniclers  of  the  period, 
in  their  description  of  the  pestilential  sickness  which 
decimated  the  Spaniai-ds  fi'om  1493  to  1496,  specially  men- 
tion the  yellowness  of  the  skin  of  those  afflicted  at 
Ysabella. 

This  is  the  first  epidemic  of  yeUow  fever  recorded  in 
history. 


768  HISTORY    OF    YELLOW    FEYER. 

While  cruising  along  the  coast  of  San  Domingo  in  1494, 
Columbus  w^s  attacked  by  the  "American  Pestilence," 
and  narrowly  escaped  death.  His  son,  Ferdnand  Col- 
umbus, in  his  interesting  account  of  the  voj'ages  of  the 
great  explorer,  speaks  of  the  coma  which  accompanied  the 
fever. 

On  March  27,  1495,  was  fought  the  battle  of  Vega-Eeal, 
in  which  the  handful  of  Spanish  soldiers  under  Columbus 
put  to  Hight  '"a  multitude  of  Indians."  The  natives,  who 
looked  upon  the  white  men  as  gods,  fled  precipitatedly 
before  the  advancing  foreigners.  Shortly  after  the  en- 
counter, the  Spaniards  were  decimated  by  a  worst  enemy 
than  the  unoffending  islanders — yellow  fever,  which  from 
that  day  proved  the  greatest  and  almost  unsurmountable 
obstacle  to  the  colonization  of  the  New  World. 

The  pestilence  at  Yega-Real  was  so  murderous  and  the 
epidemics  which  followed  wherever  the  Spaniards  at- 
tempted to  establish  a  settlement  in  the  West  Indies  were 
so  frightfully  mortal,  that  the  King  of  Spain  decided  to 
send  all  the  malefactors  of  his  kingdom  to  Hispanola  (San 
Domingo),  promising  a  full  pardon  to  murderers  after 
sojourning  two  years  on  the  island.  Those  guilty  of 
minor  offenses  were  given  their  freedom  if  they  escaped 
the  terrors  of  the  "Yellow  Demon"  after  one  year.  It 
is  a  significant  fact  that  few  returned  to  their  native 
land. 

The  following  resume,  made  by  the  United  States 
Marine  Hospital  Service,  shows  that  in  almost  exevj  in- 
stance the  disease  under  discussion  was  carried  to  the 
seaboard  cities  of  the  United  States  by  vessels  from  the 
West  Indies : 


769 


TahlI'-,  showing   years   jn   v. men   yej.low  fever  has  inxadf.d  thk  searoard 

CITIES-  OF   THE   UNITED   STATES,  CITIES   VISITED,  AND  SOURCE  OF   INFECTION' (  1068- 
1893),  CHRONOLOGICALEY    ARRANGED. 

[Ill  this  table  caaos  of  yellow  fever  wljiclvhave  been  detected  and  detained  at  quarantine  Gta^ioiis  are 
not  consi.iered.    Epidemic  yeara  are  marked  witL  an  jE.] 


Locality. 


Origin. 


Remarks. 


Kew  York. 

Boston  . ... 
do 


l'liiladeli;bia. 


N'irffiuia. 


Ii]ilad(.li)liia. 


Hiloxi,  Hiss 

Cbarlestou,  S.  C 


Mobile 

Cbarleslon.S.  C. 


Louisiana 

Chark'stoii,  S.  C. 


Fliilad.lj.bi.-i 


T7eat  Indies. 


-do 


Pbiladelpliia 

Cliarlestoi],  S.  C 


.do 
-do 


.do 


C'barloston,  S.  C 

>? e\V  York West  Ind ics  . 


W^est  Indies  . 


Accordinij  to  Toner  tbo  llrst  appearance  of 
yellow  lever  in  the  United  States.  (Report 
U.  S.  Marine-Hospital  Service,  1873;  J.  H. 
Griscom,  M.  Rep.,  1850,  p.  561.) 

Infected  for  the  first  time  by  a  vessel  from  tho 
West.  Indies.  (B.  Dowler,  Tableau  of  Yel- 
low Fever,  1853,  p.  7.) 

AVheeler's  Heet  brought  the  disease  from  Bar- 
badosand  Martinique.  (Hutchinson,  History 
of  ITew  England,  Vol.  IL  p.  72;  and  Ledird, 
New  History  of  England,  III,  p.  110;  also  Ed. 
N.  Y.  J.  M.,  185G,  p.  278,  Toner.) 

'La  Rorlie   (Vol.  I,  p.  48) ;  accofdiDg  to   Toner 

I  tho  disease  first  visited  Philadelphia  in  1695 
and  Cliarleston  in  1699.    Both  authors  attrib- 

I     ute  the  origin  of  tlie  epidemic  to  boats  com- 

^    ing  from  the  Antilles. 

According  to  Toner  the  first  appearance  of 
yellow  fever  on  the  Delaware  (J.  N.SchooI- 
ticld,  Va.  Med.  Jour.,  1857,  p.  358),  brought  by 
boat  from  tho  West  Indies.  (B6reDger-r6- 
rand,  p.  36.> 

TiiP  lleet  of  Admiral  Nevil  brought  the  disease 
from  the  \\'est  Indies  to  \'irginia.  The  mor- 
tality wasfonsidiTablc.  The  admiral  himself 
died,  and  of  all  the  captains  only  one  sur- 
vived. (UtTenger-Fi'iaud,  Traitetlieoretique 
et  cliniquo  do  la  fievre  .jaune,  1890,  p.  37.) 

220  out  of  2,000  or  3,000  inliabitants  died  of 
yellow  fe\  er,  called  at  the  time  the  Barbados 
fever.  Ix'causo  it  was  luought  by  a  ship  from 
that  island.  (Bi^lly.  after  Lytler,  American 
Registers,  Vol.  I;"R.  La  lioche,  Ch.  M.J. 
and  Rev.,  1852,  p.  58,  Toner.) 

Simon's  Trans.  S.  C.  Med.  Assn.,  1851,  p.  37, 
Toner. 

A  severe  epideniic,  said  to  have  been  brought 
to  the  city  by  a  bale  of  cotton  from  St. 
Thomas.  The  fever  this  year  was  carried 
along  the  lints  of  trade  as  far  as  Biloxi. 
(Berenger-FOraud,  loc.cit.,p.  39.)  570deaths. 
(J.  H.  Griscom,  Visitation  of  Yellow  Fever, 
p.2.) 

Drake  Dis.  Int.  Valley  of  N.  A.,  191.    (Toner.) 

According  to  Kewclt  the  disease  was  brought 
by  way  of  the  sea.  (Bi-renger-Feraud,  lijc. 
cit.)  Simon's  Trans.  S.  C.  Mod.  Assn.,  1851, 
p.  37.     (Toner.) 

(P.  H.  Lewis.  N.  O.  Med.  Jour.,  1845,  Vol.  I, 
p.  283.) 

(Carpenter,  sketclics  from  the  history  of  yel- 
low fever,  1844,  p.  11.  Simon's  Trans.  S.  C. 
Med.  Assn.,  1851,  p.  37.     Toner.) 

Berenger-Feraud,  loe.cit.i).  43. 

Severe  epidemic,  8  to  12  deaths  daily  from  May 
ioOctolier.  (Toner.)  Brought  to  port  by  a 
vessel  from  tho  West  Indies  (Montrio  and 
Linning)  and  Simon's  Trans.  S.C.Med.  Assn.,; 
18.')l,p.  37.     (Toner.) 

Carpenter,  loe.  cit.,  p.  11.  Daily  Shroveport 
Times,  Vol.  II,  Ko.  311,  1873.  '(Toner.)  250 
deaths    .(Btrenger-Feraud,  loc.  cit.) 


Ta1!LE    S.IuWING    YKARS     IN'    WHICH     YKLLOW    FEVEK     HAS     INVADED    THK    SEAKOAKD 

ciTiKS  oi"  THK  United  States,  etc. — Contiuued. 


Year. 


1732 
1734 
1735 
1737 

173'J 
1741    E 


1741 
1741 
1741 
1742 
1742 
1742 

1743 
1743 

1743 
1744 


1745  E 

1745 
1747  E 

1747 

1747 
1748 

1748 
1749 


Locality 


175,-. 
1761 


1762  E 


1762 

1762 

1763 
1703 
1764 

17C5 


New  York 


Charlostou,  S.  C 
Xew  Haven.  Conn 
Norfolk 


Eciriark.s. 


J.  H.  Griscom,  Visitation  of  Yellow  Fever, 

p.  3.     (Touer.) 
T.  Harris.    (Philadelphia  M.  and  P.  J.,  No.  5, 

p.  21.) 
Pariset,  quoted  by  Berenger-Feraud,  loc.  cit., 

p.  45. 
Tho   disease  %vas    brought  to  Virginia*  from 

the  Antilles,  accordinj:  to  Mitchell  &.  liush. 

(All  account  of  the  Bilious  Vomiting  Yellow 

Fever.) 
According  to  Linning  and  Raiueay.    (Descrip- 
tion of  yellow  fever,  Vol.  tl,  p.  370.)     Tlie 

disease  came  from  the  AVe.st  Indies.     H. 

Hume,  Ch.  M.  J.  and  Rev.  1854,  p.  145.    (To- 
ner.)   Cai-penter,  loc.  cit.,  p.  11. 
Carpenter,  loc.  cit.,  p.  12.     The    disea-so  was 

brought  to  the  city  in  June,  presumably  in  a 

trunk  of  clothing  from   the   ^N  est   Indies. 

(Bcrenger-Ferand,  loc.  cit.)    250  deaths.    (J. 

H.  Gri.scom,  Visitation  of  Yellow  Fever,  p.  3.) 
B^renger-Feraud.     (Med.  Repos.,  Aug.  IHIO.) 
Ed.N.  Y.  J.  :ir.,lS.56,p.278.     (Toner.) 
15  dtatlis.     (Berenger-Fcraud,  loc.  cit.,  p.  47J 
Bert'ngtr-Fcraud,  loc.  cit.,  p.  46. 
Ed.N.  Y.  J.  M.,]856,p.  278.     (Toner.) 
B.  Dowler,    Tableau    of  Yellow    Fever,  p.  3. 

(Toner.) 
Do. 
217  deatlia,  J.  H.  Griscom,  VisitatioE  of  Ycllov.- 

Fever,  p.  3.     (Toner.) 
Berenger-F^raud,  loc.  cit.,  p.  48. 
Brought  to  the  city  by  an  infected  ship  from 

the    West   Indies.     (B6renger-r6raud,  loc. 

cit.,  p.  48.)    R.  La  Roche,  Ch.  M.  J.  and  Rev., 

1852,  p.  458.    (Toner.) 
According  to  Linning.  brought  to  port  by  an 

infected  ship  from  the  "West  Indies.    (B6r. 

enger-Feraud.  loc.  cit.)    W.  Hume,  Ch.  il.  J. 

and  Rov.,  1854,  p.  145.    (Toner.) 
J.  H.  Griscom,  Visitation  of  Yellow  Fcvor,  p. 

3.  (Toner.)  - 
Currie,  Rush,  and  Bally.    (Berenger-F6raud, 

loc.  cit.)    R.  La  Roche,  Ch.  M.  J.  and  Rev. 

1852,  p.  458.     (Toner.) 
Bally.      (B6renger-F6raud,    loc.   cit.)      Daily 

Shreveport   Times,  Vol.   II,   No.   311,   1873. 

(Toner.) 
J.  H.  Griscom,  Visitation  of  Yellow  Fever,  p. 

4.  (Touer.) 
The  disease  this  year  was,  according  to  Moul- 
trie and  Linning,  imported  by  a  contami- 
nated vessel  from  the  "West  Indies.  B6r- 
enger-Feraud,  loc.  cit.)  "W.  Hume,  Ch.  M.J. 
and  Rev.,  1854,  p.  145.    (Toner.) 

Dailv  Shreveport  Times,  Vol.  II,  No.  811, 1S73. 
(Toner.)  > 

Moreau  de  Jonn^s.  (Monographio  historique 
et  medicalo  do  la  fievre'jaune,  Paria,  1820, 
p.  56.) 

Sporadic.    (Linning  and  Ramsay.)    "W.  Hiimo, 
Ch.  M.  J.  and  Rev.,  1854.  p.  145.     (Toner.) 
Do. 

Harris.  Philadelphia  M.  and  Ph.  J.,1305,p  Jl. 
(Toner.) 

Severe  epidemic  Ptartod  by  a  sailor  from  Ha- 
vana, who  communicated  the  disease  to  hia 
family.  (Redman,  quoted  by  Bally.)  J-  H- 
Griscom,  Visitation  of  Yellow  Fever,  p-  5. 
(Toner.) 

Dawson  and  Do  Saussuro,  CensusTof  CharhH- 
t(in.    (Toner.) 

Dailv  Shreveport  Times,  Vol.' II,  No.  SU, 
1873.     (Toner.) 

Si)orndi'-.     (Rush.)     , 

250  deaths  (Toner),  Med.  Rep.  1853,  p,  107. 

P.  S.  Townscud.  N.  Y.  M.  and  Ph.  J.,  1823, 
I  I      p.  315.     (Toner.) 

Mobile ■ '  Drako,   Dis.   liit.   Valley   of   N.  A.,    p.  210, 

(Toner.) 


Charlcstor 


Now  York 
Philadelphia 


NorfolU 


Ncv/  York ! 

Charleston,  S.  C 'Wo.~t  Indies. 


New  York. 


Charleston,  S.C. 


.do 


.do 
-do. 


rhil.-vdelihia. 


^Vei.t  Iiidii. 


Chr.xlczU: 


(■ 


New  York. 


Pliila<lelp!ii.T 

Nantucket,  M.i.- 
PeiK-iacohi 


771 

Tahlk  sHOWtxr.  yi:ai;s  ix  wificu  yellow  fever   has  ixvaded  the   seaboard 
riTiKS  OF  THE  UxiTKD  STATES,  ETC. — Continued. 


Tear. 


Lotality. 


1765  E 


1766 

176^ 
1769    . 


1770 

.1783 

178'J 
17S9 
1789 
1789  E 

1790 
1791 
K91 
1791  E 


1792 

1792 
1793  E 
1793  E 


1793 


1793 


1791  E 
1794  E 


1794 
1794 


1794  E 


1794 
1794 


1795   E 
1795 


1795 
1705 


Pensacola 


Mobile 


Charleston,  S.  C  . 
NcwOrleau.s 


Charleston,  S.  C 
Baltimore 


Norfolk 

Baltimore  ... 
Philadelphia. 
New  York  . . . 


do 

New  Orleans. 
Philailel])hia. 
New  York  . . . 


Charleston,  S.C. 


New  York — 
New  Orleans. 
Philadelphia. 


Portsmouth,  N.H. 


New  York . 


New  Orleans 

Charleston,  S.  C  - 


Ori;;in. 


West  Indies  . 


West  Indies . 


.do 


.do 


Norfolk . . . 
Baltimore. 


Philadelphia. 


New  York 

Providence,  R.  I  . .. 


New  Haven,  Conn 


New  Orleans 

Charleston,  S.  C. 


Norfolk  . .. 
Baltimore 


Remarks. 


West  Indies. 
...do 


A  British  garrison  was  sent  from  England  to 
occupj'  the  city,  and  coming  liy  the  way 
of  the  West  Indies,  introduced  thc^  disease. 
(Monette-Williams,  Carpenter, loc.cil.,  p.  I'J.) 
125  death.s.  (Lind,  Vol.  I,  p.  45;  lJeren;:er- 
Feraud,  loc.  cit.,  and  Drake  Dis.  Int.  Valley 
of  N.  A.,  p.  190.) 

P.  H.  Lewis,  N.  O.  M.  J.,  Vol.  I,  No.  4,  1845, 
p.  283.     (Toner.) 

M.  M.  Dewier,  N.  O.  M.  J.,  1859,  p.  305.    (Toner.) 

The  first  appearance  of  yellow  fever  in  New 
Orleans.     (S.  Chaille,  Va.  M.  J.,  1858,  p.  498. 
Toner.) 

T.  Harris,  Phila.  M.  and  Ph.  J.,  1805,  p.  21. 
(Toner.) 

Webster,  quoted  by  15erenger-Fi'raud,  loc.  cit., 
p.  57. 

Bi'renger-Feraud,  loc.  cit.,  p.  58. 
Do. 
Do. 

W.  Hume,  Ch.  M.  J.  and  Rev.,  1860,  p.  24. 
(Toner.) 

Sporadic.     (Bally.) 

S.  Chaille,  Va.  M.  J.,  1858,  p.  498.     (Toner.) 

B<^renger-F6raud.  loc.  cit.,  p.  J8. 

Ed.N.Y.J.M.,1856,p.  278.  Report  on  Quaran- 
tine on  the  Southern  and  Gulf  Coasts  of  the 
U.S.     (H.E.Brown,  1873.) 

W.  Hume,  Ch.  M.  J.  and  Rev.,  1852,-V  115. 
(Toner.) 

Ed.  N.Y.J,  il..  1850,  p.  278. 

Trans.  A.  M.  A.,  Vol.  II,  1853,  p.  665.     (Toner.) 

Carpenter,  loc.  eit.,  p.  12.  4,044  deaths  in  3 
months  in  a  population  of  55,000.  (Rush.) 
The  epidemic  is  said  to  have  started  in  a 
sailors'  boarding  house,  where  the  crew  of  a 
French  corsair  (which  hart  been  contami- 
nated at  the  West  Indies)  were  stopping. 
B6renger-F6raud,  loc.  cit.,  p.  60.  Carey,  Ac- 
count of  the  Malignant  Fever,  p.  116. 
(Toner.) 

The  infection  was  brought  to  this  port  by  a 
vessel  from  Martinique.  One  of  the  crew 
died  en  route.  All  ycere  well  upon  arrival. 
The  first  case  occurred  at  the  house  where  the 
captain  was  stopping.  (BereugerFeraud, 
loc.  cit.,  p.  62.) 

Introduced  by  vessels  from  the  West  Indies, 
many  of  which  brought  refugees  who  fled 
from  Santo  Domingo.  A  vessel  entered  from 
Santo  Domingo  with  several  cases  of  yellow 
fever  on  board.  (Carev;  Carpenter,  loc.  cit., 
p.  13.)  Sporadic,  Ed.  N.  Y.  J.  M.,  1856,  j). 
278.     (Toner.) 

Stethoscope,  Vol.  Ill,  No.  11,  1853,  p.  665. 
(Toner.) 

W.  Hume,  Ch.  M.  J.  and  Rev.,  1852,  p.  145. 
(Toner.) 

J.  H.  Griscom,  N.Y.  J.  M.,1856,V.  369.     (Toner.) 

W.  Hume,  Ch.  M.  J.  and  Rev.,  1860,  p.  24. 
(Toner.) 

La  Roche,  B.  of  H.  Rep.,  Phila.,  1870.  p.  53. 
(Toner.) 

Ed.  N.  Y.  J.  M.,  1850,  p.  278.     (Toner.) 

By  boat  from  the  Antilles.  (Med.  Jour.  1812, 
■p.  28.) 

Brought  there  by  a  trunk  of  effects  of  nn  indi- 
vidual who  died  of  the  disease  at  Martiui(iue. 
Three  persons  who  assisted  in  o]ieniiig  the 
trjmk  died  of  yellow  fever  in  a  few  days. 
(Berenger-Feraiid,  loc.  cit.,  p.  63;  W.  Hume, 
Cli.  M.  J.  and  Rev.,  1860,  p.  24).    (Toner.) 

Stetho.scopo,  Vol.  Ill,  No.  11,  1853,  p.  665. 
(Toner.) 

W.  Hume,  Ch.  M.  J.  and  Rov.,  1852,  p.  146. 
(Toner.) 

J.  n.  Gri.scom,  N.Y.  J.  M..1850.  p.  309.    (Toner.) 

Toner  (U.  S.  M.  H.  S.  Rep.,  li>7'^)  ;iud  Biienger- 
Feraud,  loo.  cit. 


77i 

Table  showing  ykatis  tx  which  yellow  fever  has  invaded  the  seaboard 
CITIES  OF  THE  UNITED  STATES,  ETC. — Continued. 


Year. 


Locality. 


Origin. 


Eemarks. 


1795  E 


1795  E 
1795 

1795 

1796  E 
1790 
1796 
1796 

1790 
1796 
1796 
1796 
1796 


1797 
1797 


1797 
1797 


1797 
1797  E 


1797  E 


1798  E' 

1798 
1798 
1798  E 


1798  E 

1798 
1798  E 
1798  E 

1798  E. 

1798  E 
1798  E 


1798 

1798  E 
1798 

1799  E 


1799  E 


Xew  York . 


West  Indies. 


Philadelphia 

Providence,  R.  I 


Boston. 


New  Orleans 

Wilmington,  N.  C 

Norfolk 

Philadelphia 


Now  York 

Proviilrnce,  R.  I 

Newburyport.  Mass 

Portsmouth,  N.  H 

Charleston,  S.  C 


Boston. 


New  Orleans 

Charleston.  S.C. 


Norfolk 

Baltimore.. 


New  York 

Providence,  R.  I 


Philadelphia. 


Charleston,  S.C- 


West  Indies. 


.do 


West  Indies. 


-do 


Norfolk 

Baltimore 

Philadelphia. 


Chester,  Pa 

Newcastle,  Del.  .. 
Wilmington,  Del. 
New  York 


West  Indies 


Boston  . 


Salem.  Mass ... 

Portsmouth,  N.  11 


Newburyport,  Mass. 


West  Indies . 


West  Indies . 


Hartford.  Conn 

New  London,  Conn 
Stonington,  Conn  . . 
New  Orleans 


Charleston,  S.  C. 


The  disease  was  brought  here  by  the  brig 
Zephyr  from  Port  au  Prince.  There  were 
700  deaths  in  .3  months  in  a  population  of 
40,000.  (B<:-renger-F6raud,  loc.  cit..  p.  64; 
Bayleys  Account  of  Yellow  Fever,  1796.) 

B^rcngcr-FOraud,  p.  64. 

W.  Hume,  Ch.  M.  J.  and  Rev.,  1860,  p.  24. 
(Toner.) 

Dowler,  Tableau  of  Yellow  Fever,  1853,  p.  7. 
(Toner.) 

Stethoscope,  Vol.  lU,  No.  11, 1853,  p.  665. 

J.  H.  Grisrom,  N.  Y.  J.  M.,  p.  369 

V,i.  M.  J.,1857,  p.  95.    (Toner.) 

J.  H,  Griscom,  N. Y.J.  M.,  1856,  p.  368  and  369. 
(Toner.) 

Ed.  N.  Y.J  M..  1856,  p.  278. 

Berenger-FC'raud,  loc.  cit.,  p.  64. 

J .  H.  Griscom,  N.  Y.  J.  M.,  1856,  p.  369. 

Berenger-Ftraud,  loc.  cit.jp.  65. 

Brought  by  a  vessel  from  Havana.  (B^rengor- 
F6raud,  loc.  cit.,  p.  65.)  W.  Hume,  Ch.  M.  J. 
and  Rev.,  18.52,  p,  145. 

According  to  Warren,  brought  by  a  vesselfrom 
St.  Domingo.  (Berenger-F^raad,  loc. cit., p. 
65. )    J.  H.  Griscom,  N.  Y.  J.  M.,  1856,  p.  369. 

Stethoscope,  Vol.  HI,  No.  IL  1853,  p.  665. 
(Toner.) 

W.  Hume,  Ch.  M.  J.  and  Rev.,  1852,  p.  145. 
(Toner.) 

J.  H.  Griscom.N.  Y.  J.  M.,1866,p.  369.    (Toner.) 

J.  H.  Griscom,  Visitation  of  Yellow  Fever,  p.  8. 
(Toner.) 

Ed.  N.  Y.  J.  M.,  1856,  p.  278.     (Toner.) 

The  disease  was  brought  here  by  the  Betsy 
from  the  West  Indies.  (Berenger-Fferaud, 
loc.  cit.,  p.  65.)  45  deaths,  Dowler,  Tableau  of 
Yellow  Fever,  p.  10. 

The  college  of  physicians  of  Phi^elphis 
attributed  the  introduction  of  the  disease 
this  year  to  tlie  L'Arethuse  with  slaves  from 
Jamaica  and  Havana.  (B6rengev-F6raud, 
loc.  cit.,  p.  65.)  ] ,  300  deaths,  Rush,  Epidemic 
of  1797.     (Toner.)     Dowler,  i).  10,  loc.  cJt. 

T.  Y.  Simons.  Ch.  M.  J.  and  Rev.,  1851,  p.  779. 
(Toner.) 

Va.  M.J. ,1857,  p.  05.    (Toner.) 

W.  Hume.  Ch.  M.  J.  .^nd  Rev.,  1860,  p.  24. 

Tho  disease  was  l)rouglit  by  a  vessel  from  St. 
Domingo.  (Caillot,  ]i,  213",  and  Currie,  quoted 
by  BercDgerFeraud,  loc.  cit.,  p.  66.)  3,500 
deatlis,  Rush,  epidemic  of  1798.    (Toner.) 

50  deaths,  J.  H  Ciiscom.,  Visitation  of  Y.'Uow 
Fever,  )>.  9.     (Toner.) 

J.  Stephens,  Med.  Mus.,  1809,  p.  153.    (Toner.) 

2.50  deaths,  Med.  Mus.,  1,«09.  p.  153.     (Toner.) 

2,080  deaths,  Ed.  N.  Y.  J.  M.,  1856,  p.  278. 
(Toner.)     Carpenter,  loc.  cit.  j).  13. 

200  deaths,  J.  H.  Griscom,  N.  Y.  J.  M.,  1856,  p. 
369.     (Toner.) 

J.  Gotham,  jr.,  M.-d.  Rep.,  1856,  p.  563.    (Toner.) 

100  deaths,  brought  by  a  ship  from  Martinique. 
(Moreau  de  Jonnes,  p.  17.S.) 

]5rought  to  the  city  by  an  infected  vessel,  the 
Sally,  with  sick  abniird.  Five  days  after  her 
arrival  tho  disease  declared  itself.  (Bd-renger- 
Firaud,  loc.  cit.,  p.  67.) 

Brown,  Quarantine,  p.  8.    (Toner.) 

81  deaths,  Ed.  M.  Repos.,  1799,  p.  211.     (Toner.) 

J.  Comstock.  M.  Repos.,  1807.  p.  23.    (Toner.) 

A  sexere  epidemic  year.  Old.  acclimated  in- 
habitants died  of  the  disease.  (Beronger- 
Feraud,  loc.  cit,  p.  67.)  S.  Chaille,  Va.  M.  J., 
1858,  ]).  498.     (Toner.) 

Contaminated  by  a Siianish vessel;  239  deaths.. 
(BOrenger-Feraud,  loc.  cit.,  p.  07.)  239dcaths. 
W.  Hume,  Ch.  M.  J.  and  Rev.,  1854,  p.  145. 
(Toner.) 


'A  cevere  epidemic  year. 


773 
Table  showing  years  in  which  yellow  feveu  has  invaded  the  searoard 

CITIES   OF   THE   UNITED   STATES,  ETC. — Coutiuued. 


Locality. 


Origin. 


Remarks. 


Norfolk . . . 
Baltimore. 


Philadelphia. 


New  York. . . 
New  Orleans . 


West  ladies . 


Charleston,  S.  C . . . 

Wilmington,  N.C. 
Norfolk 


Baltimore. 


Philadelphia 

New  York 

New  Bedford,  Conn  . 

Hartford,  XlJonn 

Providence,  E.  I 


Boston. 


New  Orleans. 

Norfolk 

Baltimore  ... 


Philadelphia 

New  York 

Block  Island,  R.I... 
New  Bedford,  Mass. 

Savannah.  Ga 

Norwich,  Conn 

Philadelphia 


West  Indies . 


New  Orleans. 
Charleston... 


Norfolk 

Wilmington,  Del. 

Baltimore 

Boston 


New  York . 


New  Orleans 

Charleston,  S.  C . 


Norfolk 

Philadelphia. 
New  York... 


New  Haven,  Conn . 

New  Orleans 

Charleston , 


Norfolk , 

New  Uaven,  Conn 
Charleston , 


Norfolk . . . 
Baltimore 


Va.  M.J.,1857,p.95     (Toner.) 

W.  Hniue,  Cli.  M.  J.  and  Kev.,  I860,  p.  24. 
(Toner.) 

The  disease  is  said  to  have  been  brought  here 
this  year  by  the  sloop  La  Marie  taken  by  the 
LeGange.  (B<:-reuger-Fcraud,loc.  cit.,ii.07.) 
1,000  Ueatiis,  La  Roche,  Ch.  M.J.  and  Rev. 
1852,  p.  458.     (Toner.) 

76  deatlis.  Ed.  N.  Y.  J.  M..  1856,  p.  278.    (T(«icr.) 

Infected  by  a  vessel  from  Havana.  (R^renger- 
Feraud.loc.cit.,  p.  68.)  S.  Chaillo,  Va.  M.J., 
1858,  p.  498.     (Toner.) 

184death8,  W.Hume,  Ch.  M.J.  and  Rev.,  1854, 
p.  145.     (Toner.) 

M.  Repos.,  1800,  p.  197.  .  (Toner.) 

250  deaths,  Med.  Repos.,  Vol.  IV,  p.  320. 
(Toner.) 

W.  Hume,  Ch.  M.  J.  and  Rev.,  1860,  p.  24. 
(Toner.) 

Dowler,  loc.  cit.,  1854,  p.  10. 

21  deaths,  Ed.  N.  Y.J.  M.,  1856,  p.  278.    (Toner.) 

Brown,  Quarantine,  p.  9.     (Toner.* 

M.  Repos.,  1800,  p.  197.     (Toner.) 

W.  Hurae,  Ch.  M.  J.  and  Rev.,  1860,  p.  24. 
(Toner.) 

S.  Emlen,  N.  A.  M,  Odd  S.  J.,  1828,  p.  321. 
(Toner.)  . 

S.  Chaill6,  Va.  M.  J.,  1858,  p.  498.     (Toner.) 

Va.  M.J.,  1857,  p.95.    (Toner.) 

W.Hume,  Ch.   M.   J.   and    Rfiv.,  1860,   p.  24. 
(Toner.) 
Do. 

140  victims,  Dowler.  loc.  cit.,  1854,  p.  11. 

Aaron  C.Willev,  M.  Repos.,  I860,  p.  24.  (Toner.) 

B.  Dowler,  loc.  cit.,  1854,  p.  11. 

B.  Dowler,  loc.  cit.,  p.  11. 
Do. 

Probably  brought  to  the  city  this  year  by  the 
corsair  le  Sans-Culottes  de  Nantes,  which 
captured  the  Spanish  sliip  la  Flore,  with  yel- 
low fever,  from  the  Antilles,  and  brought  the' 
prize  to  the  city.  On  the  3d  of  August,  four 
days  after  the  arrival  of  the  corsafi',  the 
disease  appeared  in  aliostelry  frequented 
by  the  crew;  307  deaths  fo'lowed.  (Catliral 
and  Ourrie,  Bally,  p.  455;  B6rengerr6r.iud. 
p.  71;  Carpenter,  sketches  from  history  of 
yellow  fever;  aleo  W.  Hume,  Ch.  M.  J.  and 
Rev.,  1860,  p.  24.     (Toner.) 

B.  Dowler,  Tableau  of  Yellow  Fever,  1853,  p.  12. 
(Toner.) 

90  deaths,  W.  Hume,  Ch.  M.  J.  and  Rev.,  1854, 
p.  145.     (Toner.) 

Va.  M.  J. ,  1857,  p.  95.    (Toner.) 

86  deatlis.    Med.  Repos.,  1803,  p.  235.    (Toner.) 

M.  Repos.,  1803,  p.  100.     (Toner.) 

60  deaths,  J.  Gotham,  Med.  Rep.,  1856,  p.  563. 
(Toner.) 

2  deaths  at  Marine  Hospital,  W.  Hume,  Ch.  M. 
J.  and  Rev.,  1860,  p.  24.    (Toner.) 

B^reuger-F^raud,  loc.  cit.,  p.  73. 

Simon's  Trans.  S.  C.  Med.  Assn.,  1851,  p.  37. 
(Toner.) 

200  deaths.  (B6renger-F6raud,  loc.  cit.,  p.  73.) 
Va.  M.  J.,  1857,  p.  95.     (Toner.) 

195  deaths,  W.  Hume,  Ch.  M.  J.  and  Rev.,  1860. 
p.  24.     (Toner.) 

600  to  700  deaths,  Ed.  N.  Y.  J.  M.,  1856,  p.  278. 
(Toner.) 

Brown.  Quarantine,  1872,  p.  9.    (Toner.) 

S.  Chaill6,  Va.  M.  J.,1858,p.498.    (Toner.). 

148  deaths,  Simons  Trans.  S.  C.  Med,  Assn., 
1851,  p.  37.     (Toner.) 

Va.  M.  J.,  1857,  p.  95.    (Toner.) 

Brown,  Quarantine,  1872,  p.  9.    (Toner.) 

Simon's  Trans.  S.  C.  Meu. 
(Toner.) 

,Va.  M.  J.,  1857,  p.   95.    (Toner.) 

J.  H.  Griscom,  Viaitatiou  of  Yellow  Fever, 
p.  n.    (Toner.) 


Assn.,  1851,  p.  37. 


774 

TaBLB    showing    YEAKS    in    which    YKI.UtW    I'EVER    HAS    INVADED    THK    SEAUOAUD 

CITIES  ov  THK  United  States,  etc. — Coutinued. 


Year. 


Locality. 


Remadis. 


1805  E 


1805 
1805 

1805 

1805  E 

1806 
180G 

1807 
1807 

1807  E 
1807 
1807 

1808  £ 


1808 
1808 


1809 
1809 


1809  E 

1810 

1810 


1811 
1811 
1811 

1811 


1812 
1812 

1813 

1814 

1815 

1815 

1816 

1816 
1817  £ 


1817 
1817  E 


1817 


Philadelphia. 

Now  Haven,  Conn 
Providence,  R.  I  .. 


West  Indies . 


Boston 

New  York . 


Richmond.  Va. 
Newport,  R.  I . 


St.  Augustine,  Ela 
Savannah 


Charleston,  S.  C  . 

Philadelpliia 

New  York 

St.  Marys,  Ga  ... 


Savannah. 


New  York . 
Savannah  . 


New  Orleans. 
Philadelphia. 

New  York... 


Brooklyn 

Pensatola  ... 
Philadelphia. 

New  York  . . . 


Pensacola 

New  Orleans 

Philadelphia , 

Perth  Amhoy,  N.J  .. 


New  Orleans  . . . 
Charleston,  S.C. 


Pbiladel])hia 
Philadelphia 
Philadelphia 

New  York 

Philadelphia. 


West  Indies. 


West  Indies 


New  York  . . . 
New  Orleaos. 


Savannah 

Charleston,  S.  C. 


West  Indies . 


New  York 

5553 — VOL  I 28 


Brought  to  the  city  by  the  schooner  Nancy 
from  St.  Domingo.  The  disease  extended 
along  the  Delaware  to  Chester.  (Berenger- 
F(:rau<l,  loc.  cit.,  p.  80. >  300  to  400  deaths, 
Hume,  Ch.  M.  J .  and  Rev.,  1860,  p.  24.  (Toner.) 

B.  Dowler,  Tableau  of  Yellow  Fever,  p.  13. 
(Toner.) 

Presumably  brought  to  tho  city  by  three  ves- 
sels, Sainte-Croix,  Antigoa,  and  La  Havane, 
from  the  West  Indies,  Med.  .Journal,  1812. 
p.  28.     (BeraDger-FiTaud,  loc.  cit.,  p.  81.) 

J.  H.  Gri.scom,  Visitation  of  Yellow  Fever, 
p.  13.     (Toner.) 

340  deaths,  J.  H.  Griscom,  il.  Rep.,  1850,  p.  561. 
(Toner.) 

il.  Repos.,  1807,  p.  215. 

Toner  (0.  S.  M.  H.  S.  Rep.,  1873),  and  Bt;renger- 
Fc^-raud,  loc.  cit.,  y.  81.  • 

Brown,  Quarantine,  p.  32.     (Toner.) 

B.  Dowler,  Tableau  of  Yellow  Fever,  p.  U. 
(Toner.) 

162  deaths.  Simon's  Trans.  .S.  C.  Med.  Assn., 
p.  38.     (Toner.) 

3  deaths,  B.  Dowler,  Tableau  of  Yellow  Fever, 
1853.  p.  14.     (Toner.) 

3  deaths  at  Marine  Hospital,  J.  H.  Griscom, 
M.  Rep.,  1856,  p.  561.     (Toner.) 

The  Polly  arrived  at  St.  Marys,  Ga.,  from  Sa- 
vannah with  two  case.s  on  board.  The  sick 
disembarked  and  coiunmnicated  thedisea.ie 
to  the  village;  of  350  white  iohabitants  over 
300  died;  of  150  negroes,  only  3  died  of  the 
disease.     (Berenger  Feraud,  loc.  cit..  p.  82.) 

One  death  at  Marine  Hospital,  Ed.  N.  Y.J.  M., 
1856,  p.  284.     (Toner.) 

B.  Dowler,  Tableau  of  Yellow  Fever,  p.  14. 
(toner.) 

S.  Chaill6,  Ta.  M.  J.,  1858.  p.  498.     (Tonor  ) 

B.  Dowler,  Tableau  of  Yellow  Fever,  1853,  p.  II. 
(Toner.) 

By  ship  Concord  from  Havana,  Ed.  N.  Y.J.  M., 
"1856,  p.  284.     (Toner.) 

40  deaths,  Ed.  N.  Y.  J.  M.,  1856,  p.  278.    (Toucr.) 

Berenger-Feraud.  loc.  cit.,  \>.  83. 

3  deatlis,  B.  Dowler,  Tableau  of  Yellow  Fever, 
1853,  p.  14.     (Toner.) 

1  death  at  Marino  Hospital,  Ed.  N.  Y.  J.  il., 
1856,  p.  284.     (Toner.) 

Drake  Dis.  Int.  Talleyof  N.  A.,  p.  190.   (Touer.) 

S.  Chailb-,  Va.  M.  J.,  i858,  p.  498.     (Toner.) 

5  deaths,  B.  Dowler,  Tableau  of  Yellow  Fever, 

1853,  p.  14.     (Toner.) 
The  brig  Favorite  brought  the  disiasc  from 

Havana   to  Perth  Am  boy.    (I'.ciwen  on  the 

Yellow  Fever.)     (Reports  of  tho  \.  Y.  IJ.of 

H.,  Yol.  IV  p.  335.)    ( Berenger- FCraud,  loc. 

cU.,p.83.) 
S-  Chains,  Va.  M.  J.,  1858,  p.  498.     (Toner.) 
\V.  Hume,  Ch.  M.  J.   and   Rev.,  1854,  p.  145, 

(Toner.) 
0  deaths,  B.  Dowler,  Tableau  of  Yellow  Fever, 

1853.  p.  14.     (Toner.) 
7  deatlis,  B.  Dowler,  Tableau  of  Yellow  F<-ver, 

1853.  p.  14.     (Toner.) 

2  deatlis,  B.  Dowler,  Tableau  of  Yellow  Fever, 
IS.'iS,  p.  14.     (Toner.)  . 

7  death-s    at  Marine  Hospital,  Ed.  N.  Y.  J.  M., 

1856.11.284.     (Toner.) 
2  de.Uh.s,  B.  Dowler,  Tableau  of  Yellow  Fever, 

1853,  ]).  14.     (Toner.) 
Ed.  N.  Y.  J.  M.,  ISaf^p.  284.     (Toner.) 
Brought  by  the  E&glish  cutter  Phtenix  from 

Havana.     (Carpenter,  luc.   cit.,   p.   17.)    Snt 

deaths,    H.  Chaill^,   Va.  M.  J.,   1858,   p.  4'.t8- 

(Toner-) 
B6renger- Feraud.  loc.  cit-,  p.  88. 
272  deaths,  Dowler,   N.  O-  M.  J.,  1859,  p.  597. 

(Toner.) 

4  deaths  ;it  marine  hospital,  Eil.  N.  Y.  J.  M.,' 
1850,  p.  281.     (Toner.) 


775 

TUSLK     SIKIWINC    YEARS    IN    WHICH    YF.I.I.OW    I  KVFU     HAS     INVadki.    TIIK     SEAnOAKL> 
ClTllCS    (tK   TIIK    ('NITED    STATES,   KTC. — Coilt inill'<l. 


Year. 


1818  !■: 
1818 


1818 
1818  H 


isi'j  E 


Local)  fy. 


Origin. 


Rf  murks. 


Charl.-ston,  S.  C. 
New  York 


r.altimon^ Havana. 

Xrw  Orlean.s 


.do 


1810  K      Mobile. 


1819 
1819  K 


Savannah 

(Jliarlrnton,  S.  C 


I'hiladclpliia. 


linltiiuoro 

New  York 

New  Have  I),  Conn 
Boston   


West  Indies. 


New  Orleans. 


Savannah 

Baltimore 

I'liiladolphia. 


Havana  


Ni)W  York 

iliddlitowTi,  Conn  . . 
St.  Augtistiuc,  I'la  . . 


Savannah 

Mohile 

Wilmington,  N.  O 


Santiago  clc  (.'iiba. 
Ha\  ana 


TSaltimore. 
Norlolk  .. 
New  York  , 


Peusai'ida 


Xi'w  Orlean.'j 


Mohile. 


Havana 


Pen.sacola. 


Charleston,  S.  (J. ... 

Baltimore 

New  Y'ork i  Havana. 


NewOrh'ans 


Key  West 

Now  York 


AVcsl    Indie.s. 


Brooklyn,  N.Y 


Natchez,  MisH 


New  Orlean.'J 


115  deaths,     (B^rcnger-FiTaud.  loc.  rlt..  p.  88.) 

4  deaths  at  marine  liospital,  Ed.  N.  Y.  J.  M., 
18,')6,  p.281.     (Toner.) 

Carpenter,  ioc.  clt.,  p.  13. 

115   death.s,    Dewier,  N.  O.  M.  J..  1859,  p.  308. 

(Toner.) 
In tected  bv  a  vessel  from  Havana.     (Berenger 

r6raiid,loc.  cit.,  p.  89)     There   wer(^  2,190 

deaths.     (S.  Chaille,  Va.  M.  J.,  18.-)8,  p.  498, 

Toner.) 
274dcath,s,  P.  H.Lewis,  N.O.  M..T.,Vol.I,  No.  4, 

184.">,  p.  284.     (Toner.) 
A.  M.  Kec,  1820,  p.  212.     (Toner.) 
117  deaths,  Dowler,  N.  O.  M.  J.,  1859,  p.  597. 

(Tinner.) 
13  deaths,  S.  Emlen,  N.  A.  M.  and  S.  J.,  1828, 

11.321.     ('loner.) 
I).  M.  Reese,  Yellow  Fever,  1819,  p.  27.    (Toner.) 
37deatli.s,  Ed.N.  Y.  .J.  M..  1856,  p.  281 .    (Toner.) 
F.  I'a.scalis,  M.  Kepos.,  1»20,  p.  239.    (Toner.) 
S.    Emlen,   N.  A.  M.  and   S.  J.,  1828,   p.  321. 

(Toner.) 
Carpenter,  loc.  cit.  (S.  Chaill6,  Va.  M.  J..  1858, 

p.  498.) 
N'^.  O.  J^I.and  S.  J.,  1827,  p.  1.    (Toner.) 
H.  C.  Jameson,  A.J.  M.  ( '.,  IS.'SO,  p.  372.  (Toner.) 
83  deatliH,  S.  Jack.son,  A.  M.  Kec,  1821,  p.  689. 

(Toner.) 
2  deatlis  at  Marine  Hospital,  Ed.  N.  Y.J.M., 

IS-'^.O,  11.  281.     (Toner.) 
Carpenter,  lo(\<it.,  and  M.  Tully,  N.  Y.  M.  and 

I'll,  J..  1822,  p.  153. 
( 'arpentcr,  loc.  cit.    The  disease  was  brought  to 

tlie  T.'nited   S(ates  from    Havana,    and    was 

sevei'o  iu  several  localities.     (Berenger  For 

and,  loc.  <it.,  p.  90.)     140  deaths,  J.  (iotham 

M.  Hep.,  ]8.'ifi.  p.  .^64.     (Toner.) 
I'lerenger-Ferand,  loc.  cit.,  p.  89. 
HiaUe,  Dis.  Int.  Valley  of  N.  A.,  p.  191.  (Toner.) 
.1.  B.  Hill,  A.M.  l.'ec,  1822,  and  Brown,  Qnar.iu- 

tine,  i>.  18.     (Toner.) 
Il.tl.  Jamesoti,  A.J.  M.C.,  185(3,  p.372.  (Toner.) 
Va.  M.  J.,  1S.'.7,  ]<.'X,.     (Toner.) 
|i;  deaths  at  Marine,  Ho.spilal,  ICd.  N.  Y.  J.  M., 

18,".(;,  p.  281.     (Toner,) 
Bioiight  to  the  liiited  States  by  emigrants  from 

the    West,   Indies.      (Bcrenger-Feraud,   loc. 
■  (it.,  p.  loii.)    Carpenter,  loc.  cit.    259  deaths, 

I>rake,   Dis.  lut.  Valley  of  N.  A.,  !>.  229. 

(Toner.) 
•SiU  deaths.  Tran:^.    A.   M.   A  ,   1851,   p.    207. 

(Toner.)     Iteliigees   I'roin   I'l'iisai'ola  carried 

the  disease  on   the  Ann  and  Elisa  to  New- 
Orleans.    (Beiengcr-Feraud,  loc.  cit.,  p.  lUO, 

and  Caipeiiter.) 
Drake.    Dis.   Int.    Valley    of   N.  A.,   ii.    101. 

(Toner.) 
2  deaths,  N.  O.  M.  J.,  IS.'iS,  )>.  [.97.     (Toner.) 
II.  (r.  Jameeoq,  A.J.  M.  C,  ]xr,i\,  p.  372.  (Toner.) 
T'heship  Enterprise  from  Ha\ana  hronghtthe 

diseaso   into   ])ort.      (Berengt^r-Ft-raud.   loc. 

cit.,   p.    100.   and  Carpenter,  loc.   cit.)      230 

deaths,  Ed.  N.  y..T.  M.,  18,50,  p,  281. 
Tim  lirst  case  occurred  among  West  Indies' 

shi|>piug.     (Carpentei.)     1  death.  Trana.,  A. 

M.  A.,  IS.'SKp.  207.     (Toner.) 
lUrenger-Ft'iand,  loc.  cit.,  p.  100. 

5  deaths  at  Marino  Hospital,  Ed.  N.  T.  J.  M., 

1850, )..  281. 
Infected  by  the  Diana,  which  left  New  Orleans 

at  the  height  of  tho  epidemic.     The  vessel 

was  detained  in  i|uarantine  30  days  without 

disinfection.     (BerengerFeraud,  loc.  cit.,  p. 

100.)     Carpenter,  Sketches  of  Yellow  Fever. 

(Toner.) 
BerengerFeraud,  loc.  cit.,  p.  100,  and  Carpen* 

ter. 


'76 
T.\r.l.K 


-IIOWIXC    YFAUS     IN    WHK  II    YKLLOW    riCNKi:     HAS     INVADl.K    IlIK     SKAUOAKU 

CITIES  oi'  Tin:  L'Nincu  .Statks,  i:h;.— Continued. 


Year. 

1824  E 


1824 
1824 

1824  a 

1824 

1825  E 

1825 

4825 

1825 

1825 

1820 

1826 
182U 

1827  K 

1827 

1827 
1627 
1827 

1827 

1828  E 
1828  E 
1828 
1828 

182!l  ]■: 
182<J  E 
182!» 
1820 
1830  E 
18;iO  K 
18J0 

1831 

1831 
1832 

1832 

1833  £ 
1833 

1834  E 
1834  K 


Locilitv- 


Origin. 


lU'iiwirUs. 


New  ()rk;iiis.. 


Key  We.>^l  .... 
Mobile 


Uav; 


Cliarlesloii 

Isew  Vorli 

Kew  Orleans... 

Mobile 

I'eusacohi 

Cbaiieslon.S.  C 
N'ew  York 

New  ()|li:uis... 


W.-sl  Iinlic^ 


Norfolk 

New  York.'... 


New  Orltrann 


Pensiieola 

Saviiunali 

CbarFi-sloii,  S.  C 


118  (Ic.itlis.  Brnnslit  to  tlio  city  this  year  by 
olio  of  the  crew  of  a  barfre.  Tlie  roan  bad 
roinuuiniealion  willi  (lie  .S(  liooner  EuiigTaot 
from  Havana,  which  boat  bacl  yellow  ferer 
cases  on  boanl.  (Ik  ringer  I'craml,  !oc.  eit., 
]>.  1(12;  also  Carpenter  and  Trans.  A.  M.  A., 
IK'.l.i..  207.) 

n.  Tieknor,  N.  A.  M.  an.l  S.  J..  1827,  p.  213. 

Drake,  Dis.  Int.  Valley  of  N.  A.,  p.  191.  (To- 
iier.) 

235  (leatlia,  Dow  Ice  N.  0.  if.  .T.,  1859,  p.  597.  (To- 
ner.) 

S  (leatlia  at  Marine  llosiiltal,  Ed.  N'.  Y.  .1.  M.* 
JS.'.G,  p. •J81.     (Tonei.) 

•10  deaths,  Irans.  A.  M.  A..  1851,  and  Drake, 
p.  107.     (Toner.) 

Drake,  Di.s.  Int.  Valley  of  N.  A.,  p.  219.  (To- 
ner.) 

^Vest  Indian  vessel.  (Am.  Pnb.  Heallli  As.tn., 
Adl.lV.)  Brown,  Quarantine,  p.  3(i.    (Ton<-r.) 

2  d.allis,  Dowl.r,  N.  O.  M.  J.,  1850,  p.  597. 
(Toner.) 

1  death  at  .Marine  Ilospiial,  Ed.  N.Y.  J.  M.,  185C, 
p.  281.     ('loner.) 

5  (Icalbs,  Trans.  A.  M.  A.,  1851,  p.  207,  and 

Drake,  )).ly7.     (Toner.) 
Coniiuiltee's  report,  p.  14.     (Toner.) 

2  deaths  at  Marine  Hospital,  Ed.  N.  Y,  J.  M., 
1856,  p.  2f!l.     (Toiiir.) 

I(t9  deaths.  Trans.  A.  M.  A.,  1851,  p.  207,  and 
I  I       Drake,  ]i.  197.     (T'ouer.) 

Mobile I  Drake.   Dis.   Int.    Valley    of    N.    A.,   p.   219. 

I  I       (Toiler.) 

Med.  .St.ttisti08,  X'.  S.  Army,  p.  58. 

N.<>.  M.and  S..J.,  Vol.  X.p.  145.     (Toner.) 

01   deaths.  Dowler,  N.  O.  M.    J.,  1859.  p.  597. 

(Toner.) 
4  deaths  at   Marino  Ilospital,  Ed.  N.  Y.  J.  M.. 

1850,11.281.     (Toner.) 
13U  death.s.  Trans.  A.  M.  A.,  1851,  p.  207  and 

Drake,  p.  197.     (Toner.) 
20   deaths,  Dowler,  N.  O,  M.  J.,  1859,  p.  .597. 

(Toner.) 
Drake,   Dis.   Int.   V.illey    of    N.   A.,   p.    191. 
-<Toner.) 


New  York 

New  Orleans 

CliarlesloM 

Mobile 

New  York 


New  Oili:ans 

Mobile 

Key  West 

New  York 

Now  Orleans 

Cliai'lestou  

New  York 


New  ()rle:i 


Sav.-mnab . . 
New  York. 


Now  Orleans. 

do 

New  York. .. 

do 

Charleston  .. 


SoTeralea.ses(l!rreni!erFi:rand,  lor.  eit.  p.  105), 

no    deaths,  Ed.   N.    V.  J.   M.,  1850,  p.  281., 

(Toner.) 
215  ileatjis,  Trans.  A.  M.  A.  1851,  p.  207  and 

Drake,  p.  197.     (I'oi«r.) 
130  de.iths,  Drake,  Dj.s.  lut,  Yalley  of   N.  A.. 

p.  191.      (Toner.) 
C.  C.  Dupre,  Am.  J.  of  Med.  Sel.,  1841,  p.  380. 

(Toner.) 
No  deaths,  Ed.  N.  Y.  J.M..  1850,  p.  281.  (Toner.) 

Few  cases.  (Berenger-Ferainl.  loc.  cit.,]>.106.) 
117  deaths,  Trajis.  A.  M.  A.,  1851,  p.  207,  and 

Drake,  p.  197.     (Toner.) 
39  deaths,  Dowler,  N.  O.  M.  J.,  1859,  p.  597. 

(Toner.) 
Severak'ase9(IJerenger-r<Taud,  Ioc.cit.,p.l07), 

1   death,   Ed.    N.    Y.   J.    M„     1856,    p.   281. 
•  (Toner.)    • 
'2  deaths.  Trans.  A.  M.  A..  1851,  p.  207,  and 

Dr.ake,  p.  107.     (Toner.) 
Beronger-Feraiid,  lor.  eit..  p.  108. 

1  death. at  Marine]Ios).ital,  Ed.  N.Y.J.  M.,  1856, 

p.  281.     (Toner.) 
18  .le.iths,  Trans.  A.  M.  A.,  1851,  p.  207,  and 

Drake,  p.  197.     (Toner.) 
210  deaths.  Trans    A.  M.  A.,  1851,  p.  207,  and 

Drake,  p.  197.     (Toner.) 

2  deaths  at  Marine  Hospital,  Ed.  N.  Y.  J.  M., 
1856,  p.  281.     (Toner.) 

95  deaths,  Trans.   A.  M.  A..  1851,  p.  207.  and 

Drake,  p.  197.     (Toner)  * 

49  deaths,  Dowler,  N.  O.  M:  J.,  1859.  p.  597. 

(Toner.) 


777 

'J'aIII.l;    .SJIOWINC.    YEAUS    l\    WIIKH    YELLOW     1  KVEU     HAS     1N\'A1>EI>     illK     SEAliOAIU) 

cniEs  OK  HIE  Uniteu  States,  etc. — Coufiuued. 


Looiility. 


C)ri}riu. 


KS35   K 
18:'.:. 
183.-. 
■is;;f> 
18.;7  y. 


1S37  !•; 
18:!8  !•; 
l.S:)>< 

I8;i« 
1638 

is:!'.>  y. 


J8:!'.i  i: 
18;i;i 

18:i'j  !•; 

18:j0 

)8rt!i 

l8u'J 

is:j'j  ]•; 

18J0 
isiu 

1841    K 

ISII 

18U 

1811  j; 


1841 

184-j  ]•; 

184J 

184-.'  y 

184:{  ]■; 
184:1  i; 

1843 

1843 
Ihl.i 

1S44  1-; 
1844  y 

1814 
16J4 

1811 

mi:,  j: 


I'l'iisai  ola 

Xi;U  Ol  liullH. 


(Jliailii.sli)ii  

New  York 

Ni;w  Orleans 

....du 


Mobile 

Cliarl'ntoii... 
Xow  Oiloaiis. 


Havana... 


Xcw  Orleans. 


Mol.ilo 

St   AiigUHlino 

Now  York 

New  Orleans 


Oalvoaliiii... 
Ililoxi,  Mia.s. 
I'l'Msacola  . . 


Jkl*>l>ilc 

S(.  Anuu.slin.: 


'raiiipa 

.Now  Vork  . 

(Jliai  KmIoii 


Nmv  Orlians. 
Cliarlo^iloii  .. 


JCowOi  li  ans 


llavyna. 


New  Orleans. 


New  Orleans. 


Hav; 


Havana.. 


:\I(.l.il.- 

SI .  Aufiiislini 

Key  We.st,  ... 

Charleslon  .. 
Mew  Orleans. 


I'en.sacola 

Moliilo 

New  Orleans 


lieniarks. 


West  Indies 


Mobile... 
IVusaeola 


Cliarlest..!! 
Xeu  Vuik  . 


Havana,  A'era  t'ruz. 


Oalvoston  . .. 
New  Orleans 


M..l.il.'.... 
reiisacola. 


New  York 

New  Orleans. 


Ideatli  at l^Iarine  Hospital,  Ed.N.Y'.  J.  M.,  180G, 

p.  L'81.     (Toner.) 
Ihake.Dis.  Inl.Vallov '.(' X.  A.,  p.  232.  (Toner.) 
284  deatbs.  Trans.  A'.  M.  A.,  1>.  207,  1851,  and 

Drake,  p.  I'JT.     (Toner.) 
25    deatbs,    Dowler,  N.  0.  M.  J,  l.s:/J,  p.  M7. 

(Toner.) 
2  deatbs  at  Marino  Hospital,  Ed.  N.  Y.  J.  M.. 

185G,  p.  2H1.     (Toner.) 
5  deatbs.  Trans.  A.    M.  A.,  1851,  p.  207,  and 

Drake,  p.  197.  (Toner.) 
Broiigbt  to  tlie  eity  by  boats  from  Havana  to 
i  New  Orleans.  Tlioro  were  442  deatlis  iVoiu 
I  the  disease,  Trans.  A.  M.  A..  1>^51,  p.  2o7,  and 
I  Drake,  p.  197.  (Toner.)  (Jarpinter  (loc.eit.). 
i  Tbo  disease  was   brou^bl  by  AVest  Indiau 

vessels. 

130  deatbs,  Drake,  Dis.  Int.  Yalley  of  N.  A.,  p. 
220.     (Toner.) 

351  deatb.s,  Dowler,  N.  O.  M.  J.,  185'.»,  \>.  0'J7. 

(Toner.) 
17  deatbs.  Trans.  A.  M.  A.,   1851,  p.  207,  and 

Drake,  p.  197.     (Toner.) 
Drake,  Dis.  Int. Yalley  of  N.  A.,  p.  191.  (Toner.) 
(J.  0.  Dupre,  Am.  J.'  Med.  Sei.,    1841,   p.  384. 

(Toner.) 
8  deatbs  at  Marino  Hospital,  Ed.  X.  Y.J.  M., 

185(),  ]>.  284.     (T(.ner.) 
452  deatbs.   lJroiij;bt  from  Havana,    (liereiiger- 

Feraiid,  Inc.  eit;,  p.  Ill;  also  Carpenter  and 

Trans.  A.  M.  A.,  1851.) 
250  deatbs,  Galv.M.. J.,  1807,  p.  8.-.O.     (Toner.) 
Drake,  Dis.  Int.  Yalley  of  N.  A.,  I'Jl.     (Toner.) 
Drakti,  Dis.  Int.YalUyot  N.  A.,  ii.  2:13.  (Toner.) 
0.50    ileatlis,  Drake    and    lirown,  (^luaranline, 

1872.     (Toner. 1     Carpenter,  bie.  cit. 
C.  C.   DiiprO,   Am.  J.  Med.  Sci.,  l.-Sll,    p.  384. 

(Toner.) 
Drake,  Dis.  Int. Yallevof  N.  A.,p.  I'.ll.  (Toner.) 

4  <leatbs  at  I*larine  llo.spital,  Kd.  N.  Y.J.  M., 
1.><.'.1),  ji.  2.^^!.     (Toner.) 

131  deatbs,    Dowler,    N.  O.  M,  J.,  18.50,  p.  .51)7. 
(Toner.)     ^\'est  Indian  vessels.    (Car|)(Miler.) 

:!d.atlis,  T'rans.  A.  M.  A.,  1851.  p.  207.    (Toner.) 
22  deatb.s,  Dowkr,  N.  O.   M.  J.,  1859,   p.  597. 

(Toner.) 
594    deatlis,    Tran.i.   A.    M.  A.,    1851,   p.  207. 

(Toner.)     Carjieiitir. 
Drake,    Dis.  Int.    Valley'  of   N.    A.,    p.   233. 

(Toner.) 
J.  H.  Lewis,  N.O.  M.J. ,  1844,  p.  3L 
•JO  deatbs,  C.  C.  Diipre,  Am.  J.  Med.  Sei.,  1841, 

p.  :t84.     (Toner.) 
20  deatbs,   C.  C.  Dnpiv,  Am.  J.  of  Me<l.  Sei.. 
■^    1841,  p.  380.     (Toner.) 

Simons  rr;iii8.  S.  ('.  Med.  Assn.,  p.  50.    (Toner.) 
211    deatbs.    Trans.    A.   .M.   A.,    1851,    p.  -.'07. 

(Toner.)     Carpenter. 
S.  C.  Lauia-son,  Mainland  M.and  S.J.,  184:.,  p. 

30:!.     (Tomr.) 

00  deatbs.  Drake,  p.  222,  IJrown.  Quarantine, 
1872.     (T(.ner.) 

487    deatbs.    Tians.  A.  M.  A.,    1851,    p.    207. 

(Toner.)     CaiiienliT. 
240  deaths,  Drake,  loe.  eit.     (Toner.) 
Dr.  Wedderbiirn,  Kej..  of   San.  Com.,  \t.  125. 

(Tonii.) 

1  de,ilb,  Dowler.  X.O.AI.  J.,  )..  597.     {Toner.) 

5  deaths  al    MariIH^  Hospital,  Ed.  N.  Y.J.  il., 
18.5i;,  II.  2S|.      (Toner.) 

•lOiMbatbs,  (ialv.  51.  J.,  1S07,  p.8.'t8.     (Tonor.) 
^iH  de.iths,  Tian.s.  A.  M.  A.,  1851,  p.  207,  and 

l>ial.e.     (Toner.) 
Drake.  Dis.  Int.  Vaileyof  N.  A.,  p.  191.  (Toner.> 
Dr.   Weilderbiirn,  IJeji.  of  San.  Com.,  i>.  I'Jj. 

(Toner.) 

2  deaihs  at  M.irinc  Hosi.ital,  Kd.  X.  Y.J.  M.. 
IsMi,  p.2.si.     (Toner.) 

148    de.iths,   ChailK,   Ya.    M.   J.,    185G,  p.  499. 
(Toner.) 


778 

'Jaiu.k  siiowixc.  Yr,Ai;s  i.\  wiiicu  yf.i.i.ow    i  k\f.i;    mas    iwadf.I)   the   sfahoakd 
CITIES  ol-  THE  ILnjted  STATES,  ):Ti  . — Continued. 


Tiar.  ;  Locality. 


1840 

]84fi 
1847 
1847 


1847 

1847 

1847 

1848 

1848 

1848 

1848 
1848 

1848 
1849 

1849 

1849 

1850 

1831 

1851 
185'J 

1852 

IR.'iC 
1852 
185-J 
185'J 

1853 

W3 


185.1 
18.53 


1853 
1853 


liilnxi,  Miss 

Mol)ilc 

rciisarol.T 

Ki'w  Orli.ins 

Mobil.- 

rc-usaiiila 


Mohiln 

Nuw  OiK^aii 


^  Sav.aini.ali . . . 


Cliarlf'stoji 

Norfolk 

rortsiiioiith.  Va 
New  Vork 


Galvpstr)!! 

Xcw  Orleans 


IJiloxi,  Mi.ss 
Norfolk.... 


1853  K      Koy  West 


18.53 
1853 

1853 

1853 

1854 

1854 


Tampa... 
.Savannah 


iU'inark.s. 


Pensacola 'vcral     cases,     Drown,     Quarantiin*.    p.    36. 

(Ton.T.) 

Xcw  ()rl^^an.■^ !  140   d.  at  lis,   Chailli-,  Ta.  :Nr.  J.,   1856,  p.  400. 

(ToniT.) 

ronsacoL'i  i  lirown,  (,)n;iranlino,  p.  36.     (Tonor.) 

Galveston  -JOO  deaths,  (ialv.  M..j..  1%7,  p.  838.     (Toner.) 

Mew  Orlcan.s Vera  Cruz ,  15rnut;lit    from    \'era  Cruz    this   year   to   New 

Orleans  acconlinfi  to  l"'a;;et,  <m<ltpd  l)y  hOr- 
en^er-Feraud,  loc.  cit.,  p.   U.S.     There  were. 
2,2.59  deaths,  CbaiJle,  Va.  M.  J.,  1850.  p.  449. 
(Toner.) 
E.  D.  Fonnor,  N.  O.  M.  and  S.  J.,  1848.  p.  1192. 

(Toner.) 
76  deaths,  Brown,  Quarantine,  and    Fenner'.s 
Soiitli.  ]SIed.  Reports,  Vol.  II,  p.  3U4.    (Toner.) 
Dr.  Wedderburn,  lie)),  of  San.    Com.,  p.  125. 

(Toner.) 
850   deatlis,   Cbaille,  Va.  M.  J.,   18.56,  p.  499. 

(Toner.) 
75  deatlis,  Fenner,  South.  Med.  Rep.,  Vol.  II,  p. 

304.     (Toner.) 
Dr.  Wedderburn,  Rep.  of  San.  Com.,  ]>.  125. 
(Toner.) 

Charleston liereiigiT-Feraud,  lor.  cit.,p,  118. 

New  York I2dea(h.s  at  Marine  Hospital,  Ed.  N.Y.  .T.  M., 

1K,56,  ]).  284,  an<l  Traus.  A.  M.  A.,  Vol.  VII,  p. 
162.     (Toner.) 

Staten  Island,  N.  A' r.erenperFeraiid,  loe.  rit.,  p.  118. 

New  Orleans 7;i7   deaths,  Chaille,  Va.   M.   J..  1856,   p.   499. 

(Toner.) 

Mobile 50  deatlis,  Fenner,  South. Med.  Rop.,  Vol.  II,  p. 

304.     (i'oiier.) 

Charleston 125  deaths,  Dowler,  N.  O.  M.  J.,  1859,  p.  ,507. 

(Toner.) 

New  Orleans 102    deaths,  Chaille,  Va.   M.   J.,  1850,   p.  499. 

(Ton.r)- 

,d. 10    d.aths,   Chaille,  V.a.   M.   J.,    1856.    p.   499. 

(Toner.) 
r.rowii,  (Jtiarantino,  1872,  p.  43.   . 
415    deaths,  Chaille,  Va.   M.  J.,  18.56,   p.   499. 

(Toner.) 
10  deatlis,  R.  C.  Ma<-kall,  Ch.  M.  .7.  and  Rev.. 

185,5,  ji.  150.     (Toner.) 
,"I0  d.aths,  Dowler,  N.O.  M.  J.,  p.  5!)7.    (Toner.) 
Va.  M.  J..  1857,1).  95.     (Toner.) 
rorlsmouth  Relief  A.ssn.  Keiiort.  p.fll.  (Toner.) 
1   denth  at  Marine  ll()si)ital,  Ed.  N.  Y.  J.  M.. 

18,5«,  p-.284.     (ToiieV.) 
,5:i«  d.aths,  Ed.  M.  and  S.  Rop.,  Vol.  -XTII,  1867, 

No.  14,  p.  207.  (Toner.) 
7,oTo  deaths,  Chailh-,  Va.  M.  .T.,  1856,  p.  499.. 
(Toner)  Many  cities  in  Texas  and  Loui.>*- 
iana  were  visiied  by  the  disease  this  year. 
Aecordiiif'  to  Faget,  the  disease  was  broiitjlit 
this  year  by  the  English  vessel  ("abodeu  t-'as- 
tlefrom.Iauiaiea,  (Berejigor-I'V' rand, loc. eil., 
p.  123.)  » 

J.  C.  Mott,  N.  O.  M.  and  S.  J.,  1854,  p.  571. 

(Toner.) 
Inlected  by  a  vesSel  from  the  Antilles.    Tlioro 
were  1.600  deaths. 

Mobile 115d^ath8,  N.O.  M.  and  S..T.,  18.54,  p.  .571. 

'ensacol.-i E.  D.  Fenner,  H istorv  of  Yellow  Fever,  N.O., 

JH.')3,  p.49.     (Toner.) 
112   <leatbs.  Army    Med.     Statistics,'   p.  323. 

(Toner.) 
Army  Med.  Statistics,  p.  323.     (Toner.) 
K.  C."  Mackall,  Ch.  M.  .J.and  Rev.,  18.55,  p.  150. 
(Toner.) 

Philadelphia 1 12H  deaths,  W.  Jewell,  N.  Y.  J.  M.,  1856,  pp.  149, 

240,  and  Brown,  (Quarantine,  p.  10.     (Toner.) 

New  York ' 14  deatlis  at  JIarino  Hospital,  K<\.  N.  Y.J.  M., 

j      18.".6.  p.  284.      (Toner.) 

NewOrleans I  The  disease   was  carried   up  the  Mississippi 

Valli'V  as  far  as  St.  Louis,  Mo.     (lIirenfriT- 
Feraiid,  loe.  rit.)     2,423  deaths,  Cliaille,  Va. 
M.  J..  1850,  p.  490.     (Toner.) 
.    Ed.  N.  O.  M.  and  S.  J.,  1854,  p.  423.     (Toner.) 

'  A  widespread  epidemic  year. 


West  Indie; 


West  Indies. 


;  Key  W.st 


Taiu.1"  ?IIO^vI^•G  ykaks  i\  which  yj-.t.t.ow  i-kvi-r   has  twadi;!) 
ci  iij-.s  OF  Tin;  CxriicK  SrATics.  ktc— Contiiniotl. 


779 

Tin:   si:Ai5()Ar>i> 


Y.-iir. 


J854  E 

]Kr,4 

]K.-,4   E 

af-'>4 

3854   E 
1JJ54 

18.Vt 


Lociilitv. 


Origin. 


lii'iiKirlis. 


>Iol)ilo  ... 
Savanunli 


Ponaacoln. 
('liiH'lesldii 
Norfolk... 
lialvestoii 


I'liil.iilolpliin... 
]S'cu  YoiU 


I'oilsinoiith.  V; 


XorfolU 

'■  ]'orlsiiiir>n(li,  Va 

!  Xew  York 

Kcw  OrhMii.s 


OliarlMlon. 
HiooUlvii  . 
New  Oilciin 


St.  1')ionia.s 
(io  .... 


I  -. 


Clinil.sioii. 
(iahcsidii  . 


I'cDsacola. .. 
New  Orlcaus 


St.  Tboiiias 


]?ili>xi,'Mi.<i.s 
Sav:miiali.  . . 
Jio.stoii 


Cy'liarli\sti)ii 
Moliile.... 
Galveston 


Key  AVcst Havana . . . 


Clra  ilcston ; 

KfW  Orleans I 

Wiliuingtoi,  N.  C 1  Havana  . 


Pcnsacola 

Minv  Orleans. 
(!iilv(!!<ton  ... 


K-v  WcHt 

Cliarh-.-ton 

.NewbiTn,  N.  C . 


Now  Orlpan.s. 
Key  West  . . . 


Havana 


Oalvestou  . .. 
Ntw  Orl<au3. 


Pensaroln  , 

Mol.ilo 

Key  Wfst 

Galveston  , 

Ualtiijiorc 

Ivc.v  \Ve:,t 


Cuba 


Efl.jSr,asli..T.M.nTi('l  S..  1854,  p.  34.',.    (Toner.) 
580  deaths,  Hume,  Cliarleston,  ]\r.  J.,  Vol,  X, 

p.  :il.     (Toner.) 
K.  B.  S.  Hargi.s,  N.  0.  l\r.  N.,  ]850,  p.  727. (Toner.) 
027  (loatlis,  Dowler,  K.  O.  M.  J.,  p.  597.   (Toner.) 
Va.  Isl.J.,  1857,  p.  05.     (Toner.) 
404  dcatlis,  Ell.  M.  and  S.  licp..  Vol.  17, 18G7,  Xo. 

14,  p.  207.     (Toner.) 
Ed.  Nasi).  J.  M.  and  S..  1854.  p.  ^4.'..     (Toner.) 
20  deaths  nt  Marino  Ho.sj.ilal,  Ed.  N.  Y.  J.  .M., 

1850,  ]>.  284.     (Toner.) 
Portsmouth  Kcliet'Assn..  Pep.,  -[i.  Ol.     (Toner.) 
The  ISlissibsippi  Valley  was  afiJiin  inleeled  this 

year  as  far  nortlj  as  ilenii»lii,s.    (I!i'ren;:er- 
"Ftrand,   loe.cit.)     2.070  deatli.s,  riiaille,  Va. 

]\[..T.,  1H)0,  i>.  4!t!).      (Toner.) 
1,807  deaths,  Portsmonth  llelief  Assn.,  Kep<irt. 

(Toner.)     Ainer.  P.  H.  A  .,  \'o\.  I  V,  p.  280. 
1,000  deaths,  Portsniontli  Kclief  Assn.,  Keiiorf, 

p.  77.     Aiuer.  1'.  H.  A .,  V«\.  IV,  )..  280. 

deaths  at  Marino  Ho.spilal,  Ed.  X.  Y.  J.  M., 

1850,  11.284.     (Toner.) 
74    deatlis,    Cliaille,  Ya.  :M.   .1.,   1850,    p.  490. 

(Toner.) 
211  dealhs.Dowler.X.  O.  M..T.,i>.  597.    (Toner.). 
:f(l  Xat.C^tiarant.  and  San.  ('(un  ention,  j).  41. 
199    deatlis,    Chaille,  Va.  M.  ,1.,  1850,  ]).  499. 

(Toner.) 
i:t  deaths,  Do\v]or.N.O.:M.  J.,  !>  597.     (Toner.) 
:!44  deaths,   Ed.   M.   and  S.   Keji.,  Vol.   XVll, 

1867,  Xo.l4,]).  297.     (Toner.) 
R.   B.   S.   Bargis,  N.   O.   M.  N.,  18.59,  ]>.  727. 

(Toner.) 
The.    Elisal)Cth    Helen,    contaminated    at   St. 

Tli(niias,d>roui;lit  the  fe^er  Io  New  Orleans; 

3.889   death.s  'iojloweil.      (P.erengiir-Feraud,' 

loe.cit.,]).  i;i4;  al.so  Ed.  :Xled.  Eep.,  1858,  V(d. 

r.  No.  4,  p.  72.) 
S.  ( 'liaille,  Va.  M.  J.,  18.5.S,  p.  77.     (Toner.) 
S.  Chain.'',  Va.  M.  J.,  1858.  ]i.  491 .     (ronei .) 
E.   E.   Oliver,  B.  M.  and  .S.  J.,  1858,  p.  140. 

(Toner.) 
717  deaths.  Howler,  X.  O.  M.  J.,  p.  597.     (Toner.) 
Ed.  Va.  TSI.  J.,  1858,  ]..  517.     (Toner.) 
180  deaths,  Ed.  M.  and  S  Jtep.,  Vol.  XVII,  1867. 

Xo.  14,  ]).  297.     (Toner.) 
71  deatlis,  Ed.  il.  and  S.  Pep.,   1802,  p.  513. 

(Toner)     A.  IMT.  A.,  Vol.  IV. 
Brown.  Quarantine,  p.  29.     (Toner.) 
Eenner,  S.  J.  of  M.  S..  M.ay,  IsOO.    (Toner.) 
440  deaths,  W.  T.  Wra-i:;  N.  Y.  .1.  M.,  1.S09,  p. 

478;  A.  P.  H.  A.,  Vol.  IV,  an<l  ]..  225.    (Toner.) 
B.  F.  Gil.bs,  Am.  J.  M.  .Sei.,  1800,  ji.iUO.  (Toner.) 
Chaille,  J).  8.     (Toner.) 
259  deatlis,  Ed.  M.  and  S.  Pep.,  Vol.  XV II,  1867. 

Xo.  14,  p.  297.     (Toner.) 
E.  B.  Hunt.  Med.  Kej>..  1864,  p.  340.  (Toner.) 
Trans.  A.M.  A.,  Vol.  .\  X  III,  p.  292.     (Toner.) 
700  deaths,  Ke|).  Med.  Inspector,  V.  S.  A  . ;  l)eC. 

31,1804.     (Toner.) 
Harris  S:niit:irv  t;om.,]>. 264.     (Toner.) 
A.  P.  H.  A.,  Vol.  IV,  and  Brswn,  (,)iiaranlino,  p. 

40.     (Toner.) 
Galv.  M.  .J  .,  1860,  p.  338.     (Toner  ) 
Thefr(<edoin  from  yellow  fever  diirins  the  years 

of  the  w;ir  is  .'iecoiint<d  for  li\  thcr  bloi  kiido 
,  of  tho  city.     A  fact  bronglit  foi  ward  by  I'r. 

Eormeiito  to  ju'ovo  that  the  disease  was  imt. 

endemic,  in  that  city.     (Beren^er  Eeraiid.  loo. 

cit.,l>.  149.)    3.(193 deaths,  Ed.  X.  O.  31.  J..  I80S 

p.  194.      (Toner.) 
34  diiaths,  M.  Pi-p.,  1808.  p.  227.    (Toner.) 
Brown,  (^Miarimtine,  1872,  ]>.  44.     (Toner.) 
Siui;.  C.en'l's  Ollico  Circular  Xo.  1,  1808,  p.  J.52 

(T(Mier  ) 
I,1.50<leatlis,  S.  M.  Welch,  Gilv.  M.  J..  Vol.  I, 

Xo.  2,  p.  8:!.     (Toner.) 
Beren^er  Eeraud,  lue.  eit..  i>.  144.  :iiiil  Brown, 

(Quarantine.  ]>.  14.     (Toner. ) 
A.  P.  II.  .v.,  \'nl.  IV;  Blown,  (Quarantine,  p.  41. 

(Toucr.) 


■80 


TAi'.r.K  •iifowiNr.  ykat^s  in   w  iikmi    ^  iiiuW   ri-,\Ki:   ha?;  in\a1)1:u  tiir  oi.AiiOAUb 
ciTiKs  or  TiiK  Uniiki)  .States,  irrc. — Contiuuod. 


Year. 


a  800 
1870  K 


1S70 
J  870 

)87I 

1871 

1871  ]•; 

1871  E 

1872  K 
1872 

187;;  V. 
187:^  i: 

1874 


Loral  ity. 


New  Orloans.. 
.....h.  


Mobile 

Pliila(](tli.lii;i 

Cedar  Kovs,  1  la  . 

Tainpn,  I'la 

Cliarl.-.slon 

Kcw  Orleans 

.!.>  


()ri;;iii. 


Cuba 

Iloiiiliiras... 


W.'st    IlKli.S 

H.-u-ana 

...il.. 


licMiaiks. 


A.l'.n.  A.,V<>1.IV. 

5S7<lcatIi9,  .1.  C.  lMiL'<t.  N'    O.  Moil.  an<\  S.  J., 
Vol.  I,  No.  2, 187:;.    (Tom.  i.)     lioaid  ol  ll.-allh 
La.,  1870. 
P>(rrii<;<T-Kri-aiiil.lor.ci(.,  i>.  1  l-'i. 
18<li  aths,  La  Koclio,  Yellow  r.ver,  1870,  ]>li.,20, 

.   20. 
A.  1'.  ir.  A. .Vol.  IV.    Mo.l.aiidSiii;,'.  lte|).,No. 

17.p.  :!77,  Vol.  .\XV.     (Toner.) 
A.  r.  II.  .\.,  Vol.  IV. 

I  2i:!   d.Mtlis,  T'rans.  .A.  .M.   A..  Vol.  Will,  p. 

■2'Xi.     (Toner.) 
Cieiifiii  -o.s.  Ilnvaii.a     J'.oard  of    llr.illh    La.,    1871,    f..'.  d<>atlis.    Kep. 
N'.O.  r..  o(ll.,)871.     (Toner.) 

.10  dr., Ills,    Hep.  N.  O.  1!.   of  II.,  1872,    p.   17. 

I  (Toner.) 

New  York I '  B.   M.  ami   S.  .L,  Vol.   LXXX,  No.  23,  j..  587. 

(Toner., 


New  Orli'aiis 
I'ensar.d.-i  ... 


Havana. 


-do 


I 
1871        ! 
1>7.-.  E 
1875   E 
1875   E 
187G   E 

1870 

1870 

1877 
1878  E 

1876 


if;78 

187'J 


IPSO 
lSf-2 
1882 
18K2  E 
l>->:i  E 
188:J 


1884 
1887   E 


1887 
1888  E 

1883 
1891) 
189 J   E 

1803 


New  Orlr.nns 

liarranias,  Ela. . . 
Fasia<;onla,  M  iss  . . 


.do 


i:.  S.  -M.  H.  S.  Hep.,  187.1.  225  deaths;   11.  of  U. 

La.,  lS7:i.  A.  I'.H.  A  .,  Vol.  IV. 
01  deallm,  K.  V.  Mi.liel,  fjiiarle^ton  M.  J.  and 

K..  1.^74.Vol.  l,p.  2.-i'.l.     (Toner.)     A.IMI.A., 

Vol.  IV;  J.    M.  AVoodwortli,  U.  S.  M.  U.  S. 

l;ep..l87:!. 
The  eit\   was  iufeeled  tliroiifjli  tlio  Castropoa 

from   Havana.     (Hep    l'.  .S.  Mod.  Com.,  U.  S. 

M.  II.  S  l;ei>.,  1871 ;  A.  r.  U.  A.,  Vol.  IV.) 
li.of  II.  I, a.,  !S74. 
U.  S.M.  U.S.  K.p..  1875. 
1'.  S.  M.  II.  S.  Leie,  1K75,  fiO  deatli.q. 


Kev  We.st 1  ::8  duath.s.     (U.  S.  M.  II.  .S.  Ito]).,  1875.) 

Uiiiuswick '   Il.iv.ma :  112   dealliJf.     (Smitli    in    tlic    L'.  S.  M.    II.   S. 

I  I       l.'.ps.,  1870-77,  p.  185 

Dobov.Ca 1 <lo A.  r.  II.  A.,  Vol.  IV, j..  2,-,l,   ami    V.  S.  M.  II 

i  I      .S.  K.-1...1870  77. 

Savannali ..' do 1...     I'.S^.M.H.S.   ocp.,    l.<70-77,    p.    180,    A.  I".   II. 

i  A..  Vol.  IV.iT.l. 

.do A.r.U.A..Vol.lV. 


F«rnandin.i 

.Meniplii.s  and  all  I  be 
.Ml.  sis-sijipi    \all>  V 
,     to  {'airo.  111. 
New  Orkana 


New  York  .. . 
New  (Jrli  ans. 


Key  "West 

C.iiv.-.^ton 

Ni-w  tlilean.>( 

I'ensa.  .,1a 

r.i.'wlon.  Ala  . .  . 
I'eusa.-.da 


W.st  Indies  ... 


l''ensaeola(?). 
Kej  West 


Tampa.  El.a 

.lacks.jiiville,  Ela 


Havana.... 
Xl.il an/as . . 
l>.nsa...la.. 
Havana.... 


Ha\  ana... 


Tanii)a.  Ela 

Itrnnswiek,  li.a 

Eninswiek.   On.,  and 

adjaeent  islands.         I 
Satiila  lliver.Ga d 


lo 


A.  V.  IT.  A..  Vol.  IT.  and  Sternberc.  Tlio 
.steamer  ICinily  Soilder  brou;;lit  the  .lisease 
to  the  <it.v  from  the  .\Titille9.  (I!<-rent;iT- 
E.'r.iiiil,  lo.'.  I  it.)  .\  sevire  eiiidi-mic  year. 
There  wer.-  in  the  Fnited  States  125.000 cases 
smd  12,0(10  d.-ath.s.  (N.  \..Me<l.  U.,  Dec,  1878; 
r,irenj,'er-l'eraud,  bte.  eit.,  Ji.  152). 

B.'renL;ir-F.  land,  loe.  eit.,  p.  152. 

Th(^  disease  ext.nile.l  alon;;  the  Mlssis^sippi  as 
laras  Menijihis.  TTieiliseasewasbroiight  from 
til.-  .\nlilh  sto  New  Orleans  1>V  the  I'ly  mouth. 
(Med.  lap.  U.S.  Navy,  1879,Dr.  W.^olvertou.) 


National  B  of  II.  Rop  ,1882. 
V.  S.  M    II.  S.  Kep.,  1883,  192  deaths. 
MILS.  Kep.,lhK4. 
Sp.iradic  cas.s,   hot  there  was  an  epidemic  at 

tin-  ijav\.yaril,  '.i  miles  from.  I'ensaeola.    (M. 

U.S.  Kep.';  1884,  p,  200.) 

Abstraet  of  .'^an.  K.p.,  F.  S.  M.  H.  S.,  1887,  and 
r.S.  M.H.S.  l;.)!.,  pp.  12,  i:j,  1887;  280  cascB 
,'inil  02  iloaths  np  to  S.jitember. 

f.S.  M.  U.S.  li.  p.,  lS)^7-88. 

I'l.-int  City  and  ueighli.irin;;  eitics.  U.  S.  M.  H. 
S.  l{c^l.,18^8. 

rrobably  from  Tatnpa  epidemic  of  1887. 

52  deaths.     Abstr.a.t  of  S,an.  Hep.,  1894.  p.  81; 
U..S.  M.  U.S.  Rep.,  1«93. 
Do. 


ALABAMA. 

Summary  of  Yellow  Feveh  in  Alaiiama,  by  Localities. 

ALCO. 

1897.     Cases,  1;  death,  0. 

ATHENS. 

1878.     Cases,  2 ;  deaths,  2. 

BAY  MINETTE. 

1897.     Cases,  1;  deaths,  1. 

BLADEN  SPKINGS. 

18o3.     Sporadic  cases,  sclelj  among  refugees. 

BLAKELY. 

1822.     Severe  eiiidemie.     No  statistics, 

BREWTON. 

1883.     First  case,  September  12;  first  death,  Septdiiber 
10.     Last  case,  November  6.     Cases,  70;  deatlis,  28. 

CAILVWBA. 

1853.     No  record  of  cases  and  d'caths. 

(\VSTLEBEKKY. 
1905.     Cases,  2;  deaths,  2. 

.(^rrK(J\FLLE. 
1853.     No  record  of  cases  and  (hiiths. 


782  HISTORY    OK    VKLI.OW    FEVER. 

COUKTLAXD. 

1878.     Infected  l»y  Memphis.     Cases,  1;  deatlis,  1. 
DECATUR. 

1878.     Population,  1,200.     Cases,  187;  deaths,  51. 

1888.  First  case,  September  4th;  first  death,  Septem- 
ber 11.  Cases,  10;  deaths,  1.  At  the  beginning  of  the 
outbreak,  nearly  the  whole  population  fled. 

DEMOPOLIS. 

1853.     Xo  record  of  cases  and  deaths. 

DOG   RIVER. 

1853.  Population,  300.  First  case,  August  18th ;  first 
death,  August  22nd.     (\ases,  00;  deaths,  23. 

FLOMATOX. 

1897.     Cases,  98;  deaths,  5. 

FLORENCE. 

1878.     Poi)ulation,  2,500.     Cases,  1,109;  deaths,  50. 

FORT  CLAIBORNE. 

1819.  I'irst  case,  July  4;  last  case,  December  1.  No 
statistics. 

FORT   RAYON. 

1893.  First  case.  July  30;  first  (h-ath,  August  3;  last 
(balli,   Ncveiiibcr   KJ.      Cases,  (1;   (baths,  5. 

FORT  mor(;an. 

1807.     First  case,  August  13.     No  statistics. 
1893.     Cases,  2;  deaths,  1. 


ALABAMA.  '783 

FOET    ST.    STEPHEN. 

1819.     First  case,  July  4 ;  last  case,  December  1. 

FULTON. 

1853.     No  record  of  cases  aud  deaths. 

GREENSBORO. 

1897.     Cases,  1 ;  deaths,  1. 

HOLLY  WOOD. 

1858.  Infected  hv  New  Orleans.  Fii>t  case,  Auoust 
15th;  first  death,  August  29tli.  Last  case,  September  20th. 
Cases,  10;  deaths,  G. 

HUNTSVILLE. 

1873.     Cases,  3;  deaths,  1. 

1878.     Cases,  33;  deaths,  13.     All  impoiled  cases. 

JUNCTION. 

::873.     Population,  35.     Cases,  22 ;  death-;,  14- 

LEIGHTON. 

1878.  First  case,  August  18;  first  death,  August  24. 
Cases,  4;  deaths,  1. 

:morile. 

1705.  Seveial  historians  state  tliat  yellow  fever  made 
"great  havoc"  in  ^Mobile  in  1705.     No  statistics  are  given. 

1765.     Epidemic.     N({  record  of  cases  and  deaths. 

17r»n.     Sevci-o  cpidomic.     \vvy  fatal  among  new  comers. 

1819.  I»(;pulati(n,  1,200.  Numer  who  fled,  300.  First 
case,  August  19;  last  case  in  Novemlier.  On  October  22, 
tliere  was  a   liglit   frost,   l)ut   the   disease  continued  un- 


784  HISTORY    OK     YELLOW     FEVER. 

nbatcd  until  tlie  eud  of  November.     Many  persons  were 
lured  to  the  city  by  the  frost  and  fell  yictims  to  the  fever. 

1821.  Sporadic  oases;  7  deaths  in  October. 

1822.  "Only  4  or  5  cases." 

1821.  Six  fatal  cases  in  September;  last  case  on  the 
25tli,  notwithstandin<i-  that  there  was  no  frost  until  the 
latter  part  of  October. 

1825.  Seyere  epidemic.  The  Board  of  Health  con- 
cealed the  real  state  of  things  from  the  public,  and  al- 
though yellow  feyer  had  made  its  ai)pearance  as  early  as 
July,  official  announcement  was  made  on  August  10, 
"that  though  the  bilious  feyer  prevails  to  considerable  ex- 
tent, and  in  many  instances  fatal,  yet  the  Board  takes 
pleasure  in  assuring  the  public  that  no  case  of  yellow 
feyer  has  yet  occurred."  It  was  only  on  September  2, 
after  the  disease  had  become  epidemic,  that  "one  case 
of  yellow  feyer"  Ayas  reported.  Three  cases  were  reported 
on  the  5th,  four  cases  on  the  8tli,  and  on  the  11th  ot 
September,  the  "painful  announcement  that  the  disease 
is  epidemic'  was  made.  As  no  true  statistics  were  kept, 
it  is  impossible  to  giye  the  number  of  cases  and  deaths. 

1826.  Sporadic  cases  in  Sei)tember. 

1827.  A  few  cases  in  September. 

1828.  Mild  epidemic.     No  statistics. 

1829.  Population,  4,000.  Epidemic.  First  case,  August 
14.     Deaths,  130. 

1837.  For  eight  years,  ^lobile  Avas  free  fi'(;m  epidemic 
disease.  On  September  20,  1837,  four  cases  of  yellow 
feyer  su.ddcnly  nuide  their  aiipearance.  After  this  out- 
break tlie  disease  disa])pear(  d,  and  the  public  mind  was 
reassured.  There  was  a  light  frost  on  October  2,  and 
those  who  had  fled  returned  to  the  city,  feeling  certain 
that  all  danger  was  oyer.  On  October  10,  cases  erupted 
in  nearly  every  section  of  the  town,  and  the  disease  was 
soon  epidemic,  running  its  course  until  the  end  of  Xoyem- 
ber.     I)eaths,  350. 

1838.  Spciadic  cases.     Xo  statistics. 

1830.  r<)])uhUion,  11,000.  The  new  ])0]uilation  was 
composed  chiefly  of  people  from  the  North,  and  German 


ALABAMA MOBILE.  785 

and  Irish  laborers.  The  first  ease  of  yellow  fever  occurred 
on  Aiioust  11.  In  ten  days  the  disease  became  general 
thronohout  the  city.     Last  case,  October  20.     Deaths,  450. 

1841.  Scattered  cases.  The  subjects  were  from  the 
interior,  no  inhabitant  of  Mobile  being  affected. 

1842.  First  case,  August  20.  Limited  inauifestation 
cc^nfiued  to  the  southern  section  of  the  city.  Cases,  160; 
deaths,  70. 

1843.  I»oi)u]ati(.n,  11,500.  The  first  case  of  the  epi- 
demic of  1843  occurred  on  August  24,  followed  l)y  a  sec- 
ond case  on  the  2(1 ;  both  terminated  fatally.  It  was  not 
generally  known  that  the  disease  had  broken  out,  the 
l)ublic  being  kept  in  ignorance  of  the  fact.  About  Sep- 
tf^mber  10,  many  cases,  accompanied  by  black  vomit,  were 
observed,  and  the  disease  soon  became  widespread.  Last 
ease  erupted  X(iVfmber  5.     Cases,  1,350;  deaths,  750. 

1844.  First  case,  August  14.     Deaths,  40. 

1845.  INii)ulati<:u,  12,000.  First  case,  November  9. 
Dcatbs,  1. 

1840.  First  case,  September  11.     Deaths,  4. 

1847.  First  case,  August  2.     Deaths,  78. 

1848.  Fiist  case,  August  18.     Deaths,  24. 

1849.  First  case,  July  3.     Deaths,  21. 
1851.  :\Ii)(l  outbreak.     N(;  statistics. 

1853.  ]»op Illation  25,000.  Number  who  fled,  8,000. 
Infected  by  bark  ^fiUiadrs,  from  New  Orleans.  First 
case,  July  11;  first  death,  July  11.  Last  case,  December 
16.  Deaths,  1,191.  Tliere  were  many  cases  among  the 
negro  ix.pulaticn,  but  only  50  died. 

1854.  S])oradic  cases. 

1858.  First  case,  August  3;  first  deatli  August  13. 
Deatlis,  70. 

1863.  Sporadic  cases,  one  imported  from  Key  West; 
two  deaths. 

1864.  S])oradic  cases;  six  deaths. 
1867.     First  case,  August  13. 

1870.     First  case,  August  27 ;  last  case,  November  19. 


786  HISTOKV    OK    YELLOW    LEVER. 

1873.  Infected  by  Xew  Orleans.  First  ease,  August 
21 ;  first  death,  August  26 ;  last  case,  Xovember  29.  Cases, 
50 ;  deaths,  27. 

1875.  First  case,  September  1;  first  death,  September 
7;  last  case,  October  20;  last  death,  October  21.  Cases, 
10;  deaths,  8. 

187G.  First  case  (refugee  from  New  Orleans),  Septem- 
ber 5,  terminating  in  death  on  the  9th;  last  case  (refugee 
from  Savannah)  in  December;  recovered.  Both  cases  at 
Battle  House. 

1878.  Population,  31,031.  The  first  case  was  a  negro 
who  had  been  on  an  excursion  to  Biloxi,  Miss.,  Julv  24, 
was  attacked  early  in  August  and  died  August  IG.  The 
health  officer  certified  to  the  Board  of  Trade,  August  19, 
tliat  "there  was  not  a  case  of  yellow  fever  in  the  city  or 
country,-'  and  Montgomery  raised  the  quarantine  she  had 
against  ^fobile.  From  August  10  to  September  21,  there 
Avere  only  5  deaths,  but  early  in  October,  deaths  began 
increasing;  B.  B.  Fort,  of  the  Board  of  Trade  dying 
October  14,  at  Spring  Tlill.  A  majority  of  the  cases  Avere 
in  the  extreme  southern  portion  of  the  city.  A  slight 
frost  fell  in  the  suburbs,  October  23,  on  Avhich  day  there 
were  reported  3  deatlis,  5  new  cases,  and  41  under  treat- 
ment;  leather  Victdr,  of  the  Lutheran  Church,  was  among 
the  deaths.  Tlie  death  rate  decreased  till  October  31,  at 
wliich  date  no  deaths  were  repoi'ted.  Last  death,  October 
30. 

Total  cases,  297;  tctal  deatiis,  83. 

1880.  One  case,  on  board  British  bnrk  R.  11'.  ^Vno<h 
from  Havana*     No  cases  in  city. 

1897.     li)fectcd  by  Ocean  Springs,  Miss.     Cases,  301; 

dcalli^,   is. 

1903.     (\is(s,  1;  deaths,  1. 

1905.  July  24.  Four  cases  at  (iiiaiaiif ine  Station,  on 
l)(;ard  steamship  Coloinhid,  from  Colon  and  LaBoca.  No 
cases  in  citv. 


ALABAMA.  787 

MONTGOMERY. 

1853.  First  case,  September  — ;  last  case,  Xovember 
— .     deaths,  35. 

1854.  First  case,  September  — ;  last  case,  November 
— .     Deaths,  45. 

1855.  First  case,  September  — ;  last  case,  November 
— .     Deaths,  30. 

1807.  First  case,  August  13.  Sporadic  cases.  Im- 
ported. 

1870.  First  case,  August  22;  last  case,  November  19. 
Sporadic  cases. 

1873.  Infected  bv  Peusacola.  First  case,  August  27; 
first  death,  August  27;  last  case,  November  10.  Cases, 
500;  deaths,  108.     Whole  population  fled,  except  1,800. 

1897.  First  case,  October  18;  last  case,  November  10. 
Cases,  120;  deaths,  11. 

1905.     One  case,  a  refugee 

NOTSALUGA. 

1897.     Cases,  1 ;  deaths,  0. 

OAKFIELD. 

1873.     First  case,  September  22.     Cases,  7;  deaths,  1. 

POLLARD. 

1873.     Sporadic  cases.     No  statistics. 

PORTEEVILLE. 

1853.  Cases,  5 ;  deaths,  2.  All  refugees  from  infected 
places.     No  case  among  inhabitants. 

SEL-AfA. 

1853.     Population,    3,000.       Number   who   fled,    1,500. 


788  HISTORY    OF    VEI.LOW     KEVEA. 

I''ii'!-t  case,   S('i»t('iiili(a'  1;  first  death,   S('[)tt-ml)er  1;  last 
death,  Xoveinher  13.     Deaths,  32. 

1897.  First  ease,  ()ct(;l)er  23;  last,  Octcber  31.  Cases, 
12:  dtaths,  2. 

SANDY    ]:il)(}E. 

181)7.     Cases,  1;  deaths.  0. 

SPKIXG   HILL. 

1853.  As  yellow  fevtn-  has  heeii  epidemic  only  once 
in  this  l)eantifnl  i)la('e,  the  f<;ll(;win;Li'  acconnr,  snnunarized 
from  tlie  memoirs  of  Dr.  J.  (\  Xott,  Aylio  came  so  near 
exponr'din<>  the  mcsqnito  doctrine  of  the  transmission  of 
yello^v  feyer,  oyer  half  a  c(ntnry  aiio,  ^vill  lie  fonnd 
interesting-: 

On  the  12tli  of  Angnst,  jnst  aliont  the  time  yello\y  feyer 
bcuan  to  assnme  the  ejiidcMiiic  form  in  ^fobile,  and  one 
month  after  the  first  in)]!(.rted  case.  Dr.  Nctt  Ayas  called 
to  see  a  yonn.i»-  man,  wlio  had  a  Ay(41-marked  attack  of 
the  disease,  at  a  boarding;  honse  in  Mobile,  on  St.  Lonis 
Street,  near  St.  Josei)h.  On  the  14th,  the  patient  Ayas 
leiiH  y(Ml  on  a  stretcher  to  the  houpe  of  liis  brother-in-law, 
in  Sj)riiiii'  Hill,  about  the  center  of  the  setllement.  He 
recoy(a'ed,  and  twenty  days  after  lic^  ha<l  entered  the 
house,  ~)X\\  <;f  Septc  uilier,  two  childreu  liyinu,  there  were 
attacked  ^^■itll  the  fev(  r,  and  ab(  ut  two  weeks  after,  two 
other  cliiblren  Ayere  attacked:  three  liad  black  y<  luit  aud 
two  died. 

On  August  22,  a  .Mr.  Stiaiider,  cf  M<:bih',  uuiycd  his 
family  to  Sitriuii  Hill  aud  occU]tied  the  Insuse  of  .T(din 
Tonluiiu. 

Mr.  <}i'(('r  moyed  witli  his  lauiily  to  the  s;nne  house  on 
the  2!)th,  from  ^lobile,  carryinji'  a  dauiihter  c<;nyalescini!: 
from  yellow  feyer:  another  danjihter  sickened  on  the  8th; 
three  of  ^Irs.  Flemmin.u's  <liildren  in  the  same  house,  on 
the  l(lti) ;  aud  Mrs.  .J(  hu  Orcer  two  or  three  days  after. 

Di-.  Xott's  fatlier-iii-law,  0(d.  Deas,  liyed  f>n  a  lot  about 
10  yards  north  of  the  orii»iiia]  source  of  infection,  and  his 


A.  ABAMA  ^  789 

household,  wliite  and  Idack,  eciisisted  of  sixty  persons. 
Ou  tlie  7th  of  September,  oue  of  his  iieuro  woiiuii  Avere 
attaeked,  on  an  adjoining  lot ;  on  the  Sth,  his  danghter- 
in-law,  Mis.  John  Deas,  and  on  the  9th,  Mrs.  Brown,  his 
daughter;  each  being  in  a  different  lot,  and  one  hundred 
yards  from  each  other.  The  disease  then  spread  rapidly 
through  the  families  of  the  three  adjoining  premises,  at- 
tacking Ayliites  and  blacks  indiscriminately.  Fifty-four 
were  attacked  out  of  the  sixty,  and  in  fourteen  days  the 
Ayliole  tale  y>as  told — tiye  whites,  two  mulattoes  and  one 
black  were  dead  with  black  yomit,  and  the  rest  were  con- 
yalescent.     One-half  of  the  whites  attacked  died. 

Cases  existed  simultaneoui-ly  at  AVm.  Stewart's,  'Sir. 
Wheeler's,  and  Mr.  Puryis'  and  T<;ulmin's  houses,  widely 
s(^})arated  from  eacli  other;  and  in  the  lattei-  ]tart  of  Sep- 
tember and  through  October,  the  disease  yisited  the  houses 
of  (^ipt.  Stein,  IMcMillan,  Rey.  Mr.  Knapp,  Mrs.  George, 
Dubbse's,  John  Battle's  and  some  others.  The  disease 
skipped  about  in  an  extraordinary  manner;  some  houses 
escaped  entirely,  some  had  but  one  or  twe)  cases. 

Dr.  Xott  fails  t((  giye  the  number  of  cases  and  deaths. 

1878.  Oiw  death,  Octolier  14,  a  refugee  from  :Mobile. 
Xo  cases  in  the  yillage. 

STEVEXSOX. 

1878.  Population,  200.  Probably  infected  by  ]Mem- 
phis.     Fiist  case',  Septemlier  1.     Oases,  11;  deaths,  0. 

ST    STICPHEX'S    BOAT). 
18.j;i     First  case,  August  23.     Infected  by  Mobile. 

TOWX   OBEEK. 

1878.     Population.,  7.").     Deaths,  4. 
TrS(\VLOOSA. 
1878.      (^ises,  2;  d(  albs,  2. 


790  HISTORY  OF    VELLOW  FEVER. 

TUSCUMBIA. 

1878.  Populatiou,  1,200.  InftH-ted  by  Memphis.  First 
case,  September  5.     Cases,  97;  deaths,  31. 

WAGAE. 

1897.     Cases,  15;  deaths,  3. 

WHISTLER. 

1878.  A  few  cases  among  refugees;  inliabitauts  not 
attacked.  One  death  oulv.  Father  ^rarlev,  of  Mobile, 
occurred  on  October  18. 

1897.     Cases,  122 ;  deaths,  7. 

WHITING. 

1870.     Sporadic  cases ;  refugees. 
1875.     Cases  among  refugees. 

BIBLIOGRAPHY    OF  YELLOW    FEVER    IN    ALABAMA. 

Anderson  (W.  H.):  Report  on  the  Diseases  of  Mobile  in  1853.  Trans- 
actions of  the  Medical  Association  of  the  State  of  Alabama.  Svo. 
Mobile,  1854. 

Cochran  (J.)  Contributions  to  the  Transactions  of  the  Medical  As- 
sociation of  the  State  of  Alabama,  session  of  1S74.  I.  The  yellow  fever 
epidemic  of  1873.     8°.     Montgomery,  1874. 

Cochran  (J.) :  The  Outbreak  of  Yellow  Fever  at  Brewton  in  18S3. 
Tr.  Med.  Assn.  Ala.,  Montgomery,  1884,  vol.  36,  p.  170.  Also:  Rep. 
Bd.  Health  Ala.,  1883-4,  Montgomery,  1885,  p.  47. 

Forest  (W.  E.) :  The  cost  of  Yellow  Fever  Epidemics;  the  Epidemic 
at  Decatur,  Ala.,  in  1888.     Med.  Rec,  N.  Y.,  1889,  vol.  35,  p.  620. 

Gilmore  (.T,  T.) :  An  Account  of  Yellow  Fever  as  it  Prevailed  in 
Mobile  and  Vicinity  in  1873.  Reports  Am.  Pub.  Health  Assn.,  1873, 
vol.  1,  p.  393. 

Glennan  (A.  H.):  Report  of  the  Operations  of  th9  Service  in  Ala- 
bama during  the  Epidemic  of  Yellow  Fever  in  1897.  Rep.  Superv. 
Surg.  Gen.  Mar.  Hosp.  1896-7,  Wash.,  1899,  p.  649. 

Lrewis  (P.  H.):  Medical  History  of  Alabama.  New  Orleans  Medical 
and  Surgical  .Journal,  iii.  691;   iv.  3,  151,  318,  459. 


ALABAMA  791 

Lewis  (P.  H.) :  Sketch  of  the  Yellow  Fever  in  Mobile,  with  a  brief 
Analysis  of  the  Epidemic  of  1843,  etc.  N.  O.  Med.  &  Sur.  Jl.,  vol.  1, 
pp.  281,  413. 

Marks  (J.  C):  Yellow  Fever  of  Selma,  Alabama,  in  1853.  Transac- 
tions 0^  the  Medical  Association  of  the  State  of  Alabama.  Mobile,  1854. 

Michel  (R.  F.):  Epidemic  yellow  fever  in  Montgomery,  Ala.,  during 
the  summer  of  1873.  Charleston  M,  J.  &  Rev.,  1873-4,  vol.  1,  pp.  289- 
305.     Also:  Reprint. 

Michel  (R.  F.):  Epidemic  of  yellow  fever  in  Montgomery,  Ala.,  sum- 
mer of  1873.  Tr.  M.  Assn.  Alabama,  Montgomery,  1874,  p.  87.  Also, 
Reprint. 

Nott  (J.  C):  Sketch  of  the  Epidemic  of  Yellow  Fever  in  1847,  in 
Mobile.     Charleston  Med.  .11.,  vol.  3,  p.  1. 

Nott  (J.  C.) :  The  Epidemic  Yellow  Fever  of  Mobile  in  1853,  com- 
municated with  the  Sanitary  Commission  of  N.  O.  N.  O.  Med.  and 
Surg.  Jl.,  1853-4,  vol.  10,  p.  571. 

Report  of  the  committee  appointed  to  investigate  the  causes  and 
extent  of  the  late  extraordinary  sickness  and  mortality  in  the  town 
of  Mobile.  8°.  Philadelphia,  1820.  Also,  in:  Med.  Reposit.,  N.  Y., 
1820,  VOL  20,  pp.  333-344. 

Riggs  (B.  H.) :  The  history  of  the  yellow  fever  epidemic  in  Selma 
in  1853.     Tr.  M.  Assn.  Alabama,  Montgomery,  1882,  p.  400. 

Boling  (W.  M,):  Yellow  fever  in  Alabama.  N.  O.  M.  &  S.  JL,  1853-4, 
vol.  10,  p.  409. 

Stone  (G.  H.  &  Carson  (W.  H.) :  Epidemic  of  Yellow  Fever  at  Brew- 
ton,  Ala.,  Rep.  Superv.  Surg.-Oen.  Mar.  Hosp.,  Wash.,  1883-4,  p..  223. 

Wahly:  On  the  Treatment  of  Yellow  Fever  as  it  occurred  in  Mobile 
in  the  fall  of  1853.  New  Orleans  Medical  and  Surg'ical  Journal,  vol. 
11,  1854-5,  p.  289. 

Wilkinson  (J.  A.):  A  sketch  of  yellow  fever  at  Whiting  in  1870,  and 
1873.  Tr.  M.  Assn.,  Ala.,  Montgomery,  1883,  p.  175.  Also:  Rep.  Bd. 
Health,  Ala.,  1883-4,  Montgomery,  1885,  p.  120. 


ARKANSAS. 

AUGUSTA. 

1.S78.  ropulatic.i),  1,200.  Infected  by  steamboat  Ruth, 
from  ^Memphis.  First  case,  October  12,  followed  by  death 
two  days  later;  last  case,  ()ctol)er  20.     Cases,  7;  death,  7. 

COLUMBIA. 

1853.  Infected  by  steamboat  J.  M.  Brff,  from  >'ew 
Orleans,  in  June.  Patient  was  an  Irishman  who  developed 
the  disease  on  board,  and  was  left  at  a  wifodyard  just 
above  the  town.  He  died  with  black  vomit,  but  did  not 
communicate  the  disease  to  any  one.  Six  other  cases  were 
put  off  different  steamboats  at  Columbia  in  July.  The 
H.  D.  Bacon  stopped  at  this  place  about  September  1, 
having-  20  cases  of  yellow  fever  on  board.  The  captain 
and  cliambermaid  were  attacked  while  the  boat  was  at  the 
landinji',  and  both  died  shortly  after  her  departure.  Fen- 
ner  (Kj/uJfinica.  etc..  jt.  107  i,  says  that  ''nearly  every  1)oat 
from  Xe^w  Orleans"  wliich  stopped  at  Columbia  during 
the  terrible  epidemic  of  1853,  had  yellow  fever  on  board. 
The  ])eo])le  of  the  town  visited  the  boats,  but  no  one  caught 
the  disease. 

FOKEST    CITY. 

lo7.').     Two  cases,  i-efugeH'S  from   ^Me^mphis. 

1870.  Infected  by  Memphis.  First  case,  October  2; 
first  death,  Octolier  8;  last  case,  November  25;  last  death, 
Xcvcmlicr  28.     Cases,  23;  deaths,  15. 

VOWV    S.MITII. 

1823.     liii|i(;it<  (1  (ases;  no  slalifctics. 

COLDFX    LAKE. 

1878.     Tliicc  (Mscs,   rcfimccs  from   Xcv.-   OHcans. 


ARKANSAS.  793 

GEAND   LAKE. 

1853.  Infected  liy  steaiuljoat  Binily  r  Hill,  from  New 
Orleans.  First  ease,  Ani^iist  24,  in  a  niaii  avIio  had  taken 
passage  on  the  boat  at  Natchez,  Miss.  Patient  died  on 
the  24th.  Tliree  residents  of  (Irand  Lake,  who  vlj-ited 
the  boat,  were  attacked,  but  recovered.  There  was  no 
spread  of  the  disease. 

HAYNEJr^    BLUFF. 

1878.     Cases,  100;  deaths,  10. 

HELENA. 

1878.  Infected  l)y  ^Ienii>his.  First  case,  Augu^^t  17; 
first  (loath,  Angnst  2L     Cases,  77;  deaths,  9. 

HOPEFIELI). 

1878.  Infected  by  Men)i)his  on  Sei)tenilier  1 ;  last  death, 
October  23.  '<'ases,  117;  deaths,  7.  Thexe  figures  also 
include  the  immediate  vicinity. 

1870.  Two  cases,  ab.out  a  mile  from  Hopefield.  No 
eases  in  town. 

LITTLE   lUH  K. 

187S.  A  litth'  boy,  a  refug(H'  frcin  Memphis,  wlio  <li('d 
shortly  after  his  arrival,  is  the  only  case  of  y(  How  fever 
ever  observed  at  Little  IJock.  Shot-gun  (piaraiitine  was 
in  full  force. 

LOKENZO. 

1878.     Cases,  1  ;  der.ths,  1. 

NAPOLEON. 

1853.      Severe  <nilbi-eak.      No  statistics. 


794-  HISKOKY     OF     Ytl.LOW     FEVER. 

OCEOLA. 

1873.  Infected  by  New  Orleans.  First  case,  August 
— ;  first  death,  August  11;  last  case,  Atigusi:  — ;  last 
deatli,  August  11.     Cases,  1;  deaths,  1. 

SCAXLOXS. 

1878.     Cases,  4. 

TEKKEXE. 

1878.     Cases,  21;  deaths,  19. 

WASHINGTON. 

1878.     One  case  from  Hunilidldt,  Ark.;  death, 

BIBLIOGRAPHY    OF   YELLOW    FEVER    IN    ARKANSAS. 

Cummings:  An  Account  of  the  Yellow  Fever  as  it  Appeared  at  Forest 
City,  Arkansas,  during  the  Summer  of  1879.  Trans.  Med.  Society  of 
Arkansas,  1880,  vol.  5,  p.  45. 

Cummings:  National  Board  of  Health  Bulletin,  1879-80,  vol.  1,  pp. 
137;   145;   149;   161;    178;   202;    216;   289. 

Dowler:   Yellow  Fever,  p,  24. 

Epkskine:  Trans.  Am.  Pub.  Health  Assn.,  1873.  vol.  1,  p.  385. 

Fenner:   History  of  Epidemic  Diseases,  1853,  pp.  49;    106. 

Fenner:   Trans.  Am.  Med.  Assn.,  1854,  p.  526. 

Jones:   N.  O.  Med.  &  Surg.  Jl.,  1853-4,  vol.  10,  p.  328. 

Keating:   History  of  Yellow  Fever,  pp.  92;   94;   96;   250. 

National  Board  of  Health  Bulletin,  1879-80,  vol.  1,  pp.  117;   145. 

Report  Sanitary  Commission  of  New  Orleans,  1878. 

Washington  Republican,  vol.  12,  No.  260,  p.  1. 


CALIFORNIA. 

T\w  only  cases  of  yellow  foyer  oyer  obseryed  iu  the  State 
of  California,  Ayere  taken  oft'  yessels  from  South  American 
or  ^Mexican  ports,  and  treated  at  the  San  Francisco  Quar- 
antine Station.  The  disease  has  neyer  spread  to  the 
inhabitants. 

Yellow  FEyER  Years. 

1883.  According  to  Nelson  (see  Biblioo-raphy)  Le 
Courricr  dc  ^San  Francisco  published  an  account  of  a 
jury  sitting  on  a  body  in  that  city,  to  determine  the  exact 
cause  of  death.  While  taking  the  eyidence,  it  Ayas  shown 
that  the  dead  man  and  another  sick  passenger  had  been 
landed  Jrom  a  steamship  from  the  Pacific  Coast  of  Mex- 
ico, and  that  the  corpse  before  them  Ayas  that  of  a  yictim 
of  yellow  feA'er.  The  Courricr  graphically  describes  how 
that  jury  stampeded  at  the  startling  reyelation.  It  Ayas 
a  regular  sauvc  qui  pcut. 

1894.  On  August  23,  the  steamship  J3cniiiiif/ton,  from 
La  Thiion  and  other  ports  on  the  coast  of  Salyador, 
arriyed  at  San  Francisco  and  landed  three  cases  of  yellow 
fever.     No  further  information. 

1897.  May  10,  steamship  "sent  cases  ashore."  No  his- 
tory of  subs(M|uent  deyelopments.  During  the  year,  the 
folloAying  infected  yest^els,  all  from  Panama,  Ayere  de- 
tained for  obserA'ation :  Acapiiico,  ^an  Juan  and  Citi/  of 
^jjdncij.  All  these  vessels  had  lieavy  passenger  lists,  but 
no  cases  erupted  at  San  Francisco. 

June  2.  C'ltjj  of  Para,  from  Panama,  infected  Avith 
yelloAV  fever,  enter(  d  harbor.  One  case  died  as  the  vessel 
steamed  into  port.     No  developments. 

July  11,  the  steamship  arrived  from  San  Juan  de 
Guatemala.     One  case  upon  arrival.     No  further  history. 

181)8.  One  case  at  Angel  Island  Quarantine  Station, 
taken,  from  steamship  Xcu-jtort,  from  I'auama.  Death 
on  arrival. 


790  HISTORY   OF  YELLOW    FEVER. 

1IM):J.  Miiy  20,  ('ill/  o/  I'did  arrived  t'loiii  I'aiiaina  and 
was  reniaiKlcd  for  dismlVctiou,  owin<»'  to  niinors  of  yellow 
fever  on  board.  Three  days  lat("%  tlie  frei<>lit  clerk  (who 
had  been  ashore)  had  an  attack  and  died  3Iay  2.  Xo 
other  cases  reported. 

1903.  September  10,  steamslnp  Colon,  from  Panama, 
arrived  in  ])ort  Avith  a  case  of  yellow  fever  on  board. 
l*atieiit  Avas  immediately  removeel  to  Au«»el  Island  (Quar- 
antine Station,  where  he  died  the  following;  day. 

The  case  was  certainly  an  interesting-  one  from  a  fpiar- 
antine  standp((int.  Patient  was  a  strou«>,  lithe  man; 
age  given  npou  articles,  23  years  (probably  28  or  30)  ; 
native  of  Chili.  He  shii)i)ed  at  Acapnlco  upon  the  elown 
voyage.  AVas  ashore  at  Panama,  but  at  no  port  upon  the 
up  trip.  A'essel  loadeel  in  open  water  from  lighters  at  all 
ports  en  r(nite.  Fifteen  days  from  Panama,  in  the  early 
mornii'g,  the  man  reported  to  the  slii])'s  snrgeon  with 
headaclie,  jiains  in  back  over  liye^r  and  elown  right 
shoulden-.  History  of  chill  dining  night  or  early  morn- 
ing; no  history  of  malari<i ;  pnlse  05;  temperature 
40°  (102  I  ;  appearance  of  slight  icterus,  whi(  h  rapi<lly 
increased. 

Xo  written  history  ke])t  r((r  examination  of  urine  or 
blond  made.  Diagnosis  of  obstrnction  to  bile  duct.  No 
v<.miting  nct«^d. 

AVhen  seen  l>y  Passed  Assistant  Snrgeon  Cumming, 
from  whose  re])ort  this  history  is  summarizeel,  the  man 
had  jnst  been  bi'onglit  from  the  forecastle  in  the  gang- 
way in  tlie  cold  wind.  He  was  semi-conscious,  res])ond- 
ing  to  loud  iiKpiiry  as  to  vvhether  he  wanted  water.  Body 
bi-onze  vellow;  eyes  very  yellow;  tongne  not  enlarged, 
])(.i))tcd,  red  ai'ound  edge,  some  sores;  left  parotid  glanel 
<  idarged  and  tender;  some  shrinking  on  pre»ssure  in  epi- 
gastric i('gi<:n;  si)l( en  and  liver  not  enlarged  (])ercussie)n 
and  iialjiation  I.  Some  bb;od  sigiis  on  Idanket,  bnt  pos- 
sil)ly  due  to  ulcer  on  left  ( Ibow. 

After  having  been  i-emcjved,  catluMerization  bronght  235 
c.c.  of  nrine  liighly  co](  red,  sliglitlv  cloudy.  S]teciGc 
gi-avity,  1010.     l-!cacti(.n,  acid.     .Mbiniiiii   in  largo  (jnan- 


CALIFORNIA.  797 

titic^s  by  all  tests  used.  Examination  of  bhiod  for  malaria 
by  hieveral  officers,  ne.uativ(\  ]*ns  in  parotid  jiland,  ordi- 
nary dii)l(H-(tcci. 

l*atient  j^rew  worse,  <lurinii  nialit  had  classical  black 
vomit,  <lied  next  day.  Antopsy  confirmed  diaj»nosis. 
Cremated. 

The  interestini>  features  frcnn  a  sanitary  point  a?e: 
First  attack  fifteen  days  from  the  only  place  reported 
infected  (Panama),  and  about  three  days  after  leaving 
Acai)nlc(:.  The  vessel  was  thoroughly  searched  by  Sur- 
geon humming,  other  (officers,  and  attendants  for  mos- 
<|uit<(S,  (l(^ad  (sr  alive,  and  not  one  was  found,  despite  a 
<-onsiderable  reward  ottered. 

The  original  source  of  infection  was  evidently  Pananui. 

BIBLIOGRAPHY   OF  YELLOW    FEVER    IN    CALIFORNIA. 

Bereng^r-Feraud:   Fievre  Jaune,  etc.,  Paris,  1890,  p.  189. 

Bally:    Typhus  d'xVmerique  ou  Fievre  Jaune,  p.  39, 

Comming  (H.  S.):  History  cf  yellow  fever  case  on  steamship  Colon, 
at  San  Francisco  Quarantine,  from  Panama;  yellow  fever  on  vessels 
in  previous  years.  Pub.  Health  Rep.  U.  S.  Mar.  Hops.  Serv.,  Wash., 
1903,  vol.  IS,  p.  1631. 

Lind:    Diseases  Incidental  to  Seamen  in  Hot  Countries,  vol.  1,  p.  39. 

Medical  News,  X.  Y.,  1883,  vcl.  43,  p.  420. 

Nelson  (W.):  Yellow  Fever  Considered  in  its  Relation  to  the  State 
of  California.    Rep.  Bd.  Health  Calif.    Sacramento,  1884-6,  vol.  9,  p..  220. 

Perry  (A.  W.):  Yellow  Fever  at  San  Francisco.  Western  Lancet, 
San  Francisco,  1883,  vol.  12,  p.  389. 

U.  S.  Public  Health  Reports,  1897,  pp.  563,  607,  685. 

Ibid.,  1898.  p.  634. 

Ibid.,  1902,  p.   1172. 

Ibid  ,  1903,   pp.   1540;    2298. 


CONNECTICUT. 

CHATHAM. 

Um.  First  case,  August  21).  Infected  by  brig-  Polly, 
from  Sail  Domingo,  West  Indies.  Xo  record  of  cases  and 
deaths. 

HARTFORD. 

1798.     Sporadic  cases,  imported.     No  statistics. 

1800.  Old  chroniclers  say  that  yellow  feyer  Ayas  im- 
ported to  Hartford  in  1800,  and  "created  much  alarm  and 
raged  for  a  time  with  consideral)le  mortality."  Xo 
statistics. 

KXOWLES    LANDING. 

170G.     First  case,  Angiist.     Deaths,  9. 

MIDDLETOWN. 

1820.  First  case  in  June.  Tnf( cted  by  schooner  Milo, 
from  West  Indies. 

NEW    HAVEN. 

1735;  1743;  1794;  1803;  1804;  1805;  1819;  1845.  Yel- 
low feyer  was  imported  to  New  Ilayen  in  the  years  men- 
tioned, but  no  reliable  statistics  could  be  obtained. 

NEW   LONDON. 

1798.  Source  of  infection  not  stated,  writers  of  the 
])eriod  attributing  the  outbreak  to  "a  lot  dried  fish,  which 
had  decomposed  and  exposed  on  the  public  wharyes.'" 
First  case,  August  25;  last  case,  October  28.     Deaths,  81. 

NORWALK. 

1798.     Mild  outbreak.     No  statistics. 


CONNECTICUT.  799 

NOKWICH. 

1801.     Importation.     No  record  of  cases  and  deaths. 

STANFORD. 
1745.     Mild  outbreak;  no  statistics. 
STONINGTON. 
1798.     Mild  outbreak;  no  record  of  cases  and  deaths. 

BIBLIOGRAPHY   OF   YELLOW    FEVER    IN    CONNECTICUT. 

Bancroft:  Essay  on  Yellow  Fever,  p.  399. 

Beck  (J.  B.) :  Communications  concerning  the  yellow  fever  at 
Middletown  (Conn.)  In:  Hosack  (D.):  Observations  on  febrile  conta- 
gion, (etc.).     8°.     N.  Y.,  1820,  p.  53. 

Channing:  An  Account  cf  the  Pestilential  Disease  which  prevailed 
at  New  London  in  the  summer  and  autumn  of  1798.  New  York  Medical 
Repository,  vol.  2,  pp.   402-405. 

Coit  (T.):  Additional  account  of  the  pestilential  fever  which  pre- 
vailed at  New  London,  Conn.,    (1799).     Ibid.,  407. 

Holt  (C):  A  short  account  of  the  yellow  fever,  as  it  appeared  in 
New-London  in  August,  September  and  October,  1798;  with  an  accurate 
list  of  those  who  died  of  the  disease,  the  donations,  etc.  8°.  New- 
London,  1798. 

Medical  Repository,  1805,  vol.  3,  p.  292. 

Monson  (Sen'r.):  Letter  on  the  Treatment  pursued,  and  most  suc- 
cessful in  the  cure  of  the  Yellow  Fever  in  New  Haven  in  1794. 
Webster's  Collection,  p.  184. 

Monson  (Jun'r.) :  Letter  on  the  Origin,  Sym]itonis,  Progress,  etc., 
of  the  Yellow  Fever  in  New  Haven  in  1794.  Webster's  Collection,  p. 
173,  etc. 

Scott  (Charles):  Short  Account  of  the  Yellow  Fever,  as  it  appeared 
in  New  London  in  1798.     New  London,  1798. 

Strobel:   p.  101. 

Tully:  Yellow  Fever  of  Middletown  in  1820,  and  Chatham  and  its 
Neighborhood  in  1796.  Essays  on  Fevers  and  other  Subjects,  by 
Thomas  Miner  and  William  Tully.     8vo.     1823. 

Tully  (W.) :  History  cf  the  yellow  fever  as  it  occurred  at  Knowles 
Landing,  Conn.    N,  Y.  M.  &  Phys.  J.,  1822,  vol.  1,  pp.  153-158. 

Tully  (W.) :   History  of  the  peculiar  fever  that  occurred  at  Middle- 


800  HISTORY    OF    YELLOW    FEVER. 

town,  Connecticut,  during  the  months  of  June  and  July,  1820;  yellow 
fever  in  Chatham,  in  1796,  and  its  origin.  In  Miner  (T.)  &  Tully  (W.) 
Essays  on  fevers  and  other  medical  subjects,  Middletown,  1S23,  pp. 
291-403. 

Tully  (W.):  Observations  on  yellow  fever,  with  cases  which  oc- 
curred at  Middletown  and  Chatham,  in  Connecticut,  Virginia  M.  J., 
Richmond,  1856,  vol.  7,  pp.  -139-459. 


II 


DELAWARE. 

CHIUSTIANA. 

1708.  Infected  bj'  Wilmington,  Delaware.  No  stat- 
istics. 

DELAATAKE    BKEAKWATEII. 

Yellow  fever  cases  were  brought  to  LcAves  (Delaware 
Breakwater  Quarantine  Station)  by  ships  from  the  West 
Indies  in  the  following  years : 

1878.  ^rauY  cases  Avere  landed  from  ships.  Deaths,  9, 
of  which  7  were  sailors. 

1887.  August  8,  bark  Ada  (rray,  from  Ilavana.  One 
case;  recovery. 

1888.  Brig  Tmrriffe,  from  Havana.  First  case,  July 
22;  first  death,  July  27;  last  case,  July  23;  last  death, 
July  27.     Cases,  3 ;  deaths,  2. 

1889.  June  9.  Steamship  Baltiinorc  Cifij,  from  San- 
tiago de  Cul)a.     Two  cases. 

1892.  During  1892,  the  following  infected  vessels  were 
detained  at  this  station : 

Ma^'  10.  Norwegian  bark  Xor,  from  Rio  de  Janeiro. 
Nine  cases  and  two  deaths  at  Eio  and  during  passage. 

June  1.  British  bark  WilJoir  Bii.sh,  from  Rio  de 
Janeiro.  Had  several  cases  at  Rio  and  one  death  during 
voyage. 

June  6.  British  ship  FAinhaulc  from  Rio  de  Janeiro. 
Several  cases  during  voyage. 

June  28.  (ierman  ship  IxudoJpli  von  Bruninf/cr,  from 
de  Janeiro,  via  Barbados.  Eleven  cases  and  five  deaths 
while  at  Rio. 

July  25.  British  bark  Arr/riifa,  from  Pernambuco,  via 
Santos.    Several  cases  and  one  death  after  leaving  Santos. 

August  3.  British  l)arkentine  Fredcrica,  from  Santos, 
via  Guantanamo.     Several  cases  during  voyage. 

It  will  thus  be  seen  that  six  vessels,  actually  infected 
with  yellow  fever,  reached  Delaware  Br(akwater  Quar- 


802  HISTORY   OF   YELLOW   KKVER. 

antiue  during  1892.  "While  no  cases  erupted  during  tlieir 
detention,  there  is  no  telling  what  might  have  been  the 
consequences  if  rigorous  sanitary  precautions  had  not 
been  taken.  While  the  Stcgomijia  CaJopiis  no  longer 
thrives  in  the  locality,  the  epidemic  which  ravaged  certain 
sections  of  Delav.are  a  hundi'ed  years  or  so  ago,  prove 
that  the  insects,  when  imported  during  the  summer 
months,  can  be  domesticated  long  enough  to  propagate 
the  disease  under  discussion. 

1893.  July  20.  American  schooner  Hannah  McLoon, 
from  Havana  and  Matanzas.  Captain  had  died  from  yel- 
low fever  and  was  buried  on  arrival.  Five  other  cases 
en  route;  all  convalescent  when  the  ship  arrived.  Vessel 
disinfected.     Xo  other  cases. 

1897.  June  21.  German  bark  Zion  from  Eio  de 
Janeiro.  Two  cases  while  at  I\io  and  two  en  route. 
Quarantined  and  ordered  to  New  York  without  pratique. 

October  3.  Norwegian  steamship  Jolui  ^yl^son,  from 
Bocas  del  Toro,  Colombia.  Had  previously  left  Mobile 
(an  infected  place),  and  had  had  a  case  of  yellow  fever 
before  reaching  the  South  American  port,  and  another 
after  leaving  Bocas.  Owing  to  the  fact  that  yellow  fever 
was  widespread  in  the  South  that  year,  much  excitement 
was  caused  at  Delaware  Breakwater  (iuarantine  and 
vicinity,  when  news  that  an  infected  vessel  had  arrived 
became  public.  Th  cargo,  which  consisted  of  bananas, 
was  dumped  five  miles  at  sea  and  the  vessel  ordered  to 
Keedy  Island  for  oltservation.     Xo  other  cases  developed. 

Since  1897,  infected  vessels  have  arrived  at  this  station, 
but  no  interesting  developments  followed. 

DUCK   CREEK. 

1720.  Yellow  fever  imported,  but  beyond  the  state- 
ment that  '^the  village  was  almost  depo])ulated,"  no  other 
information  can  be  gleaned  from  the  historians  of  the 
period. 

XEW   CASTLE. 

1798.  Severe  outbreak;  no  statistics.  Probably  io- 
fected  by  Wilmington. 


DELAWARE.  803 

WILMINGTON. 

1798.     First  case  in  September.     Probably  infected  by 
refugees  from  Philadelj^hia.     Deaths,  200. 

1802.     Mild  epidemic  "in  the  autumn."     No  statistics. 

BIBLIOGRAPHY   OF  YELLOW    FEVER    IN    DELAWARE. 

Bancroft:  Essay  on  Yellow  Fever,  p.  357. 

Medical  Repository,  1805,  vol.  3,  pp.  128;   136;  221;   336;   368. 

Monro:  Remarks  on  the  Epidemic  of  the  Summer  and  Autumn  of 
1798,  at  Wilmington,  Delaware.  Medical  Repository,  1805,  vol.  3,  p. 
136. 

Tilton:  Observations  on  the  Yellow  Fever  as  it  appeared  at  Wilming- 
ton Delaware,  in  the  Summer  and  Autumn  of  1798.  Medical  Reposi- 
tory, 1805,  vol.  3,  p.  128. 

Vaughan  (J.) :  A  Sketch  of  the  History  of  the  Diseases  of  the  State 
of  Delaware.     Medical  Repository,  1805,  vol.  3,  pp.  221,  336,  368. 

Vaughan:  A  Concise  History  of  the  Autumnal  Fever  which  prevailed 
in  the  borough  of  Wilmington  (Del.)  in  the  year  1902.  Svo.  Wil- 
mington, 1803. 

Vaughan:  An  Account  of  Diseases  at  Wilmington  (Del)  in  the  sum- 
mer and  autumn  of  1800;  of  the  disease  originating  on  board  of  the 
U.  S.  Ship  Ganges,  etc.     Medical  Repository,  1806,  vol.  4,  p.  238. 


DISTRICT  OF   COLUMBIA. 

WASIUXGTOX. 

1855.     A  few  imported  eases  "from  the  South." 
1878.     ropiilation,    179,402.       First   case,   xViigust   10. 
Cases,  5;  deaths,  5;  all  refugees  from  Southern  cities. 
1898.     One  fatal  case,  a  refugee 

BIBLIOGRAPHY  OF  YELLOW  FEVER   IN   DISTRICT  OF 
COLUMBIA. 

Dick:    Fever    at     Alexandria,     District     of     Columbia.       New     York 
Medical  Repository,  vol  7,  p    100. 

Keating:   History  of  Yellow  Pcver,  p.  97. 

Lancet  (London),  lSo5,  vol.  2    p.  208. 

Medical  Statistics  U.  S.  Army,  1819-39,  p.  54. 

Annual  Report  Supervising  Surg.-Gen.  U.  3.,  1899,  p.  391. 


FLORIDA. 

APALACHICOLA. 

1820.     Sporadic  cases;  no  statisitcs. 

BARTOW. 
1888.     Population,  2,500.     A  few  imported  cases. 

BRAIDENTOWN. 
1888.     Scattered  cases;  imported. 

BRENT. 
1908.     One  fatal  case,  a  refugee. 
CALLAHAN. 

1888.     Infected  by  Fernandina.     First  case,  September 
10;  last  case,  October  — .     A  few  cases,  refugees. 

1871.     Infected    by    Havana.       Mild    epidemic.       No 
statistics. 

DRY  TORTUGAS. 

1893.     One  fatal  case;  imported. 

ELLAVILLE. 

1888.     A  fatal  case  in  November;  imported. 

EGMONT    KEY. 

1887.  First  case  in  July;  first  death,  July  11.     Two 
cases,  resulting  in  death. 

ENTERPRISE. 

1888.  Severe  outbreak,  considering  the  limited  number 
of  inhabitants.     No  statistics. 


806  HISTORY    OF    YELLOW    FEVER. 

FERNANDINA. 

1877.  Infected  by  Havana.     Cases,  1,500 ;  deaths,  112. 

1878,  Three  deaths  on  a  bark  from  Matanzas,  Cuba. 
1888.     Infected  by  Jacksonyille.     First  case,  August 

17,  terminating  fatally  on  the  22nd.     Complete  statistics 
lacking. 

FORT    BARRA^'CAS. 

1822.  Deaths,  7.  Source  of  infection  not  stated,  but 
probably  Hayana  or  Pensacola. 

1853.  Infected  by  Pensacola.     Cases,  5. 

1854.  T^yo  deaths ;  imported. 

1873.  First  case,  September  2G;  last  case,  Xovember 
12.     Cases,  12 ;  deaths,  3. 

1875.  There  are  different  speculations  relatiye  to  the 
origin  of  the  feyer  in  1875,  but  it  is  the  opinion  of  the 
majority  of  writers  that  it  A\as  brought  by  the  Von 
Moltlcc,  from  the  AYest  Indies,  ^vllich  anchored  betAyeen 
Forts  Barrancas  and  Pickens,  the  pilot  not  being  able 
to  bring  her  to  the  quarantine  station,  owing  to  the  ad- 
verse wind  and  tide.  It  is  currently  believed  that  a  boat 
from  Barrancas  with  enlisted  men  boarded  i\iQ  vessel 
during  the  night  to  obtain  liquor.  It  is  certainly  peculiar 
the  men  who  were  supposed  to  have  gone  on  board,  were 
the  first  to  have  taken  the  fever.  It  proved  to  be  of  a 
very  virulent  type,  and  spread  with  fearful  rapidity.  The 
commandant  of  the  Navy  Yard  making  a  call  on  the  citi- 
zens, they  responded  at  once,  and  formed  a  picket  guard, 
cutting  off  what  is  known  as  Tartar  Point,  and  extend- 
ing from  the  present  custom-house  station  to  Bayou 
Grande.  Not  a  case  of  yellow  fever  made  its  appearance 
in  the  adjacent  villages  or  the  Y^ard.  Pensacola,  having 
quarantined  against  Barrancas,  was  equally  fortunate. 

1897.     Cases,  4 ;  deaths,  1.  '       ■ 

FORT  JEFFERvSON. 

1873.  First  case,  August  24;  last  death,  October  6. 
Cases,  25;  deaths,  13. 


FLORIDA.  807 

FORT    PICKENS. 
1875.     Sporadic  cases.     No  statistics. 
GAINESVILLE. 

1871.     First  case  in  August.     No  statistics. 

1888.  Infected  bv  Jacksonville.  First  case,  Septem- 
ber 11,  terminating  fatally  on  the  17th ;  last  case,  Novem- 
ber 28.     Complete  statistics  lacking. 

GREEN   COVE    SPRINGS. 

1888.     Sporadic  cases. 

INDIAN    KEY. 

1841,  In  the  early  part  of  the  autumn  of  1841,  the 
brig  Jefferson,  from  Mobile,  Ala.,  where  a  mild  outbreak 
of  yellow  fever  was  in  progress,  landed  several  cases  at 
Indian  Key.     The  disease  did  not  spread. 

About  the  same  time,  the  schooner  Ostego,  "from  the 
west  coast  of  Florida,"  lost  several  of  her  crew  at  the 
Key  from  yellow  fever,  without  contaminating  the  in- 
habitants of  the  village. 

INTERLOCHEN. 

1887.  One  case,  October  7,  from  Tampa,  terminating 
fatally  on  the  13th. 

JACKSONVILLE. 

1857.     Severe    epidemic.       Probably    imported     from 
Havana  by  smugglers.     No  statistics. 
1877.     Epidemic.     No  statistics. 

1888.  First  case  in  a  man  from  Tampa,  Florida,  where 
"sporadic  cases"  had  been  observed,  and  who  was  taken 
ill  July  20.  A  severe  epidemic  resulted.  Complete  stat- 
istics not  given. 


808  HISTORY    or    YELLOW    FEVER. 

KEY    WEST.  ' 

1823.  Epidemic;  probably  imported  from  Havana. 
The  fever  was  so  fatal  among  the  United  States  troops 
stationed  at  the  place,  that  the  post  was  abandoned  by  the 
government  and  the  soldiers  removed  to  Pensacola. 

1824.  Mild  epidemic. 

1828.  Epidemic 

1829.  Population,  350.  The  epidemic  of  1829  was 
probably  imported  from  Cuba,  between  which  Island  and 
Key  West  much  smuggling  was  then  going  on,  as  the 
first  case  was  in  a  seaman  who  had  been  sent  ashore  from 
a  vessel  in  the  harbor.     Deaths,  26. 

1841.     Mild  outbreak.     No  statistics. 

1853,  Infected  by  Tampa.  First  case,  August  — ; 
first  death,  August  — .     Deaths,  2. 

1854.  Cases,  240;  deaths,  98. 

18G2.  Infected  by  Havana.  First  case,  June  20 ;  last 
case,  October  — .     Deaths,  75. 

1864;  1865;  1867.  Mild  manifestations  of  the  disease. 
No  statistics. 

1869.     Infected  by  Havana.     No  statistics. 

1875.  Population  10,000.  Infected  by  Kingston,  Ja- 
maica. First  case,  March  19 ;  first  death,  March  21 ;  last 
death,  August  11.     Deaths,  38. 

1876.  At  Quarantine:  Cases,  2;  deaths,  1.         I 
1878.     Population,  5,000.      Infected  by  New  Orleans. 

First  case,  July  10;  first  death,  July  11;  last  death,  Octo- 
ber 19.     Cases,' 162;  deaths,  20. 

1880.  Population,  12,000.  First  case,  July  16.  Deaths, 
34. 

1881.  First  case,  August  22;  first  death,  August  27. 
Deaths,  8. 

1887.  Infected  by  Havana.  First  case,  May  21;  first 
death,  May  23.     Cases,  283;  deaths,  64. 

1889.  Population,  25,000.  First  case,  September  21; 
last  case,  November  15.  Mild,  sporadic  manifestation. 
Cases,  7;  no  deaths. 

1890.  One  death.  ) 


FLORIDA.  809 

1892.  Cases,  0;  no  deaths. 

1893.  Cases,  2;  deaths,  2. 

1894.  A  few  eases  on  vessels  in  harbor.  No  cases  in 
town. 

1899.  Cases,  1,291;  deaths,  65. 

1900.  A  case  was  observed  as  earlv  as  January  8,  in 
the  person  of  a  civilian  employed  at  the  United  States 
Army  Post;  second  case,  January  16.  These  were  un- 
doubtedly "echoes"  of  the  epidemic  of  1899,  as  no  other 
cases  occurred  in  1900. 

1901.  Cases,  1. 

LIVE    OAK. 

1888.     Sporadic  cases. 

MACCLENNY. 

1888.     First  case,  August  8.     Cases,  338 ;  deaths,  23. 

MANATEE. 

1888.  Population,  200.  Infected  by  Tampa.  First 
case,  July  — ;  first  death,  July  20.     Cases  51. 

MANGO. 

1888.     First  case,  September  2.     Cases,  6 ;  deaths,  0. 
MANY   LAKES. 

1887.  Cases,  2 ;  deaths,  1. 

^lELLENVILLE. 

1888.  Cases,  2 ;  deaths,  0. 

MIAMI. 
1899.     Cases,  47 ;  deaths,  4. 


810  HISTORY    OF    YELLOW    FEVER. 

MICANOPY. 

188S.     Cases  among-  refugees. 

MILLLVIEW. 

1883.  Population,  300.  First  ease,  September  7;  last 
case,  September  10.     Cases,  70;  deaths,  12. 

MILTON. 

1853;  1855;  1869.  :\rild  outbreaks.  No  records  of 
cases  and  deaths. 

MOLINA. 

1883,  Infected  by  Pensacohi.  ]\rost  of  the  cases  oc- 
curred in  the  country  adjacent  to  Molina,  but  a  few  being 
observed  in  the  town. 

MULLET   KEY. 

1892.     Cases,  3 ;  deaths,  1. 

PALATKA. 

1887.  Infected  by  Tampa.  First  case,  October  7 ;  last 
case,  October  13.  Only  a  few  cases,  all  imported. 
Deaths,  1. 

PALMETTO. 

1888.  Population,  250.  Infected  by  Manatee.  First 
case,  November  19 ;  last  death,  November  23.  Cases,  85 ; 
deaths,  11. 

PENSACOLA. 

1764.  First  appearance  of  yellow  fever  in  Pensacola. 
No  record  of  cases  and  deaths. 


FLORIDA PENSACOLA.  811 

17G5.     Deaths,  125. 

1810;  1811.  Mild  epidemic.  No  record  of  cases  and 
deaths. 

1822.  Infected  by  Havana.  First  case,  August  12. 
Between  the  13th  and  20th  of  August,  20  deaths  occurred ; 
and  on  the  26th,  the  troops  abandoned  the  town  and 
encamped  on  a  dry  elevated  position  in  the  vicinity.  As 
some  men  were  necessarily  left  behind  to  guard  the  public 
property,  many  cases  occurred  among  them.  Three  med- 
ical officers,  Drs.  Elliott,  McMahon  and  Merrill,  were 
attacked,  the  tirst  of  whom  fell  a  victim  to  the  disease. 
Last  case,  October  10.     Deaths,  237. 

1824.  Deaths,  2. 

1825.  Yellow  fever  prevailed  to  a  considerable  extent 
in  Pensacola  during  the  summer  of  1827.  The  soldiers 
suffered  much.  Among  those  attacked  were  Paymaster 
Wright  and  his  whole  famih^,  his  assistant,  and  also  Dr. 
Lawson,  the  Army  Surgeon  of  the  post,  and  a  sergeant. 
No  record  of  cases  and  deaths. 

1828;  1829;  1830.  Severe  on  vessels  in  harbor;  only  a 
few  cases  in  town. 

1834.  First  case,  August  23.     Limited  outbreak. 

1835.  Sporadic  cases. 

1839.  Infected  by  New  Orleans  early  in  September. 
First  death,  September  5.  Several  doctors  died  during 
the  course  of  the  epidemic. 

1841;  1842;  1843;  1844;  1845;  1846.     Mild  outbreaks. 

1847.  Infected  by  United  States  frigate,  Mississippi, 
from  Vera  Cruz.     Limited  outbreak. 

1848.  Infected  by  ships  from  Vera  Cruz. 

1853.  In  July,  1853,  the  steamer  Vixen  arrived  at 
Pensacola  Navy  Yard  from  the  West  Indies,  both  officers 
and  men  suffering  severely  from  yellow  fever.  They  were 
at  once  sent  to  the  Naval  Hospital,  situated  about  one- 
half  mile  west  of  the  yard.  The  vessel  was  put  out  of 
commission,  hauled  along  side  one  of  the  yard  wharves, 
and  employes  were  sent  aboard  to  tallow  machinery  and 
clean  bilges.  These  men  were,  with  scarcely  an  exception, 
taken  sick  with  virulent  yellow  fever,  and  the  spread 


812  HISTORV     OF    VKLI.OW     FEVER. 

of  the  epidemic  could  be  distinctly  traced,  step  by  step, 
to  this  focus.  The  scourge  raged  with  fearful  violence 
from  the  latter  part  of  July  to  about  the  lOtli  of  October, 
carrying  off  about  200  victims  out  of  a  population  of 
only  1,200. 

1854.     Infected  by  ship  Yijcen,  from  Tampico,  Mexico. 
1858.     Sporadic  cases. 

1863.  Infected  l)y  Ignited  States  ordnance  supply  ves- 
sel Nigh  tin  f/alc.  At  the  time  tlie  Civil  AA'ar  was  iu  pro- 
gress and  there  were  some  4,500  people  in  the  town,  due 
to  a  heavy  influx  of  refugees,  besides  a  floating  population 
of  about  2,000  more.  It  is  impossible  to  estimate  the 
number  of  deaths,  but  the  havoc  caused  by  the  pestilence 
was  fearful,  it  being  a  common  occurrence  to  see  four 
or  five  coffins  carried  in  a  graveyard  in  an  oxen-team, 
the  only  available  conveyance  at  the  time.  Most  of  the 
men  belonging  to  the  mortar  fleet  were  camped  on  the 
island,  and  it  is  said  that  more  than  200  people  were 
buried  there.  The  fever  was  of  a  virulent  kind,  which 
did  not  spare  the  acclimated  portion  of  the  community. 
Strange  to  relate  at  that  time  there  were  about  3,000 
troops  stationed  at  and  about  Barrancas,  and  not  a  case 
of  fever  occurred  at  that  point,  owing  to  a  strict  quaran- 
tine picket  being  kept  by  cavalry  extending  from  the 
hospital  to  the  bayou,  men  being  close  enough  to  hail  one 
another. 

1867.  Infected  by  Jamaica.  The  United  States  gun- 
boats TacoHji  and  Yiircn  were  at  the  Xavy  Yard  at  the 
time.  The  officers  and  men  had  free  intercourse  with 
Pensacola,  little  suspecting  the  danger  to  which  they  were 
exposing  themselves,  until  two  men  belonging  to  the 
TfU'0)if/.  who  had  been  on  liberty  and  in  Pensacola,  were 
taken  sick  with  yellow  fever.  The  infection  spread  i"^p- 
idly.  The  total  number  of  cases  could  not  be  ascertained, 
but  the  deaths  were  227. 

1873.  Infected  by  Havana.  First  case,  August  5;  last 
case,  October  15.     Cases,  600;  deaths,  62. 

1874.  Population,    3,347.       Number   who    fled,    1,947. 


FLORIDA.  813 

Infected  by  Havana.       First  case,  August  17;  last  case, 
November  9.     Deaths,  354. 

1878.  Popnlation,  5,000.  American  brig-  J.  A'.  Bar, 
from  Cuban  ports,  arrived  August  17  with  the  mate  dead 
and  crew  sick  with  yellow  fever.  The  cases  were  seciues- 
tered,  and  Pensacola  escaped  an  invasion. 

1882.  Infected  by  bark  SnJrfa,  from  ^Matanza.  I'irst 
case,  August  8 ;  tirst  death,  August  26 ;  last  case,  'Novem- 
ber 2();  last  death,  November  2o!  Crises,  2,351 ;  deaths,  108. 

1883.  The  Pensacola  Navy  Yard  was  infected  by 
Havana,  the  first  case  erupting  May  27 ;  first  death,  June 
2.  From  this  focus,  the  fever  was  carried  to  Pensacola. 
The  first  case  being  reported  August  5,  and  the  first 
death  on  the  11th.    Vjases,  201;  deaths,  31. 

1881.  Sporadic  cases. 

1891.  (\ases,  2;  deaths,  1. 

1893.  (^ases,  2. 

1897.^  One  fatal  case  at  Quarantine. 

1905.  Cases,  564;  deaths,  81. 

•  PLANT    CITY. 

1887.  Population,  300.  Infected  by  Tampa.  First 
case,  Octolier  — ;  first  death,  November  14;  last  case, 
August  18. 

1888.  Population,  300.  Number  who  fled,  100.  First 
case,  June  — ;  first  death,  June  22;  last  case,  August  18. 
Deaths,  21. 

PROGKESO. 

1887.     First  cas(-,  Se])tember  30.     Cases,  0;  deaths,  1. 
SANFOIM). 

1887.  Infected  by  Tamjia.  I^irst  case,  October  8. 
Cases,  150;  deaths,  8. 

1888.  Among  refugees.  No  record  of  cases  and  deaths. 

1889.  Population,  3,000.  An  imixnted  <ase  died  April 
23. 


8  14  HISTORY    OF    YELLOW    FEVER. 

ST.    AUGUSTINE. 

1807.     First  iuvasion  by  yellow  fever.     No  statistics. 
1819,     Mild  epideniie.     No  record  of  cases  and  deaths. 

1821.  Infected  bv   Havana.       First   case   in  August. 
Deaths,  140. 

1838.  .  Mild  outbreak.     No  record  of  case  and  deaths. 

1839.  Infected  by  Charleston.     First  case,  August  15. 
No  statistics. 

1841.     Infected  by  Havana.     Deaths,  26. 
1877.     Infected  by  Fernandina.     First  case,  November 
9.     Cases,  250 ;  deaths,  50. 

ST.    JOSEPH. 

1841.     Sporadic  cases.     No  statistics. 

ST.    MARKS. 

1822.  First  cases  in  August.     Cases,  68;  deaths,  5. 

SUWANEE. 

1835.  A  few  cases.     No  record. 

1836.  First  case,  August  — ;  last  case,  November,  10. 

TALLAHASSEE. 

1841.     Infected   by   refugees   from    "towns   along   the 
coast.-'     No  record  of  cases  and  deaths. 

1867.     A  fatal  case  in  Sei)t('nib(T.     Source  pf  infection 
not  stated. 

TAMI»A. 

1839.  Sporadic  cases.     No  record. 

1871.  Infected  by  Havana.     No  statistics. 

1887.  October  7.'     Cases,  400 ;  deaths,  75. 

1888.  Last  case,  December  3;  deaths,  10. 

1899.  A  fatal  case;  imported. 

1900.  Kefugees.     No  records  of  cases  and  deaths. 
1905.     One  case;  imported. 


FLORIDA.  815 

TORTUGAS. 

1862.  Deaths,  4. 

1867.  First  case,  July  4.     Deaths,  38. 

1898.  Cases,  5;  deaths,  0. 

1897.  At  quarantine.     No  record  of  cases  and  deaths. 

WARRINGTON. 

1874.     Ropulatiou,  1,000.     Deaths,  13. 

1883.     Infected  by  Pensacola.     Sporadic  cases. 

WOOLSEY. 

1874.     Population,  1,000.     Deaths,  14. 

1883.     Infected  hy  Pensacola.     Sporadic  cases. 

BIBLIOGRAPHY   OF   YELLOW    FEVER    IN    FLORIDA. 
GENERAL. 

Epidemic  of  Yellow  Fever  in  Florida.  Rep.  Superv.  Surg.-Gen.  Mar. 
Hosp.     Wash,  1888,  p.  24,  4pl.  Imap. 

Gibier  (P):  Investigaciones  sobre  la  Fiebre  Amarilla.  (Segunda 
Serie.,  Epidemia  de  Florida,  1888.)  Cron.  Med.  Quir.  de  la  Habana, 
vol..  15,  p.  62. 

Holt  (Joseph):  A  Letter  upon  the  Causes  of  the  Introduction  of 
Yellow  Fever  in  Florida,  and  Advice  as  to  Disinfection  and  Sanitation. 
8°.    (New  Orleans,  1888.) 

BARRANCAS. 

Herron  (J.  S.) :  Yellow  fever  at  Barrancas,  near  Pensacola,  Fla., 
in  1875.     Rep.  Superv.  Surg.  Mar.  Hops.,  1874-5,  Wash.,  1876,  139-143. 

FERDINANDA. 

Horsey  (C.  W.) :  Report  of  the  epidemic  of  yellow  fever  at  Fernan- 
dina,  Fla.,  in  August,  September  and  October,  1877,  Proc,  Fla.,  M. 
Assn.,  1878,  p.  51. 

Maxwell  (G.  T.) :  Yellow  Fever  Epidemic  of  1887  and  1888  in  Florida; 
Testimony  of  Dr.  George  Troup  Maxwell;  Correspondence  with  Prof. 
Joseph  Jones,  Virginia  Med.  Monthly,  Richmond,  1889-90,  vol.  16, 
p.  266. 


8)6  HISTORY     OK     VKLLOW     FEVKR. 

Murray  (R.  I).):  Yellow  fever  epidemic  at  Fernandina.  Rep.  Superv. 
Surg.   Mar.   Hosp.,  Washington,  1878-9,  pp.  191-199. 

Ross  (J.  W.) :  The  yellow  fever  at  Fernandina.  Rep.  Superv.  Suig.- 
Gen.  Mar.  Hosp.,  Wash,  1888-9,  p.  76. 

Starbuck:  Notes  on  the  Epidemic  of  Yellow  Fever  at  Fernandina, 
Fla.     Rep.  Superv.  Surg.-Gen.  Mar.  Hospital,  Wash,  1888-9,  p.  83. 

GAINESVILLE. 

Martin    (W.):    The  Yellow  Fever  at  Gainesville,   Fla.     Rep.   Superv. 
Surg.-Gen.  Mar.  Hosp.     Wash,  1889,  p.  85. 
McKinstry  (J.):  Yellow  Fever  as  Observed  in  Gainesville  Epidemic, 

1888.  Proc.  Fla.  Med.  Assn.,  Jacksonville,  1889,  p.  43. 

Voyle  (J) :  The  Epidemic  of  Yellow  Fever  at  Gainesville,  Fla.,  and 
Deductions    Therefrom.      Proc.    Quarant.    Confer.,    Montgomery,    Ala., 

1889,  p.  71. 

JACKSONVILLE. 

Daniel  (R.  P.):  Report  on  Yellow  Fever  in  Jacksonville,  Fla.,  in 
1877.     Proc.  Fla.  M.  Assn.,  1878,  p.  23. 

Daniel  (R.  P.) :  Epidemic  in  Jacksonville,  Fla.,  1888.  Proc.  Fla. 
Med.  Assn.,  Jacksonville,  1888,  p.  57. 

Jones  (Joseph) :  Scientific  inquiries  with  reference  to  the  Yellow 
Fever  Epidemic  in  1888,  in  Jacksonville,  Fla.,  Addresses  to  several 
Physicians  engaged  in  its  Treatment,  with  replies  thereto.  Atlanta 
Med.  and  Surg.  Jl.,  1889-90,  n.  s.  vol.  6,  p.  387. 

Mitchell  (S.)  Remark.3  upon  the  Yellow  Fever  Epidemic  of  1888,  at 
Jacksonville,  Fla.,  N.  Y.  Med.  Jl.,  1889,  vol.  49,  p.  305. 

Stout  (H.  R.) :  The  Epidemic  of  Yellow  Fever  at  Jacksonville,  Fla., 
in  1888,  N.  Am.  Jl.,  Homocop,,  N.  Y.  1890,  3  s.  vol.  5,  p.  428. 

KEY  WEST. 

Annual  Report  Sup.  Surg.-Gen.  V.  S.  Army,  1875,  p.  120.  (Daily 
mortality  in  Key  West  in  1875). 

Bemiss  (S.  M.) :  Yellow  Fever  at  Key  West,  Fla.  Rep.  Nat.  Bd. 
Health,  1881,  Wash.,  1882,  vol.  3,  p.  281. 

Dupre  (C.  C):  On  the  Yellow  Fever  of  Key  West,  East  Florida. 
American  Journal  of  Medical  Sciences,  N.  S.  vol.  2,  p.  380. 

Guiteras  (J):  Some  observations  on  the  Natural  History  of 
Epidemics  of  Yellow  Fever,  based  on  a  Study  on  the  Mortality 
Statistics  of  the  City  of  Key  West;  also  a  plea  in  favor  of  a  continued 
investigation  of  this  disease  by  the  Government  of  the  United  States. 
Rep.  Superv.  Surg.-Gen.  Mar.  Hosp,,  Wash.,  1S88,  p.  75. 


FLORIDA.  817 

Maxwoll  (G.  T.):  Letter  describing  the  yellow  fever  as  it  appeared 
at  Newport,  Fla.,  in  1853,  and  Key  West,  Fla.,  in  1857..  Charleston  M. 
J.  &  Rev.,  1874,  vol.  2,  pp.  145-150. 

Moreno  (M.  R.):  Our  Board  of  Health  and  Yellow  Fever.  Key 
West,  Fla.,  June  9,  1SS7.  The  Evening  Call,  Key  West,  Fla.,  June  10, 
1887. 

Perry  (R.  J.) :  Yellow  Fever  at  Key  West,  Fla.,  1878.  Hyg.  &  M.  Rep. 
U.  S.  Navj',  Wash.,  1879,  vol.  4,  p.  729. 

Sampson:  Med.  Statistics  U.  S.  Army,  1839-1P55,  p.  323. 

Tickuor:  An  Account  of  the  Yellow  Fe-ver  which  prevailed  at 
Thompson's  Island  in  t^e  year  1824.  North  .American  Med  and  Surg. 
Journal,  vol.  3,  p.  313;  vol.  4,  p.  1. 

MACCLENNY. 

Posey  (J,  L«.):  Yellow  Fever  at  Macclenny,  Fla.  Rep.  Superv.  Surg.- 
Gen.  Mar.  Hosp.,  Wash.,  1889,  p.  96. 

MANATEE. 

Wall  (J.  P.) :  The  yellow  fever  in  Tampa,  Plant  City,  Manatee  and 
Palmetto.     Rep.  Superv.  Surg-Gen.  Mar.  Hosp.,  Wash.,  1889,  p.  60. 

MILLVIEW. 

Anderson  (W.  E.):  Yellow  fever  epidemic  at  Millview,  Fla.,  1883. 
Rep.  Bd.  Health  Ala.,  1883-4,  Montgomery,  1885,  p..  113.  Also:  Tr.  M 
Assn.  Ala.,  Montgomery,  1884,  vol.  36,  p.  236. 

PENSACOLA. 

Blount:  Yellow  Fever  on  Ship  Emma  Payzaht.  Med.  Record,  N.  Y., 
1881,  vol.  20,  p.   112. 

Boston  Medical  &  Surg.  Jl.,  1834,  vol.  11,  p.  153. 

Bouvier  (E.):  Yellow  Fever  in  Pensacola.  Proc.  Fla.  Med.  Assn., 
1886,  p.  36. 

Bouvier  (E):  Sanitary  condition  of  the  city  of  Pensacola  and 
vicinity,  1883;  report  of  some  sporadic  cases  of  yellow  fever,  of 
hygienic  measures  adopted  on  quarantine  and  sanitary  cordons,  pend- 
ing the  p.eriod  from  1st  of  April  to  the  15th  of  November,  1883,  in  the 
city  of  Pensacola,  Fla.,  and  in  it;5  vicinity.  Rep.  Superv.  Surg.-Gen. 
Mar  Hosp.,  Wash.,  1883-4,  p.  251. 

Cochran:  (Epidemic  of  1873).  Trans.  Ala.  State  Med.  Assn.,  1874, 
pp.  113,  126. 

Cochran  (J):  Report  on  yellow  fever  in  Pensacola  in  1883.  Rep. 
Bd.  Health  Ala.,  1883-4,  Montgomery,  1885,  i;.  96.     Also:   Tr.  M.  Assa. 


818  HISTORY     OF      YEM.OW     FEVKR. 

Ala.     Montgomery,  1884,  vol.  36,  p.  206,  233. 

Do  well:  Yellow  Fever  and  Malarial  Diseases  (Phila.,  1876),  p.  41. 

Gibbs  (B.  F.):  Account  of  the  epidemic  .?f  yellow  fever  which 
visited  Pensacola  navy-yard  in  the  summer  an.l  autumn  of  1863.  Aoi. 
J.  M.  Sc,  Phila.,  1866,  n.  s.,  vol.   51,  p.  340. 

Guiteras  (D.  M.) :  Notes  on  tlii  yellow  fevur  at  Pensacola  in  1883. 
Proc.  Naval  Med.  Soc,  Wash.,  1882-4,  vol.  1,  p.  '>';. 

Hargis  (R.  B.  S.) :  Yellow  fever  epidemic  at  Pensacola.  N.  O.  M.  & 
Surg.  Jl.,  1873-4,  n.  s.,  vol.  1,  p.  781. 

Hargis  (R.  B.  S.) :  The  Pensacola  yellow  fever  empidemic  of  188?. 
Am.  Pub.  Health  Assn.,  Rep.  1883,  Concord,  N.  H.,  1884,  vol.  9,  p.  306. 

Heiron  (J.  S.) :  Yellow  fever  at  Pensacola  in  1874.  Rep.  Superv. 
Surg.  Mar.  Hosp.,  Wash.,  1873-4,  p.  ]95. 

Martin  (W.) :  Conclusions  as  to  the  outbreak  of  yellow  fever  -it 
Pensacola  in  1882.    Proc.  Naval  Med.  Soc,  Wayh..  1882-4,  vol.  1,  p.  168. 

Porter  (J.  G.) :  Yellow  fever  in  Tampa  and  Pensacola,  Florida,  190l* 
Rep.  Surg.-Gen.  U.  S.  P.  H.  &  M.  H.  Service  for  1906  (Wash.,  1907), 
p.  173. 

Report  on  Yellow  Fever  and  Quaiantine;  visit  to  Pensacola.  Tr.  M. 
Assn.  Ala.,  Montgomery,  1883,  p.  144. 

Report  of  the  outbreak  of  the  yellcw  fever  epidemic  at  the  nav.'.l 
station,  Pensacola,  Florida,  1807.  Med.  &  Surg.  Reporter,  Phila  ,  186S. 
vol.17,  p..  227. 

Sternberg  (G.  M.):  Yellow  fever  in  Pensaccli,  Fla.,  in  1873,  1871, 
and  1875.    Am.  Pub.  Health  Assn.  Rep.  1875,  >'.  Y.,  1876,  vol.  2,  p.  46 ». 

Townsend  (P.  S.) :  Account  of  the  Introduction  of  the  Yellow  Feve- 
into  Pensacola  and  New  Orleans  in  the  year  1822.  Mew  York  Medicp.l 
and  Physical  Journal,  vol.  2,  p.  315. 

Tryon  (J.  R. ):  Epidemic  of  yellow  fever  at  the  navy  yard,  Pensaco  a, 
Fla.,  during  the  summer  and  fall  of  1S74.  San.  &  M.  Rep.  U.  S.  Na'/y 
1873-4,  Wash.,  1875,  p.  451. 

The  Yellow  fever  at  Pensacola  (1SS2).  Med  News,  Phila.,  1883,  vol 
13,  p.  233. 

Yellow  Fever  at  Pensacola.  Proc.  Fla.  Med.  Assn.,  Jacksonville, 
1886,  p.  36. 

Wilson  (J)  et  al.:  Report  of  a  naval  medical  board  to  investigate  the 
circumstances  connected  with  the  visitation  of  yellow  fever  at  navy 
yard,  Pensacola.    Hyg.  &  M.  Rep.  U.  S.  Navy,  Wash.,  1879,  vol.  4,  p.  699, 

PALMETTO. 
AVall.  J.  P.:    (Loc.  cit.) 

PLANT  CITY. 

United  States  Congress.  Senate.  ..A.  bill  for  the  relief  of  Wm.  P. 
Head,   of  Plant   City,   Fla.    (Compensation   for  loss   destroyed   by  fl  e 


FLORIDA.  819 

while  in  possession  of  the  Mar.  Hosp.  Board,  whilst  being  fumiga'.o'i 
in  the  Summer  of  18SS,  for  the  purpose  of  eradicating  the  germs  of 
Yellow  Fever.)      51st  Cong.,   1st  Sess.    S.   1746.     Jan.   6,  1890,  Intrcd. 
by  Mr.  Pa.sco.     Roy.    Svo.    (Wash.,  1S90.) 
Wall.  J.  P.:    (Loc.  cit.) 

SAINT  AUGUSTINE. 

Strobel,  p.  131. 

SAINT  JOSEPH. 

Boston  Med.  &  Surg.  Jl.,  IS—,  vol.  i;5,  p.  17. 

TAMPA. 

Porter,  J.  G. :   (Loc.  cit.) 

Raymond,  H.   I.:    Yellow  Fever  at  Camp  Tampa  HeighlT.     Medir-n 
News  (1898),  vol.  72,  p.  683. 
Wall.  J.  P.:    (Loc.  cit.) 


\ 


GEORGIA. 

4TLANTA. 

1870.     A  few  rases,  refugees  from  Savaiiuah. 
1S07.     Refugees.     Cases,  3;  deaths,  0. 
1905.     One  fata]  cai^e,  a  refugee. 

AUGUSTA. 

1825.  At  arsenal.  Cases,  31 ;  deaths,  7.  No  diffusion 
of  the  disease. 

1830.  During  the  summer  of  1839,  most  of  the  cities 
of  the  Soutliern  States  suffered  severely  from  yellow  fever. 
Although  the  citv  of  Augusta  experienced  its  worst  rav- 
ages, the  garrison  of  this  post,  with  the  exception  of  one 
case,  was  exempt  from  the  fatal  epidemic.  This  man 
passed  a  night  in  the  city,  in  a  state  of  intoxication. 

In  regard  to  the  origin  of  this  epidemic  which  hegan 
in  July,  much  diversity  of  opinion,  as  has  been  found  to 
obtain  at  all  periods  existed.  A  committee  consisting  <»f 
pliysicians  of  August,  by  whom  the  question  of  its  origin 
and  cause  Avas  carefully  investigated,  reported  that  the 
disease  was  of  domestic  origin,  a  tenet  which  cannot  be 
countenanced  at  the  present  day,  but  which  was  seriously 
accepted  then.  The  /oy/.s-  ct  0////0  niali  was  traced  to  a 
point  called  "trash  wharf,"  a  slide  or  inclined  plane, 
erected  in  1834,  for  the  purpose  of  throwing  the  filth  of 
the  city,  including  dead  animals,  into  the  river.  This 
mass  of  animal  and  vegetable  matter  having  accumulated 
to  the  upwards  of  200,011(1  cubic  feet,  it  was  resolved  by 
the  autlu!riti(s  of  the  <-ity  to  have  it  removed.  Accord- 
ingly, during  the  months  of  ^fay  and  June,  "its  interior 
was  exposed  to  the  action  of  the  sun."  Having  penetrated 
the  exterior  crust,  tlie  heat  evolved  was  so  great  tliat  the 
workmen,  although  wearing  thick  slioes,  were  compelled 
to  desist  from  their  work,  '"for  two  hours  at  a  time,  so  as 
to  suffer  it  to  cool." 


I 


GEORGIA.  821 

The  excayatioii  of  this  trash  heap  was  giyen  by  the 
Commission  as  the  cause  of  the  epidemic,  but  we  are  more 
prone  to  accuse  the  proverbial  "ship  from  the  West 
Indies,"     The  number  of  cases  and  deaths  is  not  stated. 

1854.     A  few  imported  cases. 

1876.  Infected  by  refugees  from  Savannah.  Outbreak 
not  general,  but  confined  to  persons  residing  in  the  neigh- 
borhood of  the  railroad  freight  3  ards.  Cases,  20 ;  deaths,  4. 

BLACKSHEAR. 
1887.     One  case;  imported 

BAINBRIDGE. 
1873.     Sporadic  cases. 

BRUNSWICK. 

1870.  Infected  by  Havana.  First  case,  August  20; 
first  death,  August  21.     Deaths,  112. 

1881.     A  few  cases  at  Quarantine. 

1890.  There  is  no  "official''  record  of  the  prevalence 
of  yellow  fever  in  Brunswick  in  1890,  but  during  the  ex- 
amination of  the  mortuary  records  of  the  town  by  officials 
of  the  United  States  Marine  Hospital  Service  in  con- 
nection Avith  the  yellow  fever  epidemic  there  in  1893,  it 
was  demonstrated,  by  the  peculiar  "jumps"  in  the  mor- 
tality, that  the  disease  had  prevailed  in  Brunswick  in 
1890,  and  had  been  kept  concealed.  Not  only  did  the 
mortuary  records  show  this,  though  the  cases  were  not 
diagnosed  as  yellow  fever,  but  evidence  of  creditable  cit- 
izens was  obtained  to  this  effect;  and  reliable  testimony, 
that  one  of  the  physicians  of  Brunswick  liad  made  the 
statement  in  the  fall  of  1890,  that  yellow  fever  was  pre- 
valent— almost  epidemic — and  "if  the  Lord  did  not  send 
a  frost  soon,  it  would  be  impossil)le  for  them  longer  to 
conceal  it."  It  is  known  now  that  yellow  fever  had  ex- 
isted in  1893,  a  month  prior  to  its  being  declared  epidemic. 

1893.     The  America.i  barkentine  Anita  Bcnciiid,  from 


822  HISTOR^    OF  yellow   fever. 

Havana,  arrived  at  the  Brunswick  quarantine — jiood  san- 
itary history— June  15,  1893.  Cleared  June  10,  1893, 
presumably  three  days  after  disinfection.  The  master, 
who  is  said  to  have  been  feeling  badly  before  leaving, 
was  in  Brunswick.  The  vessel  reached  Conquest's  wharf 
on  the  Satilla  (only  a  wharf  with  no  people  living  there) 
on  the  20th,  on  tlie  evening  of  which  day  the  master  took 
to  his  bed.  On  June  21  he  was  moved  to  Conquest  Camp, 
a  cross-tie  camp,  8  miles  distant  from  Brunswick,  where 
he  died  on  June  25.  Diagnosis  during  sickness  and  an 
autopsy  by  Dr.  Dunwoody,  yellow  fever. 

Two  colored  women  nursed  the  patient  and  several 
men  were  especially  exposed  towards  the  last  of  his  life 
and  after  death;  Drs.  Atkinson  and  McKinnon  attended 
him.  ^Y^th  the  exception  of  burning  the  mattress  and 
bedding,  no  disinfection  worth  anything  was  practiced, 
and  there  was  no  isolation  save  what  the  fears  of  the 
people  compelled;  the  two  nurses  sleeping  in  the  house 
and  circulating  freely  among  the  others.  There  were  73 
persons  in  the  camp,  living  in  small  houses  scattered 
through  the  brush. 

Suspicious  cases  subsequently  erupted  in  the  vicinity, 
and  there  undoubtedly  were  cases  in  Brunswick,  but  it 
was  only  on  September  9,  when  Surgeon  Brenham,  of  the 
United  Slates  Marine  Hospital  Service,  was  taken  ill  and 
his  case  diagnosed  yellow  fever,  that  the  disease  was 
officially  declared  present  in  the  town.  The  first  death 
among  the  inhabitants  of  Brunswick  r<'])orted  as  yellow 
fever  took  place  Sei)tember  13.  Dr.  Brenham  died  on 
the  20th.  Te  fever  was  not  of  a  virulent  character,  for 
out  of  1,001  reported  cases,  only  53  died — 40  whites,  12 
negroes  and  1  Mongolian.  A  notable  feature  of  this  epi- 
demic was  the  unusual  mortality  among  the  blacks. 

1894.     At  quarantine,  two  deaths. 

1897.     A  few  cases  at  quarantine. 

1899.     Cases  at  quarantine. 


GEORGIA.  823 

CONQUEST   CAMP. 

{Sec  Bniii.sa-ick,  1893). 

DARIEN. 

1S7G.  Infected  bj  Doboy.  First  case,  September  26; 
last  death,  November  7.     Cases,  8;  deaths,  2, 

1879.  On  bark  Caspiau,  from  Havana.  First  case, 
August  24;  last  case,  August  24.     Cases,  4;  no  details. 

I)  ALTON. 

1878.  Infected  by  Chattanooga,  Tenn.  First  case,  Oc- 
(obor  2,  terminating  in  death  on  the  4th.  Cases,  3; 
deaths,  3. 

BOBOY    ISLAND. 

187(3.  Infected  by  bark  Valentine,  from  Havana.  No 
record  of  cases  and  deaths. 

FORT  OGLETHORPE. 

1828.     Deaths,  10. 

ISLE    OF    HOPE. 

1876.  The  Isle  of  Hope  is  ten  miles  southeast  of  Savan- 
nah, with  which  city  it  is  in  constant  railroad  communi- 
cation. It  has  always  been  considered  a  place  of  refuge 
during  seasons  of  epidemic  influence;  in  1876  at  least 
three  thousand  individuals  were  added  to  its  population. 
The  first  case  of  yellow  fever  which  occurred  in  this 
locality  in  1876  was  in  the  person  of  a  man  named  De 
Gauge,  a  refugee  from  Savannah.  This  man  slept  on  the 
Island,  but  spent  each  day  in  the  city.  He  died  about  the 
22nd  of  September.  The  second  case  was  in  the  person 
of  a  man  named  Grover,  also  a  refugee  from  Savannah, 
who  only  slept  on  the  island.     He  died  on  the  23rd  of 


824  HISTORY     OF     YELLOW     FEVER. 

September.       From  these  cases  the  disease  spread,  and 
many  fatal  eases  occurred. 

Opposite  the  Isle  of  Hope,  and  at  but  a  comparatively 
short  distance  from  the  houses  in  which  the  epidemic  in- 
fluence was  most  strongly  exihibited,  is  the  celebrated 
Bethesda  School,  at  one  time  so  dear  to  the  heart  of 
John  Wesley.  At  this  point  a  considerable  number  of 
persons  were  congregated,  but  no  case  of  the  disease 
occurred. 

JEKYL    ISLAND. 

1893.     Imported  cases. 

JESUP. 
1893.     Sporadic  cases;  imported. 

^[ACON. 

f 

1876.  Early  in  October  two  cases  of  yellow  fever  oc- 
curred in  the  persons  of  employees  of  a  Macon  cotton 
ginnery.  At  the  residences  of  these  persons  were  sev- 
ei-al  refugees  from  Savannah.  Both  of  these  cases  died 
with  black  vomit.  After  these  deaths  occurred,  the 
refugees  removed  to  other  portions  of  the  city,  where  they 
were  subsequently  taken  with  the  disease,  and  in  one  in- 
stance a  fatal  case  again  occurred  from  their  presence. 
During  the  prevalence  of  this  slight  outbreak,  the  greatest 
number  of  cases  occurred  on  the  two  blocks  between 
Fourth  and  Fifth  Streets,  and  Pine  and  Oglethorpe 
Streets,  immediately  in  front  of  the  Southwestern  Kail- 
road  depot,  at  which  all  freight  from  Savannah  was  re- 
ceived and  delivered.  A  few  cases  occurred  in  the  vicinity 
of  the  Macon  and  Brunswick  Bailroad  depots,  and  other 
sporadic  cases  in  the  vicinity  of  the  railroad  yards. 

OLIVER   STATION. 

1876.  During  the  epidemic  in  Savannah,  a  case  oc- 
curred at  Oliver  Station,  on  the  Georgia  Central  Rail- 


GEORGIA.  825 

road.  For  the  accommodation  of  the  Central  Railroad 
employees  and  the  citizens  of  Savannah  during  the  epi- 
demic, a  daily  train  was  run  to  this  station,  Avhich  is 
some  forty  odd  miles  from  the  city.  The  train  remained 
at  Oliver  over  night  and  returned  to  the  city  in  the 
morning. 

On  the  night  of  September  10,  a  man  named  Lufburrow 
slept  on  board  this  train,  and  on  the  16th  Avas  suddenly 
taken  with  yellow  fever,  of  which  he  died  on  the  21st. 
This  man  had  not  been  to  the  citj^,  and  the  only  contact 
which  he  had  with  infection  was  on  the  night  he  slept 
in  the  cars. 

Two  cases  of  the  disease  occurred  ^mong  some  Ignited 
States  troops  who  were  encamped  at  this  point,  having 
evacuated  their  barracks  in  Savannah  on  account  of  the 
epidemic,  but  on  other  cases  occurred  in  the  locality. 

SAVANNAH. 

1801 ;  1807 ;  1808.     Mild  epidemics.     No  records. 

1817.  Cases  were  observed  earlier  than  usual  in  1817, 
and  by  July  the  disease  was  epidemic.  No  record  of 
cases  and  deaths. 

1818.  Mild  outbreaks. 

1819.  The  epidemic  of  1819  made  its  appearance  in  the 
latter  part  of  June,  and  went  on  increasing  in  extent  and 
destructiveness,  until  the  frost  came  and  ended  it. 

1820.  Population,  5,000.  The  disease  made  its  appear- 
ance in  May.  A  death  occurred  on  the  7th,  another  on 
the  10th,  and  another  on  the  30th  of  that  month.  In  June, 
the  mortality  was  augmented  to  a  death  on  every  second 
day,  and  the  whole  sum,  at  the  end  of  the  month, 
amounted  to  11.  In  July,  the  number  of  deaths  ran  up 
to  39,  being  an  advance  to  more  than  double  the  devasta- 
tion of  June.  In  August,  it  amounted  to  111;  in  Sep- 
tember, to  241;  in  October,  to  208;  in  November,  to  50, 
and  in  December,  to  3.  The  degree  of  mortality,  on  the 
surface  of  tliis  statement,  appears  to  have  undergone  a 
gradual  reduction  after  the  month  of  September.       But 


8t6  HISTORY    OF    VLELOW    FEVKR. 

when  it  is  considered,  tliat,  in  the  course  of  this  period, 
tlie  population  liad  l)een  srci^tly  diminished  by  absence 
and  death,  it  becomes  evident,  that,  so  far  from  havinj? 
sustained  any  diminuition,  it  was  really  increased 
throughout  the  month  of  October.  The  whole  aggxegate 
of  deaths  resulting  from  the  epidemic,  from  its  commence- 
ment in  May,  to  its  conclusion  in  December,  was  at  GG6. 

When  the  epidemic  first  appeared  in  ^lay,  the  jiopula- 
tion  of  Savannah  was  computed  at  5,000  whites.  In 
June,  and  beginning  of  July,  it  was  probably  reduced, 
from  emigration,  to  2,500 ;  and,  en  the  14:th  of  September, 
when  the  ^Mayor's  proclamation  was  ])ul)lished,  the  num- 
ber was  still  further  reduced,  and  could  not  have  exceeded 
1,500.  The  medial  population,  therefore,  of  white  inhab- 
itants, may  be  fairly  estimated  at  3,000,  for  the  whole 
season ;  which  would  constitute  a  sum  of  mortality 
amounting  to  one  in  five. 

1821;  1827;  1831;  1839;  1850.  Epidemics  of  more  or 
less  intensity.     Xo  authentic  records, 

1852.  Deaths,  19. 

1853.  Sporadic  cases. 

1854.  The  first  case  of  yellow  fever  to  precede  the  epi- 
demic of  1854,  occurred  on  August  5,  at  the  corner  of 
Lincoln  and  Broughton  Streets.  Regarded  merely  as  a 
sporadic  case,  it  was  not  reported  as  yellow  fever,  and  no 
precautions  were  taken.  Between  that  date  and  the  mid- 
dle of  the  month,  a  few  more  cases  occurred,  but  the 
health  authorities  remained  inactive,  scoffinf!;  the  idea  of 
the  disease  becoming  epidemic.  Soon  after  that  date, 
cases  manifested  themselves  in  almost  every  quarter  of 
the  town  and  the  pestilence  soon  swept  with  fearful  deso- 
lation over  the  entire  city.  Following  is  a  record  of  the 
deaths : 

August    132 

Septend)er 381 

October 67 

Total 580 


GEORGIA.  827 

Xotwitlistanding  the  large  negro  population  of  Savan- 
nah at  the  time,  only  about  15  of  that  race  died  from 
yellow  fever  during  the  epidemic. 

The  disease  exhibited  its  greatest  violence  from  the 
20th  of  August  to  the  20th  of  September,  having  com- 
menced as  an  epidemic  in  the.  northeastern  part  of  the 
citj;  it  advanced  directly  to  the  southwest,  spreading 
north  and  south  until  its  influence  was  felt  in  ever^'  part 
of  the  city. 

The  infection  is  said  to  have  been  brought  from  Havana 
by  the  brig  Charlotte  Hague. 

1858.     Sporadic  cases. 

1876.  The  jear  187(1  witnessed  the  most  mortal  epi- 
demic of  yellow  fever  which  has  ever  visited  Savannah. 
Between  August  21,  the  date  of  the  first  recorded  death, 
to  December  1,  when  the  last  death  took  place,  the  pestil- 
ence x-arried  off  1,066  persons,  of  which  809  were  white 
and  257  black. 

The  infection  is  said  to  have  been  brought  by  a  vessel 
from  Havana,  either  the  brig  Ynes  (which  arrived  on 
July  16),  the  bark  Maria,  (July  17),  or  the  brig  Pepe 
(August  2).  But  which  of  these  was  the  active  agent  of 
transmission,  has  never  been  definitely  settled. 

The  first  recorded  death  from  yellow  fever  occurred  on 
August  21,  on  Wright  Street,  a  short  ciil  de  .mc,  about 
fifty  yards  long,  the  culmination  of  Bryan  Street,  in  the 
northeastern  part  of  the  city.  The  second  occurred  in 
the  same  street  and  same  locality,  August  22.  The  third 
and  fourth,  August  26,  same  locality..  The  fifth,  August 
26,  on  East  Broad  Street,  two  doors  north  of  Broughton ; 
the  sixth,  August  27,  on  Reynolds  Street,  next  to  Gas 
House;  the  serenth,  August  27,  on  Broughton  Street, 
three  doors  west  of  Reynolds ;  the  eighth,  August  27,  on 
East  Boundary  Street,  north  end;  the  ninth,  August  27, 
on  Randolph  and  President  Streets. 

On  August  28,  five  deaths  were  recorded,  one  on  Stone 
Street,  one  on  State  Street,  between  Whitaker  and  Bar- 
nard, and  the  remaining  three  in  the  northeastern  part  of 
the  city. 


8a8  HISTORY    OF    YELLOW    FEVER. 

Ou  August  28,  the  otlior  two  not  specified. 
After  this  the  disease  spread  rapidh^,  and  was  not  con- 
fined to  any  locality.  The  highest  number  of  deaths  in 
the  city  from  yellow  feyer  in  an}-  one  day  Ayas  thirty-three, 
on  the  20th  of  September.  These  occurred  in  the  fifth 
week  of  the  epidemic,  embracing  the  period  between  the 
ISth  and  24th  of  September. 

SOUTH    ATLANTIC    QUARANTINE    STATION. 

1887.  Infected  by  Para.     First  case,  May  22. 
1880,     One  case,  April  12;  recoyeied. 

181)1.     No  record  of  cases  and  deaths. 

1894.  No  record  of  cases  and  deaths, 

1895.  Cases,  1 ;  deaths,  1, 

ST,    MARY'S, 

1808.     First  case,  September  5;  last  cas(^,  October  — . 
Deaths,  84. 

UPTON  VI LLE. 

1888.  First  case,  October  24.     Cases,  2;  no  deaths. 

BIBLIOGRAPHY   OF   YELLOW    FEVER    IN    GEORGIA. 

GENERAL. 

Felder  (W.  L.) :  Observations  on  the  Yellow  Fever  Epidemic  of 
1854,  in  Augusta,  Georgia.  Southern  M.  &  S.  J.,  Augusta,  1855,  vol. 
11,  p.  598. 

Holt  (W.  F.):  Report  of  the  State  Board  of  Health  of  the  late 
epidemic  of  yellow  fever  in  the  State  of  Georgia.  (With  appendix  > 
Report  Board  of  Health  Georgia,  1876,  Atlanta,  1877,  vol.  2,  pp.  1,  etc. 

Kollock  (P.  M.):  Notes  on  the  epidemic  fever  in  1854.  Southern  M. 
&  S.  J.,  Augusta,  1855,  n.  s.,  vol.  11,  p.  453. 

Logan  (J.  P.) :  Observation  in  regard  to  the  yellow  fever  epidenaic 
of  1876  upon  the  coast  of  Georgia.  Richmond  &  Louisville  M.  J, 
Louisville,  1877,  vol.  23,  p.  223. 

McClellan  (E.)  A  study  of  the  yellow  fever  epidemic  of  ISl^,  as  it 


< 


GEORGIA.  829 

affected  the  State  of  Georgia.  Trans.  Am.  Pub.  Health  Assn.,  1S77-S, 
vol.  4,  p..  249. 

Seagrove  (J.) :  Origin  of  yellow  fever  in  the  contaminated  air  of  a 
coasting  vessel,  and  of  the  town  of  St.  Mary's,  in  Georgia;  with  aii 
enumeration  of  its  symptoms  and  mortality,  and  the  beneficial  effects 
of  volatile  alkali  as  a  remedy,  during  the  autumn  of  1808.  Med 
Reposii.,  N.  Y.,  1810,  vol.  13,  p.  135.  Also:  Am.  M.  &  Phila.  Reg.,  N. 
Y.,  1814,  vol.  3,  p.  417. 

White  (J.  E.) :  Typography  of  Waynesborough  (Georgia)  and  its 
vicinity,  with  the  State  of  the  thermometer  and  weather  for  part  of 
the  year  1802;  to  which  is  added  some  account  of  the  disease  which 
prevailed,  and  a  few  observations  on  yellow  fever,  and  the  princip:;! 
remedies  of  fever.  Med.  Repository,  N.  Y.,  Second  Hexade,  vol.  3, 
pp.  36;  140;   241. 

ATLANTA. 

McLellan:   Trans.  Am.  Pub.  Health  Assn.,  1877-8,  vol.  4,  p.  282. 

Sawtelle  (H..  W.) :  Report  of  Measures  taken  at  Atlanta,  Ga.,  in  con- 
nection with  the  Yellow  Fever  Epidemic  of  1897,  under  the  direction 
of  the  Burgeon-General.  Rep.  Superv.  Surg.-Gen.  Mar.  Hospi  1896-7, 
Wash.,  1899,  p.  665. 

Summerall  (W.  B.) :  The  case  cf  yellow  fever  recently  occurring  in 
Atlanta,  Ga.,  history,  clinical  notes,  and  observations.  Atlanta  J.  Rec, 
Med.,  1905-6,  vol.  7,  p.  505. 

U.  S.  Public  Health  Reports,  1897,  p.  1419. 

Ibid.,  1905,   p.   2754. 

AUGUSTA.. 

Austin:  Trans.  Am.  Pub.  Health  Assn.,  1877-8,  vol.  4,  p.  234. 

Campbell:    Ibid.,  1879.  vol.  5,  p.  132. 

McLellan:   Ibid.,  1877-8,  vol.  4,  p.  281. 

Boston  Medical  &  Surgical  Jl.,  1839,  p.  36. 

Medical  Statistics  U.  S.  Army,  1819-1839,  pp.  37,  349. 

Nashville  Jl.  Med.  &  Surgery,  1854,  p.  345. 

Report  of  the  Origin  and  Cause  of  the  late  Epidemic  (Yellow  Fever) 
in  Augusta.  Submitted  to  a  meeting  of  the  physicians  of  Augusta  on 
the  10th  of  December,  1839.  Reprinted  by  order  of  Council,  November, 
1877.     Svo.     Augusta,  1877. 

Robinson  (F.  M.):  A  Report  on  the  Origin  and  Cause  of  the  late 
Epidemic  in  Augusta,  1839.     Augusta,  1839. 

Smelt:  An  Account  of  the  Epidemic  Disease  which  prevailed  at 
Augusta  (Georgia)  and  its  Neighborhood  in  1804.  Medical  Repository, 
vol.  9,  p.  125. 


830  HISTORY     OK    YELLOW     FEVER. 

BRUNSWICK. 

Booth  (A.  R.) :  Tables  Showing  the  results  of  Observations  with 
Regard  to  Remittent  and  Yellow  Fevers,  taken  During  the  Yellow 
Fever  of  1893,  in  Brunswick,  Ga.  Rep.  Superv.  Surg.-Gen.  Mar.  Hosp., 
1894.    Wash.,  1895,  p.  323. 

Faget  (C):  Some  Observations  on  Yellow  Fever  in  Brunswick,  Ga., 
in  1893.  Rep.  Superv.  Surg.-Gen.  Mar.  Hosp.,  1894.  Wash.,  1895,  p. 
328. 

Le  Hardy  (J.  C.) :  The  Yellow  Fever  Epidemic  of  Brunswick  and 
its  management  by  the  Marine  Hospital  Service.  Virginia  Medical 
Monthly,  Richmond,  1894-5,  vol.  21,  p.  594;   688;  835;   961;  1103;  1200. 

McLellan:   Loc.  cit.,  p.  275. 

Smith:  Ann.  Rep.  Surg.-Gen.  U.  S.,  1876.,  pp.  77,  185. 

Elliott:   Nat.  Board  of  Health  Bulletin,  1881-2,  vol.  3,  pp.  92,  127. 

Ann.  Rep.  S.-G.,  U.  S.,  1894,  p.  298. 

U.  S.  P.  H.  Reports,  1894,  vol.  9,  pp.  668,  728. 

Ibid.,  1897,  p.  775. 

BAINBRIDGE. 

Washington  Republican,  Oct.  25,  1871,  p..  1. 

BLACKSHEAR. 

U.  S.  Pub.  Health  Rep.,  ISSS,  p.  192. 

DARIEN. 

McLellan,  loc.  cit.,  p.  279. 

Harris:  Nat.  Bd.  Health  Bulletin,  vol.  1,  p.  104. 

DALTON. 

Keating:   History  of  Yellow  Fever,  p.  93. 
Trans.  Am.  P.  H.  A.,  vol.  4,  p.  251. 

FORT  OGLETHORPE. 

Med.  Stats.  U.  S.  Army,  1819-1839,  p.  66. 

ISLE  OF  HOPE. 

McLellan,  loc.  cit.,  p,.  280. 

MACON. 

McLellan,  loc.  cit.,  p.  281.  ' 


GEORGIA.  831 

OLIVER  STATION. 

McLellan,  loc.  cit,  p.  281. 

SAINT  MARY'S. 

Seagrove  (James) :  An  Account  of  the  Origin  and  Nature  ol  the 
Yellow  Fever,  as  it  prevailed  in  the  Town  of  St.  Mary's,  Georgia,  in 
the  Autumn  of  1808.  Medical  Repository,  vol.  13,  p.  135;  Medical 
Register,  vol.  3,  p.  417. 

SAVANNAH. 

Arnold  (D.),  of  Savannah:  Two  Cases  of  Black  Vomit,  with  Observa- 
tions.    American  Journal  of  the  Medical  Sciences,  N.  S.,  vol.  3,  p.  316. 

Austin:  Trans.  Am.  P.  H.  A.,  1877-8,  vol.  4,  p..  234. 

Berenger-Feraud,  pp.  88,  89,  108,  134. 

Byrd  (H.  L.) :  A  few  facts  relating  to  the  late  epidemic  of  yellow 
fever  in  Savannah.  Oglethorpe  M.  &  S.  J.,  Savannah,  1858-9,  vol.  1, 
pp.  286-301. 

Chaille:  Virginia  Med.  Jl.,  1858,  p.  491. 

Daniell  (W.  C):  Observations  upon  the  Autumnal  Fevers  of  Savan- 
nah.    8vo.     Savannah,  1826, 

De  la  Motta  (J.):  An  oration  on  the  causes  of  the  mortality  among 
strongers,  during  the  late  summer  and  fall.     8°.     Savannah   (1820). 

Falligant  (L.  A.):  A  monograph  of  the  yellow  fever  of  1876,  in 
Savannah,  Ga.,  N.  Am.  J.  Homoeop.    N.  Y.,  1878,  vol.  26,  pp.  289,  458. 

Falligant  (L.  A.) :  Report  on  the  epidemic  of  yellow  fever  in 
Savannah,  Georgia,  duiing  the  months  of  September,  October  and 
November,  1876.    N.  Am.  Homoeop.  J.,  N.  Y.,  1878,  vol.  26,  pp.  289,  458. 

Hume  (W.) :  On  the  introduction  of  yellow  fever  into  Savannah  in 
the  year  1854,  in  reply  to  a  letter  from  R.  C.  Mackall.  Charleston  M. 
J.  &  Rev.,  1856,  vol.  11,  p.  1. 

Le  Hardy  (J.  C.) :  Yellow  fever;  its  history,  causes,  nature,  path- 
ology and  treatment;  considering  exclusively  the  epidemic  of  1876  in 
Savannah.     Tr.  Georgia  M.  Assn.,  Atlanta,  1878,  vol.  29,  p.  64. 

Mackall  (R.  C.) :  Introduction  of  Yellow  Fever  into  Savannah  in  the 
year  1854.     Charleston  Medical  Journal,  1885,  vol.  10,  p.  150. 

Russell  (H.  P.):  An  official  register  of  the  deaths  which  occurred 
among  the  white  population  in  the  city  of  Savannah  during  the  extra- 
ordinary season  of  sickness  and  mortality  which  prevailed  in  the 
summer  and  fall  months  of  the  year  1820;  to  which  is  annexed  a  list 
of  the  persons  (as  far  as  could  be  ascertained)  who  died  out  of  the 
city  after  retreating  from  it.  Also  the  aggregate  amount  of  deaths 
among  the  people  of  color.    8°.    Savannah,  1820. 


832  HISTORY     OK    YELLOW     FEVER. 

Smith  (H.):  Yellow  fever  at  Savannah  and  Brunswick.  Rep.  Superv. 
Surg.  Mar.  Hosp.,  Wash.,  1878,  p.  175. 

Stone  (G.  H.) :  Yellow  fever  at  Savannah,  Ga.  in  1876.  Rep.  Surg.- 
Gen.,  1878,  p.  107. 

Ward  (John  E.):  Reports  to  the  City  of  Savannah  for  the  year  1854. 
8vo.     Savannah,  1854. 

Waring  (W.  R.):  Report  to  the  City  Council  of  Savannah,  on  the 
Epidemic  Disease  of  1820.    8°.     Savannah,  1820. 

White  (O.  A.) :  Report  upon  yellow  fever  as  it  appeared  in  Savannah, 
Georgia,  in  1876.     X.  York  M.  J.,  1877,  vol.  25,  p.  249. 

WoodhuU  (A.  A.) :  On  the  causes  of  the  epidemic  of  yellow  fever  at 
Savannah,  Georgia,  in  1876.  Am.  J.  M.  Sc,  Phila.,  1877,  n.  s.,  vol.  54, 
p.  47. 

White:  May  not  yellow  fever  originate  in  the  United  States?  An 
etiological  study  cf  the  epidemic  at  Savannah  in  1876.  Trans.  Pub. 
Health  Assn.,  1879,  vol.  5,  p.  107. 


i 


ILLINOIS. 

CAIRO. 

1873. 

Infected  by  river  boatmen  from  Memphis.  New  Orleans 
and  intermediate  points. 

On  the  1st  of  September,  two  cases  of  yellow  fever  were 
received  at  the  hospital  from  the  steamer  Man/  Alice; 
on  the  10th,  two  cases  from  the  tow-boat  B:  and  on  the 
24th,  one  case  from  the  Kci/stone.  Four  of  these  case» 
were  fatal,  beiuj;'  in  the  stage  of  collapse  when  brought  in. 
The  fatal  cases  all  had  black  vomit. 

Tlie  first  fatal  case  among  the  citizens  did  not  occur 
until  i?ei)tember  13,  Avhen  the  cashier  of  the  Illinois  Cen- 
tral wharf-boat  died.  Then  followed  in  rapid  succession 
several  other  cases  among  persons  employed  in  the  same 
locality.  Xext,  a  man  on  Captain  Phillips'  wharf-boat 
sickened,  and  died  on  the  fourth  daj-.  A  colored  woman, 
who  did  the  washing  of  his  clothing,  took  the  disease  and 
died  one  week  after;  and  a  cliild  in  the  house  Avhere  the 
nurse  died,  also  took  the  disease,  but  recovered. 

There  were  in  all  13  deaths  out  of  43  cases  of  yellow 
fever  among  the  citizens,  making,  with  the  four  deaths 
among  those  landed  here  with  the  disease,  seventeen 
deatlis  from  yellow  fever  between  September  1  and  Sep- 
tember 25. 

It  was  especially  noted  that  the  disease  was  confined  to 
persciis  ('m])loyed  about  the  river  and  the  localities  above 
desci'ibed;  the  four  or  five  excei)tioi)s  which  occurred  be- 
ing in  the  families  of  men  who  were  thus  employed. 

The  disease  did  not  make  its  appearance  among  the  cit- 
izens until  after  the  first  two  cases  were  received  at  the 
hospital  from  the  steamer;  aiul  no  new  fatal  cases  oc- 
cuii'ed  among  citizens  after  the  establishment  of  quar- 
antine. 


834  HISTORY    OF    YELLOW    FEVER. 

1878. 

Infected  hy  steamboats  from  "points  below,"  as  follows : 

On  An.uust  3,  1878,  the  steamboat  Golden-  Crown  an- 
chored in  the  river  opposite  Cairo ;  Avas  examined  by  the 
quarantine  physician,  and  one  case  of  yellow  feyer  found 
on  board.  Two  other  cases  of  the  disease  were  reported 
as  being  secreted  on  the  boat  at  the  same  time.  The 
steamer  was  not  allowed  to  land.  August  9,  the  steam- 
boat John  A.  i<cuddcr  passed  Cairo  for  8t.  Louis,  haying 
one  case  of  yellow  fever  on  board,  a  refugee  from  New 
Orleans.  On  the  8th  iust.,  ^lartin  Alplien  applied  at  the 
office  of  the  ^Marine  Hospital  Service  and  stated  that  he 
shipped  from  this  poi't,  on  the  steamboat  John  D.  Porter, 
the  27th  of  July;  that  he  continued  on  the  vessel  till  the 
Gth  inst.,  Avhen  he  was  taken  sick,  and  returned  to  Cairo 
on  the  Dora  Cable,  which  steamer  met  the  Porter  between 
Paducah  and  Cairo.  Me  was  sent  to  the  hospital  suffer- 
ing from  what  was  supposed  to  be  a  form  of  malarial 
fever.  On  the  third  day  after  admission  the  disease  was 
pronounced  to  be  yellow  fever,  and  in  about  two  hours 
afterwards  black  vomit  occurred  in  profusion,  and  the 
patient  died  three  hours  subsequently  in  convulsions. 

Lewis  Clark  arrived  from  ^Memphis,  on  the  steamboat 
Jawes  B.  Parker,  on  the  15th  inst.,  and  was  taken  ill  with 
fever  the  same  night  at  his  mother's  house.  The  case  re- 
mained without  treatment  until  the  4th  inst.,  and  when 
medical  attendance  was  procured,  the  case  was  past 
recovcjy. 

On  September  4,  four  members  of  a  family  by  the  name 
of  Porter,  residing  two  miles  outside  of  (^airo,  on  the 
banks  of  the  Mississippi,  were  suddenly  stricken  with  the 
fever. 

On  the  8th,  :\lr.  ThcMuas  Nalley,  the  editor  of  the 
Cairo  "Bulletin,"  was  taken  ill  with  the  fever  and  died 
on  the  12th. 

Isaac  I\Iulkey,  an  employe  of  the  same  office,  died  on 
the  morning  of  the  l^tli. 

Jolin  Crafton  and  a  man  named  Sullivan,  both  em- 
ployes of  the  "Pulb'tin''  office,  becoming  ahirmed  by  the 


ILLfNOIS CAIRO.  8S5 

death  of  ^Nfr.  Xallev,  spent  the  niiiht  in  a  drunken 
debauch.  The  followinc,  morning,  the  13th,  Crafton  ap- 
peared at  the  hospital  as  a  private  patient,  and  died  on 
the  afternoon  of  the  Ifitli.  Sullivan,  on  the  morning  of 
the  13th,  went  to  Mound  City,  seven  miles  from  Cairo, 
where  he  died  on  the  15th. 

On  the  10th,  Houston  Dickey,  age  18,  was  attacked  and 
died  on  the  morning  of  the  loth. 

On  the  morning  of  the  22nd,  G.  W.  Craig  was  admitted 
to  the  hospital  with  well-marked  symptoms  of  yellow 
fever.  The  man  was  a  refugee  from  the  South,  had 
stopped  at  Clinton  Station,  Ky.,  and  had  engaged  himself 
temporarily  as  a  cook  in  a  large  boarding-lKuise.  He  had 
also  swept  out  some  empty  cars  in  which  refugees  had 
been  brought  from  the  South.  As  soon  as  he  was  taken 
sick  he  started  for  Cairo,  crossing  the  river  in  a  skiff 
during  the  night. 

On  the  29th  of  September,  in  a  family  by  the  name  of 
Petree,  residing  in  the  city,  a  daughter,  age  about  sixteen, 
was  taken  ill  with  what  Avas  pronounced  to  be  bilious 
fever,  but  linalh'  proved  to  be  yellow  fever.  The  girl's 
mother  had  been  taken  sick  sliortly  before,  the  exact  time 
not  being  obtained.  She  and  licr  daughter  had  been 
sleeping  together  previous  to  their  illness.  The  mother 
died  October  2,  of  yellow  fever. 

Upon  the  same  street  as  the  "Bulletin--  building,  about 
two  hundred  feet  distant,  resided  a  Mr.  Wilcox.  This 
gentleman  Avas  of  a  very  nervous  temperment,  and  was 
greatly  alarmed  about  tlie  yellow  fever.  On  the  21st  of 
September  he  was  seized  with  a  chill,  which  was  followed 
by  high  fever.  On  tlie  24th,  he  entered  the  hospital.  The 
same  evening  his  pulse  stood  at  112;  temperature, 
102°;  very  much  prostrated.  A  violent  thunder  storm 
came  on  later  in  the  evening  which  greatly  alarmed  him, 
and  soon  after  he  sank  into  collapse. 

On  October  10,  Dr.  AValdo  was  taken  sick,  admitted  to 
the  hospital,  and,  notwithstanding  all  care  and  attention, 
died  the  18th. 


836  HISTORY    OK     YELLOW     FEVtR. 

It  will  be  seen  from  the  preceding  report  that  there 
were  two  centers  of  infection,  one  proceeding  from  the 
"Bulletin"  building,  where  the  editor  died  on  the  12th, 
This  district  covered  an  area  of  about  three  city  blocks 
in  the  heart  of  the  city,  and  the  vicinity  of  the  custom- 
house. The  other  infected  district  was  located  in  the 
upper  part  of  the  town,  between  20th  and  21st  Streets, 
and  covered  two  or  three  blocks. 

From  August  8,  to  September  7,  there  were  three  cases 
of  yellow  fever  and  two  deaths— all  of  them  refugees.  On 
Sei)tember  7,  the  first  case  among  the  inhabitants  oc- 
curred, and  from  that  date  to  November  5,  inclusive,  there 
were  51  deaths  among  the  inhabitants.  The  total  number 
of  cases  was  88. 

1897. 

Four  refugees  from  infected  points  in  the  South,  had 
yellow  fever  in  Cairo  in  1807.  There  were  only  four  cases 
with  no  deaths.  The  disease  did  not  attack  the  in- 
habitants. 

CHICAGO. 

1878.     One  death,  a  refugee  ''from  the  South." 
1905.     Week  ending  October  7,  one  death,  a  refugee. 

^rorxT  CAiniEL. 

1888,  A  fatal  case,  a  refugee  from  Decatur,  Ala.  Sep- 
tember 25. 

KOCKFOED. 

1888.  One  case,  a  i'(  fugee,  from  Decatwr,  Ala.,  Sep- 
temlxM-  24,  diea  29th.     Tliei-e  was  uo  spread  of  the  disease. 

BiBLlOGRAPHY   OF   YELLOW    FEVER    IN    ILLINOIS. 

Aimesse   (J.  AV):    Measures  taken  at  Cairo,  Illinois,  to  prevent  the 
introduc'tion  of  yellow  fever.     Ann.  Rep.  Sup.  Surg.-Gen.,  1906,  p.  188. 
Annual  Report  State  Board  of  Health  of  Illinois,  18SS,  pp.  Ixi;   Ixvi. 
Annual  Report  Sup.  Sur.-Gen.,  1873,  p.  108. 


ILLINOIS.  837 

History  of  Yellow  Fever  at  Cairo,  111.  Ann.  Rep.  Sup.  Surg.-Gen., 
1878-9,  p.  149. 

Kalloch  (P.  C):  Report  of  Yellow  Fever  occurring  at  Cairo,  111. 
Ann.  Rep.  Sup.  Surg.-Gen.,  1899,  p.  668. 

Report  Sanitary  Commission  of  1878. 

U.  S.  Pub.  Health  Reports,  1897,  p.  1419. 

Ibid.,  1905,  p.  2754. 


INDIANA. 

INDIANAPOLIS. 

1S7S.     Two  cases,  September  12,  refugees ;  one  case  died 
ou  the  ITth. 

NEW    ALBANY. 

1878.     'Cases   on   steamboat  Marj/   Houston,   from   in- 
fected points.     There  was  no  spread  of  the  disease. 


INDIAN    TERRITORY. 

MAYSVILLE. 

1905.     A  fatal  case,  a  refugee,  September  1. 


KENTUCKY. 

BOWLING  GREEN. 

1878.     First  case,  8oi)tember  2.     Cases,  42 ;  deaths,  19. 

CLINTON. 

1878. 

Two  cases  of  yellow  fever  occurred  October  25.  There 
was  much  excitement,  and  many  citizens  left  the  town 
in  great  haste. 

COVINGTON. 

187&     One  case,  a  refni>ec  from  New  Orleans. 

DANVILLE. 
1878.     One  case,  September  3;  died  on  the  9th. 

FILLMOKE. 
1878.     One  fatal  case,  a  refugee  from  New  Orleans. 

FULTON. 
1878.     Cases,  12;  deaths.  5. 

HICKMAN. 

1878.  Yellow  fever  was  never  epidemic  in  Hickman, 
until  1878.  The  first  case  was  Charlie  Hendricks  on 
August  13,  supposed  to  have  been  infected  on  the 
railroad  trains,  as  he  jieddled  apples  and  mixed  with 
passengers.  He  died  August  10,  on  the  17th  his  little 
sister,  Louisa,  died,  affected  similarly;  both  had  black 
vomit.     No  death  until  August  28,  when  Edward  Mangel 


840  HISTORY    OF    VKL1.0W    FEVER. 

died.  Mrs.  J.  AYitting  died  the  29tli,  Jimmie  Young;  the 
30th,  and  numerous  new  cases  continued  to  occur  through- 
out the  town.  A  panic  ensued,  scores  were  dead  or 
dying,  Imndreds  ill  and  over  a  thousand  fled.  Nearly  all 
the  local  physicians  died,  four  of  the  volunteer  doctors 
died,  450  citizens  were  prostrated  with  the  fever,  150  died. 
Date  of  the  last  death,  November  Gth.  Total  cases,  454; 
total  deaths,  180. 

JORDAN  STATION. 

1878.     Deaths,  2. 

LEXINGTON. 

1905.     Cases,  2. 

LOUISVILLE. 

1873.  First  case,  September  22 ;  last  case,  October  15. 
Deaths,  5. 

1878.  Population,  100,890.  Early  in  the  yellow  fever 
season,  Louisville  opened  her  gates  as  a  "city  of  refuge" 
from  the  raging  disease.  Thousands  flocked  from  the 
South,  many  bringing  the  disease.  On  the  17th  of  August, 
3  cases  of  fever  were  sent  to  the  United  States  ^Marine 
Hospital,  from  the  steamer  ^unfloiccr  Belle,  1  white  and 
2  colored.  On  the  23rd  of  August,  Mr.  H.  R.  Davis,  of 
the  firm  of  Rrynut  &  Davis,  Grenada,  came  to  Louisville 
and  put  up  at  the  AN'averly  Hotel.  In  a  few  days  he  was 
stricken.  Drs.  Walling  and  Gaillard  were  summoned  and 
later  Dr.  Luke  Blackburn  was  called  to  see  him;  he  had 
black  vonut  and  died  on  the  31st.  A  hearse  was  driven 
up  the  alley  in  the  rear  of  the  hotel  and  the  coffin  borne 
huri'iedly  away  at  midnight.  When  he  was  first  taken 
ill,  two  nurses  were  emi)l()ycd.  A  young  man,  also  from 
Grenada,  who  assisted  in  nursing,  was  also  taken  ill  with 
fever,  but  recovered.  On  the  12th  of  September,  Drs. 
Lloyd  and  Griffith  were  summoned  io  a  refugee  family 
on  33rd  Street,  and  found  7  occupying  a  small  room  on 


KENTUCKN ^^LOUISVII.LE.  841 

the  ground  floor  of  an  old  frame  house.  Three  children 
with  yellow  fever  lay  in  one  corner,  the  father  in  the 
other,  and  the  mother,  with  a  babe  in  arms,  watching  and 
nursing  them.  Conveyances  were  telegiai)hed  for,  and  in 
a  little  while  two  hacks  carried  them  to  the- yellow  fever 
hospital,  an  infirmary  which  the  city  had  erected  and 
equipped  for  this  disease  early  in  the  season.  Mr.  Lutz 
died  September  25,  on  11th  Street  near  Maple,  also  two 
cases  (colored)  on  Bible  Alley.  Meta  Flynu,  Nathanial 
Mudd,  Wm.  Shaw,  Eddie  Beiryman,  Mrs.  Ryan  and  many 
others  died  of  black  vomit  on  or  near  Maple,  Eleventh 
and  Bible  Alley,  all  being  near  the  L.  &  N.  B.  B.  depot; 
but  a  diversity  of  opinion  existed  as  to  the  disease.  Some 
excitement  arose.  Three  physicians,  Drs.  Bell,  Yandell 
and  Force,  i^ublishing  a  card  endeavoring  to  allay  excite- 
ment, caused  a  panic  for  a  day  or  two,  but  the  frightened 
ones  were  ridiculed  out  of  their  alarm,  and  returned.  No 
case  originated  elsewhere  in  the  city.  Total  cases,  12G; 
total  deaths,  34. 

1879.  Population,  175,000.  A  fatal  case,  a  refugee 
from  Memphis. 

1888.  Population,  200,000.  A  fatal  case,  a  refugee, 
September  19. 

1897.  On  August  14,  1897,  a  man  came  to  Louisville 
from  Ocean  Springs,  Mississippi,  and  was  taken  ill  on  his 
arrival.  His  case  was  diagnosed  as  yellow  fever  by  the 
attending  physician,  who  had  lived  in  the  South,  and  had 
clinical  experience  with  the  disease.  The  patient  was 
immediately  spirited  away  from  the  hotel,  where  he  had 
been  taken  ill  to  a  jjrivate  sanitarium  in  the  city,  where 
he  exhibited  all  the  phenomena  of  yellow  fever.  He  died 
on  the  IGth.  He  was  (piietly  buried  by  the  health  author- 
ities.    There  were  no  developments  from  this  case. 

At  the  time,  there  was  no  suspicion  that  yellow  fever 
was  prevalent  in  Ocean  Springs,  although  'Slengue''  was 
said  to  be  epidemic  in  the  town.  Nevertheless,  the  Louis- 
ville health  officer  immediately  notified  the  healtli  author- 
ities of  New  Orleans  of  the  circumstances,  naturally 
concluding  that  this  city  would  be  vitally  interested  in 


842  HISTORY    OK    YKM.OW     FEVER. 

investigating!:  the  "suspicious  cases,"  wliicli  had  mani- 
festcMl  themselves  in  Ocean  S])i'in^',  and  which  had  been 
diaiinosed  as  denj^ue  by  the  physicians.  Actin<i'  on  this 
information,  and  also  alarmed  by  the  fact  that  Dr. 
Theard,  of  New  Orleans,  had  reported  an  nnecpiivocal 
case  of  yellow  fever  in  his  practice,  the  President  of  the 
Louisiana  State  Board  of  Health,  with  members  of  his 
staff,  went  to  Ocean  Springs,  made  an  investioation  of 
the  disease  prevailino-  there.  As  a  result  of  this  tardy 
investigation  by  the  health  officers  of  New  Orleans,  the 
infection  was  brought  to  our  doors  and  resulted  in  dis- 
astrous outbreak  of  yellow  fever, 

MEDLEY'S    LANDING. 

Only  one  case,  that  of  a  man  who  contracted  the  dis- 
ease while  nursing  his  brothers  at  Hickman. 

TRENTON. 

1878.     One  dc^ith,  a  refugee. 

BIBLIOGRAPHY    OF   YELLOW    FEVER    IN    KENTUCKY. 

Ann.    Rep.    Sup.   Surg.-Gen.,    1S73,   p.    109. 

Berry  (T.  D.):  The  Breeding  of  the  Yellow  Fever  Mosquito  at 
Louisville.     Bulletin,  Kentucky  Medical  Assn.,  vol.  1,  p.  255   (1904). 

Brown  (E.  O.):  Official  report  of  i\hy  ician  in  charge  of  the  yellow 
fever  hospi'tal,  Louisville,  Ky.,  1878.  Louisville,  Ky.,  1878.  12p.  2  tab. 
8°. 

Brown  (J.  E.) :  Yellow  fever  [Cloverport,  Ky.].  Louisville  M. 
News,  1878,  vol.  6,  p.  226. 

•  Dowell  (G.):  Louisville,  1873.  In  his  "Yellow  Fever  and  Malarial 
Diseases,"   1876,   p.   39. 

Holland  (J.  W.):  Nature  and  source  of  the  yellow  fever  at  Louis- 
ville, Ky.,  in  1878.     Am.  Pract.,  Louisville,  1879,  vol.  20,  p.  352. 

Keating:   History  of  Yellow  Fever,  pp.  43;  93;  251, 

McReynolds  (J.  O.):  [Two  cases  of  Yellow  Fever  at  Trenton,  Ky.]. 
Louisville  M.  News,  1879,  vol.  7,  p.  41. 

National  Board  of  Health  Bull.,  1878-9,  vol.  1.  p.  45. 


KENTUCKY.  843 

Procter  (J.  R.) :  Notes  on  the  yellov^  fever  epidemic  at  Hickman, 
Ky.,  during  the  summer  and  autumn  of  187S.  Frankport,  1879,  E.  H. 
Porter,  41  p.  2  pi.  Imap.    4°. 

Procter  (J.  R.) :  Notes  on  the  yellow  fever  epidemic  of  Hickman, 
Kentucky,  1878.  Rep.  Bd.  Health  Ky.,  1878-9,  Frankport,  1879,  vol.  1, 
p.  73.     4pl. 

Report  Sanitary  Commission,  1878. 

Thomas  (R.  C):  Yellow  Fever  in  Southern  Kentucky.  Med.  and 
Surg.  Reporter,  Phila.,  1878,  vol.  39,  p.  523. 

Thomas  (R.  C):  A  history  of  the  outbreak  of  yellow  fever  in 
Bowling  Green,  Ky.,  in  1878.  Rep.  Bd.  Health  Ky.,  1878-9,  Frankport, 
1879,  vol.  1,  p.  37,  Ipl. 

Thompson  (P.):  Yellow  Fever  in  Kentucky.  Rep.  Bd.  Health  Ky., 
vol.  1878-9,  p.  47. 

U.  S.  Pub.  Health  Rep.,  1905,  p.  2754. 

Ibid.,  1897,  p.  1419. 

Ibid.,  1888,  p.  219. 

Yandell  (L.  P.):  The  Late  Yellow  Fever  Outbreak  in  Louisville. 
Louisville  Med.  News,  1878,  vol.  6,  p.  275. 

Yandell  (L.  P.):  The  Board  of  Health's  Report  on  the  Yellow  Fever 
in  Louisville.     Louisville  M.  News,  1878,  vol  6,  pp.  239-24L 


LOUISIANA. 

ABITA   SPRINGS. 

1905.  lufected  by  New  Orleans.  First  case,  July  30, 
Cases,  4;  no  deaths. 

ALEXANDRIA. 

1819;  1S22;  1827;  1831;  1837;  1839;  1847;  1853;  1854; 
1855,  yellow  fever  years.     No  record  of  cases  and  deaths. 

1898.  First  case,  October  G;  last  case,  October  16. 
Cases,  200 ;  deaths,  2. 

1905.     First  case,  July  28.     Cases,  21;  deaths,  3. 

ALGIERS. 

A  District  of  Xcic  Orleans,  irJiich  see. 

AMITE    CITY. 

1898.  First  case,  October  13;  last  death,  October  13. 
Cases,  1 ;  deaths,  1. 

ARCENEAUX   PLACE. 

1879.     First  case,  August  10.     Cases,  1;  no  deaths. 

ASCENSION    PARISH. 

1823.  Locality  not  stated.  No  record  of  cases  and 
deaths. 

AMELIA. 

1905.     First  case,  August  8.     Cases,  86;  deaths,  5. 

AMESVILLE. 

1905.     First  case,  July  25.     Cases,  3 ;  deaths,  1. 


LOUISIANA,  845 

ARDOYNE    PLANTATJON. 
1905.     First  case,  August  1.     Cases,  200;  deaths,  11. 

ATHERTON. 

1905.     Cases,  8;  deaths,  2. 

ATTAKAPAS    CANAL. 

1879.     Cases,  62 ;  deaths,  18. 

BALDWIN. 

1905.     First  case,  October  20.     Cases,  1;  deaths,  0. 

BARATARIA. 

1905.     First  case,  August  15.     Cases,  56;  deaths,  7. 

BATON   ROUGE. 

1817;   1819;    1820;   1821.       Yellow   fever   years.      No 
records  of  cases  aud  deaths. 
1822.     Deaths,  60. 

1827;  1829.     No  record  of  cases  and  deaths. 
1829.     Deaths,  7. 

1837.     No  record  of  cases  aud  deaths. 
1843.     First  case,  October.     No  statistics. 
1847;  1858.     No  record  of  cases  aud  deaths. 

1878.  Infected  by  New  Orleaus.     First  case,  August 
10;  first  death,  August  18.     Cases,  2,435;  deaths,  193. 

1897.  (^ises,  5;'deaths,  2. 

1898.  First  case,  September  25 ;  last  case,  October  15. 
Cases,  176 ;  deaths,  4. 

1905.     First  case,  September  9.     Cases,  8;  deaths,  1. 

BAYOU    BOEUF. 

1879.  Populatiou,    150.       Infected   by   Morgan    City. 
First  case,  Se])teuibei'  5;  first  death,  Se]>teuiber  25;  last 


846  HISTORY    OF    YELLOW    FETER. 

case,  November  10;  last  death,  Xoveiiiber  10.     Cases,  77; 
deaths,  21. 

1905.     First  ease,  August  1.     Cases,  15;  deaths,  0. 

BAYOU    BRULO. 

1905.     First  ease,  October  4.     Cases,  40;  deaths,  6. 

BAYOU   CANE. 
1905.     First  case,  September  3.     Cases,  1;  deaths,  0. 

BAYOl^   COOK. 

1905.     First  cat-e,  July  3.     Cases,  2;  deaths,  1. 

BAYOU   CYPBEMOKT. 

1878.     Infected  by  Thibodaiix,  La.     First  case,  Novem- 
ber — .     Deaths,  7. 

BAYOU  GOULA. 

1878.     Deaths,  4. 

1905.     First  case,  August  1.     Cases,  17;  deaths,  3. 

BAYOU   NATCHEZ. 

1005.     First  case,  t^epteiuber  3.     Cases,  20;  deaths,  G. 

BAYOT'    PLA()UE:\IINE. 

1853.     First  case,  September  17;  last  case,  September 
30.     Cases,  9;  deaths,  0. 

BAYOU    SARA. 

1839;  1847;  1853.     No  record  of  cases  and  deaths. 
1878.     Population,  700.     Cases,  250;  deaths,  13. 


LOUISIANA.  847 

BAYOU  TEKKEBONNE. 
1905.     First  case,  September  4.     Cases,  1;  deaths,  0. 

BEL   AMI. 

1905.     First  case,  September  8.     Cases,  106;  deaths,  15. 

BELLE  GROVE. 
1905.     First  case,  August  31.     Cases,  74 ;  deaths,  12. 

BELLE    HELENE. 
1905.     First  case,  October  17.     Cases,  2;  deaths,  0. 

BELLESEIN  PLANTATION. 
1905.     First  case,  August  2(1.     Cases,  43;  deaths,  5. 

BELMONT. 
1905.     First  case,  August  29.     Cases,  1 ;  deaths,  0. 

BERWICK  crrr. 

187S.  Population,  150.  Infected  by  iNforgan  City. 
First  case,  September  27;  last  case,  November  4;  first 
deatli,  October  7.     Cases,  99;  deaths,  7. 

1879.  Population,  500.  Infected  by  Morgan  City. 
First  case,  September  8;  first  death,  September  12;  last 
case,  December  1;  last  death,  December  1.  Cases,  75; 
deaths,  16. 

1905.     First  case,  September  7.     Cases,  1 ;  deaths,  1. 

BIG    BURNS. 

1905.     Cases,  1 ;  deaths,  0. 


848  HISTORY    OF    YELLOW     FKVtR. 

BLANCHARD. 

1S7D.     Cases,  1 ;  deaths,  1. 

BON   AMI. 

1005.     First  case,  August  G.     Cases,  5(5;  deaths,  8. 

BONNET    CAERE. 

1878.     Several  cases  and  deaths;  no  record. 

BORGUEMOUTH. 

1905.     First  case,  September  20.     Cases,  1 ;  no  deaths. 

BORODINO. 
1905.     First  case,  September  24.     Cases,  1;  no  deaths. 

BOWIE. 

1898.     First    case,    October   G;    last   case,    October    6. 
Cases,  1;  no  deaths. 

1905.     First  case,  July  2G.     Cases,  1 ;  deaths,  1. 

BROUSSARD. 

1878.     Deaths,  1. 

BRULE    SACREMENTO. 

1878.     Deaths,  22. 

BUNKIE. 

1905.     First  case,  July  20.     Cases,  22;  deaths,  8. 

BUR  AS. 

]S47.     Sporadic  cases.     No  statistics. 

1854.     First  case,  September  22.     No  record, 

1878.     Infected  by  New  Orleans.     Cases,  14;  deaths,  3. 


LOUISIANA.  849 

CANAAN    LANDIN(J. 

1878.     Cases,  28;  deaths,  0. 

CAROLINE   LANDIN(J. 

1878.  A  fatal  case  in  October. 

CAREOLLTON. 

{A  District  of  Ncio  Orleans^  icJiich  see). 

CEDAR  GROVE. 

1905.     First  case,  September  IG.     Cases,  2;  deaths,  0. 

CENTREVILLE. 

1853.     First  case,  September  15;  last  case,  November 
18.     Cases,  45;  deaths,  7. 

1855.     First  case,  September  — ;  last  case,  October  — . 

1879.  First  case,  September  21 ;  first  death,  September 
25;  last  case,  December  4.     Cases,  44;  deaths,  14. 

CHALMETTE. 

1905.     First  case,  September  30.     Cases.  7;  deaths,  0. 

CHENIERE    CAMINADA. 

1905.     First  case,  August  27.     Cases,  02;  deaths,  5. 

CHENIERE    CANE. 

1878.     No  record. 

CINCLARE. 

1898.     First  case,  October  15;  last  case  October  25. 
Cases,  11 ;  deaths,  1. 


850  HISTORY    OF     YELLOW     FKVEll. 

CLARK   CHENIERE. 

1905.     First  case,  July  1(>.     Cases,  44;  deaths,  3. 

CLIXTOX. 

1854.     First  case,  September  1 ;  last  case,  December  — . 
1S7S.     Infected  by  Xew  Orleans.     Fir>;>t  case,  Septem- 
ber 23.     Cases,  96;  deaths,  15. 

CLOUTIEIIYILLE. 

1853.  V'lvst  case,  Aiu»iist  14;  first  deadi,  December  14. 

1854.  Xo  record. 

COLUMBIA. 

1878.     Infected  by  X'ew  Orleans.     First  case,  October 
3;  last  case,  October  27.     Cases,  2;  deaths.  0. 

COOK'S   LANDING. 

1878.     Population,  35.     Cases,  15;  deaths,  4. 

CORIXXE. 
1905.     First  case,  July  20.     Cases,  IG;  deaths,  4. 

COTE   BLANCHE. 

1905.     First  case,  Angust  18.     Cases,  300;  deaths,  51. 

COVINGTON. 

1847.     Sporadic  cases.     No  record. 
1905.     Infected  by  New  Orleans.     First  case,  Septem- 
ber 23.     Cases,  4;  deaths,  1.     All  refugees. 

CRESCENT   FARM. 

1905.     First  case,  Angust  30.     Cases,  205;  deaths,  1. 
It  seems  incredible  that  such  a  small  mortality  should 


LOUISIANA.  851 

have  resulted,  but  the  liiiiircs  are  "official/'  and  we  eaii  do 
110  more  than  publish  them.  In  our  opinion,  seventy-live 
per  cent,  of  the  eases  reported  as  ""yellow  fever''  were  erro- 
neoush'  classified  as  such. 

CYPREMORT. 

1879.  Infected  by  Xew  Orleans.  First  case,  October 
17 ;  first  death,  October  25 ;  larst  case,  November  22.  Cases, 
33 ;  deaths,  9. 

DELHI. 

1878.  Population,  500.  Infected  by  Vicksburg-.  First 
case,  August  11;  first  death,  August  15.  Cases,  164; 
deaths,  34. 

DELOGNY. 

1898.  First  case,  October  1;  last  case,  October  1. 
Cases,  1 ;  deaths,  1. 

DELTA. 

1878.  Population,  300.  Infected  by  Vicksbnrg.  First 
case,  August  27;  first  death,  September  2.  Cases,  87; 
deaths,  47. 

1905.     Cases,  GO ;  deaths,  G. 

DES  ALLEMANDS. 

1878.  Population,  GO.  First  case,  August  20;  last 
case,  October  27;  first  death,  August  24;  last  death,  Octo- 
ber 30.     Cases,  32;  deaths,  17. 

DESLONDE. 

1870.     First  case,  September  22.     Cases,  40;  deaths,  1. 

DIAMOND. 

1905.     First  case,  August  16.     Cases,  8 ;  deaths,  0. 


852  HISTORY    OF    VKLLOW    FEVER. 

dia:\iond  plantation. 

1005.     First  case,  Jnly  20.     Cases,  55;  deaths,  10. 

DOXALDSONVILLE.  J 

1827.  No  record. 

1839.  Infected  by  New  Orleans.     Deaths,  15. 

1878.  Population,  1,500.     Cases,  484;  deaths,  83. 

1905.  First  case,  August  28. 

DUNBOYNE. 

1878.     Deaths,  5. 

EDGARD. 
1905.     First  case,  September  11.     Cases,  3;  deaths,  0. 

ELLENDALE. 
1905.     First  case,  August  30.     Cases,  27;  deaths,  2. 

EMPIRE. 
1905.      First  case,  July  31.     Cases,  1  ;  de.-ilhs,  0. 

EkSTELLE   i»lantation. 

1905.      I-'ii-st  case,  September  5.     Cases,  3;  deaths,  0. 

EFKEKA. 

1878.      Deaths,  1. 

F^'F1{ETTE. 

1905.     First  case,  Septeuiber  1(>.     Cases,  1;  deaths,  1. 

EVEKGREEN. 

1905.     Cases,  2;  deaths,  0. 


853 


LOIIIMANA. 

FI8H    lUVEK. 

1878.  Xo  record  of  cases  autl  deaths. 

FLORE  NVILLE. 
1905.     First  case,  September  3.     Cases,  1  deatlis,  1. 

FOLEY    PLANTATION. 

1879.  First  case,  October  10.     Cases,  4;  deaths,  L 

FORT    PIKE. 
1820.     Sporadic  cases  amciiii  soldiers.     No  statistics. 

FORT    ST.   PHILIP. 
1820.     Sporadic  cases  aiuciiii'  troops.     No  record. 
1905.     Cases,  1;  dealhs,  0. 

FRANKLIN. 

1830.     No  record  of  cases  ard  deat1;s. 

1853.  First  case,  October  10;  first  dealh,  October  23; 
last  case,  October  24;  last  death,  October  25.  Cases,  3; 
deaths,  2. 

1854;  1858;  1807.     No  record  of  cases  and  deaths. 

1897.  Cases,  3;  deaths,  1. 

1898.  Cases,  007;  deaths,  9. 

1905.     First  case,  Septeiuber  25.     Cases,  5;  deaths,  0. 

FRELLSIN. 
1900.     First  case,  October  18.     Cases,  1;  deaths,  0. 

pre:\ieaux. 

1879.     First  case,  October  22.     Cases,  2;  deaths,  1. 


85i  HISTORY     OK     YELLOW     FEVER. 

FEEXCH   SETTLE:\rEXT. 

1871).  First  case,  Xoveiiibei'  11) ;  last  case.  December  — . 
Cases,  60;  deaths,  5. 

GLENWILD    PLANTATION. 

1905.     First  case,  September  15.     (\'iscs,  2;  deaths,  1. 

rJOOJ)   llOFE  PLANTATION. 
1905.     First  casi^,  Auj-ust  10.     <'j!ses,  2t\:  deaths,  1. 

GliAMElJCV. 
1905.     First  case,  Septembci"  L     Cases,  1  :  deaths,  0. 

GEANI)     ISLE. 
1905.     First  case,  September  4.     Cases,  74;  deaths,  S. 

GKAND   LAKE. 
1905.     First  case,  July  25.     Cases,  41;  deaths,  7. 

GREENWOOD. 

1873.  Infected  by  Slireyepcrt.  Fii-st  case,  September 
29;  first  death,  October  3;  last  death,  October  29.  Cases, 
19 :  deaths,  4. 

1905.     First  case,  September  7.     Cases,  1 ;  deaths,  0. 

GEETNA. 

1878.     Deaths,  53. 

1905.     First  case,  September  22.     Cases,  5;  deaths,  2. 

GROSSE   TETE. 

1905.     V\v>t  case,  September  2.     Cases,  45;  deaths,  5. 


LOUISIANA.  H55 

HAHNVILLIO. 

1S7S.     Population,  200.     No  slitCs-llc  s. 

HAMMOXl). 

187S.  InfcH'tcd  by  Ozyka,  Miss.  Vwat  chhq,  September 
IS;  lirst  deatli,  September  '21;  lawt  death,  November  1. 
Deatlis,  5. 

IIAKKISONBUEG. 

187S.     r(ti)nlali()ii,  275.     Cases,  30;  deaths,  10. 

HARVEY'S  CANAL. 

1898.  First  ease,  September  24;  last  case,  October  6. 
Cases,  ^11;  deaths,  3. 

1905.     First  case,  September  1.     Cases,  5;  deaths,  0. 

HENDERSON. 

3878.  ropulatioi),  400.  First  ease,  August  30.  Cases, 
75;.  deaths,  18. 

HOUMA. 

1878.     First  case,  October  — .     Deatlis,  6. 
1898.     First  case,  September  23;  last  case,  October  5. 
Cases,  40;  deaths,  2. 

1905.     First  case,  August  30.     Cases,  7;  deaths,  0. 

JACKSON. 

1898.     First  case,  October  15.     Cases,  15 ;  deaths,  0. 

JACKSON    P.AKKACKS. 
1834.     Deaths,  3. 


856  HISTORY    OF    YELLOW    FEVER. 

JEFFERSON   PAEISH. 

1898.     First  case  in  September.     Cases,  5;  deaths,  0. 

JEANERETTE. 

1854,     No  record. 

1857.     First  case,  October  7. 

JESUIT  BEND. 

1854.     First  case,  September  12. 

1878.     First  case,  Se])trnil)(T  22.     Cases,  2;  deaths,  2. 

KEMPA  BEND. 

1905.     First  case,  September  17.     Cases,  2;  deaths,  0. 

KEXTWOOD. 

1905.     First  case,  September  18.     Cases,  2;  deaths,  0. 

KENNER. 

1905.     First  case,  Aiiiiiist  18.     Cases,  360;  deaths,  33. 

LABADIEVILLE. 

1878.  Popnlation,  180.  Infected  by  New  Orleans. 
First  case,  August  10;  first  death,  Aujjust  21.  Cases,  160 ; 
deaths,  24. 

LAFAYETTE. 

1905.     First  case,  September  26.     Cases,  4;  deaths,  0. 

LAFOURCHE    CROSSING. 

1878.  First  case,  September  12;  last  case,  December 
18;  first  death,  September  18;  last  death,  December  21. 
Cases,  209 ;  deaths.  26. 


LOUISIANA.  857 

1879.  Infoeted  by  Morgan  City.  First  cas-o,  Octolier 
2;  first  deatli,  October  5;  last  case,  December  1;  last 
death,  Noyeiiiber  27.     Cases,  40;  deaths,  9. 

1905.     First  cace,  August  26.     Cases,  35;  deaths,  5. 

LAKE   CHARLES. 

1898.     First  case,  October  10.     Cases,  1;  deaths,  0 
LACtOXDA  tlaxtattox. 

1878.  Iiif(H't(Hl  l)y  Xe^y  Orleans.  First  case,  Septem- 
ber 5;  first  death,  September  10.     Cases,  591  ;  deatlis,  42. 

LAKE    PROVIDENCE. 

1853.  Population,  1,000.  Infected  by  XcAy  Orleans. 
First  case,  Angnst;  first  deatli,  Augnst  31. 

1905.     Firsf  case,  July  21.     Cases,  327 ;  deaths,  23. 

LAPLACE. 

1905.     First  case,  August  10.     Cases,  103;  deaths,  18. 

LAROSE. 
1905.     First  case,  August  29.     Cases,  13;  d(>atlis,  5. 

LECOMPTE. 

1905.     First  case,  September  11.     Cases,  2;  deatlis,  0. 

LEEYILLE. 

(LafourrJtc  Pa  visit ) . 

1905.     First  case,  May  24.     Cases,  375;  deaths,  07. 


858 


HISTORY  OF  YEI.I.OW    FEVER. 


LOBDELL. 


1808.     First  case,  Oc-tober  12;  last  case,  Octolicr  12. 
Only  case  recorded. 

LOWEK    TEXAS. 

1871),     Cases,  30;  deaths,  7. 

LUCY. 

\'.)V,7t.      i'^iisi   case,  OcUjIht  .">.     Cases,  ;> :  deal  lis,  0, 

LUDIXGTOX. 

1005.     Cases,  38;  deaths,  0. 

LULING. 

1878.  Viv>i  case,  Scjitciiilici'  1.").     Cases,  2  (hat lis,  0. 

LUTCHEIJ. 

181)8.     First  case,  Octohcr  IT),     (^ases,  14;  deatlis,  2. 
irxi";.      V\v>t  case,  Aii.uust  11.      (^ases,  5;  dtallis,  0. 

:\IAF1S(JXVILLK. 
1905.     First  case,  August  14.     Cases,  1 ;  (h'atlis,  0. 

:\  FA  L:\roT. 

1879,  h'ii-st  case,  XoveiiilxM'  1.     Cases,  1;  deatlis,  0. 

:\JAXT)FVILLE. 
1847.     Xo  record  <!f  cases  and  deaths. 


LOUISIANA.  8.59 

1878.  ropulatioii,  300.  Yellow  fever  made  its  appear- 
ance about  the  middle  of  September.  A  child  died  Sep- 
tember 2(),  and  a  few  scattering  cases  followed.  A  youni^' 
lady  from  2sew  Orleans  died  next,  and  a  Catholic  priest 
died  October  2.     Deaths,  3. 

1005.     First  case,  Anjinst  19.     Cases,  2;  deaths,  1. 

MANSURA. 
1905.     First  case,  November  10.     (^ases,  1  ;  deatlis,  0. 

MARIXGOUIN. 

1905.     First  case,  Oct.  1.     Cases,  1;  deaths,  O. 
MAIIY    PLAXTATIOX. 

1879.  Infected  by  Mor.oan  City.  First  case,  October 
10;  first  death,  October  13;  last  case,  December  — ;  last 
death,  October  18.     Cases,  45;  deaths,  3. 

McDONOGHVILLE. 

1905.     First  case  September  1.     r%ases,  20;  deaths,  0. 
1858.     Xo  record  of  cases  and  deaths. 

MEKAYILLE. 

1905.     First  case,  September  10.     Ceases,  0;  deaths,  0. 

:\rEurjTT. 

1905.     First  case,  September  10.     Cases,  2;  deaths,  0. 

^lEK   KOUGE. 
1905.     First  case,  September  10.     Cases,  1;  deaths,  0. 


860  HISTORY    OF     YELLOW     FEVER. 

MILLAUDOK 

11)05.     First  case,   September  8.     Cases,  2;  deaths,  0. 

MILLIKE]S"S    BEND. 
1905.     Cases,  27 ;  deaths,  1. 

MOREAUVILLE. 
1905.     Cases,  1;  deaths,  0. 

MORGAX    CITY. 

1878.  Population,  3,000.  Infected  by  New  Orleans. 
First  case,  An,i>nstl7;  last  case,  Xovemher  10;  first  death, 
Auo-ust  22;  last  death,  November  11.  Cases.  586;  deaths, 
109. 

1879.  Population,  3,000.  First  case,  July  25;  first 
death,  August  10;  last  case,  December  1;  last  death,  De- 
cember 4.     Cases,  89;  deaths,  25. 

1905.     First  case,  July  28.     Cases,  11 ;  deaths,  0. 

MOISE    SETTLEMENT. 

1905.     First  case,  August  30.     Cases,  52 ;  deaths,  3. 

NAPOLEONVILLE. 

1878.  Population,  500.  Infected  by  Lafourche  Cross- 
ing.    First  case,  August  10.     Cases,  3;  deaths,  0. 

NATCHITOCHES. 

1839.     No  record  of  cases  and  deatbs. 

1905.     No  record  of  cases  and  deaths. 

1905.     First  case,  September  IG.     Cases,  1;  deaths,  1. 

NERO. 

1905.     Cases,  1. 


LOUISIANA.  861 

NEW   IBERIA. 

1839.  No  record  of  cases  and  deaths. 

1867.  No  record  of  cases  and  deaths. 

1870.  No  record  of  cases  and  deaths. 

1905.  First  case,  October  10.     Cases,  18;  deaths,  1. 

1900.  First  case,  Angnst  19.     Cases,  I. 

NEW   IBERVILLE. 

1905.     Cases,  2;  deaths,  0. 

NEW    ORLEANS. 

11 ISTOKICAL   ReSUMK. 

Thv  Birth  of  the  rity. 

In  the  spring  of  1718,  Bienville  selected  a  site  for  fi 
town  on  the  banks  of  the  ^Mississippi,  an<l  placed  fifty 
men  to  ch\ar  off  the  gronnds,  as  the  location  of  the  fntnre 
capital  of  the  province.  The  ground  selected  was  that 
which  is  now  covered  by  the  lower  portion,  oi-  French 
part,  of  tlie  present  Ciiy  of  New  Orleans.  The  following 
spring,  the  river  overflowed  its  banks,  the  new  settlement 
was  com])leted  innndatcd,  and  the  site  seemed  to  present 
an  nncertaii)  location  for  a  city,  which  remained  for  sev- 
eral years  little  mere  llinii  a  military  post  remote  from 
tlie  settl(>ments.  For  three  y(  ars  Bienville's  headqnarters 
remained  at  ^Mobile. 

Tlie  liisterian,  :M.  Le  I»age  Dn  Pratz,  who  came  over 
with  a  coloDV  of  eii>ht  hni'dred  men  in  1718,  under  the 
ansDices  of  the  A\'est  India  Comnany,  states  that  six 
weeks  before  the  arrival  at  Cai)e  Francais,  St.  Domingo, 
fifteen  hundred  persons  died  of  an  epidemic  called  the 
Siam  Distemper.  l)u  Bratz  uives,  however,  no  facts  to 
show  that  anv  of  the  body  of  emigrants,  some  of  whom 
settled  at  New  Oi-leans  and  others  at  Natchez,  suffered 
A\ith  yellow  fever,  Uw  he  stales  that  after  a  passage  of 


862  HISTORY    OF    YELLOW    FEVER. 

three  months,  ineludiuo-  the  six  Avoeks  spent  at  Cape 
Francais,  thoy  arrived  at  the  Ishmd  of  ^Massacre,  since 
called  Isle  of  Daiiphiue,  on  August  25,  after  a  prosperous 
voyage,  no  one  having  died,  or  having  been  even  danger- 
ously ill.  Du  Pratz  describes  the  location  of  the  future 
capital  of  Louisiana  in  1718,  as  being  marked  cut  by  a 
hut  covered  with  palmetto  leaves. 

As  early  as  the  year  1718,  when  Xew  Orleans  was 
founded,  a  company  ship  had  sailed  from  France  with 
troops  and  one  hundred  convicts,  destined  for  Louisiana, 
but  had  never  been  heard  of.  Toward  the  close  of  1821, 
there  arrived  in  Louisiana,  a  French  officer  who  gave 
some  account  of  this  ill-fated  vessel.  It  was  now  dis- 
covered that  like  the  fleet  of  LaSalle,  she  had  missed  the 
Mississippi,  and  had  been  driven  to  the  west.  Her  com- 
mander had  mistaken  the  island  of  Cuba  for  that  of  St. 
Domingo,  and  had  been,  compelled  to  pass  through  the 
old  channel  to  get  into  the  gulf.  He  made  a  large  bay, 
in  the  29th  degree  of  latitude,  and  discovered  that  he  had 
lost  his  way.  His  misfortune  aa  as  increased  by  a  disease 
breaking  out  among  the  convicts. 

Five  of  the  officers  thought  it  less  dangerous  to  land, 
with  provisions  for  eight  days  and  their  arms,  than  to 
continue  on  board. 

FirKl  ImportaiiGU  of  African  AS7f/rr.s. 

The  first  importation  of  African  slaves  numbering  500, 
was  made  in  1711),  a  large  portion  ot  Avhich  was  sent  to 
Xew  Orleans,  and  transferred  to  the  Avest  bank  of  the 
river  to  a  plantation  oAvned  by  a  company.  The  re- 
mainder Avere  sold  chiefly  to  the  agricultural  settlements 
of  the  lower  ^Iississipi»i.  AVe  haAC  no  accounts  of  any 
importation  of  yelloAv  fever  by  these  or  subsequent  cargoes 
of  slaves  under  the  French  reign. 

The  ''Phi f/ lie  of  Mar.^ciUcs/' 

P.eii.ard  de  la  Harpe  states  that  on  the  1st  of  July,  1720, 

the  king's  ships,  Jjc  Conitc  dc  Toulouse,  sixty-four  guns, 

cpmmanded  by  Af.  de  Vatel,  after  the  death  of  M.  de 

Cafaro,  on  tlie  17lh  of  June,  and  the  ^aint  Henri,  seventy 


NEW     ORLKANS.  863 

gims,  commanded  by  M.  Douce,  arrived  iu  Louisiana. 
They  broujilit  with  tliem  from  the  island  of  St.  Domingo, 
a  contagious  fever  or  mahidy,  whicli  carried  oft'  a  great 
number  of  persons  every  day.  After  opening  several 
bodies,  it  was  discovered  that  the  disease  came  from  a. 
corruption  which  engendered  a  quantity  of  worms  iu  the 
stomach. 

Francois  Xavier  3Iartin  gives  a  wholly  different  ac- 
couiit  of  the  origin  and  nature  of  this  malady,  and  classes 
it  with  the  Oriental  Plague.  He  says:  ''Two  line-of- 
battle  ships  came  in  the  latter  part  of  June,  1720,  from 
Toulon.  They  were  in  great  distress;  Caftaro,  the  com- 
modore, and  most  of  their  crews  had  fallen  to  the  plague, 
which  some  sailors  iu  these  ships  Avho  come  from  Mar- 
seilles, had  communicated  to  the  others;  that  city  being 
ravaged  by  jiestilence,  brought  there  by  a  ship  from  Lyde, 
in  the  J.evant.  Father  Laval,  a  Jesuit,  royal  professor  of 
hydrography  in  the  colleges  of  Toulon,  had  hj  the  king's 
order,  taken  passage  on  board  this  fleet,  with  directions 
to  make  astronomical  observations  in  Louisiana.  The 
chaplains  of  the  ship  having  died,  the  father,  considering 
science  an  object  of  minor  consideration  to  a  minister  of 
the  altar,  thought  it  his  duty  to  bestow  all  his  time  in 
administering  spiritual  relief  to  the  sick,  who  for  a  long 
time  Avere  very  numerous,  and  he  sailed  back  with  the 
ships. 

Orif/in  of  ^htnrii  in  Loidmrua. 

Experiment  having  shown  that  Europeans  could  not 
stand  the  labors  of  tiie  field,  but  sickened  and  died  under 
the  burning  suns  of  Louisiana,  and  the  chilling  dews  and 
fogs  of  night;  the  Western  Company  was,  tliercfore,  com- 
pelled to  introduce  African  negroes  to  cultivate  the  plan- 
tations scattered  on  the  bayous  and  rivers  of  the  delta 
of  the  ^lississippi,  and  for  several  years  it  furnished  the 
agricultural  interests  of  the  colony  with  several  liundred 
annually,  which  was  the  origin  of  African  slavery  in 
Louisiana.  In  1824,  ^F.  de  Bienville  drew  up  a  code,  con- 
taining all  the  legislation  a]»iilicaltle  to  slaves  in  Louis- 


864  HISTORY    OF    YBLLOW    FKVIR. 

iana,  which  remained  in  force  until  1803.  It  appears  that 
duriu*;  the  rear  1781,  Louisiana  received  no  less  than 
1,3(>T  nejiroes  from  the  coast  of  Africa.  We  have  failed 
to  discover  in  the  writinf^s  of  La  Harpe,  Du  Pratz,  Char- 
levois,  ^lartin,  Gayarre  and  others,  any  facts  sustaining 
the  view  advanced  by  some,  tliat  yellow  fever  was  first 
imported  into  Louisiana  by  the  slave  shi])S. 

Du  Pratz,  wlio  visited  New  Orleans  and  BiUtxi  in  1722, 
states  that  at  the  latter  place  more  than  five  hundred 
persons  died  of  famine.  He  states  that  ''the  lireat  plenty 
of  oysters  found  ujion  the  coast  saved  the  lives  of  them, 
although  obliged  to  wade  up  to  their  thighs  for  them,  a 
gunshot  from  the  shore.  If  this  food  nourished  several 
of  them,  it  threw  numbers  into  sickness,  wliicli  was  still 
more  heightened  l)y  tlie  bmg  time  they  were  obliged  to  be 
in  the  water." 

Families  aud  Hnrricaurs. 

In  the  beginning  of  August,  1723,  Bienville  removed 
his  head(]uarters  to  New  Orleans.  A  most  destructive 
hurricane  desolated  the  province  on  the  lltli  of  Septem- 
ber, 1723.  The  church,  hospital  and  thirty  houses  were 
levelled  to  the  ground  in  New  Orleans;  three  vessels  that 
lay  before^  it  were  driven  onshore.  The  crops  above  and 
below  AV('r<^  totally  destroyed,  and  many  houses  of  the 
planters  blown  down.  Famine  threatened  the  colonists 
with  its  horrors,  but  they  were  in  some  degree  relieved 
l»y  the  appearance  of  an  unexpected  cro])  of  rice.  7)/,s- 
ea^c  luhhtl  in  flic  full,  ils  honorx  to  lliosc  of  iiiipciKtluif 
deafJi. 

In  1724,  the  white  population  of  Louisiana,  says  La 
ITarpe,  amounted  to  aboutl,700  souls,  and  the  black  pop- 
ulation 3,:5()().  If  La  llarpc's  statement  be  true,  it  shows 
an  astonishing  diminution  of  the  Nxliitc  jtopulation,  which 
in  1721,  was  comi>ulcd  at  5,400. 

.1//   Hiiilji  Deforcsiuiioii  Ed  id. 

During  the  fall  of  1726,  Perrier,  a  lieuteuant  of  the 
king's  ships,  having  been  appointed  commandant  general 
of  Louisiana,  sli(.i-<ly  after,  Bienville  sailed  for  France; 


NEW    ORI.EANS.  865 

one  of  tlie  articles  of  instruction  to  (}<tvernor  Perrier  ran 
thus:  "Whereas  it  is  inaiutained  that  the  diseases  ichicU 
prerail  in  Xeir  Ovleuns  duriiu/  the  summer  proceed  from 
the  iraiit  of  air,  and  from  the  city  being  smothered  by  the 
nci(/hhorin</  iroods,  irhivli  press  so  close  around  it,  it  shall 
he  the  care  of  M.  Perrier  to  Jiare  them  cut  doicn,  as  Jar  as 
Lake  PonlcJiartrain/'  These  instructions  shoAV :  That 
at  that  remote  time,  tlie  summer  was  tlie  sicldy  seas^on  at 
New  (h-leans,  as  it  has  continued  ever  since  up  to  very 
recently;  and  to  make  the  city  more  healthy,  the  gov- 
ernment as  far  baelv  as  172(),  was  struck  with  thq 
necessity  of  an  improvement  which  was  only  finally  ex- 
ecuted to  fulfill  the  necessities  of  the  Federal  troops  dur- 
ing their  hostile  occupation  in  1863,  1864  and  1865. 

Colonial  Xcw  Orleans. 

In  the  year  1727,  the  land  of  which  the  City  of  New 
Orleans  now  stands,  not  being  protected  by  an  adequate 
levee,  was  subject  to  annual  inundations,  and  Avas  a  per- 
fect quagmire,  presenting  no  better  aspect  than  that  of 
a  vast  sink  or  sewer.  The  waters  of  the  Mississippi  and 
those  of  Lake  Pontchartrain,  met  at  a  ridge  of  high  land, 
which  by  theii-  common  deposits  they  had  formed  between 
Bayou  St.  John  and  Xew  Orb^ans,  called  the  highland  of 
the  lepers.  To  drain  the  city,  a  wide  ditch  was  dug  on 
Bourbon  Street,  the  third  from  and  parallel  to  the  river; 
each  lot  was  surrounded  by  a  small  ditch,  Avhicli  in  the 
course  ()f  time  filled  ui),  exce])t  the  ])art  fronting  the 
stre(  t,  so  that  every  square  instead  (if  (^very  lot  was 
ditched  in.  The  whole  city  was  surrounded  by  a  large 
ditch,  and  fenced  in  with  sharp  stakes  wedged  close  to- 
gether. In  this  way  a  c(jnvenient  si)ace  was  drained.  In 
the  language  of  (layarre,  "mc^uiuilocs  buzzed,  and  enor- 
mous frogs  croaked  incessantly  in  (oncca-t  with  other 
indescribable  sounds;  tall  reeds  and  grasses  of  every 
variety  grew  in  the  streets,  and  in  the  yards,  so  as  to 
intercept  all  communication,  and  offered  a  safe  letreat 
and  places  of  concealment  to  venomous  reptiles,  wild 
beasts  and  malefactors,  who  protected  by  these  impene- 


866  HISTORY    OF    YELLOW     FEVIR. 

trable  juugies,  committed  with  impunity,  all  sorts  of  evil 
deeds."  Is  it  any  matter  of  surprise,  therefore,  that  the 
hot  mouths  of  summer  and  autumn  were  even  at  this  early 
day,  dreaded  for  their  destructive,  pestilential  fevers? 


The  First  Levee. 

Governor  Perrier  signalized  the  beginning  of  his  admin- 
istration, by  the  completion  on  the  15th  of  Xovember, 
1727,  in  front  of  New  Orleans,  of  a  levee  eighteen  hundred 
yards  in  length,  and  so  bi'oad  that  its  summit  measured 
eighteen  feet  in  width.  This  same  levee,  although  con- 
siderably reduced  in  its  proportion,  he  caused  to  be  con- 
tinued eighteen  miles  on  both  sides  of  the  cit^^  above  and 
below.  He  announced  to  the  company  that  he  would  soon 
undertake  to  cut  a  canal  from  New  Orleans  to  Bayou  St. 
John,  in  order  to  open  a  communication  with  the  sea, 
through  the  lakes,  and  he  mentions  the  arrangements 
which  he  had  made  with  the  inhabitants  in  relation  to  the 
negroes  they  were  to  furnish  for  the  execution  of  this 
work,  which  was  actually  begun,  but  to  which  subsequent 
events  put  a  stop.  Thus  it  is  seen  that  the  plan  of  the 
canal  which  now  bears  the  name  of  Carondelet,  did  not 
originate  with  the  !?^panish  governor. 


Pestilence^  Famine,  Drouths  and  Hurricanes. 

From  a  dispalcli  (if  Diron  d'Artnguette.  dated  April 
23,  1733,  we  learn  that  small-pox  was  then  raging  in 
Louisiana,  and  that  from  this  cause  and  famine,  the 
result  of  the  destruction  of  the  crops  by  a  hurricane,  the 
colony  was  on  the  eve  of  being  depopulated. 

Bienville  and  Salmon,  in  a  joint  dispatch  of  the  31st  of 
Angust,  173."),  say:  "Tlie  mortality  of  cattle  is  frightful, 
tlie  drouglit  is  excessive  and  the  heat  is  suffocating.  Such 
hot  Aventher  has  never  been  known  since  the  foundation 
of  the  colony,  and  it  has  now  lasted  four  months  without 
anv  change.'' 


NEW    ORLEANS.  867 

Tlic  ''Mad  Do(f'  Epidemic. 

Vt'hiU''  the  planters  were  sulTeriiic:  from  droiiiilit,  after 
having  sntt'ered  from  innndations,  the  inhabitants  of  New 
Orleans  were  laboring  under  a  strange  kind  of  infection. 
They  could  hardly  venture  out  of  their  houses  without 
being  bitten  by  mad  dogs.  These  animals  had  increased  to 
such  ail  extent,  that  they  had  become  an  intolerable 
nuisance,  and  to  remedy  the  evil,  the  royal  commissary, 
Salmon,  ordered  them  to  be  hunted  down,  on  certain  days, 
from  five  o'clock  to  six  o'clock  in  the  morning.  He  also 
jtrohibited  negroes  and  Indians  from  having  dogs,  under 
the  penalty  for  the  offender  of  being  sentenced  to  wear 
an  iron  collar. 

Festilencc  More  Fatal  fJtaii  War. 

In  1734,  Bienville  was  reappointed  Governor  of 
Louisiana. 

The  force  which  Bienville  assembled  in  1739,  for  the 
subjection  of  the  Chickasaw  Indians,  consisted  of  up- 
wards of  1,200  white,  and  double  that  number  of  Indian 
and  black  troops.  This  comparatively  large  army,  un- 
accountably spent  six  months  in  making  preparations  for 
its  march.  In  the  meanwhile,  the  troops  lately  arrived 
from  France  became  unhealthy,  and  many  died,  and  the 
climate  had  an  almost  equally  deleterious  influence  on 
those  from  Canada.  Early  the  next  fall,  the  regulars  and 
militia  of  Canada  and  Louisiana,  who  had  escaped  the 
autumnal  disease,  were  prostrated  by  fatigue,  and  Bien- 
ville was  compelled  to  confine  his  call  for  service,  to  his 
red  and  black  men.  They  were  his  only  effective  force. 
In  the  Chickasaw  war,  peace  was  ])urchased  at  the  price 
of  many  valuable  lives — estimated  at  500,  out  of  1,200 
white  troops,  not  slain  in  battle,  but  destroyed  by  the 
fevers  of  the  climate. 

Cession  to  Spain. 

On  the  third  of  November,  1703,  a  secret  treaty  was 
signed  at  Paris,  between  the  French  and  Spanish  Kings, 


8()8  HISTORY     OK     YELLOW     FEVER. 

I)V  wliicli  tlic  fcnucr  ccdtMl  to  tlic  latter,  the  part  of  the 
IH•o^■ill(•(>  (  f  Louisiana  \\iiicli  lies  on  tlie  wi'steni  side  of 
tlie  Mississii)i)i,  iiicludiiij;  the  City  of  Xew  Orh^aiis. 

The  suhseqiient  history  of  New  Orleans,  including:  the 
cession  to  the  Ignited  States  and  other  political  events, 
is  well  knoAvn  to  the  niajoritv  of  onr  readers.  This  re- 
sume, taken  from  the  memoirs  of  the  late  Joseph  Jones, 
one  of  Louisiana's  most  distin«>nishcd  suri»eons  and 
autlioi's,  '-overs  the  most  interestiuo'  period  in  the  life  of 
the  lii  aiitifnl  metropolis  of  the  South. 

Si'^niARY  OF  Epii)e:mi('s.* 

Accordimi'  t<t  (MiaiUe  (A'/'-  OrJains  MciJira]  <iikJ  »S'//y- 
(/ii-dl  JoiniKiI,  IS.IS,  ]).  SIS),  there  is  authorily  for  stating 
that  cases  of  _v(  llov\'  fever  occurred  in  New  Orleans  in 
17(11)  and  171)1  ;  ether  auth(!rities  assert  the  f ev(  i-  was  also 
present  in  1703,  1794  and  1795 — hut  the  first  un(]uestion- 
ahle  e])ideniic  did  not  occur  until  179(5,  at  Avhich  time  the 
city  had  a  i)oi)uhiti<in  of  about  (>,000. 

The  yellow  fever  years  in  New  Orleans,  from  17(11)  to 
the  last  epidemic  (11)05),  nuiy  be  summariztd  as  follows: 

17(11).  I-'irst  traditional  appearance  of  yellow  fever  in 
New  Orleans.      No  statistics. 

1791 ;  1793;  1791.  No  record  <!f  (  ases  and  dc  aths.  The 
di.uiiing  of  the  Carondelet  Canal  (  Ohl  I>asin  )  was  begun 
in"  1794. 

1795.      Limited  (Uitbreak. 

179(1.  I-'irst  anthentic  invasion  of  N(  w  (h-leans  by  yel- 
low fever.      No  reliable  statistics  obtainable. 

1797.  N(»  rec(  rd  of  cases  and  deaths.  The  Old  Basin, 
the  present  liead  of  the  Carondebt  Canal,  ^^•as  excavated 
in  1797 

1799.  No  record  of  cases  and  di  aths.  Crevasse  ab(;ve 
the  city. 

1800;  ISOl;  1S()2;  1S03;  1S()4;  ISOl);  ISll.  No  record 
of  cases  and  deatlis.  Hurricane,  doinj^  mneh  damage  lo 
city,  in  ISll. 

isi2.     roiuilation,  19,229.     War  with  (Jreat  Britain. 
*  Dates  of  important  excavations,  etc.,  are  given  because  of  their 
fanciful   association,   at  the   time,   with   yellow   fever  out- 
breaks. 


NEW    ORLEANS.  869 

1817.  ropiilation,  24,19(;.  Infected  1)y  British  Cutter 
Phocui.r,  frciii  Havana.  First  ease,  Jniie  18;  last  death, 
December  —  -.  Deaths,  80.  Extensive  crevasse  al)()ve  city 
the  year  jirevioiis. 

1818.  Pcpnhition,  25,100.  :Mild  epidemic.  Deaths,  115. 

1819.  r<ipuhition,  2(),183.  Infected  hy  Havana. 
Severe  epidemic.     First  case,  July  1.     Deaths,  2,190. 

1820.  Population,  2T,17r).  First  case,  July  — .  That 
year,  the  wooden  sidewalks  in  the  business  portion  of  the 
city  were  removed  and  bricks  or  flags  substituted. 

1821.  No  record  of  cases  and  deaths. 

1822.  ropulaticin,  31,70(1  First  case, -September  1. 
Cases,  337 ;  deaths,  237. 

1823.  Population,  33,971.  Infected  bv  Pensacola. 
First  case,  Auoust  23.     Cases,  2,337 ;  death'^,  239. 

1824.  Population,  3(),23().  Infected  by  Havana.  First 
case,  Aujiust  4.     Cases,  1()7;  deaths,  108. 

1825.^  Population,  38,501.  First  case,  June  23.  Cases, 
99;  deaths,  49.  Diuiiiuii'  of  Gormeley's  Canal  to  drain 
upper  part  of  city. 

182fi.  Population,  40,7()(i.  First  case.  May  18.  Cases, 
24;  d(niths,  5.     Diiiiiinii  (if  MelixniK^ije  Canal. 

1827.  Poi)ulatii:n,  43,031.  First  case,  July  19.  Cases, 
372;  deaths,  109. 

1828.  P(;i)ulation,  45,29(5.  First  case,  June  18.  Cases, 
290;  deatlis,  150. 

1829.  Population,  47,501.  First  case,  :\[ay  23.  Cases, 
435;  deaths,  215. 

1830.  P(;i)ulation,  49,82(1.  First  case,  July  15.  Censes, 
250 ;  deaths,  117. 

1831.  Poi)ulation,  52,455.  First  case,  June  9.  Cases, 
3;  deaths,  2. 

1832.  Population,  55,084.  First  case.  Auj>ust  15. 
Cases,  20;  deaths,  18. 

1833.  Population,  57,713.  First  case,  July  12.  Cases, 
422;  deaths,  210.  Heavy  rains,  lasting-  from  June  to 
September. 

1834.  l»oi)ulation,  00,342.  IMrst  case,  Au.mist  28. 
Cases,  150;  deaths,  95. 


870  HISTORY    OF    YELLOW    FIVER. 

1835.  Population,  02,971.  First  case,  August  23. 
Cases,  505 ;  deatlis,  281.  '■ 

1830.     Population,    05,000.       First    case,    August    21.         J 
Cases,  0;  deaths,  5. 

1837.  Population,  08,229.  First  case,  July  21.  Cases, 
998 ;  deaths,  112. 

1838.  Population,  70,858.  First  case,  August  25. 
Cases,  22 ;  deaths,  17. 

1839.  Population,  73,137.  First  case,  July  23.  Cases, 
1,080;  deaths,  152. 

1810.  Population,  70,110.  First  case,  July  25.  Cases, 
3;  deaths,  3. 

1811.  Population,  78,715.  First  case,  July  27.  Cases, 
1,111;  deaths,  591.  Drainage  Commission  actively  en- 
gaged in  drainage  and  clearing. 

1812  Population,  81,371.  First  case,  July  30.  Cases, 
425 ;  deaths,  211. 

1813.  Population,  81,003.  First  case,  July.  Cases, 
1,090 ;  deatlis,  187. 

1811.  Population,  80,032.  First  case  in  July;  last 
case,  September.  Cases,  109 ;  deaths,  83.  Overflow  from 
Lake  Pontchartrain;  city  liooded  to  Burgundy  Street. 

1815.     Population,  89,201.     Deaths,  2. 

1810.  Population,  102,070.  First  case  in  August ;  last 
case  in  October.  Deaths,  110.  Faubourg  Lafayette  an- 
nexed to  city,  increasing  population. 

1817.  Population,  108,099.  First  case,  July  0;  last 
case  in  December.  Deaths,  2,300.  War  with  Mexico. 
Melpomene  Canal  cleaned  out.     Heavy  rains. 

1818.  Population,  115,503.  First  case,  June  21  ;  last 
case  in  November.  Deaths,  808.  Extensive  excavations 
made  for  foundations  of  T'nited  States  Custom-house. 
This  Avork  went  on  uninterruptedly  until  September, 
1819.  Two  acres,  20  by  7  feet  wide  and  8  feet,  7  inches 
deep,  were  excavated. 

1819.  Population,  122,511.  First  case,  July  28;  last 
case,  Decemlier  — .     Deaths,  709. 

1850.  Population,  129,717.  First  case  in  January, 
terminating  fatally;  2  deaths  in  ]March,  1  in  ^May,  1  in 


NEW    ORLEANS.  871 

July,  G2  ill  Aiiiiiist,  33  in  September  and  4  iii  October. 
Total  deaths,  107. 

1851.  ropulation,  138,599.  Deaths,  17.  Excavations 
for  railroads,  gas  and  waterworks. 

1852.  Population,  117,411.  First  case,  July ;  last  case, 
December  — .     Deaths,  45G.     Claiborne  Canal  dug. 

1853.  Population,  151,132.  Infected  by  ship  Camhodcn 
Castle,  from  Kingston,  Jamaica.  First  case,  May  22; 
last  case,  December.     Deaths,  7,849. 

The  epidemic  of  1853  was  the  most  mortal  which  has 
ever  afflicted  Xew  Orleans. 

1854.  First  case.  May ;  last  case,  December ;  first  death, 
June  12.     Deaths,  2,425. 

1855.  First  case,  June  19;  last  case,  December. 
Deaths,  2,670. 

1850.  Population,  153,421.  Infected  l^y  Vera  Cruz. 
First  case,  June  28 ;  last  case,  Xoyember  — ,     Deaths,  74. 

1857.  Population,  157,242.  Infected  by  Havana  via 
Mobile.  First  case,  January;  last  case,  December. 
Deaths,  200. 

1858.  Population,  101,033.  Infected  by  St.  Thomas, 
West  Indies.  First  case,  June  10;  first  death,  June 
10 ;  last  case,  October  10.     Deaths,  4,845. 

1859.  Population,  104,804.  Infected  by  brig  Elizaheih 
EUrn,  from  Havana.     First  case,  June  — .     Deaths,  91. 

1800.  Population,  108,075.  Deaths,  15. 

18(;i.  Population,  170,949.  Civil  War.     No  cases. 

1802.  Infected  by  Key  West.     Deaths,  2. 

1803.  Population,  175,497.  Deaths,  2. 

1804.  Population,  177,708.  Deaths,  6. 

1805.  Population,  180,943.  Cases,  1 ;  deaths,  1. 
18()0.  Population,    182,318.     First    case,    August    10. 

Deaths,  185. 

1807.  Population,  184,503.  First  case,  June  10;  last 
case,  December  22.     Deaths,  3,107. 

The  first  case  died  in  the  Charity  Hospital  on  June  the 
10th,  a  seaman  who  had  been  em]»b!y(Ml  in  the  navigation 
of  the  Lake.  Three  weeks  before  his  death  he  had  shipped 
upon  the  bark  Bessie,  loading  with  staves  in  the  Fourth 


872  HISTORY    OF    YELLOW     FEVER. 

District,  and  boniid  fdi-  Barcelona.  This  vessel  had  sailed 
from  Havana  in  .Mareli,  airivinii  liere  in  April  laden  with 
sn«iar.  8he  was  reported  clean  and  liealthy.  Soon  after 
arriving',  went  into  dry  doek  in  Algiers.  Inqniries  were 
made  as  to  her  after  her  sailino-.  She  arrived  at  her  desti- 
nation Avithont  mishap  as  to  the  lives  of  her  crew. 

The  second  case  reported  was  by  Dr.  Rrickell,  as  hav- 
ing;' been  taken  on  the  13th  of  Jnne,  on  St.  Charles  Street 
near  Jnlia.     The  man,  John  Boddis,  recovered. 

The  third  case,  reported  by  Dr.  Folwell,  on  Jnlia  Street, 
between  Camp  and  St.  Charles  Streets,  died  on  the  23rd 
ol"  Jnne. 

The  fonrth  case  died  on  the  2r)th  of  Jnne.  His  name 
Avas  J.  B.  Bonnonan.  He  arrived  npon  the  steamer  W.  G. 
He  ties,  from  Galveston,  on  the  21st,  whence  he  came  from 
Indianola  direct.  He  had  a  chill  at  Calveston  on  the  19th 
and  died  on  the  2nt]i. 

The  fifth  case,  J.  Dongherty,  reported  by  Dr.  L.  H. 
Cohen,  died  on  the  20th  of  Jnne  in  the  Charity  Hospital. 
He  came  from  Xo.  fil  Girod  Street,  and  was  employed  on 
coal  bariies  at  Aliiiers. 

The  sixth  case  was  Lient.  Dewey,  who  died  at  the  St. 
Charles  Hotel.  He  came  by  steamer  direct  from  Indian- 
ola, and  was  bronmht  from  the  vessel  to  the  hotel  sick. 

The  vessel  cominji'  to  this  port,  clearly  infected,  was 
11m'  l»ai-k  Florence  J-\'frrs.  which  saib^l  from  Havana  on 
the  3rd  of  Jnne  laden  ^\^\\h  snuar.  She  was  stopped  at 
the  Qnarantinc  Station,  Jnne  the  12th,  whei'e  she  was 
delaiix'd  ten  days,  alllnMiiih  ]'ei)orted  clean  and  healthy, 
was  fnhiiuated  and  released.  She  arrived  at  Ali»iers,  June 
22.  The  wife  (;f  the  ca])tain,  !Mrs.  Hooper,  died  of  yellow 
fever  on  the  30th.  This  case  was  reported  by  Dr.  Brnns. 
Her  sister  also  was  attacked  on  the  25th,  bnt  recovered. 
The  second  mate  (Thomas)  was  taken  ill  Jnly  4,  and 
died  ill  the  TMiarity  Hospital  on  the  Otli.  The  ca])tain  also 
died  on  the  13th.  ' 

The  fever  existed  thi-cnuhcnt  Jnly  in  the  city,  and  nntil 
near  the  middle  of  Anj^nst  before  acqnirinji-  epidemic 
l)r(.porficns. 


NEW    ORLEANS.  873 

Froui  the  middle  of  August  to  the  end  of  September, 
the  mortality'  Avas  considerable. 

18GS.  Population,  18(5,008.  First  death,  October  5. 
Deaths,  5. 

18G9.     Deaths,  3. 

1870.  Infected  by  steamship  A(/itcs,  from  Honduras. 
First  case,  ]May  IG;  last  case,  December.     Deaths,  588. 

1871.  Infected  by  brig  Mar//  Pratt,  from  Cuba.  First 
case,  August  1;  last  case,  October.     Deaths,  51. 

1872.  First  case,  August  28;  last  case,  November  30. 
Deaths,  39. 

1873.  Infected  by  bark  Val/un-aiso,  from  Havana. 
First  case,  July  1;  last  case,  November  19;  first  death, 
July  8.     Cases,*^3G8;  deaths,  22G. 

1871. 

The  outbreak  of  1871  is  interesting,  fiom  a  point  of 
high  rate  of  mortality,  considering  the  limited  number  of 
cases.  There  were  altogether  20  cases,  of  which  17  died. 
The  first  two  cases  were  discovered  by  the  B<tard  of 
Health  on  the  same  day  (August  19)  at  No.  170  Victory 
Street,  in  the  iiersons  of  two  Irish  boys,  aged  G  and  9, 
who  had  only  lieen  in  the  city  six  months.  Yellow  fever 
had  been  quite  severe^  in  tliat  l)b;ck  the  year  jtrevious 
(1873).  The  little  patients  died.  On  August  25,  the 
mother  of  the  tots,  aged  30,  contracted  the  disease  and 
died  shortly  afterward.  The  other  cases  occurred  as 
follows : 

September  21 — N(t.  102  Front  Levee  Street — Died. 
September  22— No.  159  Julia  Street— Died. 
Septemlter  23— No.  117  :\ragiiolia  Street— Died. 
Se})t('mber  2(5 — No.  10  Dumainc  Street — Died. 
September  29— N(j.  019  (}(todchildren  Street— Died. 
October  1— No.  390  Magazine  Street— Died. 
October  7 — No.   1(59   ]>ai(ii)iie  Sti-eet — Recovered. 
Octobe'r  8 — No,  112  ^Magazine  Stre^et — Dieel. 
October  ..—No.  102  Old  Levee  Stre'et— Died. 
October   .  . — Unknown — Died. 


874  HISTORY    OF    YELLOW    EEYER. 

October  15 — No.  15  Rousseau  Street — Died. 

Octol>er  17 — Xo.  1)5  Spain  Street — Jvecovered. 

October  21— Xo.  im  Orleans  Street— Died. 

October  22— Xo.  619  Goodcliildren  Street— Died. 

X^ovember  1 — Bark  Qiicriisstoioi — Recovered, 

X>)Ycniber  2 — Bark  Qiiccii.stoini — Died. 

X^'ovember  28 — Chartres  Street — Died. 

According"  to  the  records  of  the  Board  of  Health  (1871), 
the  fourth  case  occurred  in  the  same  scpiare  where  yellow 
fever  had  prevailed  the  year  before.  Cases  5,  and  G  were 
infected  at  Pascagoula,  Miss.,  and  cases  18  and  19  were 
imported  from  Havana  by  the  bark  Qiicenstoicn. 

1875.  First  case,  August  8;  first  death,  August  12; 
last  case,  X'ovember  28.     Cases,  100;  deaths,  CI. 

187(>.     Deaths,  41. 

1877.  Tlie  history  of  yellow  fever  for  the  year  1877, 
in  X'ew  Orleans,  is  limited  to  a  single  case.  A  man  ar- 
rived on  the  steamsh'p  St.  IjOh'is.  from  Havana,  X'ovember 
6,  and  died  the  next  morning  at  the  corner  of  Rousseau 
and  IMiilip  Streets,  with  ui)uiistakal)le  symptoms  of  yellow 
fever.  He  had  sickened  four  days  previously,  within  a 
few  hours  after  leaving  Havana,  where  he  had  stayed 
three  Aveeks;  but  continued  to  go  about  the  ship  until 
after  passing  the  quarantine,  and  in  this  way  failed  to 
attract  the  attention  of  the  resident  physician. 

1878. 

This  is  one  of  tl)e  most  notabb^  (epidemics  of  yellow 
fever  in  th(^  history  of  X'ew  Orleans,  ov\ing  to  the  numer- 
ous ])laces  which  were  infected  frcnu  tliis  focns. 

On  ]\ray  22,  1878,  the  ship  Eiiiihi  Ji.  >^oii'Irr  arrived  at 
fpiaiantine  below  X>w  Oi-leans,  having  called  at  Havana 
during  her  tri]).  T'pon  her  an-ival.  Dr.  Carrington,  the 
quarantine  ofhcer,  after  making  an  examination,  tele- 
gra]»lied  Dr.  Chop]un,  President  cf  the  Louisiana  Board 
of  Health,  as  folbnvs: 

"The  SoiuJci-  has  a  case  of  intermittent  on  board. 
Wliat  shall  T  do?"' 


NEW     ORLEANS 187  8.  875 

Dr.  Clioppiu  replied: 

"Fumigate  and  disinfect  the  ship  and  satisfy  yourself 
of  the  character  of  tlie  disease  before  you  let  her  come 
up." 

The  sick  man  was  placed  in  the  quarantine  hospital 
and  finally  recovered. 

Tlie  Sotulcr  after  five  hours'  detention,  and  disinfection 
with  sulphur  burned  in  pans,  was  permitted  to  go  up  to 
the  city.* 

Soon  after  arrival  at  her  wharf,  ^Ir.  Clark  the 
purser,  was  taken  ill,  and  Dr.  Drew,  of  Pilot  Town,  who 
had  taken  passage  at  that  point,  was  called  to  treat  the 
case.  The  physician  did  not  consider  this  a  case  of  yel- 
low fever,  as  he  signed  the  certificate  of  deatli,  ''Malarial 
fever."  An  investigation  of  the  case  at  the  house  where 
he  died,  however,  slicwed  that  the  treatment  was  more 
suitable  to  yellow  fever  than  to  am^  other  disease.  This 
death, was  n(;t  brought  to  the  notice  of  the  Board  of 
Health  by  any  direct  communication,  official  or  otnerwise, 
but  from  infcu-mation  received  tlirough  rumor.  It  is  a 
significant  fact  in  connection  with  Clark's  case,  that  he 
died  at  2  o'clock,  a.  m.,  and  was  buried  at  10  a.  m.,  the 
same  day.  Xo  public  announcement  of  his  death  v;i;-..i 
mad(^  until  the  following  Sunday. 

Mr.  Elliott,  the  second  engineer  of  the  louder,  was 
taken  sick  sliortly  after  his  arrival,  and  was  attended  by 
a  private  physician  at  his  boarding-house,  corner  of  Front 
and  Gircd  Streets,  until  the  evening  before  his  death, 
without  apparently  a  suspicion  on  the  part  of  any  one 
that  lie  had  yellow  fever.  Late  in  the  evening  of  May  29, 
he  was  removed  to  Hotel  Dieu,  where  he  died  within  a 
few  hours.  A  careful  post  mortem  examination  Avas 
made  by  two  competent  physicians,  and  the  body  was  sub- 
se(pi(U)tly  inspected  by  Dr.  Choppin.  Xo  one  of  these 
physicians  doubted  the  nature  of  the  disease. 

For  about  two  months  after  the  above  occurrences,  no 

*  Detention  of  ])assengers  in  quarantine,  for  observation, 
abolished  by  Legislature  of  1876  and  reliance  placed  on 
disinfection  alone. 


876  HISTORY    OF    YELLOW    FEVER. 

now  casos  dev(  loped.  If  yellow  fever  existed,  it  was  not 
reported  to  the  l^oard  of  Health,  or  was  of  such  a  mild 
nature  as  not  to  be  differentiated  from  the  malarial  fevers 
common  in  th<(se  days. 

Alxtut  file  middle  of  July  some  cases  of  a  strongly  sus- 
picious character  came  to  li<>ht  on  Constance  Street,  near 
its  intersection  with  Terpsichore,  and  in  a  few  days  all 
doubt  was  removed  of  their  true  natui'e.  About  the  7th 
of  July,  a  younj>'  man,  named  Cohn,  came  to  the  Touro 
Infirmary  frcnn  Gasquet  Street,  between  Yillere  and 
]\larais.  ])resentiu_i>-  str(tn<>'  a])pearances  of  yellow  fever, 
but  he  recovered  before  atteution  Avas  drawn  to  Constance 
Street,  and  his  case  was  considered  questionable.  AVithin 
a  few  days,  cases  were  found  near  the  corner  of  Front 
and  Girod,  where  Elliott  had  sickened;  on  Bienville,  near 
where  Clark  had  died  and  on  Clail)orne  Street;  a  case 
on  Robertson  Street,  near  the  home  of  Colin,  who  had 
been  at  the  Touro  Infirmary,  not  much  more  than  a  quar- 
ter of  a  uiile  fr(fm  where  Clark  died,  and  a  still  less  dis- 
tance from  Hotel  Dieu,  Avhere  Elliott  died. 

The  line  of  infection  was  tolerably  char,  thouj^h  lonj? 
latent,  from  Clark  to  Colin  and  subse(iuent]y  to  the  cases 
on  Bienville  and  Ivcfbertson  Streets;  also  fr(;m  Elliott, 
sick  at  his  b(;ardii»,u-]iouse,  t<»  the  subse(|uent  outbreak  at 
the  coi'uer  of  b^ront  and  (lirod;  but  the  outbreak  on  Con- 
stance Street  was  so  far  from  the  wharf  of  the  t>ioii<Jrr 
(fully  half  a  mile),  aud  so  loni;  after  her  arrival  (more 
than  six  weeks),  that  it  was  ]ou*y  considered  out  of  ques- 
tion to  establish  a  ccniicction  between  them. 

Inv(  stiuaticDs  made  afterwai-d  by  the  Board  of  Health, 
showed  that  s(;me  of  the  eailiest  cases  (»n  Ccmstance 
Street,  122,  occurred  in  the  family  of  a  Mr.  Caven,  who 
was  enjiiiuer  on  the  tui>bont  (lidrlir  Wootl.  This  lioat 
lay  at  the  same  v»iiarf  occU])ie<l  by  the  Soiidcr,  immedi- 
ately after  the  dei)arture  of  tlie  latter  for  Havana,  as 
stated  by  Caven  himself  at  the  time  of  his  illness. 

On  July  24,  the  followinc:  communication  was  sent: 


NEW    ORLEANS 1878.  877 

Xew  Okleaxs,  July  24,  1878. 
Dr.  J.  M.  W(;(t(lw(;i-tli,  Surj^eon-Gencral, 

^laiine  Uijspital  Sci-vice,  AVasliiiii^toii,  1).  (\ 
Sir — It  now  liecr.mes  iiiv  duty  to  I'uport  the  existence 
of  yellow  fever  in  New  Orleans.  About  tlie  12tli  inst., 
cases  Ixii^au  to  occur  in  tlie  practice  of  several  of  our 
physicians  near  the  intersection  of  Constance  and  Terp- 
sichore Streets,  wliich  presented  suspicious  symptoms, 
and  we  now  reckon  fourteen  cases  at  that  focus  of  in- 
fection, with  six  deaths.  In  addition  to  those,  seven  other 
cases  have  c<»me  to  light  at  different  points,  and  much 
more  scattered,  four  of  which  have  already  resulted 
fatally. 

TJespectfuUy,  your  obedient  servant, 

Samuel  Choppix,  M.  1)., 
President,  Board  of  Health. 

Early  in  Au,i>ust  the  fever  began  spreading  rai)idly 
througli  the  city  and  vicinity,  and  throughcnit  all  of  Sep- 
tember and  most  of  October,  raged  furiously,  attracting 
by  its  terrible  death  roll,  the  attention  of  this  and  many 
foreign  nations.  From  all  quarters,  physicians,  nurses 
and  sui)])lies  came,  but  not  until  late  in  Xovend)er  did 
the  demon  of  pestilence  finally  make  his  exit  from  the 
unfortunate  city. 

This  memoral)le  epidemic  may  be  briefly  summarized 
as  follows : 

Population  of  New  Orleans  in  1878,  210,000.  Infected 
by  ship  E hill  11  li.  Saiidci;  from  Havana.  First  case.  May 
22;  first  death,  .Mav  25;  last  case  and  death,  Decendter  12. 
Cases,  27,000  ;  deaths,  4,04(5. 

1871).  First  case,  ]March  20,  on  board  steamship  Balti- 
more, recovei-y.  No  other  manifestation  until  June,  when 
the  first  case  in  the  city  jtrojjer  occuricd  at  No.  184  Tliird 
Street,  and  was  reported  by  Dr.  r^dmond  Souchon.  The 
first  death  took  placc^  on  July  27,  corner  Second  and  Con- 
stance Streets.  The  epidemic  lasted  until  October,  last 
case  on  the  21st  and  last  death  on  the  2;ird.  Cases,  48; 
deaths,  19. 

1880.     Deaths,  2. 

1883.     One  death. 


878  HISTORY      OK     YELLOW     tEVER. 

1889. 

One  fatal  case,  imported  from  Livingston,  Guatemala, 
under  the  following-  circumstances : 

Mr.  E.  DeVilla,  United  States  consular  agent  for  the 
United  States  of  Colombia,  had  been  at  Guatemala  City, 
and  from  there  went  overland  to  Livingston,  Guatemala, 
where  he  took  passage  on  the  steamship  City  of  Dallas 
for  New  Orleans,  on  the  26th  of  September.  The  second 
dav  out  he  was  taken  Avith  a  cliill  followed  by  fever,  but 
did  not  keep  to  his  berth  after  the  chill.  He  continued 
to  feel  ill  during  the  voyage,  but  before  arrival  of  the 
vessel  at  the  Mississippi  quarantine,  he  dressed  himself 
and  went  on  deck,  thus  passing  insi)ection  by  the  quar- 
antine officer.  The  master  of  the  vessel  made  affidavit 
that  there  had  been  no  one  sick  during  the  voyage.  The 
vessel  had  a  clean  bill  of  health,  and  there  being  no  report 
of  yellow  fever  at  Livingston,  the  vessel,  after  being  dis- 
infected, was  allowed  to  proceed  to  Xcav  Orleans,  Avhere 
she  arrived  at  8  p.  m.,  October  1. 

The  patient  was  seen  by  Dr.  J.  J.  Castcllanos,  October 
2,  had  had  fever,  nausea,  hiccough,  pain  in  the  region  of 
the  stomach,  and  bilious  vomiting.  When  seen  again  at 
night  he  was  vomiting  black  A'omit,  followed  by  black 
hemorrhagic  stools.  The  next  morning,  black  vomit  still 
persisted  and  he  had  urinary  suppression,  hicocugh  and 
unemic  convulsions. 

Dr.  Castellanos  reported  the  case  to  the  Board  of  Health 
office,  and  a  commission  of  experts,  composed  of  Drs. 
J.  P.  Davidson,  C.  J.  Bickham  and  George  Howe,  was 
summoned  and  requested  to  see  the  case  and  pass  upon  it. 

In  the  mean  time  the  man  had  died  (October  3,  11:35 
a.  m. ),  and  at  2  p.  m.  the  above  named  physicians,  with 
Dr.  Castellanos  and  Dr.  B.  Matas,  who  had  been  called 
in  consultation,  proceeded  to  the  house,  Xo.  149  Decatur 
Street,  and  after  obtaining  a  history  of  the  case  and  hold- 
ing an  autopsy,  unanimously  declared  that  death  had 
benn  caused  l)v  yellow  fever. 

There  were  no  devcloiiments  from  this  case  and  the 
city  continued  to  be  free  from  epidemic  disease  during 


NEW     ORLEANS.  879 

the  oJ<>lit  followinii-  years,  and  would  nudoubtedly  have 
enjoyed  a  longer  inimiinit3^  but  for  infection  from  out- 
side sources  in  1897. 

1897. 

The  first  authentic  case  of  yellow  fever  in  New  Orleans 
in  1897,  was  reported  by  Dr.  Sidney  L.  Theard,  on  Sep- 
tember 4th.  The  biennial  report  of  the  Louisiana  State 
Board  of  Health  for  the  years  1896-97,  published  in  Feb- 
ruar}^,  1898,  recounts  that  an  earlier  case  had  been  re- 
ported as  suspicious  on  September  1st,  by  a  prominent 
physician  of  N'^w  Orleans  (Dr.  E.  T.  Shepard),  which, 
on  investigation  by  members  of  the  Commission  of  Ex- 
perts of  the  State  Board  of  Health,  had  been  declared 
not  to  be  yellow  fever.  Of  this,  however,  no  one  had  any 
knowledge  at  the  time  except  those  immediateh^  connected 
with  the  public  health  service.  Dr.  Shepard's  case  ended 
in  recovery. 

The  case  of  fever  in  Dr.  Theard's  practice  was  reported 
by  him  to  the  Secretary  of  the  State  Board  of  Health,  on 
Saturday,  September  4,  (1897),  at  3  o'clock  p.  m. ;  the 
President  of  the  Board  having  left  that  same  evening  for 
Ocean  Springs,  to  again  investigate  the  prevailing  fever 
at  that  point,  believed  to  be  dengue.*  i 

Dr.  Theard,  having  been  engaged  in  practice  al)out  six: 
.years  only,  had  had  no  occasion  to  see  yellow  fever,  the 
last  epidemic  of  that  disease  having  occurred  in  1878, 
and  only  had  a  book-knowledge  of  the  disease.  For  that 
reason  two  members  of  the  Commission  of  Yellow  Fever 
Experts  were  delegated  to  consult  with  him.  The  patient 
was  seen  that  same  evening  at  8  p.  m.,  and  the  case  pro- 
nounced to  be  one  of  malarial  hemorrhagic  fever. 

A  prolonged  search  was  made  the  next  morning  by  Drs. 
Theard  and  Pothier,  the  latter  a  distinguished  pathologist, 
for  malarial  organism  in  the  patient's  blood,  but  none 
found. 


*  Previous  investigations  of  the  fever  at  Ocean  Springs  by  the 
State  health  officials  of  Mississippi,  Alabama  and  Louisiana, 
had  resulted  in  a  diagnosis  of  dengue  fever. 


880  IIJSTORV     OK     YELLOW    FEVKR. 

Oil  Moiidny  moriiinji-  tlie  i)atieiit  (IJaoiil  (U'lpi)  dietl, 
and  ])r.  Tlieard  iiotitied  the  secietaiy  of  ilie  Board  of 
Health,  by  ]»hone,  that  he  would  ho  doAVii  in  person  at 
the  Board  of  Health  office  to  j-iiiii  the  deatli  retnrn,  and 
wonld  aseiihe  the  deatli  to  yelloAv  fever.  On  his  arrival 
there,  shortly  afterward,  he  found  a  nuniber  of  piiysicians 
in  waitinji',  seekiuj^"  news  about  Oeean  Springs,  among 
them  one  of  the  experts  who  had  seen  the  ease  on  behalf 
of  tlie  Board  of  Health,  and  who  was  still  of  so  strong  a 
mind  that  the  ease  was  malaria  that  he  offered  to  sign 
tlie  death  eertitieate  as  sueh.  This  Dr.  Tlieard  would  not 
accept,  unshaken  in  his  own  <liagnosis  of  yellow  fever. 

Hapjiening  to  enter  the  office  of  the  Board  of  Health 
about  this  time,  Dr.  F.  W.  Parliam,  upon  being  made 
familiar  with  the  facts  in  the  case  and  the  wide  divergence 
of  views  of  the  experts  and  medical  attendant,  suggested 
the  advisal»ility  of  an  autopsy  under  the  circumstances, 
so  that  nttthing  coubl  be  left  to  opinion  or  conjecture. 
Pending  a  jio.si  iiiortciii  investigation,  a  telegram  was  sent 
to  the  President  of  the  Board  of  Health,  ad\ising  him  of 
the  facts. 

An  autopsy  held  at  10  oclock  a.  m.,  by  Drs.  Pothier, 
Touatre,  Salomon,  H.  S.  Oili])hant,  Parham  and  Theard, 
confirmed,  beyond  (|uestioii,  the  Tatter's  diagnosis  of  yel- 
low fever. 

The  announcement  of  yelloAV  fever  shocked  the  commer- 
cial S])irit  of  the  community.  It  was  a  rude  awakening 
for  New  Orleans  after  nineteen  years  of  uninterrupted 
prosperity  and  freedom  from  epidemic  disease,  and  severe 
and  bitter  criticism  was  dii-ected  at  Dr.  Theaid  from 
many  (piarters  in  conse(|uence. 

The  date  of  report  of  this  case  is  imi)or<ant  in  that  the 
patient  hailed  from  Ocean  Springs,  then  under  investi- 
gation, and  tliat  traiidoads  of  jiersons  who  I'eturned  from 
the  Gulf  Coast  resorts  on  Sunday,  Septemlxu'  5th,  would 
not  have  been  permitted  to  enter  New  Orb^ans,  had  Dr. 
Theard's  opinion  prcAailed  on  Saturday,  Sc])tember  4. 

Nineteen  hundred  and  eight  cases  of  fever  Nvere  reported 
in  1897,  with  298  deaths,  the  last  case  being  reported  on 
December  25. 


NEW    ORLEANS.  881 

1898. 

One  fatal  case  in  January.  No  cases  were  reported 
until  September  17,  when  a  dinith  from  yellow  feyer  cre- 
ated consternation  in  the  community.  Cases  continued 
to  occur  until  October  22,  when  frost  put  an  end  to  the 
activities  of  the  Sfcgomi/iac.     Cases,  118;  deaths,  57. 

1899. 

According'  to  tlie  Annual  Keport  of  the  Louisiana  State 
Board  of  Health  for  1898-99  (p.  40),  the  first  case  of 
yellow  feyer  was  reported  on  ^Nfay  28,  in  the  person  of  a 
young,  white  girl,  residing  at  1217  EoA'al  Street,  Second 
District. 

On  August  28,  a  second  case  was  reported  at  4520  Camp 
Street,  in  the  Sixth  District,  full^-  three  miles  distant 
from  the  original  case. 

A  third  case  was  reported  September  1,  and  a  fourth 
on  the  7th.  Sporadic  cases  continued  to  erupt  up  to 
Noyember  15,  on  which  day  the  last  case  Ayas  reported. 

The  most  searching  inquiry  failed  to  reyeal  the  source 
of  the  primary  infection.     Cases,  81;  deaths,  23. 

1905. 

The  epidemic  of  1905  is  memorable  in  many  ways,  but 
what  has  stamped  it  indelibly  in  the  minds  of  the  great 
thinking  puldic  of  the  entire  ciyilized  world,  is  the  grand 
victory  whicli  science,  with  tlie  modern  weapon  intelli- 
gently wielded,  lias  achieved  against  a  disease  which  is 
foreign  to  this  country  and  which,  we  sincerely  hope,  has 
been  forever  ostracised  from  our  shores. 

A  detailed  account  of  the  operaations  of  the  United 
States  ^larine  Hospital  Service,  ably  guided  by  our  local 
physicians,  will  be  found  in  another  part  of  this  volume 
(Part  IV).  For  the  benefit  of  the  layman  and  the  busy 
practitioner,  the  following  summary  has  been  made  by 
Mr.  James  M.  Augustin,  of  the  staff  of  the  Xcw  Orleans 
Picayune: 


882  HISTORY  OF   VILLOW    FEVER. 

Wlieu  it  became  known  to  the  public  on  July  21st,  1905, 
that  there  was  yellow  fever  in  Xew  Orleans,  an  investi- 
gation by  the  health  authorities  brought  out  an  estimate 
of  one  hundred  cases  and  twenty  deaths,  up  to  that  date. 
This  supposition  was  borne  out  by  the  vital  statistics  for 
tlie  month  of  July,  in  Avhich  the  death-rate  was  abnor- 
mally large,  the  mortality  from  typhoid  fever  having 
been  over  twenty  in  excess  of  the  normal ;  and  it  was  on 
this  record  that  Dr.  Kohnke,  the  Health  Officer  of  the 
City,  based  his  estimate  of  twenty  deaths  from  yellow 
fever,  prior  to  July  21st.  After  that  date,  the  number 
of  cases  and  the  death  rate  ran  on  even  lines,  possibly  a 
little  in  excess  of  the  same  rates  for  the  corresponding 
period  of  1878,  until  the  highest  record  was  reached  on 
August  12th,  when  105  cases  were  reported,  and  many 
citizens  believed  that  tlie  disease  was  beyond  control. 

The  work  of  eradication  was  begun  by  Dr.  Kohnke  in 
a  small  way,  with  such  means  as  he  had  at  his  disposal, 
and  when  o;n  July  2Gth,  Dr.  J.  H.  AVhite,  of  the  United 
States  Public  Health  and  Marine  Hospital  Service  offered 
him  such  assistance  as  he  could  render,  the  offer  was 
accepted.  Passed  Assistant  Surgeon  Eichardson  was 
detailed  to  help  in  the  organization  of  the  work  in  the 
infected  quarter,  bounded  by  St.  Ann,  Rami)art,  Barracks 
Streets  and  the  Mississippi  Eiver ;  and  a  few  days  later 
on  the  arrival  of  Passed  Assistant  Surgeon  Berry,  he  also 
was  assigned  to  the  sanxe  duty.  Al)0ut  this  time  it  be- 
came evident  that  the  infection  was  widespread,  not  only 
in  New  Orleans,  but  in  other  part  ofl  Louisiana  and  Mis- 
sissippi; and  the  State  and  City  Boards  of  Health,  real- 
izing the  tremendous  task  which  confronted  them,  asked 
In  conjunction  with  the  business  organizations,  the  aid 
of  the  National  Government  by  sending  a  telegram  to  the 
President.  This  met  with  the  prompt  acquiescence  of  the 
President,  and  after  an  exchange  of  telegrams  between 
the  Citizens'  Committee  and  the  Surgeon  General  to 
wlw/m  the  matter  had  been  referred,  it  was  arranged  that 
the  United  States  Public  H^altli  and  :Marine  Hospital 
Service  provide  the  number  of  officers  estimated,  by  Dr. 


NEW  ORLEANS 1905.  883 

White,  to  be  necessary  for  the  work,  and  that  the  City 
authorities  and  the  citizens  should  meet  the  remainder 
of  the  expense.  The  work  to  be  done  under  Dr.  White's 
direction,  with  an  absolutelj^  free  hand,  no  conditions 
whatever  being  imposed  upon  him. 

While  the  task  to  be  undertaken — the  eradication  of 
yellow  fever  after  it  had  already  had  a  start  with  616 
cases  and  a  large  number  of  foci — was  the  most  stupend- 
ous of  its  kind  ever  attempted,  the  opportunity  given  by 
the  people  of  New  Orleans,  the  facilities  extended,  and 
the  absolute  non-interference  on  the  part  of  politicians, 
constituted,  altogether,  a  most  remarkable  exhibition  of 
public  spiritedness  and  presented  a  magnificent  oppor- 
tunity to  do  good  work.  Dr.  White  and  his  staff  of  forty 
surgeons  took  charge  on  the  Stli  of  August,  and  formed 
an  organization  in  each  ward  on  the  9th.  To  the  ward 
organizations,  Dr.  Wliite  transferred,  from  day  to  day, 
detachments  of  men  from  the  original  central  office, 
which  had  been  working  under  the  City  Board  ofi  Health 
as  one  unit  for  the  whole  City.  This  was  done  because 
Dr.  White  believed  that  the  work  to  be  done  was  too  vast 
to  be  satisfactorily  accomplished  from  a  central  office, 
and  that  it  would  be  preferable  to  have  a  number  of  head- 
quarters corresponding  to  the  ward  sub-divisions  by 
wards.  In  order  to  guard  against  breakdowu,  the  sys- 
tem of  transferring,  gradually,  from;  the  central  office  to 
the  sub-stations,  in  each  ward,  was  adopted,  for  the  dis- 
infecting, screening  and  oiling  gangs,  and  this  coDtinucI 
with  the  addition  of  new  material  to  the  ward  headquar- 
ters until  the  central  force  was  entirely  eliminated  and 
the  work  finally  rested  in  the  hands  of  the  ward  com- 
manders. In  addition,  a  force  was  maintained  in  the 
district  originally  iufpcted,  doing  daily  house  to  house 
inspection  and  disinfection,  sometimes  of  whole  blocks, 
until  about  the  middle  of  September  when  the  originally 
infected  district  became  jnstly  known  as  the  "disinfected 
district,"  and  from  a  sanitary  standpoint,  one  of  the  clean- 
est places  in  the  City. 

As  an  illustration  of  the  character  of  the  work  that 
was  done,  let  it  be  supposed  that  a  physician  reports  a 


Sm  HISTORY    OF    YELLOW    FEVER. 

case  of  either  yellow  fever  or  of  suspicious  fever,  to  the 
central  office  or  to  the  ward  in  which  the  case  is  located. 
Tlie  screening  wagon  immediately  goes  to  the  case.       If 
the  patient  is  not  too  ill  to  be  removed,  a  room  is  screened 
and  all  the  mosquitoes  therein  are  killed  by  sulphur  fumi- 
gation   (two  pounds  of  sulphur  to  one  thousand  cubic 
feet  of  air  space).     Then  the  screened  room  is  properly 
ventilated  to  eliminate  the  last  trace  of  the  sulphur  fumes 
and  the  sick  j^erson  is  moved  into  that  room.     The  other 
rooms  are  similarly  treated.     If  the  patient  is  too  ill  to 
be  removed  from  one  room  to  the  other,  the  preliminary 
fumigation  is  omitted;  but  as  soon  as  possible  without 
detriment  to  the  sufferer,  a  thorough  killing  of  moscpii- 
toes  is  undertaken.     The  ward  commander  keeps  in  con- 
stant touch  with  the  attending  physicians.     If  the  houses 
on  either  side  are  very  close  to  the  infected  premises, 
rhey,  too,  are  fumigated.     Preliminary  to  the  final  dis- 
infection, all  cracks  in  doors  and  windows  are  sealed,  as 
also  the  orifice  of  the  fire-place.     The  workers  are  cau- 
tioned to  make  as  little   noise  as   })()ssible,   because   the 
patient  nVust  not  be  disturbed,  and  the  moscpiitoes  must 
not  be  frightened  so  as  to  seek  safety  in  flight.     There- 
fore, all  pasting  is  done  first,  then  all  furniture,  or  any 
article  or  ornament  liable  to  danmge  from  sulpliur  fumes 
are  removed,  and  then  the  sulphur  i)ots  are  lit,  and  the 
door  immediately  closed. 

If  the  occurrence  of-  a  group  of  cases  in  close  proximity 
to  one  another  indicated  the  existence  of  a  new  focus  of 
infection,  the  fumigation  was  a])])li('d  to  whole  blocks 
and  this  method  effectiinlly  arrested  the  spread  of  the 
disease. 

The  State,  the  City  and  tlie  citizens  contributed  more 
than  .f 31 0,000  to  help  in  the  work  of  stampino-  out  yellow 
fever,  and  of  that  amount,  at  least  four-fifths  was  sub- 
ject to  Dr.  White's  order.  The  State's  ai)])ropriation 
was  !i?l 00,000,  the  fMty's  |fiO,000,  and  the  citizens'  con- 
;tril>ution  1100,000.  No  outside  aid  was  accepted,  and 
several  offers  for  assistance  were  declined  with  gratitude. 
Besides  the  above  amounts,  there  was  raised  considerable 


NEW   ORLEANS 1905.  885 

mont'T  by  the  voliiutoer  ward  organizations,  who  spent 
$30,000  for  screening  of  cistern,  and  oiling  them,  and  in 
iusjiections  for  sanitary  pnrposes.  The  fight  against  in- 
fection was  extended  to  every  parish  in  Louisiana, 
wherever  tlie  fever  appeared,  and  some  of  the  expenses 
were  borne  b}'  local  appropriations. 

fhily  21st,  an  address  was  issued  to  the  citizens  of 
New  Orleans,  signed  by  Dr.  Quitman  Kohnke,  health 
officer,  and  Dr.  J.  H.  ^Vhite,  Surgeon  U.  S.  P.  H.  &  M. 
H.  Service,  and  endorsed  by  the  advisory  committee  of 
the  Orleans  Parish  Medical  Society,  calling  attention  to 
the  emergency  existing  in  the  city,  and  asking  the  help 
of  every  individual  for  the  limiting  and  preventing  of 
the  spread  of  the  disease.  It  having  been  scientifically 
proved  that  the  mosquito  is  the  only  means  of  transmis- 
sion of  yellow  fever,  it  is  especially  urged  tliat  the  fol- 
lowing %simple  directions  be  followed  by  the  householders 
of  the  city,  for  the  summer  months : 

1st.  Empty  all  unused  receptacles  of  water.  Allow 
no  stagnant  water  on  the  premises. 

2nd.  Screen  cistern  after  placing  a  snmll  (]uantity  of 
insurance  oil  (a  teacupful  in  each  cistern),  on  the  sur- 
face of  the  water. 

3id.  Place  a  snmll  quantity  of  insurance  oil  in  cess- 
pool or  privy  vault. 

4fh.     Sleep  under  mosquito  nets. 

5th.  Sci-een  doois  an<l  windows  whencn'er  possible, 
with  fine  screen  wire. 

July  2Gth  an  emergency  hospital  on  Dunmine  Street 
was  opened  in  charge  of  Dr.  Hamilton  P.  Jones  and  a 
staff  of  yellow  fever  experts.  It  had  a  capacity  to  accom- 
modate eighty  patients. 

Rev.  Paroli,  a  Catholic  priest  of  Italian  nadoiialHy, 
and  immuncs  was  installed  as  cha]ilaiii,  and  also  for  the 
purpose  of  visiting  the  sick  Italians  and  inducing  them 
to  consent  to  removal  lo  metre  hygienic  surroundings. 
The  chief  men  in  the  Italian  colony  aided  greatly  in  this 
work  of  education  amoui;-  their  counti-ymen.  and  also  got 


886  HISTORY    OF    YELLOW     FEVER. 

up  a  subscription  wliicli  amounted  to  five  tliousand  dol- 
lars to  be  used  in  relief  work. 

Besides  his  work  of  stamping  out  the  fever  by  practical 
means,  Dr.  White  disseminated  good  advice.  He  sug- 
gested :  First.  Tliat  the  ward  organizations  be  made  per- 
manent, and  the  work  that  is  being  done  sliould  continue. 

Secondly.  That  throughout  the  entire  City  there 
should  be  a  "mosquito-killing  daj',"  once  a  week.  On 
that  day,  the  entire  population  should  make  an  effort  to 
kill  just  as  many  mosquitoes  as  possible,  by  fumigating 
their  houses  with  sulphur. 

Thirdly.  That  all  gutters  be  thoroughly  flushed  once  a 
week. 

Fourthly.  That  inspections  of  cisterns  be  made,  in 
each  ward,  every  week,  to  find  out  if  tliey  liave  been  prop- 
erly screened. 

Fifthly.  That  all  suspicious  cases  be  reported  at  once 
to  the  central  office. 

Dr.  Wliite  was  solicitous  in  impressing  tlie  citizens  with 
the  absolute  necessity  of  conforming  to  the  rules  and  reg- 
ulations based  on  the  new  doctrine  of  transmission  of  yel- 
low fever  by  the  mos(]uito,  and  witli  tlie  assurance  that  the 
house  quarantines  of  previous  epidemics  would  not  be 
resorted  to.  He  also  enlisted  the  co-operation  of  physi- 
cians by  sending  the  following  letter  to  every  doctor  in 
the  city:  "Considering  the  imperative  necessity  of  insti- 
tuting, at  the  earliest  possible  moment,  prophylactic  meas- 
ures in  the  case  of  any  person  suffering  of  a  fever  which 
may,  subsequently,  be  shown  to  be  yellow  fever,  you  are 
urgent  ly  r(M| nested  to  report  to  this  office  not  only  any  case 
of  fever  which  you  may  be  sure  is  yellow  fever,  but  also 
any  case  you  may  be  unable,  even  at  your  first  visit,  to 
say  is  not  yellow  fever.  We  enclose  you  <ards  which  will 
facilitate  your  report  of  such  cases,  and  will,  at  the  same 
time,  give  us  your  authorization  to  inspect  the  said  prem- 
ises and  do  whatever  may  be  necessary  to  prevent  the  ex- 
tension of  the  infection  in  the  house  or  neighborhood. 
We  desire  simply  to  get  the  co-operation  of  the  entire 
profession  of  this  city  in  the  checking  of  the  multipli- 


NEW     ORLEANS 1905.  887 

cation  of  new  foci  of  infection,  and  the  early  destructiom 
of  those  already  existing/' 

Dr.  White  made  a  persistent,  systematic  and  scientific 
fight  against  yellow  fever,  and  its  agent  of  transmission — • 
the  mosqnito — [ind  Avon.  From  Angust  12th  nntil  frost 
occnrred  on  December  5,  there  was  a  constant  and  steady 
decline  in  the  nnmber  of  cases,  dail}'.  The  greatest  nnm- 
ber  of  cases  was  from  August  12th  to  16th,  when  for  those 
five  days  the  nnmber  was  338.  The  record  for  the  last  five 
days  ending  October  10th  was  108. 

The  official  record  of  deaths  for  these  periods  in  1878 
and  1905  was : 


Aug.  10, 

0 

ct.  10, 

1878. 

1905. 

1878. 

1905. 

27 

4 

54 

4 

31 

4 

48 

1 

22 

G 

41 

0 

14 

12 

48 

3 

20 

12 

39 

4 

114  38  230  12 

There  had  been  no  frost,  and  yet  the  figures  were  drop- 
ping, not  as  rapidlj^  as  could  be  wished,  but  with  a  grati- 
fying certainty,  towards  the  vanishing  point.  And  this, 
when  the  city  of  New  Orleans  had  not  quarantined  against 
any  infected  point  to  any  greater  extent  than  to  put  on  an 
observation  of  persons  arriving  from  these  points;  and 
when  many  infected  persons  came  here  and  were  taken 
sick.  It  is  highly  prol)a]de  that  at  least  ten  per  cent,  of 
cases  were  of  people  coming  from  infected  localities. 

Dr.  White  commended  the  idea  and  helped  the  people 
in  carrying  it  out,  of  cleaning  gutters,  screening  and  oil- 
ing cisterns,  cleaning  up  back  yards,  emptying  vaults, 
draining  low  lands,  &c.,  not  because  this  sanitary  work 
would  tend  to  eliminate  yellow  fever  per  se,  but  because 
it  served  the  pnrpose  of  desiroying  the  moscpiito  family. 
The  fight  made  on  the  mosquito  was  ])rodiicti\'e  of  notable 
results.  In  spite  of  the  general  ignorance  of  the  prin- 
ciples of  the  mosquito  doctrine  of  yellow  fever  infection. 


888  HISTORY    OF    YELLOW    FEVER. 

and  the  amount  of  prejudice  against  the  acceptance  of  a 
new  theory,  modern  thoujiht  prevailed,  and  Avhile  preju- 
dice paid  its  price  iu  lives  and  suffering,  that  price  was 
not  nearly  as  great  as  would  have  been  if  the  men  of 
science  had  failed  in  their  duty. 

The  epidemic,  it  Avas  generally  conceded,  had  its  origin 
in  infection  brought  into  New  Orleans  during  the  latter 
part  of  May,  1005.  The  epidemic  of  1878,  also  began  in 
May.  That  of  1878  pursued  its  death-dealing  course,  un- 
checked, until  the  frost  came.  The  death  roll  amounted 
to  4000  persons  in  the  City  of  Xew  Orleans  alone.  The 
A-isitation  of  1905  had  a  larger  non-immune  po])ulation  to 
feed  upon,  and  double  the  number  of  iuhaltitauts.  It  was 
discovered  about  the  same  time,  in  the  middle  of  July, 
and  side  by  side,  the  figures  will  show  that  if  it  had  been 
allowed  to  ccntinue  its  course,  the  record  of  1878  would 
have  been  surj)assed.  As  a  matter  of  fact  that  record  was 
surpassed  in  the  total  number  of  deaths  up  to  August 
10th.  But  that  date  Avas  the  turning  point  in  the  fight. 
Tlie  campaign  started  by  Health  Officer  Kohnke,  in  July, 
and  taken  up  by  the  ^larine  Hospital  Service  on  August 
8th,  and  enlarged  and  extended  so  to  better  meet  the  con- 
ditions, began  to  tell  and,  thenceforth,  the  followers  of  the 
new  doctrine  knew  thev  had  won.  The  City  of  New 
Orleans  and  the  Avhole  South  were  fortunate  in  the  selec- 
tion of  the  man  who  led  them  out  of  darkness,  and  showed 
them  tliat  yellow  fever  was  no  more  the  bugbear  and  terror 
of  bygone  days. 

It  is  confidently  predicted  that  yellow  fcA'er  will  never 
again  be  able  to  commit  such  ravages  in  New  Orleans. 
Tlie  acceptance  of  the  modern  doctrine  is  universal  since 
the  com])lete  demonstration  in  this  City,  by  the  stam])ing 
out  of  the  fever  before  frost,  something  never  heard  of 
before,  wlien  it  had  gained  such  a  foothold  as  it  had,  in 
1005.  The  fight  is  now  against  the  source  of  infection, 
wliich  is  Latin  America. 

Hoit  ^Vas   Yelloir  Fever   I iifrodiicrd   in   Xeir   OrJcaiis    in 

1005? 

From  llie  report  of  Dr.  Souclun!,  President  of  the  Louis- 
iana State  Board  of  Health  to  Governor  Blanchard,  on 


NEW     ORLEANS 1905.  889 

the  3rd  of  December,  1905,  the  fonowiiig  synopsis  is  had: 

''The  flrst  knowledge  of  cases  suspicious  of  fever  reached 
President  Souchon  on  AVednesday,  Juh^  12th,  at  3:45  P. 
31.,  when  two  pliysicians  called  at  the  office  and  informed 
him  that  they  each  had  a  case  presenting  sjniptoms  sus- 
picious of  yellow  fever ;  one  a  woman  Avho  had  died  that 
da^^  at  1039  Decatur  Street,  the  other,  a  boy,  son  of  a 
man  who  kept  a  grocery  two  doers  from  the  home  of  the 
woman,  and  who  lived  at  2520  Bayou  Road  Street.  The 
boy  Avas  exijected  to  die  at  any  moment,  and  died  about 
the  time  of  the  interview.  The  two  physicians  stated  that 
these  two  cases  lacked  one  of  the  most  important  symp- 
toms of  yellow  fever :  want  of  correlation  between  tJie 
pulse  and  temperature,  and  that  they  had  not  called  to 
report  tliese  cases  as  yellow  fever,  but  to  mention  them  as 
suspicious  and  confer  with  the  health  authorities  about 
them. 

On  Thursday,  July  13th,  one  of  these  same  physicians 
told  President  Souchon  that  he  thought  he  would  have 
two  more  suspicious  cases  to  report  the  next  day.  These 
cases  were  reported  on  the  following  day,  at  HOT  Decatur 
Street,  suspicious  of  yellow  fever,  which  he  decided  to 
see,  himself,  and  he  did  so.  Dr.  Souchon's  opinion  Avas 
that  these  cases  presented  some  symptoms  of  yellow  fever. 
These  four  cases,  each  presenting  some  suspicious  symp- 
toms, had  been  reported  direct  to  President  Soucnon  by 
two  physicians,  but  not  one  of  the  attending  physicians 
was  willing  to  shoulder  the  responsibility  of  pronouncing 
them,  positively,  yellow  fever. 

On  jMonday,  July  17th,  a  physician  nolifi(d  President 
Souchon  that  there  Avere  two  cases  of  yelloAV  fever  in  tlie 
Hotel  Dieu,  and  the  president  Avent  to  the  Hotel  Dieu, 
and  saw  two  cases  presenting  symi)toms  of  yelhAv  fever. 

The  next  day  the  State  Poard  of  Healili,  after  henriiig 
the  report  of  i)r.  SoucIkhi,  iiislrueted  him  bv  resolution 
to  Avrite  to  Dr.  Wymam,  Dr.  Talx.r,  of  Texas;  Dr.  Hunter, 
of  iMississi])pi,  and  Di-.  Sanders,  of  Alabama,  that  there 
were  cases,  here,  ])resenting  sym])toms  of  yellow  fever. 

After  the  arriA-al  of  health  officers  from  other  Southern 
States,  an  autopsy  Avas  held  at  the  (Miarity  Hosi)ital,  the 


890  HISTORY    OF    YELLOW    FEVHR. 

findings  of  which  were  indisiDutably  yellow  fever.  This 
was  wired  to  Dr.  Wyniam,  and  other  health  officers  by 
President  Souchon,  and  it  was  also  made  public. 

In  his  rejDort,  Dr.  Sonchon  asks  "How  yellow  fever  en- 
tered the  State?" 

He  replies,  "This  the  Board  frankly  admits,  it  does  not 
know."     Several  hypotheses  can  be  adduced,  however. 

It  is  probable  that  yellow  fever  existed  in  Belize  and 
Puerto  Cortez  for  several  weeks  before  it  was  reported 
here,  and  that  a  case  from  Belize  or  Cortez,  in  period  of 
incubation,  was  introduced  here  before  the  ^tarine  Hos- 
pital advised  the  Board,  on  May  2J:th,  that  yellow  fever 
existed  in  those  places.  In  the  liolit  of  subsequent  events 
it  is  now  a  well-established  belief,  that  yellow  fever  had 
existed  here  for  quite  a  while  before  it  was  brought  to  the 
surface.  It  is  said  that  a  case  died  in  the  Charity  Hos- 
pital on  May  31st,  presenting  symptoms  of  yellow  fever, 
but  the  house  surgeon  said  it  was  not  yellow  fever,  ht  <1 
one  physician  wlio  had  a  large  Italian  practice,  told  Pres- 
ident Souchon  that  the  first  two  cases  he  knew  presenting 
suspicious  symptoms,  were  seen  by  him,  accidentally,  on 
July  1st,  but  that  he  had  seen  none  before.     Both  died. 

Beport  of  Dr.  Q.  KohnJcc,  Citi/  Health  Officer. 

The  report  of  Dr.  Kolinke  agrees,  in  the  main  with  tliat 
of  Dr.  Souchon  as  to  the  date  of  discovery  of  the  first 
case  of  yellow  fever,  and  it  goes  on  to  give  details  of  the 
preventive  and  precautionary  measures  taken;  and  speaks 
of  the  assistance  given  by  the  citizens,  and  the  aid 
promptly  rendered  by  the  Italian  Citizens'  Committee; 
also  the  systematic  fumigation,  disinfection  and  other 
hygienic  measures  prosecuted.  Dr.  Kohnke  speaks  in 
high  terms  of  the  excellent  work  done  bv  Dr.  J.  H.  White, 
of  the  U.  S.  Public  Health  and  :\Iarine  Hospital  Service. 
He  says : 

"The  splendid  work  of  the  corps  headed  by  Dr.  Wliite 
cannot  be  too  highly  valued;  the  results  obtained  should 
not.  however,  be  attributed  to  this  cause  alone;  for,  the 
volunteer   ward   organizations   and   the   combined    influ- 


NEW     ORLEANS 1905.  891 

ences,  organized  and  iudividnal,  of  men  and  women,  dis- 
tinguished visitors  and  residents,  all  contributed  im^ior- 
tantlj,  to  the  successful  issue  of  the  first  extensive  cam- 
paign against  yellow  fever  in  a  large  American  city." 

With  reference  to  the  preventive  measures  by  the  cam- 
paign against  the  mosquito,  Dr.  Kohnke  saj's : 

"A  comparison  of  the  present  visitation  with  that  of 
1878,  and  consideration  of  the  fact  that  the  infection, 
appearing  on  a  given  date,  is  modified  by  the  preventive 
measures  aiDi^lied  about  fifteen  days  previously,  shows  the 
continuous  effect  of  mosquito^  destruction  instituted  with 
our  first  knowledge  of  the  possible  presence  of  infection. 
The  period  of  fifieen  days  after  AugustlO  th,  in  1878,  was 
marked  by  an  increase  in  number  of  cases  reported  daily 
to  an  average  of  104  cases,  while  in  1905,  the  daily  aver- 
age for  the  same  period,  was  sixty-one  cases.  The  deaths 
(daily  average),  were,  in-  1878,  thirty-two,  while  in  1905, 
the  daily  average  was  seven.  In  1878  the  fever  increased 
markedly,  toward  September.  In  1905  it  decreased.  The 
highest  point  reached  was  on  Septend)er  12,  when  more 
than  one  hundred  cases  were  reported. 

After  that  date  the  cases  dwindled  down  and  ere  many 
days  the  victory  was  won. 

Report  of  Dr.  Thomas,  Quarantine  Physician. 

Under  date  of  October  30tli,  1905,  Governor  Blanchard 
made  a  request  on  Dr.  John  N.  Thomas,  State  Quarantine 
Physician  at  the  Mississippi  Quarantine  Station  for  a  full 
and  complete  report  of  his  administration  of  the  Quaran- 
tine Station,  insofar  as  the  same  is,  or  is  not,  responsible 
tor  the  introduction  of  yellow  fever  into  New  Orleans. 

The  Governor  presented  five  subjects  to  guide  Dr. 
Thomas  In  the  preparation  of  the  report,  viz. : 

1st.     Description  of  official  duties. 

2nd.  Powers  and  duties  of  the  State  Board  of  Health 
in  connection  with  the  Quarantine  Station. 

3rd.  Quarantine  regulations,  and  l)y  whom  prescribed ; 
also,  detailed  methods  of  enforcement,  and  names  of  sub- 
ordinates. 


892  HISTORY    OF    YELLOW    FIVIR. 

4tli.  Details  of  the  arrivals  of  ships  with  fever,  aboard ; 
■svhat  was  done  about  theiu;  what  bills  of  health  they 
carried;  and,  if  fiiiiiigated  at  port  of  departure. 

5th.  Were  there  any  modifications  of  quarantine 
regulations? 

The  substance  of  Dr.  Tliomas'  report  was  that  the  laws 
and  regulations  were  fully  enforced ;  that  he  did  not  know 
how  the  fever  got  into  New  Orleans,  but,  if  the  infection 
came  through  infected  mosquitoet^,  it  came  fr(tm  Colon  or 
from  Havana ;  if  through  an  infected  individual,  from 
Havana,  most  likely,  or  possibly  from  one  of  the  ports 
vrithin  the  five  days'  limit.  He  believed  the  period  of 
detention  should  not  be  less  than  six  days.  He  presented 
a  great  deal  of  evidence  to  show  that  Havana  was  infected, 
and  he  considered  the  Island  of  Cuba  a  constant  menace. 

Dr.  Tliomas  submitted  the  following  list  of  vessels  which 
arrived  at  Quarantine  with  fever  on  board: 

July  S.     K^aphir,  from  Colon,  1. 

July  9.     Ro)/<il  Ej'chaii(/(\  from  Colon,  via  Mobile,  1. 

July  31.     Tc.rau,  from  Vera  Cruz,  1. 

August     S.     ]'<))ti>  Rico,  from  Vera  Cruz,  1. 

August  12.     ASV//y/n'/-,  from  Colon,  3. 

August  24.     Ori(/('ii,  from  Colon,  4. 

September  8.     E.rcclsior,  fi'om  Havana,  1. 

October  27.     Cifij  of  Tain  pica,  from  Vera  Cruz,  1. 

October  27.     St.' Croix,  from  Vera  Cruz,  1. 

Total  cases  imported,  14. 

All  of  these  vessels,  except  the  Excelsior,  and  the  Porio 
Eico,  had  been  fumigated  at  the  port  of  departure,  and 
the  disease  broke  out,  on  all  of  tluMu,  wiUiin  live  days  after 
fumigation. 

Dr.  Thomas  said  "I  believe  that  yellow  fever  is  usually, 
if  not  always  imported  throuuh  an  infected  individual, 
with  the  disease  incubating  in  his  system,  who  ])asses 
through  one  of  the  many  quarantine  stations,  and  gets 
into  the  country  before  the  initial  attack  of  fever.  Since 
it  is  known,  however,  beyond  doubt,  that  the  mosquito 
is  the  conveyor  of  the  disease,  I  believe  that,  under  favor- 
able conditions,  mosquitoes  can  be  imported  from  infected 
ports,  and  be  the  means  of  conveying  and  spreading  the 


LOUISIANA.  893 

disease  in  the  couutry.  If  this  were  not  a  possibility, 
what  is  the  use  of  fumigating  vessels,  for  we  fumigate  now, 
to  kill  mosquitoes  only? 

''We  were  infected  this  year  thruogh  one  of  these 
sources;  I  am  unable  to  say  which,  for  I  do  not  know.  If 
however,  it  was  through  imported  infected  mosquitoes,  I 
would  say  that  we  got  our  infection  from  Colon,  or  from 
Havana.  If  through  an  infected  individual,  from  Havana, 
most  likely — possibly  from  a  port  within  the  five  days' 
limit,  and  the  case  developed  after  five  days." 

NEWTON. 

1905.     One  case;  recovery. 

OLIVIA. 

1905.     Cases,  G;  deaths,  1. 

OMEGA  AND  RALEIGH  LANDINGS. 
1878.     Deaths,  5. 

OPELOUSAS. 

1826.     Infected  by  New  Orleans.     Cases,  3;  deaths,  1. 

1828.  Infected  by  Ncav  Orleans.     Cases,  4;  deaths,  3. 

1829.  No  record  of  cases  and  deaths. 

1837.     First  case,  October  20;  last  case  in  November. 
1839.     First  case  in  August;  last  case  in  November. 
1842;  1853;  18G7.     No  record  of  cases  and  deaths. 

OSTRICA. 

i 

1905.     First  case,  July  26.     Cases,  1 ;  deaths,  0. 


894  HISTORY    OF    YILLOW    KKVER. 

PAINCOUETVILLE. 

187S.  Population,  400.  First  case,  August  14;  last 
case,  October  2G.     Cases,  181;  deaths,  15. 

PATTERSON. 

1853.     Infected  by  New  Orleans.     First  case,  August 

13;  last  case  in  December.     No  statistics. 

1854 ;  1855 ;  1857.    First  case,  September.    No  statistics, 
1863,     First  case,  August  8;  first  death,  August  13; 

last  case  and  last  death  in  December,     Cases,  500 ;  deaths, 

45. 

1878,  The  first  case,  Mrs.  Dr.  L.  W.  Tarleton,  con- 
tracted the  disease  at  Logonda  Plantation,  where  the 
disease  is  supposed  to  have  been  brouglit  from  New 
Orleans,  September  2.  She  died  soon  after.  The  disease 
spread  rapidly  and  was  very  malignant.  Cases,  125; 
deaths,  28,  of  which  5  were  colored.  Cases  near  town, 
white  and  colored.  175;  deaths  outside  town,  whites,  40; 
colored,  25.     Date  of  last  death,  November  23. 

1879.  First  case,  Noveml)er  20 ;  last  case,  December  6. 
Cases,  2;  deaths,  0. 

PHARR    PLANTATION. 

1879.  Infected  by  Berwick.  First  ease,  November  10 ; 
last  case,  December  2.     Cases,  6;  deaths,  5. 

PILOT   TOWN. 

1878.  Infected  by  Port  Eads.  First  case,  August  18; 
last  case,  October  16;  first  death,  August  22.  Cases,  113; 
deaths,  17. 

PATTERSON. 

1897.     Cases,  1 ;  no  deaths, 

1905.     First  case,  July  31.     Cases,  700;  deaths,  52. 

PECAN  GROVE. 

1878.     Deaths,  2. 

1905.     First  case,  August  18.     Cases,  20;  deaths,  5. 


LOUISIANA.  895 

PLAQUEMINE. 

1837 ;  1839 ;  1847.     ^'o  record  of  cases  and  deaths. 

1853.  First  case,  August  20 ;  first  deatli,  August  26 ; 
last  case,  December  15;  last  death,  December  9. 

1858.     No  record  of  cases  and  deaths. 

1878.  Population,  1,500.  Infected  by  Xew  Orleans. 
First  case,  August  1.     Cases,  1,159 ;  deaths,  125. 

1898.  First  case,  October  15;  last  case,  October  15. 
Cases,  6;  deaths,  1. 

POIXTE    MICHEL. 

1880.     Sporadic  cases. 

POINT   PLEASANT. 

1878.  Fever  appeared  in  August.  There  were  about 
60  cases  and  13  deaths. 

PLATTENVILLE. 

1905.     Cases,  1 ;  deaths,  0. 

POINTE-A-LA-HACHE. 

1851.     First  case,  October.  . 

1878.     Cases,  4;  deaths,  4. 

1905.     First  case,  October  2.     Cases,  1;  deaths,  0. 

POINT    CELESTE. 
1905.     First  case,  July  30.     Cases,  32;  deaths,  6. 

PONCHATOULA. 

1878.  Infected  by  New  Orleans.  First  case,  October 
6 ;  first  death,  October  10.     Cases,  12 ;  deaths,  3. 

PORT   BAPKE. 

1870.     No  record  of  cases  and  deaths. 


896  HISTORY    OF    YELLOW    riTEK* 

POIiT    BAIiKOW. 

1878.     Deaths,  7. 

1905.     First  case,  July  24.     Cases,  73,  deaths,  10. 

PORT    EADS. 

1878.  August  5,  one  case  of  yellow  fever  appeared,  and 
August  11,  fourteen  cases.  Dr.  Warren  Stone,  with  two 
nurses,  Mrs.  Dupree  and  ^frs.  Eastman,  came  from  New 
Orleans  to  attend  them.  He  telegraphed  back,  "fever  in- 
creasing." The  first  fatal  case  was  Mrs.  Capt.  Moran. 
The  cases  occurred  rapidly.  Many  workmen  went  away, 
and  work  on  the  jetties  was  suspended.  Total  cases,  02; 
total  deaths,  11.     Date  of  last  death,  October  11. 

PORT  HUDSON. 

1839.     Infected  by  New  Orleans. 
1811.     No  record  of  cases  and  deaths. 
1813.     No  record  of  cases  and  deaths. 

1878.  First  case,  September  9;  first  death,  September 
13.     Cases,  100;  deaths,  11. 

PUGH   PLACE. 

1879.  First  case,  October  2.     Cases,  33 ;  deaths,  0. 

PROSPECT    PLANTATION. 

1905.     Cases,  8;  deaths,  1. 

RALEIGH    LANDING. 

1878.     No  record  of  cases  and  deaths. 
1905.     One  case,  August  6. 

REBECCA   PLANTATION. 

1905.     First  case,  September  10.     Cases,  20;  deaths,  1. 


LOUISIANA.  897 

RED   RIVER   LANDING. 
1878,     No  record  of  cases  and  deaths. 

RESERVE    PLANTATION. 
1905.     First  case,  August  14.     Cases,  11;  deaths,  2. 

RICHOC. 

1878.     Cases,  62;  deaths,  18. 

RIVERSIDE    PLANTATION. 
1905.     First  case,  July  23.     Cases,  218 ;  deaths,  10. 

ROSEDALE. 
1905.     First  case,  September  5.     Cases,  5 ;  deaths,  1. 

SARPY. 
1905.     First  case,  August  19.     Cases,  13;  deaths,  2. 

SHELBURN. 
1905.     Cases,  15;  deaths,  1. 

SHREVEPORT. 

1853.     No  record  of  cases  and  deaths. 

1873.  Population,  9,000.  Infected  by  New  Orleans. 
First  case,  August  12;  first  death,  August  19;  last  case, 
November  10.     Cases,  3,000;  deaths,  759. 

1905.     Cases,  3;  deaths,  1. 

SHREWSBURY. 
1905.     First  case,  August  15.     Cases,  6 ;  deaths,  2. 

SMITHLAND. 

1878.  A  plantation  in  Point  Coupee  Parish,  La.  The 
only  fatal  case  reported  is  that  of  Dr.  W.  D.  Smith,  who 
died  September  25. 


898  HISTORY     OK    YELLOW     FEVER. 

SMITHVILLE. 
1905.     First  case,  Sei^tember  G.     Cases,  1;  deaths,  0. 

SMOKE  BEXD. 

1905.     First  case,  August  28.     Cases,  3;  deatlis,  1. 

SOUTHDOWN. 
1905.     First  case,  OctoLer  19.     Cases.  1;  deaths,  1. 

SOUTH    PASS. 
1878.     Cases,  42;  deaths,  2. 

SOUTHWEST   PASS. 

1878.     Cases,  2G ;  deaths,  8. 

STEVENSON. 

1878.     Two  fatal  cases. 

ST.  BERNARD. 

1878.     Infected  by  New  Orleans.     First  case,  August 
25 ;  first  death,  August  29.     Cases,  19 ;  deaths,  7. 
1905.     First  case,  July  20.     Cases,  51;  deaths,  2. 

ST.    CLARE. 

1905.     Cases,  1;  deatlis,  0. 

ST.    ELIZABETH. 

1905.     First  case,  July  13.     Cases,  21;  deaths,  8. 


LOUISIANA,  899 

ST.    FKANCISVJLLE. 

1811 ;  1817 ;  1819 ;  1823 ;  1827 ;  1828.     Xo  record  of  cases 
and  deaths. 

1829.     First  case,  September  22. 

1839.     First  case,  August  28. 

1813.     First  case,  August  28. 

184G.     Deaths,  1. 

1848.     Deaths,  1. 

1853.     No  record  of  cases  and  deaths. 

ST.    GABRIEL. 

1878.     Population,  425.     Cases,  132;  deaths,  38. 
1905.     Cases,  2;  deaths,  0. 

ST.    JAMES. 

1878.  ~    Cases,  36;  deaths,  4. 

1898.     First    case,    October   1;   last    case,    October   1. 
Cases,  1 ;  deaths,  0. 

ST.    JOSEPH. 

1905.     First  case,  September  18.     Cases,  3;  deaths,  0. 

ST   MARTIXVILLE. 

1839.     No  record  of  cases  and  deaths. 

ST.  ROSE. 

1905.     First  case,  August  22.     Cases,  61 ;  deaths,  6. 

STORY'S. 

1905.     Cases,  2;  deaths,  0. 

SUNRISE. 
1905.     First  case,  July  30.     Cases,  1;  deaths,  0. 


900  HISTORY    OF    YELLOW    FEYER. 

TALLULAIL 

1878.     Cases,  33 ;  deaths,  4. 

1905.  First  case,  about  August  8.  Cases,  1,040; 
deaths,  23. 

TANGIPAHOA. 

1878.  Population,  200.  Infected  by  Xe\\'  Orleans. 
First  case,  September  1.     Cases,  150;  deaths,  50. 

TECHE   COUNTRY. 

1878.  Population,  1,033.  First  case,  September  10; 
first  death,  September  13.     Cases,  715;  deaths,  81. 

TERKE-AUX-BOEUF. 

1905.     First  case,  September  9.     Cases,  1;  deaths,  0. 

THIBODAUX. 

1839.     Sporadic  cases. 

1846.  First  case,  September  20 ;  last  case,  October  15 ; 
last  death,  October  14. 

1853.  Deaths,  100. 

1854.  First  case,  September  12 ;  last  case,  October. 

1878.  Population,  2,800.  First  case,  July  30;  first 
death,  August  28.     Cases,  750 ;  deaths,  65. 

1879.  First  case,  October  15;  last  case,  October  15. 
Cases,  1;  deaths,  0. 

1905.     Cases,  1;  deaths,  1. 

TOCA. 

1905.     First  case,  September  8.     Cases,  10;  deaths,  0. 

TRENTON. 

1853.  Population,  145.  Infected  by  New  Orleans, 
First  case,  August  1;  first  death,  August  6.  Cases,  52; 
deaths,  28. 


•I 


LOUISIANA.  901 

UNION   PLANTATION. 

1905.     First  case,  October  13.     Cases,  1;  deaths,  0. 

UPPER   TEXAS. 

1879.     First   case,    October    6;   last   case,    October   6. 
Cases,  2;  deaths,  0. 

VACCARO. 

1905.     First  case,  July  2G.     Cases,  2 ;  deaths,  0. 
VACHERIE. 

1878.  No  record  of  cases  and  deaths. 

A^\RNER. 
1898.     Cases,  1;  deaths,  0. 

VERRET. 
1905.     First  case,  September  4.     Cases,  2;  deaths,  0. 

VIDALIA. 

1853.     Population,    GO.       Infected    by    Natchez,    iMiss. 
First  case,  August  20 ;  first  death,  August  25.    Deaths,  16. 

VILLE  PLATTE. 

1870.     No  record  of  cases  and  deaths. 

VIVIAN. 

1879.  Cases,  4 ;  deaths,  0. 

WAOCr  A:\rAN. 

1905.     First  case,  July  IG.     Cases,  GO;  deaths,  5. 


902  HISTORY    OF    YELLOW    FEVER. 

WASHIXGTOX. 

1837.     No  record  of  cases  aud  deaths. 

1852.  Infected  b}^  New  Orleans.     First  case,  Septem- 
ber 14 ;  first  death,  September  16. 

1853.  First  cae,  August  15. 

1851;  1867.     No  record  of  cases  and  deaths. 

WATERLOO. 

1839.     Infected  by  New  Orleans. 

WATEKPKOOF. 

1905.     First  case,  September  23.     Cases,  1 ;  deaths,  0. 

WEEK'S    ISLAND. 

1879.     No  record  of  cases  and  deaths. 

WESTWEGO. 

1905.     First  case,  July  25.     Cases,  2 ;  deaths,  2. 

WILSON. 

1898.     First  case,  Septendx-r  26;  last  case,  October  15. 
Cases,  303;  deaths,  7. 

WOODLAWN. 

1905.     First  case,  July  30.     Cases,  16;  deaths,  2. 
Insert  Bibliography 


NEW  ORLEANS— ^RIOGRAPHY.  903 

BIBLIOGRAPHY    OF    YELLOW    FEVER    IN    LOUISIANA. 
NEW   ORLEANS. 

Albers  (P.  B.) :  Cases  of  Sporadic  Yellow  Fever  (1857).  N.  O.  Med. 
&  Surg.  Jl.,  November,  1857,  p.  357. 

American  Institute  of  Homoeopathy.  Special  report  of  the  Homeoo- 
pathic  Yellow  Fever  Commission  ordered  by  the  *  *  *  for 
presentation  to  Congress.     8°.     New  Orleans,  1879. 

Analysis  of  the  "records  of  yellow  fever  in  New  Orleans  in  1876..  N. 
O.  Med.  and  Surg.  Journal,  1876-7,  n.  s.  vol.  4,  p.  480. 

Axson  (A.  F.):  Report  on  the  Origin  and  Spread  of  the  Epidemic  in 
New  Orleans  in  1853.  In  Report  of  the  Sanitary  Commission  of  New 
Orleans,  1854. 

Bahier  (A.)  (et  al.) :  Rapport  fait  a  la  Societe  Medicale  de  la 
Nouvelle-Orleans  sur  I'epidemic  de  fievre  jaune  qui  a  regno  dans  cette 
ville  pendant  I'ete  et  I'automne  de  I'annee  1839..     8°.     Paris,  1840. 

Barbot  (J.  P.):  Cases  of  Yellow  Fever  (1857).  N.  O.  Med.  and 
Surg.  Joumal,  November,  1857,  p.  358. 

Barton  (Ed.  E.):  Account  of  the  epidemic  fever  which  prevailed  in 
New  Orleans  during  the  autumn  of  1833.  American  Journal  of  Med. 
Sciences,  vol.  15,  p.  30. 

Barnes  (F. ):  Yellow  fever  in  New  Orleans.  New  Orleans  Med.  and 
Surg.  JL,  1867,  vol.  20,  p.  196. 

Barton  (Ed.  E.):  Report  read  to  the  Academy  of  Sciences  of  New 
Orleans  in  defence  and  explanation  of  the  report  of  the  Sanitary 
Commission  to  the  City  Council.  N.  O.  Medical  News  and  Hospital 
Gazette,  vol.  2,  No.  3,  p..  97. 

Barton  (Ed.  E.) :  Report  of  the  Board  of  Health  of  New  Orleans, 
November  17,  1841,  on  the  fever  of  that  year..  Bulletin  of  Medical 
Sciences,  vol.  2,  p.  1. 

Barton  (Ed.  E.):  Report  upon  the  Sanitary  Condition  of  New  Or- 
leans, in  report  of  the  Sanitary  Commis"ion  of  New  Orleans  for  1853, 
p.  213. 

(See  review  of  the  above  Report,  in  N.  O.  Med.  and  Surg.  Journal, 
vol.  11,  p.  523;  do.,  in  Charleston  Medical  Journal  and  Review,  vol.  10. 
p.  535.) 

Barton  (E.  E.) :  Account  of  the  Epidemic  Fever  which  prevailed  in 
New  Orleans  during  the  autumn  of  1833.  American  Journal  of  Medical 
Sciences,  vol.  15,  p.  30.  Same  in  pamphlet  form,  with  additions,  pp. 
52,  Philadelphia,  1834. 

Barton  (Ed.  E.) :  Report  to  the  State  Medical  Society  on  the 
Meteorology,  Vital  Statistics,  and  Hygiene  of  the  State  of  Louisiana. 
8vo.     New  Orleans,  1851. 


904  HISTORY    OF    YELLOW    FEVER. 

Barton  (E.  H.) :  The  cause  and  prevention  of  yellow  fever  at  New 
Orleans  and  other  cities  in  America;  and  notices  of  the  report  of  the 
Sanitary  Commission,  dated  New  Orleans,  December  12,  1854.  3  ed. 
8°.     New  York,  1857. 

Barton  (E.  H.) :  Report  on  'the  Meteorology,  Mortality  and  Sanitary 
Condition  of  New  Orleans,  for  the  years  1854  and  1855.  Trans..  Amer. 
Med.  Assn.,  1856,  vol.  9,  p.  723. 

Barton  (Ed.  E.):  Introductory  Lecture  on  Acclimation.  8vo.  New 
Orleans,  1857. 

Baxter:  Statement  of  the  Yellow  Fever  as  it  Occurred  in  New  Or- 
leans in  1819.     New  York  Medical  Repository,  vol.  2i,  p.  1. 

Baxter  (J.):  Reply  to  the  Replication  of  the  Medical  Society  of 
Louisiana.     Med.  Repository,  1822,  n.  s.,  vol.  8,  pp.  223;  229. 

Berjot  (E.) :  Report  of  the  epidemic  of  yellow  fever,  which  raged  at 
New  Orleans  in  1878.  N.  O.  Med.  and  Surg.  Jl.,  1880,  n.  s.,  vol.  8,  pp. 
139;   145,. 

Board  of  Health  and  Yellow  Fever.  New  Orleans  Med.  Jl.,  1844-5, 
vol.  1,  pp.  217;  219. 

Barren  (P.  D.) :  An  Historic  Memorabile  (relating  to  the  j'ellow 
fever  epidemic  of  1799).  New  Orleans  Medical  and  Surgical  Journal, 
1896-7,  vol.  49,  p.  318. 

Bemiss  (S.  M.) :  Report  upon  yellow  fever  in  Louisiana  1878,  and 
subsequently.  N.  O.  M.  &  S.  Jl.,  1883-84,  n.  s.,  vol.  11,  pp.  81,  161.  4 
diag.     2  oh.    Also:  Reprint. 

Beugnot  (J.  F.) :  An  Essay  on  Yellow  Fever.  N.  O.  M.  &  S.  Jl.,  vol. 
1,  p.  1. 

Beyer  (G.  E.):  On  the  origin  of  sporadic  cases  of  fever.  N.  O.  M. 
&  S.   JL,  1906-7,  vol.   54,  p.   407. 

Boyce  (R.):  Yellow  Fever  Prophylaxis  in  New  Orleans,  1905.  Liver- 
pool School  of  Tropical  Medicine,  Memoir  XIX,  1906,  p.  1. 

Brady,  (C.  M.) :  Circumstances  of  the  First  Appearance  of  Yellow 
Fever  in  New  Orleans.     N.  O.  M.  &  S.  Jl ,  1905,  vol.  58,  p.  743. 

Bruns,  (H.  D.) :  Experiences  during  the  Yellow  Fever  Epidemic  of 
1905.     N.  O.  M.  &  S.  Jl..  1906,  vol.  59,  p.  196. 

Cartier  (A.  J.  F.):  La  fievre  jaune  de  la  Nouvelle-Orleans.  8°. 
Paris,  1859. 

Carroll  (J.):  Yellow  Fever  in  New  Orleans.  N.  O.  M.  &  S.  JL,  1906, 
vol.  59,  p.  180. 

Castellanos  (J.  J.):  An  Historic  :\remorabile.  Proc.  Orleans  Parish 
Medical  Society,  1896,  New  Orleans,  1898,  p.  168. 

Cartwright  (S.  A.):  Prevention  of  Yellow  Fever.  N.  O.  M.  &  S.  JL, 
1853-4,  vol.  10,  pp.  292,  406.  Also:  Ohio  M.  &  S.  JL,  Columbus,  1853-4, 
vol.  6,  pp.  201,  227. 


I 


NEW    ORLEANS — R  IBLIOGRAPH  >  .  905 

Chaille   (S.  E.) :   Yellow  Fever  of  1S5S  in  New  Orleans.     N.  O.  M.  & 

5.  Jl.,   1858,  vol.  15,  pp.   805,  819. 

Chaille  (S.  E.) :  The  yellow  fever,  sanitary  conditions,  and  vital 
statistics  of  New  Orleans  during  Its  military  occupation,  the  four 
years  1862-5.  N.  O.  M.  &  S.  Jl.,  1870,  vol.  23,  pp.  536,  598.  Also: 
Reprint. 

Chaille  (S.  E.):  Yellow  fever,  or  "yellow  jaundice"  in  New  Orleans 
in  1882;  disputed  case  of  Louis  (or  Ludwig)  Deschler.  N.  O.  M.  &  S. 
JL,  1882,   n.  s.,  vol.   10,   pp.   194,  205. 

Chaille  (S.  E.) :  Some  Yellow  Fever  Data.  N.  O.  M.  &  S.  Jl.,  1905, 
vol.  58,  p.  191. 

Coleman  (W.  L.):   Yellow  Fever.     N.  O.  M.  &  S.  Jl.,  1879,  n.  s.,  vol. 

6,  p.  618. 

Considerations  generals  sur  les  mesures  a  prendre  pour  mettre  la 
Nouvelle-Orleans  a  I'abri  de  la  fievre  jaune.  8°.  Nouvelle-Orleans, 
1864. 

Conkrite  (L.):  An  inquiry  into  the  pathology  and  'treatment  of 
yellow  fever,  as  it  prevailed  at  New  Orleans,  August,  1829.  West.  J. 
M.  &  Phys.  Sc,  Cincin.,  1830,  vol.  3,  pp.  367,  393. 

Davidson  (J.  P.):  Some  personal  reminiscences  of  early  epidemics 
in  New  Orleans.  New  Orleans  Med.  &  Surg.  JL,  1886-7,  n.  s.  vol.  14, 
p.  920. 

Detention  (The)  Camp  at  Oakland  Park.  Rep.  Bd.  Health  La., 
1896-7,  Baton  Rouge,  1898  ,p.  44,  3pl. 

Delery  (C):  (Rappoit  du  Bureau  de  sante  de  la  Nouvelle-Orleans 
pour  I'annee  1860.)  Jo  Soc.  Med.  de  la  N, -Orleans,  1860-61,  vol.  11, 
pp.  181,  185. 

Delery  (C.  F.) :  Memoire  sur  Tepidemie  de  fievre  jaune  qui  a  regne 
a  la  Nouvelle-Orleans  et  dans  les  campagnes  pendant  I'annee  1867. 
4°.     Nouvelle-Orleans,  1867. 

Del  Orto  (J.):  Yellow  fever.  N.  O.  M.  &  S.  JL,  1879,  n.  s.,  vol.  6, 
p.  638. 

Diary  (The)  of  a  Samaritan.  By  a  member  of  the  Howard  Associa- 
tion of  New  Orleans.     8°.     New  York,  1860. 

Dowler  (B.):  Tableau  of  the  yellow  fever  of  1853,  with  tp.pographical, 
chronological,  and  historical  sketches  of  the  epidemics  of  New  Orleans 
since  their  origin  in  1796,  illustrative  of  the  quarantine  question.  8°. 
New  Orleans,  1854. 

Dowler  (B.):  The  first  death  from  yellow  fever  in  New  Orleans,  in 
1854.     N,  O.  M.  &  S.  JL,  1854-5,  vol.  11,  p.  284. 

Dowell.  Weekly  summary  cases  and  deaths  in  1873.  In  his  Yellow 
Fever  and  Malarial  Diseases,  1876,  p.  31. 

Dowler  (B.) :  Researches,  Historical,  Topographical  and  Critical,  on 
Yellow  Fever.     N.  O.  M.  &  S.  JL,  1846-7,  vol.  3,  p.  165. 


906  HISTORY     OF    YELLOW     FEVER. 

Drew  (E.  S.) :  The  first  case  of  j'ellow  fever  in  New  Orleans,  1878. 
Santarian,  N.  Y.,  1880,  vol.  8,  pp.  35,  37. 

Dupuy:  Precis  historique  de  I'epidemie  de  fievre  jaime  qui  a  regne 
en  1819  a  la  Nouvelle-Orleans.  J.  Gen.  de  Med.,  Chir.  Pharm.,  Paris, 
1821,  vol.  Ixxiv,  pp.  203,  229.  Also  Transl.  (Abstr.) :  Med.  Reposit,  N. 
Y.,  1821,  n.  s.,  vol,  6,  pp.  15;  19. 

Editorial:  Yellow  Fever  Situation  (1905).  X.  O.  M.  &  S.  Jl.,  1905, 
vol.  58,  p.  254. 

Epidemic  (The)  of  1853,  at  New  Oi leans.  Golvestou  M.  Jl.,  1867, 
vol.  2,  pp.  876,  907. 

Epidemic  (The)  summer.  List  of  interments  in  all  the  cemeteries 
of  New  Orleans  from  May  1st  to  November  1st,  1853...  To  which  is 
added  a  review  of  the  yellow  fever,  its  causes,  (etc.)  8°.  New  Or- 
leans, 1853. 

Escumbas  (M.):  La  fievre  jaune  observee  a  la  Nouvelle-Orleans 
pendant  les  mcis  de  .Juillet,  Aout,  Septembre,  Octobre,  1878,  et  son 
Traitement.     16°.     Nouvelle-Orleans,  1879. 

Extraits  de  quelques-unes  des  lettres  sur  la  fievre  jaune.  I,  2,  4,  7, 
lettres  et  appendise.    8°.    Nouvelle-Orleans,  1S59. 

Faget  (.1.  C):  Etude  medicale  de  quelques  questions  importantes 
pour  la  Louisiana,  et  expose  succinct  d'une  endemie  paludeenne  de 
forme  catarrhale,  qui  a  sevi  a  la  Nouvelle-Orleans,  Particulierement 
sur  les  enfants,  pendant  I'epidemie  de  fievre  jaune  de  1858.  8°. 
Nouvelle-Orleans,  1859. 

Faget  (J.  C):  Considerations  generales  sur  les  mesures  a  prendre, 
sanitaries  et  quarantenaires,  pour  mettrw  le  Nouvelle-Orleans  a  I'abri 
de  la  fievre  jaune.     Union  Med.,  Paris,  1864,  2.  s.,  vol.  24,  pp.  196,  334. 

First  (The)  death  from  yellow  fever  in  1858.  N.  O.  M.  &  S.  Jl.,  1858, 
vol.  15,  pp..  568,  573. 

Fenner:  The  epidemic  of  1847.  N.  O.  M.  &  S.  JL,  vol.  5,  1848-9,  p. 
192. 

Fenner  (E.  D.) ;  An  account  of  the  Yellow  Fever  which  prevailed  in 
New  Orleans  in  the  year  1846.    N.  O.  M.  &  S.  Jl.,  vol.  3,  1846-7,  p.  445. 

Fenner:  An  Account  of  the  Yellow  Fever  in  New  Orleans  in  1848. 
N.  O.  M.  &  S.  Jl.,  vol.  6,  1849-50,  p.  9. 

Fenner:  History  of  the  Epidemic  Yellow  fever  at  New  Orleans  in 
1853.    8  vo.    New  York,  1854. 

Fenner:  Fever  Statistics;  showing  the  relative  proportion  of  the 
different  forms  of  fever  admitted  into  the  New  Orleans  Charity 
Hospital  during  a  period  of  seven  years,  etc.  N.  O.  M.  &  S.  Jl.,  1848-9. 
vol.  5. 

Grcs  et  Girardin:  Rapport  fait  a  la  Societe  Medicale  (de  la  Nouvelle- 
Orleans),  sur  la  fievre  jaune  qui  a  regne  d'une  maniere  epidemique 
pendant  I'ete  de  1817.     8vo.     New  Orleans,  1817. 


1 


NEW     ORLEANS — BIHLIOGRAPH  Y.  907 

Halphen  (Michel):  Memoire  sur  le  Cholera  Morbus  complique  d'une 
epidemie  de  Fievre  Jaun  qui  a  regne  simultanement  a  la  Xouvelle- 
Orleans  en  1832.     8vo.     Paris,  1833. 

Harris  (E,  B.):  Cases  of  the  yellow  fever  prevalent  at  New  Orleans 
in  the  summer  and  fall  cf  1833.  Am.  J.  M.  Sc,  Phila.,  1834,  vol.  14, 
pp.  41    74. 

Harrison  (John):  Remarks  on  Yellow  Fever.  X.  O.  M.  &  S.  Jl, 
1845-6,  vol.  2,  pp.  129,  321. 

Hava  (Adrian) :  The  Essential  Roles  of  the  Pneumo-Gastric  Nerves 
in  Yellow  Fever.     N.  O.  M.  &  S.  JL,  1898,  vol.  50,  p.  574. 

Health  of  the  City.     N.  O.  M.  &  S.  JL,  1849-50,  vol.  6,  pp.  407,  410. 

Herrick  (S.  S.) :  Review  of  the  Yellow  Fever  in  New  Orleans, 
1869-74.     Ibid.,  1874-5,  n.  s.,  vol.  2,  pp.  645,  652. 

History  of  the  yellow  fever  epidemic  in  the  Fourth  District;  disin- 
fection and  fumigation;  sanitary  conditions  of  the  district;  sanitary 
measures  generally  considered.  Rep.  Bd.  Health  Louisiana,  1878. 
X.  O.,  1879,  pp.  77;   95. 

Holcombe  (W.  H.) :  Repoi't  on  the  yellow  fever  of  1867,  to  the 
American  Institute  of  Homoeopathy.    8°.    New  Orleans,  1869. 

Holt  (J.):  Cases  of  yellow  fever  in  New  Orleans  in  1876.  N.  O.  M. 
&  S.  JL,  1876-7,  n.  s.,  vol.  4,  pp..  337,  427. 

Holt  (J.):  Analysis  of  the  record  of  yellow  fever  in  New  Orleans  in 
1876.    Ibid.,  pp.  480,  495.    Also,  Reprint. 

Holt  (J.) :  Yellow  fever  in  New  Orleans  during  the  year  1879.  N. 
O.  M.  &  S.  JL,  1879-80,  n.  s.,  vol.  8,  pp.  615,  625. 

Holt  (Dr.):  And  the  Pass  Christian  delegation.  8°.  (New  Orleans, 
1886).     Repr.  from  New  Orleans  Daily  States,  October  18,  1886.. 

Holt  (J.):  The  chain  of  circumstances  connected  with  the  appear- 
ance of  yellow  fever  in  New  Orleans  during  the  summer  of  1879.  N. 
O.  M.  &  S.  JL,  1879-80,  n.  3.,  vol.  7,  p.  375. 

Hort  (W.  P.):  Report  of  the  Board  of  Health  of  New  Orleans,  1846. 
N.  O.  M.  &  S.  JL,  vol.  3,  p.  467. 

Hort  (W.  P.):  Remarks  connected  with  the  sanatory  conditions  of 
the  city  of  New  Orleans.     N.  O.  M.  &  S.  JL,  1848-9,  vol.  5,  pp.  256,  266. 

Husemann    (T.):    Die   Sterblichkeit  der  Angehorigen   verschiedener 

Lander    am    galben    Fieber    in    New  Orleans    wahrend    der    1853    er 

Epidemie..     Mcnatsbl.   f.   Med.   Statist,  u.  off.     Gsndtspilg.,  BerL,   1859, 
p.  29. 

Jones  (Joseph):  Yellow  fever  epidemic  of  1878,  in  New  Orleans. 
N.  O.  Med.  &  Surg.  JL,  n.  s.,  vol.  6,  pp.  599,  683,763,  851,  946.  (See 
also  his  Medical  &  Surgical  Memoirs). 

Jones  (J.):  Notes  upon  the  yellow  fever  of  1873,  in  New  Orleans. 
Boston  M.  &  S.  JL,  1873,  vol.  89,  pp.  543,  546. 


908  HISTORY    OK    YELLOW    FEVER. 

Kohnke  (Q.):  The  Yellow  Fever  Epidemic  of  1905  in  New  Orleans. 
American  Public  Health  Association  Reports,  1907,  vol.  32,  pt.  1,  p.  39. 

Layton  (T) :  Address  delivered  at  the  fifth  anniversary  celebration 
of  the  New  Orleans  Medical  and  Surgical  Association.  Yellow  Fever.) 
N.  O.  M.  &  S.  Jl.,  1879,  n.  s.,  vol.  6,  p.  511. 

Lawrence  (J.  V.  O.  B.) :  Discection  of  subjects  dead  of  yellow  fever, 
made  at  New  Orleans,  during  the  years  1817,  1818  and  1819.  Phila. 
J.  M.  &  Phys.  Sc,  1825,  vol.  10,  pp.  2,  252, 

Lemoine:  Rapport  sur  une  relation  de  I'epidemie  de  fievre  jaune 
qui  a  regne  a  la  Nouvelle-Orleans  en  1839.  Rev.  Med.  Franc,  et  Etrang., 
Paris,  1840,  vol.  4,  p.p.  321,  342. 

Malignant  billious  remittent,  or  yellow  fever,  in  new  Orleans.  Med. 
Reposit ,  N.  Y.,  1820,  vol.  20,  pp.  269,  273. 

Martin  (S.):  Protestation  centre  quelques  attaques  du  dr.  C.  Faget. 
T.  Soc.  Med.  de  la  N.-Orleans,  1860,61,  vol.  2,  pp.  133,  146. 

Maurice  (E.  F.):  Reflexions  sur  la  fievre  jaune  a  la  Nouvelle-Orleans. 
Gas.  d.  Hop  ,  Paris,  1863,  vol.  36,  p.  406. 

Mercier  (A):  (Memorials  to  the  Legislature  of  the  State  of  Louisi- 
ana.) N.  O.  M.  &  S.  JL,  1858,  vol.  15,  pp.  221,  252.  (See,  also.  Supra, 
Axson.) 

Mercier:  La  fievre  jaune  a  la  Nouvelle-Orleans.  Gas  des  Hop., 
Paris,  1858,  vol.  31.  pp.  467,  567,  1859;  vol.  32,  pp.  27,  71,  114. 

Mercier  (A.):  La  fievre  jaune;  sa  maniere  d'etre  a  I'egard  des 
strangers  a  la  Nouvelle-Orleans  et  dans  les  campagnes.  Quelques  mots 
sur  son  passe  et  son  avenir  en  Europe.  Letters  adressees  a  la 
Gazette  des  hopitaux  de  Paris,  avec  un  avant-p.ropos  et  un  appendice. 
8°.    Paris,  1860. 

McFarlen  (J.  S.):  The  epidemic  summer  (in  New  Orleans  in  1853), 
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912  HISTORV    OF    YELLOW    FEVFR. 

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■I* 


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Yellow  fever  at  Lake  Providence,  La,  London  Med.  Times  &  Gaz., 
1853,  vol.  7,  p.  465. 

Yellow  fever  at  Madisonville,  La.,  in  1818.  (French.)  Tralliet, 
Examen  Critique,  etc.,  Relatif  a  la  Fievre  Jaune  (Lyons,  1830),  p.  15. 


I 


I 


915 

MAINE. 

EASTPORT. 
1902. 

For  the  first  aud  ouly  time  iu  its  history,  .yellow  fever 
was  brought  to  the  doors  of  Eastport  in  1902,  The  Brit- 
ish bark  Birnam  Wood  from  Rio  de  Janeiro,  June  19,  in 
baUast  for  St.  John,  New  Brunswick,  anchored  iu  Little 
Machias  Bay,  Sunday  night,  iVugust  3,  flying  signals  of 
distress.  Dr.  Shaw,  of  ^Macliias  boarded  the  vessel  and 
found  that  the  ba.k  had  yellow  fever  on  board;  three  of 
the  crew  having  died  and  the  captain  and  cabin  boy  being 
down  with  the  fever.  After  fumigating  the  vessel,  she 
was  towed  to  St.  John,  Xew  Brunswick,  and  arrived  at 
quarantine  outside  Partrdige  Island,  on  August  5. 

There  was  no  diffusion  of  the  disease  ashore. 

PORTLAND. 
1801. 

On  August  19,  1801,  the  ship  Ocean  arrived  at  Portland 
from  Havana  via  New  York,  where  she  had  performed 
quarantine  twenty  da,ys.  The  vessel  had  lost  several  of 
her  crew  from  yellow  fever  during  the  voyage,  and  had 
left  some  sick  at  the  hospital  on  Staten  Island. 

A  merchant  of  Portland  and  liis  clerk  who  visited  the 
ship  on  business,  were  attacked  shortly  afterward  (Au- 
gust 24)  with  a  disease  which  proved  to  be  yellow  fever. 
Both  recovered. 

The  merchant's  son,  a  lad  of  12,  who  had  accompanied 
his  father  on  board  the  ship,  next  took  the  disease 
(August  25)  and  died  on  the  31st. 

Two  of  the  merchant's  laborers  were  also  attacked  and 
died  on  the  fifth  day  after  the  onset. 

The  next  cases  occurred  in  the  persons  of  two  young 
men,  from  a  remote  and  healtliy  part  of  the  State,  who 


916  MAINE.  T 

went  ou  board  the  Ocean  soou  after  their  arrival  at  Port- 
land, and  assisted  in  removing  sundry  articles  from  the 
ship's  hold.  Four  days  after,  they  were  both  attacked 
with  3'ellow  fever,  but  eventually  recovered. 

The  disease  did  not  spread  to  the  other  inhabitants  of 
Portland,  but  was  confined  solely  to  persons  who  com- 
municated with  the  vessel,  which  proves  that  the  infected 
mosquitoes  did  not  migrate  to  the  shore,  ^| 

Total  case,  7;  deatlis,  ?i. 

In  addition  to  the  above  cases,  it  is  worthy  of  note  that 
the  captain  of  a  packet,  who  took  goods  out  of  the  Ocean 
and  carried  them  to  Boston,  was  seized  with  yellow  fever 
on  liis  arrival  at  the  Massacliusetts  town  and  died.  One 
of  his  crew,  who  had  assisted  him  in  removing  the  cargo, 
also  sickened  and  died.  ''His  skin,"  says  the  old  chron- 
icler, "was  of  a  deep  yellow  color.-' 

1839. 

In  1830,  it  is  again  ''a  ship  from  Havana,"  which  brings 
yellow  fever  to  the  City  of  Portland.  There  were  only  a 
few  cases,  confined  to  the  ship's  crew.  The  inhabitants 
of  Portland  were  not  affected. 


BIBLIOGRAPHY  OF  YELLOW    FEVER    IN    MAINE. 

EASTPORT. 

Small:   U.  S.  Public  Health  Reports,  1902,  vol.  17.  p..  1871. 

PORTLAND. 

Barker:   N.  Y.  Medical  Repository,  1803,  vol.  6,  p.  78. 

Austin:   Trans.  American  Medical  Association,  1877-8,  vol.  4,  p.  235. 


917 

MARYLAND. 

BALTIMORE. 

According  to  Carroll  (Old  Man/land,  190G,  Vol.  2,  p.' 
17),  yellow  fever  must  have  been  introduced  a  great 
many  times  in  Baltimore,  yet  the  only  important  epidemic 
outbreaks  of  the  disease  took  place  in  1794,  1797,  1800 
and  1819.  It  is  notable  that  all  the  outbreaks  began  at 
Locust  Point  or  about  the  docks  and  wharves,  and  they 
can  be  traced  directly  or  indirectly  to  the  shipping.  The 
relative  high  ground  upon  which  the  city  is  built  and 
the  distance  at  the  time  of  the  city  proper  from  the 
wharves  and  shipping,  explain  why  the  inter-urban  resi- 
dents suffered  but  little,  while  those  living  upon  the 
poorly-drained,  low-lying  districts  near  the  river,  were 
compelled  upon  such  occasions  to  flee  for  safety. 

Summary  of  Epidemics. 

1783;  1789. 

Berenger-Feraud  (Fievre  Jainic,  etc.,  1890,  pp.  57  and 
58),  says  that  yellow  fever  prevailed  for  the  first  time  in 
Baltimore  in  1783,  and  reappeared  in  1789,  but  gives  no 
details. 

1794. 

The  epidemic  of  1794  is  the  first  of  which  any  authentic 
information  is  available. 

According  to  Carroll  (lor.  cit.,  p.  18)  who  quotes  Dr.vs- 
dale  as  his  authority  (see  Bibliography  at  the  end  of  this 
article),  the  yellow  fever  epidemic  of  1794  first  made  its 
appearance  at  two  points,  remote  from  eacli  other,  viz. : 
at  Bowley's  Wharf,  in  the  town,  and  at  Fell's  Point. 
Many  cases  occurred  throughout  the  town,  but  these 
originated  eitlier  from  communication  with  liowley's 
Wharf  or  the  Point,  and  the  infection  could  be  distinctly 
traced  to  one  of  those  two  jjlaces.     Bdiig  puzzled  to  ex- 


918  HISTORY    OF    YELLOW    KEVER. 

plain  why  the  infection  was  confined  to  those  two  places, 
Dr.  Drvsdale  f(nind  that  the  first  cases  on  the  Point  were 
confined  to  liouses  whose  celhirs  were  filled  with  sta<j;nant, 
putrid  water,  and  he  also  found  black,  putrid  and 
offensive  water  beneath  the  stores  in  which  the  sick  re- 
sided at  Bowley's  Wharf.  Almost  all  of  those  who  were 
first  affected  Avere  new-comers.  Dr.  Drysdale  describes 
the  Point  as  beini>  low  and  flat;  its  streets  j;enerally  not 
paved,  its  alleys  filthy  and  the  i^round  marshy  in  many 
places.  The  fre(]uent  warm  rains  kept  the  noxious  places 
constanth'  moist  under  a  hot  sun. 

Dr.  Carroll  observes  that  we  can  easily  recop,nize  these 
as  conditions  favorable  to  the  multii)l<-ation  of  mosqui- 
toes, and  the  domestic  habits  of  the  Stcf/oini/ia  mosquito 
would  tend  to  keep  the  infection  rather  closely  confined 
to  these  localities. 

Dr.  Drysdale  further  makes  the  si«>,nificant  statement 
that  remittents  were  present  from  a  very  early  period. 
It  is  more  than  probable  that  many  of  these  remittents 
were  true  yellow  fever,  because  under  the  belief  then  pre- 
vailin.s:,  that  these  were  simply  the  prevailing?  types  of 
summer  fever,  they  would  not  be  reported.  It  is  also 
probable  that  if  occasional  cases  were  known  to  have  been 
yellow  fever,  some  physicians  would  have  concealed  them, 
from  the  same  motives  that  prevail  to-day. 

Dr.  Drysdale  saw  the  first  case  just  before  death,  on 
the  7tli  of  August  at  Bowley's  Wharf,  in  the  town,  and  on 
the  14th,  20th,  22nd  and  2-3rd  of  the  same  month,  he  saw 
five  additional  cases  at  the  same  jtart  of  the  wharf.  There 
were  also  at  the  same  place  some  other  cases  which  did 
not  come  under  his  care.  Dr.  Drysdale  states  that  there 
was  consideiable  sickness  at  Fell's  Point  after  the  death 
of  his  l?rst  case,  and  many  deaths  had  occurred  suddenly 
or  after  a  short  indisjMJsition.  An  investigation  was  made 
by  three  of  the  most  respectable  i)hysicians  who  reported 
that  the  prevailing  fever  was  the  common  endemic  of  the 
season,  Avhich  visited  the  Southern  and  Middle  States 
annually,  viz. :  the  bilious  remittent  fever.  The  number 
of  eases  now  rapi<lly  increased  so  that  by  September  25tli, 


MARYLAND liAJ-TIMORE.  919 

about  seven  weeks,  five  physicians  were  attacked  autl  two 
of  them  died.  The  cases  liad  become  so  numerous  that 
Dr.  Coulter  visited  and  prescribed  for  more  tlmu  120  per- 
sons daily.  By  the  end  of  the  month  many  families  had 
souii'ht  refu![ie  in  the  country.  During-  this  time  the  city 
remained  unusually  healthy,  and  althoujih  some  persons 
infected  at  the  Point,  died  in  the  city  proper,  the  disease 
failed  to  spread  in  that  locality. 

The  infection  is  saul  to  have  been  disseminated  by  the 
ship  Tninnph,  which  arrived  at  Fell's  Point  about  the 
last  of  June,  1794,  with  almost  all  her  crew  indisposed, 
having  previously  been  moored  along  side  a  schooner 
whose  captain  had  died  from  yellow  fever  during  the 
voyage  from  the  West  Indies. 

The  total  number  of  deaths  ascribed  to  yellow  fever 
during  this  epidemic  was  3G0. 

The  following  quotation  from  Dr.  Drysdale's  work  is 
of  significant  interest  at  this  time  of  the  known  propaga- 
tion of  yellow  fever  by  the  ^tcgomyia  Calopus-  race  of 
mosquitoes : 

"Locusts  were  not  more  numerous  in  the  reign  of 
Pharaoh,  than  iiwsqiiitoei^  fJirouf/h  the  la.sf  for  luojitJif^: 
yet  these  insects  were  very  rare  only  a  few  years  past, 
when  a  far  greater  portion  of  Baltimore  was  a  marsh."" 

The  fact  that  the  mosquitoes  were  not  widely  diffused 
through  the  city,  evidently  saved  Baltimore  from  a  more 
disastrous  epidemic. 

1795. 

Mild  outbreak;  no  statistics. 

1797. 

First  cases  were  observed  in  August ;  last,  in  November. 
Previous  to  September  17,  the  fever  was  confined  to  cer- 
tain places  and  fo  "such  as  had  breathed  the  air  evolved 
from  them;''  on  that  day,  a  strong  southeast  wind 
"wafted  the  effluvia  in  a  southw(>st  direction,  and  diffused 
the  infection  among  the  inhabitants  in  the  ujiper  parts 
of  Frederick,  Gay  and  Calvert  Streets,  who  became  im- 


920  HISTORY    OF    YELLOW    FEVER. 

mediately   implicated   in    the   horrors   of    yellow   fever." 
{Carroll,  loc,  eit.,  p.  21). 
The  outbreak  was  limited  and  the  mortality  small. 

179S. 

Sporadic  cases;  developments  unimportant. 

1800. 

Carroll  {Old  Maryland,  190(3,  vol.  2,  p.  21)  is  authority 
for  the  statement  that  the  epidemic  of  1800  was  the  sever- 
est Baltimore  has  ever  experienced.  The  mortality  from 
yellow  fever  is  recorded  to  have  been  1,197,  or  about  one 
in  fifty  of  the  population  of  60,000.  Again  the  disease 
began  at  Fell's  Point,  on  the  borders  of  the  Cove,  which 
extended  from  Jones'  Falls  to  the  interior.  The  Faculty 
of  Medicine  of  Baltimore,  after  investigation,  reported  to 
the  Mayor  that  in  their  belief  the  disease  was  not  im- 
ported btit  originated  in  the  Cove  from  the  stagnation 
and  putrefaction  of  filth,  under  a  summer's  sun.  Of 
course,  at  this  enlightened  age,  we  know  this  theory  to 
be  wrong  and  the  natural  tendency  is  to  incriminate  our 
old  friend,  "a  ship  from  the  West  Indies." 

The  first  two  cases  appeared  on  the  2nd  of  May,  an- 
other on  the  8th  of  June,  one  on  the  9th,  10th  and  13tli; 
then  from  the  22nd  they  became  more  numerous.  It  is 
unfortunate  that  there  is  no  detailed  description  of  this 
epidemic,  the  most  disastrous  that  Baltimore  ever  ex- 
perienced, i 

1800;  1801;  1802;  1805;  1818.  Sporadic  cases:  no 
statistics. 

1819. 

The  next  general  outbreak  took  place  in  1819  {Carroll, 
loc.  fit.,  p.  21),  following  the  arrivnl  of  an  infected  ship 
from  Havana.  In  a  letter  to  the  editors  of  the  Medical 
Repository  (1801,  vol.  4,  p.  351),  Dr.  Pierre  Chatard,  of 
Baltimore,  writing  October  19th,  cites  the  first  cases  as 
follows :     The  fever  commenced  raging  at  Fell's  Point  in 


MARVI.ANU ^BALTIMORE.  921 

the  beginning  of  July,  and  never  ceased  there  until  the 
end  of  October.  It  appeared  also  at  Smith's  Dock,  toward 
the  end  of  July,  carrying  off  five  persons  whose  names  are 
given,  and  others.  The  persons  named  had  counting 
houses  on  the  dock  or  in  the  vicinity.  No  other  cases 
appeared  at  the  dock  for  two  months,  at  the  end  of  which 
time  two  more  appeared.  Dr.  Chatard  attributes  the 
absence  of  cases  during  this  time  to  the  great  quantity  of 
lime  that  had  been  strewn  on  the  ground,  by  order  of  the 
Mayor.  The  lime  was  again  applied  and  the  cases  ceased. 
At  Fell's  Point  the  disease  raged  for  three  months  before 
it  subsided.  The  greater  part  of  the  population  retired  to 
the  healthier  portions  of  the  city  and  many  of  them  sick- 
ened and  died  there,  but  none  of  their  friends  or  relatives 
suffered  in  consequence. 

1820 ;  1821 ;  1822.     Sporadic  cases.     No  statistics. 

1858. 

Sporadic  cases.  Ten  cases  are  reported  to  have  oc- 
curred at  Fort  ]\rcHenry,  from  infected  vessels  in  (piar- 
antine. 

18G8;  1873. 

Imported  cases.     No  developments. 

1870. 

The  last  serious  outbreak  of  yellow  fever  in  Baltimore 
took  place  in  187(5.  The  history  of  this  epidemic  is  as 
follows  (Morrifi,  Tranfi.  American  Piihlic  HcaUh  .l.s.s'ori- 
ation,  1877-8,  vol.  4,  p.  212)  : 

The  first  case  (death)  was  reported  by  Dr.  Winter- 
nitz,  on  the  14th  of  September,  1876.  This  was  followed 
by  forty-four  cases  of  the  disease,  of  which  forty  died. 
Then  the  authorities,  thoroughly  alarmed,  had  all  the 
people  living  in  the  infected  quarter,  sick  and  well,  r um- 
bering in  all,  one  hundred  and  fiftv  persous,  removed  to 
the  Quarantine  ITospital,  sctme  miles  from  the  city.  A 
cordon  was  placed  around  the  locality;  the  Avhole  place 
Avas  purified;  nearly  a  hundred  cart  loads  of  filthy  ac- 
cumulations were  removed;  the  privies  were  emptied  and 


922 


HISTORY    OF    YELLOW    FEVER. 


filled  up  with  clay;  the  homes  and  clothing  of  the  people 
were  cleansed  and  disinfected,  and  a  certain  pon'tion  of 
the  latter  destroyed,  and  every  possible  source  of  infection 
was  reuKJved.  The  result  of  these  measures  was  that  not 
a  single  case  of  the  disease  occurred  afterwards,  and  the 
whole  trouble  disappeared  as  if  by  the  power  of  a  majii- 
clan's  wand.  Tliouiih  <nie  hundred  and  fifty  persons  were 
removed  to  the  Marine  Hospital,  and  twenty-five  cases 
were  treated  there,  fifteen  of  which  proved  fatal,  not  a 
sinji'le  one  of  those  engaj^ed  in  removin<>-  the  sick — nurses, 
physicians,  etc. — contracted  the  disease.  Only  one  sing'le 
death  took  place  at  a  distance  from  the  infected  district, 
and  that  was  a  patient  who  had  lived  in  one  of  tlie  houses 
in  which  tlicre  had  been  several  cases,  and  who  <lied  twen- 
ty-four hours  after  leaving  it.  "A  ship  from  the  Spanish 
Main"  (South  America)  is  accused  of  liaving  brought  the 
infection. 

1878. 

Two  deaths  on  board  the  May  Queen,  from  Kio  de 
Janeiro. 

1883. 

July  27,  four  cases  on  board  the  ship  Califoriiid,  from 
Vera  Cruz. 

1894. 

The  steamship  SainucI  '/\i/:(il\  from  Havana,  arrived  on 
August  4,  witli  four  cases  of  yellow  fever  on  board.  One 
of  the  i)atients  died  at  the  Maryland  University  Hospital, 
and  another  occupied  a  bed  in  one  of  the  wards  before  the 
nature  of  his  illnes  was  discovered. 


About  the  same  time,  the  bark  Alien,  also  from  Havana, 
had  three  cases  of  yellow  fever  on  board  while  in  the 
quarantine  basin. 

Since  1894,  no  cases  of  yellow  fever  have  l)een  observed 
in  Baltimore  or  at  the  quarantine  station. 


MARYLAND BALTIMORE.  923 

BIBLIOGRAPHY    OF   YELLOW    FEVER    IN    MARYLAND. 
BALTIMORE. 

Additional  Number  to  tlie  Letters  of  Humanitas,  together  with  John 
Hillen's,  William  Jenkins,  and  Dr.  McKenzie's  Letters  and  other 
Documents,  Relative  to  Polly  Elliott's  Case;  and  a  Reply  to  the  same, 
by  James  Smith,  phisician.     8vo.     Baltimore,  1801. 

Carroll  (J.):  The  Epidemics  of  Yellow  Fever  in  Baltimore.  Old 
Maryland,  1906,  vol.  2,  p.  17. 

Chatard:  Notice  Succincte  du  Typlrus,  etc.,  qui  se  manifesta  a 
Baltimore  au  mois  de  Juillet,  1819.  Observateur  des  Sciences 
Medicales  de  Marseille,  vol.  5,  p.  333. 

Chatard:  On  the  Yellow  Fever,  as  it  appeared  at  Baltimore  in  the 
summer  and  autumn  of  1800.  New  York  Med.  Reposit.,  1801,  vol.  4, 
p.  235. 

Drysdale:  Account  of  the  Yellow  Fever  in  Baltimore  in  1794.  Coxe's 
Phila.  Medical  Museum,  vol.  1,  1804,  pp.  22,  121,  241,  361. 

Jameson  (H.  G.):  On  the  yellow  fever  in  Baltimore.  Am.  J.  M.  Sc, 
Phila.,  1856,  n.  s.,  vol.  32,  p.  372. 

Johnson  (Ed.) :  A  series  of  Letters  and  other  Documents  relating 
to  the  late  Epidemic  or  Yellow  Fever  (1819).     8vo.     Baltimore,  1820. 

Kemp.  (W.  M.) :  What  Baltimore  did  in  a  Sanitary  way  during  the 
yellow  fever  in  Norfolk  and  Portsmouth  in  1855.  Tr.  M.  &  Chir,  Fac. 
Maryland,  Bait.,  1882,  p.  132. 

Late  (The)  epidemic  in  Baltimore.  Bait.  Phys.  &  Surg.,  1876,  vol. 
6,  p.  37. 

Moores  (D.):  [Origin  of  the  yellow  fever  in  Baltimore.]  Med,. 
Reposit.,  N.  Y.,  1801,  vol.  4,  p.  351. 

Morris  (J.):  History  of  the  epidemic  in  Baltimore  in  1876,  Am.  Pub. 
Health  Assn.  Rep.,  1877-8,  Boston,  1880,  vol.  4,  p.  243. 

Official  statement  of  the  causes  of  the  late  epidemic  yellow  fever, 
in  the  city  of  Baltimore,  by  the  District  Medical  Society  of  Maryland. 
Med.  Reposit.,  N.  Y.,  1820,  vol.  20,  p.  345. 

Opinion  of  the  Medical  Faculty  of  Maryland  relative  to  the 
Domestic  Origin  of  the  Pestilential  Sickness  in  Baltimore  during  the 
hot  season  of  1800.     Medical  Repository,  1801,  vol.  4,  p.  351. 

Reese  (D.  M.):  Observations  on  the  Epidemic  of  1819,  as  it  pre- 
vailed in  a  part  of  the  city  of  Baltimore,  etc.,  12mo.     Baltimore,  1819. 

Revere  (Jno.):  An  Account  of  the  Fever  which  prevailed  in  certain 
parts  of  Baltimore  during  the  summer  and  autumn  of  1819,  with  some 
Remarks  on  its  Origin  and  Treatment.    Medical  Recorder,  vol.  3,  p.  214. 

Rush  (B.):  Account  of  the  yellow  fever  in  Baltimore,  in  1794.  Phila. 
M.  Museum,  1804-5,  vol.  1,  p.  22. 


9£4  HISTORY    OF    VELI.OW    FEVER. 

Series  (A)  of  letters  and  other  documents  relating  to  the  late 
epidemic  or  yellow  fever;  comprising  the  correspondence  of  the  mayor 
of  the  city,  the  board  of  health,  the  executive  of  the  State  of  Maryland, 
and  the  reports  of  the  faculty  and  District  Medical  Society  of  Balti- 
more. Also  essays  of  the  physicians,  in  answer  to  the  mayor's  circular 
requesting  information  for  the  use  of  the  city  council  in  relation  to 
the  causes  which  gave  origin  to  this  disease.  To  which  is  added  the 
late  ordinance  re-organizing  the  board  of  health,  etc.  8°.  Baltimore, 
1820. 


» 


925 

MASSACHUSETTS. 

The  Epidcinies  of  New  Englund  in  Colonial  Ti)iies. 

In  1018,  two  years  before  the  landiiif;-  of  tlie  Pili'Tim 
Fathers  at  Plymouth,  there  appeared  amoiiii;  tlie  Indians 
of  the  country,  one  of  the  most  remarkable  epidemics  on 
record.  So  fatal  was  the  pestilence,  that  the  warriors 
"were  reduced  from  nine  thousand  to  a  few  hundreds." 
The  Massachusetts  tribe  alone  was  supposed  to  haye  lost 
2,700  out  of  3,000  persons.  {Iliiichinson.,  Histortj  of 
Ma.ssaehusetts,  yol.  1,  p.  34). 

The  same  authority  states  that  in  1021,  many  places 
which  had  been  populous  Indian  yillages,  were  found  ''all 
deserted — all  dead." 

Noah  Webster,  in  his  work  on  Pestilence,  attempts  to 
decide  that  this  pestilence  was  the  fever  which  has  since 
received  the  appellation  of  "yellow  fever;"  his  reliance 
for  this  opinion  being  the  statement  of  General  Gookin 
(Massachusetts  Historical  Collections,  vol.  1,  p.  143), 
which  reads  as  follows: 

"AVhat  the  disease  was  which  so  generally  and  mortally 
swept  them  away,  I  cannot  learn;  doubtless  it  was  some 
pestilential  disease.  I  discoursed  with  some  Indians  that 
were  then  youths,  who  say  the  bodies,  all  over,  were  ex- 
ceeding yellow  (describing  it  by  a  yellow  garment  they 
showed  me)  both  before  they  died  and  afterwards." 

That  this  was  not  small-pox  (a  frequent  scourge  of  the 
aborigines),  is  evident  from  several  circumstances;  but 
the  basis  (above  cited)  for  the  inference  that  it  was  yel- 
low fever,  is  too  slight,  especially  Avhen  we  remember  what 
Webster  ignores,  that  it  raged  in  winter,  which  yellow 
fever  never  does,  at  least  in  Northern  latitudes.  It  was 
most  probably  a  malignant  typhus,  with  bilious  compli- 
cations, jaundice  and  nasal  hemorrhages  of  paludal 
origin. 

At  the  commencement  of  the  settlement  of  Plymouth, 
our  venerable  ancestors  suffered  very  much  from  sick- 


926  HISTORY  OF  YELLOW   FEVER. 

ness.     At  the  end  of  three  iiiontlis  after  their  arrival,  53 
only  survived  of  tlie  101  who  came  iu  the  Mcnjfloiccr. 

"The  sick  were  destitute  of  almost  all  the  comforts 
which  their  miserable  condition  rendered  indispensable. 
Their  sufferings  were  increased  by  the  want  of  well  jjer- 
sons  to  ijerform  the  duties  among-  the  sick;  there  being, 
at  one  time,  not  more  than  six  or  seven  persons  in  toler- 
able health."     Thatchers  Hisfori/  of  Pli/mouth,  p.  32. 

In  1()31,  small-pox,  first  breaking  out  at  Haugus,  spread 
from  Xarraganset  to  Piscataqua,  and  westward  to  Con- 
necticut Eiver,  and  swept  off  entire  villages  of  the  In- 
dians. When  Increase  Mather  wrote,  there  were  living 
some  old  residents,  who  on  that  ocacsion  helped  to  bury 
whole  families  of  the  natives  at  the  same  time. 

At  the  close  of  1633,  small-pox  again  broke  out,  and 
made  great  devastations  among  the  unfortunate  native 
races  of  Massachusetts.  Chickatabut,  the  great  sachem 
of  the  tribe,  was  among  the  victims 

Plymouth  was  again  visited  with  a  mortal  sickness  in 
1634,  of  which  twenty  men,  women  and  children  died; 
among  Avhom  was  "that  most  excellent  and  pious  man," 
Dr.  Samuel  Fuller,  the  first  ])hysician  of  "Xew  England. 
It  must  have  been  occasoned  by  a  fever  of  douiestic  origin, 
as  the  colony  had  at  that  time  no  intercourse  with  for- 
eign countries,  except  P]ngland. 

Great  sickness  prevailed  among  the  Indians  at  ]Mar- 
tha's  Vineyard  in  1645.     Few  escaped. 

In  1647  a  malignant  fever  prevailed,  "occasioned  by  the 
excessive  heat  of  summer;"  and  an  ei)idemic  influenza 
passed  through  the  whole  country,  and  universally  af- 
fected the  colonists  and  natives;  l)ut  it  was  not  very  mor- 
tal, "wherein  a  S])ecial  providence  of  God  appeared,  for 
not  a  family  nor  but  a  few  persons  escaping  it;  our  hay 
and  corn  had  to  be  lost  for  Avant  of  help;  but  such  was 
the  mercy  of  God  to  his  i)eople,  as  few  died — not  above 
forty  or  fifty  in  the  Massachusetts  and  near  as  many  in 
Connecticut."     Winthrop'R  Journah  vol.  2,  t>.  310. 

Another  epidemic  distemper,  similar  to  ;hat  of  1647, 
passed  through  New  England  in  1655.     It  began  in  June, 


MASSACHUSETTS.  927 

and  few  persons  escaped.  Anion_i>'  those  who  died  was 
Eev.  Xathaniel  Eogeis,  of  Ipswich. 

Sickness  and  mortality  thronghout  New  England  in 
1658. 

Croup  is  first  mentioned  in  the  annals  of  the  country 
in  IGSO.  Other  malignant  diseases  also  prevailed  about 
this  time.  Thirty  children  died  in  Rowley,  ^Nlass,  A  day 
of  thanksgiving  was  appointed  in  Connecticut,  for  the 
"abatement  of  the  sickness  in  the  country,  and  a  supply 
of  rain  in  time  of  drought." 

Small-pox  was  very  fatal  in  Charlestown,  ]Mass.,  in 
1677.  The  records  state  that  thirtV'-one  died  of  the  dis- 
ease, one  of  whom  was  the  Eev.  Thomas  Shepard. 

In  1678,  small-pox  in  Boston ;  but  we  have  seen  no  ac- 
ecount  of  its  victims.  Seven  or  eight  hundred  are  said  to 
liave  died  of  it  in  Massachusetts.  About  this  time  "the 
seasons  were  unfavorable,  and  the  fruits  blasted,  while 
malignant  diseases  prevailed  among  the  people.  The  sick- 
ness and  bad  seasons  were  attril)uted  by  our  pious  an- 
cestors to  the  irreligion  of  the  times,  and  to  their  disuse 
of  fasting;  and  a  meeting  was  held  to  investigate  the 
causes  of  God's  judgments,  and  to  propose  a  plan  of  re- 
formation."    Webster,  vol.  1,  p.  203. 

Tlie  influenza  began  in  Xovemlx^',  1697,  and  prevailed 
until  I^'bruary,  in  ^Massachusetts.  Whole  families  and 
whole  towns  were  seized  nearly  at  the  same  time.  In  the 
following  year  (1608),  a  "mortal  disease  prevailed  so 
much,  in  Fairfield,  Connecticut,  that  well  persons  were 
not  found  to  take  care  of  the  sick  and  bury  the  dead. 
Seventy  died  in  three  months,  out  of  a  population  of  less 
than  one  thousand.  At  the  same  time,  a  dreadful  mor- 
tality occurred  in  Dover,  New  Hami)shire. 

Yellow  fever  i)revailed  at  Ilollin.ston,  ]Nrassachusetts, 
"of  which  died,  Mr.  Stone,  the  minister,  and  14  of  his 
congregation."  How  the  fever  was  introduced,  is  left  to 
conjecture. 

In  1743  an  "infectious  fever"  ]M-evaib'd  in  liciston. 
Yellow  fever  prevailed  in  New  York,  Philadelphia,  New 
Haven,  Conn.,  and  Stamford,  Conn.,  was  distressed  by  a 


928  HISTORY    OF    YELLOW    FEVER. 

malignant  dysentery,  which  swept  away  70  inhabitants 
out  of  a  few  hundreds. 

"About  the  same  time  (the  precise  year  is  not  known) 
a  malignant  epidemic  disease  laid  waste  the  Indian  tribes, 
which,  from  the  description  given  by  the  traders,  would 
appear  to  be,  though  it  probably  was  not,  the  infectious 
Yellow  Fever.  In  consequence  of  it,  the  Senecas  removed 
their  quarters  two  or  three  times  in  a  few  jears.  The  dis- 
ease was  said  to  have  been  confined  to  the  Indians,  the 
white  people  living  and  trading  Avitli  them  not  being 
affected.      (Griscom,  p.  4). 

The  Mohegan  tribe,  between  New  London  and  Norwich, 
were  "wasted  by  the  same  malady"  in  1746.  From  an 
account  given  by  a  Mohegan  priest,  "a  man  of  good  sense 
and  integrity,"  as  related  by  a  Dr.  Tracy,  of  Norwich, 
who  attended  them  as  a  physican,  and  was  the  only  white 
man  atfected,  the  following  were  the  symptoms  of  this 
disease:  The  patient  first  complained  of  a  severe  pain 
in  the  head  and  back,  which  was  followed  by  fever;  in 
three  or  four  days  his  skin  turned  as  3'ellow  as  gold;  a 
vomiting  of  black  matter  took  place,  and  generally  a  bleed- 
ing of  the  nose  and  mouth,  which  continued  till  the 
patient  died.     One  hundred  of  the  tribe  died.." 

Summary  of  Yi:llow  Fever  Years. 
BOSTON. 

1G21.  According  to  Dowler  (1853,  p.  7),  first  appear- 
ance of  yellow  fever  in  Boston.     No  authentic  statistics. 

1G93.  An  English  squadron  under  Admiral  Wheeler, 
after  remaining  a  month  at  Barbadoes  and  twenty-one 
days  at  ]Martiniqu(s  l)i'ought  yellow  fever  to  Bost(m,  where 
it  caused  great  mortality.  (Hiifcltiiisoii's  History  of  ^cw 
England,  vol.  5,  p.  110). 

1795.  Infected  by  vessels  from  the  West  Indies.  Only 
a  few  cases.     The  fever  did  not  spread  to  the  inhabitants. 

179G.  Yellow  fever  broke  out  on  August  26,  the  first 
death   taking   place  on   the  29th.       Source  of  infection 


MASSACHUSETTS.  949 

obscure.  Warren  (see  Bihliography) ,  like  the  majority 
of  the  good  old  souls  of  the  period  who  have  written  on 
yellow  fever,  maintains  that  "it  was  caused  by  noxious  sub- 
stances exhaled  into  the  atmosphere  from  putrefying  ani- 
mal or  vegetable  matter  or  both."  Only  130  deaths  are 
recorded,  which  proves  that  the  disease  was  undoubtedly 
confined  to  imported  cases. 

1798.     Serious  outbreak.     Deaths,  200. 

171)9;  1800.  Imported  cases;  no  important  develop- 
ments. 

1801.  The  master  of  a  packet  plying  between  Boston 
and  Portland,  Maine,  who  took  goods  out  of  a  ship  in- 
fected with  j^ellow  fever,  which  was  at  the  latter  port, 
was  taken  ill  with  the  disease  on  his  arrival  at  Boston, 
and  died  shortly  afterAvards.  One  of  his  sailors  sickened 
also  at  the  same  time  and  died.  The  marked  yellow^  color 
of  the  skin  of  the  latter  is  specially  mentioned  by  the 
chroniclers  of  this  episode  { Banker ,  New  York  Medical 
Repository,  1803,  vol.  6,  p.  78). 

The  fever  did  not  spread  to  the  inhabitants  of  Boston, 

1802.  Limited  outbreak.     Deaths,  GO. 

1805;  1819;  1858.  Infected  by  the  shipping.  No  im- 
portant developments. 

1885.  On  September  24,  the  steamship  Craighill,  from 
Colon,  Panama,  anchored  in  Boston  harbor.  Four  cases 
of  yellow  fever  were  discovered  on  board,  and  were  trans- 
ported to  Gallup's  Island  Hospital,  where  they  eventually 
recovered.  The  captain  of  the  vessel  had  died  from  yellow 
fever  during  the  voyage. 

The  city  was  not  infected. 

CHELSEA. 

1877.  Two  yellow  fever  patients  were  disembarked  at 
the  Chelsea  Hospital,  on  December  12,  from  the  ship 
Laura  Wilson,  from  San  Domingo  City.  One  of  the 
patients  died  on  the  IGth,  the  other  recovered. 

HOLLISTON. 
1741.     Holliston,  25  miles  from  Boston,  was  the  scene 
of  a  mild  outbreak  in  1741.     Deaths,  15. 


930  HISTORY    OF    YELLOW    FEVER. 

NANTUCKET. 

1763.     Deaths,  259. 

NEW    BEDFORD. 

1800 ;  1801 ;  1821.  Yellow  fever  outbreaks.  No  record 
of  cases  and  deaths. 

NEWBURYPOET. 

1796.  According?  to  Brockway  (National  Board  of 
Health  Bulletin,  1881-2,  toI.  3,  jl  179),  yelloAv  fever  vis- 
ited Newbiiryport  on  several  occasions.  As  early  as  1793, 
at  which  time  yellow  fever  was  devastating  Philadelphia, 
Governor  Hancock,  of  Massachusetts,  issued  the  follow- 
ing proclamation : 

"Whereas  a  dangerous  and  infectious  disease  is  prevalent  at  this 
time  in  the  city  of  Philadelphia,  and  it  being  highly  expedient  that 
effectual  measures  should  he  adopted  to  prevent  its  introduction  with- 
in this  commonwealth  [Massachusetts], 

"I  do,  therefore,  in  pursuance  to  a  resolution  passed  by  the  two 
branches  of  the  legislature  this  day,  require  all  sheriffs  and  their 
deputies,  the  selectmen  and  constables  of  the  several  towns  in  this 
commonwealth,  to  take  effectual  measures  for  examining  all  persons, 
with  their  baggage  and  other  effects,  by  land  or  water,  coming  from 
Philadelphia  or  any  other  infected  place,  and  where  there  is  reason  to 
apprehend  that  the  infection  may  be  communicated,  that  they  take 
such  measures  as  the  law  in  such  cases  made  and  provided  directs  for 
detaining  and  cleansing  the  persons  and  baggage  from  which 
danger  may  be  apprehended,  so  as  to  effectually  prevent  the  intro- 
duction and  spreading  of  said  infectious  disease  among  the  good 
people  of  this  commonwealth." 

(Signed,  etc.) 

Newburyport,  in  response  to  this  proclamation,  and  in 
view  of  the  great  mortality  from  yellow  fever  raging  at 
Philadelphia,  the  accounts  published  from  there,  stating 
that  one  hundred  persons  were  buried  in  one  day  at  this 
time,  and  in  the  general  alarm  which  prevailed,  issued 
this  "notification :" 


MASSACHUSETTS NEWBURYPORT.  93  1 

"Whereas  a  dangerous  and  infectious  disease  is  now  prevailing, 
not  only  in  Philadelphia,  but  also  in  the  leeward  and  winward  West 
India  islands,  this  is  to  forbid  all  pilots,  and  others,  on  penalty  of 
the  law,  from  bringing  any  vessel  from  Philadelphia  higher  up  the 
Merrimac  River  than  the  Black  Rocks,  or  any  vessel  from  a  foreign 
port  to  any  wharf  in  this  town,  but  let  them  remain  in  the  stream 
until  examined  by  the  health  officer  and  certificate  from  him  be  ob- 
tained certifying  her  being,  in  his  opinion,  free  from  infection. 

"By  order  of  the  selectmen. 

"Published  September  23,  1793." 

The  quarantine  ground,  so  called,  was  about  a  mile  and 
a  half  below  the  town. 

The  selectmen  also  reminded  the  inhabitants,  at  this 
date,  to  give  special  attention  to  cleanliness  and  recom- 
mended the  most  scrui^ulous  examination  of  the  streets, 
that  no  dead  carcasses  or  other  offensive  things  are  suf- 
fered to  remain,  and  to  the  "necessity  of  causing  all  drains 
and  offensive,  stagnant  waters  in  yards  or  near  houses 
to  be  cleansed,"  etc. 

The  selectmen  of  Newburyport,  in  tlie  summers  of  1794 
and  1795,  urge  a  strenuous  enforcement  of  the  quarantine 
regulations,  as  the  yellow  fever  was  prevailing  in  several 
of  the  cities  in  the  United  States,  especially  in  New 
Haven,  in  1784,  to  such  an  extent  as  to  break  up  the  col- 
lege; and,  as  early  as  i\fay  14,  1795,  the  pilots  and  masters 
were  ordered  by  the  selectmen  of  Newburyport  "not  to 
bring  any  vessel  above  Black  Rocks  then  having,  or  dur- 
ing the  voyage  having  had,  any  person  on  board  infected 
with  small-pox  or  any  pestilential  disease,  or  coming  from 
any  port  where  such  diseases  prevail,  until  liberty  is  ob- 
tained from  the  selectmen.  On  hoisting  a  color  on  the 
shrouds  (of  the  vessel)  a  proper  person  will  attend  on 
board  to  see  the  vessel  well  cleansed  and  to  make  report 
of  her  situation." 

Summary  of  Epidemics. 

1796. 

The  same  authority  quoted  above  (Brockway)  states 
that  yellow  fever  made  its  appearance  in  Newburyport  in 
1796,  causing  great  elarm,  but  it  was  not  until  about  the 


932  HISTORY  or  yellow  fever. 

middle  of  August  that  it  was  publicly  noticed,  although 
it  commenced  lu  Juue,  aud  from  the  middle  of  that  mouth 
until  the  5th  of  October,  tifty-tive  faltal  cases  were  re- 
ported. Tradition  says  that  some  of  the  prominent  citi- 
zens of  the  town  at  this  time  took  steps  to  secure  the 
services  of  an  experienced  French  physician,  Dr.  Francis 
A^ergnies,  whom  the  local  paper  mentioued  as  having  ar- 
rived in  Xewburyport  in  the  summer  of  this  year,  from 
the  island  of  Guadaloupe.  That  this  gentleman  rendered 
important  service  was  evident,  as  the  town  at  a  public 
meeting  of  the  citizens,  in  April  of  the  following  year, 
1797,  unanimously  voted  "that  the  thanks  of  the  town  be 
given  to  Dr.  A'ergnies,  for  his  prompt  assistance  aud 
advice  the  last  summer  (1796),  when  the  town  was  visited 
Avitli  a  malignant  disorder." 

Dr.  Vergnies  continued  his  residence  in  Xewburyport 
in  the  general  practice  of  his  medical  profession  until  his 
death  in  1830. 

These  cases  of  yellow  fever  are  the  tirst  which  Dr. 
Brockway  found  publicly  acknowledge  as  such,  and  re- 
ported in  the  history  of  the  town.  One  of  the  historians 
of  Newburyport  remarks  that  "this  malignant  fever,  a 
disease  then  practically  unknown  to  the  members  of  the 
medical  faculty  here,  but  which  was  thought  to  be  sim- 
ilar, if  not  identical  with  the  yellow  fever  of  the  Houth, 
first  appeared  in  a  house  on  Water  Street,  etc.,  in  the 
immediate  neighborhood  of  one  of  the  wharAcs  in  the  har- 
bor, and  its  ravages  were  contined  to  a  narrow  locality 
and  short  distance  in  this  street,  whicli  was  closed  or 
-chained  up'  to  prevent  passage."  It  was  conjectured  by 
some  that  the  disease  originated  on  the  s])ot,  but  the  most 
reasonable  conclusion  Avas  that  it  was  brought  in  a  ves- 
sel from  one  of  the  West  India  islands;  and  this  opinion 
was  generally  entertained.  That  the  fever  Avas  caused  bv 
decayed  fish  in  the  dock  was  believed  in  by  nuniy,  there  is 
no  doul>t,  as  the  town,  at  a  special  meeting  called  July 
21,  1796,  chose  an  "inspector  of  police"  to  remove  all 
nuisances,  and  to  "prohibit  fish  beinii'  thrown  Into  the 
river,"  etc.  Among  the  victims  to  this  disorder,  which 
caused   great   excitement   in    the   town,   and    widespread 


MASSACHUSETTS NEWBURYPORT.  933 

alarm,  were  several  prominent  citizens  of  the  town,  in- 
cluding an  eminent  resident  physician,  Dr.  J.  Bernard 
Swett.     The  fever  disappeared  with  the  frost. 

In  1797,  July  27,  the  town  voted  to  choose  a  health 
officer  to  carry  into  effect  a  law  of  the  commonwealth 
passed  the  month  previous,  "to  prevent  the  spreading  of 
contagious  sickness."  Public  attention  in  this  town  was 
again  called  in  the  following  summer  to  the  danger  from 
yellow  fever  by  its  prevalence  in  Philadelphia,  New  York, 
Alban3%  Newport,  Boston  and  several  other  places  at  the 
North,  up  to  the  middle  of  September. 

1799. 

In  the  summer  of  1799  there  was  a  return  of  yellow 
fever  at  Newburyport,  which  the  petitioners  for  a  special 
town  meeting  called  "an  alarming  mortal  sickness;"  and 
a  health  committe  was  chosen  to  adopt  measures  to  pre- 
vent the  fever  from  spreading,  and  to  secure  a  more  rigid 
quarantine. 

The  reappearance  of  the  yellow  fever  this  summer  in 
Philadelphia  caused  general  alarm,  and  in  this  town  the 
fear  Avas  not  groundless,  as  the  health  committee  reported 
nine  persons  "as  having  died  of  malignant  fever"  up  to 
July  23.  The  health  officer,  meantime,  had  ordered  the 
free  use  of  unslacked  lime  in  the  streets  of  the  town,  and 
wherever  there  was  any  accumulation  of  filth,  "and  par- 
ticularly in  vaults."  Up  to  the  6th  of  August  there  ap- 
pear to  have  been  fifteen  fatal  cases,  and  the  health  com- 
mittee reported  on  that  day  "that  the  fever  had  not  been 
communicated  except  in  the  vicinity  of  the  lower  Long 
Wharf,"  and  they  recommend  that  those  persons  who  have 
left  that  neighborhood  remain  away  until  notified  by  the 
committee.  A  week  later  several  of  the  traders  advertise 
that  they  have  returned  to  the  town  with  their  goods  to 
their  places  of  business  in  Water  Street. 

The  fever  in  this  instance  Avas  sup])osed  to  have  been 
brought  into  town  by  a  vessel  which  arrived  from  St. 
Thomas  on  the  29th  of  June,  and  is  re]iorted  in  the  news- 


954  HISTORY    OK    YELLOW    FEVKR. 

paper  as  having  discharged  her  cargo  at  the  wharf  men-; 
tioned  above,  and  that  nearly  all  those  who  !iad  died,  had 
labored  on  board  of  this  vessel. 

1829. 

Two  cases,  in  1829,  close  the  history  of  yellow  fever  in 
Newburyport.  A  prominent  physician  of  the  town,  Dr. 
Bradstreet,  who  was  then  Health  Officer  of  the  port,  vis- 
ited a  vessel  "from  the  South,''  which  was  then  ai  quar- 
antine and  contracted  yellow  fever,  and  died  shortly  after 
the  onset.     His  daughter  shared  the  same  fate. 

The  disease  did  not  spread  to  the  other  inhabitants  of 
the  place. 

SALEM. 

1798.     Limited  outbreak.     No  authentic  statistics. 

BIBLIOGRAPHY  OF  YELLOW   FEVER   IN    MASSACHUSETTS. 

BOSTOX. 

Ayer  (J.) :  Yellow  fever  in  Boston.  Extr.  Rec.  Bost.  Soc.  M.  Improve. 
(1856-9),  1859,  vol.  3,  p.  255.  Also:  Boston  M.  &  S.  J.,  1858-9,  vol.  lix, 
p.  140-143. 

Brown  (Samuel):  An  Account  of  the  Pestilential  Disease  which 
prevailed  at  Boston  in  the  summer  and  autumn  of  1798.  Medical 
Repository,  vol.  2,  p.  390. 

Brown  (S.) :  A  Treatise  on  the  Nature,  Origin,  and  Progress  of  the 
Yellow  Fever,  especially  as  it  has  prevailed  in  Boston.  8vo.  Boston, 
1800.  (See  a  Review  of  this  volumns  in  Medical  Repository,  vol.  4, 
1901,  p.  63.) 

Case  of  the  Ship  Ten  Brothers;  being  the  Report  of  a  Committee  of 
the  Board  of  Health,  unanimously  accepted,  and  published  by  order 
of  the  Board.     Boston,  1819. 

Glover  (M.  W.):  Yellow  Fever.  Invasions  of  the  Disease  (in  Bos- 
ton) in  Early  Times.     Yellow  Fever  Institute  Bulletin,  No.  2,  1902. 

Ingalls:  Weekly  Reports  to  the  editors  of  Medical  Repository  of 
New  York,  on  the  malignant  Yellow  Fever  in  Boston  in  1819.  Medical 
Repository,  vol.  10,  p.  256. 

Interesting  (An)  account  of  the  plague,  yellow  fever,  etc.,  as  they 
have  prevailed  in  different  countries;  printed  at  the  request  of  thie 
Boston  Board  of  Health.     8°.     Boston,  1820. 


MASSACHUSETTS.  935 

Page  (W.  H.) :  Yellow  fever  in  Boston..  Boston  M.  &  S.  Jl.,  1S70, 
vol.  Ixxxiii,  p.  253. 

Rand:  Of  the  Epidemic  lately  prevalent  in  Boston  (179S).  Medical 
Repository,  1S99,  vol.  2,  p.  486. 

Rand  and  Warren:  Account  of  dissections  of  bodies  dead  of  tlie 
late  malignant  epidemic  at  Boston.  Ibid.,  249-252.  Also:  Mem.  Am. 
Acad.  Arts  &  Sc,  Cambridge,  1804,  vol.  2,  pt.  2,  p.  130-136. 

Report  of  the  Joint  Special  Committee  of  the  House  of  Representa- 
tives of  Massachusetts,  to  whom  were  referred  the  memorials  of  the 
Massachusetts  Medical  Society,  and  American  Statistical  Association, 
etc.,  for  a  Sanitary  Survey  of  the  State.     8vo.     1849. 

Warren  (J.):  Yellow  fever  in  Boston.  Med.  Communicat.  Mass.  M. 
Soc,  Boston,  1809-13,  vol.  2,  p.  462. 

Yellow  Fever  in  Boston  in  1819;  to  which  is  added  a  Note  by  Dr. 
George  Hayward  on  the  same  subject.  The  New  England  Journal  of 
Medicine  and  Surgery,  1819,  vol.  8,  p.  380.  See  also:  North  American 
Review,  vol  10,  p.  395. 

GENERAL. 

Buel  (W.) :  An  Account  of  the  febrile  disorders  which  prevailed  in 
Sheffield,  in  the  State  of  Massachusetts,  in  the  years  1793,  1794  and 

1795.  In:   Webster    (N.) :    Collection  of  papers  on  fever.     8°.     N.  Y., 

1796,  p.  53. 

Coffin  (C):  An  account  of  the  pestilential  fever  which  prevailed  at 
Newbury  Port,  State  of  Massachusetts,  in  1796.  Med.  Repository,  N. 
Y.,  1797-8,  vol.  1,  p.  504. 

Parrish  (J.) :  Remarkable  account  of  the  yellow  fever  as  it  prevailed 
among  the  Indians  on  the  Island  of  Nantucket,  in  1763-64.  N.  Jersey 
M.  Reports,  Burlington,  1852,  vol.  6,  p.  107. 


936 

MICHIGAN. 

DETROIT. 

1878. 

A  solitary  case,  "imported  from  the  South,"  is  the  only 
record  for  Michigan.  The  incident  happened  during  the 
great  epidemic  of  1878,  which  devastated  the  Southland. 
Our  authority  does  not  state  whence  the  refugee  came, 
but  simply  records  the  fact  that  he  fled  from  some 
Southern  city  to  escape  the  pestilence,  and  that  he  died 
shortly  after  reaching  Detroit.  (Vide  Annual  Report 
Michigan  State  Board  of  Health,  1879,  pp.  221,  224). 


» 


937 

MISSISSIPPI. 

ANGUILLA. 

1905.     Cases,  1 ;  deaths,  0. 

BAEKLEY. 
1897.     Cases,  10;  deaths,  4. 

BAY    ST.    LOUIS. 

1820.     Cases,  280. 

1830.     Xo  record  of  cases  and  deaths. 

1835.     Cases,  9;  deaths,  1. 

1853.     No  record  of  cases  and  deaths. 

1878.^  Population,  3,000.  Infected  by  New  Orleans. 
First  case,  August  11;  last  case,  December  24;  first  death, 
Auo'ust  15.     Cases,  030 ;  deaths,  82. 

1897.     Cases,  40;  deaths,  4. 

BEACHLAND. 

1878.     Deaths,  24. 

BELLE   FONTAINE. 

1878.     No  record  of  cases  and  deaths. 

BENTON. 

1853.     No  record  of  cases  and  deaths. 

1878.     First  case,  October  11.     Cases,  3;  deaths,  1. 

BILOXL 

1702.  Tradition  says  that  yellow  fever  was  pi-esent  in 
Mississippi  during;  the  early  years  of  the  eii^hteenth  cen- 
tury. The  bio_ora])her  of  Iberville,  in  his  memoirs,  states 
that  he  had  vellow  fever  at  Biloxi   in  1702,  Avhicli  nuide 


938 


HISTORY    OF    YELLOW    FEVER. 


such  ravages  on  his  constitution  as  to  cause  his  return 
to  France  for  the  purpose  of  restoring  his  shattered 
health.  This  was  the  first  appearance  of  yellow  fever  on 
the  Gulf  Coast  of  the  United  States. 

1702 ;  1839 ;  1847 ;  1853 ;  1858.  Yellow  fever  years.  No 
record  of  cases  and  deaths. 

1878.  Population,  2,000.  Infected  by  New  Orleans. 
First  death,  August  17 ;  last  death,  November  23.  Cases, 
600 ;  deaths,  45. 

1897.     Cases,  592;  deaths,  27. 

1905.     A  few  imported  cases.     No  developments. 

BLUFF    SPRINGS. 

1873.  Population,  200.  First  case,  September  9; 
deaths,  9. 

BOLTON. 

1878.  Population,  200.  First  death,  August  12.  Cases, 
144;  deaths,  34. 

BOVINA. 

1878.     Population,  100.     Deaths,  7. 
BEANDON. 

1853.  Population,  1,200.  Infected  by  Vicksburg.  First 
case,  September  18;  first  death,  September  23;  last  case, 
December  3 ;  last  death,  December  3.  Cases,  13 ;  deaths,  9. 

1854.  First  case,  September  23;  last  case,  November 
18. 


BROWN'S    PLANTATION. 

1878.     Infected  by  Canton,  ^Miss.     First  case,  Aug-ust 
13 ;  first  death,  August  18.     Cases,  21 ;  deaths,  4. 

BRYAN. 

1878.     Infected  by  New  Orleans.     First  case,  Septem- 
ber 29.     Cases,  10 ;  deaths,  1. 


Missisisippi.  939. 

BYKAM. 

1878.     No  record  of  cases  and  deaths. 
CANTON. 

1855.     No  record  of  cases  and  deaths. 

1878.  Population,  3,000.  Infected  by  New  Orleans. 
First  case,  August  1;  last  case,  December.  First  death, 
Aug-ust  19.     Cases,  921;  deaths,  180. 

1898.  First  case,  October  10;  deaths,  October  28. 
Cases,  9;  deaths,  0. 

CARSON'S  CITY. 

1879.  No  record  of  cases  and  deaths. 

CARDIFF    LANDING. 

1878.     Deaths,  8. 

CARROLLTON. 

1878.     No  record  of  cases  and  deaths. 

CAYUGA. 

1878.     Cases,  38 ;  deaths,  9. 
1897.     Cases,  25;  deaths,  1. 

CENTERVILLE. 

1899.  Cases,  2;  deaths,  0. 

CLIFTON. 
1853.     No  record  of  cases  and  deaths. 
CLINTON. 

1897.  Cases,  42;  deaths,  2. 

1898.  First  case,  October  8;  last  case,  October  15. 
Cases,  40 ;  deaths,  0. 


940  HISTORY  OF  YELLOW  FEVER. 

COOPER'S   WELLS. 

1855.  Infected  by  New  Orleans.  First  case,  Angust 
23 ;  first  death,  August  31.     Cases,  70 ;  deaths,  13. 

CONCORDIA. 

1879.  Population,  250.  Number  Avho  fled,  130.  First 
case,  August  2G;  first  death,  August  31;  last  case,  Octo- 
ber 24.     Cases,  75;  deaths,  20. 

CORINTH. 

1873.     Cases,  3 ;  deaths,  0. 

COUNTY    FARM. 

1897.  Cases,  2 ;  deaths,  0. 

COX  LANDING. 
1878.     Cases,  12;  deaths,  4. 

CRYSTAL    SPRINGS. 

1898.  First  case,  October  11;  last  case,  October  21. 
Cases,  7;  deaths,  0. 

DRY    GROVE. 

1878.  Infected  by  Brown's  Plantation.  First  case, 
September  2 ;  first  death,  September  7.  Cases,  75 ;  deaths, 
41. 

DUCK    HILL. 

1878.     Cases,  36 ;  deaths,  14. 

DURANT. 

1878.     Deaths,  1. 

1897.     Cases,  1;  deaths,  1. 


Mississippi  9  +  1 

EDWARDS. 

1878.     Deaths,  3. 

1897.  Cases,  455;  deaths,  29. 

1898.  First  case,  September  27;  last  case,  October,  15. 
Cases,  12;  deaths,  1. 

ENOKA. 

1905.     Cases,  1;  deaths,  0. 

EUCUTTA. 

1898.     First  case,  June  21;  last  case,  June  21.     Cases, 
1 ;  deaths,  0. 

FAYETTE. 

1898.  Cases,  5;  deaths,  0. 

FLORA. 

1899.  No  record  of  cases  and  deaths. 

FORT  ADAMS. 
1839.     Infected  by  New  Orleans. 

FRIAR'S    POINT. 

1878.     Population,  550 ;  first  case,  August  17 ;  last  case, 
November  1.     Cases,  25;  deaths,  7. 

GAINSVILLE. 

1878.     Cases,  5;  deaths,  2. 

GARNER    STATION. 
1878.     Population,  200.     f\nses,  31;  deatlis,  13. 

GOODRICH    LANDING. 

1878.     Population,  1509.  First  case,  August  1.  Deaths, 
42. 


942  HISTORY    OF     YELLOW    FEVER. 

GKAND  GULP. 

1839.     No  record  of  cases  and  deaths. 

1853.  Infected  by  Port  Gibson,  La.  First  case,  Sep- 
tember 10. 

GRAND  PLAIN. 

1878.     No  record  of  cases  and  deaths. 

GRAVEL   PIT. 

1878.     Population,  85.     Cases,  20. 

GREENVILLE. 

1853.  PopulatioD,  300.  Number  Avho  fled,  100.  First 
case,  September.     Cases,  17;  deaths,  9, 

1878.  Population,  2,300.  First  case,  August  18;  last 
case,  November  10;  first  death,  August  21;  last  death, 
November  15.     Cases,  1,000 ;  deaths,  400. 

GRENADA. 

1878.     Population,  2,500.      First  case,  July  26;  first 
death,  July  31.     Cases,  1,040 ;  deaths,  326. 
1878.     Cases,  87;  deaths,  17. 

GULMAN    STATION. 

1878.  Infected  by  Vieksburg. 

HANSBORO. 

1879.  First  case,  June  17.     Cases,  2. 

HAMBURG. 
1905.     Cases,  50 ;  deaths,  8. 


MISSISSIPPI.  943 

HANSBOKO. 

1878.  Infected  by  Kew  Orleans.  First  case,  August 
31 ;  last  case,  January  19 ;  first  death,  September  24 ;  last 
death,  December  21.     Cases,  200;  deaths,  16. 

1905.     Cases,  5;  deaths,  0. 

HARRISON. 

1898.     First  case,  October  G;  last  case,  October  30. 
1905.     Cases,  2;  deaths,  0. 

HATTIESBURG. 

1898.     First  case,  October  8 ;  last  case,  October  21. 

r 

I 

HERMANVILLE. 

1898.  First  case,  October  4;  last  case,  October  13. 
Cases,  2;  deaths,  0. 

HENDERSON'S   POINT. 

1897.     Cases,  3 ;  deaths,  0. 

HERNADO. 

1878.  Population,  1,200.  First  case,  August  15;  last 
case;  August  21.     Cases,  240;  deaths, "80. 

HINDS    COUNTY. 
Convict  Camp. 
1897.     Cases,  6;  deaths,  0. 

HOLLY    SPRINGS. 

1873.  Infected  by  ]\remphis.  Only  a  few  imported 
cases. 

1878.  Population,  3,000.  First  case,  August  18;  first 
death,  August  25.     Cases,  1,369;  deaths.  309. 


944 


HISTORY    OF     YELLOW     FEVER. 

HOEN    LAKE. 


1878.  Cases,  30;  deaths,  IT. 

1879.  A  few  imported  cases 

lUKA. 

1878.  Infected  by  Memphis.  First  case,  September 
18;  first  death,  September  27.     Cases,  G;  deaths,  3. 

JACKSON. 

1853.  Population,  3,000.  First  case,  August  21 ;  first 
death,  September  5.     Cases,  350;  deaths,  112. 

1854,  Sporadic  cases. 

1878.  Population,  2,250.  Infected  by  New  Orleans. 
First  case,  August  20 ;  last  case,  December  1 ;  first  death, 
August  31 ;  last  death,  November  28.  Cases,  480 ;  deaths, 
86. 

1888.     Cases,  15;  deaths,  5. 

1898.  First  case,  September  10;  last  case,  November 
10.     Cases,  208;  deaths,  11. 

1899.  Cases,  61 ;  deaths,  9. 

KING'S   POINT. 

Cases,  92 ;  deaths,  6. 

LAKE. 

1878.  Population,  325.  Infected  by  Mcksburg.  First 
case,  August  24;  first  death,  September  5.  Cases,  300; 
deaths,  86. 

LAWRENCE   STATION. 

1878.     Cases,  16;  deaths,  5. 

LEBANON. 
1878.     First  case,  August  29.     Cases,  90 ;  deaths,  10. 


MISSISSIPPI.  945 

LEOTA   LAXDIXG. 

1878.  Infected  b^^  Greenville.  First  case,  Kovember 
21;  last  case,  Xovember  21;  tirst  death,  Ivovember  26; 
last  death,  November  20.     Cases,  1;  deaths,  1. 

LIVINGSTON. 

1878.  Infected  by  Canton.  First  case,  August  28. 
Cases,  15;  deaths,  10. 

LOGTOWN. 

1878.     Cases,  40 ;  deaths,  9. 

LONG  BEACH. 
1905.  ,  Cases,  1 ;  deaths,  0. 

LUMBERTON. 
1905.     Cases,  1 ;  deaths,  0. 

MADISON. 
1878.     Population,  50.     A  few  imported  cases.     , 

McCOMB   CITY. 

1878.  Population,  1,000.  First  case,  September  28; 
first  death,  October  2.     Cases,  63 ;  deaths,  21. 

McHENRY. 

1897.  Cases,  30 ;  deaths,  1. 

1898.  First  case,  June -9;  .last  case,  June  29.  Cases, 
22;  deaths,  0. 

McNIARY. 

1878.     Cases,  36;  deaths,  9. 


946 


HISTORY    OF     VKLLOW     FEVER. 


MEKIDIAN. 


1898.  First  case,  October  15;  last  case,  October  17. 
Cases,  3;  deaths,  0. 

MICHIGAN   CITY. 

1878.     Cases,  2;  deaths,  2. 

MISSISSIPPI    CITY. 

1878.  Infected  by  New  Orleans,  First  case,  August 
21;  last  case,  December  10.     Cases,  200;  deaths,  15. 

1879.  Infected  by  New  Orleans.  First  case,  July  7; 
first  death,  July  16. 

1899.  Cases,  27;  deaths,  2. 
1905.     Cases,  71;  deaths,  0. 

MOSS    POINT. 

1905.     Cases,  3;  deaths,  0. 

MT.    PLEASANT    ROAD. 

1879.     No  statistics. 

MULATTO   BAYOU. 

1878.     Cases,  1 ;  deaths,  1. 

NATCHEZ. 

"'r'"^ ■■ 

1817.  First  case,  September  — ;  last  case,  November  9. 
Deaths,  9. 

1819.  First  case,  September  — ;  last  case,  December 
— .     Deaths,  180. 

1823.  First  case,  August  10;  last  case,  October  18. 
Deaths,  312. 

1825.     Deaths,  130. 

1827.     No  statistics. 


MISSISSIPPI.  .    947 

1828.  Deaths,  90. 

1829.  First  case,  September  1;  last  case,  November. 
Deaths,  90. 

1837.  First  case,  September  8 ;  last  case,  November  25. 
Deaths,  280. 

1839.  First  case,  September  — ;  last  case,  November. 
Deaths,  235. 

1811.  No  statistics. 

1818.  First  case,  June  — ;  last  case,  November. 

1853;  1851;   1855;   1858.     No  statistics. 

1898.  Cases,  37 ;  deaths,  4. 

1900.  No  statistics. 

1905.  Cases,  143 ;  deaths,  7. 

NITTA   YUMA. 

1897. ,  Cases,  27 ;  deaths,  11. 

OAK    GKOVE. 

1879.     Infected  by  Memphis. 

OCEAN   SPRINGS. 

1878.  Population,  600.  Infected  by  New  Orleans. 
First  case,  August  15 ;  last  case,  December  2 ;  first  death, 
August  18;  last  death,  December  5.  Cases,  175;  deaths, 
SO.^ 

1897.  Cases,  23;  deatlis,  6.  New  Orleans  was  in- 
fected from  this  focus  and  experienced  a  serious  epidemic. 

OKOLONA. 

1878.     First  case,  August  10.     Cases,  3 ;  deaths,  1. 

ORWOOD. 

1898.  First  case,  August  31;  last  case,  October  27. 
Cases,  100;  deaths^  5. 


948 


HISTORV     OK     VKLLOW     FKVER 

OXFORD. 


1898.  First  case,  September  21;  last  case,  October  27. 
Cases,  86;  deaths,  12. 

OSYKA. 

1878.  Population,  925.  Infected  by  Xew  Orleans. 
First  case,  July  27;  tirst  di^atli,  Auinnst  15.  Cases,  300; 
deaths,  45. 

1900.     Sporadic  cases. 

PASCACiOULA. 

1847.     No  statistics. 
1875.     Deaths,  60. 
1878 ;  1893.     No  statistics. 
1897.     Cases,  35;  deaths,  2. 

PASS   CHRISTIAN. 

1843;  1847;  1855;  1858.     No  statistics. 

1878.  Population,  2,000.  Infected  by  New  Orleans. 
First  case,  August  29 ;  last  case,  December  4 ;  ^rA  death, 
September  4;  last  death,  November  22.  Cases,  199; 
deaths,  23. 

1879.  No  statistics. 

PEARLINGTON. 

1878.     Cases,  201 ;  deaths,  24. 
1905.     Cases,  2;  deaths,  0. 

PERKINSTON. 


1897.  Cases,  1 ;  deaths,  0. 

1898.  First  case,  June  22;  last  case,  June  22. 
1;  deaths,  0. 

PF/riT    GULF    HILLS. 

1853.     No  statistics. 


.  ases 


MISSISSIPPI.  949 

POPLARVILLE. 

1898.     First   case,   October  9;   last   case,   October   23. 
Cases,  24;  deaths,  1. 

PORT  GIBSON. 

1853.     Infected  by  New  Orleans.       First  case,  August 
15;  first  death,  August  IT. 

1878.     Population,  1,400.     First  case,  August  3;  first 
death,  August  8.     Cases,  620 ;  deaths,  115. 

1898.     First   case,    October   G;   last   case,    October    G. 
Cases,  1;  deaths,  1. 

1905.     Cases,  G3;  deaths,  2. 

QUARANTINE. 

1878.  Cases,  5;  deaths,  2. 

1884.  Infected  by  Colon.     Cases,  1 ;  deaths,  0. 

1888.  Infected  by  ship  Maria,  from  Havana.  Cases,  3; 

deaths,  0. 

1890.  Cases,  6;  deaths,  2. 

1891.  Infected  bv  (Miandeleur.     Cases,  12;  deaths.  1. 

1892.  Cases,  4;  deaths,  0. 

1893.  Cases,  3;  deaths,  1. 
1895.  Cases,  3. 

1897;  1898;  1899.     Cases  from  infected  vessels. 
1903.     Cases,  4 ;  deaths,  2. 
1905.     Cases,  41;  deaths,  1. 

REFUGE   LANDING. 

1878.     First  case,  September  9;  first  death,  September 
29.     Cases,  19  ;  deaths,  11. 

QUEEN    niLL. 

1808.     I'^irst   case,   October  15;  last  case,  October  15. 
Cases,  1;  deaths,  1. 


950  msiouv   of  vkllovv   fever 

RIDGELAND. 

1898.     First  case,   October   8;   last  case,   October   IT. 
Cases,  7;  deaths,  0. 

ROCKY  SPRINGS. 

1878.     Deaths,  38. 

RODNEY. 

1829.  No  statistics. 

1843.  First  case,  September  6. 

1817.  No  statistics. 

1853.  Sporadic  cases. 

ROSETTA. 

1905.     Cases,  32;  deaths,  7. 

ROXIE. 

1905.     Cases,  IG;  deaths,  G. 

SCOTT'S. 

1878,     Population,  50. 

SCRANTON. 

1878.     First  case,  October  5;  first  death,  Ojtober  11. 
Cases,  60 ;  deaths,  20. 

1897.     Cases,  3G3;  deaths,  18. 
1905.     Cases,  17;  deaths,  0. 

SSNATOBIA. 

1878.     Population,  1,400.     Cases,  2G;  deaths,   7. 

SHIELDSBOROUGH. 

1820.  First  case,  August  20. 

1828.  No  statistics. 

1829.  First  case,  August  5.     Cases,  46 ;  deaths,  8. 
1839.  No  statistics. 


1 


MISSISSIPPI.  951 

SMITH'S    STATION. 

1878.     Infected  by  Yicksburg.     Cases,  16. 

SOEIA. 

1905.     Cases,  2 ;  deaths,  0. 

STARKVILLE. 

1898.  First  case,  October  G;  last  case,  October  IS. 
Cases,  9;  deaths,  0. 

STONEVILLE. 

1878.  Population,  50.  Infected  by  New  Orleans. 
Cases,  23;  deaths,  15. 

SULPHUR    SPRINGS. 

1878.  Infected  by  Canton.  First  case,  August  23; 
first  death,  August  28 ;  last  death,  October  26.  Cases,  15 ; 
deaths,  5. 

SENATOBIA. 

1878.  Population,  1,200.  Infected  by  Grenada.  First 
case,  September  1.     Cases,  26;  deaths,  7. 

SUMMIT. 

1878.     Deaths,  4. 

SUMRALL. 
1905.     Cases,  1;  deaths,  0. 

SUNFLOWER. 

1878.     Cases,  48;  deaths,  15. 

TAYLOR. 

1898.  First  case,  August  1;  last  case,  October  21. 
Cases,  106;  deaths,  14. 


95S  HISTORY    OF    YELLOW    FEVER. 

TERKEXE. 

1878.     Cases,  12;  deaths,  4. 

TERKY. 

1878.     Population,  225.     Cases,  10;  deaths,  5. 

TOUGALOO. 

1898.  First  ease,  October  16;  hist  case,  October  17. 
Cases,  2;  deaths,  0. 

TOULNE. 

1878.     No  statistics. 

VICKSBURG. 

1839.     Infected  by  New  Orleans.     Deaths,  50. 

1841 ;  1847.     No  statistics. 

1853.  Population,  4,000.  Infected  by  New  Orleans. 
First  case,  July  — ;  first  death,  August  1. 

1858;  1871.   'No  statistics. 

1878.  Infected  by  Ne^y  Orleans.  First  case,  July  21 ; 
last  case,  December;  first  death,  July  24;  last  death, 
Noyember  21.     Cases,  5,000;  deaths,  872. 

1905.     Cases,  185 ;  deaths,  28. 

WARDVILLE. 

1898.     Scattered  cases. 

WASHINGTON. 

1825.  First  case,  August;  last  case,  Noyember. 
Deaths,  52. 

WATERFORD. 

1898.  First  case,  September  9;  last  case,  October  C. 
Cases,  2 ;  deaths,  0. 


MISSISSIPPI.  •  953 

WATEK    VALLEY. 

187l,  i*opiilatiou,  3,000.  First  case,  August  9;  first 
death,  August  30.     Cases,  200;  deaths,  64. 

1898.  First  case,  Octohei-  7;  last  case,  October  21. 
Cases,  12;  deaths,  0. 

WAVELAND. 

1897.  Cases,  4;  deaths,  0. 

1898.  First  ease,  October  10;  last  case,  October  18. 
Cases,  20 ;  deaths,  1. 

W.    PASCAGOULA. 

1897.  Cases,  8;  no  deaths. 

WHITZELL'S   LANDIXC. 

1877.  No  statistics. 

WINONA. 

1878.  Population,  1,500.  lufected  by  (Jreiiada.  I'^irst 
case,  August  9.     Deaths,  3. 

WINTERVILLE. 

1878.  Infected  by  Greenville.  First  case,  August  28; 
first  death,  September  15.     Cases,  151 ;  deaths,  20. 

WOODVILLE. 

1844;  1852.     No  statistics. 

1853.     First  case,  August  9;  first  death,  August  13. 
1855.     First  case,  August  27;  first  death,  Sei)tcniber  2. 
1858.     :So  statistics. 

1898.  First  case,  October  0;  last  case,  October  0. 
Cases,  1;  deaths,  0. 


OS*  HISTORY    OF   ■SEI.I.OW    FKVER. 

YAZOO  CITY. 

1853.  ropiilatiou,  2,000.  First  case,  Anj-iist  28;  fiis-t 
death,  September  1. 

1878.  PopiilatioD,  2,500.  Infected  by  Vicksbiirn:. 
First  case,  September  15;  first  death,  September  21. 
Cases,  17;  deaths,  9. 

1898.  First  case,  October  0;  last  case,  November  10. 
Cases.  2fi ;  deaths,  0. 

BIBLIOGRAPHY    OF    YELLOW    FEVER     IN     MISSISSIPPI. 

Anderson  (E.  H.) :  The  late  Jackson  fever,  and  previous  epidemics 
elsewhere.     Memphis  Med.  Monthlj',  18S8,  vol.  8,  p.  545. 

Anderson  (E.  H.) :  Some  remarks  upon  our  recent  invasions  of 
yellow  fever,  by  an  octogenarian  M.  D,  Memphis  M.  Monthly,  1897, 
vol.  17,  p.  549. 

Archinard  (J.  J.) :  The  yellow  fever  at  Ocean  Springs,  Miss., 
report  of  a  case  and  autopsy.     X.  O.  M.  &  S.  Jl.,  1897-8,  vol.  1,  p.  258. 

Ballard  (J.  C):  In  regard  to  yellow  fever  at  Hattiesburg,  Miss.,  a 
criticism  of  Rev.  Mr.  Peebles.     Med.  News,  N.  Y.,  1898,  vol.  73,  p.  663. 

Beazley  (J.  S.):  An  account  of  the  Epidemic  Yellow  Fever  at 
Cooper's  Well,  Miss.,  in  1855.  Trans.  Amer.  Med.  Assn.,  1856,  vol.  9, 
p.  685. 

Cartwright  (A) :  Post-mortem  examinations  in  the  yellow  fever  of 
Natchez.     X.  O.  M.  &  S.  Jl.,  March,  1857,  p.  649. 

Cartwright  (Samuel  A.):  On  the  yellow  fever  of  Xatchez,  Miss.,  in 
1847.    X.  O.  M.  &  S.  Jl.,  vol.  5,  p.  225. 

Cartwright  (S.  A.):  The  yellcw  fever  at  Xatchez  in  all  its  bearings 
on  the  quarantine  question  and  yellow  fever  at  New  Orleans.  N.  O, 
M.  Xews  &  Hosp.  Gaz.,  1855-6,  vol.  2,  pp.  1,  16. 

Champlin  (A.  P.) :  The  fever  at  Biloxi,  Miss.,  during  the  summer 
and  autumn  of  1886.     Gallard's  Med.  Jl.,  X.  Y.,  1887,  vol.  43,  p.  335. 

Grant  (H.  A.),  Tackett  (J.  R.)  and  Folkes  (H.  M.) :  Yellow  Fever. 
Mississippi  Med.  Assn.,  Biloxi,  1898-9,  vol.  2,  p.  33. 

Guiteras  (G.  M.) :  The  Epidemic  in  Vicksburg.  Ann  Rep.  Sup. 
Surg.-Gen.  U.  S.,  1906,  p..  148. 

Hicks  (B.  J.):  On  the  yellow  fever  in  Vicksburg,  Mississippi,  in 
1847.     X.  O.  M.  J.,  vol.  5,  p.  220. 

Hogg  (Samuel):  An  account  of  the  Epidemic  Fever  of  Xatchez, 
Mississippi,  in  the  years  1837,  1838,  and  1839.  Western  Journal  of 
Medicine  and  Surgery,  vol.  1,  p.  401. 


MISSISSIPPI.  955 

Holt  (A.  C.) :  Yellow  fever  at  Woodville,  Miss.,  and  its  vicinity. 
Trans.  Amer.  Med.  Assn.,  1S56,  vol.  9,  p.  653. 

Johnston  (W.):  The  outbreak  of  yellow  fever  at  Jackson,  Miss.,  in 
Sept.,  1888.  Am.  Pub.  Health  Assn.,  Rep.  1888,  Concord,  1899,  vol.  14, 
p.   51. 

Jones  (R.  E.) :  If  it  was  not  Yellow  Fever,  what  was  it?  Journal 
Miss  Med.  Assn.,  1899,  vol.  3,  p.  800. 

Kilpatrick  (A.  R.) :  An  account  of  the  Yellow  Fever  which  prevailed 
in  Woodville,  Miss.,  in  the  year  1844.  N.  O.  Med.  &  Surg.  JL,  vol.  2, 
p.  40. 

Kilpatrick  (A.  R.):  Epidemic  of  Yellow  Fever  which  scourged  the 
inland  town  of  Woodville,  Miss.,  in  1844.  Med.  and  Surg.  Reporter, 
Phila.,  1878,  vol.  40,  p.  85. 

Lavinder  (C.  H.):  Yellow  fever  at  Natchez,  Miss.,  Rep,  Surg.-Gen.  U. 
S.  P.  H.  S.  M.  H.  Service  for  1906.     (Wash.,  1907),  p.  155. 

Lewis  (P.  H.):  Thoughts  on  the  yellow  fever,  being  a  brief  critical 
notice  of  the  following  recent  works,  viz:  1st.  'Observations  on  the 
epidemic  yellow  fever  of  the  South  West,  by  J.  W.  Monette,  1843;"  2d. 
"Sketches  from  the  history  of  yellow  fever,  showing  its  origin;  to- 
gether with  facts  and  circumstances,  disproving  its  domestic  origin, 
and  demonstration  of  itsc  transmissibility,  by  W.  M.  Carpenter,  1844." 
N.  O.  M.  &  S.  JL,  1844-5,  vol.  1,  pp.  31,  44. 

Louisiana  State  Board  of  Health:  Report  on  the  Biloxi  Fever.  N. 
O.,  1886.     Reprint  from  X.  O.  Picayune,  Sept.  8,  1886,  vol.  8. 

Louisiana  State  Board  of  Health:  Outbreak  of  yellow  fever  at 
Biloxi,  Harrison  County,  Miss.,  and  its  relation  to  interstate  notifica- 
tion.    N.  O.,  1886,  vol.  8. 

Magruder  (A.  L.  C):  A  history  of  the  epidemic,  which  prevailed  at 
Vicksburg  during  the  Fall  of  1847.     N.  O.  M.  &  S.  JL,  vol.  4,  p.  689. 

McAllister:  The  yellow  fever  of  Grand  Gulf,  Miss.,  in  1853.  N.  O. 
M.  &  S.  JL,  1853-4,  vol.  10,  p..  675. 

McMullen  (J.) :  Yellow  Fever  in  Hamburg  and  Roxie,  Miss.  U.  S. 
Marine  Hospital  Service.  Report  of  the  Supervising  Surgeon  General 
for  1906,  p.  167. 

Merril  (A.  P.):  An  Essay  on  the  Yellow  Fever,  as  it  appeared  at 
the  Bay  of  St.  Louis  in  1820.     N.  O.  M.  &  S.  JL,  vol.  8,  p.  1. 

Merrill   (A.  P.):    Ibid.     In  his:    Med.  Essays.     8°.     N.  O.,  1851,  p.  3. 

Merrill  (A.  P.):  On  the  Epidemic  of  1852  in  Natchez,  Mississippi, 
North  American  Medical  &  Surgical  Journal,  vol.  2,  p.  217. 

Merrill  (A.  P.):  On  the  Yellow  Fever  of  1823  in  Natchez,  Missis- 
sippi.    Phila.  Medical  and  Physical  Journal,  vol.  9,  p.  235. 

Monette:  Observations  on  the  Epidemic  Yellow  Fever  of  Natchez, 
and  the  Southwest.     Louisville.  1842. 

Monette:  Epidemic  Yellow  Fever  of  Washington,  Mississippi,  1825. 
Western  Med.  and  Phys.  JL  and  Am.  JL,  vol.  1,  p..  243. 


956  HISTORY     OF     VKLI.OW     FEVKR. 

Monette  (J.  W.) :  The  Epidemic  Yellow  Fever  of  NaJtchez.  An  essay 
read  before  the  Jefferson  College  and  Washington  Lyceum,  December 
2,  1837,  12mo.     Natchez,  1838. 

Perlee  (A.) :  An  account  of  the  Yellow  Fever  at  Natchez  as  it  pre- 
vailed in  the  autumn  of  1817  and  1819.  Phila.  Med.  and  Phys.  Jl., 
vol.  1,  p.  1. 

Stone  (C.  H.):  Quarantine  and  Yellow  Fever  at  Natchez  in  1853, 
and  1855,  etc.     N.  O.  Med.  New.  and  Hosp.  Gaz.,  November,  1855. 

Ibid.,  Trans.  Amer.  Med.  Assn.,  1856,  vol.  9,  p.  643. 

Stone  (C.  H.):  Report  on  the  Origin  of  Yellow  Fever  in  the  Town 
of  Woodville,  Miss.,  in  the  summer  of  1844.  N.  O.  M.  &  S.  Jl.,  1844-5, 
vol.  1,  p.  520. 

Stone  (C.  H.):  The  History  of  the  Mild  Yellow  Fever,  which  pre- 
vailed in  the  City  of  Natchez  in  1848.  Natchez,  1849.  See  also  N.  O. 
Med.  and  Surg.  Jl.,  1848-9,  vcl.  5,  p.  549. 

Stone  (C.  H.):  The  history  of  the  mild  yellow  fever,  which  pre- 
vailed in  the  city  of  Natchez  in  1848,  with  observations  respecting  its 
chainaoter  and  natural  mode  of  cure;  to  which  is  appended,  from 
various  authors,  descriptions  and  notices  of  that  disease,  of  dengue, 
and  of  inflamation  of  the  stomach  and  bowels.     8°.    Vidalia,  La.,  1849. 

Stone  (C.  H.):  Report  on  the  Origin  of  Yellow  Fever  in  the  Town  of 
Woodville,  Mississippi,  in  the  Summer  of  1844.  N.  O.  M.  &  S.  Jl., 
vol.  1,  1844-5,  p.  520. 

Thornton  (J.  J.):  Yellow  Fever  at  Brandon,  Miss.,  in  1853  and  1854. 
Trans.  American  Med.  Assn.,  1856,  vol.  9,  p.  699. 

Tcoley  (Henry):  History  of  the  Yellow  Fever  as  it  appeared  in  the 
City  of  Natchez  in  1823.     Vol.  8,  Natchez,  1823. 

(Second  Edition.     Washington,  Mississippi.     Same  date.) 

Valetti  (C.  de)  and  Logan  (T.):  A  Report  on  the  Yellow  Fever  that 
recently  prevailed  at  Woodville  (Miss.),  1844.  N.  O.  M.  &  S.  Jl., 
1844-5,  vol.  1,  p.  237. 

Vansant  (J.):  Brief  account  of  yellow  fever  at  New  Orleans  and 
Pascagoula  in  1875.  Rep.  Superv.  Surg. --Gen.  Mar.  Hosp.,  1874-5, 
Wash.,  1876,  p.  147. 

Wasdin  (E.):  Inspection  of  the  Gulf  Coast  between  Mobile  and  Pass 
Christian;  yellow  fever  in  Mississippi  City,  Gulfport  and  Handsboro; 
Gulf  Coast  Maritime  Patron.  Rep.  Surg.-Gen.  U.  S.  P.  H.  S.  M.  H. 
Service  for  1906.     (Wash.,  1907),  p.  169. 

Williams:  On  the  Yellow  Fever  at  Rodney,  Mississippi,  in  the  year 
1847.     N.  O.   M.  &   S.  Jl,  1848-9,  vol.   5,  p.  217. 

Williams  (W.  G.)  and  Andrews:  An  account  of  the  Yellow  Fever 
which  prevailed  at  Rodney,  Mississippi,  during  the  autumn  of  1843. 
N.  O.  M.  &  S.  Jl.,  1844-5,  vol.  1,  p.  35. 

Williams:  Yellow  Fever  in  Mississippi.  N.  O.  M.  &  S.  JL,  1853-4, 
vol.   10.  pp.  327,  385. 


95/ 


MISSOURI. 

In  the  sumiiior  of  1819,  yellow  fever  iiiaile  its  appear- 
ance simultaneously  at  many  plaees  throughout  tlie 
United  States.  A  bilious  remittent  fever  of  a  malij-uant 
teudeuej'  became  epidemic  both  in  Missouri  territory  and 
in  the  State  of  Illinois.  Although  it  generally  assumed 
a  milder  form  than  on  the  seaboard;  yet  many  of  the 
eases  reported  had  the  characteristic  features  of  typhus 
ict erodes  so  decidedly  marked,  that  the  Surgeon-General 
entertained  no  doubt  of  the  identity  of  the  disease.  {Arnii/ 
Med.  Stats.,  1819-1839,  p.  8). 

There  is  no  record  as  to  what  localities  in  Missouri  were 
affected. 

NEW   DESIGN. 

1797.  Population,  200.  Deaths,  57.  Source  of  in- 
fection obscure. 

ST    LOUIS. 

1854.  A  few  cases  were  imported  to  St.  Louis  in  1854. 
No  statistics. 

1855.  August  14,  an  imported  case.     No  developments. 

1878. 

]Many  cases  of  yellow  fever  were  brought  here.  Among 
the  first  fatal  cases  was  Capt.  W.  O.  Nelson,  of  Port 
Eads,  commander  of  the  Dredge-boat  at  that  place,  and 
member  of  the  firm,  Eads  &  Nelson,  wreckers.  He  died 
at  St.  Louis,  August  13.  Fatal  cases  among  refugees  con- 
tinuing, much  excitement  arose,  and  a  strict  quarantine 
was  established.     Total  cases,  110;  total  deaths,  40. 

The  following  resume  by  Surgeon  Walter  Wyman, 
United  States  :Marine  Hospital  Service,  and  ])ublislied  in 
his  Annual  I{ei)ort  Un-  that  year,  is  of  sufficient  interest 
to  be  reproduced  here : 

]^r.  Wyman  observes  that  tlie  chief  point  of  interest 
connected  with  the  epidemic  of  1878  in  St.  Louis,  is  that, 


958  HISTORY     OF    YELLOW     FEVER. 

for  the  first  time  in  tli  history  of  the  city,  yellow  fever 
seized  iiiion  inhabitants  not  previonsly  exposed  in  more 
southern  latitudes. 

During  previous  epidemics,  isolated  cases  brought 
from  the  South  have  been  treated  with  no  thought  of  pos- 
sible danger ;  but  the  experience  of  the  outbreak  under  dis- 
cussion, showed  that  former  immunity  from  the  disease 
is  no  guarantee  of  the  city's  future  safety.  There  were 
at  least  fourteen  local  cases  of  yellow  fever  contracted — 
three  within  the  city  limits,  five  upon  the  quarantine 
transfer  boat,  and  six  at  quarantine  hosx)ital.  Ten  of  the 
fourteen  died,  and  it  is  reasonable  to  suppose  that  had 
it  not  been  for  the  efficient  regulations  of  the  Health 
Department,  the  scourge  would  have  been  felt  far  more 
severely. 

The  first  case  occurring  in  St.  Louis  was  that  of  a 
steamboat  clerk  just  from  New  Orleans,  who  showed  the 
first  symptoms  upon  the  15th  of  July,  and  died  upon  the 
19th.  Several  cases  of  a  like  nature  soon  followed,  and 
the  Board  of  Health  becoming  concerned  by  reason  of 
these  deaths  and  the  large  number  of  refugees  flocking 
to  the  city,  determined  to  open  the  quarantine  hospital 
located  ten  miles  below,  upon  the  western  bank  of  the 
river. 

At  first  the  quarantine  restrictions  were  limited,  but 
as  the  ejDidemic  increased  in  severity,  more  rigid  regu- 
lations were  enforced.  All  boats  were  obliged  to  land 
and  were  detained  for  a  thorough  inspection.  Their  holds 
were  disinfected  with  chlorine,  and  all  sick  persons  re- 
moved to  the  hospital.  Trains  entering  the  city  from  the 
South  were  also  boarded,  to  prevent  the  admission  of 
yellow  fever  cases.  Within  the  city  limits,  all  refugees 
were  ferreted  out  by  the  police  and  by  health  officers  ap- 
pointed for  that  purpose,  and  nolens  volcns  were  taken 
by  ambulance  to  the  steamer  EdwanUvillc — a  ferry-boat 
prepared  for  the  reception  of  such  cases — and  at  once  con- 
veyed to  quarantine. 


MISSOURI ST.     LOUIS. 


959 


Between  August  21,  the  date  on  which  the  station  was 
opened,  and  October  22,  the  date  of  the  reception  of  the 
hist  case,  there  were  treated  at  quarantine  129  patients, 
88  of  whom  had  yellow  fever.  Of  the  88  yellow  fever 
cases,  42  died. 

There  was  nothing  peculiar  in  the  character  of  these 
cases,  unless  it  were  a  marked  suppression  of  the  urine, 
which  characterized  nearly  all  of  them.  The  average 
period  of  incubation  cannot  be  determined  from  the 
records  of  the  hosiDital. 

Of  the  cases  of  local  origin  the  majority  were  con- 
tracted or  treated  at  quarantine,  but  for  convenience  tbe 
following  tabulated  statement  of  all  local  cases  is  ap- 
pended: 


Nurse  in  city  hospital    .   .   . 

Steward  at  quarantine      ... 

Xieht  watchman  at  quarantine 

luisrineer   at   quarantine  .    .    . 

I'oliceuian  at  t[\xarantine  .    .    . 

Resident  physician  at  quaran- 
tine   

Cook  of   quarantine-boat    .   . 

Xurse  on  quarantine-boat  .   . 

Dauehter  of  quarantine-stew- 
ard  

Wile  of  the  cook  of  quaran- 
tine-! loat    

l>eck-han<l  on  tiuarantine-boat 

Secone  nurse  on  quarantine- 
l)oat 

Boy.  Cieorsre  Pilcher 

Captain   of   quarantine-boat  . 


AuEf.  26 

Sept.  2 
Sept.  1.1 
Sept.  20 
Sept.  21 

Oct.  9 
Oct.  9 
( )ct.      9 


Unknow 
Oct.  18 


Locality. 


Death  or  other  Result. 


I.ocalit}\ 


:City  .  .  .  . 
Quarantine 
Quarantine 
Quarantine 
Quarantine 


Augr.  .31  .  .  'city  .  -  • 
Recovered  Quarantine 
Recovered  Quarantine 
Recovered  Quarantine 
Recovered    Quarantine 


Quarantine  .  .  .  Oct.  l.S  .  .  Quarantine 
Onboard  of  boat  Oct.  10'  '  iQuarantine 
On  board  of  boatlOct.    19.    .IQuarantine 


Quarantine 


City Oct.     U> 

On  board  of   lioat  Oct.    18 


Quarantine 


Quarantine 
Quarantine 


On  board  of   boat  Unknown     Cit.\'     •    .    . 

City Oct.    22  .    .    Q\uiranline 

On  board  of  boat  Oct.    —  .   .   Cit.\-     .    .    . 


It  will  be  noticed  in  the  al)ove  table  that  five  of 
the  employes  of  the  transfer-boat  Edicanhvillc  con- 
tracted yellow  fever  and  died;  not  one  recovered.       It 


960  HISTORY     OF    YELLOW     FEVER. 

slioiikl,  in  candor,  be  stated,  however,  that  tlie  disease  of 
v/liich  the  boat's  eaptain  died  was  returned  by  the  attend- 
ing physician  as  typho-niahirial  fever,  but  was  considered 
by  others,  wlio  were  ])robal)ly  correct,  to  have  been  yellow 
fever. 

The  two  fatal  cases  Avhich  were  taken  from  the  city  and 
died  at  (piarautine  possess  some  interest.  One  was  the 
wife  of  the  cook  of  the  boat.  This  man,  Nicholas  (raft, 
v»as  taken  ill  on  the  9th  of  October,  (Wednesday),  left 
the  boat  and  visited  his  wife  in  the  city.  The  followinjj: 
day  (Thursday)  he  was  removed  to  quarantine.  I'pon 
the  following  Sunday,  (October  13),  his  Avife  manifested 
sypmtoms  of  yellow  fever,  was  removed  to  ({uarantine, 
where  she  died  October  IG. 

The  other  city  case,  which  died  at  (piarantine,  was  re- 
moved from  South  St.  Louis,  commonly  called  Caron- 
delet.  The  resident  physician  pronounced  it  an  undoubted 
case  of  yelloAv  fever,  stating  that  the  patient  had  black 
vomit  and  other  well-marked  symptoms. 

The  boy  was  removed  by  order  of  the  health  officers, 
who  found  him  lying  by  the  side  of  a  sister  who  had 
expired  a  short  time  previous,  with  apparently  the  same 
disease.  The  physicians  in  attendance  upon  the  sister, 
returned  as  the  cause  of  her  death,  a  disease  other 
than  yellow  fever,  and,  upon  incjuiry,  it  was  found  that 
some  nine  or  ten  deaths  had  occurred  in  the  same  gen- 
eral neighborhood,  the  symptoms  of  which  closely  simu- 
lated yellow  fever;  but  the  diagnosis  nmde,  had  been 
typho malarial  fever,  malarial  h:emori'hagica,  &c. 

Whether  these  were  cases  of  yellow  fever  or  not  became 
a  subject  of  warm  dispute  among  the  Carondelet  physi- 
cians, the  nmjority,  liowc^ver,  claiming  exemi)tion  of  that 
portion  of  the  city  from  the  plague. 

One  other  fact  concerning  the  lo<al  (piarantine  cases 
should  not  be  omitted.  When  the  nurse  of  the  quarantine 
boat  was  first  taken  sick,  he  was  ])laced  in  a  convalescent 
ward,  his  disease  being  deemed  simply  malarial. 

Two  convalescents  from  other  diseases  soon  after  con- 
tracted yellow  fever,  one  of  whom  died.  Although  no 
dates  have  been  obtained  concerning  these  two  cases  they 


MISSOURI ST.     LOUIS.  961 

should  properly  be  added  to  the  list  of  local  cases — mak- 
ing in  all  sixteen. 

By  reason  of  the  vigilance  of  the  health  authorities,  as 
above  described,  comparatively  few  cases  of  yellow  fever 
were  treated  in  the  city.  So  far  as  can  be  ascertained 
there  were  about  thirty-five  refugee  cases  and  sixteen 
deaths  within  the  city  limits,  but  it  is  probable  that  some 
cases  were  concealed  in  order  to  prevent  a  forcible  trans- 
fer to  quarantine. 

1879. 

Two  cases,  refugees  from  Memphis.  First  case,  fatal 
in  October;  last  case  also  terminating  in  death,  Novem- 
ber 15. 

BIBLIOGRAPHY   OF  YELLOW   FEVER    IN    MISSOURI 

Anonymous:  Is  it  identified?  A  supposed  germ  of  yellow  fever 
which  attached  itself  to  a  glass  in  New  Orleans.  It  is  not  thought 
likely  to  return  this  year.  [From  St.  Louis  epRublican,  May  12,  1879.] 
St.  Louis  Clin.  Rev.,  1879-80.  vol.  2,  p.  103. 

Coles  (W.) :  A  Case  of  Yellow  Fever.  St.  Louis  Med.  and  Surg.  Jl., 
1878,  vol.  35,  p.  261. 

Dorsett  (W.  B.)  and  Outley  (F.  T.):  [On  Dr.  Ford's  case  of  urinary 
suppression  in  yellow  fever,  etc.]     St.  Louis  Cour  of  Med.,  1879,  vol. 

1,  p.  72. 

Ford  (W.  H.):  Reports  of  the  St.  Louis  Med.  Soc.  on  Yellow  Fever; 
consisting  of  the  report  of  the  committee  appointed  to  inquire  into 
the  relations  of  the  epidemic  of  1878  to  the  city  of  St.  Louis,  and  a 
report  on  the  meteorological  conditions  and  etiology  of  yellow  fever, 
and  of  certain  other  diseases  associated  with  a  high  temperature,  and 
on  the  treatment  of  yellow  fever.  St.  Louis,  1879,  G.  O.  Rumbold  & 
Co.,  327  p.  3  pi.    3  tab.     2  ch.  8°. 

Ford  (W.  M.):  A  reply  to  the  card  of  Doctors  Dorsett  and  Outley. 
St.  Louis  Cour.  of  Med.,  1879,  vol.  1,  p.  208. 

Hausnaan- (A.):  .OLb8eE.vaJ.lQns„,oii^y.ellow^  fever.  St.  Louis  M.  &  S. 
Jl.,  1879,  vol.  36,  p.  19. 

Hill   (S.  D.  v.):   Yellow  Fever.     St.  Louis  Cour.  of  Med.,  1879,  vol. 

2,  p.  326. 

Is  St.  Louis  to  have  an  epidemic  of  Yellow  Fever?  [Edit.]  St. 
Louis  Cour.  of  Med.,  1879,  vol.  1,  p.  400. 

Wyman  (W.) :  Notes  upon  yellow  fever  epidemic  of  1878  in  St. 
Louis  and  at  St.  Louis  quarantine.  Rep.  Superv.  Surg.-Gen.  Mar. 
Hosp.,  Wash.,  1878-9,  p.  143. 


962 


NEW   HAMPSHIRE. 

PORTSMOUTH. 

1793.  Infected  liy  a  s^liip  from  Martiuique.  Limited 
outbreak. 

1790.  First  case,  August;  last  ease,  October.  The 
deaths  were  about  100.  The  prevalence  of  epidemic 
dysentery  at  the  same  time  ai>  the  feyer,  served  to  gTeatly 
swell  the  mortality. 

1802.     Sporadic  cases;  deaths,  10. 


BIBLIOGRAPHY   OF  YELLOW    FEVER    IN    NEW    HAMPSHIRE. 

Berenger-Feraud:  Fievre  Jaune,  etc.,  Paris,  1890,  p.  8. 

Keating:  History  of  Yellow  Fever,  p.  81. 

New  York  Medical  Repository,  1799,  vol.  2,  p.  211. 


I 


■^'3^' 


96ar 

NEW   JERSEY. 

BRIGHTON. 

1798.     Limited  outbreak.     Xo  statistics. 

BURLINGTON. 

1798.     Limited  outbreaks.     No  statistics. 

CAMDEN. 

1853.  Infected  by  Philadelphia.  No  complete  stat- 
istics. 

GLOUCESTER. 

180o.~  Source  of  infection  obscure.  Outbreaks  was  not 
general. 

1870.  A  few  cases,  refugees  from  New  York  and  Gov- 
ernor's Island.     No  accurate  statistics. 

JERSEY   CITY. 

1878.  One  case,  Septendier  IG,  a  refugee,  terminating 
in  death  on  the  20th. 

PERTH    A]MBOY. 

1811.     Deaths,  5. 

PORT    ELIZABETH. 

1798.  Infected  by  Philadelphia.  First  case,  August 
9;  last  case  in  September.     Cases,  13;  deaths,  6. 

WOODBURY. 

1798.     Probably  infected  by  Philadelpliia.     No  record. 
1853.     One   case,   a  refugee  from   Philadelphia.      Re- 
covery. 


984  HISTORY    OE    YELLOW    EEYER. 

BIBLIOGRAPHY   OF  YELLOW   FEVER    IN    NEW   JERSEY. 

Gotham:   N.  Y.  Med.  Repository,  1856,  p.  564. 

Griscom:  Visitations  of  Yellow  Fevor.  u.  9. 

History  of  the  Yellow  Fever  which  prevailed  at  Perth  Amboy,  New 
Jersey,  in  the  Summer  of  1811,  and  of  the  Evidences  of  its  Importation 
into  that  place.     Medical  and  Philos.  Register,  vol.  3,  p.  94. 

Keating:  History  of  Yellow  Fever,  p.  80. 

Report  of  the  Board  of  Health  of  New  York  on  the  Yellow  Fever 
at  Perth  Amboy  in  1811,  by  Drs.  Hosack,  Bayley,  and  Douglass. 
Medical  and  Philosophical  Register,  vol  3,  p.  95.  Edinburgh  Medical 
and  Surgical  Journal,  vol.  8,  p.  165. 

Lee:  N.  Y.  Med.  Repository,  1800,  vol.  3,  p.  246. 

Report  Sup.  Surg.-Gen.  U.  S.  A.,  1873,  p.  87. 

Report  Board  of  Experts,  1878. 

Transactions  College  of  Physicians,  Phila.,  1853. 


II 


965 

NEW    YORK. 

ALBANY. 

1746.     First  case  in  August.     Deaths,  45. 
1798.     No  statistics. 

BAY    RIDGE. 

1856.     Infected  by  Brooklyn.  Only  a  few  cases  resulted. 

?■ 

BKOOKLYN. 

1809.  First  case  in  July;  last  case  in  September. 
Deaths,  40.     Infected  by  ship  Concord,  from  Havana. 

1823.     No  statistics.  ' 

1856.  Infected  by  Governor's  Island.  First  case,  July 
14.     Cases,  29. 

1878.  At  Navy  Yard.  First  case,  July  12;  last  case, 
July  18.     Cases,  8;  deaths,  3.  / 

1879.  Population,  565,000.  Deaths,  11 ;  all  refugees 
from  infected  places. 

1888.  Population,  805,855.  Infected  by  Spanish  bark 
Maria  Louisa  from  Havana  and  steamship  Ccarcusc  from 
Pernambuco. 

CATSKILL. 

1743 ;  1794.     Sporadic  cases. 

1803.  First  case,  August  10 ;  last  case,  September  23. 
Deaths,  8. 

1804.  No  statistics. 

GREENFIELD. 

1798.     Sporadic  cases. 

GOVERNOR'S   ISLAND. 

1856.  Infected  by  shii)piiig.  On  July  26,  the  nrst  case 
of  yellow  fever  occurred  in  a  resident  of  Rotten  Row — 
she  died  with  black  vomit,  August  2.     On  August  1,  three 


966  HISTORY    OF    YELLOW    FEVER. 

otlier  eases  oceurred,  one  in  IJotten  Kow  and  two  from 
South  Battery;  and  in  these  two  places  the  disease  fixed 
its  abode,  as  it  were,  almost  exclnsively,  and  eontinned 
until  tlie  number  of  cases  amounted  to  sixty-three,  iifteen 
of  whom  died,  1  in  4,2.  Very  few  cases  occurred  on  other 
parts  of  the  Island,  liesides  fc^outh  Battery  and  Kotten 
Bow,  and  those  that  did  thus  occur  were  in  almcst  eyerj 
instance  (probably  all)  in  persons  ^^h(!  were  in  the 
habit  of  yisiting  Botten  Bow. 

In  South  Battery  the  disease  continued  its  rayajLics  un- 
til early  in  September,  Avhen  the  cccupants  were  renujyed 
to  quarters  in  audtlu^'  pcrtion  of  the  Island,  only  two 
cases  occurring'  auicnu  tluin  after  tluir  remoyal.  In 
Botten  Bow  it  linjiered  until  checktd  by  cool  weather  on 
the  9tli  of  October. 

Cases,  150;  deaths,  52. 

1870.  Bopulation,  771.  I-'irsl  case,  August  13;  tirst 
death,  August  20;  last  case,  October  2(5;  last  death,  Octo- 
ber 29.     Cases,  159 ;  deaths,  52. 

GOWANUS. 

1S5G.     Infected  by  shippinji".     Sporadic  cases, 

HUXTINOTOX. 

1795;  1798.  Limited  ()ntl)reaks.  Xo  authentic  stat- 
istics. 

LOCKPOBT. 

1878.  One  fatal  case,  a  refu.i'ee  from  ^lemphis,  Sep- 
tember 29. 

:\rONTAT'K   POINT. 

1898.     Cases,  1;  deaths,  0. 

NEW    YOBK. 

1008.  First  appearance  of  yellow  feyer  in  the  United 
States.     Xo  complete  statistics. 

Yellow  feyer  rajned  seyerely  in  New  Ycik,  to  such  a 
dejiCi'ee  that  scarcely  a  iiaticiit  suryiy<'d  it;  and,  by  some 


NEW    YORK  CITY.  967 

accounts,  it  was  niore  fatal  than  any  disease  since  that 
period.  It  was  popnhnly  known  as  "the  f>Teat  sickness." 
One  account  states  that  several  hundred  died  uj)  to  Sep- 
tenihei*,  and  70  more  during  tlie  succeeding  week,  in  a 
population  of  only  (),00()  or  7,000.  On  account  of  the 
pestilence,  the  Assemhly  was  held  at  Jamaica,  Long 
Island.  The  disease  was  said  to  have  l)een  imported  from 
St.  Thomas. 

Last  deatli,  Se])tendier  30.     Deaths,  370. 

1711).  "In  the  vcnr  1710,  there  were  a  few  cases  of  yel- 
low fever  near  the  Old  Slii) ;  but  by  the  vigorous  exertions 
of  the  Board  of  Health  and  the  blessing  of  Divine  Provi- 
dence, it  was  su])i)ressed  before  it  had  attained  an  alarm- 
ing height."      (Bardic,  p.  22). 

1743!     Deaths,  217. 

1745;  1747;  174S;  1703.  Yellow  fever  years.  No 
statistics. 

1780.     Deaths,  70. 

1701.  First  case,  August  — ;  last  case,  October  15. 
"Oeneral  Malcolm  and  some  other  very  respectable  citi- 
zens fdl  victims  to  its  fury."      (Hardir,  p.  1). 

1702;  1703;  1704.     Yellow  fever  years.     No  statistics. 

1705.     hirst  case,  July  10.     Deaths,  732. 

170(1;  1707.     No  statistics. 

170S.     (Jreat  epidemic.     Deaths,  2,080. 

(From  1700  to  date,  unless  otlierwise  noted,  the  figures 
given  in  this  resume  represent  occurrences  at  the  (Quar- 
antine Hos])ital ). 

1700.  First  case,  July  — ;  last  case,  Novend)er.  Cases. 
163;  deaths,  74. 

1800.  First  <ase,  September  — ;  last  case,  October  14. 
Cases,  38;  deaths,  21. 

1801.  First  case,  Se])tember  — ;  last  case,  Octolx'r  — • 
Cases,  35;  deaths,  10. 

1802.  erases,  5;  d(niths,  2. 

1803.  First  case,  July  18;  last  case',  Oelober  20.  Cases, 
1,030;  deaths,  000. 

FpidtMnic  in  the  city. 

1804.  Cases,  8 ;  deaths,  5. 


968  HISTORY    OF    YELLOW    FEVER. 

1805.  First  case  June  — ;  last  case,  October  — .  Cases, 
43;  deaths,  25.  In  the  city  proper  there  were  600  cases, 
of  which  262  died. 

1806.  First  case,  June;  last  case,  November.  Cases, 
2;  deaths,  0. 

1807.  Cases,  3 ;  deaths,  3. 

1808.  Cases,  1;  deaths,  1. 

1809.  Cases,  2;  deaths,  2. 

1810.  Cases,  1 ;  deaths,  1. 

1815.  Cases,  19 ;  deaths,  7. 

1816.  Cases,  2 ;  deaths,  0. 

1817.  Cases,  5;  deaths,  4. 

1818.  Cases,  7 ;  deaths,  4. 

1819.  First  case,  August.     Cases,  26;  deaths,  19. 

1820.  Cases,  2;  deaths,  2. 

1821.  Cases,  28 :  deaths,  16. 

1822. 

At  the  Marine  Hospital  the  first  case  erupted  July  10 
and  the  last  November  6.     Cases,  43;  deaths,  25. 

The  city  was  infected  by  the  Marine  Hospital  and  ex- 
perienced a  limited  epidemic.  The  first  cases  were  dis- 
covered July  17,  at  No.  26  Rector  Street.  By  September, 
the  disease  was  widespread.  On  the  28tli  of  that  month, 
the  followino-  remarkable  document  was  presented  to 
the  common  council  and  ordered  promulgated: 

"To   the   Honourable  tthe   Mayor,   Aldermen   and   Commonalty   of  the 
city  of  New- York: 

The  memorial  of  the  undersigned  clergymen  of  different  denomina- 
tions of  this  city,  respectfully  suggests  to  your  honourable  body,  that 
acknowledging  as  we  do  the  being  and  Providence  of  the  "only  Lord 
God  our  Lord  Jesus  Christ,"  and  confessing  as  we  must,  a  common 
criminality  and  demerit  in  his  sight,  and  visited  as  we  are  with  one  of 
those  desolating  scourges,  which  himself  expressly  challenges  in  his 
word,  not  only  as  a  judgment,  of  which  he  is  the  righteous  disposer; 
but  as  one  of  his  "sore  judgments,"  upon  a  community  of  transgres- 
sors, and  knowing  as  we  may,  that  his  own  invisible  agency  appoints 
and  controls,  in  sovereign  wisdom,  all  the  series  of  secondary  causes. 


NEW    YORK  CITY.  969 

however,  complex  and  inscrutible  to  man,  it  becomes  us,  every  way  in 
our  collective  character  as  a  city,  and  after  the  example  of  ancient 
Nineveh  to  humble  ourselves  under  the  mighty  hand  of  God,  that 
he  may  exalt  us  in  due  time. 

The  reasons  and  propriety  of  such  a  general  humiliation  before  God, 
are  sufficiently  obvious,  we  fondly  hope,  to  your  honourable  body. 

Having  thus  suggested  to  your  Honorable  Body  a  measure  which 
we  confide  to  your  wisdom  to  approve,  because  it  seemed,  all  things 
considered,  to  be  expedient  and  incumbent;  a  measure,  which  seems 
to  be  demanded,  not  more  by  our  present  circumstances  and  the 
aspect  of  Divine  Providence,  than  by  the  commcn  consent  of  the  wise 
and  the  good  and  praying,  that  "the  wisdom  that  is  from  above," 
may  enlighten  all  your  deliberations  and  bless  your  administration, 
we  subscribe  ourselves,  honourable  Sirs,  your  friends  and  fellow 
citizens. 

J.  B.  Romeyn  R.  M'Cartee 

E.  Washburn  James  G.  Ogilvie 

N.  Bangs  S.  Martindale 

Alexander  M'Leod  Isaac  Chase 

H.  Peneveyre  William  Gray 

S.  N.  Rowan  Samuel  H.  Cox 

Samuel  Nott,  Jun.  Ward  Stafford 

Nich.  S.  Marselus  Peter  Ludlow,  Jun. 

Tlie  disease  was  not  very  widespread,  for  there  were  only 
401  eases,  of  whieli  230  died. 

1823.  Cases,  8 ;  deaths,  5. 

1824.  Cases,  28;  deaths,  8. 

1825.  Cases,  2;  deaths,  1. 

1826.  Cases,  2 ;  deaths,  2. 

1827.  Cases,. 0;  deaths,  4. 

1828.  Cases,  1;  deaths,  0. 

1829.  Cases,  4;  deaths,  0. 

1830.  Cases,  2 ;  deaths,  1. 

1831.  Deatlis,  1. 

1832.  Cases,  1;  deaths,  1. 

1833.  Cases,  12 ;  deaths,  2. 

1834.  Cases,  3;  deatlis,  1. 

1835.  Cases,  2;  deaths,  2. 
1838.  Cases,  2G ;  deaths,  8. 
1830.  Cases,  4;  deaths,  4. 


970 


HISTORY     OK    YELLOW     FEVER, 


rases-,  9;  deaths,  2. 


1843.  Cases,  18 ;  deaths,  3. 

1814.  First  case,  August  12. 

1840.  Cases,  2;  deaths,  0. 

1847.  Cases,  1;  deaths,  0. 

1848.  (^ases,  2(5;  deaths,  12. 

1852.  Cases,  1;  deaths,  0. 

1853.  Cases,  44;  deaths,  15. 

1854.  Cases,  45;  deaths,  20. 

1855.  Cases,  12;  deaths,  5. 

1856. 


After  a  lapse  of  thirty-four  roars  (1822  to  1850  i  yelhjw 
fever  again  made  its  ajjix^aranee  iu  New  Yoi'k.  ]U4\veeu 
these  years,  many  cases  Avere  brought  by  A'essels  from  the 
Spanish  ]Maiu,  Init  they  were  all  tr(  ated  at  the  ^Inriiie  Hos- 
[tital,  and  iu  no  instance  was  the  infection  carried  ashore. 
In  1850,  however,  the  population  of  tlie  metropolis 
of  the  world  had  a  narr(;w  escape  from  the  clutches  of 
the  Yellow  Denutn. 

The  circumstances  were  as  follows : 

(hie  case  of  yelk;w  fever  Avas  received  from  Havana  in 
the  month  of  April;  but  no  otlier  cases  were  seen  until 
June  IS,  when  the  bark  Jul  id  M.  Hallock.  from  Santiago 
de  Cuba,  arrived,  with  ca])tain,  first  mate,  an<l  a  pas- 
senger sick  with  the  fever.  On  the  21st  of  the  same 
month,  the  ship  J<inr  H.  (lH(J<J(jii.  from  Havana,  arrived, 
having  a  i)assenger  an<l  four  seamen  dangerously  ill  with 
the  disease;  and  fr( m  ihc  same  vessel  three  other  cases 
Avere  subse(|U(M)tly  received.  These  were  all  of  a  strongl.v. 
marked  character;  and  some  of  them  occurring  n)aii.v 
days  after  the  ship's  arrival,  an  infected  eonditiou  of  the 
vessel  was  naturally  inferred,  and  the  spread  of  the  in- 
fection antici])ated.  Vm-ui  this  ship  the  infectioi)  did 
spread,  until  at  least  twenty  of  the  stevedores  ai;d  lighter- 
men who  were  engaged  in  unloading  her,  contracted  the 
disease. 

In  the  AniiiKi]  Rcporf  of  the  J*]ii/sicifiii  in  CJiirf  of  iJir. 
Marine  Hospifal  at  Quarantinr  for  1850,  puldishcd  at 
All)auy  in  1857,  is  presented  a  chrfsnological  summaiy  of 


NEW     -SORK   CITY.  971 

all  tlie  cases  of  yellow  fev<'r  that  oofurrod  dTiriiijj:  this 
rcniaikahle  outhreak.  A  veeord  of  538  eases  is  giveu,  of 
Avldeli  more  than  one-third  died. 

1870. 

In  1870,  New  York  ai^ain  fonnd  the  spectre  of  yellow 
fever  at  her  doors,  and  only  escaped  an  invasion  of  the 
disease  t]ii'(;iii>h  the  inactivities  of  the  *s7r//oy//_///r/  CaJopus, 
who  confined  tluii*  oi)erations  to  a  circumst  rihed  area. 

The  following;'  resnme  is  made  from  the  account  given 
by  Dr.  INIoreau  JMorJ'is,  City  Sanitary  Inspect(;r,  in  the 
Amiud]  Report  of  tJtc  Xcic  Yorl-  Bo<n<J  of  Health  for 
1870: 

On  September  13,  1870,  information  reached  the  Bureau 
of  Sanitary  Ii)si)ection  that  a  ]Mrs.  Kelly  was  lying  dead 
at  No.  14  Essex  Street,  New  York.  She  had  been  sick  for 
about  a  week,  ''with  a  fever,  which  did  not  present  the 
types  of  the  ordinary  fevers  usually  found  in  the  city." 
An  immediate  investigation  of  the  history  and  circum- 
stances attending  this  case,  aroused  the  suspicion  that  it 
might  have  been  yellow  fever.  The  body  was,  therefore, 
sent  to  the  morgue  at  once  for  a  specific  investigation. 
The  bed  was  burned,  and  the  rooms  and  clothing  thor- 
oughly fumigated  and  disinfected. 

It  was  ascertained  that  her  husband,  James  Kellv,  had 
been  sick  also  with  the  same  syniptoms,  and  had  been 
removed  to  Bellevue  Hospital,  where  he  had  died  upon 
Ihe  sanu'  day  (the  12th)  as  bis  Avife. 

A  ])(;st-mortem  examination  vs'as  held  upon  the  body 
or  James  Kellv,  on  the  131  h  of  S(  ittember,  by  the  curator 
rf  Bellevue  ?*ledical  (Allege,  which,  it  was  presumed, 
W(;nld  reveal  the  true  character  (!f  the  disease. 

The  hospital  record,  as  n)ade  at  the  time  of  the  inves- 
tigation, is  as  follows: 

'Mantes  Kelly,  admitted  Sd.tembcr  12,  1S70:  his- 
tory, obscure:  conjatose  when  adiiiitte<l ;  skin,  jauixliced; 
respiraticju,  30;  pulse,  11(1;  temix'rature,  08  12  deg.  F. ; 
hepatic  tenderness;  tongue,  dry  and  coated;  died,  Sep- 
tember 12,  3:30  ]).  m. 


972  HISTORY    OF    YELLOW    FEVFR. 

"Autopsy,  September  13.  Brain  and  membranes,  nor- 
mal ;  larynx,  normal ;  oesophagus,  mucous  membrane 
eroded  in  longitudinal  patches."  This  case  received  a  cor- 
oner's investigation,  and  the  verdict  of  the  jurors  was 
"Death  by  exhaustion."  The  medical  certificate  attached 
to  the  coroner's  return,  certifies  that  the  cause  of  his 
death  was  "Coma  (cause  unknown)." 

Signed  by 

JOHN  J.  REID,  M.D., 
Medical  Attendant  at  Inquest. 
No  post-mortem  examination  of  the  body  of  Mrs.  Kelly 
was   held,   but  the   certificate   of   death   is   recorded   as 
follows : 

Coroner's  verdict — "Pernicious  fever." 
Medical  certificate — "Is  supposed  to  be  either  yellow 
fever  or  tvphus  fever." 

(Signed)         WOOSTER  BEACH, 

Medical  Attendant  at  Inquest. 

The  records  of  the  examination  unfortunately  were  so 
meagre,  as  to  aft'oid  no  clue  to  the  disease,  and  the  doubt 
still  existed  as  to  its  true  character,  until  subsequent  cases 
and  further  investigation  pronounced  the  diagnosis.  •^, 

In  tracing  the  source  of  their  illness,  it  was  subse- 
quently discovered  that  both  Mr.  and  Mrs.  Kelly  had  been 
visiting  and  attending  the  "wake"  and  funeral  of  a  rela- 
tive on  Governor's  Island,  on  the  2nd  and  3rd  days  of 
September,  reuiaining  thereon  over  night. 

This  relative,  Wm.  narringtoi\  was  a  soldier  upon  the 
Island,  who  died  on  the  1st  of  September,  of  what  was 
stated  at  the  time  as  "typho-malarial  or  bilious  fever." 

It  was  also  asceitniued  that  a  ^Irs.  Ann  :\rcCormnck, 
another  relative  who  had  attended  the  same  "wake"  and 
funeral,  had  subsequently  sickened  and  died  on  the  9th 
of  September,  at  4*)  Oliver  Street.  Tlie  cause  of  her 
death  was  certified  hy  tlie  attending  physician  as  "typhus 
fever."  By  careful  inquiries,  it  was  found  that  these 
three  cases  presented  ahnost  identical  symptcms.  Their 
similai'ity  and  (;bscurity  indicated  a  coincident  exposure 
to  the  same  exciting  cauj-e,  and  incited  still   further  in- 


fj^ 


NEW    YORK  CITY.  97S 

quiry.  This  resulted  (after  a  delay  of  four  days,  caused 
by  false  information)  in  the  discovery,  as  before  stated, 
of  their  presence  at  the  funeral  of  Wm.  Harrington,  on 
Governor's  Island. 

Attention  being  now  directed  to  that  island  as  the 
source,  a  Health  Inspector,  with  another  medical  officer 
who  had  been  familiar  with  diseases  of  tropical  climates, 
was  directed  to  visit  it  and  report  upon  its  character.  It 
was  found  that  a  disease  of  similar  character  had  been 
prevailing  there  since  the  13th  of  August  (over  a  month), 
and  which  the  surgeons  in  attendance  described  as  a 
type  of  malarial  fever,  accompanied  with  more  than  usual 
fatal  results.  Many  of  the  residents  had  suffered,  some 
with  a  very  mild  attack,  readily  yielding  to  treatment, 
while  others,  seized  in  a  more  violent  form,  had  suc- 
cumbed. No  suspicion  of  yellow  fever  had  been  enter- 
tained by  the  attending  surgeons  of  the  post,  neither 
could  they  become  satisfied  of  the  fact  until  the  pathog- 
nomonic symptom  of  "black  vomit"  subsequently  appeared 
as  the  disease  progressed. 

The  report  of  the  two  officers,  after  visiting  the  cases 
upon  the  Island,  was  that  the  type  of  disease  was  that 
of  the  "pernicious  remittent  fever  so  frequently  seen  in 
the  South,  and  which  so  generally  precedes  yellow  fever 
in  that  locality." 

The  surgeons  of  the  post  had  made  post-mortem  exami- 
nations of  the  dead,  and  had  carefully  watched  with  the 
microscope  for  casts  or  other  evidences  of  yellow  fever; 
no  case  had  presented  "black  vomit,"  and,  therefore,  no 
correct  diagnosis  had  been  made. 

The  suspicions  which  had  been  entertained  by  the  med- 
ical officers  of  the  Board  of  its  being  yellow  fever,  were 
thus,  in  a  measure,  quieted,  as  no  positive  evidence  had 
yet  presented  itself. 

About  this  time  other  cases  presenting  the  same  doubt- 
ful symptoms  occurring  in  New  York  City  had  come  to 
the  knowledge  of  the  Board,  all  of  which  were  traced  to 
Governor's  Island  as  their  source;  and  a  fresh,  or  rather 
increased  outbreak,  with  more  marked  symptoms,  having 
occurred  upon  the  Island,  the  Board,  anxious  to  settle,  if 


97-t 


HISTORY     OF    YELLOW     FEVER. 


possible,  the  doubt  requested  Dr.  J.  C.  Nott,  of  ^Nfobile, 
a  genth^iuau  who  had  hirue  ex])ei-ieiU'e  iu  thi,-^  special  dis- 
ease in  Scjuthern  States,  to  visit  the  Island  and  report 
his  opinion.  On  the  2nd  of  September  he  visited  the 
Island,  and  the  diaiin<jsis  was  made  clear  by  a  post- 
mortem examination  of  a  recent  case  of  this  disease  and 
the  presence  of  "black  vomit"  in  others.  His  report  to 
the  Board  on  the  following  day,  Avas  that  it  was  undoubt- 
edly yellow  fever.  A  special  committee  was  immediately 
appctinted  by  the  Board,  consistino-  of  the  Chairman  of 
the  Sanitary  Committee,  Dr.  G.  Ceccarini,  the  Health 
Officer  of  the  Port,  Dr.  John  M.  Carnochan,  and  the  City 
Sanitary  Inspector,  Di-.  ^Moreau  ^forris,  and  it  was  au- 
thorized to  take  the  necessary  measures  for  the  removal 
to  quarantine  of  those  sick  with  yellow  fever  at  Gov- 
ernor's Island,  and  to  protect  this  city  from  said  disease; 
and  it  was  further  instructed  to  investij^ate  the  cri^in  of 
the  disease  and  the  circumstances  of  its  inti'oduction  at 
Governor's  Island, 


The  Committee,  upon  the  same  day,  visited  the  Island, 
and  becomino-  satisfied  of  the  true  nature  of  the  disease, 
so  I'eported  to  the  Bctard,  and  at  once  conferred  with  the 
Gommandant  of  the  Tost,  General  Neil,  with  reference  to 
removino-  those  sick,  and  placino-  the  Island  under  quar- 
antine restrictions,  etc.,  etc.  It  was  referred  directly  to 
General  ]\rcDowell,c((mniandinii-  the  De})artment  of  the 
East,  by  whose  order  alone  such  measures  could  be  af- 
fected. The  same  nijiht,  in  consultation  with  General 
Cuyler,  ^NFedical  Director  of  the  same  department.  General 
]\IcDow(^ll  promptly  issue<l  the  necessary  orders,  as  had 
been  suij.cested  by  the  Committee.  The  followinj?  two 
days  were  devoted  actively  to  procuring-  (he  means  of 
makini;-  the  transfer  of  ])atients,  which  was  accomidished 
on  the  mornino-  of  October  1.  Sixty  patients,  including 
many  who  were  in  a  convalescent  stai^e,  were  then 
remcived. 

Other  cases  continued  to  i)resent  themselves  and  it  was 
not  until  the  26th  of  October  that  the  last  case  appeared. 


New  YORK  City.  975 

The  records  of  the  cases  occiirrinj;'  npoii  (lovei-iior's 
Ishiiid  will  he  found  in  the  history  of  the  prevalence  ot 
yellow  fever  at  that  place  in  the  i)recediug-  pa<2,es. 

From  time  to  time  the  following-  cases  were  discovered 
in  New  York  City,  durini»-  the  period  of  its  prevalence 
upon  the  Island.  Each  case  was  closely  watched  by  the 
medical  otiicers  of  the  Board,  and  Avithout  an  exception 
all  were  ascertained  to  have  visited  the  Island  either  as 
nurses  or  friends  of  the  sick,  or  were  scddiers  on  leave 
of  absence,  taken  sick  at  their  homes.  The  record  is  as 
follows: 

1.  Ann  ^rcrormack,  49  Oliver  Street,  died  Septombci^ 

9,  1870. 

2.  James  Kellv,  14  Essex  Street,  died  September  12^ 

1870. 

3.  Mrs.  Kelly  (wife  of  above),  11  Essex  Street, 

died  September  12,  1870. 

4.  David  Stranev,  12  Tell  Street,  died  September  15, 

1870. 

5.  Mrs.  :\Iertens,  89  Tlinton  Street,  died  September  25, 

1870. 

6.  Peter  Becker,  125  Clinton  Street,  died  October  1, 

1870. 

7.  Eliza  :\Iertens,  89  Clinton  Street,  died  October  2, 

1870. 

8.  Eliza  Stelche,  from  Governor's  Island,  at  Btllevue 

Hospital,  ditHl  October  4,  1870. 

9.  William  H.  :\Iorris,  117  West  Twenty-tirst  Street, 

died  October  9;  1870. 

10.  Charles  Haab,  126  East  Fourth  Street,  a  soldier 

on  leave,  taken  sick  September  19,  recovered. 

11.  John  Hatfner,  405  West  Forty-first  Stieet,  a  soldier 

on  leave,  taken  sick  September  25,  recovered. 

There  is  no  evidence  of  any  other  case  haviui?  occurred 
in  the  city. 

With  reference  to  these  cases,  it  was  ascertained  beyond 
all  question  as  follows : 

Tlie  first  four  were  per.'-ons  who  visited  Oovernor's 
Island  and  attended  the  funeral  of  Wm.  Harrinoton,  who 
died  on  the  1st  of  September  and  was  buried  on  the  3rd; 


97  6  HISTORY    OF    YELLOW    FEVER. 

the  fifth,  sixth  and  seventh  cases  were  immediate  relatives 
of  Sergeant  Merten's,  who  was  sick  upon  the  Island,  and 
whom  they  visited  and  attended  upon  as  nurses — No.  5 
being  the  mother,  No.  6  the  brother-in-law  and  No.  7  the 
sister. 

The  eighth  case  was  a  soldier's  wife  residing  upon  the 
Island,  who  was  removed  therefrom  surreptitiously,  for 
fear  of  being  taken  to  Quarantine  Hospital,  and  taken  to 
Bellevue  Hospital,  where  she  died ;  the  disease  being  un- 
recognized until  after  death  by  the  medical  attendants. 
Case  nine  was  a  discharged  soldier  from  the  Island,  sick 
when  he  left,  ill  two  weeks  before  death  at  his  father's 
house.  Cases  10  and  11  were  soldiers,  at  home,  on  leave 
of  absence,  taken  sick  while  at  home,  and  remaining  there; 
finally  recovered. 

These  eleven  cases,  scattered  in  different  portions  of 
the  city,  it  was  feared,  might  prove  centers  for  infection, 
and  were  watched  with  great  care.  In  each  case  all  the 
measures  of  disinfection  and  sanitary  care  were  applied, 
which  would,  if  possible,  prevent  its  further  spread. 

In  no  instance  did  any  person  suffer  from  its  effects, 
or  from  the  diffusion  of  any  poison  therefrom,  beyond  the 
case  itself,  within  the  city. 

1872.  No  statistics.     On  vessels  in  harbor. 

1873.  First  case.  May  23;  first  death,  August  1;  last 
case,  October  1;  last  death,  September  27.  Cases,  62; 
deaths,  13. 

In  the  city  proper,  three  fatal  cases,  all  refugees  from 
New  Orleans. 

1875.  On  vessel  in  harbor. 

1876.  Cases,  2;  deaths,  2.     Refugees  from  Savannah. 

1878. 

Population,  1,235,389. 

Yellow  fever  appeared  August  16th.  Patrick  Wm. 
Riley,  a  horse-shoer  from  New  Orleans,  arriving  that  day, 
very  sick,  was  sent  to  quarantine  and  soon  died.  Wil- 
liam Schultz  died  August  22;  a  week  later,  Mrs.  Joseph 
Cellers,  a  Memphis  refugee,  living  in  Tenion  Court,  a 


NEW     YORK   CITY.  977 

naricw  lane  near  53  University  Place,  was  taken  with 
fever  just  after  giving  birth  to  a  cliild;  she  was  sent  to 
quarantine,  and  died  September  30.  Dr.  N.  A.  Lindlej^, 
who  felt  the  s^^mptoms  of  yellow  fever  on  his  way  from 
Memphis,  arrived  at  quarantine  September  23,  and  died 
there.  He  was  one  of  the  many  heroes  of  the  terrible 
epidemic  of  1878,  being  among  the  first  to  respond  to  the 
call  for  aid  when  the  fever  broke  out  in  Memphis.  Worn 
out  with  incessant  work,  he  sought  to  return  to  his  family, 
who  were  in  the  North.  When  he  reached  New  York,  he 
proceeded  at  once  to  the  quarantine  hospital,  and  gave 
Dr.  Vanderpoel  an  account  of  his  case.  Re  received  every 
attention;  Dr.  Vanderpoel  visiting  him  three  times  a 
day.  lie  rallied  on  Friday  night,  l)ut  sank  rapidly  soon 
after,  and  died  at  noon  September  30. 

Total  deaths,  4 — all  refugees.  The  di^^^oaf-e  did  not 
spread  to  the  inhabitants. 

1879.  ~    First  case,  June. 

1880.  Fourteen  cases,  of  which  five  proved  fatal,  from 
vessels  in  harbor. 

1881.  Population,  1,206,517.     Deaths,  1. 

1887.  First  case,  September  7.     Cases,  1. 

1888.  Population,  1,535,538.  One  case,  a  refugee  from 
Oak  Lawn,  Fla.,  on  September  10;  death,  September  12. 

1888.  Infected  by  Port  au  Prince,  Hayti.  First  case, 
November  24. 

1880.  Cases  from  various  vessels  arriving  from  in- 
fected ports.  First  case,  Jui^e  10;  firrt  dealh,  September 
15.     Cases,  5 ;  deaths,  2. 

1800.  Cases,  1. 

1803.  Case;',  1 ;  deaths,  1. 

1895.  No  statistics. 

1890.  Cases,  1;  deaths,  1. 

18{)7.  Cases  from  vessels  in  harbor. 

1808.  Cases,  1;  deaths,  1. 

1901.  Cases,  3. 

1905.  Deaths,  1. 

QUEENSBOROUGH. 

1801.  Scattered  cases. 


978 


HISTORY    OF     YKLi.OW     FEVER. 


KED    HOOK. 
185G.     Scattered  cases. 

EONDOUT. 
1843.     Scattered  cases. 

STAPLETOX. 
1848.     First  case,  August  23. 

STATEN    ISLAND. 
1848.     Scattered  cases. 

TOMPKINYILLE. 

1848.     Scattered  cases. 

WALLABOUT. 

1804.     Scattered  cases.     Infected  bv  vessels  fioni  Cape 
Haytien,  Hayti,  and  Guadeloupe. 

WEST    NECK. 
1795.     Scattered  cases. 

WEST    POINT. 
1804.     No  statistics. 

YELLOW    HOOK. 
185G.     Infected  by  Governor's  Island.     No  statistics. 


NEW    YORK.  979 

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which  prevailed  in  the  City  cf  New  York  in  the  Summer  of  1798,  in  a 
Letter  to  Dr.  Hcsack.  j.Ieclical  £nd  Philosophical  Register,  vol.  3, 
p.  2C3. 

Miller:  Report  on  the  Malignant  Disease  which  prevailed  in  the  City 
of  New  York  in  the  Autumn  of  1805,  addressed  to  the  Governor  of  the 
State  of  New  Ycrk.     Collected  works,  p.  87. 

Pascalis:  Statement  of  Occurrences  in  the  City  of  New  York  during 
an  Epidemic  of  Yellow  Fever  in  1819.  See  Medical  Repository,  vol. 
20,  p.  229.     (N.  S.,  vol.  5,  No.  3.) 

Pestilence:  Account  of  the  Yellow  Fever  of  New  Ycrk  in  1805. 
Medical  Repository,  vol.  9,  p..  211. 

Ramsay  (Alex.):  Observations  on  the  Yellow  Fever  of  New  York  in 
1803.     Edinburgh  Medical  and  Surgical  Journal,  vol.  S,  p.  422. 


NEW     YORK.  9S1 

Remarks  on  the  Report  of  the  Medical  Society  on  the  Fever  in 
Bancker  Street.     8vo.     New  York,  1820. 

Report  of  the  Board  of  Health  of  New  York,  1806,  p.  19.     8vo. 

Report  of  the  Committee  appointed  by  the  Medical  Society  cf  the 
State  of  New  York,  to  inquire  into  tie  Symptoms,  Origin,  Cause,  and 
Prevention  of  the  Pestilential  Disease!     8vo.     New  Yoik,  1799. 

Report  of  the  Committee  of  the  Medical  Society  of  the  city  and 
country  of  New  York,  on  the  Causes  and  Character  of  the  Epidemic 
Fever  which  prevailed  in  Eancker  Street  and  its  vicinity,  in  the  sum- 
mer and  auUimn   of  1S20.     New  York,  1820. 

Rogers  (John  R.  B):  A  Letter  on  the  Yellow  Fever  of  Brooklyn  in 
1809,  and  Proofs  of  its  Non-importation  there.  New  Yoik  Medical 
Repository,  vol.  13,  p.  198. 

Rogers:  Remarks  on  Dr.  Gillespie's  Report  on  the  Yellow  Fever  of 
Brooklyn  in  1811.  American  Medical  and  Philcsopnical  Register,  vol. 
1,  p.  253. 

Seaman  (V.):  An  Account  cf  tl:e  Ep.idemic  Disease  which  appeared 
at  New  Y,ork  in  the  Summsr  and  Autumn  of  1800.  Medical  Repository, 
vol.  4,  p.  248. 

Seaman:  An  Inquiry  :'nto  the  Cause  of  Prevalence  of  Yellow  Fever 
in  New  York.     Medicr.1  Repository,  vol.  1,  p.  315. 

Seaman:  An  Account  of  the  Epidemic  Yellow  Fever,  as  it  appeared 
in  the  City  of  New  York  in  the  year  1795.     Webster's  Collection,  p.  1. 

Smith  (E.  H.) :  Letters  to  William  Buel,  on  the  Fever  which  pre- 
vailed in  New  York  in  1795.    Webster's  Collection. 

State  (A)  of  Facts  relative  to  the  late  Fever  wkic'n  appeared  in 
Bancker  Street  and  its  Vicinity.  Published  by  order  of  the  Board  of 
Health.    New  York,  1821. 

Townsend:  An  Account  of  the  Yellow  Fever  as  it  prevailed  in  the 
City  of  New  York  in  the  Summer  and  Autumn  of  1822.  8vo.  New 
York,  1823. 

Vache  (Alex.  J.):  Letters  on  Yellow  Fever,  Cholera,  and  Quarantine, 
addressed  to  the  Legislature  of  the  State  of  New  York;  with  additions 
and  notes.     Svo.     New  York,  1852. 

Walters  (Daniel  D.) :  Diary  of  the  Occurrences  of  the  first  month  of 
the  Yellow  Fever  which  prevailed  in  the  City  of  New  York  in  1822. 
New  York  Medical  and  Physical  Journal,  vol.  1,  p.  469. 

Yates:  Observations  on  the  Yellow  Fever  of  New  York  in  1822. 
Medical  Repository,  vol.  23,  p.  1. 

Yates  (Christ.  C):  Review  cf  an  essay  on  the  Bilious  Epideniic 
Fever  prevailing  in  the  State  cf  New  York.     Svo.     Albany,  1813. 


98i 

NORTH     CAROLINA. 

BEAUFOirr. 

1854.     No  accurate  statistics. 

1804.     Infected  by  Newberiie,  N.  C.     First  case,  Sep- 
tember 24;  last  case,  November  17.     Deaths,  G8. 
1871.     No  statistics. 

GOLDSBORO. 

1888.     One  case,  a  refugee  from  Florida ;  recovery. 

HATTEBAS. 

18C4.     Infected  by  Newberne.     No  statistics. 

MOORHEAD    CITY. 

1864.     Infected  by  Newberne.     No  statistics. 

NEWBERNE. 

1709.     No  statistics. 

1864.     Population,  0,000.     First  case,  September;  last 
case,  November.     Deaths,  700. 

ROANOKE   ISLAND. 

1864.     Infected  by  Newberne. 

SMITHVILLE. 

1862.     No  statistics. 

WASHINGTON. 

1800.     No  statistics. 


NORTH    CAROLINA.  983 

WILMINGTON. 

1796;  1800;  1821.     Yellow  fever  years.     No  statistics. 
18G2.     Infected   by   Nassau,   Bahama   Islands.       First 
case,  August  G;  last  case,  November  17.     Deaths,  440. 

BIBLIOGRAPHY  OF  YELLOW   FEVER   IN   NORTH  CAROLINA. 

Berenger-Feraud:   Fievre  Jaune,  etc.,  Paris,  1890,  p.  05, 

Brown:   Quarantine,  p..  18. 

Choppin:   Trans.  Am.  Pub.  Health  Assn.,  1877-8,  vol.  4,  p.  195. 

Griscom:  N.  Y.  Jl.  of  Med.,  1856,  p.  369. 

Hand:  Trans.  Am.  Pub.  Health  Assn.,  1877-8,  vol.  4,  p.  293. 

Hill  (John):  Some  Observations  on  the  Yellow  Fever,  as  it  pre- 
vailed in  Wilm:ngton,  North  Carolina,  in  the  Autumn  of  1821.  Am. 
Med.  Recorder,  1822,  vol.  5,  p.  86. 

N.  Y.  Med.  Repository,  1808,  p.  197. 

Ibid.,  1800,  p.  187. 

Report  Med.  Inspector  U.  S.  Army,  December  31,  1864. 

Rep.  Sup.  Surg.-Gen.,  1873,  p.  89. 

Rosset  (De):  An  Account  of  the  Pestilential  Fever  which  prevailed 
at  Wilmington,  North  Carolina,  in  1796.  Medical  Repository,  vol.  2, 
p.  153. 

U.  S.  Pub.  Health  Reports,  1881,  p..  180. 

Wragg:     N.  Y.  Med.  Jl.,  1869,  pp.  225,  478. 


984 


OHIO. 

CALEDONIA. 

1878.     One  case,  a.  refugee. 

CINCINNATI. 

1871;  1873.     Cases  amoii"-  refugees. 

1878.  Population,  280,000.  The  first  case  was  a  young 
lady  living  in  a  house  where  baggage  from  New  Orleans 
was  stored,  and  the  second  case  occurred  in  the  same 
locality,  Harris  Hackett  and  Blanche  Offner  died  August 
28.  A  Jewish  refugee  died  on  Walnut  Hills.  The  family 
Hed,  the  alarmed  nurse  left  the  body,  and  no  one  would 
enter  the  house  to  bury  the  corpse,  until  Police  Officer 
Joe  Smith  bravely  led  the  way. 

Total  cases,  all  refugees,  49 ;  total  deaths,  19.  Date  of 
last  death,  October  31st. 

1879.  Eefugee  from  Memphis.  No  cases  among  in- 
habitants. 

1897.     One  case,  a  refugee. 
1905.     Three  cases — all  refugees. 

DAYTON. 

1878.  Population,  38,374.  Yellow  fever  v.\ns  brought 
here  in  September  by  some  refugees  from  Key  West  and 
other  infected  places.  Among  the  fatal  cases  was  Joseph 
Lebolt,  from  Holly  Springs,  ^liss.  He  was  attended  by 
the  celebrated  Dr.  Julius  Wise,  of  Memphis,  who  only 
reached  his  bed-side  a  few  hours  before  he  died.  Very 
few  other  cases  occurred. 

1897.     Population,  175,000.     One  case,  a  refugee. 

GALLIPOLIS. 

1790. 
This  is  one  of  the  famous  epidemics  of  history,  cited 
by  nearly  every  author  on  yelloA\-  fever.     The  facts  are 


9>5 


obscure,  however,  and  we  have  grave  doubts  that  tliis 
outbreak  was  yellow  fever. 

1878. 

Population,  3,700.  First  cases  were  Chas.  Degelman, 
engineer,  and  A\'m.  Koidler,  of  the  steamer  Joliii  iHibKon, 
which  landed  three  miles  below  the  city  on  August  20. 
September  11,  JoseiJh  Porter,  Avatchman  of  the  Joliii  D. 
Porter,  died.  His  body  was  not  permitted  to  be  moved 
from  his  house,  nor  his  wife  to  leave.  The  Kch(yol;^  closed, 
business  suspended  and  many  citizens  tied.  ]Mrs.  Brown 
died  September  27,  below  town,  where  the  infected  dis- 
irict  was  located.  The  disease  disappeared  October  17. 
Total  cases,  51 ;  total  deaths,  31. 

MARIETTA. 

1832.     No  statistics. 

NEWTON    FALLS. 

1898.     No  statistics. 

BIBLIOGRAPHY   OF   YELLOW    FEVER    IN    OHIO. 

Long  (V^.  H.):.  Yellow  Fever  at  Gallipo'.is,  1S7S.  Rep.  Supeiv.  Surg.- 
Goii.  Mar.  Hosp.,  Wash.,  1878-9,  p.  127. 

Medaris:    (Cincinnati,  1898).     Ohio  Med.  J.,  1898,  vol.  9,  p.  25. 

Minor  (T..  C):  Special  report  on  yellow  fever  in  Ohio  as  it  ap- 
peared during  the  summer  cf  1878.  Rep.  Health  Dept.  Cincin.;  1879, 
vol.  12,  p.  173. 

Reeve  (J.  C):  Was  it  a  Case  of  Yellow  Fever?  Cincinnati  Lancet- 
Clinic,  1879,  vol.  3,  p.  187. 


986 

PENNSYLVNNIA. 

BALD   EAGLE   VALLEY. 
1799.     Sporadic  cases. 

CHESTEIL 
1798.     Deaths,  50. 

CHESTEK    COUNTY. 
1805.     Sporadic  cases. 

KENSINGTON. 
1793.     Sporadic  cases. 

LISBURN. 
1803.     First  cases  in  August.     No  statistics. 
MARCUS   HOOK. 

1798.  First  case,  August.     Cases,  60;  deaths,  4. 

NITTANY^ 

1799.  Sporadic  cases. 

PHILADELPHL\. 

1093.  First  appearance  of  vellow  fever  in  Philadel- 
phia, according  to  Webster,  La  Roche  and  Berenger- 
Feraud.     No  record. 

1G95.     Traditional  outbreak. 

1699.  First  outbreak  epidemic.  Population,  3,800. 
First  cases  in  June:  first  death,  July  15.     Deaths,  220. 

1732.     Deaths,  250. 


PENNSYLVANIA PHILADELPHIA.  9FT 

1741.  First  case,  3Iay;  first  death  in  June;  last  case 
in   Ir^eptember.     Deaths,  210. 

1712;  1713;  1711.     Yellow  fever  years.     Xo  statistics. 

1717.     First  case  in  June;  last  case  in  October. 

1700.     Scattered  cases. 

1762.  First  case,  August  28;  last  case,  November  — ; 
last  death,  October  30.     No  statistics. 

1763;  1789;  1791.     Yellow  fever  years.     No  statistics. 

1793.  Great  epidemic.  Population,  10,111.  Number 
who  fled,  17,000.  First  case,  August  18;  first  death, 
August  22 ;  last  case  in  December.     Deaths,  1,011. 

1791;  1795;  1796.     Scattered  cases. 

1797.  Severe  epidemic.  First  case,  August  1;  last 
case,  October  15.     Deaths,  1,292. 

1798.  Another  great  epidemic.  Population,  60,000. 
First  case,  August  1 ;  last  death  in  November.  Deaths, 
3,506. 

1799.  Severe  epidemic.  First  case,  June  28 ;  last  case 
in  October ;  last  death,  October  18.     Deaths,  1,015. 

1800.  First  case  in  Julv;  last  case  in  September. 
Deaths,  20. 

1801.  Scattered  cases. 

1802.  First  case  in  August.     Cases,  598;  deaths,  307. 

1803.  First  case,  July  19;  first  death,  July  25;  last 
case,  October  5;  last  death,  October  20.  Cases,  3,900; 
deaths,  195. 

1805.     First  case,  Julv;  last  case,  October, 
1806;  1807;  1808;  1809;  1810;  1811;  1812;  1813;  1814; 
1815;  1816.     Scattered  cases.     No  statistics. 

1818.  Cases,  2;  deaths,  2. 

1819.  First  case,  June  23.     Cases,  21 ;  deaths,  20. 

1820.  First  case,  Julv  21 ;  last  case,  November.  Cases, 
125 ;  deaths,  83. 

1826.     Scattered  cases. 

1853.  Infected  by  ship  Mandarm,  from  Cuba.  First 
case,  July  19 ;  last  case,  October  7 ;  last  death,  October  12. 
Cases,  170 ;  deaths,  128. 

1854.  Scattered  cases. 

1870.     First  case,  June  29.     Deaths,  18. 


i'8«  HISTORY     OF     VEI.I.OW     FF.VKU. 

1878.  Two  cases,  refugees  frcm  Vicksburg,  August  24. 
Canes,  4;  deaths,  1. 

1879.  Cases  ou  brig  SJtasta,  from  Havti. 
1883.     Cases  on  brig  Julid  Blake,  from  Havana. 
1893.     Cases,  3;  deaths,  0.     In  haibor. 

PITTSBUKG. 

1878.     One  case  from  the  ill-starred  John   D.  Porter, 
died  soon  after  arrival  at  Pitts-burg.     I\o  de^.elcpments. 

SOUTHWARK. 

1793.     A  suburb  of  Pliiladelpliia,  viiich  see. 

BIBLIOGRAPHY    OF   YELLOW    FEVER    IN    PENNSYLVANIA. 

Academy  of  Medicine  cf  Philadelp.iia:  Proofs  of  the  Origin  of  the 
Yellow  Fever  in  Philadelphia  and  Kensington,  in  the  year  1797,  from 
Domestic  Exhalations,  etc.     Philadelphia,  1798. 

Account  cf  the  Rise,  Progress,  and  Termination  of  the  Malignant 
Fever  lately  prevalent  in  Philadelphia.     Small  8vo.     Philadelphia,  1793. 

Bache  (Thomas  Hewson) :  Observations  on  the  Pathology  of  the 
Cases  of  Yellow  Fever  admitted  into  the  Penncylvania  Hospital  during 
the  summer  of  1853.  American  Journal  cf  the  Medical  Sciences,  N. 
S.,  vol.  28,  p.  121,  July,  1854. 

Bond  (Thomas):  An  Introducto:y  Lecture  to  a  course  of  Clinical 
Lectures  in  the  Penn.  Hospital,  deliveied  en  the  3rd  of  December, 
1766.     North  American  Medical  and  Surgical  Journal,  vol.  4,  p.  264. 

Caldwell  (C):  A  Semi-annual  Craticn  on  the  Origin  of  Pestilential 
Diseases.  Delivered  before  the  Arademy  of  medicine  of  Philadelphia; 
17th  December,  1798.     8vo.     Philadelphia,  1799. 

Caldwell:  Facts  and  Observations  relative  to  the  Origin  and  Nature 
of  the  Yellow  Fever.  Medical  and  Physical  Memoirs,  etc.  8vo.  Phila- 
delphia, 1801. 

Caldwell:  Thoughts  on  Febrile  Miasms:  Intended  as  an  Answer  to 
the  Boylston  Medical  Prize  Question  for  1820,  Whether  f«ver  is  pro- 
duced by  the  decomposition  of  animal  or  vegetable  substances,  etc.? 
8vo.     Boston  Medical  and  Surgical  Journal,  vol.  3,  p.  473. 

Caldwell:  An  Address  to  the  Philadelphia  Medical  Society  on  the 
Analogies  between  Yellow  Fever  and  true  Plague.  8vo.  Philadelphia, 
1801. 


PENNSYLVANIA.  98^ 

Caldwell:  An  Essay  on  the  Pestilential  or  Yellow  Fever  as  it  pre- 
vailed in  Philadelphia  in  the  year  1S05.  8vo.  Appendix  to  Alibert. 
Philadelphia. 

Caldwell:    Escay:;  on   Malaria  and   Temperament.     Svo.     Lexington, 

isai. 

Caldwell:  An  Anniversary  Oration  on  the  subject  of  Quarantine, 
delivered  before  the  Philadelphia  Medical  Society,  on  the  21st  Janu- 
ary, 1897. 

Caldvv-ell:  Thourhts  on  Quarantine  and  other  Sanitary  Systems, 
being  an  escay  which  received  the  prize  of  the  Boylston  Medical  Com- 
mittee of  the  Plarvard  University,  August,  1834.     Boston,  1834. 

Caldwell:  A  Rei;ly  to  Br.  Kaygarth's  "Letter  to  Dr.  Percival  on 
Infectious  Fevers,"  and  his  "Address  to  the  College  of  Physicians  at 
Philadelphia  on  the  Prevention  of  the  American  Pestilence,"  etc.  Svo. 
Philadelphia,  1802. 

Caldwell:  A  Dissertation  in  answer  to  certain  Prize  Questions,  pro- 
posed by  his  Grace  the  Duke  of  Holstein  Oldenberg,  respecting  the 
Origin,  Contagion,  and  General  Philosophy  of  Yellow  Fever,  etc. 
Medical  and  Fhyjical  Memoirs.     Svo.     Lexington,  1826. 

Caldwell:   General  Physiology  of  Yellow  Fever.     1841. 

Carey  (M.):  Observations  on  Dr.  Rush's  Inquiry  into  the  Origin  of 
the  late  Epidemic  Fever  in  Philadelphia.  December,  1793.  Philadel- 
phia. 

Carey  (M.) :  A  short  Account  of  tire  Malignant  Fever  lately  pre- 
valent in  Philadelphia,  etc.     Svo.     1794. 

Cathrall:  Medical  Sketch  of  the  Syncchus  Maligna,  which  prevailed 
in  Philadelphia  In  1793.     Svo.     Philadelphia,  1794. 

College  of  Physicians  of  Philadelphia.  Proceedings  relative  to  the 
Prevention  of  the  Introduction  and  Spreading  of  Contagious  Diseases. 
Svo.     Philadelphia,  1793. 

Ibid.:  Facts  and  Observations  relative  to  the  Nature  and  Origin 
of  the  Pestilential  Fever  which  prevailed  in  this  City  in  1793,  1797, 
and  1798.     Philadelphia,  17C8. 

Ibid.:  Additional  Facts  and  Observations  relative  to  the  Nature  and 
Origin  of  the  Pestilential  Fever.     Svo.     Philadelphia,  1806. 

Cresson  (Joshua) :  Meditations,  written  during  the  prevalence  of 
the  Yellov/  Fever  in  the  city  of  Philadelphia,  in  the  year  1793.  Small 
Svo.     London,  1803. 

Currie:  A  Eketch  of  the  Rise  and  Progress  of  the  Yellow  Fever, 
and  of  the  proceedings  of  the  Beard  of  Health,  in  the  year  1799.  Svo. 
Philadelphia,  1800. 

Currie  (Wm.) :  A  Treatise  on  the  Synochus  Icterodes,  or  Yellow 
Fever,  as  it  Ic-tely  appeared  in  the  city  of  Philadelphia.  Svo.  Phila- 
delphia, 1794. 


9;^0  HISTORY     OF    YELLOW     FEVER. 

Currie:  Memoir  on  the  Yellow  Fever  which  prevailed  in  Philadel- 
phia in  the  year  1798.     8vo.     Philadelphia,  1798. 

Currie  and  Cathrall:  Facts  and  Observations  on  the  Origin,  Progress 
and  Nature  of  the  Fever  which  prevailed  in  certain  parts  of  the  city 
and  districts  of  Philadelphia  in  the  summer  and  autumn  of  1802;  to 
which  is  added  a  Summary  of  the  Rise  and  Progress  of  the  Disease 
in  Wilmington,  communicated  by  Dr.  E.  A.  Smith,  and  Dr,  J.  Vaughan. 
Svo.     Philadelphia,  1802. 

Deveze  (J.):  Recherches  et  Observations  sur  la  Maladie  Epidemique, 
qui  a  regne  a  Philadelphia  en  1793,  depuis  le  mois  d'Aout  jusque  vers 
le  milieu  de  Decembre.     Philadelphia,  1794.     French  and  English. 

Deveze  (J.) :  Dissertation  sur  la  Fievre  Jaune,  qui  regna  a  Phila- 
delphia, depuis  le  mois  d'Aout,  jusque  vers  le  milieu  du  mois  de 
Decembre,  1793.     An.  xii.     1804. 

Folwell.  Short  History  of  the  Yellow  Fever  that  broke  out  in  the 
City  of  Philadelphia  in  July,  1797.     8vo.     Philadelphia,   1797. 

Griffiths   (S.  P.):     (Copy  of  manuscript  memorandum  book  kept  by 

during  the  yellow  fever  epidemic  in  Philadelphia  in   the  year 

of  1798;   with  annotations  by  J.  K.  Mitchell).     MS.  foolscap. 

Helmuth  (J.  Henry  C.) :  A  short  Account  of  the  Yellow  Fever  in 
Philadelphia,  for  the  reflecting  Christian.  Translated  from  the  Ger- 
man, by  Charles  Erdmann.     8vo.     Philadelpliia,  1794. 

Helmuth  (J.  H.  C):  Kurze  Nachricht  von  den  sogenannten  gelben 
Fieber  in  Philadelphia  fur  den  nachdenkenden  Christian.  16°.  Phila- 
delphia, 1793. 

History  of  the  Yellow  Fever  that  \)roke  out  in  the  City  of  Phila- 
delphia in  July,  1797.     8vo.     Philadelphia,  1797. 

Jackson  (Sam.):  An  Account  cf  the  Yellow  or  Malignant  Fever 
which  appeared  in  the  city  of  Philadelphia  in  the  summer  and  autumn 
of  1820.  8vo.  Philadelphia,  1821.  Originally  published  in  the  Phila- 
delphia Medical  and  Physical  Journal,  vol.  1,  p.  313;   vol.  2,  p.  1, 

Jewell  (Wilson):  Yellow  or  Malignant  Bilious  Fever  in  the  vicinity 
of  South  Street  wharf,  Philadelphia,  1853.  Svo.  Philadelphia,  1853. 
Se  also  Transactions  of  the  College  of  Physicians  of  Philadelphia. 

Jones  (Absalom)  and  Richard  Alleno:  A  Narrative  of  the  Proceed- 
ings of  the  Black  People  during  the  late  awful  calamity  in  Philadel- 
phia in  1793.     Svo.     Philadelphia,  1794. 

La  Roche  (R.) :  Remarks  on  the  Origin  of  the  Yellow  Fever  which 
prevailed  in  Phila.  in  1853.  Transactions  of  the  College  of  Physicians, 
N.  S.,  vol.  2,  Phila. 

La  Roche  (R.):  A  Statement  of  Facts  respecting  the  mortality  oc- 
casioned by  the  Yellow  Fever  in  the  City  of  Philadelphia  during  the 
various  epidemics  from   1699  to   1620,  etc.     Charleston  Med.   Jl.,  Vol. 


PENNSYLVANIA.  991 

7,  p.  458. 

La  Roche:  Remarks  on  the  Origin  of  the  Yellow  Fever  which  pre- 
vailed in  Philadelphia  in  1853.  Transactions  of  the  College  of 
Physicians,  N.  S.,  vol.  2.     Philadelphia, 

Letter  from  the  Secretary  of  the  Commonwealth  of  Pennsylvania, 
relative  to  the  late  Malignant  Fever.     Philadelphia,  1798. 

Minutes  of  the  Proceedings  of  the  Committee  appointed  on  the  14th 
September,  1793,  by  the  Citizens  of  Philadelphia.  8vo.  Philadelphia. 
8vo.     Philadelphia,  1794.     (New  Edition  in  1848.) 

Mitchell  (T.  D.) :  Why  has  Yellow  Fever  ceased  to  visit  Philadel- 
phia as  an  Epidemic?    N.  O.  M.  &  S.  Jl.,  vol.  9,  p.  717. 

Nassy  (D.):  Observations  on  the  Causes,  Nature  and  Treatment  of 
the  Epidemic  Disorder  prevalent  in  Philadelphia.  8vo.  (French  and 
English).     Philadelphia,  1793. 

Occasional  e3say3  on  the  yellow  fever,  by  a  Philadelphian.  8°. 
Phila.,  1800. 

Parrish:  Some  Account  of  the  Appearances  on  Dissection  in 
certain  cases  cf  Yellow  Fever,  and  notices  of  some  symptoms  of  the 
disease  as  it  appeared  in  the  City  Hospital  in  the  year  1805.  Coxe's 
Medical  Museum,  vol.  3,  p.  187. 

Pascalis:  An  Account  of  the  Contagious  Epidemic  Yellow  Fever 
which  prevailed  in  Philadelphia  in  the  summer  and  autumn  of  1797. 
8vo.     Philadelphia,  1798. 

Patterson  (J):  Remarks  on  some  of  the  Opinions  of  Rr.  Rush  re- 
specting the  Yellow  Fever  which  prevailed  in  Philadelphia  in  1793. 
8vo.     Londonderry,  1795. 

Philadelpliian  (A) :  Interesting  Essays  chiefly  on  the  subject  of  the 
Yellow  Fever.     8vo.     Philadelphia,  1820. 

Philadelphia  (A.):  Occasional  Essays  on  the  Yellow  Fever.  8vo. 
Philadelphia,  1800. 

Purse  (B.  S.) :  Yellow  Fever  and  Filth.  Med.  Rec.  N.  Y.,  1878,  vol. 
14,  p.  327. 

Report  of  the  Joint  Committee  of  Councils  relating  to  the  Malignant 
or  Pestilential  Diseases  of  the  summer  and  autumn  of  1820,  in  Phila- 
delphia.    Philadelphia,  1821. 

Rush  (Benjamin) :  Letter  to  Dr.  John  Rodgers,  of  New  York,  on 
the  Fever  of  1793,  dated  October  3,  1793.  Duncan's  Medical  Comment- 
aries, vol.  19,  p.  345. 

Rush:  An  Inquiry  into  the  Origin  of  the  late  Epidemic  Fever  in 
Philadelphia.  In  a  Letter  to  Dr.  Redman,  President  of  the  College  of 
Physicians.     December,  1793. 

Rush:  Observations  upon  the  Origin  of  the  Malignant  Bilious  Fever 
in  Philadelphia,  and  upon  the  Means  of  preventing  it.  Addressed  to 
the  Citizens  of  Philadelphia,  1799. 


99:2  HISTORY  OF  yellow  fever, 

Rndi:  A  Second  Address  to  the  Citizens  of  Philadelphia,  containing 
Additional  Proofs  of  the  Domestic  Origin  of  Yellow  Fever.  8vo. 
Philadelphia,  1799. 

Rush:  An  Ancient  of  the  Bilious  Remitting  Yellow  Fever,  as  it  ap- 
peared in  the  City  of  Philadelphia  in  the  year  1793.  8vo.  Philadelphia, 
1794. 

Rush  (B.) :  Medical  Inquiries  and  Observations.  4  vols.  Phila.,  1809, 
Containing  an  Essays  on  the  Xon-Contagion  of  Yellow  Fever,  and  Ac- 
counts of  the  Epidemics  cf  Phila.  in  1793,  1794,  1797,  1798,  1799,  1802, 
1803,  and  1805,  and  of  the  Sporadic  Cases  which  occurred  in  1795,  1796, 
1800,  1801  and  1804. 

Shaw  (Wm.) :  Cn  the  Autumnal  Epidemic  Fever  which  prevailed  in 
Philadelphia  in  1803.     8vo.     Philadelphia,  1804. 

Stavely  (A.) :  A  statistical  history  of  Yellow  Fever  in  Philadelphia, 
with  a  report  of  two  cases  recently  treated  at  the  Episcopal  Hospital. 
Med.  News,  Phila.,  1891,  vol.  58,  p.  509. 

Stuart  (Jame3):  Dissection  of  a  Body  that  died  of  the  Yellow  Fever 
at  Philadelphia,  in  the  Autumn  of  1805,  with  Practical  Observations 
and  Remarks.     Medical  Museum,  vol.  2,  p.  299. 


993 

RHODE    ISLAND. 

BLOCK    Ifc^LAND. 

1801.  First  case  in  April;  first  death,  August  2;  last 
case  in  December. 

BRISTOL. 

1795;  1790;  1797.     Yellow  fever  years.     No  statistics. 

NEWPORT. 

180G.     Scattered  cases. 

PROVIDENCE. 

1791.     Infected  by  a  tramp  ship  which  had  communi- 
cated with  vessels  from  West  Indies.     No  statistics. 
1795.     Deaths,  45. 
1796;  1797;  1800.     Scattered  cases. 

1802.  Infected  by  ship  Frassana,  from  New  Orleans. 
1805.     Scattered  cases. 

WESTERLY. 

1798 ;  1808.     Scattered  cases. 

BIBLIOGRAPHY  OF  YELLOW   FEVER   IN    RHODE   ISLAND. 

Bancroft:  An  Essay  on  Yellow  Fever,  p.  401. 

Berenger-Feraud :  Fievre  Jaune,  etc.,  Paris,  1S90,  p..  81. 

Bowen  (Parden) :  Observations  on  the  Origin  and  Nature  of  the 
Yellow  Fever  which  prailed  in  Providence  (R.  I.)  in  the  summer  of 
1805,  in  a  letter  to  J.  Hardie,  Secretary  of  Board  of  Health  of  New 
York.     Med.  and  Philos.  Register,  vol.  4,  p.  331. 

Bowen  (P.):  Observations  on  the  Foreign  Origin  and  Contagious 
Nature  of  the  Yellow  Fever  as  it  prevailed  in  Providence  (R.  I..),  and 
other  parts  of  the  United  States,  in  a  letter  to  Dr.  Hosack.  Med.  and 
Philos.  Register,  vol.  4,  p.  341. 


994  HISTORY    OF     YELLOW     FEVER 

Brown  (M.) :  Brief  remarks  on  the  origin  of  yellow  fever  in  some 
parts  of  the  State  of  Rhode  Island.  Med.  Reposit.,  N.  Y.,  1800,  vol. 
3,  p.  267-270. 

N.  Y.  Med.  Repository,  1805,  p.  267. 

Snow  (E.  M.) :  History  of  yellow  fever  in  Providence,  in  years  1797, 
1800,  1803,  1805,  1820.  Reprinted  from  the  journal  of  June,  1857. 
[Newspaper  cutting  from  Providence  Journal,  Sept.  23,  1878.] 

Wheaton  (L.  J.) :  A  Brief  Account  of  the  Yellow  Fever  which  has 
appeared  at  different  times  in  Providence,  Rhode  Island,  with  a 
Topographical  Sketch  of  that  town,  and  some  Reflections  on  the  use 
of  Mercury.     Medical  Repository,  vol.  10,  p.  329. 

Willey  (A.  C.) :  A  short  account  of  the  yellow  fever  which  ap- 
peared on  Block  Island,  in  the  summer  and  autumn  of  1801.  Ibid., 
1803,  vol.  4,  p.  123. 


995 

SOUTH    CAROLINA. 

BEAUFORT. 

1817.  Infected  by  Charleston.  No  record  of  cases  and 
deaths. 

1871.     First  case,  August  6.     Deaths,  7. 

CHARLESTON. 

1693;  1699;  1700;  1703;  1728;  1732;  1731;  1739;  1745; 
1718;  1749;  1753;  1755;  1761;  1762;  1768;  1770;  1792; 
1794  ;  1795 ;  1796 ;  1797 ;  1798.  Yellow  fever  years.  No 
authentic  statistics. 

1799.  No  record  of  cases;  deaths,  239. 

1800.  No  record  of  cases;  deaths,  184. 

1801.  Scattered  cases. 

1802.  No  record  of  cases;  deaths,  96. 

1803.  Scattered  cases. 

1804.  No  record  of  cases;  deaths,  148, 

1805.  Scattered  cases. 

1807.     No  record  of  cases;  total  deaths,  162. 

1809 ;  1812.     Scattered  cases. 

1817.  First  case,  July ;  last  case,  November.  No  record 
of  cases;  total  deaths,  272. 

1819.  First  case,  August;  last  case,  October.  No 
record  of  cases;  total  deaths,  177. 

1822.  First  case,  June;  last  case,  August.  No  record 
of  cases,  total  deaths,  2. 

1824.  First  case,  August;  first  death,  August;  last 
case,  November.     No  record  of  cases;  deaths,  235. 

1825.  First  case,  August;  last  case,  September.  No 
record  of  cases;  deaths,  2. 

1827.  First  case,  August;  last  case,  November.  No 
record  of  cases;  deaths,  64. 

1828.  First  case,  August;  last  case,  September.  No 
record  of  cases;  deaths,  26. 

1830.  First  case,  September ;  last  case,  November.  No 
record  of  cases ;  deaths,  30. 


996  HISTORY     OF    YELLOW     KKVER. 

1834.  First  case,  August;  last  case,  October.  Xo 
record  of  cases;  deaths,  49. 

1835.  First  case,  August;  last  case,  September.  Xo 
record  of  cases;  deaths,  25. 

1838.  First  case,  August;  last  case,  November.  Xo 
record  of  cases;  deaths,  351. 

1839.  Infected  by  Burmah,  from  Havana.  First  case, 
June  7 ;  first  death,  June,  8 ;  last  case,  October.  Xo  record 
of  ca&es;  deaths,  131. 

1810.  First  case,  August;  last  case,  October.  Xo 
record  of  cases ;  deaths,  22. 

1813.  First  case,  Xovembor ;  last  case,  Xovember.  Xo 
record  of  cases ;  deaths,  1. 

1819.  Infected  by  ship  Xiima,  from  Havana.  First 
case,  August  6 ;  last  case,  X'ovember.  Xo  record  of  cases ; 
deaths,  125. 

1852.  First  case,  August;  last  case,  Xovember.  X"o 
record  of  cases;  deaths,  310. 

1851.  Population,  50,000.  Infected  by  Key  West. 
First  case,  May  14;  first  death,  August  IG;  last  death, 
Xovember.     Cases,  20,000;  deaths,  027. 

1856.  First  case,  August;  last  case,  X^ovember.  Xo 
record  of  cases;  deaths,  211. 

1857.  First  case,  September;  last  case,  Xovember.  X'o 
record  of  cases;  deaths,  13. 

1858.  First  case,  July;  last  case,  December;  last 
death,  December  22.     X'o  record  of  cases;  deaths,  717. 

1862.  Scattered  cases. 

1864.  First  case,  July  27 ;  no  record  of  cases  or  deaths. 

1871.  First  case,  Julv  10;  no  record  of  cases;  deaths, 
213. 

1874.  X^o  record  of  cases;  deaths,  37. 

1875.  One  fatal  case  from  Savannah. 

1876.  X^^o  record  of  cases;  deaths,  27. 
1898.  Charleston  Quarantine.     One  death. 

COLUMBIA. 

1854.     Xo  statistics. 


SOUTH    CAROLINA.  997 

FOET    MOULTRIE. 

1824.     Population,  70  soldiers.     Cases,  12;  no  deaths. 
1834.     Infected  by  Charleston.     Cases,  5;  deaths,  2. 
1852.     First  case,  September  7.     Cases,  33;  deaths,  4. 
1858.     First  case,  August  15.     Xo  record  of  cases  and 
deaths. 

GEOllGETOWN. 

1854.     First  case,  August  20 ;  last  case,  October  28.    No 
record. 

HILTON    HEAD. 

1862.     First  case,  September  8;  last  case,  October,  25. 
Xo  record. 

JAMES    ISLAND. 

1876.  No  record  of  cases ;  deaths,  2. 

MOUNT    PLEASANT. 

1817;   1848;    1852;    1854;    1856;    1857;    187(5.     Yellow 
fever  j^ears.     No  statistics. 

PORT    ROYAL. 

1877.  X"o  record  of  cases;  deaths,  25. 

SULLIVAN'S    ISLAND. 
1876.     X'o  statistics. 

BIBLIOGRAPHY  OF  YELLOW   FEVER   IN  SOUTH   CAROLINA. 

Am.  Jl.  Med.  Sciences,  vol.  32,  p.  564.     Epidemic  of  1856.) 

An  Account  of  the  Yellow  Fever  of  Charleston,  South  Carolina,  as 
it  appeared  in  the  year  1817.  Philadelphia  Medical  and  Physical 
Journal,  vol.  3,  p.  250. 

Bancroft:  Essay  on  Yellow  Fever,  pp.  352;  470. 

Byrd  (H.  L.):  Observations  on  Yellow  Fever.  Charleston  Medical 
Journal,  vol.  10.  p.  329. 


998  HISTORY     OF  YEl.I.OW    KKVER. 

Cain  (D.  J.) :  History  cf  the  Epidemic  of  Yellow  Fever  in  Charleston, 
S.  C,  in  1854.     Trans.  American  Med.  Assn.,  1856,  vol.  9,  p.  588. 

Chalmers:  An  Accoimt  of  the  Weather  and  Diseases  of  South 
Carolina.    2  vols.    8vo.   London,  1776. 

C'aisolm  (J.  J.):  A  brief  Sketch  of  the  Epidemic  of  Yellow  Fever  of 
1854  in  Charleston.  Charleston  Medical  Journal  and  Review,  vol. 
10,  p.  433. 

Currie:  Observations  on  Dr.  Tucker  Harris'  paper  on  Yellow  Fever 
of  Charleston,  Barton's  Medical  and  Phys.  Journal,  vol.  2,  p.  21. 

De  Saussure  (H.  W.) :  Statistics  of  the  cases  of  Yellow  Fever  re- 
ceived into  the  Almshouse,  Charleston,  South  Carolina,  from  1840  to 
1843.     Charleston  Medical  Journal,  vol.  2,  p.  3.     1847. 

Dickson:  Remarks  on  the  Yellow  Fever  in  Charleston,  South  Caro- 
lina, in  the  Summer  of  1828.     Eclectic  Journal,  vol.  4,  p.  109. 

Fever  (Yellow).  Epidemic  in  Charleston,  1849.  Charleston  Medical 
Journal,  vol.  4.     1849. 

Harris  (Tucker) :  Facts  and  Observations,  chiefly  relative  to  the 
Yellow  Fever,  as  it  has  appeared  at  different  times  in  Charleston, 
South  Carolina.     Barton's  Med.  and  Phys.  Journal,  vol.  2,  p.  21. 

Hayne  (A.  P.):  Notes  on  Yellow  Fever,  as  it  prevailed  in  Charles- 
ton during  the  Summer  cf  1849.  Charleston  Medical  Journal,  vol.  6, 
pp.  341,  481,  627;   vol.  7,  p.  1. 

Hewitt.     History  of  South  Carolina.     2  vols.     8vo.     London,  1779. 

Hume:  An  Inquiry  into  some  of  the  General  and  Local  Causes  to 
which  the  Endemic  Origin  of  Yellow  Fever  has  been  attributed  by 
myself  and  others.     Charleston   Medical  Journal,  vol.  9,  p.  721.     1854. 

Hume  (Wm.) :  Meteorological  and  other  Observations  in  reference 
to  the  cause  of  Yellow  Fever  in  Charleston,  etc.  Charleston  Med.  Jl , 
vol.  5,  p.  1850. 

Hume  (Wm.):  On  the  Introduction,  Propagation  and  Decline  af  the 
Yellow  Fever  in  Charleston,  during  the  summer  of  1854.  Charleston 
Med.  Jl.,  vol.  10,  p.  1855. 

Hume  (Wm.):  Report  to  the  City  Council  of  Charleston,  relative  to 
the  source  and  origin  of  Yellow  Fever,  etc.  Charleston  Med.  Jl.,  vol. 
9,  p.  145. 

Hume  (Wm.):  Sequel  to  Meteorological  and  other  Observations  in 
reference  to  the  causes  of  Yellow  Fever  in  Charleston,  brought  for- 
ward to  1852.     Charleston  Med.  Jl.,  vol.  8,  p.  55. 

Hume  (Wm.) :  The  Yellow  Fever  of  Charleston  Considered  in  its 
Relation  to  the  West  India  Commerce.  Charleston  Med.  Jl.  and  Rev., 
1860,  vol.  15,  p.  1.    Also:  Reprint. 

Johnson:  Oration  delivered  before  the  Medical  Society  of  South 
Carolina,   December   24,   1807.     8vo.    Charleston,   1807. 


SOUTH    CAROLINA.  999 

Johnson  (Joseph) :  Some  Account  of  the  Origin  and  Prevention  of 
the  Yellow  Fever  in  Charleston,  South  Carolina.  Charleston  Medical 
Journal,  vol,  4,  p.  154. 

Legare  (Thomas):  Dissertion  cu  the  late  Yellow  Fever  in  Chaiies- 
ton.    8vo.    1817. 

Mackall  (R.  C):  Introduction  of  Yellow  Fever  in  Savannah  in  the 
year  1854.     Charleston  Med.  Jl.,  vol.  10.     p.  150. 

X.  Y.  Med.  Repository,  1801,  vol.  1,  p.  217..  (Epidemics  of  1700,  1732, 
1739,  1745,  1748  and  1792,  in  Charleston.) 

N.  Y.  Med.  Repository,  1801,  vol.  4,  p.  217.  (Epidemic  of  1800  in 
Charleston.) 

Porter  (John  B.):  On  the  Climate  and  Salubrity  of  Fort  Moultrie 
and  Sullivan's  Island,  with  Incidental  Remarks  on  the  Yellow  Fever 
of  the  City  of  Charleston.  American  Journal  of  Medical  Sciences, 
July  and  October,  1854;   Ibid.,  January,  April  and  October,  1855. 

Ramsay  (David):  Facts  concerning  the  Yellow  Fever  at  it  ap- 
peared at  Charleston,  South  Carolina,  in  1800.  Medical  Repository, 
vol.  4,  p.  217. 

Ramsey:  Remarks  on  the  Fever  of  1807  at  Charleston.  Medical 
Repository,  vol.  11,  p.  233. 

Ramsay:    The  Charleston  Medical  Register  for  the  year  1802.    12mo. 

Ramsay:    The  History  of  South  Carolina,  etc.     2  vols.  8vo.    1809. 
Ramsay  (W.  G.) :    Observations  on  the  cases  of  Yellow  Fever  re- 
ceived into  the  Marine  Hospital,  Charleston,  from  July,  1834,  to  Nov. 
1838.     Charleston  Med.  JL,  vol.  2,  p.  635. 

Shecut  (J.  L.  E.  W.):  Medical  and  Philosophical  Essays,  etc.,  con- 
cerning the  Domestic  Origin  of  the  Yellow  Fever  of  Charleston,  South 
Carolina.     8vo.     Charleston,  1819. 

Simons:  A  eRport  read  before  the  City  Council  of  Charleston,  with 
an  Appendix,  in  Reply  to  the  Report  of  Wm.  Hume,  M.  D.  Charleston 
Medical  Journal,  vol.  9,  p.  329. 

Simons:  A  Report  on  the  History  and  Causes  of  the  Stranger's  on 
Yellow  Fever  of  Charleston.  Read  before  the  Board  of  Health.  8vo. 
Charleston,  1839. 

Simons:  An  Address  delivered  before  the  South  Carolina  Medical 
Association,  in  May,  1851.    8vo.    Charleston,  1851. 

Simons  (T.  Y.):  An  Essay  on  the  Yellow  Fever  as  it  has  occurred 
in  Charleston,  including  its  Origin  and  Progress  up  to  the  present 
time.     Charleston  Med.  Jl.,  vol.  6,  p.  798. 

Simons:  Observations  in  Reply  to  William  Hume,  M.  D.  Charleston 
Medical  Journal,  vol.  10,  p..  170. 

Simons:  Observations  on  the  Yellow  Fever,  as  it  occurs  in  Charles- 
ton, South  Carolina.     The  Carolina  Journal,  etc.,  vol.  1,  p.  1. 


1000  HISTORY    OF     VKM.OW     FEVER, 

Simons:  Reply  to  the  Report  of  Wm.  Hume,  M.  D.  Charleston  Med. 
Jl.,  vol.  9,  p.  329. 

Strobel:  Yellow  Fever,  etc.,  p.  171.  (Epidemic  of  1S39  in  Charles- 
ton.) 

Strobel:    Yellow  Fever,  etc.,  p.  219.    (Early  epidemics  in  Charleston.) 

"Waring:  A  Summary  of  the  Climate  and  Epidemics  of  Savannah 
during  the  series  of  years  from  1826  to  1829.  (This  is  the  Breakbone 
Fever,  which  Dr.  W.  regards  as  analogous  to  Yellow  Fever.)  North 
American  and  Surgical  Journal,  vol.  9,  p.  374;  vol.  10,  p.  136. 

Waring  (J.  J.):  The  epidemic  at  Savannah,  1876;  its  causes;  the 
measures  of  prevention  adopted  by  the  municipality  during  the  ad- 
ministration of  Hon.  J.  F.  Wheaton,  mayor.  Savannah,  Ga.,  1879. 
188  p.  4  pi.  1  may.    8°. 

Yellow  Fever  in  Charleston  in  1838.  American  Jl.  Med.  Sciences, 
1838,  vol.  45,  p.  263. 


1001 

TENNESSEE. 

BAILEY   STATION. 

1879.     Infected  by  Memphis.     No  records  of  cases  and 

deaths. 

BAKTLETT. 

1878.  First  case,  August  20;  last  case,  October  20; 
last  death,  November  8.     Cases,  74;  deaths,  0 

BEACH   GKOVE. 

1878.     One  death,  a  refugee. 

BELL'S    DEPOT. 
1878.     Cases,  5;  deaths,  3. 

BETHEL    SPRINGS. 
1878.     One  death,  a  refugee. 

BROWNSVILLE. 

1873.     Cases,  4 ;  no  deaths. 

1878.  Number  who  fled,  3,000.  Infected  bv  Memphis. 
First  case,  August  20 ;  first  death,  September  1 ;  last  case, 
October  29 ;  last  death,  November  8.     Cases,  747 :  deaths, 

212. 

BUNTYN. 

1878.  Throughout  the  epidemic  of  1878,  Buntyn  was 
crowded  with  ]\[emphis  refugees,  and  the  first  case  of  fever 
occurred  October  1st.  Among  the  last  cases  was  that  of 
Jefferson  Davis,  Jr.,  son  of  ex-President  Jefferson  Davis. 
He  died  October  Ifith. 

1879.  Infected  by  Memphis.     Cases,  15;  deaths,  3. 


lOOi  HISTORY     OK     YELLOW     FEVER. 

CHATTANOOGA. 

1878.  Numbei-  wlio  tied,  (),000.  First  case,  August  15 ; 
first  death,  Aui-iist  21 ;  last  death,  November  10.  Cases, 
44G;  deaths,  135. 

COLLIERSVILLE. 

1878.  Number  who  fled,  100.  Infected  by  :N[emphis. 
First  death,  August  21.     Cases,  135;  deaths,  5C. 

COVINGTON. 

1878.  Population,  1,200.  Almost  entire  pojjulation 
fled.     No  record  of  cases;  deaths,  1. 

EIUN. 

1878.  Population,  723.     Cases,  38;  deaths,  10. 

FOl^EST   HILL. 

1879.  No  statistics. 

FRAYSER    STATION. 

1878.     No  statistics. 

GADSDEN. 

1878.     Population,  530.     Cases,  (5;  deaths,  4. 

GALWAY. 

1878.     Population,  00.     Cases,  13;  deaths,  8. 

GERMANTOWN. 

1878.  iTifectod  b^-  :\remphis.  First  case,  August  20. 
Cases,  89 ;  deaths,  35. 


TENNESSEK.  lOOS 

GILL'S    STATION. 

1878.  No  records  of  cases;  deaths,  1. 

GIJAND   JUNCTION. 

1873.     Cases,  1;  deaths,  0. 

1878.  Number  who  tied,  100.  First  case,  August  11; 
first  death,  August  17.     Cases,  185;  deaths,  71. 

HARKISON    STATION. 

1879.  PopuhUiou,  100.  Infected  by  Memphis.  Ca^es, 
12. 

HERNANDO    ROAD. 

1879.     Infected  b}^  Memphis.     Cases,  4. 

HORN    LAKE. 

1879.  First  case,  September  11 ;  first  death,  September 
14;  last  case,  September  — ;  last  death,  September  18. 
Cases,  3;  deaths,  1. 

HORN   LAKE   ROAD. 

1879.  First  case,  August  20;  first  death,  August  25. 
Cases,  13;  deaths,  5. 

HU:Mr>OLDT. 
1873.     Infected  bv  Mempliis.     Cases,  3;  deaths,  0. 

HUNTINGTON. 

1873.     No  record  of  cases;  deaths,  1. 

JACKSON. 

1878.     No  record  of  cases ;  deaths,  3. 

KNOXVILLE. 

1878.  Cases  among  refugees,  principally  from  Chat- 
tanooga. 


loot  HISTORY     OF     YELLOW     P'KVER. 

LA    GRANGE. 

1878.  First  case,  September  3;  first  death,  September 
G.     Cases,  128;  deaths,  37. 

MAKTIN. 

1878.  Number  who  fled,  250;  first  case,  August  28. 
No  record  of  cases;  deaths,  40. 

MASON. 

1878.  First  case,  August  29 ;  first  death,  September  2. 
Cases,  61;  deaths,  21. 

McCALLUM   FARM. 

1879.  No  statistics. 

McKENZIE. 
1878.     No  record  of  cases;  deaths,  3. 

ME:MPnis. 

1828 :  1853 ;  1855 ;  1860.     No  statistics. 

■.1867.     No  record  of  cases;  deaths,  231. 

1873.  Infected  by  Cochran,  Alabama.  First  case, 
September  14;  last  case,  November.  Cases,  10,000; 
deaths,  2,000. 

1878.  Number  who  fled,  30,000.  Infected  by  New 
Orleans.  First  case,  August  6;  last  case,  December  12. 
Cases,  18,500 ;  deaths,  5,000. 

1879.  Population,  40,000.  Numbei'  who  fled,  23,890. 
First  case.  May  23;  first  death.  May  26.  Cases,  2,010; 
deaths,  587. 

1897.     Cases,  52;  deaths,  14. 


TENNESSEE.  1005 

MILAN. 


1878.     Number  who  fled,  1,800.     Infected  by  Memphis. 
First  case,  August  26;  first  death,  August  29.Cases,  19; 


deaths,  12. 


MOSCOW. 


1878.  Number  who  fled,  70.  Infected  by  Memphis. 
First  case,  August  21.     Cases,  109;  deaths,  35, 

MUKFKEESBORO. 

1878.     No  record  of  cases ;  deaths,  2. 

NASHVILLE. 

1878.  Infected  by  Memphis.  First  case,  August  3L 
Cases,  27 ;  deaths,  13. 

NUBIA. 

1878.     Cases,  2 ;  deaths,  2. 

PAHIS   AND    SUBURBS. 

1878.  Nearly  the  whole  population  fled.  Infected  by 
Memphis.  First  case,  August  23;  last  case.  October  4. 
Cases,  35;  deaths,  23. 

PIGEON   ROOST    ROAD. 

1879.  No  record. 

RALEIGH. 

1878.     No  record  of  cases;  deaths,  14. 

ROSSVILLE. 
1878.     No  record  of  cases ;  deaths,  6. 


1006  HISTORY    OF    \ELLO\V     KF.VER. 

SHELBY    DEPOT. 

1873.     No  record  of  cases ;  deaths,  3. 

SHELBYVILLE. 

1879.     lufected    by    Memphis.       Xo    record    of    cases; 
deaths,  1. 

SOMEBVILLE. 

1878.  yuml)er  who  fled,  (I.jO.     Infected  \>\  Memphis. 
Cases,  167;  deaths,  57. 

TULLAHOMA. 

1879.  One  fatal  case  in  August,  from  ShelbTville. 

UXIOX   CITY. 

1878.  Xo  record  of  cases;  deaths,  1. 

VICE-PEESIDEXT'8    ISLAXD. 

1879.  InfiM-ted  liv   Minipliis.       First    and    only    case, 
October  8;  died  October  13. 

WHITE    HAVEX. 

1878.     Population,  100.     Cases,  1;  deaths,  2. 

WHITE    STATIOX. 

1878.  Infected  by  Memphis.       First  case,  Auj;ust  25; 
first  death,  Auijust  28.     Cases,  05;  deaths,  50. 

1879.  Infected  bj  Memphis.       First  case,  October  6. 
Cases,  1;  deaths,  0. 

WTLLTSTOX. 
1878.     Cases,  18;  deaths,  11. 


TENNRSSEE.  1007 

WINCHESTEE. 

187S.     Cases,  1;  deaths,  1. 

WYTHE. 

1873.     Infected  by  ]Mempliis.     Cases,  G ;  deaths,  0. 
1878.     Xo  record  of  cases;  deaths,  1. 

BIBLIOGRAPHY   OF  YELLOW    FEVER    IN   TENNESSEE. 

Am.  Jl.  Med.  Sciences,  1856,  p.  624.    (Memphis,  1828.) 

Baxter  (G.  A.):  Atmospheric  dissemination  of  yellow  fever,  with 
methods  of  disenfections  used  at  Chattanooga,  and  the  results.  Tr. 
M.  Soc.  Tenn.,  1879,  vol.  46,  p.  158. 

Bougarel  (C):  La  Fievre  Jaune  a  Memphis.  France  Medicale, 
Paris~,  1879,  vol.  26,  pp.   533,  573  and  589. 

Cochran  (J.  F.):  Observations  on  yellow  fever  in  Bartlett,  Tenn. 
Richmond  and  Louisville  M.  J.,  Louisville,  1879,  vol.  27,  p.  1. 

Dake  (J.  P.) :  The  yellow  fever  of  Memphis.  (From,  Nashville 
Daily  American).    Med.  Counselor,  Chic,  1879-80,  vol.  2,  p.  16. 

Dowell,  p.  32.    (Memphis,  1873). 

Ernskine  (J.  H.):  A  Report  on  Yellow  Fever  as  it  Appeared  in 
Memphis,  Tenn.,  in  1873.  Reports  American  Public  Health  Assn., 
1873,  vol.  1,  p.  386. 

Hamilton  (F.  B):  Quarantine  in  Jackson,  Tenn.  Nashville  J.  M. 
&  S.,  1879,  n.  s.,  vol.  23,  p.  53. 

Keating  (J.  M.) :  A  history  of  the  yellow  fever.  The  yellow  fever 
epidemic  of  1878,  in  Memphis,  Tenn.,  embracing  a  complete  list  of  the 
dead,  the  names  of  the  doctors  and  nurses  employed,  names  of  all 
who  contributed  money  or  means,  and  the  names  and  history  of  the 
Howards,  together  with  the  other  data  and  lists  of  the  dead  elsewhere. 
Memphis.  1879.    454  p.  roy.  8°. 

Le  Monnier  (Y.  R.):  Epidemic  of  Memphis  in  1873.  N.  O.  Med.  & 
Surg.  .Jl.,  vol.  1,  n.  s.,  1873-4,  pp.  449,  536,  656. 

Letter  from  Memphis.    Boston  Med.  &  Surg.  JL,  vol.  101,  p.  388. 

Merrill  (A.  P.):  On  the  Health  and  Mortality  of  Memphis,  Tennes- 
see.    A.  Public  Address,  etc.    8vo.    Memphis,  1853. 

Saunders  (D.  D.):  Observations  on  the  five  yellow  fever  epidemics 
occurring  in  the  city  of  Memphis.  Tennessee.  Tr.  M.  Soc.  Tennessee, 
Nashville,  1882,  p..  62. 

Saunders  (D.  D.) :  Epidemic  of  Memphis  in  1873.  N.  O.  Med.  & 
Surg.  Jl.,  1873-4,  vol.  1,  n.  s.,  p.  791. 


1008 


HISTORY    OF    YELLOW    FKVKR. 


Smith  (George  and  Tuck  (W.  J.):  Letters  on  the  Yellow  Fever  at 
Memphis,  Tennessee,  in  1853.  New  Orleans  Medical  Journal,  vol.  10, 
p.  662. 

Smith  (G.)  and  Tuck  (W.  J.) :  Letters  on  the  Yellow  Fever  of  Mem- 
phis, Tenn.,  in  1853.     N.  O.  Med.  Jl.,  vol.  10,  p.  662. 

Thorton  (G.  B.) :  The  Memphis  yellow  fever  epidemic  of  1879. 
Boston  Med.  and  Surg.  JL,  1879,  vol.  101,  p.  787. 

Vanderman  (J.  H.):  Yellow  fever  in  Chattanooga  in  1878.  Nash- 
ville J.  M.  &  S.,  1879,  n.  s.,  vol.  24,  p.  47. 

Wight  (E.  M.) :  Yellow  fever  at  Chattanooga  in  1878;  topographic, 
telluric,  atmospheric  and  other  influences.  Tr.  M.  Soc,  Tenn.,  1879, 
vol.  46,  p.  161. 


1009 

TEXAS. 

ALLEYTON. 

1867.  First  ease,  September  4;  last  case,  December. 
]No  record  of  cases;  deaths,  45. 

ANDEKSON. 

1867.     No  record. 

AUSTIN. 

1867.     No  record. 

BASTROP. 

1867.     No  record. 

BEAUMONT. 

1863.     No  record. 

1897.     Cases,  1;  deaths,  0. 

BELLEVILLE. 

1855.     No  record  of  cases;  deaths,  L 

BRAZOBIA. 

1859.     No  record. 

BROWNSVILLE. 

1853.  First  case,  September  23;  last  case,  December 
23.     No  record  of  cases ;  deaths,  50. 

1862.     No  record. 

1879.     No  record. 

1882.  Population,  4,500.  First  case,  June  24:  first 
death,  —;  last  case,  November  10;  last  death,  November  6. 
Cases,  1,072 ;  deaths,  63. 


1010  HISTORY    OF    YELLOW    FEVER. 

BRENHAM. 

18G7.  First  case,  August  11;  last  case,  October  31. 
No  record  of  cases;  deaths,  120. 

CALVERT. 

1SG7.  First  case,  October  12;  last  case,  January  10, 
1868.     No  record  ol"  cases  or  deaths. 

1873.  Population,  1,500.  Number  who  fled,  900.  In- 
fected by  Shreveport,  La.  First  case,  September  5;  first 
death,  September  10;  last  death,  December  29.  Cases, 
450;  deaths,  125. 

CAMEL. 

1903.     Cases,  28;  deaths,  1. 

CINCINNATI. 

1853.     No  record. 

CHAPEL    HILL. 

1807.  First  case,  August  8 ;  last  case,  December.  No 
record  of  cases;  deaths,  123. 

COLUMBIA. 

1833 ;  1873 ;  1903.     No  statistics. 

CORPUS    CHRTSTI. 

1853.  No  record. 

1854.  Population,  1,000.  Infected  by  New  Orleans. 
No  record  of  cases;  deaths,  30. 

1862.     No  record. 

1867.     Infected  by  Indianola,  Texas.     First  case,  Au- 
gust.    No  record  of  cases  or  deaths. 
1873.     No  record. 


TEXAS.  I  0  I  1 

1882.  (Eefuge  Camp).  First  case,  August  23;  first 
death,  August  25;  last  ease,  August  23;  last  deatb,  August 
25.     Cases,  4;  deaths,  2. 

1903.     No  record. 

CORSICANA. 

1873.     No  record. 

CASTEOVILLE. 

1903.     Cases,  1. 

CYPRESS  BAY. 

1853;  1859.     No  statistics. 

DANVILLE. 

1867.     No  record. 

DE    WITT    COUNTY. 

1903.     Cases,  5;  deaths,  1. 

EDINBURG. 
1859.     First  case,  July.     No  record  of  cases ;  deaths,  13. 

GALVESTON. 

1839.  Population,  1,000.  First  case,  September  30; 
last  case,  October  11.     No  record  of  cases;  deaths,  250. 

1844.  Population,  G,000.  First  case,  July  5.  No 
No  record  of  cases;  deaths,  400. 

1847.  Population,  0,000.  First  case,  October  1;  last 
case,  November  25.     No  record  of  cases;  deaths,  200. 

1853.  Population,  8,000.  First  case,  August  30;  last 
case,  November  28.     No  record  of  cases;  deaths,  536. 

1854.  First  case,  August  9 ;  last  case,  November  5.  No 
record  of  cases ;  deaths,  404. 


1012  HISTORY    OK    YELLOW    FKVER. 

1858.  Population,  10,000.  First  case,  August  27 ;  last 
case,  iNovember  14.     JS'o  record  of  cases;  deaths,  873. 

1850.  Population,  10,000.  First  case,  (September  17; 
last  case,  iS'ovember  30.     No  record  of  cases;  deaths,  183. 

1864.  Population,  5,000.  First  case,  {September  1; 
last  case,  Kovember  20.     Xo  record  of  cases ;  deaths,  259. 

1866.  Population,  12,000.  No  record  of  cases; 
deaths,  3. 

1867.  Population,  22,000.  First  case,  June  26;  last 
case,  November.     No  record  of  cases;  deaths,  1,150. 

1870.  Population,  22,500.  No  record  of  cases ;  deaths, 
16. 

1873.  Population,  25,000.  No  record  of  cases; 
deaths,  7. 

1882.  No  statistics. 

1894.  No  record.     On  vessel  in  harbor. 

1895.  No  record.  On  vessel  in  harbor. 
1897.  Cases,  12;  deaths,  0.  On  vessel, 
1905.  One  case,  on  vessel  in  harbor. 

GOLIAD. 

1867.  First  case,  July  12.  No  record  of  cases; 
deaths,  23. 

HARRISBURG   JUNCTION. 

1867.     No  record. 

HEMPSTEAD. 

1867.  First  case,  Auniist  0:  last  case,  November  25. 
No  record  of  cases;  deaths,  151. 

HOCKLEY. 

1853.     No  record. 

HONDO. 

1903.  One  case,  a  refugee. 


TEXAS.  1013 

HOUSTON. 

1839  ;  1844 ;  1847 ;  1848.     No  statistics. 
1853.     Population,  7,000.     First  case,  August  28;  first 
death,  September  4.     No  record  of  cases  and  deaths. 

1854;  1858;  1859;  18(54.     No  statistics. 
1870.     No  record  of  cases ;  deaths,  1. 
1897.     Cases,  3;  deaths,  0.     Refugees. 

HUNTSVILLE. 

1868.     First  case,  August  9 ;  hist  case,  October  19.     No 
record  of  cases;  deaths,  130. 

INDEPENDENCE. 

1867.     No  record. 

INDIANOLA. 

1852.  No  record. 

1853.  PopuLation,  1,000.       Infected  by  New  Orleans. 
First  case,  August.  30.     No  record  of  cases;  deaths,  106. 

1858 ;  1859 ;  1862.     No  statistics. 

1867.     Infected   by   ship   Margarita  from   Vera    Cruz. 
First  case,  June  20.     No  record  of  cases ;  deaths,  80. 

LA    GRANGE. 

1867.     First  case,  August ;  last  ca»*^e,  December.       No 
record  of  cases;  deaths,  200. 

LAREDO. 

1903.  Cases,  1.008;  deaths,  107. 

1904.  Cases,  10. 

LIBERTY. 

1867.     No  record. 


1014  HISTORY    OF    YELLOW    FEVER. 

LIVEKPOOL. 

1853.     First    case,     August.       Xo    record     of     cnscs; 
deaths,  4. 

LYNCHBUEG. 

1853.     Scattered  cases.     Xo  statistics. 

MATAGORDA. 

1862.     X'o  record  of  cases;  deaths,  120. 
1803.     X"o  record. 

MILLICAN. 

1864.     X^o  record. 

1867.     First  case,  October  15;  last  case,  X'ovemher  12. 
No  record  of  cases;  deaths,  4. 

MIXERA. 
1903.     Cases,  137;  deaths,  16. 

XAVA80TA. 
1867.     First  case,  August  12 ;  last  case,  December.     Xo 
record  of  cases;  deatlis,  154. 

OLDTOWX. 

1867.     Xo  record. 

PALARYAXA. 

1882.     Infected   by   Point   Isabel,   Texas.      Cases,   18; 
deaths,  2. 

POIXT  ISABEL. 

1853.     Xo  record. 

1882.     First  case,  August  29.     Cases,  208. 

PORT  LAVACA. 
1867.     First  case,  July  3;  last  case,  October  29.     Xo 
record  of  cases  or  deaths. 


TEXAS.  1015 

KICHMOND. 
1853;  1859.     No  record. 

RIO    GRANDE    CITY. 

1867.     Xo  record. 

SABINE   CITY. 

1853.  Population,  200.  First  case,  July;  last  case, 
October  1.     No  record  of  cases ;  deaths,  11. 

1863.  First  case,  July;  last  case,  October  1.  No 
record  of  cases;  deaths,  14. 

SALINA. 
1853.     No  record. 

SALUVIA. 
1853.     No  record. 

SAN  ANTONIO. 
1903.     Cases,  43;  deaths,  16. 

SAN  JACINTO. 
(See  Lynchburg). 

SANTA    MARIA. 

1882.  First  case,  October  24;  first  death,  October  29. 
Cases,  3;  deaths,  0. 

SUGARLAND. 

1859.     No  record. 

VELASCO. 

1853.     Infected  by  New  Orleans.     No  record. 

VICTORIA. 

1867.  First  case,  Anjjust  1 ;  last  case,  December  25. 
No  record  of  cases;  deaths,  200. 


1016  HISTORY     OK     VEI.I.OW     FEVER. 

BIBLIOGRAPHY  OF  YELLOW   FEVER   IN   TEXAS. 

Bowers  (J.  M.):  The  yellow  fever  epidemic  at  Columbus,  Tex., 
October,  1873.  Letter  to  Dr.  C.  O.  Weller.  Texas  Med.  Jl.,  Austin, 
1903,  p.  164,  vol.  19. 

Dinwiddie  (R.  L.) :  Yellow  fever;  the  Laredo  epidemic.  Tr.  Texas 
M.  Assn.,  Austin,  1904,  vol.  36,  p.  140. 

Goldberger:  Transactions  on  account  of  the  yellow  fever  at  Laredo, 
Tex.  Pub.  Health  Rep.  U.  S.  Mar.  Hosp.  Serv.,  Wash.,  1904,  vol.  19, 
p.  962. 

Guiteras  (G.  M.):  Report  on  the  epidemic  of  yellow  fever  of  1903, 
at  Laredo,  Minera,  and  Cannel,  Texas.  Rep.  Surg.-Gen.  Pub.  Health 
&  Mar.  Hosp.  Serv.,  U.  S.    Wash.,  1904,  p.  303. 

Guiteras  (G.  M.) :  The  yellow  fever  epidemic  of  1903  at  Laredo,  Tex. 
J.  Am.  M.  Assn.,  Chicago,  1904,  vol.  43,  p.  115. 

Harrison  (R.  H.) :  Yellow  Fever  Reports.  Texas  Med.  News,  Austin, 
1896-7,  vol.  6,  p.  490. 

Heard  (T.  J.) :  On  the  Topography,  Diseases  and  Climate  of  Wash- 
ington, Texas.     Trans  Amer.  Med.  Assn.,  1856,  vol.  9,  p.  690. 

McCraven  (W.):  On  the  Yellow  Fever  of  Houston,  Tex.,  in  1847. 
N.O.  Med.  and  Surg.  Jl.,  vol.  5,  1848-9,  p.  227. 

Parker  (D.) :  Facts  and  Conclusions  in  Regard  to  the  Calvert 
Epidemic  of  1873.     Trans.  Tex.  Med.  Assn.,  1878,  vol.  10,  p.  164. 

Purnell  (J,  H.):  Report  of  conditions  existing  in  San  Antonio,  Tex., 
and  vicinity  with  relation  to  preventing  spread  of  yellow  fever.  Pub. 
Health  Rep.  U.  S.  Mar.  Hosp.  Serv..  Wash.,  1903,  vol.  17,  p.  1768. 

Purnell  (J.  H.) :  Transactions  on  account  of  yellow  fever  at  Laredo, 
Tex.  Pub.  Health  Rep.  U.  S.  Mar.  Hosp.  Serv.,  Wash.,  1904.  vol.  19, 
p.  715. 

Reuss  (J.  M.) :  An  outbreak  of  yellow  in  DeWitt  County.  Tr.  Texas 
M.  Assn.,  Austin,  1904,  vol.  36,  p.  135. 

Richardson  (T.  F.):  Yellow  Fever  in  DeWitt  Co.  (Texas).  U.  S. 
Public  Health  Reports,  1903,  vol.  17,  p.  1925. 

Smith:  An  Account  of  the  Yellow  Fever  which  appeared  in  the 
City  of  Galveston,  Republic  of  Texas,  in  the  Autumn  of  1838,  with 
Cases  and  Dissections.     12mo.     Galveston,  1839. 

Smith  (A.) :  Med.  Topography  of  the  City  of  Galveston,  Tex.,  with 
an  Account  of  the  Symptoms  and  Pathology  of  the  Yellow  Fever  which 
prevailed  in  that  City  in  the  Autumn  of  1839.  Amer.  Jl.  of  Med. 
Scien.,  vol.  25,  p.  499. 

Smith  (Ashbel).  Yellow  Fever  of  Houston,  Texas,  in  1853.  See 
Fenner's  Report,  vol.  7,  of  the  Transactions  of  the  American  Medical 
Association,  p.  530. 


TEXAS.  1017 

Fenner  (E.  D.) :  On  the  Yellow  Fever  of  Norfolk  and  Portsmouth. 
Va.    Trans.  American  Med.  Assn.,  1856,  vol.  9,  p.  711. 

Hazen  (C.  M.):  Yellow  fever  in  Virginia.  Med.  Reg.  Richmond, 
1899-1900,  vol.  3,  p.  137. 

Koiner  (A.  Z.) :  The  case  of  (transported)  yellow  fever  in  Rich- 
mond.   Virginia  M.  Month.,  Richmond,  1878,  vol.  5,  p.  668. 

Mitchell:  Additional  Observations  on  the  Yellow  Fever  of  Virginia, 
addressed  to  Dr.  Franklin.  American  Medical  and  Philosophical 
Register,  vol.  4,  p.  383. 

Mitchell  John) :  Letter  to  Governor  Golden,  containing  an  Account 
of  the  Yellow  Fever  as  it  appeared  in  Virginia  in  1737,  1741,  1742. 
Medical  Museum,  vol.  1,  p.  1.  See  also  Medical  and  Philosophical 
Register  of  New  York,  vol.  4,  p..  181. 

Tabor  (G.  R.):  The  1903  epidemic  of  yellow  fever  in  Texas,  and  the 
lesson  to  be  learned  from  it.  Austin,  1905,  22p.  8°.  Forms  No.  64,  of 
Bull.  Univ.  Tex.  Med.    Series  No.  3. 

Thayer  (A.  E.) :  Study  of  a  case  of  yellow  fever.  (Galveston,  1905.) 
Med.  Rec,  N.  Y.,  1907,  vol.  71,  p.  45. 

Wassam  (A.  M.):  The  recent  yellow  fever  scare  in  Southwest 
Texas.     Southern  Clinic,  Richmond,  1898,  vol.  21,  p..  33. 

West  (H.  A.):  Yellow  Fever  in  Galveston.  Phila.  Med.  Jl.,  1898, 
vol.  1,  p.  685. 


1018 

VIRGINIA. 

ABINGDON. 

187S.  First  and  only  case  was  Judge  L.  V.  Dixon,  a 
refugee  from  Memphis,  who  died  September  17. 

ALEXANDRIA. 

179G.     No  statistics. 

BELLONA    ARSENAL. 

1S29.     No  record  of  cases ;  deaths,  1. 

BOWER'S   HILL. 

1855.  Infected  by  steamer  Ben  Franlcliii  from  St. 
Thomas,  West  Indies.  First  case,  Julv;  first  death,  Au- 
gust; last  case,  July;  last  death,  — .     Cases,  2;  deaths,  2. 

CAPE  CHARLES  QI\\RANTINE. 

1893.  Cases,  3. 

1894.  No  record  of  cases;  deaths,  2. 

1897.  No  record. 

1898.  Cases,  2;  deaths,  1. 

CAPE   HENRY. 
1894.     Cases,  3. 

CITY    POINT. 

1798.     No  record. 

FORTRESS    :\rONROE. 

1888.  Infected  by  Spanish  bark,  Bucuavriifiira,  from 
Havnnn.  One  case,  Octoher  26,  terminating  in  death  on 
the  27th. 


VIRGINIA.  1019 

GOSPORT. 
1855.     No  record. 

HAMPTON  ROADS. 

1809.     Xo  record. 

1883.     Infected  bv  vessels.  No  record  of  cases  or  deaths. 

1899.  At  National  Soldiers'  Home.  Source  of  infec- 
tion undetermined,  but  ''an  old  soldier/'  who  had  recently 
arrived  from  Santiago  de  Cuba  and  was  taken  ill  at  the 
Home,  thought  to  have  been  original  focus.  First  case 
died  July  28.  Depopulation  resorted  to  by  U.  S.  Marine 
Hospital  authorities,  with  such  good  results,  that  out  of 
the  3,500  inmates  of  the  Home,  only  45  contracted  the 
fever,     ^lortality  13.     Last  death,  August  7. 

Only  one  case  occurred  outside  of  the  above  limits,  name- 
ly, in  the  town  of  Phoebus,  directly  "across  the  creek"  from 
Hampton,  the  source  of  infection  being  plainly  traced  to 
the  Home, 

NORFOLK. 

1737;  1711;  1742;  1747;  1789;  1794;  1795;  1796;  1797; 
1798 ;  1799  ;  1800  ;  1801 ;  1802 ;  1803 ;  1804 ;  1805.  Yellow 
fever  years.     No  statistics. 

1821.  First  case,  August  1.  No  record  of  cases  or 
deaths. 

1825;  1826.     No  statistics. 

1848.     Infected  by  Vandalia.     Cases,  2;  deaths,  0. 

1852.     Cases,  3 ;  deaths,  3. 

1854.  No  statistics. 

1855.  First  case,  June  30;  last  case,  October.  No 
record  of  cases;  deaths,  1,807.  Infected  by  Bcii  Fraiil-Uii, 
St.  Thomas,  West  Indies. 

1878.     No  record  of  cases;  deaths,   1. 

PETERSBURG. 
1798.     No  statistics. 


10^0  HISTORY    OF    YELLOW    FEVKR. 

PHOEBUS. 

1899.     Cases,  1 ;  deaths,  0. 

PORTSMOUTH. 

1834.  One  death. 

1852.  Cases,  4;  deaths,  4. 

1854.  Infected  by  French  ship,  Chimcre,  from  T\'est 
Indies,  Cases,  7;  deaths,  2. 

1855.  Infected  br  Norfolk.     No  complete  statistics. 

RICHMOND. 

1806.     No  statistics. 
1878.     One  case,  a  refugee. 

SCOTT'S    CREEK. 

1855.     No  statistics. 

WINCHESTER. 

1802;  1803.     Scattered  cases.     No  statistics. 
1804.     First  case  in  July.       No  record  of  cases  and 
deaths. 

1871.     One  fatal  case. 

BIBLIOGRAPHY   OF  YELLOW    FEVER    IN    VIRGINIA. 

Acher  (Robert):  History  of  the  Yellow  Fever,  as  it  appeared  at 
Norfolk  during  the  summer  and  autumn  of  1821.  Medical  Recorder, 
vol.  5,  p.  60. 

Armstrong  (G.  D.) :  The  summer  of  the  pestilence.  A  history  of 
the  ravages  of  the  yellow  fever  in  Norfolk,  Va.,  A.  D.  1855.  12°. 
Phila..  1856. 

Colden:  Observations  on  the  Yellow  Fever  of  Virginia,  with  some 
Remarks  on  Dr.  J.  Mitchell's  account  of  the  Disease.  In  a  Letter  to 
Dr.  J.  Mitchell,  of  Virginia.  Medical  and  Philosophical  Register,  vol. 
4,  p.  378. 

Donaldson  (F.) :  Yellow  Fever  at  Hampton,  Va.  Medical  News, 
1899,  vol.  75,  p.  240. 


VIRGINIA.  1021 

Ramsay  (W.  G.,  of  Norfolk,  Va.):  Letter  to  Dr.  Mitchell  concerning 
the  Pestilential  Sickness  in  Norfolk  in  the  summer  and  autumn  of 
1795.    Webster's  Collection,  p.  154. 

Report  of  the  origin  of  the  yellow  fever  in  Norfolk  during  the 
summer  of  1855.  Made  to  city  council  by  a  committee  of  physicians. 
8°.   Richmond,  1857. 

Selden  and  Whitehead:  On  the  Yellow  Fever  at  Norfolk,  Virginia, 
in  the  Summer  and  Autumn  of  1800.  Medical  Repository,  vol.  4,  p. 
320;  Ibid.,  vol.  6,  p.  247. 

Stephenson  (F.  B.) :  Yellow  fever  at  Norfolk,  and  Portsmouth,  Va , 
in  1855.     Proc.  Nav.  Med.  Sec,  Wash.,  1882-3,  vol.  1,  p.  84. 

Storrs  (R.  S.,  Jr.):  Terrors  of  the  pestilence;  a  sermon,  preached 
in  the  church  of  the  Pilgrims,  Brooklyn,  N.  Y.,  on  occasion  of  a  col- 
lection in  aid  of  the  sufferers  at  Norfolk,  Va.,  September  30,  1855.  8°. 
New  York,  1855. 

Yellow  fever  in  the  National  Soldiers  Home,  near  Hampton,  Va. 
Pub..^  Health  eRp.  U.  S.  Mar.  Hosp.  Serv.,  Wash.,  1899,  vol.  14,  pp. 
1253,  1309,  1359. 


1022 

VERMONT. 

GKAKD    ISLE. 

1789.  Condie  and  Folwell  (p.  98),  state  that  yellow 
fever  caused  "considerable  mortality  in  Grand  Isle  in 
1798."     Source  of  infection  not  stated. 

EOYALTON. 

1798.  Epidemic  (Condie  and  Fohvell,  loc.  cit.)  Xo 
statistics. 

WINDSOR. 

1798.  The  same  authorities  state  "a  similar  fever"  pre- 
vailed at  Windsor  in  1798.     No  statistics. 

BIBLIOGRAPHY   OF  YELLOW   FEVER   IN   VERMONT. 

Condie  and  Folwell:  History  of  the  Pestilence  commonly  called 
Yellow  Fever,  which  almost  desolated  Philadelphia  in  the  months  of 
August,  September  and  October,  1798.  Philadelphia  (no  date),  pp. 
97,  98. 


1023 

WASHINGTON. 

PORT    TOWNSEND    QUARANTINE. 

1S97;    1902.     Infected   vessels   from    South   American 
ports.     No  cases  erupted  at  Quarantine  or  in  the  city. 

BIBLIOGRAPHY  OF  YELLOW   FEVER    IN   WASHINGTON. 

U.  S.  Public  Health  Reports,  1897,  p.  1041. 
Ibid.,  1902,  p.  2539. 


1024 

WEST    VIRGINIA 

AVHEELIXG. 

1878.     One  ease,  a  refugee. 


PART    IV. 


YELL.OW   FEVER 


EPIDEMIC 


OF 


1905. 


I 


EXPERIENCES    DUKINd    THE    YELLOW    FEVER 
EPIDEMIC    OF    1905. 

By  Henry  Dickson  Bkuns,  ^L  D.,  XE^v  Orleans,  La. 

As  "all  experience  is  au  areli  where  tliro'  i>leaiiis  the 
imtraveird   world,"   and  as  no  faithful   account  of  any 
portion  of  a  j^reat  event  by  an  eyewitness  can  be  wholly 
useless  or  uninteresting",  I  have  decided  to  offer  you  these 
notes  of  my  experience  during  the  epidemic  of  1905 — the 
more  as  I  was  engaged  not  as  a  practitioner,  l)ut  as  a 
volunteer  sanitary  lab()rer,  l)ut  seeing  and  acting  always 
from  the  viewpoint  of  the  medical  man.     You  all  know 
how  the  summer  of  1905  wore  uneventfully  along,  until 
the  latter  part  of  July,  when  a  sudden  "slump"  in  stocks 
set  all  male  gossips  agog  seeking  an  explanation.     You 
recall  how,  in  casting  about  to  finance  the  immediately 
necessary   sanitary   work,    our   health   officers    called  to- 
gether the  representatives  of  the  associated  banks  and 
made  known  to  them  the  secret,  and  how,  like  all  secrets 
communicated  to  more  than  one  person,  it  soon  became 
the  common  property  of  the  town.     On  July  the  21st  the 
news  reached  my  ears ;  on  Thursday,  the  25th,  it  was  un- 
obtrusively i)ublislicd  in  the  newspapers.     That  night  I 
received  a  note  asking  nu'  to  meet  certain  neighbors  on 
the  evening  of  the  2Cth  in  the  basement  of  Trinity  Church. 
Those  invited  all  lived  in  the  middle  portion  of  the  Tenth 
Ward,  and  the  me(4ing,  it  was  w(^ll  understood,  was  to 
devise  means  to  place  our  immediate  surroundings  in  the 
best  possible  sanitarj-^  condition  with  the  least  possible 
waste  of  time.     The  Tenth  Ward  (tf  New  Orleans,  you 
must  know,  runs  from  the  river  to  the  swam]),  and  from 
Felicity  to  First  Streets.  ^leetings  of  citizens  had  already 
been  called  and  volunteer  work  had  already  liegun  in  sev- 
eral of  the  other  wards. 

]\eporting  at  the  designated  time  and  i)lace,  I  found 
present  the  Rev.  Beverley  Warner,  the  signer  of  the  call ; 
Dr.  Joseph  Holt,  ^Messrs,  Hunt  and  William  Henderson, 


1028  angustin's   history  of  yellow  fever. 

]\rr,  Hewes  Gnrlev,  ^Ir.  George  Leverieh,  Capt.  Robert 
Perriu,  Messrs.  Charles  and  Arthur  Palfrey-,  Capt.  I.  L. 
Lyons,  Mr.  Eobert  B.  Parker,  Dr.  G.  King  Logan,  Mr. 
Harrj  Charles,  Mr.  George  Allaiu,  Dr.  Allan  Eustis,  Dr. 
L.  G.  LeBeuf  and  Mr.  Hoffman. 

With  little  ado  the  meeting  was  organized  by  calling 
me  to  the  chair.     Without  debate  it  was  decided  that  the 
first  thing  to  be  done  to  comliat  inyasion  of  our  neighbor- 
hood b}-  the  feyer  was  to  make  our  cisterns  impossible  to 
the  stegomyiae  as  breeding  places.     To  do  this,  according 
to  the  scientific  knowledge  of  the  day,  it  would  be  neces- 
sary to  oil  them  (pour  upon  the  surface  of  the  water  a 
small  quantity  of  coal  oil)  and  next  to  coyer  their  tops  in 
such  a  way  that  no  opening  larger  than  one-sixteenth  of 
of  inch  square  should  remain  unclosed.     Secondly,  that 
all  premises  should  be  frequently  inspected  and  all  stand- 
ing water  poured  out,  drained  away  or  oiled,  and  all  cess- 
pools, and  priyy  yaults  cleansed  and  oiled  not  less  than 
once  a  week.     Primarily  our  efforts  were  to  be  directed 
to    covering     (''screening''    was    the    Ayord    uniyers-ally 
adopted)  as  rapidly  as  might  be  consistent  with  thorough- 
ness, our  employees  endeayoring  to  extc^nd  their  useful- 
ness by  warning  and  instructing  householders  as  to  the 
need    and    the    mode    of    cleansing    and    keeping    their 
premises  so  as  to  make  them  inhos])itable  to  the  mosquito. 
As  a  matter  of  course,  money  would  be  at  once  needed, 
and  the  chair  was  authorized  to  ap])oint  a  finance  and 
other  necessary  committees.     He  was  also  asked  to  be- 
come the  organizer  and  diiector  of  the  work.     I  accepted 
on  the  express  condition  that  I  should  haye  absolutely 
nothing  to  do  Ayith  the  raising  or  handling  of  the  funds. 
The  condition  being  agreed  to,  haying  no  faith  in  the  per- 
formance of  large  committees — especially  where  time  is  a 
consideration — I  appointed  ^Ir.   Hunt  Henderson  chair- 
man of  the  Finance  Committee,  with  power  to  appoint 
other  members  if  he  chose,  and  Dr.  Jos<q)h  Holt  and  Dr. 
G.  King  Logan  as  medical  adyiscTs  and  assistants.     Dr. 
Holt  continued  to  act  as  adviser  whenever  called  upon 
until   our   work   ended,   and   Dr.   Logan   was  our  active 


PERSONAL    EXPERIENCES,     1905 BRUNS.  1029 

lieutenant  nnt'l  he  was  apitointed  Aetinij,'  As^sistant  Sur- 
geon in  the  I'ublie  Health  and  Marine  Hospital  Service. 
It  was  understood  by  all  that  our  work  Avould  at  first 
be  confined  to  that  part  of  th(^  ward  represented  by  the 
gentlemen  present — a  considerable  strip  lying  between 
Magazine  and  Baronne  Streets.  We  would  do  all  in  our 
power  to  put  it  in  such  order  that  the  health  oflicials 
might  be  relieyed  of  all  care  about  it.  xVfterwards,  if 
time  and  means  allowed,  and  it  should  prove  agreeable 
to  the  residents  of  a  larger  area  of  the  ward,  we  might 
gradually  extend  the  limit  of  our  endeavor.  For  at  this 
time  it  was  the  common  impression  that  the  State  and 
city  health  authorities  were  about  to  begin  a  campaign 
of  cleaning,  draining,  oiling  and  cistern  closing  along  the 
river  front  of  each  ward,  progressing  steadily  toward  the 
rear  or  swamp  boundary.  Evidently,  if,  upon  reaching 
the  middle  or  wealthier  portion  of  the  wards,  they  could 
be  found  already  in  satisfactory  order,  not  only  great 
expense  and  labor,  l)ut — what  then  was  even  more  preci(}us 
— time  would  be  saved.  It  is  needless  to  say  that  no 
adequate  idea  prevailed  of  the  magnitude  or  cost  of  such 
a  task;  or  of  the  extent  of  tlie  infection  and  the  difficulties 
of  sanitation  in  the  original  infected  district;  conditions 
which  at  once  began  to  absorb  all  the  efforts  and  resources 
of  the  State  and  City  Health  Boards,  rendering  it  impos- 
sible for  tliem  to  throw  any  force  worth  speaking  of  into 
parts  of  the  city,  as  yet  slightly  or  totally  uninvaded.  It 
was  this  inadequacy  of  means  to  the  end  which  brought 
about  the  api)eal  to  the  United  States  for  assistance  and 
the  supplanting  of  the  local  sanitary  authorities  Ivy  the 
national — the  United  States  Public  Health  and  Marine 
Hospital  Service.  Yet,  looking  back,  there  is  reason  to 
believe  that  liad  our  Health  Boards  pursued  a  course 
similar  to  the  national  organization's,  liad  they  appealed 
at  once  to  the  community  for  a  third  of  a  million  as 
sinews  of  war,  had  they  put  every  ward  in  the  cily  in 
charge  of  a  medical  man  of  sense  and  character  and  estab- 
lished a  detention  hosjiital  or  hospitals,  under  men  of 
experience,  they  might  have  done  as  well.  That  the  money 
was  forthcoming  the  event  showed;   that  the  men  were 


1030  augustin's   history  ok  yei.i.ow   fever. 

availabh^  was  i)r()V(  n  1»y  the  takiii<i-  into  its  service  of  some 
two  score  of  our  younger  phjsiciaDs  by  the  Public  Health 
and  ^farine  Hospital  Service,  and  the  uumercus  capable 
v(jhinte<'r  and  i)aid  workers  who  were  imnudiately  de- 
veloped by  the  citizens'  aid  associations. 

But  to  return  from  this  digression  :  Dr.  Beverley  War- 
ner very  kindly  placed  the  basement  of  his  church 
(Trinity),  together  with  its  large  yard,  at  our  service  as 
a  headquarters.  The  offer  was  gratefully  accepted,  and 
the  meeting  adjourned.  It  may  be  stated  at  once  that  the 
resolution  to  keep  distinct  the  financial  and  executive  de- 
partments of  our  work  was  rigidly  adhered  to.  All  con- 
tributions to  the  fund  were  nuide  to  and  acknowledged  by 
the  chairman  of  the  Finance  Committee,  or  in  his  absence 
by  Capt.  I.  L.  Lyons.  The  final  statement  prepared  by 
him  shows  that  the  total  amount  collected  was  .fl,48(>, 
cf  which  an  unexpended  balance  of  |234  was,  by  mutual 
agreement,  turned  over  to  the  Bev.  Beverley  Warner, 
superintendent  of  volunteer  ward  organizations,  and  was 
by  him  covered  into  the  general  fund  raised  by  the  citi- 
zens in  fulfillment  of  their  promise  to  the  United  States 
Public  Health  and  ^Marine  Hospital  Service;  so  that  our 
work  cost  us  almost  |33  for  each  of  the  thirty-eight  blocks 
worked  over.  Save  in  emergencies,  nearly  all  suppli<^s 
were  lirought  througli  a  purchasing  agent,  a  ])osition 
which  Mr.  Hewes  Gurley  kindly  volunteered  to  fill.  Tin- 
approved  bills  were  paid  by  our  treasurer.  He  also  paid 
the  weekly  clerical  and  labor  payrolls  ])i'e])ared  by  our 
office  force,  so  that  every  bill  ])assed  throiigli  at  bast  two 
hands  and  no  question  as  to  the  misapplication  of  a  cent 
could  possibly  arise.  The  final  statement  already  referred 
to  contains  many  interesting  data  as  to  the  amount  -ot 
matei'ial  consumed  in  protecting  tlie  tliirty-(  iglit  rather 
thinly-built-up  blocks  in  the  area  of  work,  For  instance, 
we  used  no  less  than  200  pounds  of  bill  posters'  tacks,  41 
hammers,  28  ])airs  of  shears,  58  l)alls  of  twine,  3  dozen 
sacking  needles,  (>  gross  of  large  safety  i)ins  and  IT  ex- 
tension ladders,  besides  many  one  and  tw(:-i»:allon  oil  cans, 
several  large  and  small  tin  funnels,  barrel  faucets,  scratch 
])ads  and  bill   files.     All  these  not   consumed  in  service 


PERSONAL    EXPERIENCES,      1905 HRUNS.  1031 

we  turned  over  to  the  Public  Health  and  Marine  Hospital 
Service  officer  in  charge  of  the  ward  on  the  completion  of 
our  work.  Seven  barrels  of  oil  Avere  given  us  by  the  Gen- 
eral Citizens'  Committee;  of  which  we  used  four  and  re- 
turned over  three  to  the  Public  Health  and  Marine  Hos- 
pital Service  Acting  Assistant  Surgeon.  Unfortunately 
no  exact  idea  of  the  amount  of  cloth  consumed  can  be 
arrived  at,  because  a  large  quantity  of  cotton  cloth  of 
excellent  quality  was  given  us  by  the  ^Nlaginnis  Cotton 
Mills,  and  because,  until  we  had  finished  "screening''  and 
were  engaged  only  in  inspecting  and  repairing,  all  other 
cloth  was  purchased  and  presented  to  us  by  Mr.  Kobert 
Parker.  That,  during  the  work  of  inspection  and  repair 
alone,  we  found  it  necessary  to  use  no  less  than  1,034  2-3 
yards  at  a  cost  of  |38.82  faintly  indicates  the  great  quan- 
tity  consumed.  Another  donation,  six  barrels  of  creosote, 
given  us  by  ]Mr,  Sylvester  Labrot,  Avas  experimented  with 
in  treating  gutters,  both  stagnant  and  flowing.  It  was 
found  very  useful,  for  its  specific  gravity  being  high  it 
sinks  and  continues  for  a  long  time  to  produce  an  oily 
film  upon  the  surface  of  the  Avater.  On  this  account,  and 
by  reason  of  its  antiseptic  and  deodorizing  properties 
aiso,  a  half  and  half  mixture  Avith  coal  oil  Avas  found  to 
be  the  best  material  for  treating  privy- vaults  (Dr.  Samuel 
Logan,  Acting  Assistant  Surgeon,  Public  Health  and 
Marine  Hospital  Service)  and  exposed  pools,  from  the  sur- 
face  of  Avhich  coal  oil  scum  quickly  cA^aporates. 

Our  first  day,  July  27,  Avas  mainly  occupied  in  finding 
proper  foremen,  but  Avork  Avas  begun.  From  the  start 
Ave  determined  to  send  out  no  Avorkmen  except  under 
trustAvorthy  and  intelligent  foremen,  and  Ave  Avere  for- 
tunate in  obtaining  men.  A  few  were  secured  on  July 
27,  and  the  others  in  the  next  day  or  tAVO.  They  Avere: 
L.  Mitchell,  E.  F.  Salerno,  C.  P.  May  and  K.  i\  Finlay, 
under-graduates  of  Tulane  ]Nredical  Dei)artment;  C.  J. 
Chapotin,  C.  Kubel,  A.  M.  Warner,  George  I^])ton  and 
the  Pev.  George  Summey,  editor  of  the  "Southwestern 
Presbyterian,-'  a  volunteer.  The  course  of  Dr.  Sunnney 
cannot  be  too  highly  praised.  Quietly,  Avithout  in  any 
Avay  seeking  notoriety,  he  abandoned  his  i)rofessional  and 


1032  augi:stin's   history  of  yellow   fever. 

editorial  labors  and  devoted  his  whole  time  to  working;  as 
an  oiling  and  screening  foreman.  The  Avisdom  of  secur- 
ing entirely  competent  foremen  before  putting  any 
laborers  in  the  field  became  more  and  more  apparent  as 
we  went  on.  Not  only  were  the  men  kept  steadily  at 
work  and  all  questions  of  "soldiering-'  eliminated,  but 
great  loss  of  time  in  getting  to  work  in  the  morning,  in 
keeping  well  provided  with  material  and  in  deciding 
promptly  upon  the  correct  solution  of  many  difficult  little 
mechanical  problems  of  thorough  cistern  covering,  which 
frequently  arose,  were  prevented.  These  foremen  rapidly 
got  together  a  highly  efficient  l)ody  of  workmen,  as  they 
were  given  full  i)ower  to  employ  and  discharge,  and  the 
lazy  or  incompetent  were  soon  weeded  out.  Indeed,  fail- 
ure to  secure  the  right  kind  of  foremen  and  to  grant  them 
these  powers,  together  with  the  intrusion  of  political  in- 
fluences which  insisted  upon  the  employment  of  dwellers 
in  a  ward  upon  work  in  that  ward,  regardless  of  fitness 
or  sobriety,  often  forcing  the  retention  of  men,  drunken, 
inept  or  incompetent,  seemed  the  chief  source  of  wasteful 
expenditure  and  inefficient  work  which  I  observed  in 
some  parts  of  the  city.  Our  foremen  and  clerks  (except 
the  volunteers)  received  two  dollars  a  day,  and  our 
laborers  one  dollar  and  fifty  cents.  The  largest  number 
of  laborers  employed  was  seventy-five  and  the  smallest, 
six.  Our  highest  weekly  payroll  was  |502.15,  and  the 
lowest,  $(iC).~o.  The  opportunity  to  earn  this  money  at 
the  height  of  the  dull  summer  season  and  during  a  time 
of  epidemic  was  a  godsend  to  a  large  number  of  men, 
some  middle-aged  with  dependent  families,  but  the  largest 
number  young  and  single.  Tlie  (piality  of  lal)or  we  were 
able  to  engage  was  quite  extraordinary,  consisting  of 
clerks  and  minor  railroad  employees  of  every  kind,  factory 
hands,  mechanics,  etc. — all  men  of  intelligence  and  en- 
ergy. ]Mauy  were  young  fellows  who  had  come  here 
during  the  prosperous  winter,  obtained  work,  been  dis- 
charged when  quarantine  confined  the  business  of  the 
city,  and  who  Avere  thus  enabled  not  only  to  support  them- 
selves, but  to  lay  aside  enough  to  pay  for  transportation 
to   other,    and    for    the   time    more    favorable,    fields    of 


PERSONAL    EXPEIENCES,     1905 BRUNS.  103S 

employment.  The  s^ame  was  true,  of  eoiirse,  throTitjjliout 
tlie  city,  and  the  money  put  into  ciieulation  in  the  execu- 
tion of  sanitary  work  and  for  material  was  instrumental 
in  conyerting  Ayliat  must  otherwise  have  been  a  season  of 
poverty  and  privation  to  the  masses  into  one  of  compar- 
ative prosperity  and  comfort.  AMiat  a  contrast  to'  the 
old  days,  when  under  a.  visitation  of  the  yellow  plague 
there  was  nothing  to  be  done  but  to  sit .  still,  to  suffer 
and  to  die!  How  often  is  wisdom  not  only  justified  of 
her  children,  but  of  her  collateral  descendants! 

We  began  work  knowing  that  wire  gauze  was  ue ob- 
tainable in  the  city  and  that  our  scieening  must  be  done 
with  cloth.  We  made  use  of  three  (jualities,  being  always 
glad  to  use  what  we  could  get,  and  generally  1;(  ing  unable 
to  choose  what  we  would  take.  One  was  a  good  cheese- 
cloth heavy  enough  to  be  used  in  single  thickness;  another, 
a  much  more  sleasy  material,  requiring  to  be  doubled  to 
be  of  sufficient  strength,  and  the  third,  the  material  given 
by  the  Maginnis  JMills,  good  heavy  coarse  sheeting  and 
good  light  duck.  This  we  found  far  and  away  the  lieyt, 
and  our  expen'ience  led  us  to  believe  it  morc^  suited  even 
to  permanent  work  than  wire  gauze  because,  being  more 
pliable,  it  can  be  more  exactly  apjilied  to  the  closing  of 
minute  cracks  by  the  average  workman,  and,  if  well 
painted  over,  it  must  prove  more  durable,  for  every 
variety,  save  the  very  expensive  true  bronze-wire  gauze-, 
rapidly  corrodes. 

Our  first  day's  experience  showed  that,  b(^«:ides  th.e  ob- 
viously necessary  barrels  of  coal  oil  and  the  extension 
ladders,  five  and  two  gallon  oil  cans,  tin  funnels,  barrel 
spigots,  hammers  and  tacks,  shears,  sacking  needles  and 
twine,  and  large  safety  pins  were  needed  for  cutting  and 
fastening  the  cloth.  Our  men  tried,  but  (piickly  rejected 
one  after  the  other,  all  the  suggest(>d  oiling  devices,  from 
bottles  tied  to  poles  to  tin  cans  which  ojjened  wIku 
pressed  upon  the  cistern  rim.-  Some  of  these  were  found 
difficult  and  time-consuming  to  fill,  others  c(!uld  n<  t  be 
introduced  behind  the  overhanging  eaves  of  certain  types 
of  cisterns,  Avhile  still  others  were  more  likely  to  shower 
their  contents  upon  the  heads  of  the  users  tlian  within 


1034  ArGusTix's  history  of  ykllow   fever. 

tlu*  cisterns  to  he  oiled.  They  were  all  superseded  by  a 
ladder  and  a  commou  pint  or  <iiiart  beer  or  wine  bottle. 
These  could  be  handily  carried  by  a  striuti:  tied  around 
the  neck,  ra])idly  filled  by  means  of  a  funnel,  and  easily 
])(ik{  d  into  and  emptied  thr(;u<ih  any  openinj^-  in  a  covered 
cistern.  After  the  first  day  there  arose  a  loud  demand 
from  the  workmen  for  carjienters'  aiuons  to  hold  their 
tacks  and  small  tools  while  workinjj;'  on  the  ladders,  and 
for  tacks  with  heads  i>uarded  by  pasteboard,  as  they  held 
the  cloth  better  and  could  be  more  rapidly  used.  To 
supply  these  needs  we  asked  the  assistance  of  the  ladies 
of  the  neiiihljorhocd,  and  in  a  day  of  two  they  furnished 
us  with  more  than  two  dozen  carpenters'  aprons  of  cheap 
ticking-  and  no  end  of  pasteboard  cut  into  squares  of  about 
one  inch.  The  whole  leisure  time  of  our  office  force  and 
of  all  our  visitors  was  spent  in  pushing-  tacks  throui2;h 
these  pasteboard  squares,  l)ut  dnrinji'  the  height  of  the 
work  the  demand  exceeded  this  supply,  and  we  were 
f)bliged  to  engage  two  small  boys  at  a  quarter  of  a  dollar 
a  day.  The  speed  developed  by  these-  little  professionals, 
their  rivalry  and  their  devic(^^  for  facilitating  their  work 
afforded  us  all  much  amusement. 

Early  experience  showed  the  best  working  unit  to  be 
a  foreman  and  two  laborers  for  an  oiling  gang,  and  three 
laborers  for  a  screening  gang.  In  the  oiling  gang  this 
allowed  two  laborers  to  carry  the  extension  ladder,  their 
bottles  and  a  two-gallon  oil  can  each,  while  the  foreman 
usually  carried  an  extra  oil  can.  In  the  screening  gang, 
two  lal)orers,  if  the  cistern  wore  large,  worked  on  the 
ladders,  while  the  thii-d  and  foreman,  who  directed  the 
■^ijork,  assisted  in  moving  the  ladders,  handing  up  the 
material,  helping  to  diajie  the  cloth,  etc.  If  the  cisterns 
•were  small  two  of  the  lal)orers  worked  at  one  and  the 
foreman  and  the  remaining  man  at  another.  Toward  the 
beginning  of  the  second  week  many  of  our  foremen  were 
able  to  work  two  or  even  three  gangs  of  three  men  each 
upon  the  cisterns  of  contiguous  ]»rop(Tties;  l)ut  the  reit- 
erated instructions  to  all  were  thoroughness  and  diligence, 
but  no  more  speed  than  was  compatible  with  efficient 
work.     The  route  from  premise  to  premise  was  usually 


PERSONAL  EXPERIENCES,   1905 BRUNS.  1035 

by  means  of  their  laddc^is  ovei-  back  fences.  Tims  unoc- 
cupied premises  were  reached  as  rapidly  as  occupied  ones, 
and  the  front  streets,  as  a  rule,  presented  no  evidence  of 
the  presence  of  the  workers.  Occasictnally  a  ladder  or  a 
big  oil  can  standing-  by  a  front  fence,  a  wagon  cloth  and 
laddor  laden,  its  sleepy  driver  lolled  upon  the  seat,  its 
hang-dog-looking  mule  somnambulistically  stamping  flies 
beneath  the  torrid  sun,  would  serve  to  guide  the  executive 
who  wished  to  drop  in  unawares  to  see  how  his  men  were 
getting  on.  Two  wagons- were  used  during  the  whole  of 
our  work,  save  for  the  last  few  days  of  reinspection.  One 
Avas  furnished  by  Mr.  Eobert  Parker,  tlu^  diriver  being 
paid  by  us;  the  other,  together  Avith  its  driver,  was  sup- 
plied bA'  the  Messrs.  Henderson.  During  the  first  days 
they  hauled  the  oil  l)arrels  and  dei)c:>ited  them  in  the 
yards  of  obliging  citizens  at  convenient  points  throughout 
the  distinct ;  they  carried  fresh  supplies  to  the  oiling  gangs 
as  the  contents  of  their  cans  were  used  up;  and,  on  morn« 
ings  when  oiling  was  to  be  begun  at  a  distance  from 
headquarters,  they  carried  the  men,  their  ladcbrs  and 
their  oil  to  the  starting  point.  After  the  first  five  days, 
when  oiling  had  been  completed  and  the  oil  barrels  had 
been  hauled  back  to  head(|uarters,  they  hauled  the  ladders 
and  material  to  the  starting  ])oints  every  morning,  and 
were  fairly  busy  all  day  hauling  extra  material  or  trans- 
porting gangs,  which  had  comi)leted  one  block,  to  a  new 
one.  When  not  emi)loyed  they  reported  to  headcpiarters 
and  remained  in  its  immediate  vicinity  leady  to  be  dis- 
patched on  any  errand. 

Our  office  force,  composed  of  Dr.  O.  King  Logan,  Cap- 
tain T^obert  Perrin  (volunteer),  Mr.  C.  i\  Waterman, 
Mr.  George  Leverich  and  Dr.  J.  D.  Weis  (volunteer), 
soon  had  everything  systematized  and  working  with 
machine-like  smoothness.  Our  day's  work  began  at  7  a. 
m.,  and  at  that  hour  of  each  sunnner's  morning  I  found 
one  or  two  members  of  the  office  force,  the  foreman  and 
their  gangs,  and  the  two  wagons  ass(  lubled  befo.ie  the 
basement  of  Trinity  Church.  The  doors  were  unlocked, 
the  hiig  gates  of  the  yard  swung  o]ien,  and  a  scene  of 
orderly  haste  and  bustle  began.     Tlie  uauiis  loaded  their 


1036  augistin's   history  of  yellow   keyer. 

ladders  and  the  day's  supplies  of  cloth  upon  the  wagons, 
and  then  each  foreman  i-eceived  from  one  (f  the  office 
men,  stationed  at  a  window  opening  ou  the  Ya-rd,  oil  cans, 
funnels  and  a  box  containing  tacks,  carjienters'  aprons, 
hammers,  shears  and  all  things  needed  bv  his  gang  for 
the  day.  These  boxes  were  also  placed  in  the  wagons  and 
away  they  went  to  the  parts  of  the  district  wherein  work 
was  to  be  pushed  during  the  day.  At  0  p.  m.  the  wagons 
loaded  with  the  boxes  and  ladders  returned.  The  two 
ladders  belonging  to  each  gang,  tied  together  and  properly 
numbered  were  stored  in  the  yard.  Oil  cans  and  work 
boxes  were  passed  by  the  foremen  through  the  window 
to  a  member  of  the  office  force,  Ayho  looked  to  see  that  all 
tr>)ls  taken  cut  were  returned.  Each  foreman  handed 
his  day's  report  to  another  member  of  the  office  force, 
who  had  charge  of  that  particular,  and  the  day's  work 
was  at  an  end. 

Owing  to  the  yarying  density  with  wliich  the  squares 
in  the  territory  were  built  up  and  the  great  ditferences  in 
size  of  cisterns  encountered,  to  ayoid  also  any  stimulus 
to  hasty  work  by  the  excitement  of  tiyalry  between  our 
foremen,  no  effort  was  made  to  keep  account  of  the  num- 
ber of  yaults  and  cisterns  oiled  and  screened  daily.  In- 
stead, a  large  diagrammatic  map  of  the  thirty-eight 
squares,  showing  their  city  numbers  and  the  streets 
bounding  them,  was  prepared  and  posted  upon  one  wall 
of  our  headfiiiarters.  As  the  oiling  was  com])leted  on  a 
s([uare,  a  blue  circle  containing  the  date  was  drawn  upon 
the  square  indicated  on  the  map;  when  the  screening  of 
a  square  was  finished  a  red  cross  holding  within  its  arms 
the  date  was  drawn.  Eyery  morning  a  general  order 
directing  each  foreman  to  the  square  that  he  and  his  gang 
would  lie  em])loyed  upon  during  the  day  was  hung  upon 
a  bill-filp  near  the  map.  If  a  square  had  been  so  far 
completed  dui-ing  one  day  it  was  sure  to  be  finished  the 
next,  then  the  general  order  would  irdicjito  the  )-(|uare 
to  which  the  gang  should  next  ])roceed.  In  this  Ayay  a 
glance  at  the  map  told  not  only  how  tlu^  w(  rk  was  pro- 
ceeding and  how  long  a  time  had  elapsed  since  a  partic- 
ular square  had  been  oiled  or  screened,  but  just  where 


PERSONAL  EXPERIENCES,     1905 URUNS.  1037 

every  foreman  and  his  gnng  mii>lit  be  found  at  any  par- 
ticular time  if  need  arose  to  eommnniciite  witli  liim,  send 
additional  supplies,  etc.,  as  very  often  happened.  Extra 
material  needed  throu.iih  the  day  was  issued  u])on  a  writ- 
ten requisition  upon  headquartea's  by  a  foreman.  ''" 
material  was  issued  by  a  member  of  the  office  force,  one 
of  whom  was  always  present,  and  the  requisition  hun«^ 
on  a  bill-file  kept  for  that  purpose  and  properly  labeled. 
Foremen  were  supplied  with  small  scratch  pads.  On  the 
first  leaf,  under  the  date  of  each  day,  they  copied  from 
the  general  order  their  assignment,  and  on  the  following 
leaves  kept  account,  by  street  and  number,  of  the  premises 
visited,  and  the  number  of  vaults  and  cisterns  oiled  and 
screened  at  each.  They  also  jotted  down  the  presence  of 
any  nuisance  on  any  premise  and  anything  else  note- 
worthy. The  last  leaf  bore  the  names  cf  the  gang  em- 
ployed under  that  foreman  during  the  day  and  was  signed 
by  him.  From  these  reports  the  daily  labor  roll  could  be 
made  out  without  fear  of  mistake  e)r  contradiction.  All 
reports  of  nuisances,  improperly  wire-screened  cisterns, 
■old  wells  which  should  be  filled,  pools  or  butts  of  stand- 
ing water,  were  hung  upon  a  file.  Every  night  these  were 
taken  up  l)y  a  special  volunteer  aid  (Dr.  Joseph  D.  Weis), 
who  devoted  himself  to  this  task,  writing  and  mailing  a 
courteous  note  to  the  property  holder  asking  for  a  recti- 
fication of  the  condition.  The  number  of  concealed  cis- 
terns (many  in  small  back  rooms),  of  old  unuse^d  wells 
(some  under  but  slightly  raised  buildings),  or  paitly 
buried  water-butts,  shallow  ponds,  etc.,  discovered  in  the 
comparatively  small  area  under  our  care,  was  astonish- 
ing. A  wall  file  was  also  kept  for  the  posting  of  com- 
plaints of  property  holders,  and  these  you  may  be  sure 
were  numeious  and  varied.  ]Many  seemed  unable  to  real- 
ize that  damag(^  to  a  piece  of  rotten  gutter  pii)e  was  far 
more  than  compensated  by  the  value  of  the  cistern 
screening  being  elone  for  them  at  public  expense.  How- 
ever, each  com])laint  Avas  taken  uj)  and  attended  to,  and 
in  the  end,  we  believe,  to  evei'y  one  satisfactorily.  It  will 
be  seen  that  hanging  bill-files  i)layed  a  large  part  in 
systematizing  our  work.     It  was  found  the  least  trouble- 


1038  aloustin's  history  of   yellow   fever. 

some  war  of  keeping  all  kinds  of  niemoraucla  and 
accounts  in  a  business  of  emergency  like  this.  Indeed, 
the  walls  of  our  headcjuarters  were  covered  with  rows  of 
files,  each  surmounted  by  a  label  indicating  its  purpose. 
Only  two  boo;ks  were  kept,  one,  the  property  book,  an 
inventory  of  our  tools  and  stores  entered  as  they  were 
purchased ;  the  other,  the  alphabetical  payroll  made  up 
from  the  daily  reports  of  the  foremen  for  the  laborers  and 
for  the  office  force  by  our  chief  clerk.  An  important  file, 
called  the  "Skip  Book,''  hung  from  a  nail  in  the  wall.  It 
contained  a  list  of  particularly  difficult  jobs  of  cistern 
covering.  For  it  came  to  pass  that,  during  the  first  rush 
of  the  screening  gangs  over  the  district,  certain  cisterns 
were  left  unscreened,  either  because  they  were  overlooked 
or  were  hidden  away  in  houses  or  sheds,  when  they  were 
usualh'  reported  to  us  by  tenants,  or  because  they  were 
of  such  size,  height  or  other  difficult  nature  as  to  be 
beyond  the  skill  of  the  first  gang  which  encountered  them. 
Those  unfamiliar  with  New  Orleans  must  know  that 
the  main  drinking-water  supply  is  from  rain  collected 
from  the  roofs  in  wooden  containers  like  railroad  tanks, 
and  almost  always  fitted  with  covers.  ^Many  of  these 
receptacles  are  arranged  one  above  the  other  in  two  or 
even  three  tiers  or  stories,  so  that  the  top  of  the  highest 
may  be  level  with  or  even  a  little  above  the  house  roof. 
They  are  to  be  seen  of  every  diameter  and  height.  The 
covers  may  be  of  plank,  in  which  case  they  are  often  old 
and  rotten  or  constructed  of  sheet-iron  over  wooden 
frames,  conical,  dome  or  minaret  sha])ed,  and  these  often 
prt^scut  seam-cracks  or  rust-lKilcs.  Many  very  wide  cis- 
terns, twelve  to  fifteen  feet  in  diameter,  without  covers 
of  any  sort,  were  met  with.  The  ^'skips''  were  for  the 
most  part  of  this  character,  and  a  gang  of  specially  handy- 
men under  a  foreman  of  exceptional  intelligence  and 
aptitude  was  constantly  engaged  in  dealing  with  them. 
In  this  ^Messrs.  Summey  and  Horton  rendered  valuable 
service.  In  covering  lai'ge  cisterns  with  \ov\  rotten  tops 
or  none  at  all,  a  ladder  had  to  be  passed  across  the  top 
from  one  point  on  the  rim  to  another,  and  a  rude  frame 
of  boards  or  scantling  constructed.     A  large  sheet  made 


PERSONAL    EXPERIENCES,     1905 URUNS.  1  039 

by  se^Ying  breadths  of  cloth  together,  the  seams  being 
carefiillT  wrapped  iu  and  stitched  with  twine,  was  then 
drawn  over  the  frame  and  taclved  down  all  around.  In 
screening  to  cover  cracks  and  holes  in  sheet  iron  domes, 
similar  sheets  had  to  be  made  and  wrapped  about  these 
cupolas.  Sometimes  poncha-like  discs  with  a  central  hole 
were  slipped  over  the  spike,  which,  like  that  on  a  German 
helmet,  often  adorns  these  metallic  domes,  and  Avere 
fastened  down  everywhere  to  the  side  of  the  cistern.  In 
the  case  of  a  large  cistern  encased  in  cement,  into  which 
tacks  could  not  l)e  driven,  the  cloth  cover  was  allowed 
to  depend  far  down  and  then  drawn  close  to  the  cistern 
circumference  with  cord  passed  around  and  around  it. 
^lany  of  the  ways  in  wliicli  the  cloth  was  fitted  close 
around  awkward  inlet  and  outlet  pipes  did  credit  to  the 
American  reputation  for  ingenuity.  Indeed,  these  inlet 
and  outlet  pipes  were  a  subject  of  much  concern  to  all 
engaged  in  cistern  covering.  At  first  we  enclosed  outlet 
pipes  satisfactorily  by  i)utting  a  s^puire  of  cloth  <;ver  the 
lower  end,  gathering  the  edges  close  about  the  pipe  and 
securing  them  in  this  position  by  wrapping  around  and 
around  with  tAvine.  But  sometimes  trash  accnmuhited 
at  the  lower  end  of  the  pipe,  behind  the  cloth,  and  caused 
stoppage.  Later  a  better  plan,  suggested  by  one  of  the 
Marine  Hospital  surgeons,  of  fastening  with  cord  to  the 
lower  end  of  the  pipe  a  sleeve  of  cotton  ch)th  about 
eighteen  inches  long,  Avas  adopted.  AVhen  the  cistern 
overflowed  water  passed  freely  through  the  sleeve  at  the 
end  of  the  pii)e;  wlien  the  flow  ceased  tlie  clotli  collapsed 
and  prevented  the  ingress  of  mosipiitoes.  Inlet  pipes 
coming  from  the  roof  gutters  we  at  first  closed  by  i»lug- 
ging  the  topening  from  the  gutter  into  the  i)ipe  with  a 
cone  made  of  wire  gauze  i)ainted  to  i)revent  rusting.  The 
cone,  about  six  inches  across  the  top,  could  be  ])U>hed 
tightly  into  the  opening  of  various  sized  pipes,  effectu;jlly 
sealing  them  against  tiie  entrance  of  anything  more  than 
one-sixteenth  of  an  inch  in  diameter.  They  could  be 
quickly  made  by  rolling  up  a  s(iuare  of  wire  gauze,  as 
a  cornucopia  is  made  from  a  sheet  of  paper,  and  fastened 
My  a  few  turns  of  wire  raveled   from   the  edge  of  thei 


1040  augustin's   history  of   vei.low  fever. 

gauze.  A  handy  workman  was  kept  making  them,  and 
we  used  up  many  dozen ;  sixty-six  feet  of  yard-wide  gauze 
being  consumed  before  we  abandoned  this  method.  The 
cones  were  given  up  partly  on  account  of  the  impossibility 
of  getting  fine  gauze  and  partly  because  householders 
objected  to  them,  on  the  ground  that  trash  washed  down 
the  roof  gutter  would  dam  against  the  cone  edges  and 
cause  the  roof  gutter  to  overflow.  I  confess,  however, 
that  it  seemed  to  me  better  that  this  should  occasionally 
happen  than  that  the  trash  should  find  entrance  into  my 
cistern,  as  the  cone  could  easily  be  pulled  out  and  the 
gutter  cleaned  whenever  necessary.  We  substituted  the 
same  sleeves  that  were  tied  over  the  ends  of  outlet  pipes. 
Where  the  cistern  end  of  the  inlet  pipe  could  be  readily 
got  at,  the  sleeve  was  tied  over  its  open  end  just  as  with 
the  outlet  pipes.  Where  the  cistern  end  of  the  inlet 
pipe  was  within  the  cistern  cover  and  not  get-at-able,  the 
sleeve  was  passed  into  the  inlet  pipe  at  its  origin  from 
the  roof  gutter;  then  a  straight  bit  of  elastic  steel  about 
a  foot  long,  and  one-sixteenth  inch  thick,  and  a  half  ot 
an  'inch  wide,  Avas  curled  into  a  circle  and  passed  justj 
within  the  mouth  of  the  sleeve.  When  released  it  ex- 
panded to  the  circumference  of  the  pipe  and  held  the 
mouth  of  the  sleeve  closely  applied  to  the  pipe's  inner 
surface.  For  these  sleeves  we  were  also  indebted  to  the 
ladies  of  our  neighborhood,  who  had  several  hundred 
made  for  us  at  a  cost  of  five  dollars. 

Our  main  task  was  completed  at  about  the  time  that 
the  Health  and  31arine  IT()S])ital  Service  ottlce,  under  Act- 
ing Assistant  Surgeon  Samuel  Logan,  was  established  in 
the  ward.  For  the  sake  of  greater  ease  of  co-operation, 
our  lH'a(l(|uarters  were,  therefdre,  now  moved  to  the  com- 
modious buibling  occupied  as  head(iuartcrs  by  Dr.  Logan. 
Our  force,  which  had  been  gradually  reduced  as  the  work 
drew  to  completion,  was  cut  down  to  two  gangs  of  a  fore- 
man and  three  men  each.  These  were,  naturally,  selected 
from  among  the  most  conscientious,  experienced  and  in- 
genious of  all  Avho  had  been  in  our  employ.  On  August  9th 
they  began  a  systematic,  minute  inspection  of  all  screen- 
ing Avork.     Their  orders  were  to  re-oil  any  cistern  found 


PERSONAL    EXPERIENCES,     1905 BRUNS.  1041 

defective  and  to  leave  all  mosquito-tight  behind  them. 
One  wagon  was  retained  to  carry  the  ladders,  cloth  and 
other  material  to  and  from  work.  Following  instruc- 
tions, the  foremen  themselves  mounted  the  ladders  and 
inspected  every  foot  of  screening  at  close  range,  examin- 
ing especiall}'  the  cistern  tops  and  the  inlet  and  the  outlet 
pipes.  If  any  defect  was  found  the  cistern  was  oiled,  the 
men  were  instructed  how  to  make  it  mosquito-tight,  and 
exact  completion  of  these  repairs  carefully  overseen.  At 
the  same  time  an  additional  lookout  for  standing  water, 
hidden  wells,  or  other  nuisances  was  kept,  and  all  such 
were  noted  in  the  foreman's  daily  report.  These  reports 
were  at  once  turned  in  to  Acting  Assistant  Surgeon 
Logan,  who  instituted  instant  and  energetic  measures  for 
the  treatment  and  abolition  of  these  nuisances.  Although 
we  thought  our  screening  had  been  exceptionally  well 
done,  and  always  under  repeated  instructions  t6  prefer 
thoroughness  to  speed,  yet  so  many  were  the  damages  in- 
nicted  by  wind  and  weather,  and  so  numerous  the  other 
small  defects  and  omissions  discovered  on  critical  review 
that  it  took  twenty  days  to  go  over  the  territory  (thirty- 
eight  blocks)  and  make  all  perfect.  The  wire  screening 
at  this  time  being  put  on  by  private  contractors  to  replace 
our  cloth  proved  especially  defective  and  vexatious.  Those 
engaged  in  wire  screening  seemed,  for  the  most  part,  to 
have  failed  to  grasp  its  purpose  and  to  be  unable  to  realize 
that  a  gap  of  over  one-sixteenth  of  an  inch  makes  a  whole 
job  useless.  They  seemed  to  tliink  that  anything  which 
would  exclude  an  English  sparrow  would  answer  the 
purpose. 

As  soon  as  this  first  inspection  was  finished  (August 
29th)  reinspection  was  begun.  Those  blocks  which  had 
first  been  given  to  one  inspector  were  now  assigned  to  the 
other  and  vice  versa.  By  Sej)t.  7th,  this  second  inspection 
being  virtually  completed,  and  the  acting  assistant  sur- 
geon of  the  Public  Health  and  Marine  Hospital  Service 
having  the  whole  sanitary  work  of  the  ward  well  in  hand, 
I  could  see  no  reason  for  the  maintenance  of  an  extra 
cog  to  the  machinery.  I  therefore  closed  our  office.  The 
ladders  and  other  implements  on  hand  were,  after  con- 


1C42  augustin's   history  ok  yellow   fever, 

sultation  with  those  interested,  turned  over  to  the  Public 
Health  and  Marine  Hospital  Service  officer ;  our  accounts 
were  balanced  by  Captain  I.  L.  Lyons,  our  actinp:  ch«ir- 
man  of  the  Finance  Committee,  the  cash  surplus  donated 
through  Dr.  Warner  to  the  Citizens'  Auxiliary  Commit- 
tee, and  our  work  was  done. 

It  is  pleasant  in  looking  back  to  be  able  to  believe  that 
we  accomplished  what  we  set  out  to  do:  To  make  a  belt 
across  this  large  and  populous  ward  so  thoroughh'  oiled 
and  screened  as  to  be  mosquito-proof,  and  thus  to  save  to 
the  central  authorities  care,  expense  and,  above  all,  time. 
The  area,  six  by  six  blocks,  Avas  sufficiently  large  to  form 
an  interesting  experiment.  So  far  as  I  know  it  was  the 
only  district  in  which  volunteer  sanitary  work  was  carried 
on  from  beginning  to  end  under  the  constant  personal 
supervision  of  a  medical  man.  By  all  testimony  the 
stegomyia,  though  not  as  extinct  as  the  dodo,  became  in 
the  center  of  this  tract  a  curiosity.  Around  some  of  its 
edges,  where  our  neighbors  were  not  so  well  protected 
until  the  Public  Health  and  Marine  Hospital  Service  took 
hold  of  the  work,  I  am  told  that  many  could  be  found. 
The  area  became  infected  seventeen  times;  the  first  time 
in  the  last  days  of  July,  but  so  far  as  we  know  the  in- 
fection' never  spread  but  in  a  single  instance — in  the 
square  at  the  corner  of  Camp  and  Felicity  Streets.  Ten 
times  out  of  the  seventeen  the  infection  occurred  on  the 
boundaries  of  the  area.  It  occurred  six  times  on  the 
(.'amp  Street  and  three  times  on  the  Baronne  Street 
boundary;  never  on  the  First  Street  boundary. 

One  may  be  sure  that  the  experience  of  our  men  was 
checkered  with  incidents  both  ]deasant  and  unpleasant 
during  their  forty- five  days'  campaign.  Though  for  the 
most  part  the  people  acquiesced  very  good-naturedly  in 
what  was  being  done  for  the  common  weal,  tlie  belief 
in  the  mosquito  theory  was  by  no  means  universal.  One 
liard-h(»aded  old  Irishwoman  obdurately  refused  to  allow 
her  cistern  to  be  oiled.  When  finally  pc^rsuaded  by  one 
of  the  most  diplomatic  of  our  foremen  she  exclaimed : 
"W(41,  come  in  and  do  it,  if  yez  is  bound  to,  but  I  don't 
believe  yez  can  keep  the  Lord  from  gittin'  those  He  wants 


PERSONAL    EXPERIENCES,     1905 BRUNS.  1043 

by  piittin'  a  little  ile  on  the  cistlierns."  The  most  un- 
pleasant incident  had  to  do  with  ward  politics.  After  we 
had  been  at  work  about  a  day  and  a  half,  the  political 
leader  of  the  ward  called  a  meeting-  to  "organize  the 
ward."  This  meeting  was  attended  by  nearly  all,  if  not 
all,  the  gentlemen  who  had  been  piesent  at  the  Trinity 
Church  meeting  and  others  from  the  central  division. 
The  meeting  was  organized  by  the  ward  leader,  and  all 
motions  carried  and  all  nominations  confirmed  were  made 
or  suggested  by  him.  The  ward  was  divided  into  three 
sections.  The  middle  one,  extending  from  Camp  to 
Baronne  Street,  was  confided  to  our  care.  It  was  resolved 
that  the  chairman  of  the  meeting  and  the  executives  of 
the  three  divisions  should  meet  and  appoint  a  Finance 
Committee  to  have  charge  of  collections  and  disburse- 
meiDts  for  the  whole  ward.  The  gentlemen  from  the  central 
division,  at  whose  instance  I  had  begun  the  work,  were 
without  confidence  in  sanitary  work  conducted  under 
political  auspices.  I  was  unwilling  to  direct  such  Avork 
in  co-operation  with  a  Finance  Committee  for  whose 
appointment  I  should  share  responsibility,  but  in  whose 
selection  I  should,  at  best,  have  but  one  vote  out  of  three. 
We  therefore  left  the  meeting  and  determined  to  continue 
our  work  independently.  Afterwards  a  rumor  was  cir- 
culated that  the  wealthier  inhabitants  of  the  central  divi- 
sion selfishly  subscribed  money  to  protect  themselves 
alone  and  left  their  jKiorer  neighbors  of  the  front  and  rear 
to  meet  the  cost  of  sanitary  work  as  best  they  could.  This 
is  untrue.  I  know  that  more  than  a  score  of  the  well-to- 
do  living  in  the  middle  division  contributed  to  the  oiling 
and  screening  in  all  three  divisions;  many  most  gener- 
ously to  the  Avard  funds  and  to  the  general  fund  besides. 
That  more  Avliom  I  do  not  know  did  so  is  highly  probable. 
The  slow  progress  of  our  first  inspection,  which  took 
twenty  days,  was  the  subject  of  some  disagreeable  criti- 
cism. I  mention  it  here  to  emphasize  the  difficulty  and 
the  time-consuming  nature  of  this  work  when  thoroughly 
done.  It  was  said  that  our  men  Avere  not  doing  their 
duty,  but  were  dawdling  over  their  Avork  for  the  purpose 
of  drawing  pay  for  a  longer  time.     The  accusation  was 


104.4  auoistin's   history  ok   yellow    fever. 

ridiculous.  First,  the  two  foremen  in  charge  of  inspec- 
tion and  repair  were  selected  from  the  large  number  who 
had  been  in  our  employ  by  reason  of  their  trustworthi- 
ness, diligence  and  skill.  Their  characters  to  those  who 
know  them  are  refutation  enough.  Secondly,  their  work 
was  not  done  in  secret,  but  under  the  eyes  of  the  nuiny 
Public  Health  and  Marine  Hospital  Service  men  who  were 
constantly  about  the  premises  where  they  Avere  employed, 
of  the  citizens  in  whose  yards  they  worked  and  under  my 
;own,  for  I  frequently  dropped  in  upon  them  at  uuex- 
pected  times.  Thiidly,  a  like  opinion  has  never  been 
heard  from  any  who  closely  followed  this  kind  of  work. 
On  the  contrary,  that  two  gangs  of  four  each  could  have 
thorougholy  covered  thirty-eight  blocks  in  twenty  days 
has  seemed  to  them  evidence  of  remarkable  industry.  A 
reliable  man  of  experience  stated  that  he  had  found  m 
one  block  in  another  district  twenty-six  cisterns,  supposed 
to  be  properly  screened,  which  were  lamentable  defective 
and  which  would  have  required  many  days  to  repair 
effectually.  Such  criticism  shows  ignorance  of  the  jirac- 
tical  difficulties  to  be  overcome  in  so  closing  the  various 
types  of  cisterns  in  any  district  of  New  Orleans  as  to 
make  them  absolutely'  mosquito-tight. 

Suggestions. 

The  experience  of  our  summer's  work  resulted  in  the 
following  reflections : 

That  the  attempt  to  screen  during  an  epidemic  is  most 
unfortunate.  During  such  a  time  of  stress  the  work  is  hur- 
riedly and  imperfectly  done  and  cisterns  which  are  really 
open  to  the  mosquito  are  sui)i)()sed  to  be  properly  closed. 
Too  much  attention  is  concentrated  upon  this  work  and 
the  search  for  other  standing  water  is  neglected.  These 
and  the  cesspools  remain  uncnii)tied  or  unoiled  and  con- 
stitute a  source  of  great  danger.  It  would  be  far  better 
during  the  actual  prevalance  of  the  disease  to  concentrate 
all  attention  and  all  work  upon  keeping  every  cistern 
propei'ly  oiled  and  reoiled,  upon  seeking  out  and  emptying 
or  oiling  every  body  of  standing  Avaatcr,  and  upon  the 
thorough  fumigation  and  refumigation  of  dwellings. 


PERSONAL    EXPERIENCES,      1905 BRUNS.  1045 

The  thorough  screening  of  cisterns  so  as  to  leave  no 
opening  larger  than  one-sixteenth  of  an  inch  can  only  he 
done  hy  skilled  workmen.  A  very  common  fault  in  this 
work  is  the  neglect  to  carry  the  wire  gauze  or  othen 
material  a  foot  or  two  down  the  sides  of  the  cistern.  The 
staves  of  many  cisterns  do  not  come  close  together  at  the 
top,  and,  especially  in  dry  spells,  there  are  large  cracks 
between  the  staves,  extending  down  a  foot  or  more  from 
the  top  through  which  any  mosquito  can  readily  pass. 

Inspection  and  reinspection  of  the  screening  are  as  im- 
portant as  the  work  itself,  and  must  be  thoroughly,  in- 
telligently and  conscientiously  done  to  be  of  value.  In 
practice  it  was  found  impossible  to  do  this  work  with  less 
than  two  workmen  to  move  altout  the  long  extenFion  lad- 
ders and  a  foreman  g€  greater  sagacity-  and  fidelity'  to 
observe,  note  and  direct  the  necessary  repairs.  Inspec- 
tion done  from  the  grouiul,  done  in  any  way  than  by  going 
over  the  whole  Avork  minutely  from  a  ladder-top,  is  worse 
than  useless,  in  that  it  establishes  a  false  belief  in  safety 
where  no  safety  exists.  The  work  too,  if  well  done,  is 
tediously  slow,  and  many  gangs  will  be  required  to  in- 
spect a  whole  city  within  any  reasonable  time.  I'nless 
our  health  authorities  are  particularly  careful  and  for- 
tunate in  the  selection  of  their  emjiloyees  for  this  avc-i'K, 
the  foundation  of  a  calamity  will  be  laid.  It  is  certain 
that  the  accrage  city  employe  possesses  neither  the  intel- 
ligence nojr  the  fidelity  to  be  a  foreman  of  such  work. 
Eeinspection  is  necessary  because  most  of  the  material 
commonl}'  used  is  very  perishable.  Only  the  l)est  qiuility 
of  bronze  wire  effectively  resists  the  constant  action  of 
air  and  water.  It  is  a  pity  that  the  screening  ordinance 
does  not  permit  the  use  of  a  good  <|uality  of  duck.  Our 
experience  led  us  to  the  conviction  that  this  material  can 
be  more  closely  and  effectively  applied  by  the  ordinary 
workman  than  wire  gauze,  and  when  oil  painted  it  cer- 
tainly lasts  longer.  The  objection  that  it  prevents 
adequate  aeration  of  the  water  is  without  force.  It  is 
practically  impossible  to  close  hermetically  a  wooden  cis- 
tern. Rain  water  is  charged  to  saturation  as  it  falls: 
coolness  and  darkness  are  unfavorable  to  vegetable  and 


1046  AUGUSTIN  S    HISTORY    OF    YELLOW    KSVER. 

therefore  to  animal  life,  and  make  for  purity  of  tlie  con- 
tained water.  As  it  is  impossible  to  know  liow  lonj;  de- 
fects may  have  existed  before  they  are  found,  all  cisterns 
with  gaps  more  than  one-sixteenth  of  an  ineh  should  be 
at  once  reoiled  by  the  inspectors. 

There  can  be  but  little  doubt  that  the  Stcgoinj/ia.  Avhat- 
ever  may  be  her  haliits  now,  will,  if  driven  to  it,  take  to 
depositing-  her  eggs  in  gutter  water  and  that  the  larva? 
will  learn  to  endure  their  new  environment.  Hence  it  is 
of  the  greatest  importance  not  only  that  underground 
drainage  and  sewerage  should  be  pushed  to  completion 
as  rapidly  as  possible,  but  that  paving  with  asphalt,  upon 
which  unbroken  surfaces  must  be  maintained,  should  go 
hand  in  hand  with  this  work.  The  asphalt  pavement, 
sloping  gradually  to  tlie  curl>,  leaves  no  deep  gutter  in 
which  stagnant  pools  can  be  maintained.  Wherever  tne 
wfork  has  been  done  in  such  fashion  as  to  leave  these,  it 
should  be  remodeled  without  delay,  and  where  the  neces- 
sities of  heavy  hauling  demand  material  other  than 
asphalt,  it  should  be  so  laid  as  to  abolish  forever  the  old- 
fashioned  deep  gutter.  A  comparison  of  the  gutters  on 
Gravier  Street  from  Camp  Street  to  Baronne  witli  those 
on  Howard  Avenue  from  St.  Charles  to  Baronne;  of  those 
on  Po^'dras  Street  from  Camp  to  Baronne  Avith  those  on 
Girod  between  the  same  streets,  and  of  those  on  St. 
Charles  Street  between  Julia  and  Girod  with  those  on 
Carondelet  between  the  same  streets,  will  give  a  striking 
illustration  of  the  importance  of  this  work  and  the  need 
for  prompt  remodeling. 

In  some  cities  the  tenant  is  required  by  law  to-  sweep) 
or  cause  to  be  swept  down  every  morning  the  stretch  of 
gutter  before  his  house.  The  ordinance  is  easily  enforced 
by  a  word  from  the  policeman  on  the  beat  to  the  house- 
holder or  his  servant,  and  all  are  easily  educated  to  the 
advantages  of  the  plan.  It  appears  that  such  an  ordi- 
nance would  be  specially  useful  in  this  city. 

An  experience  with  even  a  very  limited  area  showed 
that  this  old  city  is  peculiarly  rich  in  hidden  Avells,  cis- 
terns and  other  containers.       I  beg  to  suggest  that  an 


PERSONAL    EXPERIENCES,     1905 BRUNS.  1047 

important  part  of  the  work  of  our  health  officers  in  pre- 
paring for  the  coming-  summer  should  consist  in  obtain- 
ing as  complete  a  knowledge  of  the  location  of  these 
containers  as  possible.  This  could  be  done  by  urging  all 
citizens  possessing  such  knowledge  to  communicate  it  at 
once  to  the  health  authorities  either  directly  or  through 
the  public  press.  We  found  last  summer  that  many 
tenants  were  unaware  of  the  presence  of  such  sources  of 
danger  on  their  premises,  and  we  often  obtained  knowl- 
edg  of  them  in  an  indirect  Ay  ay  from  former  tenants  or 
builders  of  the  houses.  The  search  for  all  unscreened 
bodies  of  standing  water  on  all  premises  cannot  be  pushed 
with  too  great  a  yigor  if  we  are  to  exterminate  the 
Stcffoinf/ia. 

^fay  I  be  permitted  to  say  that  perliaps  the  health 
authorities  might  enlist  the  seryices  of  the  physicians  of 
the  city  as  yolunteer  inspectors  of  premises,  alleys,  etc? 
The  general  practitioner  on  his  rounds  penetrates  into 
eyery  quarter  and  into  almost  eyery  dwelling  of  the  city. 
In  furtherance  of  the  general  good  these  gentlemen  might 
be  persuaded  to  note  doAyn  and  report  to  the  health  officer 
eyery  threatening  nuisance  which  comes  under  their  eyes 
without  any  uncomfortable  use  being  made  of  their  names. 
It  seems  to  me  also  that  it  has  become  eminently  a 
part  of  our  duty  to  encourage  by  word  and  example  the 
sentiment  that,  its  mode  of  propagation  being  well  under- 
stood, yellow  feyer  has  been  robbc<l  of  its  terrors  and  is 
no  more  to  be  regarded  with  pjinic-terror  by  intelligent 
people  than  an  outbreak  of  small-pox  or  diphtheria.  As 
we  in  small-pox,  by  the  yaccination  of  all  non-immunes, 
and  in  diplitlieria  by  the  bold  use  of  the  serum,  both  as  a 
prophylactic  and  a  cure,  proceed  at  once  to  stamp  out 
what  were  in  times  past  two  of  the  most  mortal  plagues, 
so  now  u])on  the  apjxniiance  of  yellow  feyer  we  can  by  the 
prompt  report  of  all  suspicious  cases,  and  tlieir  proper 
protection  either  at  home  or  in  detention  hospitals,  by  the 
thorough  fumigation  of  infected  dwellings,  and  by  reduc- 
ing to  the  least  possibh^  numlu'r  all  Ijrccding  ])laces  of  the 
Stef/onnjia,  cut  down  to  a  minimum  the  mortality,  and 
therefore  the  dread,  of  this  one-time  scourge.     This  must 


1048  augustin's   history  of  yellow   fever. 

follow  as  the  logical  result  of  our  uewly  acquired  knowl- 
edge; and  Avheu  it  is  coui^led  with  a  calm  appreciation  of 
the  litter  lack  of  protection  afforded  by  even  the  most 
rigid  quarantine,  so  glaringly  illustrated  by  the  epidemic 
of  last  summer  in  this  State,  yellow  fever  will  take  its 
place  in  the  popular  mind  along  side  of  small-pox,  diph- 
theria and  rabies — as  a  disease  to  be  avoided,  but  no 
longer  capable  of  striking  whole  communities  with  sense- 
less fear,  canceling  their  humanity  and  exalting  above 
manly  sentiment  the  brutish  instinct  of  self-preservation. 

Perhaps  it  is  Utopian  as  yet  even  to  hope,  but  the  day 
must  come  when,  if  Ave  are  to  be  protected  in  our  health 
and  lives  by  sanitary  officials,  these,  more  than  any  of 
our  public  officers,  will  be  chosen  by  the  application  of  the 
strictest  of  civil  service  laws.  We  can  imagine,  if  we 
cannot  hope  for,  boards  of  health  composed  of  a  chief 
sanitary  officer  and  two  or  three  assistants ;  subordinate 
to  them  a  body  of  inspectors,  and  clerks  of  vital  statistics, 
each  receiving  a  salary  sufficient  to  compensate  him  for 
devoting  his  life  to  this  important  work.  Admission  to 
the  lowest  grade  of  this  profession — say  a  clerkship  of 
vital  statistics — would  be  open  to  young  medical  men  of 
good  character.  Upon  a  vacancy  occuiiing  in  the  next 
highest  grade — let  us  say  that  of  inspector — a  successful 
competitive  re-examination  would  promote  the  brightest 
of  the  clerks;  and  so  on  to  assistant  to  the  chief  sanitary 
officer,  and  finally  to  that  of  chief,  when  that  official 
should  be  retired  after  a  long,  but  fixed,  period  of  service. 
To  some  such  method  the  inevitable  processes  of  evolution 
must  lead  at  last. 

But,  come  what  may,  through  the  long  years  that  we 
are  developing  wisdom  enough  to  choose  the  protectors 
of  out  lives  and  of  lives  dearer  to  us  than  our  own  by 
some  better  test,  some  higher  <|ualification,  than  that  of 
political  subservience,  we  should  at  least  be  too  ])r()udly 
manful  to  fear  and  falter  beneath  afflictions  that  follow 
as  the  night  the  day,  the  folly  of  our  own  acts. 


1049 

SOME  LESSONS  TAUGHT  BY  THE  EPIDEMIC  OP 

1905.  i 

By  Charles  Chassaignac^  M.  D.,  New  Orleans. 

Dean   New   Orleans   Pohjclinic;   Editor   ^^Ncio    Orleans 
Medical  and  Surgical  Journal/^  etc.  i 

In  this  short  article,  the  attempt  will  be  made  to  call 
attention  to  some  of  the  most  important  practical  lessons 
which  may  be  learned  from  many  things  which  occurred 
during  the  prevalence  of  yellow  fever  in  Louisiana  and 
Mississii)pi  in  1905. 

I  shall  cull  from  my  personal  observation  during  that 
time,  perhaps  from  j^revious  experience  viewed  in  a  new 
light,  and  as  well  from  the  work  of  others.  In  other 
words,  a  fcAv  of  my  deductions  may  prove  to  be  new  to 
some  readers,  while  others,  no  doubt,  will  be  recognized 
as  merely  new  interpretations  of  old  knowledge  or  ex- 
planations of  facts  previously  not  understood. 

Truth  of  Mosquito  Propagation. 

The  correctness  of  the  mosquito  doctrine  was  confirmed 
on  a  larger  scale  and  at  a  larger  number  of  places  than 
ever  before.  That  mosquitoes  are  the  sole  known  prac- 
tical means  of  the  propagation  of  yellow  fever  was  demon- 
strated in  the  City  of  New  Orleans  beyond  a  reasonable 
doubt. 

When  the  existence  of  the  scourge  became  known,  it 
was  still  early  in  summer,  in  July,  the  same  month  that 
it  became  epidemic  in  1853.  It  was  soon  discovered  that 
numerous  foci  already  existed,  located  at  different  parts 
of  the  city.  The  type  of  fever  was  recognized  to  be 
severe;  an  old  and  esteemed  practitioner  then  stated  to 
the  author  that  its  virulence  reminded  him  of  tliat  of  the 
fever  of  1853.  The  percentage  of  non-immunes  among 
the  inhabitants  was  large,  owing  to  the  large  increase  in 
population  since  the  last  mild  epidemic  and  to  the  fact 
that  the  last  severe  pestilence  had  occurred  twentj^-seven 


10.30  AIGISTIn's     HISTOR^      OF    YELLOW      FEVER. 

years  previous.  To  sum  up  the  situation,  all  conditions 
were  ^ucli  as  to  lead  the  thou<>litful  to  expect  an  epidemic 
of  vast  proportions,  high  mortality  and  long  duration. 

What  actually  happened  was  this:  The  total  number 
of  cases  officially'  reported  was  3,384  with  a  mortality  of 
451,  about  13%.  As  always,  many  cases  must  have  failed 
of  report,  while  deaths  were  necessarily  reported.  The 
fever  was  over  about  the  first  of  November,  although  the 
first  frost  occurred  only  on  December  5,  and  the  funds 
raised  for  the  sanitary  campaign  were  not  exhausted. 

The  onh'  difference  in  the  warfare  waged  against  the 
pestilence  in  1905  and  that  of  previous  campaigns  was 
that  measures  were  based  solely  on  the  mosquito  doctrine: 
the  protection  of  the  sick  against  the  bites  of  mosquitoes 
by  means  of  screens,  mosquito  bars,  &c. ;  the  killing  of 
mosquitoes  in  infected  premises,  chiefly  with  sulphur 
fumes;  also  the  gradual  de>:truction  and  elimination  of 
all  Stcfjonii/ia  by  general  fumigation,  the  screening  oi 
cisterns  and  other  water  containers.  The  education  of 
the  public  at  meetings  and  lectures  were  auxiliary 
methods  of  material  assistance. 

Not  only  there  was  no  general  exodus  of  non-immunes, 
but  oi^  those  who  did  go  away,  none  took  sick  who  re- 
turned after  the  disease  was  under  control  and  before  the 
occurrence  of  frost.  Formerly  this  was  a  danger  against 
which  people  had  been  warned ;  invariably,  a  few  of  those 
who  did  not  heed  the  warning  fell  sick  shortly  after  their 
return,  owing  to  the  lack  of  destruction  of  infected 
mosquitoes. 

Why,  then,  this  enormous  difference  in  the  ])revalence, 
the  mortality  and  the  duration  of  the  ei)idemic?  Why 
should  there  have  been  in  1853,  when  the  fever  became 
epidemic  in  the  same  month,  a  mortality  of  7,849;  in 
1878,  when  the  fever  was  epidemic  a  month  later,  a  mor- 
tality of  4,050,  or  respectively  about  eighteen  and  nine 
times  greater  than  in  1905,  when  the  po])u]ation  had 
largely  increased?  Why  should  tho  epidemic  have  been 
arrested  before  frost  for  the  first  time  in  the  history  of 
the  disease  in  New  Orleans,  although  there  yet  remained 
a  large  percentage  of  non-immunes? 


LESSONS    TAUGHT    BY    EPIDEMIC    OF     1905 CHASSAIGNAC  1051 

Because  the  mosquito  doctrine  was  for  tlie  first  time 
the  basis  of  the  work  done  for  the  control  of  the  disease 
and,  notwithstanding  the  formidable  difficulties  encoun- 
tered, it  proved  emiuently  successful. 

Similar  results  followed  analogous  measures  at  many 
localities  in  Louisiana  and  Mississippi.  I  shall  relate 
only  a  striking-  instance  as  observed  directly'  by  me  in 
Tallulah,  iu  Madison  Parish,  where  I  was  recpiested  to  go 
by  the  president  .of  the  State  Board  of  Health  in  the 
middle  of  September. 

Tlie  infection  had  been  brought  there  on  July  21.  The 
first  suspicious  cases  were  discovered  about  August  9. 
Precautionary  measures  taken  after  the  confirmation  of 
the  diagnosis,  gave  rise  to  the  hope  that  there  would  be 
no  further  cases  and  a  greater  sense  of  confidence  was 
engendered  by  the  statement,  on  August  2G,  that  all  cases 
of  illness  in  the  town  had  been  critically  examined  by  a 
representative  of  the  Public  Health  and  ^Marine  Service 
who  declared  that  there  was  not  a  suspicion  of  yellow 
fever  in  tlie  town. 

Owing  to  this  the  people  threw  caution  to  the  winds, 
screens  were  torn  out  because  they  increased  the  heat, 
persons  about  to  flee  decided  to  remain.  By  the  end  of  the 
month  undoubted  and  severe  cases  were  recognized,  and  on 
September  5  there  were  at  least  twenty  cases  among  the 
comparatively  small  white  population,  while  fatalities 
among  the  best  known  people  gradually  wrought  the  pox)U- 
lation  to  a  high  pitch  of  excitement  and  panic.  Many  fled, 
including  prominent  officials,  the  terror  being  intensified 
because  practically  all  were  non-immunes,  the  little  town 
never  before  having  had  a  visitation  of  the  scourge,  and 
because  of  the  high  rate  of  mortality.         ' 

Arriving  on  September  11,  I  found  that  over  a  dozen 
deaths  had  occurred  and  that  of  the  forty  town  blocks, 
all  but  three  or  four  were  infected;  in  other  words,  the 
infection  was  general.  The  only  Avatcr  su]»])ly  was  de- 
rived from  cisterns,  tanks,  barrels  and  wells,  and  the 
town  was  swarming  witli  stegomyia  mosquitoes. 

An  anti-mosquito  campaign  was  inaugurated  at  once; 
all  Avater  containers  were  oiled  within  twenty-four  hours; 


1052  /-ugistin's  history  of  yellow  fever. 

the  sick  were  screened  or  protected  by  netting ;  systematic 
fumigation  was  carried  on  vigorously;  latrines  were 
treated  with  crude  oil  and  lime. 

Within  a  week  the  number  of  new  cases,  which  had 
been  progressively  increasing,  were  diminishing  and  by 
the  end  of  September,  long  before  frost,  the  epidemic  was 
over,  although  a  census  taken  at  that  time  showed  that 
there  were  yet  not  fewer  than  200  nonimmunes  who  had 
nat  had  the  fever. 

Confirmatory  evidence  in  a  negative  sense  is  not  lack- 
ing. Referring  to  only  one  notable  instance,  I  shall  quote 
from  the  report  of  the  State  Board  of  Health  in  regard 
to  Patterson,  La.,  where  "conditions  were  such  as  to  make 
it  practically  impossible  to  control  the  people,  and  the 
fever,  although  repeatedly  checked,  ran  its  course  until 
frost."  This  and  a  few  analogous  experiences  of  both 
tj'pes  showed  that  there  was  that  year  no  exceptional 
tendency  in  the  fever  to  end  early,  but  that  where  the 
mosquito  fight  was  properly  carried  out  the  outbreak  was 
stopped  before  frost,  otherwise  it  continued  as  usual  until 
frost. 

Infection  in  Proportion  to  Xunihcr  of  Bites. 

A  lesson  taught  also  by  occurrences  in  1905  is  that, 
other  things  equal,  the  degree  of  virulence  of  the  infection 
is  probably  due  to  the  number  of  bites  by  infected  mos- 
quitoes received  by  the  victim.  It  is  natui'al  this  should 
be  so  as  there  is  no  poison  known,  animal  or  vegetable, 
organic  or  inorganic,  the  effects  of  which  are  not  in  pro- 
portion to  tlie  dose.     The  more  bites  the  larger  the  dose. 

My  attention  was  attracted  to  this  point  early  during 
my  stay  in  Tallulah.  The  houses  in  which  the  infection 
had  been  most  severe,  as  evidenced  by  the  number  both 
of  cases  and  of  fatalities  were  those  where  mosquitoes 
abounded,  where  water  receptacles  were  most  numerous. 

An  interesting  and  significant  contrast  was  shown  in 
the  history  of  two  practitioners  who  both  did  courageous 
and  useful  work  in  the  ill-fated  village. 

One  was  a  young  physician  employed  by  the  State 
Board  of  Health,  who  thought  himself  immune  as  he  had 


LESSONS  TAUGHT  BY    EPIDEMIC    OF    1905 CHASSAIGNAC.  1053 

had  a  slight  attack  during'  a  previous  epidemic,  and  who 
labored  faithfully  without  thinking  of  taking  any  pre- 
cautions. ]More  than  once  during  the  first  days  he  showed 
me  the  bites  he  had  received  while  on  his  morning  or  his 
evening  round,  considering  them  somewhat  as  a  joke  and 
mentioning  how  he  had  watched  some  of  the  insects  at 
work.  In  less  than  ten  days  after  he  went  on  duty  he 
was  stricken  with  a  characteristic  attack  of  3'ellow  fever, 
being  apparently  overwhelmed  by  the  toxemia  and  suc- 
cumbing earlj',  notwithstanding  his  youth  and  the  de- 
voted care  he  received. 

The  other  was  an  older  practitioner,  a  local  man,  who 
had  never  been  exposed  to  the  disease  and  frankly  ac- 
knowledged his  fear  of  it,  nothwithstanding  which  he  did 
his  duty  as  nobh^  as  the  other.  The  difference  is  that  he 
used  all  possible  precautions,  sleeping  in  a  screened  house, 
smearing  his  face  and  hands  with  pennyroj-al  frequently, 
using  a  fan,  and  otherwise  dodging  mosquitoes  as  best  he 
could.  This  man  escaped  the  fever,  o^',  as  I  believe,  four 
ov  five  days  after  receiving  the  only  noticeable  bite  he 
suffered,  he  had  the  slightest  kind  of  a  walking  case, 
well-nigh  imperceptible. 

The  surroundings,  the  worK,  the  degree  of  fatigue  were 
the  same  in  both  men.  x^e.^^sychic  element,  the  age,  the 
comparative  immunity  were  all  in  favor  of  the  one  who 
contracted  the  disease  in  a  virulent  and  fatal  form.  The 
conclusion  seems  obvious. 

In  line  wdth  the  facts  just  mentioned  it  must  be  recalled 
that  it  has  been  asserted  previously,  especially  by  the 
French  observers  in  Brazil,  that  the  number  of  bites  were 
the  bites  of  one  mosquito  produced  only  a  mild  attack. 

Virulence  Diminishes  ''Pari  Passu"  icith  ihc  Destruction 

of  Mosquitoes. 

For  the  reasons  given  above,  systematic  fumigation, 
and  the  destruction  of  mosquitoes  by  any  other  means, 
first  shows  its  effect  by  a  reduction  in  the  mortality  rate, 
by  a  decrease  in  the  intensity  of  the  symptoms  in  those 
stricken.       This  can  be  understood  easily.       As  soon  as 


1054-  augustin's  history  of  yellow  fever. 

tlie  number  of  infected  mosquitoes  is  materially  lessened, 
it  stands  to  reason  that  those  who  are  unfortunate  enough 
to  be  bitten  at  all  are  likely  to  receive  fewer  bites  than 
those  who  became  victims  when  there  were  yet  numerous 
hordes  of  the  dangerous  pests.  As  long  as  there  are  any 
infected  mosquitoes  at  all  and  also  non-immunes  exposed 
to  their  bites,  so  long  must  there  break  out  some  cases  of 
fever,  hence  the  length  of  time  that  usually  elapses  before 
the  very  last  case  is  observed;  in  a  much  shorter  time 
enough  mosquitoes  are  destroyed  to  cut  down  the  average 
number  of  bites  received  by  those  who  are  exposed,  con- 
sequently the  virulence  is  diminished  long  before  the  dis- 
ease is  completely  arrested. 

This  was  shown  conclusively  by  the  course  of  events 
in  New  Orleans  during  1005.  For  July,  before  the  san- 
itary campaign  was  effective,  the  rate  of  mortality  among 
the  reported  cases  was  20% ;  for  August  it  dro])ped  to 
13%;  yhile  for  the  other  two  months  of  the  epidemic  it 
averaged  11.5. 

In  Tallulah,  this  was  observed  also.  The  fatalities  were 
most  numerous  just  before  the  inauguration  of  active 
warfare  against  mosquitoes  and  they  diminished  steadily 
thereafter.  So  much  so  that  no  one  died  of  yellow  fever 
who  took  sick  after  the  work  was  well  started  but  the 
much  regretted  young  physician  whose  case  has  already 
been  outlined  and  was  excei)tional  in  more  ways  than  one. 
The  mortality  was  arrested  first,  then  the  severity  of  the 
cases  further  decreased  noticeably  some  time  before  the 
epidemic  was  over. 

Susccptihilitij  of  Xcgrocs. 

It  was  shown  conclusively  dnring  1905  that  negroes 
are  about  as  ]ial)le  to  contract  tlie  disease  as  the  whites, 
but  that  they  have  it  usually  in  a  remarkably  mild  form. 
There  again  a  valuable  illustration  can  be  obtained  from 
Tallulah  and  vicinity:  of  90  white  cases,  IS  died,  or  20%; 
of  about  950  coloi'ed  cases,  only  5  died,  or  little  over  1/2%. 
In  Lake  Providence  and  vicinity,  of  80  whites  who  were 
stricken,  15  died,  or  nearly  20%,  while,  of  247  colored 


LESSONS  TAUGHT  RY  EUDEMIC  OF    1905  —  CHASSAIGNAC.  1055 

patients,  8  died,  or  a  little  more  than  3%.  There  were 
reported  from  Patterson  about  500  cases  amoni?  the  white, 
with  a  mortality  of  51,  yet,  of  about  200  colored  casea 
only  one  died, 

Several  negroes  were  observed  by  me  in  Tallulali,  who 
had  symptoms  just  about  sufficient  to  make  a  diagnosis 
possible,  yet  who  were  scarcely  sick,  some  not  even  inter- 
rupting- their  work.  At  first  very  few  of  the  darkies  re- 
ported their  sick  and  it  was  only  when  it  became  bruited 
about  that  the  sick  were  supplied  with  delicacies,  especi- 
ally chicken  during  convalescence,  that  we  obtained  any 
idea  of  the  large  number  who  were  having  the  disease. 

The  difference  between  the  morbidity  in  the  two  races 
might  be  explained  by  the  greater  resistance  of  the  blacks 
to  the  poison  after  its  entrance  in  the  system,  but  I  am 
inclined  to  the  belief  that  it  is  because,  other  things  equal, 
the  black  man  receives  a  smaller  dose  of  the  poison  owing 
to  the  fact  that  he  gets  bitten  less.  This  may  be  due  to 
his  tougher  skin,  or  to  the  strong  musky  smell  cominj]^ 
from  his  surface  which  may  keep  the  mosquitoes  away 
in  a  way  analogous  to  that  of  pennyroyal  nnd  other  strong 
scents  which  are  used  with  that  end  in  view. 

Be  that  as  it  may,  we  all  know  that  mosquitoes  are  less 
felt  by  the  colored  than  by  the  Avhites,  and  1005  showed 
that  negroes  are  just  as  prone  to  contract  yellow  fever 
as  their  white  neighbors,  but  have  it  in  a  very  mild  form. 

Tliis  is  an  exceedingly  important  lesson  for  obvious 
reasons,  as  it  was  formerly  thought  that  the  negroes  were 
practically  immune  and  cases  among  them  must  have 
been  overlooked  easily  and  frequently. 

Q uaran t Ines   Uniii tcUif/cnt. 

Numerous  occurrences,  illustrating  different  phases  of 
the  subject,  have  shown  that  the  kind  of  quarantines  re- 
sorted to  up  to  1005  were,  to  say  the  least,  unintelligent 
because  they  either  were  unnecessary,  on  the  one  hand, 
or  did  not  attain  their  ]uirpose,  on  the  other.  Quaran- 
tines other  than  those  against  persons  wlio  might  be 
infected  or  objects  that  might  carry  infected  mosquitoes 
were  proved  to  be  unnecessary  by  the  large  number  of 


1056  augustin's  history  of  yellow  fever. 

places  which  remained  free  of  the  disease  notwithstandinji: 
the  fact  that  ordinary  business  shipments  were  received 
as  usual,  or  at  most  were  fumigated  before  leaving  tlie 
infected  locality.  The  United  States  postal  authorities 
refused  to  fumigate  the  mails  and  no  harm  came  of  the 
o^mission. 

On  the  other  hand,  some  places  became  infected  which 
had  tried  the  non-intercourse  or  shot-gun  quarantine  born 
of  ignorance  and  panic.  No  land  quarantine  can  be 
absolute;  every  avenue  can  not  be  guarded  adequately. 
The  stricter  the  quarantine  the  more  object  there  is  in 
evading  it  and  the  more  apt  is  the  evasion  to  be  success- 
ful; also  the  average  quarantine  is  apt  to  be  put  on,  in 
these  days  of  rapid  and  easy  communication  only  after 
people  have  scattered  from  the  point  of  original  infection, 
some  of  them  perhaps  to  the  quarantining  place  which  is 
lulled  into  a  sense  of  false  security  because  it  has  put  up 
the  bars  against  the  rest  of  the  world. 

We  have  learned  that  the  only  sensible  restrictions  are : 
1°  Detention,  for  a  sufficient  time,  of  persons  coming 
from  an  infected  or  suspected  point.  2°  Fumigation  with 
sulphur  of  any  inanimate  oljjects  or  packages,  coming 
from  such  places,  which  might  by  any  chance  contain 
living  mosquitoes,  possibly  infected.  3°  Careful  screen- 
ing of  trains,  steamboats  or  other  means  of  transjjortation 
between  infected  and  non-infected  points. 
Prophylaxis  in  Place. 

It  was  demonstrated  during  the  prevalence  of  yellow 
fever  in  1005,  that  a  community  able  and  willing  to  rid 
itself  of  stegomyia  mosquitoes  could  look  upon  the  in- 
troduction of  a  case  of  tlie  disease  wiili  e(iuanimity.  The 
means  of  propagation  having  been  disposed  of  there  can 
be  no  danger  of  a  spread  of  the  infection  and  the  presence 
of  the  infected  person  is  no  longer  a  menace  to  the 
population. 

^[organ  City,  for  instance,  its  health  and  municipal 
authorities  having  been  among  the  early  converts  to  the 
mosquito  doctrine,  had  its  cisterns  oiled  and  screened, 
its  street  gutters  liberally  treated  with  Beaumont  crude 
oil,  and  became  practically  free  from  the  stegomyia.     On 


LESSONS    TAUGHT    BY   EPIDEMIC  OF    1905 CHASSAIGNAC.  1057 

an  important  factor  in  the  degree  of  infection  and  that 
two,  if  not  three,  different  occasions,  patients  ill  with 
yellow  fever  came  into  the  town  from  near-by  infected 
points  and  remained  during  the  course  of  the  disease 
without  their  presence  causing  any  outbreak  of  the 
pestilence. 

This  and  analogous  experiences  make  it  clear  that  any 
place,  by  means  of  a  timely  expenditure  of  energy  and 
money,  may  put  into  effect  prohjlactic  measures  whose 
efficiency  can  be  counted  upon. 

Prophylaxis  in  Person. 

In  places  where  general  preventive  measures  have  not 
been  attempted  or  have  proved  inadecjuate,  iudividuals 
may  do  much  in  the  way  of  personal  prophylaxis. 

The  screening  of  buildings  or  of  living  rooms  and  re- 
maining within  them  from  before  sunset  to  after  sunrise 
proved  of  value  during  1905.  For  those  who  had  to 
go  about,  anointing  the  face,  neck  and  hands  with 
penn^-royal,  camphor  or  other  pungent  substance;  the 
systematic  use  of  kid  gloves  and  fans;  wearing  a  wide 
flounce  of  nios<iuito  netting  below  the  hat  brim,  in  short, 
the  avoidance  of  mcsciuito  bites  by  all  means  possible, 
apparently  proved  of  value. 

Hereafter  it  should  be  considered  the  proi)er  thing 
for  individuals  to  carry  out  prophylactic  measures  in 
order  to  re-enforce  those  instituted  by  communities  or 
municipalities. 

DcpopiiUitioii  of  Infected  Places. 

The  exodus  from  infected  places  of  a  more  or  less  largo 
proportion  of  the  population,  sometimes  by  calculation, 
sometimes  me^rely  by  imi)ulse,  showed  in  1005  that  this 
could  be  a  very  useful  procedure. 

The  moment  yellow  fever  has  gained  anything  of  a 
foothold  in  a  community,  as  many  of  the  non-immunes  as 
possible  under  existing  circumstances  should  be  removed 
until  such  time  as  general  prophylactic  measures  shall 
have  become  thoroughly  effective.  '    • 


1".')8  augustin's   history   of   yellow   fever. 

However,  this  should  be  done  with  system  although 
promptly.  The  refugees  should  he  segregated  in  a  mos- 
quito free  eamp,  train  or  boat  during  the  period  of  incu- 
bation of  the  disease.  It  has  invariably  followed  when 
people  hurriedly  left  a  stricken  place  that  a  certain  num- 
ber have  fallen  sick  on  the  road  or  in  a  strange  place 
where  people  have  been  afraid  of  them,  where  it  has  been 
difficult  to  secure  proper  attention  at  the  hards  of  ex- 
perienced persons,  and  often  where  the  siirroundings  have 
been  unfavorable.  By  means  of  the  plan  just  mentioned, 
the  few  who  are  unfortunate  enough  to  fall  sick  are  able 
to  get  immediate  and  satisfactory  attention,  thereby  secur- 
ing the  best  chance  of  recovery,  while  thoise  remaining 
well  are  free  to  start  on  their  journey  without  a  sword  of 
Damocles  hanging  over  them.  This  can  save  both  physical 
suffering  and  mental  anguish. 

Detention  Camps. 

What  has  just  been  said  shows  only  one  of  the  useful 
purposes  served  by  detention  camps.  These  have  proved  to 
be  of  the  greatest  utility  in  avoiding  onerous  restrictions 
upon  travel  and  preventing  the  paralysis  of  all  business 
depending  upon  the  going  of  persons  in  and  out  of  infected 
places.  All  those  whose  affairs  are  important  enough  to 
warrant  their  losing  a  few  days  during  detention  are  nV>b* 
to  continue  their  peregrinations  without  additional  inter- 
ference or  delay.  In  the  past,  a  larger  number  have 
been  kept  away  from  places  infected,  suspected  or  sus- 
ceptible, by  the  dread  of  being  bottled  up  indefinitely 
through  quarantine  than  by  the  fear  of  the  disease  itself. 
We  have  learned  how  to  provide  against  this  risk  by 
means  of  detention  camps  and  how  to  esta])lish  them 
promptly  at  a  reasonable  cost  for  equipment  and 
maintenance. 

TJie  Great  Lesson. 

The  epidemic  of  1905,  and  all  it  meant  of  financial  loss, 
suffering,  grief  and  death,  could  have  been  avoided  by 
the  timely  acceptance  of  the  mosquito  doctrine  and  the 
practical  application  of  its  principles.     As  always,  the 


LESSONS   TAUOHT   BY   EPIDEMIC  OF    1905 — CHASSAIGNAC.  1059 

ounce!  of  prevention  would  have  betn  better  than  the 
pound  of  cure.  Let  us  hope  that  this  lesson  has  been 
well  learned  and  has  sunk  deep.  The  people  of  New 
Orleans,  of  Louisiana,  of  our  Southland,  did  nobly,  a3 
they  always  do,  when  confronted  by  an  appalling  emer- 
gency' ;  but,  with  their  mercurialism,  will  they  give  proper 
heed  to  future  possibilities  now  that  conditions  are  normal 
again? 

We  must  persevere  in  our  study  of  sanitary  problems 
in  general  and  the  warfare  against  mosquitoes  in  partic- 
ular. Neither  is  it  too  early  to  give  serious  attention  to 
the  chances  of  entrance  of  bubonic  plague,  nor  premature 
to  train  our  batteries  on  the  rats.  A  stitch  in  time  saves 
nine  times  nine. 


1060 

THE  WOJUv  OF  THE   MEDICAL  rKOFESSION   OF 
NEW  ORLEANS  DUIUXO  THE  EPIDEMIC  OF 

By  Louis  G.  LeBkuf.  M.  1).,  Xi:w  Orleans, 

President  Orleans  Parish  Medleal  Society,  1905;  Visiting 
Physician  to  Charity  Hospital,  yew  Orleans. 

In  September,  1897,  a  special  meeting-  of  tlie  Orleans 
Parish  Medical  Society  was  called  to  discuss  the  yellow 
fever  situation.  This  meeting-  was  also  convened  to  in- 
struct the  Younger  members  of  the  profession  into  the 
etiologv,  symtomalogY  and  treatment  of  the  disease.  The 
conference  proved  verv  valuable.  Profiting  by  this  ex- 
perience, a  similar  meeting  was  called  at  the  outset  of  the 
fever  in  1905.  In  calling  the  met  ting  to  order  the  Chair- 
man expressed  himself  in  tbe  foll(»wii>g  words: 

"No  experience  in  my  eighteen  years  of  practice  ever  impressed  me 
more  forcibly  than  just  such  a  meeting  as  this  'held  eight  years  ago 
in  the  room  of  this  society,  called  by  Dr.  John  Callan,  the  then  efficient 
President,  for  the  discussion  of  the  same  subject.  It  was  also  to  try 
and  educate  the  new  men  of  our  profession  who  had  never  seen  this 
dreaded  disease.  At  t'liat  time  we  had  with  us  men  who  told  us  of  just 
such  a  meeting  called  nineteen  years  before,  in  1878.  We  are  happy 
to  say  that  most  of  these  men  are  still  with  us.  These  two  previous 
meetings,  epoch-making  as  they  were,  undoubtedly  also  were  the 
saddest  occurrences  of  our  corporate  existence,  and  we  must  hope  that 
this  will  be  the  last  we  ever  will  'hold  for  this  purpose.  Let  us  trust 
that  the  work  now  being  done  along  the  line  of  destruction  and  pro- 
tection, following  the  ascertion,  belief  and  dogma  on  the  etiology  of 
yellow  fever,  will  mean  the  turning  point  of  a  new  era,  the  regenera- 
tion from  our  former  abject,  hopeless  condition  to  something  definite, 
something  tangible. 

"Let  us  remember  how  we  felt  twenty-six  years  ago.  Let  us  remem- 
ber how  we  felt  eig'nt  years  ago  with  nothing  ahead  of  us,  nothing 
which  could  be  planned,  nothing  to  combat.  Prophylaxis  in  person 
always  failed,  prophylaxis  in  place  always  futile.  No  measure  ever 
controlled  the  situation;  no  amount  of  disinfection  ever  helped,  and 
when  the  entire  truth  was  told,  the  only  relief  which  came  was  v.-'hen 
the   frost   of   November   appeared    as   a   Heaven-sent   Nemesis   to   our 


WORK   OF   THE     MKDICAL   HROFhSSION,     190     LkPeUK.  lOGI 

dreadful  scourge.  To-day  the  situation  is  different,  and  though  we 
may  not  succeed  entirely  in  this  present  campaign,  though  we  may  not 
c'jeck  the  disease  at  once  (for  various  causes  which  will  have  to  be 
told  later),  we  hope  to  restrict  it  to  some  extent,  to  diminish  its  too 
extensive  spread,  and  to  instill  some  hope  into  our  municipal  fellow- 
citizens,  a  hope  which  will  mean  the  regeneration  and  the  rehabilita- 
tion of  our  dear  city  to  the  standard  which  she  cQould  have  amongst 
the  future  great  cities  of  our  co.;ntry. 

"I  want  to  report,  besides,  that  your  Advisory  Committee  has  been 
continuously  and  actively  at  work  since  last  Saturday  night.  The 
task  has  not  been  the  easiest  and  pleasantest.  We  will  submit  a  very 
thorough  report  later  wihen  the  work  is  over,  and  we  hope  then  to 
show  you  that  we  have  endeavored  rigidly  to  coiiform  with  the  princi 
pies  which  govern  the  disinterested,  and  high  ethical  standard  estab- 
lished by  this  society.  We  Ciave  taken  part  in  every  conference,  in 
every  meeting  called  for  the  organization  of  the  great  work  which  is 
being, tried  in  this  city.  One  of  the  members  cf  your  society  wrote  the 
first  instructions  which  were  published  last  Sunday  morning  to  govern 
all  households  regarding  the  control  of  t'le  situation,  Another  mem- 
ber of  the  committee  helped  on  a  committee  of  three  to  plan  and  organ- 
ize the  up-to-date  Emergency  Screened  iHospital,  which  was  placed  in 
operation  in  thirty-six  hours.  And  though  their  names  do  not  appear 
in  print,  nearly  every  important  article  or  medical  direction  in  the 
public  press  "iias  been  furnished  or  revised  by  your  committee.  As  we 
are  still  actively  at  work  in  the  campaign  undertaken,  we  wish  merely 
to  report  this  as  brief,  temporary  report  until  later,  when  we  can  give 
you  a  fuller  and  final  report." 

Tliougli  Carlos  Fiulay  had  advanced  the  tliecrv  (  f  iiios- 
qnito  dissemination  of  yellow  fever  since  1881  at  Havana, 
and  tlionjih  the  U.  S.  Army  YelloAv  Fever  Commission, 
consistinii-  of  Reed,  Carroll,  Amrcmonte  and  Lazear,  had 
made  their  epoch  makinii'  experiments  in  IflOO,  and  Lazear 
had  already  sealed  the  trnth  of  the  mosciuito-infected 
transmission  by  his  martyrdom  as  a  holocaust  to  the 
proof  of  his  hcjicf,  and  tlKiniih  we  had  had  the  rejiort  of 
the  Yellow  Fever  AN'orkinii'  Party  No.  2,  consistinu'  of 
Drs.  Pothier  and  Parker  and  Prof.  Beyer,  with  their 
conclusions  frcnu  their  work  at  Vera  Cruz,  still  our  public 
was  profoundly  i.iin(;rant  of  these  scientitic  discoveries. 
When  the  tirst  knowled.uje  reached  our  city  of  the  jircsence 
at  this  dread  disease  in  our  midst,  there  was  almost  a. 
panic — stocks  and  bonds  went  beogino^,  a  pall  seemed  to 


\06'2  AIGUSTIN    S     HISTORY     OF     YELLOW     KEVER. 

be  tlirown  on  all  things,  a  general  exodns  of  these  who 
could  atford  it  took  place  and  the  coniniereial  interests 
seemed  paralyzed.  The  experience  of  former  years  was 
staring  the  nnitiated  public  in  the  face.  They  remem- 
bered the  injury  to  the  city  commercially,  and  the  thous- 
ands of  lives  lost  in  the  previous  epidemics.  New  Orleans 
was  like  a  rejuvenated  city,  with  the  millions  spent  here 
in  public  improvements,  and  the  great  activity  in  bus- 
iness and  in  railroad  construction,  due  to  the  recognition 
of  its  wonderful  future  and  prospects  from  the  advantages 
of  proximity  to  the  promised  Panama  Canal  South  Amer- 
ican trade.  Everything  showed  it  to  be  on  the  eve  of 
great  growtli  and  development,  so  that  when  the  news 
came  to  us  of  this  epidemic,  it  was  a  dreadful  catastrophe. 
The  public  remembered  the  pitch  barrels  of  1878,  the 
flags  and  costumes  of  gruesome  attendants  in  1897,  ard 
nearly  all  were  in  mourning  for  some  dear  frierd  or 
relative. 

Yellow  fever  itself,  when  i)r(:p(rly  treated  or  better, 
Avhen  properly  let  alone  and  nursed,  is  not  sucl)  a  vei'y 
fatal  disease.  In  the  hands  of  a  competent  medical  at- 
tendant the  mortality  is  not  so  great  as  many  other  dis- 
eases, but  it  was  the  mystery  of  its  onset  and  the  strnnuc 
unaccoui'table  manner  of  its  ]iroi)agation  wliich  chilhMl 
the  heart  and  struck  terror  to  the  bravest.  All  mankind 
has  some  innate  su])erstiti(}n,  and  any  disease  which 
comes  in  the  night,  as  in  this  instance  stealin;':  from  house 
to  house,  sometimes  taking  a  vnIicIc  l)l(:(k  witlujut  cross- 
ing the  sti'cet,  but  n)ost  times  si;i  ending  all  over  like 
wildfire,  without  any  one  being  alsh'  to  ex]tlain  its  exact 
cause  and  mode  of  trai'smission,  I'atuially  ai)))all(  d  every 
one. 

This  was  the  condition  of  affairs  wlicn  tltis  campaign 
opened,  and  this  was  tb"  st-it<>  of  (Imt-  -  -  'en,  on  July 
22nd,  we  were  told  publicly  of  this  trouble.  No  '^' 
tressed  people  ever  found  its  medical  nrcifession  more 
united  and  more  willing  to  help  than  errs  was  on  that 
date.  There  was  a  trenierdonr,  v-nk  ahffid  of  us,  the 
work  of  education,  of  teachina'  tl-e  new  lelief  and  the 
training  in  the  great  eam];aign   ef  pirj  I'vlaxis  and  de- 


WORK   OF  THE   MEDK  AL   PROFESSION,     1905 LeBuEF.  1  0G3 

striiction,  the  tlioii&auds  of  laymen  who  were  willing  to 
make  the  good  fight.  Our  part  was  the  important  one, 
and  the  difficult  one ;  it  is  not  very  easy  to  reform  the 
uninitiated  to  new  ideas;  ignorance  is  generally  self- 
satisfied  and  prejudiced,  and  the  propagandist  of  the  new 
theory  and  ot  the  new  scientific  facts  has  to  proye  his 
contention  before  it  is  helieyed. 

It  was  not  all  to  tell  the  public  of  the  established  facts 
of  Los  xVnimas  and  Vera  Cruz;  we  were  forced  to  start 
a  campaign  of  education  and  forced  to  labor  on  the  front 
line  to  direct  the  work  of  destruction  and  preyention. 

The  old  theory  of  fomites  and  infection  was  oyer,  and 
the  simple  fact  that,  first,  a  mosquito,  and  the  female 
^tcgomyia  Calopus  at  that  (fasciata  as  it  was  caliea 
then)  was  the  offender;  secondly,  it  could  transmit  the 
disease  only  if  it  was  allowed  to  bite  a  yellow  feyer 
patient  during  the  first  three  days  of  illness ;  thirdly,  and 
lastly,  that  this  yello^y  feyer  infected  mosquito  could  uot 
reproduce  the  disease  before  about  twelve  days  after  its 
inoculation  or  injection. 

So,  starting  from  these  three  basic  fundamental  truths, 
three  specific  lessons  had  to  be  taught,  and  practiced  as 
the  very  catechism  and  Bible  of  our  entire  conduct. 

(a) Enforce  the  protection  of  the  yellow  fever  patients 
from  the  bite  of  all  mosquitoes,  to  exclude  the  special 
offender;  /.  c.  provide  mosquito  bars  and  screen  the  room 
of  the  patient  at  once. 

(b)  This  work  of  screening  had  to  be  performed  as 
early  as  possible  to  prevent  infected  moscpiitoes  from 
escai)ing  and  propagating  the  disease. 

(c)  The  final  destruction  of  all  the  mosquitoes  v,lti<-^' 
might  have  perchance  bitten  a  case,  befoie  the  t\velve 
days  of  incubation  or  digestive  preparation  was  completed 
in  the  salivary  glands  or  digestive  tract  of  the  irsect  and 
thus  rendered  it  dangerous  to  other  human  beings. 

Though  these  three  simple  truths  were  i)lain  and  easy, 
it  was  only  the  starting  point  of  the  great  educational 
fight  the  medical  profession  had  ab.cad  of  it.  To  be  more 
certain  of  our  success,  it  was  ^^•iser  to  destroy  all  the  mos- 


1064'  augustin's   history  ok   vnliow   fever, 

quitoes  we  could,  both  directly  by  neueral  fiimii;ation, 
and  also  by  diminislilDii-  the  probalile  sources  of  their 
habitat. 

Screeuiu<»-,  saggiuo-  outters  of  roofs,  barrels,  water  con- 
tainers or  any  stationary  vehicle  where  larva?  niijoht  be 
hatched — this  was  the  do<>ma  and  instruction  vre  bad  to 
disseminate.  If  we  were  successful,  thou.nh  we  might  not 
be  able  to  stop  the  disease,  as  we  had  been  informed  of  it 
too  late,  and  for  various  inexplicable  reas^ons  the  fact  of 
tbe  presence  here  had  been  uiirecoiiiiized,  or  if  recognized 
had  been  through  criminal  neglect  and  blindness  allowed 
to  spread  beyond  control,  we  would  possibly,  with  a  good 
fight,  be  able  to  restrain  its  too  great  spread,  and  prove 
to  the  Avorld  by  this  re^trictiou  tliat  we  could  do  some- 
thing that  would  affect  its  unlimited  spread,  and  therefore 
re-establish  confidence  aud  build  for  our  future  an  assur- 
ance of  action  and  control  which  would  allow  us  to  throw 
off  our  chains  and  fetters,  and  forever  juove  our  immunity 
from  what  we  could  henceforth  call  the  Mosquito  Fever, 
instead  of  the  awe-instilling  name  of  Yellow  Fever. 

As  a  good  deal  of  the  following  history  which  must  be 
related  personallv  refers  to  the  Avork  of  the  Advisory  Com- 
mittee of  the  Orleans  Parish  ^Nfedical  Pnciety.  of  which 
the  present  writer  was  Chairman,  I  will  take  the  liberty, 
in  most  of  the  remainder  of  this  article,  to  give  excerpts 
of  reports  written  by  Drs.  Sidney  L.  Theard,  the  ablei 
Secretary  of  the  City  Board  of  Health;  Prof.  Kupert 
Boyce,  Dean  of  the  Liverpofil  School  of  Tropical  ^Nfcdi- 
ciiie;  Beverend  Beverly  Warner,  in  charge  of  the  Citizens' 
Educational  Campaign,  and  the  1005  Annual  Beport  of 
llie  Orleans  Parish  Medical  Society: 

The  First  Stcpft  in   fJir  Caiii/xiif/ii   (iiid  the  Orf/diii.zatio'H 
of  the  Refioi(rce!<  of  the  Citi/  /o  Coinlxtt  fJic  Disease. 

On  Friday,  July  21st,  a  meeting  of  the  State  and  City 
Boards  of  Health,  the  representatives  of  the  Public 
Health  and  ^Marine  Hospital  Service,  and  Health  Officers 
from  surrouudiug  States  with  Drs.  LeBeuf  and  ^Magruder, 
was   convened   in   order  to   reassure   the  public   and   to 


WORK   OF   THE   MKUICAL   PROFESSION,     1^05 LkBeUF.  1065 

check  the  stringent  and  onerous  quarantine  precautions 
which  had,  on  the  rumors  of  the  presence  of  yellow  fever, 
been  promptly  taken  by  the  surrounding  States  against 
New  Orleans,  although  as  yet  no  official  declaration  had 
been  made.  As  an  example  of  this  promptitude,  it  is 
worthy  of  note  that  the  State  of  Mississippi  had  issued 
a  quarantine  ordinance  on  the  daj'  cf  the  meeting. 
Shortly  after  the  meeting  on  Friday  the  first  step  in  gen- 
eral medical  organization  was  taken  by  the  appointment 
on  the  following  day,  July  22nd,  of  an  Advisory  Board, 
consisting  of  the  Chairman,  Dr.  Louis  LeEeuf  and  three 
other  nieml)ers  of  the  Orleans  Parish  :\redical  Society, 
viz.,  Drs.  John  Callan,  ^larcus  J.  Magruder  and  John  F. 
Oechsner.  This  Committee  was  appointed  to  co-operate 
with  the  health  authorities  and  to  help  to  the  best  of  their 
judgment  in  the  campaign  ahead  of  them.  It  was  now 
fully  recognized  by  these  representative  medical  men  that 
much  valuable  time  had  already  been  lost,  and  that  the 
prophylactic  measures  which  had  up  to  this  time  been 
adopted  by  the  health  authorities  were  neither  sufficiently 
extensive  nor  precise.  The  failure  of  New  Orleans  in  this 
respect  emphasizes  what  every  International  Sanitary 
Convention  had  drawn  attention  to,  namely,  the  necessity 
of  prompt  notification  of  yellow  fever.  Without  this,  in- 
ternational and  interstate  laws  of  sanitation  can  not  be 
administered  with  science,  Avisely  and  humanely. 

On  the  evening  of  July  22nd,  the  Advisory  Committee, 
the  Medical  Health  Officer  and  Dr.  J.  H.  White,  V.  S. 
;Marine  Hospital  Service,  after  a  protracted  consultation, 
issued  the  first  authoritative  and  collective  pronounce- 
ment upon  the  precautions  which  were  necessary  to  be 
adopted.     The  manifesto  reads  as  follows : 

An  emergency  exists  in  our  city  which  demands  the  attention  of 
every  individual,  with  the  view  to  limiting  and  preventing  the  spread 
of  epidemic  disease.  It  has  been  scientifically  proved  that  the  mosquito 
is  the  only  means  of  the  transmission  of  Yellow  Fever.  Measures 
sCiould  be  especially  directed  against  them.  It  is  especially  urged  by 
the  undersigned  that  the  following  simple  directions  be  followed  by 
the  householders  of  this  city  during  the  summer  months: 


]066  aigustin's   history  of  yellow  fever. 

First — Empty  all  unused  receptacles  of  water.     Allow  no   stagnant 
water  en  the  premises. 

Second — Screen  cisterns,  after  placing  a  small  quantity  of  insurance 
oil  (a  teacupful  in  each  cistern)  on  the  surface  of  the  water. 

Third — Place  a  small  quantity  of  insurance  oil  in  cesspools  or  privy 
vaults. 

Fourth — Sleep  under  mosquito  nets. 

Fift'J — Screen  doors  and  windows  wherever  possible  with  fine  mesh 
wire. 

(Signed)  QUITMAN  KOHXKE, 

Health  Officer. 
J.  H.  WHITE, 

Surgeon,  U.  P.  H.  and  M.  H.  S. 
ADVISORY  COMMITTEE, 

O.  P.  M.  S. 

Ou  the  same  day  (July  22)  the  aiithcritit^-,  italizina: 
that  New  Orleans  was  unprcvided  with  a  Fever  Isolation 
Hospital,  took  steps  to  ac(piire  an  old  house  in  the  in- 
fected quarter  in  the  Italian  district.  It  seems,  of  course, 
very  extraordinary  that  in  the  tyventieth  century,  and  in 
a  port  of  the  jireat  importance  and  size  of  Xew  Orleans, 
that  no  proper  provision  should  haye  existed  for  the  isola- 
tion of  infectious  cases.  .  There  is  no  doubt,  however, 
after  having-  paid  dearly  for  their  experience,  that  the 
Citizens  of  New  Orleans  will  rot  in  future  allow  this 
defect  to  go  unremedied. 

The  Hospital  receiyed  its  first  patients  on  July  2r)th, 
and  in  spite  of  the  fact  that  it  was  placed  in  the  midst 
of  most  unsanitary  surroundings  and  overcrowded,  it, 
nevertheless,  answered  its  purpose  very  well,  owing  to 
the  very  rigid  precautions  against  the  possibilities  of 
mosquitoes  becoming  infected  from  the  patients.  It  was, 
indeed,  a  most  striking-  demonstration  of  the  harmle^^sness 
of  the  disease  in  the  absence  of  the  Stcf/ojuj/in ;  seven  non^ 
immunes,  including  myself,  spent  a  portion  of  each  day 
in  the  wards,  but  in  no  instance  did  infection  arise.  The 
entrance  to  all  the  wards  was  barred  by  double  screened 
doors,  so  that  one  set  c-f  drjcrs  were  closed  before  the 
second  set  were  opened. 

A  few  weeks  after  the  opening  of  this  Hospital,  it  be- 
came necessary  to  change  into  another  temporary  make- 
shift. 


WORK   OF  THE   MEDICAL   PROFESSION,      190.5 LEBi-UF.  1067 

The  new  premises  were  lai'ij;er,  more  airy  and  situated 
amongst  more  sanitary  surroundings.  Owing  to  the  sub- 
sidence of  the  fever,  it  had,  however,  far  less  work  to  do 
than  the  former.  There  is  no  doubt  that  the  emergency 
hospitals  did  magniticent  service,  and  that  the  greatest 
credit  was  due  to  Dr.  Hamilton  P.  Jones,  Dr.  Paul  Emile 
Arcliinard,  Dr.  J.  Birney  Guthrie,  and  to  these  who  as- 
sisted them  in  the  most  arduous  and  difficult  task,  ren- 
dered still  more  trying  owing  to  the  ho^-tile  attitude  of 
tiiC  poorer  classes  of  Sicilians  and  Italians. 

Simultaneously  with  the  fcrniation  of  the  Medical 
Advisory  Board,  a  meeting  was  held  in  the  City  Hall, 
under  the  auspices  of  tli3  Mayor,  the  State  and  City 
Health  Officers,  and  a  number  of  citi5:eEs  prominent  in 
business  and  professional  life,  to  review  the  fever  sitiia- 
tion~  and  to  raise  money.  The  outcome  of  the  meeting 
was  the  successful  launching,  under  the  chairmanshi])  of 
Mr.  Charles  Janvier,  of  a  Finance  Committee — The  Citi- 
zens' Yellow  Fever  Fund  Committee — for  the  purpose  of 
collecting  funds  to  carry  on  the  tight  against  the  fever. 
On  Sunday,  July  23rd,  the  Bevererd  Dr.  Beverlv  Warner, 
from  his  pulpit,  took  the  first  step  in  Anti-Y(^lh>w  Fever 
propagandism  amongst  religious  derominations,  and  on 
Monday,  Julv  24tli,'  the  Fourteentih  Ward  of  the  Citv 
organized  and  met  for  the  purpose  of  cleaning  up  and 
screening  its  own  district,  and  for  authority  to  Issue  an 
advertisement  '"For  bids  to  screen  its  250  cisterns  with 
copper  gauze  or  cheese  cloth,  and  for  tenders  to  clean 
out  the  drains."  All  present  at  this  meeting  subscribed 
to  the  Ward  Funds.  Its  example  Avas  immediatelv  fol- 
lowed l)y  the  otl'(M-  wards,  rrd  thus  we  started  the  Ward 
Organization,  which  was  subsequently  placed  under  the 
direction  of  Dr.  Warner. 

It  will  now  be  simple  to  trace  the  steps  in  the  campaign 
if  I  follow  tlie  work  of  the  sev(M'al  organizations: 

1.  The  Local  Medical  Organization. 

2.  The  Ward  Oraanization. 

3.  The   Public   Health   and   ^Maiine  Hospital    Service 

Organization. 

4.  The  Educational  and  Press  Organization. 

5.  The   Financial   Organization. 


I06i  augustin's   history  ok  ^  eli.ow   fever. 

THE    LOCAL    MEDICAL   ORGANIZATION. 

Appeal  for  Ciric  Co-operation. 

On  Monday,  Jnly  24tli,  1905,  a  prorlaniation  was  issned, 
signed  bv  the  Mayor  and  concurred  in  by  the  ^Medical 
Authorities,  setting  forth  the  situation,  and  calling  upon 
the  citizens  to  co-operate  with  the  Health  Authorities  in 
stamping  out  the  fever.     It  read  as  follows: 

Mayoralty  of  New  Orleans, 
City  Hall,  July  24th,  1905. 
To  the  People  of  New  Orleans: 

The  Health  situation  in  this  city  is  serious,  but  not  alarming.  Be- 
cause of  this  situation,  quarantine  has  been  declared  against  New 
Orleans  by  several  States  and  Cities.  It  is  proper  that  the  actual 
facts  be  recognized  and  dealt  with  resolutely  and  calmly. 

It  is  authoritatively  stated  by  eminent  sanitarians  that  within 
recent  years  visitation  of  Yellow  Fever,  more  widely  spread  than  that 
wh:'ch  is  in  our  City,  have  been  successfully  met  and  absolutely 
suppressed  by  methods  whose  potency  has  been  demonstrated  by  as- 
certained results,  and  the  application  of  which  is  simple.  T'lose 
methods  are  now  adopted  by  our  own  State  and  City  Health  Authori- 
ties, with  the  volun'teer  assistance  of  the  United  States  Marine 
Hospital  Service,  and  the  Orleans  Parish  Medical  Society  of  this 
Parish.  To  the  perfect  and  speedy  success  of  the  mea:>ureo  to  be 
followed,  the  co-operation  cf  every  householder  is  necessary.  That 
given,  the  people  may  confidently  expect  a  speedy  release  from  the 
trying  conditions  in  which  they  are  now  placed,  and  from  the  appre- 
hension of  its  recurrence  in  the  future. 

I,  therefore,  as  Mayor,  urge  all  citizens  and  householders  to  render 
cordial  and  ready  obedience  to  the  instructions  which  may  from  time 
to  time  be  given  hy  the  Healt)'.i  Authoritie.--,  and  to  render  every  aid 
within  their  power  to  those  Authorities  in  the  earnest  efforts  which 
they  are  now  making,  and  in  which  they  will  persist  for  the  absolute 
stamping  out  of  this  infection.  These  instructions  are  not  difficult  of 
performance;  tl'aey  are  easily  to  be  understood,  and  can  be  followed 
with  but  little  expense.  Since  the  consensus  of  sanitary  and  medical 
opinion  of  to-day  is  that  the  infection  of  Yellow  Fever  is  transmitted, 
or  can  be  transmitted,  only  by  means  of  the  sting  of  the  insect  known 
as  the  "cistern  mosquito,"  the  following  advice  recently  given  by  Dr. 
Kohnke,  the  City  Health  Office;  by  Dr.  Souchon,  President  of  the 
State  Board  of  Health;  Dr.  White,  Surgeon  of  t^ae  United  States  Marine 


WORK   OF   THE   Mi<;DICAL   PROFKSSION,      1905 LeBeUF.  1  009 

Hospital  Service,  and  an  Advisory  Committee  of  the  Orleans  Parish 
Medical  Society,  should  be  willingly  and  implicitly  obeyed  by  every 
householder  in  this  city: 

First. — To  keep  empty  all  unused  receptacles  of  water  in  every 
house,  and  allow  no  stagnant  water  on  any  premises. 

Second. — To  screen  all  cisterns  after  placing  a  small  quantity  of  in- 
surance oil  (a  teacupful  in  each  cistern)  on  the  surface  of  the  water. 
Third. — To  place  a  small  quantity  of  insurance  oil  in  cesspools   or 
privy  vaults. 

Fourth. — Sleep  under  mosquito  nets. 

Fifth. — WCierever  practicable,  screen  doers  and  windows  with  wire 
screens  of  close  mesh. 

The  foregoing  advice  may  from  time  to  time  be  given  by  the  Health 
Authorities  with  more  particularity.  Whatever  emanates  from  them 
must  be  accepted  as  given  for  the  good  of  the  city  and  the  preserva- 
tion of  every  individual  of  its  population,  and  should  be  respected  and 
followed  to  the  letter. 

I  repeat,  upon  the  information  of  t'iiose  qualified  from  actual  investi- 
gation and  scientific  knowledge  to  speak  upon  this  subject,  that  the 
situation  in  our  city  is  not  alarming,  and  that  if  it  is  treated  by  our 
people  earnestly  and  intelligently,  that  this  situation  will  soon  be 
eliminated  and  demonstration  will  be  made  to  the  world  that  for  the 
future  the  infection  cf  Yellow  Fever  can  have  no  permanent  lodgement 
within  the  borders  of  the  city  of  New  Orleans. 

MARTIN  BEHRMAN,  Mayor. 
We  concur  in  tCie  above. 

QUITMAN   KOHNKE, 

City  Health  Officer. 
EDMOND  SOUCHON,  M.  D., 

President,  L.  S.  B.  H. 
J.  H.  WHITE, 
Surgeon,  P.  H.  and  Marine  Hospital  Service. 
ADVISORY   COMMITTEE, 
Representing  Orleans  Parish  Medical  Society. 

II.     APPEAL  FOK  EARLY  NOTIFICATION. 

On  July  24tli,  1905,  a  most  iinportaiit  notifo  was  also 
issued  to  the  members  of  tlie  ]Medical  Profession  from  the 
Orleans  Parish  ^ledical  Society,  and  sii^red  by  the  Ad- 
visory (Vnimittee,  Dr.  \Miite,  U.  S.  P.  11.  &  M.  H.  S.,  and 
the  President  of  the  Louisiana  State  Board  of  Health 
urging  up6n  each  medical  nmn  the  absolute  necessity  of 


1070  augustin's  history   of  yellow   fevkr. 

early  uotitication  and  of  rcpoi-tiiiji  all  cj^hcs  (if  fever.  It 
is  iiuqiiestionably  an  exceptionally  wise  circular  and 
touches  a  very  weak  spot.     I  reproduce  it : 

Orleans  Parish  Medical  Society, 

New  Orleans,  La.,  July  24,  1905. 

Dear  Doctor: — We  want  to  specially  urge  you  to  report  all  your 
cases  of  fever — malarial,  typhoid  or  fever  of  any  kind — during  this 
summer,  to  the  City  Board  of  Health.  It  is  absolutely  essential  to  the 
checking  of  the  spread  cf  Yellow  Fever  in  our  city  that  all  cases  of 
fever  sihould  be  promptly  and  conscientiously  reported.  Our  patients, 
the  public  and  the  surrounding  communities,  will  naturally  look  to  our 
profession  in  this  great  emergency,  and  the  responsibility  rests  in  a 
great  measure  with  us  to  check  this  condition,  or  at  least  to  limit  its 
too  extensive  spread.  It  is  a  well  known  and  scientifically  proven 
dogma  that  the  mosquito  theory  is  to  be  accepted  as  a  fact;  then  we 
must  exert  ourselves  to  the  utmost  to  destroy  the  mosquito,  the  only 
host  of  transmission  of  Yellow  Fever.  Let  us,  13hen,  make  a  consis- 
tent campaign  against  it,  educate  our  patients  regarding  this  situa- 
tion and  the  danger  of  it,  and  direct  them  to  place  patients  immediate- 
ly under  netting  pending  action  cf  the  Board  of  Health.  Neither  your 
patient  nor  the  household  will  be  subjected  to  the  obnoxious  house 
quarantine  of  several  years  ago. 

Above  all  things,  report  your  cases  promptly,  to  permit  us  to  check 
any  further  foci  of  infection. 

Even  if  you  are  not  positive  tlhat  the  mosquito  is  the  only  source  of 
transmission  of  Yellow  Fever,  give  your  city  the  benefit  of  the  doubt 
in  this  important  and  vital  matter.  , 

Respectfully, 

BDMOND  SOUCHON,  M.  D., 
President  Louisiana  State  Board  of  Health. 

QUITMAN  KOHNKE,  M.   D., 
Health  Officer  of  the  City  of  New  Orleans. 
J.  H.  WHITE,  M.  D., 
Surgeon,  U.  S,   Public  Health  and  Marine  Hospital  Service,  in  charge 
of  the  Government  Measures. 

JOHN  CALLAN,   M.  D., 
J.  F.  OECHSNER,  M.  D. 
M.  J.   MAGRUDER,   M.   D., 
L.  G.   LeBeuf,  M.   D.,  Chairman, 
Advisory  Committee,  Orleans  Parish  Medical  Society. 


WoRK  OF  THE  MKDICAL  PROFESSION,    190' LeBeUF.  1071 

III.     APPEAL   FOR   IMMEDIATE    SCREENING    OF 
SUSPECTED  CASES  AND  FUMIGATION. 

This  circular  Avas  immediately  followed  by  another  to 
the  medical  men,  again  urging  the  importance  of  early 
notification  and  careful  fumigation.  As  regards  the 
method  of  fumigation  the  circular  is  not  as  stringent  on 
this  subject  as  subsequent  experience  found  to  be  abso- 
lutely" necessary  to  ensure  safety: 

Orleans  Parish  Medical  Society, 

New  Orleans,  La. 

Dear  Doctor: — In  an  earnest  attempt  to  work  in  harmony  with  the 
plan  of  procedure  adopted  'by  the  HealUi  Authority,  and  the  U.  S. 
Public  Health  and  Marine  Hospital  Service,  now  being  enforced  in  a 
general  inspection  of  our  entire  city,  we  want  to  suggest  to  you,  as 
your  Advisory  Committee  acting  with  these  bodies,  that  you  report  at 
once  any  case  of  fever  in  your  practice  remotely  suspicious  of  being 
Yellow  Fever.  If  you  want  to  do  your  city  the  greatest  good  in  this 
hour  of  trial,  immediately  constitute  yourself  as  a  Health  Officer  for 
the  premises  of  the  sick  you  are  called  to  attend.  Even  before  the 
regular  Sanitary  Inspector  of  the  Board  reaches  the  house,  place  the 
patient  at  once  under  a  mosfiulio  bar,  pending  further  proceedings. 
•Also  order  at  once  another  lOom  fumigated  with  sulphur — 2  pounds 
to  the  1,000  cubic  feet — and  then  thoroughly  scieen  it.  .'i  it  canG';t 
be  done  in  a  perfect  manner  at  least  order  all  the  openings  screened 
with  either  cheese  c'ot'j'  or  other  light  material,  well  packed  so  a.i  to 
allow  no  mosquitoes  in  the  room.  Keep  only  one  door  free,  covering 
all  the  transoms  in  the  same  manner.  On  entering  this  door  beat  the 
air  thoroughly  with  a  cloth  before  opening.  When  the  room  is  pre- 
pared, remove  the  patient  to  it,  fumigating  the  room  just  vacated  in 
the  same  manner. 

After  the  first  three  days  of  the  fever  the  Stegomyia  fasciata  cannot 
be  infected  from  that  patient,  but  we  must  be  careful  to  keep  the  room 
well  closed  until  the  final  fumigation  or  destruction  of  any  mosquitoes 
which  might  have  remained  in  the  room.  Look  to  the  general  hygiene 
of  the  house,  inquire  whether  the  cirterns  or  any  otTier  open  receptacles 
of  standing  water  about  the  premises  have  been  properly  oiled  or 
screened.  Act  in  this  matter  regardless  of  the  worK  which  will  be 
done  by  the  constituted  authorities,  for  your  own  personal  good  and 
for  the  greatest  good  of  your  city.  In  other  words,  Doctor, 
take  every  possible  precaution  to  protect  all  of  your  fever  cases  from 
being  bitten  by  mosquitoes  during  the  first  three  days  of  fever. 


107  2  AL'GUSTIN   S     HISTORY     OF    YELLOW     FEVER. 

Our  interest  in  the  entire  matter  is  the  same  as  yours,  and  we  must 
worli  for  the  same  purpose.  The  part  to  be  played  by  our  profession 
is  an  extremely  'mportant  one;  the  faith  and  trust  of  the  entire  com- 
munity is  placed  on  our  shoulders,  and  we  must  fully  deserve  fhe  con- 
fidence reposed  in  us. 

Very  sincerely  yours, 
ADVISORY  COMMITTEE,  Orleans  Parish  Medical  Society. 

IV.  APPEAL  FOR  AN  EDUCATIONAL  CAMPAIGN. 

Another  circular  was  issued  on  July  24tli,  1905,  directed 
to  the  Board  of  Health,  poiutiug  out  the  necessity  of  a 
Campaign  of  Education,  and  urging  the  importance  of 
asking  the  Clergy  to  especially  disseminate  knowledge 
from  the  pulpit  in  the  matter  of  yellow  feyer.  The  cir- 
cular then  proceeds  to  give  useful  information  in  case 
of  infection,  and  finally  appeals  for  united  action  in  a 
general  warfare  against  the  i^tcf/o)iii/ia  : 

Orleans  Pari;;h  Medical  Society, 
New  Orleans,  July  24th,  1905. 

Gentlemen: — ^The  condition  existing  at  present  is  one  that  calls  for 
the  most  strenuous,  prompt  and  vigorous  measures  capable  of  institu- 
tion. In  view  of  the  absence  of  the  necessity  for  obnoxious  local  or 
house  quarantine,  the  co-operation  of  physician  and  householder  should 
be  a  matter  of  comparatively  easy  solution.  A  campaign  of  education 
s'hould  be  boldly  inaugurated.  The  clergyman,  during  his  rounds  and 
from  his  pulpit,  should  be  a  valuable  agent  in  the  dissemination  of 
this  knowledge.  The  Advisory  Committee  of  the  Orleans  Parish 
Medical  Society  begs  to  recommend  that  the  following  measures  be 
instituted  at  once,  with  the  view  of  stamping  out  the  few  foci  of  in- 
fection of  Yellow  Fever  which  now  exists  in  our  city: 

Cases  of  fever  of  any  character  developing  in  the  infected  area  may 
be  regarded  as  suspicious,  and  the  patient  immediately  protected  from 
mosquitoes.  The  house,  cisterns,  yards,  drains,  gutters,  cesspools  and 
vaults  should  be  carefully  inspected,  and  no  breeding  spots  for 
mosquitoes  should  be  overlooked. 

The  gutters  and  streets  must  be  carefully  inspected,  and  no  breed- 
ing spots  for  mosquitoes  should  be  overlooked. 

The  gutters  and  streets  must  not  be  neglected.  If  the  case  proves 
to  be  one  of  Yellow  Fever,  the  house  must  be  screened  and  the  rooms 
in  the  house  other  than  the  one  occupied  by  the  patient  must  be 
fumigated  to  destroy  all  mosquitoes  in  them.  When  the  case  ends, 
either  by  recovery  or  death,  the  room  occupied  by  the  patient  must 
be  fumigated,  for  the  same  reason. 


WORK  OF  THE  MEDICAL  PROFESSION,    1905 Lb  BeUF.  1073 

The  success  of  these  procedures  will  largely  depend  upon  the 
promptness  and  earnestness  with  w'hich  mosquitoes  are  prevented 
from  coming  in  contact  with  the  patient  and  the  destriction  of  all 
mosquitoes  in  the  room  after  the  patient  is  cured  or  dies. 

The  new  foci  of  infection  must  be  diligently  sought  and  drastic 
measures  adopted  for  stamping  them  out.  It  is  only  through  the  pro- 
per conciliatory  education  of  the  physician  and  t'he  layman,  and 
through  their  sincere  co-operation,  that  anything  can  be  accomplished. 

For  the  vast  portion  of  the  city  not  infected,  we  recommend  that  a 
sufficiently  large  force  of  men  be  immediately  organized  to  place  oil 
in  all  unscreened  cisterns,  or  other  breeding  places  of  mosquitoes, 
and  distribute  circulars  among  householders  enlisting  t'heir  co-opera- 
tion.    All  gutters  should  either  be  flushed  or  oiled. 

An  active,  vigorous  and  persistent  warfare  on  mosquitoes  should,  in 
our  opinion,  be  immediately  instituted  from  one  end  of  the  city  to 
the  other,  as  in  this  way  localities  now  healthy  may  be  kept  so,  even 
though  foci  of  infection  be  Introduced.  We  believed  t'hat  the  sanitary 
regeneration  of  this  city  depends  entirely  upon  prompt  and  vigorous 
action  upon  your  part.. 

With  the  profoundest  assurances  of  our  heartiest  co-operation  with 
you  in  any  movement  to  better  the  sanitary  conditions  of  the  city, 

We  beg  to  subscribe  ourselves, 

ADVISORY  COMMITTEE,  Orleans  Parish  Medical  Society. 

V.     A  WAEXIXG  TO  BEWARE   OP  THE  DANGER 

OF    OVERLOOKING    THE    LESS     OBVIOUS 

BREEDING  PLACES  OF  THE  STEGOMYIA. 

A  Tery  useful  aud  practical  notice  was  also  sent  out 
by  the  Advisory  Committee,  directing-  attention  to  the 
importance  of  not  overlookini«-  possible  receptacles  of 
water  in  the  house,  as  pitchers,  flower-pots,  etc.  It  reads 
as  follows : 

Orleans  Parish  Medical  Society, 

New  Orleans,  Louisiana. 
We  desire  to  call  your  attention  to  the  wrigglers  seen  inside  of  the 
residence  of  people.  Probably  the  public  in  the  fight  against  fhe 
mosquito  have  directed  all  their  efforts  against  the  cisterns  and  the 
barrels  or  the  outside  containers,  still  a  source  of  great  danger  also 
exists  inside  of  the  bedrooms  in  the  water-pitchers,  in  the  dining- 
room,  or  in  the  conservatory  in  the  water-pots,  vases  or  pots  for 
plants.  A  frequent  error  and  a  great  menace  Is  t'he  habit  which  some 
householders  have  of  only  partly  emptying  a  water-p.itcher,  and  though 


1074'  AUGUSTIN   S     HISTORY     OF     YELLOW     FEVER. 

it  is  refilled  daily  it  is^  never  entirely  emptied,  leading  always  one-half 
pint  or  so  for  the  larvae  to  develop.  Any  physician  in  his  daily  rounds 
can  see  this  illustrated  by  inspecting  the  various  water-pitchers  in 
the  bedrooms. 

On  this  same  line  we  beg  to  again  call  your  attention  to  the  accumu- 
lation of  water  in  the  urns  of  the  cemeteries,  as  well  as  in  the  sagged 
gutters  of  the  house  drains,  which  are  a  great  source  of  mosquito 
breeding  after  rain. 

VI.     APPEAL   FOPv   A   MORE    SKILLED   MEDICAL 
BODY  TO  CONDUCT  THE  CAMPAIGN. 

On  August  the  4tli,  tlie  fever  still  makino-  headway  in 
spite  of  all  local  efforts,  the  Advisory  Board  took  very 
decided  action.  It  candidly  expressed  the  opinion  that 
it  had  not  confidence  in  the  efficacy  of  the  work  performed 
up-to-date;  THAT  THIS  WORK  IMUST  BE  ABSO- 
LUTELY PERFECT  IN  ITS  WORKING  TO  BE  EFFI- 
CIENT, and  to  accomplish  the  desired  re-organization  it 
was  necessary  to  call  in  the  assistance  of  the  Public 
Health  and  ^larine  Hospital  Service  of  the  United  States : 

Orleans  Parish  INIedical  Society, 
New  Orleans,  La.,  August  4th,  1905. 
City  Board  of  Health, 

New  Orleans: 

As  there  has  appeared  a  new  case  in  the  Frye  focus,  which  ihas  been 
in  existence  since  Monday,  while  we  had  been  told  that  the  instruc- 
tions previously  agreed  upon  in  the  management  of  all  maturing  foci 
had  been  rigidly  carried  out,  and  especially  so  in  this  case.  As  we 
are  not  satisfied  that  the  fumigation  performed  by  the  City  Board  of 
Health  has  been  absolutely  effective,  we  feel,  as  we  have  shared  some 
of  the  responsibility  of  this  work,  and  that  it  is  a  matter  of  too  great 
importance  to  be  kept  on  in  this  unorganized  and  unsystematic 
manner.  This  is  the  first  serious  visitation  of  Yellow  Fever  in  this 
country  since  the  mosquito  has  been  recognized  as  the  only  mode  of 
transmission,  and  we  are  unwilling  to  support  the  City  Board  of 
Health  in  what  we  consider  an  ineffective  service. 

We  regard  this  as  the  first  crucial  test  in  America,  and  it  must  be 
absolutely  perfect  in  its  working  to  be  efficient.  We  think  that  the 
community  has  lost  confidence  in  this  work.  We  know  the  profession 
has  lost  faith  in  it.  Hence,  we  cannot  keep  on  up^holding  a  system  in 
which  we  do  not  fully  concur,  so  we  desire  to  strongly  recommend 


WORK  OF  THE  MEDICAL  PROFESSION,    1905 Le   BeUF.  1075 

that  the  system  be  completely  reorganized,  or  that  the  entire  Yellow 
Fever  situation  in  New  Orleans  be  placed  in   the  absolute  control  of 
the  United  States  Public  Health  and  Marine  Hospital  Service. 
Very  respectfully  yours, 
ADVISORY  COMMITTEE,  Orleans  Parish  Medical  Society. 

As  a  result  of  this  letter  and  of  a  telegram  despatched 
to  the  President  of  the  United  States,  the  Public  Health 
and  Marine  Hospital  Service  assumed,  in  a  few  days, 
assumed  control  of  the  campaign.  The  Advisory  Com- 
mittee, however,  continued  their  useful  work  and  co- 
operated with  the  new  forces  under  Dr.  White,  just  as 
they  had  done  with  the  Local  Health  Authorities,  con- 
tinuing- to  issue,  with  the  advice  of  Dr.  White,  most 
useful  circulars,  and  to  generally  encourage  in  every  way 
the  citizens  to  keep  up  the  tight  Avith  unahated  vigor.  As 
the  circulars  which  thc^y  issued  show  a  thorough  knowl- 
edge of  the  situation  and  great  foresight,  I  gave  them  in 
fail. 

VII.     LETTER  WARNING  MEDICAL  INIEN  NOT  TO 

OVERLOOK  THE  MILD  TYPE  OF  YELLOW 

FEVER  WHICH  :\L\Y  P>E   FOUND   IN 

THE  NATIVE  BORN. 

Orleans  Parish  Medical  Society, 
New  Orleans,  La.,  August  17th,  1905. 

Dear  Doctor: — In  the  consistent  campaign  we  are  now  waging 
throug^hout  the  city  against  the  fever  we  want  to  enlist  your  hearty 
assistance. 

We  have  shown  up  to  now  a  uniform  activity,  and  if  some  of  the 
work  already  accomplished  begins  to  show  some  little  improvement, 
we  feel  it  is  greatly  due  to  your  co-operation.  This,  though,  is  the 
crucial  moment  and  you  must  keep  up  reporting  all  your  cases  with 
unfailing  promptness.  THE  NATIVE  BORN  WILL  UNDOUBTEDLY 
BEGIN  TO  BE  AFFECTED,  AND  WILL  SHOW  THE  LIGHTEST  AND 
MILDEST  TYPES  OF  THE  DISEASE;  IT  IS  SPECIALLY  WITH  RE- 
GARD TO  THESE  THAT  WE  WISH  TO  WARN  YOU,  FOR  IT  IS  AS 
IMPORTANT  TO  THE  SUCCESS  OF  THE  WORK  BEING  DONE  BY 
THE  U.  S.  P.  H.  AND  MARINE  HOSPITAL  SERVICE  THAT  THE 
MILD  CASES  BE  REPORTED  AS  WELL  AS  THE  MARKED  CASES. 
THESE  MUST  BE  SCREENED  AS  CAREFULLY  AS  OTHERS. 


1076  AUGrSTIN's     HISTORY    OK     YELLOW     FEVER. 

One  stegomyia  infected,  in  the  first  three  days  from  such  a  case, 
can  produce  a  number  of  serious  and  even  fatal  cases.  Tae  means 
employed  are  being  systematized  and  rendered  less  objectionable 
daily  by  the  service,  so  let  us  endure  a  little  inconvenience  for  the 
welfare  of  all. 

Beware  of  the  so-called  immunization  or  acclimatization  fever  and 
report  these  cases  as  promptly  and  rigidly  as  if  they  were  perfectly 
characteristic,  so  that  the  authorities  will  be  able  to  give  them  the 
same  sanitary  treatment. 

Very  earnestly  yours, 
ADVISORY  COMMITTEE,  Orleans  Parish  Medical  Society. 

VIII.  APPEAL    TO    HOUSEHOLDERS    TO    DELAY 
^'MOVING    DAY"    OX    ACCOUNT    OF    DANGER 

OF    SPREADING    INFECTION. 

In  view  of  the  near  approach  of  "Moving  Day"  (October  1st)  the 
undersigned  deem  it  their  duty  to  direct  your  attention  lo  the  danger 
likelv  to  attend  a  general  moving  of  tenants  from  house  i  )  house. 

Persons  moving  from  infected  localities  may  later  uev-j'op  the  ;ever 
in  uninfected  neighborhoods,  thereby  developing  new  ro  ;.  Others  now 
residing  in  uninfected  houses  may  contract  the  disease  by  removing 
into  houses  where  mild  cases  of  fever  may  have  occurred  and  re- 
covered without  medical  attention,  and  consequently  escaping  fum)?"a- 
tion.  Non-immunes  coming  into  such  'houses  will  almost  inevitably 
contract  Yellow  Fever,  thereby  adding  to  our  present  troubles. 

We  do  therefore  urge  the  importance  of  taking  such  steps  as  may 
be  necessary  to  delay  the  general  movement  for  at  least  thirty  days. 
ADVISORY  COMMITTEE,  Orleans  Parish  Medical  Society. 

IX.  DANGER     OF     RE^IOVAL     OF     TEMPORARY 

CISTERN    SCREENS. 

Orleans  Parish  Medical  Society, 
New  Orleans,  La.,  September  13,  1905. 
There  being  a  pretty  general  understanding  in  the  community  that 
the  cheese-cloth  screens  over  cisterns  have  to  be  removed  by  October 
1,  and  the  regular  18-mesh  to  the  inch  wire  screen  substituted  by  that 
date,  we  believe  that  a  number  of  persons  are  now  having  this  change 
done  to  the  great  danger  of  a  general  liberation  of  all  mosquitoes  im- 
IM-isoned  or  bred  from  the  pupae  in  the  cisterns.  We  cannot  afford, 
in  the  final  fight  of  checking  Yellow  Fever  in  our  midst,  to  neglect  so 
important  a  matter  as  this,  so  we  strongly  urge  that  the  change  from 


WORK  OF  THE  MEDICAL  PROFESSION,    1  &05 LeBeUF.  2  077 

(^lieese-cloth  to  wire,  if  not  legally  postponed  until  December  1,  shall 
be  by  having  the  wire  screen  placed  over  the  cheese-cloth  without  re- 
moving the  latter. 

ADVISORY  COMMITTEE,  Orleans  Parish  Medical  Society. 

Besides  all  this  work,  the  Orleans  Parish  Medical 
Society  issued  seven  thousand  pamphlets  of  directions 
and  instructions  to  the  medical  profession  and  the  trained 
nurses  of  the  entire  South.  Tln^se  pamphlets  were  sent 
broadcast  at  the  expense  of  the  Treasury  Deitartment  of 
the  United  States.  The  c( intents  of  these  pamphlets  were 
carefully  written  by  Dr.  Kudolph  ]Matas,  and  were 
approved  hy  the  Society  as  an  exact  clinical  and  pro- 
phylactic treatise  of  the  entire  yellow  fever  treatment. 

In  conclusion,  let  me  add  that  the  hard-worked  pro- 
fession of  New  Orleans  never  demurred  when  called  upon 
to  do  its  duty  in  the  repression  of  the  epidemic.  The  fol- 
lowinji'  al)le  phyt'icians  lectured  ?nd  demonstrated  the 
propaganda  of  sanitary  and  hyj>enic  rules  in  every  corner 
of  the  city;  from  the  pulpit  of  churches  and  synaocx>ues 
to  the  factories  on  the  river  front;  from  the  nes^ro  meeting 
houses  back  of  town  to  the  school  houses  on  the  front  of 
the  city.  Yes,  and  further  still,  many  were  called  cut  to 
speak  in  country  places  as  far  as  Opelousas  and  ^fer 
Rouj?e,  at  their  own  expense,  and  at  great  sacrifice  to  their 
practice.  Amongst  a  list  of  volunteers,  I  Avish  to  name 
those  that  come  to  my  juind  at  this  moment: 

Dr.  Juan  Guiteras,  from  Havana;  Sir  Rupert  Boyce, 
Dean  of  the  Liver])ool  Sclioid  of  Tr(f])ical  ^Medicine,  from 
England — two  experts,  as  distinguished  volunteers  in  our 
cause;  Dr.  Quitman  Kohnke,  wlu;se  Lantern  Slide  demon- 
strations were  most  conclusive  and  interesting;  Dr.  Bev- 
erly AVarner;  Dr.  O.  L.  Bothicn-;  Dr.  Allan  Eustis;  Dr. 
P.  E.  Archinard;  Dr.  Chas.  Chassaignac;  Dr.  J.  11.  AVhite; 
Dr.  J.  A.  Storck;  Dr.  Ilenrv  D.  Bruns;  Dr.  II.  B.  Oess- 
ner;  Dr.  S.  L.  Theard;  Dr.  John  Oallan;  Dr.  J.  B.  Guthrie; 
Dr.  E.  D.  :Martin;  Dr.  M.  J.  :\ragruder;  Dr.  John  E. 
Oechsner;  Dr.  E.  L.  :McGelKe  and  Dr.  Jos.  Dolt. 


107S 

STATISTICAL  REVIEW  OF  THE  YELLOW  FEVEPw 
EPIDEMIC  OF  1905,  NEW  OPLEAXS. 

P.Y   JULES   LAZARD,    M.    D.,    NEW    ORLEANS, 

Statistician  of  the  YcJloiv  Fever  (Uiin])ai(/u,  Xeic  Orleans^ 
1905,  U.  S.  rnblic  HealtJi  and  Marine  Hospital  Service. 

General    Remarks. 

Ill  epidemics  of  all  diseases,  reference  is  always  made 
to  the  previous  visit  of  the  disease  in  a  community.  Dur- 
ing the  epidemic  of  1905  in  New  Orleans,  the  table  of  the 
epidemic  of  1878  was  used  in  studying  the  progress  of 
the  disease,  as  this  epidemic  resembled  the  one  of  1905, 
only  that  the  latter  began  earlier  in  the  year  and  for  that 
reason  it  was  prognosticated  that  it  Avould  be  more  severe, 
a  prophecy  not  borne  out  by  later  results. 

Because  of  the  use  made  of  the  figures  of  1878,  Avhicli 
were  inaccurate  and  fragmentary,  it  was  deemed  advis- 
able to  i^lace  in  a  compact,  intelligent  and  accurate  form, 
the  figures  of  1905.  The  writer  is  quite  aware  that  figures 
are  very  dry  and  uninteresting,  unless  some  point  is  to 
be  illustrated  or  proved. 

Xew  Orleans  succeeded  very  well  f'or  a  number  of  yeais 
in  keeping  yellciw  fever  out  by  maintaining  a  maritime 
quarantine  and  an  inspection  system  against  the  Tropics. 
This  system  succeeded  very  well  from  1898  to  1905,  but 
"the  best  laid  schemes  (if  mic:>  an'  men,"  etc.  It  was  in 
no  position,  however,  to  successfully  combat  the  disease 
once  it  entered  the  community,  except  by  some  gigantic 
movement,  entailing  the  labor  of  many  men  and  the  ex- 
penditure of  much  iiKsney.  .^luch  tinu'  is  Ic-st  in  training 
men,  physicians,  fumigators  and  laborers  before  the  force 
can  work  intelligently.  It  was  clearly  seen  in  1905  that 
the  success  of  a  fight  against  an  e])idemic  de])ended  abso- 
lutely upon  organization  and  e(|uipment. 

Good  and  liad  are  difPerent  sides  (if  the  same  picture. 
The  entry  of  the  disease  in  1897,  with  a  slight  reappear- 
ance the  following  year,  taught  New  Orleans  the  ineflfici- 


STATISTICAL  REVIEW,    1905 LAZARD.  1079 

encT  of  her  archaic  sewerage  system  and  her  poor,  poor 
water  siipi)lY  system,  thonjih  she  was  on  tlie  banks  of  the 
world's  i;r(^atest  river,  flowin"'  tlie  purest  water. 

The  A'isitations  of  yellow  fever  above  noted  gave  New 
Orleans  sn^iiiestion  for  a  change  in  these  important  sys- 
tems of  a  municipality.  In  1807  and  1898,  the  mosquito 
doctrine  was  not  fully  known,  or  not  known  at  all,  but 
the  helplessness  of  the  city  and  the  fervent  prayers  for 
an  early  frost,  clearly  indicated  that  something  of  a  most 
radical  sort  must  be  done,  if  ever  this  disease  made  its 
entry  again.  A  new  drainage  and  water  system  was  voted 
and  passed  upon.  This  was  the  good  side  of  the  picture 
of  the  epidemics  of  1897  and  1898.  Otherwise  there  is 
no  telling  how  long  the  city  would  have  delayed  in  insti- 
tuting these  sanitary  reforms. 

"With  a  free  supply  of  water,  cisterns — vats  for  collect- 
ing hnd  retaining  rain  water  from  roofs — will  soon  lie 
torn  down  by  order  of  the  law,  unless  the  "Taxpayers' 
Association"  is  stronger  in  its  opposition  than  it  seems 
to  be.  This  will  rid  the  city  of  the  greatest  breeding 
places  of  the  l>^t('(/o)ni/ia  fasciata  or  calopus,  or  whatever 
we  may  presently  decide  to  call  the  mosquito  which  has 
cost  the  South  so  many  thousands  of  lives  and  such  vast 
sums  of  money. 

On  July  21,  1905,  a  quarantine  was  declared  against 
New  Orleans  by  the  neighboring  states.  There  is  no  way 
by  which  it  can  be  definitely  stated  when  the  first  case 
appeared  in  this  city.  This  is  always  a  difficult  matter. 
Below  are  some  deaths  taken  from  all  sources — the  records 
of  the  City  Board  of  Health,  Charitv  Hospital,  Touro 
Infirmary,  Hotel  I  )ieu.  It  is  conceded  by  all  who  watched 
the  progTess  of  the  disease  that  it  began  in  the  "Tnf(M'ted 
District,"  an  area  from  tlie  :\rississippi  Biver  to  the  wood 
side  of  Bourbon  Street  and  the  lower  side  of  St.  Ann  to 
the  upper  side  of  I<:s])lanade  Avenue — the  "Little  Italy'* 
of  New  Orleans,  an  area  covering  twenty-four  Sipiares. 

Here  is  the  record  : 

"SUSPICIOUS"  DEATHS,  1905,  PREVIOUS  TO  EPIDEMIC  PERIOD. 

June  19— L.  M.,  Italian,  aged  51— Chronic  nephritis  and  aortic  aneurism. 
June  20 — L.  K.,  Austrian,  aged  28 — Malarial  remittent  fever. 


1080  avgustin's   history  oe  yeilcw  fever. 

June  23—1.  B.,  Italian,  aged  28— Malarial  fever. 

July  1 — A.  S.,  Italian,  aged  40 — Endocarditis,  1118  Gallatin. 

July  2 — J.  M.,  Italian,  aged  14 — Continued  fever.  1118  Gallatin. 

July  3— diV.,  Italian,  aged  2— TyiAoid  fever.  lllS  Gallatin. 

July  9— S.  A.,  Italian,  aged  24— Malarial  Taxemia,  520  St.  Philip. 

July  10— G.  v.,  Italian,  aged  65— Oastric  Cancer,  528  St.  Philip. 

July  12 — F.  S.,  Italian,  aged  28 — Ac.  par.  Nephritis,  1021  Decatur. 

July  12 — A.  L.,  Italian,  aged  26 — ^Hemorrhagic  fever,  1039  Decatur. 

July  12— F.,  La.,  aged  16— Febris  Hemorrhagica,  1028  Chartres. 

July  13— G.  G.,  Italian,  aged  32— Chr.  Par.  Nephritis,  528  St.  Philip. 

July  17— F.  S.,  Italian,  aged  30— Typhoid,  1026  Chartres. 

July  17 — L.    G.,    nationality   not   given,    aged    45 — Alco^holism,    1105    N. 

Peters. 
July  17— J.  S.,  Italian,  aged  52 — Malarial  fever,  1107  Decatur. 
July  17 — F.  S.,  Italian,  aged  45 — Pneumonia,  605  St.  Philip. 
July  17— G.  T.,  Italian,  aged  46— Typhoid,  528  St.  Philip. 
July  17 — J.  E.  A.,  nationality  not  given,  aged  1 — 'Pertussis  and  Cong. 

of  the  brain,  1127  N.  Peters. 
July  17— J.  M.,  Italian,  aged  14— Continued  fever,  528  St.  Philip. 
July  17— S.  R.,  Italian,  aged  22— Typhoid,  1123  N.  Peters. 
July  18— J.  G.,  Italian,  aged  47— Typhoid,  1113  Chartres. 
July  18— Di  S.,  aged  30— Typhoid,  514  Ursulines. 
July  19— N.  T.,  Italian,  aged  29— Typhoid,  533  St.  Philip. 

July  19— V.  S.,  Italian,  aged Typhoid,  1139  Royal. 

July  19— L.  B.,  Italian,  aged  68— Typhoid,  1031  Chartres. 

July  19— R.  M.,  Italian,  aged  56— Typhoid,  1117  Decatur. 

July  20 — J.  L.,  Italian,  aged  53 — Malarial  fever,  17th  St.  Canal. 

July  20— L.  E.,  Italian— Typhoid,  1022  Conti. 

July  20 — S.  v.,  Norwegian,  aged  30 — Typhoid  and  Ac.  Nephritis. 

July  20— G.  D.  A.,  Italian,  aged  51— Typhoid,  528  Ursulines. 

July  20— B.,  Italian,  aged  19— Typ'hoid,  528  Ursulines. 

July  22— M.  C,  Italian,  aged  38— Typhoid,  624  St.  Philip. 

July  22— D.  di  V.,  Italian— Malarial  fever,  1115  Gallatin. 

July  22— G.  R.,  Italian,  aged  38— Typhoid,  524  St.  Philip. 

July  24— M.  G.,  Italian,  aged  24— Anuria,  530  Ursulines. 

The  report  of  tlie.se  deaths  is  submitted  as  "'suspicious'* 
for  the  chief  reason  that  they  occurred  in  the  "Infected 
District,''  or  bore  some  rehition  to  tliis  locality. 

Amonj^-  other  things  Avhich  New  Orleans  learned  for 
herself  and  tau«»ht  the  world  is  that  free  publicity  should 
be  given  to  the  first  case.  It  does  not  pay  to  keep  it  as 
a  secret,  because  it  is  a  secret  that  refuses  to  be  kept, 
and  other  reasons.  The  watchword  for  all  communities 
when  dealing  with  a  contagious  disease  is  Publicity. 


STATISTICAL   REVIEW,      1905 LAZARD.  108! 

The  figures  below  are  as  the  cases  appeared,  are  official, 
and  Avere  compiled  by  the  writer  in  his  daily  rei)ort  to  the 
officer  in  command  during-  the  e})idemic.  From  the  in- 
ception of  the  disease  to  August  8th,  the  City  Board  of 
Health  was  in  charge;  after  this  time  until  to  close  of  the 
ei)ideniic  in  Noyember,  the  U.  S.  Public  Health  and 
Marine  Hospital  Seryice^ — Dr.  J.  H.  White  in  command, 
was  in  charge  of  the  fight  against  the  disear^e.  The  disease 
was  fought  on  lines  laid  down  by  the  mosquito  doctrine; 
its  success  is  a  part  of  the  history  of  the  city,  and  a  bright 
example  of  modern  epidemiology. 

When  quarantine  was  declared  against  the  city,  it  was 
agreed  upon  that  there  must  haye  been  100  cases  and  20 
deaths  prior  to  this  date.  A  figure  which  is  approxi- 
mately correct  as  in  the  beginning  of  the  epidemic  and  up 
to  August  5,  the  mortality  was  about  20  per  cent.  When 
the  Marine  Hospital  Seryice  took  charge  August  8,  there 
were  101  foci,  counting  the  ''Infected  District''  as  a  single 
focus.  On  Xoyeml)er  7,  there  bad  been  842  foci — meaning 
that  there  were  812  squares  in  which  yelloy\'  feyer  had 
occurred. 

A  "focus"  was  arbitrarily  fixed  and  had  no  practical 
value  in  watching  the  course  of  the  disease,  it  came  about 
by  staining  the  map  of  the  city  in  the  square  in  which 
a  case  appeared  for  the  first  time.  A  focus  when  once 
established  was  counted  throughout  the  epidemic  as  a 
focus,  when  as  a  matter  of  fact  it  was  no  longer  infectious 
It  is  best  in  all  epidemics  to  giye  the  public  all  informa- 
tion desired,  but  this  must  be  of  the  cliaracter  that  will 
be  understood.  A  focus  was  not  understood,  and  the 
public  assumed  very  correctly  from  its  limited  knowledge 
that  there  were  812  points  of  infection  in  the  city. 

DAILY  RECORD  OF  CARES  AND  DEATHS  AND  CASES  UNDER  TREATMENT, 

1905  EPIDEMIC. 
Under  rinler 


Da'  e 

Cases 

Deaths 

Treatment 

I  )ate 

Cases 

Deaths 

Treatni't 

July     20 

100 

20 

July 

26 

15 

6 

21 

— 

1 

27 

26 

2 

22 

20 

3 

28 

21 

3 

23 

10 

2 

29 

29 

7 

24 

14 

1 

30 

27 

3 

221 

25 

11 

4 

31 

21 

5 

158 

1082  ai'gustin's  history  of  yellow  fever, 

] 


Sept. 


I'uder 

X'nder 

Cases 

Deaths 

Treatment 

Date 

Cases 

Deaths 

Treatm't 

1 

42 

6 

177 

Sept.  16 

42 

2 

370 

2 

32 

11 

190 

17 

24 

2 

363 

3 

54 

5 

226 

18 

34 

6 

351 

4 

43 

5 

257 

19 

34 

4 

341 

5 

30 

8 

270 

20 

50 

6 

365 

C 

28 

8 

266 

21 

36 

4 

359 

7 

32 

8 

272 

22 

37 

4 

352 

8 

60 

4 

306 

23 

45 

6 

352 

9 

63 

7 

338 

24 

24 

2 

331 

10 

68 

5 

385 

25 

37 

3 

322 

11 

61 

9 

401 

26 

31 

5 

308 

12 

105 

9 

476 

27 

19 

5 

300 

13 

50 

12 

465 

28 

23 

4 

291 

14 

55 

12 

470 

29 

28 

2 

287 

15 

62 

6 

504 

30 

31 

2 

272 

16 

66 

4 

546 

Oct.   1 

23 

3 

260 

17 

74 

4 

592 

2 

19 

3 

243 

18 

62 

8 

590 

3 

30 

2 

232 

19 

58 

4 

588 

4 

22 

4 

228 

20 

45 

4 

566 

5 

2S 

3 

219 

21 

61 

9 

566 

6 

25 

4 

214 

22 

57 

9 

518 

7 

29 

3 

226 

23 

53 

5 

528 

8 

19 

0 

226 

24 

44 

7 

522 

9 

17 

1 

216 

25 

65 

6 

525 

10 

18 

4 

201 

26 

47 

10 

500 

11 

16 

2 

195 

27 

31 

13 

448 

12 

15 

2 

192 

28 

45 

5 

434 

13 

25 

4 

185 

29 

45 

7 

418 

14 

19 

5 

181 

30 

46 

4 

419 

15 

9 

3 

162 

31 

41 

6 

402 

16 

15 

3 

155 

1 

39 

4 

389 

17 

6 

1 

144 

2 

37 

3 

375 

18 

5 

0 

130 

3 

29 

o 

364 

19 

8 

0 

122 

4 

55 

5 

405 

20 

4 

0 

112 

5 

32 

2 

348 

21 

7 

0 

105 

6 

31 

4 

357 

22 

2 

0 

94 

7 

35 

6 

346 

23 

4 

0 

77 

S 

44 

4 

348 

24 

4 

2 

65 

9 

41 

1 

346 

25 

9 

2 

66 

10 

27 

7 

331 

26 

3 

0 

57 

11 

38 

0 

334 

27 

2 

4 

58 

12 

43 

3 

340 

28 

4 

0 

39 

13 

43 

4 

353 

29 

2 

1 

32 

14 

49 

6 

346 

30 

4 

0 

26 

15  43  2  357  31  3  2  22 


STATISTICAL    RKVIKW,    1905 LAZARD.  I  OSS 

Under  Under 

Date  Cases        Deaths        Treatment  Date  Cases     Deaths    TreatmU 

Nov.       1  0  2  19  Nov.     10  0  0 

2  1             0  17  11  0  0 

3  1             1  14  12  0  0 

4  0            1  13  0  0 

5  11  14  0  0 

6  10  15  0  0            ' 

7  11  16  1  0 

8  0  0  

9  0             0  Total     3,402  452 

The  i^eneral  mortiility  was  13.11  per  cent.,  tliougli  this 
must  l)e  coiisidered  as  beiuo-  too  low  for  the  general  epi- 
demic; bnt  for  the  want  of  better  figures  we  may  accept 
this  as  the  mortality  for  the  yellow  fever  epidemic  iu 
Xew  Orleans  in  1905.  It  is  easy  to  understand  that  many 
cases  were  called  yellow  fever  unless  they  showed  very 
pronounced  symptoms  of  other  diseases  early  in  their 
courses,  owing  to  the  importance  of  screening  the  cases 
early. 

Up  to  August  31,  the  Italians  of  native  birth  furnished 
51  per  cent,  of  the  mortality.  After  this  date  the  fire 
having  consumed  all  available  material  in  the  ''Infected 
District"  slowly  became  more  evident  in  other  residential 
districts. 

Deaths  Clas-sified  According  to  Age. 
Deaths  from  yellow  fever  up  to  November  8,  1905: 

Ages—  1-2   S 

3-5   11 

G-IO    10 

11-15    38 

10-20    50 

21-25    50 

20-30    05 

31-35    30 

30-40    47 

41-45    30 

40-50    23 

51-00    27 

01-70    10 

71-75    1 

430 


lOS*  augustin's  history  oe  yellow  feyer 

Conceded  by  Board  of  Health  .  .   20 
Unclassified   2 

4o2 
Deaths  by  ]Moxths. 

July 57 

August    £20 

September Ill 

October • 58 

November  8 G 

■152 

Mouths.                           Male.  Female. 

July 24  13 

Auiiust 157  63 

September 73  38 

October 30  26 

November 6 

Males 290  140 

Females 140 

Board  of  Health  .  .     20 
Unclassified   2 


452 
Deaths  According  to  Nationality. 
Nationality.  Deaths. 

Italy  .'. 164 

Fi'auce 30 

(Jei-many 18 

Austria 6 

INlexico 4 

Bussia 4 

CMiiua 1 

Sweden   1 

Switzerland   1 

Canada   2 

Greece 3 

Ireland   3 

Australia    3 


STATISTICAL     REVIEW,     1905 LAZARD.  1085 

Scotland 1 

Denmark 1 

Portngal 1 

Norway 1 

Spain 1 

Holland 1 


255 

United  States  .'. 197 


452 

Louisiana  furnished  137  of  197  deaths;  many  of  which 
w^ere  of  Italian  parentage. 

Six  negroes  died  of  yellow  fever  in  this  epidemic. 

On  August  12,  there  were  105  cases  rei^orted.  This 
jump  in  the  number  of  cases  Avas  more  apparent  than  real 
and  requires  some  explanation.  In  the  interim  of  the 
transfer  of  tlie  charge  of  the  epidemic  from  the  City 
Board  of  Health  to  the  U,  S.  Public  Health  and  Marine 
Hospital  Service,  there  were  a  great  number  of  medical 
inspector's  cards  which  were  held  over  for  some  days,  while 
the  arrangements  were  being  perfected  and  the  force  or- 
ganized. It  being  the  close  of  the  Aveek,  Saturday,  the 
cards  AA^ere  counted  in  as  neAV  cases. 

On  September  IG  the  Diamond  FestiA'al  AA'as  given,  the 
revenue  of  Avhich  went  into  the  yelloAV  fever  campaign 
fund.  On  October  26,  President  Koosevelt  paid  the  city 
a  Aisit.  His  visit  to  the  city  allayed  the  scare,  the  "could 
get  aAvays"  returned,  and  commei  ce,  Avhich  Avas  not  hurt 
as  badly  as  in  1897  and  1898,  AA'as  resumed. 

Comparative  ^Mortality,  1901,  1905,  190G. 

Comparative  mortality  from  all  diseases  for  Ncav  Or- 
leans : 

1901.  1905.  1906. 

w.     c.       w.     c.       w.     c. 

June    17.15  28.57  19.68  29.72  19.29  35.32 

July 16.22  28.43  19.53  22.46  15.82  30.00 

August    14.57  24.43  26.01  27.91  17.34  31.36 

September 15.19  25.14  18.57  27.77  12.54  24.41 

October 15.76  19.11  17.02  31.53  15.70  28.33 

November 17.76  30.71  16.72  27.23  17.68  30.82 


1086 

REQUIKEMENTS  OF  THE  M0kS(21  ITo  DOCTRINE.* 

BY  DR.  S.  L.  THEARD. 

Sccrctaru  to  Ciiij  Board  of  Health,  Xcic-  Orleans,  La. 

It  was  my  intention  at  first  to  prepare  an  elaborate 
article,  reviewing  and  analyzing  some  of  the  more  im- 
portant recorded  facts  and  incidents  of  our  immediate 
sanitary  history  (and  some  as  3'et  unrecorded  ones),  but 
I  soon  realized  that  whateyer  might  be  said  must  finally 
be  made  to  rest  upon  certain  primary  basic  principles,  a 
brief  consideration  of  which  would  be  all-sufiicient ;  for 
upon  their  intelligent  application  must  eventually  depend 
the  success  of  all  sanitary'  operations  directed  at  the  con- 
trol of  yellow  fever. 

I  take  for  granted  that  everybody  accepts  to-day  the 
mosquito  doctrine  of  yellow  fever  transmission — that  no 
one  any  longer  seriously  disputes  the  fact  that  the 
stegomyia  mosquito,  a  most  ccinmon  species  of  the  insect 
in  the  South  and  the  Tropics,  is  the  natural  conveyer  of 
of  yellow  fever ;  that  mosquitoes  can  suck  up  infectious 
germs  from  the  blood-stream  of  yellow  fever  patients  only 
during  the  first  four  days  of  the  disease;  that  stegomyia 
mosquitoes  become  infectious  only  ten  or  twelve  days 
after  becoming  contaminated;  that  tlie^-  can  transmit  in- 

*  The  two  articles  which  follow  are  from  the  pen  of  Dr.  Sidney 
L.  Theard,  who  has  been  closely  associated  with  the 
health  affairs  of  New  Orleans  since  the  establisfhment  of 
a  municipal  hoard  of  health  for  that  city  in  September, 
1898,  serving  that  body  in  the  capacity  of  secretary  and 
sanitary  officer.  The  articles  are  reproduced  from  the 
transactions  of  the  Louisiana  State  Medical  Society  for 
1906.  They  are  introduced  because  they  contain  som© 
important  local  history  not  generally  known,  and  also 
because  his  conclusions  are  so  different  from  those  gener- 
ally accepted  at  the  time.  In  one  of  the  articles  Dr. 
Theard  has  shown,  with  the  force  of  mathematic  precision, 
the  invaluable  services  rendered  by  him  in  the  fever  fight 
of  1905.— G.  A. 


MOSQUITO    DOCTRINE THEARD.  1087 

fection  continually  thereafter,  at  intervals  of  feeding, 
until  death;  that  .stegomyia^  bite  preferably  in  the  day- 
time; that  a  non-immune  inoculated  by  tlie  l)ite  of  an 
infectious  mosquito  will  show  symptoms  of  yellow  fever 
only  three  or  four  days  afterwards  (exceptionally,  five 
or  six). 

Rigid  tests,  both  direct  and  eliminative,  have  established 
all  of  this. 

I  assume  also  that  the  more  important  characteristics 
and  habits  of  this  species  of  mosquito  are  Avell-known, 
for  instance,  that  it  is  a  domestic,  not  a  migratory  mos- 
quito, flying  but  short  distances  and  being  habitually 
found  within  houses. 

All  of  which  is  suflflcient  for  present  purposes.  The 
fact,  for  instance,  that  only  the  female  bites  and  not  the 
male,  is  a  matter  of  no  practical  importance  here,  how- 
ever entertaining  it  may  be  to  lay  audiences;  for  sanitary 
measures  directed  at  mosquito  destruction  will  in  all  like- 
lihood never  include  the  weeding  out  of  the  males  from 
the  females.  Ko  greater  importance  attaches  to  many 
other  details,  purposely  omitted  here  for  that  reason. 

To  maritime  quarantine  the  application  of  the  mos- 
quito doctrine  is  most  simple,  fJicorcficalli/:  It  calls  for 
disinfection,  with  an  efficient  culicide,  of  all  vessels  from 
infectible  ports,  together  with  their  cargo,  before  unload- 
ing, and  the  detention  for  five  days,  for  observation  of  all 
persons  from  such  ports.  This  can  never  be  put  into 
practice,  however,  because  of  the  exigencies  of  trade  and 
travel.  The  disinfection  of  the  cargo  of  fruit  vessels,  for 
instance,  most  attractive  to  mosquitoes  (as  much  so 
almost  as  sugar),  could  not  be  effectively  carried  out  with- 
out so  injuriously  affecting  the  fruit  as  to  make  it  un- 
marketable. Again,  I  seriously  doubt  that  hindrances 
thrown  in  the  path  of  an  American  citizen  because  of 
the  mere  possibility  of  his  being  infected  in  consequence 
of  his  accidental  residence  in  some  port  classed  as  "in- 
fectible,"  could   stand   the  test   of  law. 

There  is  even  less  probaltility  that  nu'asur(>s  api)roxi- 
matiug  the  extreme  requireuHMits  of  the  mosquito  doctrine 
will  ever  be  operated  in  guarding  against  the  entrance  of 


1088  augustin's   history   of  yellcvv   fever. 

infection  by  way  of  the  back-door — the  railroads;  for 
experience  has  tan<;ht  ns  tliat  danger  from  that  source  is 
mucli  less,  and  restrictiye  measures  will  probably-  alwa3'S 
be  less  stringent  in  consequence. 

The  point  which  I  wish  to  make  clear  and  emphasize, 
is,  that  no  system  of  (juarantine  will  eyer  proye  an  ab- 
solute safeguard  against  the  entrance  of  pestilence.  It 
will  merely  reduce  the  danger  to  a  minimum. 

Eyen  if  an  apparently  ideal  system  could  be  deyised, 
sober  judgment  would  temper  our  expectations  Ayith  the 
thought  that  perfection,  unfortunately,  is  of  another 
world  only. 

Our  present  system  of  maritime  quarantine  could  be 
made  the  highest  expression  of  what  will  probably  eyer 
be  attempted  in  this  direction,  at  least  for  many  years  to 
come,  by  reyerting  to  the  former  practice  of  disinfecting 
the  empty  hold  of  fruit-yessels  from  iufcctihle  as  well  as 
from  infected  ports.  This  seems  to  liaye  giyen  us  tem- 
porary immunity  in  the  past,  for  a  period  of  years,  as  was 
pointed  out  to  this  Society  at  its  1903  meeting. 

We  cannot  brush  by  lightly  the  possibility  of  future 
infection.  Just  as  long  as  yellow  feyer  exists,  and  I  am 
yet  to  learn  of  a  single  disease  which  has  eyer  been  wiped 
out  from  the  face  of  the  earth  (names  change,  but  dis- 
eases remain)  ;  just  as  long  as  there  are  stcgomyiip  flying 
loose  somewhere  in  this  wide  world  of  ours;  just  so  long- 
will  we  haye  to  reckon  with  the  possibility  of  the  re- 
introduction  of  yellow  feyer  infection  and  be  prepared  to 
preyent  its  spread  wlu^n  it  appears. 

AVhat,  then,  should  our  conduct  be  when  the  disease 
shows  in  our  midst?  is  the  (piestion  which  naturally  sug- 
gests itself. 

Careful  consideration  of  the  mos(|uito  doctrine,  in  its 
application  to  the  local  control  of  the  spread  of  yellow 
feyer,  forces  upon  us  three  conclusions : 

First.  We  must  prevent  the  access  of  non-infected 
mosquitoes  to  yellow  fever  eases  durinf/  tJie  first  four  daj/s 
of  the  disease.  This  can  only  be  done  by  the  judicious 
use  of  the  mosquito-bar,  and  those  yarious  oils  so  repul- 


MOSQuirO     BOCTRINE THKARD.  1089 

sive  to  mosquitoes.  Necessarily  the  results  obtained  will 
lariiely  depend  upon  the  active  co-operation  of  the  house- 
hold. 

Second.  Wc  luiist  destroy  mosquitoes  posslhhj  already 
infected.  This  can  be  accomplished,  partly  by  screening 
of  the  infected  room  or  rooms  (to  prevent  the  escape  of 
contaminated  mosquitoes  until  thc}^  can  conveniently  be 
destroyed),  and  partly  by  fumigation  (more  especially  of 
living  apartments).  In  a  measure  we  must  again  depend 
upon  the  co-operation  of  the  household,  both  active  and 
passive. 

Exceptionally  another  room  may  be  prepared  by  screen- 
ing and  fumigation,  for  the  reception  and  further 
treatment  of  the  case,  and  all  mosquitoes  immediately 
destroyed,  by  fumigation  of  the  remaining  rooms. 

Oiling  of  water  containers  in  the  infected  and  eight 
adjacent  squares  will  also  serve  to  diminish  the  number 
of  mosquitoes  liable  to  become  infected,  either  from  the 
actual  case  if  the  screening  is  imperfect  or  not  continu- 
ously practiced,  or  from  some  other  unrecognized  or  un- 
rej^torted  case  in  the  same  neighborhood. 

Fumigation  of  contiguous  houses  might  also  be  prac- 
ticed, where  permitted. 

Third.  IT^c  must  prevent  the  access  of  uon-Uuniuues  to 
infected  localities  or  infected  premises.  This  can  only  be 
accomplished  hj  the  judicious  use  of  the  sanitary  cordon 
at  the  outset,  and  later  of  a  modified  house-quarantine  for 
the  prevention  of  promiscuous  visiting  and  the  removal 
of  persons,  possibly  in  the  incubative  stage  of  the  disease, 
from  infected  to  non-infected  districts. 

These  are  the  three  basic  requirements — the  indis- 
pensable tripod — in  all  measures  directed  at  the  control 
of  3'ellow  fever.  They  are  the  inevitable  corollary  of  the 
Mosquito   Doctrine;  they  naturally  flow  from  it. 

To  ignore  any  of  them  would  be  a  grave  mistake.  Such 
omission  could  only  result  from  the  grossest  ignorance 
of  the  subject  or  the  poorest  judgment.  Or  else  we  would 
have  to  look  for  its  explanation  in  the  inability  to  enforce 
full  measures  of  prevention,  because  of  a  half -stand  Avrong- 
fully  taken  at  the  outset,  and  persistently  kept  up  there- 


1090  aigustin's  history  of  yellow  fever. 

after  for  the  aj^parent  sake  of  consistency — the  result 
of  a  rein^ehensible  and  futile  effort  to  practice  that  al)om- 
inable  policy — concealment.  Futile  indeed,  for  truth  in 
the  end  must  inevitably  prevail. 

The  principles  themselves  are  not  new. 

As  for  the  methods  here  suggested  for  their  enforce- 
ment, they  have  with  me  the  strength  of  faith  ever  since 
my  acceptance  of  the  mosquito  doctrine,  and  are,  as  suc- 
cinctly stated,  the  same  views  held  and  the  same  recom- 
mendations made,  to  the  proper  health  authority,  as  early 
as  July  13th,  1905. 

No  one  disputes  the  correctness  of  the  first  two  jiroposi- 
tions :  screening  of  patients  and  infected  premises,  and 
destruction  of  mosquitoes.  Regarding  the  third  there 
seems  to  be  a  divided  opinion,  (as  far  as  I  have  been  able 
to  ascertain  in  couAersation  on  the  subject).  Some  favor 
the  sanitary  cordon  under  all  circumstances;  others  are 
in  doubt  as  to  its  possible  effect  for  good,  save  in  the  first 
two  or  three  cases.  All,  however,  seem  to  agree  that  a 
modified  house-quarantine  is  most  important. 

By  modified  house-quarantine  I  mean  the  stationing  of 
guards  at  the  door  of  infected  premises  to  prevent  re- 
movals and  promiscuous  visiting.  No  further  restrictions 
need  be  placed  on  the  members  of  the  household,  who  can 
not,  as  we  now  know,  convey  infection  to  others,  and  who 
would  be  at  perfect  liberty  to  enter  and  leave  the  house 
as  they  please.  In  the  light  of  the  mosquito  doctrine, 
the  stringent  measures  of  1897  are  no  longer  permissible. 

Guards  might,  additionally,  l)c  stationed  at  the  four 
corners  of  badly  infected  s(|uares.  And  if  the  desirability 
of  operating  this  measure  be  granted,  we  have,  in  essence, 
the  rudiments  of  a  sanitary  cordon,  which  can  be  made 
large  or  small  acocrding  to  the  exigencies  of  the  case, 
and  the  auiount  of  infection  to  be  contended  with.  With 
this  important  difference,  however,  that  such  restrictive 
measure  should  be  applied  at  the  very  outset,  on  the  first 
intimation  of  the  ])r('senco  of  infcctiou,  in  an  endeavor  to 
strangle'  the  disease  outright,  and  not  Ije  gradually  evolveel 
as  the  epidemic  progresses. 


MOSQUITO     DOCTRINE THEARD  1091 

Agaiust  liouse-quarantine  the  only  argument,  with  a 
sembhiuce  of  force,  wliioli  can  be  advanced,  is,  that  rigid 
measures  might  tend  to  discourage  the  reporting  of  cases. 
To  begin  with,  a  modified  house-quarantine,  such  as  1 
have  suggested,  is  not  a  rigid  measure.  Nevertheless,  let 
us  carr}^  the  argument  to  its  logical  conclusion.  There 
are  persons  who  object  to  a  guard  in  front  of  their  house 
in  small-i)ox;  others,  to  sanitary  surveillance  of  conval- 
escent scarlatina  cases;  still  others,  to  disinfection  after 
diphtheria,  or  to  a  card  on  their  door,  or  to  any  sanitary 
care  and  attention  which  ma^^  be  bestowed  upon  them  by 
boards  of  health.  Shall  all  of  this  be  abandoned  in  con- 
sequence? The  very  absurdity  of  the  proposition  be- 
comes apparent. 

The  epidemic  of  1005  has  frequently  been  compared 
with  that  of  1878,  and  most  laudatory  conclusions  have 
been  drawn  therefrom,  from  time  to  time.  The  truth  of 
the  matter  is,  that,  while  much  was  accomplished,  a  good 
deal  of  whpt  might  have  been  done  was  not  even  at- 
tempted. And  here  is  tlie  result :  Though  the  screening  of 
patients,  and  the  wholesale  destruction  of  mosquitoes,  by 
fumigation  and  oiling,  the  number  of  cases  Avas  markedly 
reduced;  it  is  probable,  also,  that  the  character  of  the 
epidemic  was  changed,  from  what  appeared  to  be  at  the 
outset  a  most  virulent  type,  to  a  much  milder  form  of  the 
disease;  for,  remember,  the  degree  of  reaction  in  indi- 
vidual cases  depends  as  much  upon  the  number  of  bites 
inflicted  by  contaminated  mosquitoes  as  u])on  tlu'  degree 
of  infectiousness  of  the  contaminated  mosquitoes  them- 
selves. But,  through  failure  to  regulate  the  access  of  non- 
immunes to  infected  premises  and  localities,  the  disease 
was  permitted  to  spread  rapidly  to  the  four  corners  of  the 
city;  and,  appearing  in  our  midst  at  about  the  same  time 
that  it  had  shown  itself  in  1878,  it  disappeared  only  when 
the  usual  duration  of  yellow  fever  e]u*demics  had  been 
spent,  some  ten  days  sooner  only  than  in  1878. 

These  are  the  bare  facts  of  the  subject,  presented  witli- 
out  any  blatant  effort  at  rhetoric. 

In  concluding,  let  me  say  that  nothing  is  further  from 
my  mind  than  the  desire  to  minimize  or  discredit  any 


1092  AUGUSTIX'S    HISTORY    OF    YELLOW     FEVER. 

good  work  wliicli  may  have  been  done  iu  the  past^  or 
which  may  now  be  under  way.  The  wholesale  destruction 
of  mosquitoes  last  summer  was  a  most  essential,  proper 
and  laudalde  undertakino-,  however  costly  and  liowever 
much  complained  of  at  times;  and  the  measures  now 
operated  throughout  the  city  to  stay  the  rapid  breeding 
and  multiplication  of  stegomyia^,  are  no  less  meritorious. 
At  no  time,  in  fact,  should  there  be  a  relaxation  in  all 
those  preventive  measures,  which  alone  hold  out  a  promise 
of  relative  immunity.  At  no  time  should  there  be  a  lull, 
from  a  false  sense  of  security,  in  that  costly  vigilance 
which  is  the  price  of  safety. 


1093 
NEW  ORLEANS  YELLOW  FEVER  IN  1905.* 

BY  DR.  S.  L.  THEAKD. 

If  the  history  of  the  yellow  fever  of  last  siiinmer  is  to 
be  written  in  the  aunals  of  this  Society,  there  at  least 
]et  it  be  written  right. 

If  what  I  am  about  to  say  has  the  appearance  of  an 
effort  at  self-praise,  I  earnestly  ask  that  you  pause  a 
while  and  consider,  that  whatever  may  be  said  by  me  now, 
might  have  been  said  some  eight  or  nine  months  ago,  that 
I  persistently  refrained  during  all  of  that  time  from  any 
public  expressions  or  utterances  in  the  matter,  and  that 
I  am  speaking  now  under  stress  of  circumstances. 

The  claim  which  I,  in  turn,  advance  (and  it  will  be 
made  good  hy  dates  and  by  facts),  is:  That  the  back- 
bone of  yellow  fever  was  broken  in  this  city  last  summer 
whilst  the  lamented  Dr.  Richardson  and  myself  were  in 
charge  of  the  special  sanitary  operations  of  the  Board  of 
Health. 

As  much  was  done  then  as  could  be  accomplished  at  the 
time  within  the  lines  authorized  by  the  Board  of  Health. 
Surely  the  disease  could  not  have  been  aborted,  for  at  no 
time  was  this  feasible  in  the  absence  of  any  restrictive 
measures  calculated  to  prevent  the  removal  of  persons, 
possil)ly  in  the  incubative  stage  of  the  disease,  from  in- 
fected to  non-infected  districts,  or  the  access  of  non- 
immunes to  infected  premises,  and  the  consequent  dissem- 
ination of  the  disease  in  that  Avay. 

Now  for  the  facts. 

Knowledge  of  the  presence  of  yellow  fever  infection  in 
New  Orleans  last  summer  was  first  had  on  the  afternoon 
of  July  12.  On  July  22  announcement  of  the  fact  was 
made  by  the  State  Board  of  Health. 

From  July  13  to  July  22  the  sanitary  measures  prac- 
ticed were  instituted,  conducted  and  supervised  by  the 
City  Health  Officer.  During  that  tinu'  I  was  engaged  in 
other  work  at  the  office  of  the  Board  of  Health. 


See  foot  note  to  preceding  Article. 


1094  AUGUSTIn's    HtSTORV    OK    YELLOW    FEV«R. 

Ou  July  23,  after  the  announcement  of  yellow  feyer, 
the  sanitary  operations  of  the  Board  were  entrusted  to 
m^'  care  and  superyision.  On  Jul^^  26,  Dr.  Farrar  llich- 
ardson,  of  the  Public  Health  and  Marine  Hospital  Seryice, 
became  associated  with  me  in  that  work.  The  health 
officer  at  that  time  was  engaged  more  especialh-  in  the 
deliyer^'  of  public  addresses  calculated  to  arouse  the  in- 
terest of  the  masses  in  the  mosquito  doctrine  of  yellow 
feyer  transmission. 

On  the  eyening-  of  July  26,  four  days  after  being  placed 
in  charge  of  the  sanitary  work  of  the  Board,  I  announced 
to  the  Adyisory  Committee  (a  committee  of  seyen  com- 
posed of  two  representatiye  business  men,  two  members 
of  the  Adyisorj'  Committee  of  the  Orleans  Parish  Medical 
Society,  and  two  members  of  the  Board  of  Health,  with 
the  City  Health  Officer,  also  chairman  of  the  Board  of 
Health,  as  chairman)  that  I  had  completed  the  arrange- 
ment of  the  sanitary  forces  of  the  Board  into  etfectiye 
organization. 

On  August  12,  in  response  to  an  appeal  addressed  on 
August  4  to  the  President  of  the  United  States  by  in- 
fluential citizens,  members  of  the  medical  profession,  the 
Goyernor,  the  ^Mayor,  the  then  President  of  the  Louisiana 
State  Board  of  Health  and  the  City  Health  Officer,  the 
Federal  authorities  assumed  entire  charge  of  tlie  sanitary 
work  in  progress.  Formal  transfer  of  the  emergency 
forces  had  been  made  on  August  8,  ou  pajjcr,  in  a  letter 
addiessed  by  the  Health  Officer  to  Dr.  J.  H.  White,  of 
the  Public  Health  and  ^Marine  Hospital  Seryice;  but  the 
arinal  transfer  occupied  seyeral  days,  being  finally 
effected  only  on  the  morning  of  August  12. 

Xow  as  to  the  deductions  to  be  di'awn  from  these  facts. 

I  haye  here  a  chart,  originally  ])reparcd  some  three  or 
four  months  ago,  for  possilde  insertion  in  the  biennial 
report  of  the  Board  of  Health,  llicn  in  course  of  ])rei)ara- 
tion.  It  shows  the  rise  and  fall  of  yellow  fever  from  July 
22  to  November  22.  ( No  record  was  kept  of  cases  reported 
from  July  12  to  July  22,  and  none  can  be  presented). 

Dots  with  a  connecting  light  line  show  the  number  of 
cases  repoi-ted  from  day  to  day;  heavy  unbroken  lines  are 
made  to  divide  the  chart  into  periods  of  fifteen  days  ac- 


NEW  ORLEANS,  1905 THEARU.  1095 

tivity,  aud  the  reading  of  the  A'arioiis  periods  is  facilitated 
by  the  iutroductiou  of  a  heavy  brol^eu  line.  The  reading' 
of  each  period  is  made  to  include  the  figures  of  the  first 
day  of  the  following  period  for  the  reason  that  a  large 
number  of  the  cases  reported  each  day  Avere  discovered 
the  day  before;  and  for  the  additional  reason  that  efforts 
directed  at  mosquito  destruction  were  in  point  of  fact 
begun  only  on  the  cucnuig  of  July  13,  after  the  Frey 
funeral,  the  sanitary  operations  of  the  Board  thereafter, 
throughout  the  epidemic,  being  always  from  3  P.  M.  one 
day  to  3  P.  M.  the  next  day. 

The  broken  black  line  shows  the  "epidemic  tendency" 
of  the  disease  from  time  to  time. 

It  is  not  the  total  number  of  cases  reported  in  any 
given  period,  as  compared  with  the  total  number  of  cases 
in  some  other  period,  which  enables  us  to  determine  the 
"tendency"  of  an  epidemic  to  rise  or  to  abate;  it  is  the 
relation  of  the  daily  figures  to  one  another,  in  either 
period,  which  establishes  that  fact.  For  example:  If  in 
a  given  period  of  fifteen  days  the  cases  reported  show 
as  2,  4,  C,  8  and  so  on  up  to  30,  and  in  the  next  period 
as  30,  28,  2G,  etc.,  down  to  2,  the  total  in  either  case 
Avill  be  the  same — 240;  but  clearly  in  the  first  period  the 
disease  would  be  incrcasinfj  and  in  the  second  period  it 
would  be  dccreasinff.  Bare  figures  here  mean  nothing;  it 
is  the  fact  or  incident  back  of  them  which  counts.  To 
make  this  still  stronger :  If  the  daily  rate  of  report  was 
2,  4,  G,  etc.,  up  to  30  in  one  period,  and  30,  29,  28,  etc., 
down  to  10  in  the  next  period,  we  would,  in  the  first  in- 
stance, have  a  total  of  only  240,  as  against  345  in  the 
next  period;  still  the  disease  would  be  clearly  increasing 
in  the  first,  and  decreasing  in  the  latter  instance. 

There  is  a  great  difference  between  the  }iii)iihcr  of  people 
walking  in  a  given  place  and  the  direction  in  which  tliey 
walk.  And  the  numerical  strength  of  a  retreating  army 
is  a  matter  of  secondary  importance  when  chronicling  the 
fact  that  it  is  l)eing  routed. 

It  matters  not  that  the  disease  was  decreasing  less 
rapidly  than  it  had  increased;  the  fact  that  it  was  decreas- 
ing remains.  And  clearly,  a  disease  Avhich  is  decreasing 
is  being  controlled  and  is  on  the  wane. 


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1098  augistin's  history  ok  yellow   fevkr. 

So  much  for  the  value  of  bare  figures  uusupported  by 
facts  or  logical  analysis.  I  now  revert  to  the  main 
proposition. 

From  a  sanitary  point  of  view,  the  result  or  effect  of 
efforts  directed  at  mosquito  destruction  on  a  certain  da^^, 
becomes  noticeable  onl3'  fifteen  days  afterwards.  With 
this  important  difference  between  ''point  of  time''  and 
"point  of  effect"  well  in  mind,  it  must  be  apparent,  even 
to  the  most  suiDcrficial  observer,  that  the  sanitary  control 
of  yelloAv  fever  was  well  in  hand  at  the  time  that  the 
Federal  Authorities  took  charge.  Clearly  the  top  was 
knocked  from  the  epidemic  as  the  result  of  the  sanitary 
measures  operated  from  July  28  to  August  11;  and  wJio- 
ever  teas  then  in  charge  deserves  credit  for  that  work. 

The  meat  and  substance  of  it  all — shown  graphically 
on  the  chart  presented — established  definitely  and  abso- 
lutely and  beyond  all  cavil,  is :  that  the  epidemic  was  on 
the  ascending  scale  up  to  August  12  as  the  result  of  the 
naif-measures  practiced  prior  to  the  announcement  of 
yellow  fever  and  during  the  few  days  required  after  that 
to  bring  order  out  of  chaos  and  arrange  the  sanitary  forces 
of  the  Board  of  Health  into  effective  organization;  that 
it  Avas  on  the  descending  scale  during  the  fifteen  days 
which  followed,  as  the  result  of  the  work  conducted  by 
Dr.  Richardson  and  myself;  that  the  fever  showed  a  ten- 
dency to  rise  during  the  next  fifteen  days,  probably  be- 
cause of  the  swapping  of  horses  in  mid-stream,  the  T^nited 
States  Public  Health  and  ^Marine  Hospital  Service  having 
taken  full  charge  of  the  work  by  that  time ;  that  it  again 
abated  during  the  following  fifteen  days;  that  the  fever 
was  never  aborted  at  any  time;  that  after  the  main  force 
of  the  epidemic  had  been  taken  away  from  it  (through 
work  performed  from  July  28  to  August  11,  as  expressed 
from  August  12  to  August  20)  the  fever  tlureafter  ran  a 
mild  course  under  the  continuous  sanitary  measures  ap- 
plied; but  that  it  finally  disappeared  only  after  the  usual 
])eriod  of  duration  of  yellow  fever  epidemics  had  been 
reached — from  three  to  five  months — in  this  instance, 
approximately,  five  months. 

Dr.  Tiieaud  also  said: 


NEW  ORLEANS,  1905 THEARD.  1099 

"I  wish  to  add  that  the  word  epidemic  has  not  been 
used  by  me  in  the  usual  and  more  commonly  accepted 
sense  of  the  word — that  a  majority  of  the  people  were 
afflicted  with  the  disease,  or  that  the  deaths  from  the 
disease  were  for  a  time  in  excess  of  the  total  deaths  from 
all  other  diseases;  but  merely  and  only  in  the  sense  that 
it  was  "on  the  people/'  very  much  as  rain  mioht  be,  ex- 
tendinj>-  as  it  did  from  Carrolltou  to  the  Barracks,  and 
from  the  River  to  the  Lake. 

"I  also  wish  to  say  that  some  ma}-  possibly  lean  to  the 
belief,  held  by  a  few,  that  fifteen  days  is  too  short  an  in- 
terval of  time  to  judge  of  the  effect  or  result  of  efforts 
directed  at  mosquito-destruction — that  an  interval  of 
eighteen  or  twenty  days  is  required.  If  so,  it  Avill  only 
strengthen  my  position,  for  I  would  not  lie  called  upon, 
then,  to  explain  the  apparent  lack  of  success  following  the 
work  practiced  during  the  few  days  which  I  stated  had 
been  required  to  arrange  the  forces  of  the  Board  into 
effective  organization.-' 


IIUO  Aioi  stin's   history  of  vkllow   fever. 

AXTI-MOSQUITO  ORDIXA^'CES. 

Full   Text  of   the   Measures   Adopted   by   the    Citt 

Council  of  New  Orleans  During  the 

Epidemic  of  1905. 

On  August  1,  1905,  at  a  time  wlieu  the  yellow  fever 
epidemic  Avas  spreading  with  alarming  rapidity,  the  City 
Council  of  Xew  Orleans,  adopted  the  following  ordinance: 

Ordinance  Xo.  319G.  X.  C.  S. 

Section  1.  Be  it  ordainiMl  l)y  the  ('ouncil  of  the  City 
of  Xew  Orleans,  that  no  water  liable  to  l)reed  mosquitoes 
shall  he  stored  within  tlie  limits  of  the  city,  except  under 
the  following  conditions: 

Sec.  2.  Water  kept  in  cisterns,  tanks,  barrels,  buckets 
or  other  containers  for  a  period  longer  than  one  week 
shall  be  protected  from  mosquitoes  in  the  following  man- 
ner: Cisterns  shall  he  covered  with  oil  liy  the  property 
owner  or  agent  thereof  within  forty-eight  hours  after  the 
promulgation  of  this  ordinance  and  provided  with  a  cover 
of  wood  or  metal ;  all  openings  in  the  top  or  within  six 
feet  of  the  top  larger  than  one-sixteenth  of  an  inch  to  be 
screened  with  netting  of  not  less  than  eighteen  mesh, 
or  cheese  clotli  or  other  suitable  material  by  the  ]iroperty 
owner  or  agent  thereof  within  forty-eight  hours  after 
the  promulgation  of  this  ordinance;  provided,  that  after 
the  first  day  of  October,  1905,  all  property  owners  shall 
be  required  to  screen  cisterns  with  wire  netting  of  the 
proper  size  mesh  as  required  by  the  Board  of  Health  in 
sucli  a  manner  as  to  prevent  the  entrance  of  mosquitoes. 

Sec.  3.  Tanks  or  barrels  or  similar  containers  to  be 
constructed  in  the  manner  provided  for  cisterns,  or  in 
some  other  manner  satisfjutory  to  the  Board  of  ITealth. 

Sec.  4.  Buckets  containing  water  for  longer  than  one 
week  (such  as  fire  buckets  in  cotton  presses)  and  other 
similar  containers  of  stagnant  water,  shall  be  covered  in 
such  a  manner  as  to  prevent  the  entrance  of  mosquitoes. 

Sec.  5.     Water  in  ponds,  pools  or  basins,  in  public  or 


ANTI-MO.SyllTO     ORDINANCES,    1905.  1101 

private  parks,  places  of  resort  or  resideuces,  or  iu  depres- 
sions or  excavations  made  for  any  purpose,  shall  be  stocked 
with  iiiosquito-d(^stroyino-  fish,  or  covered  with  protective 
netting  or  shall  Ite  drained  oft"  at  least  once  every  week,  or 
shall  be  covered  with  coal  oil  in  a  nienner  satisfactory 
to  the  Board  of  Health  by  the  owner  or  agent  thereof 
within  forty-eight  hours  after  the  promulgation  of  this 
ordinance. 

Sec.  G.  The  Board  of  Health  may,  in  its  discretion, 
whenever  deemed  necessary,  treat  stagnant  water  by  ap- 
plying oil  to  its  surface  in  such  a  manner  as  to  destroy 
mosquitoes. 

Sec,  7.  The  object  and  purpose  of  this  ordinance  is 
declared  to  be  the  preventon  of  the  spread  of  disease  by 
the  destruction  of  mosquitoes. 

Sec.  8.  The  penalty  for  violation  of  this  ordinance  or 
any  section  thereof,  shall  l)e  a  fine  /of  not  more  than 
twenty-five  dollars  or  imprisonment  for  not  more  than 
thirty  days,  or  both,  and  failure  to  comply  Avitli  any  pro- 
vision shall  be  considered  a  separate  offense  for  each  day 
of  its  continuance  after  proper  notification  bv  the  Board 
of  Health. 

On  September  2Gtli,  the  following  ordinance  was  passed : 

Xo.  3277,  NEW  COUNCIL  SEBIES. 

AN  ORDINANCE  to  pi-omote  the  public  health  by  pre- 
scribing the  manner  in  which  water  lialde  to  breed 
mosquitoes  shall  be  cared  for  within  the  limits  of  the 
City  of  New  Orleans. 
Be  it  ordained  l)y  the  Council  of  the  City  of  New 
Orleans : 

Section  1.  That  it  shall  be  unlawful  to  set  up,  liave, 
keep  or  maintain  on  any  premises  in  the  City  of  New 
Orleans,  any  cistern,  tank  or  well  that  is  not  screened 
with  wire  mesh  not  coarser  than  (eighteen  (18)  wires  to 
the  inch,  both  ways,  provided  that  the  inlets  and  outlets 
of  such  cisterns,  tanks  or  wells  may  be  screened  in  any 
manner  or  with  anv  material  ai)])roved  by  the  Board  of 
Health  of  the  City  of  New  Ojleans.  that  will  thoroughly 


1102  aigustin's   history   of  ^  ellow   fever. 

prevent  the  ingress  or  egress  of  mosquitoes  to  and  from 
the  water  therein  contained;  provided,  however,  that  no 
water  seal  shall  be  used  in  screening  any  such  inlets  or 
outlets. 

Sec.  2.  That  it  shall  be  unlawful  to  have,  keep  or 
maintain  on  an3'  premises  in  the  Citj  of  Xew  Orleans, 
lot  or  batture,  or  in  anv  cemetery,  park  or  square,  any 
pond,  pool,  fountain,  trough,  urn  or  water  receptacle  of 
any  similar  character  or  kind,  unless  the  same  is  kept 
constantly  covered  with  kerosene  oil  from  February  1  to 
December  1  in  each  year,  or  be  kept  constantly  stocked 
with  mosquito-destroying  fish,  or  covered  with  the  protec- 
tive netting-  specified  in  Section  1. 

Sec.  3.  That  it  shall  be  unlawful  between  February  1 
and  December  1  in  each  and  every  year  to  have  or  keep  on 
any  premises,  water  in  any  can,  pitcher,  bowl,  bottle,  tub, 
bucket,  barrel,  trough  or  other  receptacle,  unless  the  same 
be  thoroughly  emptied,  dried  or  cleansed  every  five  (5) 
days  before  being  refilled;  provided,  however,  that  fire 
liarrels  may  be  maintained  on  premises,  provided  that 
they  are  properly  screened  with  18x18  Avire  mesh,  but  all 
fire  buckets  shall  be  maintained  empty. 

Sec.  4.  Tliat  it  shall  be  unlawful  to  have  or  maintain 
on  any  jiremises  in  the  City  of  New  Orleans  any  open  well, 
unless  the  same  be  continuously  closed  or  screened  as 
altove  provided,  so  as  to  prevent  the  ingress  or  egress  of 
mosquitoes  to  and  from  the  Avater  therein  contained  and 
the  drawing  of  water  therefrom  be  operated  by  pumi^s. 

Sec.  5.  Tliat  it  shall  be  unlawful  to  have  or  maintain 
any  gutter  or  drain  or  roof  in  or  on  whicli  waler  stands 
after  rains,  without  drawing  off  thoroughly. 

Sec.  6.  That  it  shall  be  unlawful  to  liave,  keep  or 
maintain  on  any  premises  in  the  City  of  y<?w  Orleans, 
any  open  cesspool  or  privy  vault,  to  the  li(piid  contents 
of  which  mosquitoes  have  ingTess  or  egress,  unless  the 
same  be  thoroughly  covered  with  petroleum  oil  every  fif- 
teen (15)  days  from  February  1  to  December  1  in  each 
and  every  year. 

Sec.  7.  That  every  lot  or  square  in  this  city,  which, 
in  the  judgment  of  the  Board  of  Health,  is  near  enough 


ANTI-MOSQUITO     ORDINANCES,     1905.  1103 

to  tlie  house  of  its  inhabitants  on  which  water  stands  in 
pools  or  ponds,  or  Avhich  contains  excavations  or  holes  or 
depressions  in  which  water  may  stand,  is  hereby  declared 
a  menace  to  public  health,  and  the  owner  thereof  who 
shall  fail,  after  notice  by  the  City  Board  of  Health  and 
W'ithin  the  time  therein  prescribed,  to  fill  or  drain  the 
same  or  keep  it  covered  with  petroleum  oil,  shall  be 
deemed  guilty  of  a  violation  of  this  ordinance. 

Sec.  8.  That  it  shall  be  unlawful  to  set  up,  have,  keep 
or  maintain  in  any  house  or  hotel,  water  closets  furnished 
with  a  tank  or  basin  with  water  seal,  unless  such  tanks 
or  basins  be  emptied  and  the  water  therein  (renewed  at 
least  once  in  five  (5)  days,  from  February  1  to  December 
1  in  each  and  every  year,  or  be  kept  during  same  period 
thoroughly  covered  with  kerosene  oil. 

Sec.  9.  That  the  City  Board  of  Health  shall  cause  this 
ordinance  to  be  enforced  in  all  its  provisions,  and  to  that 
end  said  board  or  persons  acting  under  its  authority  shall 
have  the  right  any  time  from  9  a.  m.  to  4  p.  m.  each  day 
to  enter  upon  premises,  lots,  squares,  parks  or  battures, 
and  any  i^erson  charged  witli  any  of  the  duties  imposed 
by  this  ordinance  failing,  after  notice  by  said  Board  of 
Health  and  within  the  time  prescribed  l)y  said  notice,  to 
perform  said  duties,  shall  be  deemed  guilty  of  a  violation 
of  this  ordinance,  and  for  eacli  day  after  the  expiration 
of  said  notice  the  party  notified  fails  to  comply  with  said 
notice  shall  be  guilty  of  a  separate  violation  of  this  ordi- 
nance, and  all  fines  collected  for  violations  of  this  ordi- 
nance shall  be  paid  to  the  City  Board  of  Health  by  the 
Recorder  collecting  the  same;  provided,  hoAvever,  that  no 
notice  from  the  Board  of  Health  or  its  officers  shall  be 
required  to  hold  any  person  liable  to  penalties  for  the 
violations  of  Sections  1,  2,  3,  4,  6  and  S  of  this  ordinance, 
the  provisions  of  Avhich  sections  are  declared  to  be  self- 
operative  and  imperative;  but  in  cases  under  those  sec- 
tions where  screening  has  been  improperly  done  originally, 
or  where  the  screening  has  gotten  out  of  order,  or  has 
been  injured  and  rendered  defective  without  tlie  knowl- 
edge of  the  owner,  or,  if  absent  his  agent,  then  tlie  pen- 


110*  augustin's   history  of  yellow   fkver. 

allies  shall  be  imposed  only  oii  failure,  after  notice,  to 
make  the  necessarj^  changes  and  repairs,  | 

Sf.c.  10.  The  owners,  and,  in  their  absence,  the  agents 
of  owners,  of  all  premises,  lots,  squares,  parks  or  battnres 
in  the  City  of  Kew  Orleans,  shall  be  liable  for  violations 
of  the  provisions  of  Sections  1,  4,  5  and  7  of  this  ordi- 
nance, except  in  cases  Avhere,  without  the  knowledge  of 
such  owner  or  agent,  the  tenant  of  or  trespasser  on  any 
premises,  lot,  square,  park  or  batture  shall  violate  the 
provisions  of  this  ordinance,  in  Avhicli  event  such  tenant 
or  trespasser  shall  be  lialde  for  such  violation ;  where  the 
jjremises  are  vacant,  or  are  occupied  jointly-  by  the  owner 
and  his  tenant  or  sub-tenant,  the  owner,  or,  in  his  ab- 
sence, his  agent,  shall  be  liable  for  violations  of  Sections 
2,  0,  6  and  8  of  this  ordinance.  The  tenants  or  occu- 
piers of  all  premises,  lots,  etc.,  shall  be  liable  for  viola- 
tions of  Sections  2,  3,  6  and  8  of  this  ordinance,  and,  in 
tlie  case  above  provided,  for  violations  of  Sections  1,  4, 
5  and  7  thereof. 

Sec.  11.  That  any  person  who  shall  violate  any  section 
of  this  ordinance,  shall  be  punished  by  a  fine  of  not  moro 
than  twenty- five  (-^25)  dollars,  or  by  im])risonment  for 
not  more  than  thirty  (30)  days,  or  both,  in  tlie  discretion 
of  the  court  having  jurisdiction.  Each  and  every  day  of 
failure  to  comply  witli  any  of  the  provisions  of  this  ordi- 
nance shall  constitute  a  separate  ott'ense  and  be  punished 
as  such. 

Sec.  12.  That  this  ordinance  shall  be  enforced  on  and 
after  January  1,  1900;  until  that  date  Ordinance  No. 
31 9G,  N.  C.  S.,  shall  remain  in  force,  except  so  much  there- 
of as  requires  wire  screening  to  be  coni])leted  by  October 
1,  1905,  Avhicli  part  of  said  ordinance  is  hereby  repealed. 


' 


PART  V. 


THE    ACCEPTED 


MODERN    THEORIES 


CONCERNING 


YELLOW  FEVER. 


1107 


THE  ETIOLOGY  OF  YELLOW  FEVER. 

From  tliG  Standpoint  of  1908  and  in  Retrospect. 
By  G.  Farrar  Pattox,  M.  D.,  New  Orleans. 

Professor    of    Clinical    Medicine,    Post-Graduate    Department,    Tulane 

University  of  Louisiana;   Secretary  Louisiana  State  Board 

of  Health,  1896-1906. 

I. 

First  Definite  Suggestion  of  the   Truth. 

Nowhere  in  the  histoiy  of  scientific  research  is  there  a 
more  conspicuous  instance  of  the  tenacity  with  which 
nature  seems  to  guard  her  secrets  than  in  the  long  and 
deadly  struggle  it  has  cost  mankind  to  wrest  from  her  the 
secret,  so  priceless  and  yet  so  simple  when  discoTerod, 
of  the  causation  of  yellow  fever.  When  we  think  of  the 
countless  learned  men  who,  singly  and  as  members  of 
special  commissions,  have  so  earnestly  and  patiently 
labored,  generation  after  generation,  to  solve  this  vital 
problem,  while  the  insect  by  which  the  infection  is  con- 
veyed mockingly  buzzed  about  their  heads,  we  cannot 
pay  too  high  a  tribute  to  the  acumen  of  Dr.  Carlos  J. 
Finlay  of  Havana,  who  as  far  back  as  1881  not  only  ad- 
vocated with  absolute  confidence  the  doctrine  that  yellow 
fever  is  conveyed  by  the  bite  of  a  mosquito,  but  correctly 
designated,  as  was  proved  twenty  years  later  by  the  ex- 
periments of  the  IT.  S.  Army  Commission  under  Surgeon 


1108  augustin's   history   ok  yellow   fever. 

Walter  IJeed,  the  particular  iiiosqiiito,  and  the  only  one, 
so  far  as  known,  by  which  the  disease  is  transmitted  to 
man. 

Unfortunately,  Fiulay  did  not  at  that  time  haye  the 
adyantage  enjoyed  by  later  inyestigators  of  deriying  help- 
ful suggestions  from  the  knowledge  of  the  role  played  bv 
the  mosquito  in  malarial  feyer,  but  reasoning  on  the  sim- 
ple doctrine  of  direct  inoculation,  he  thought  that  the  pro- 
boscis of  the  mosquito  biting  a  patient  ill  with  yellow 
feyer  became  contaminated  with  the  yirus  of  the  disease, 
which  in  turn  was  directly  infused  into  the  blood  of 
other  persons  subsequently  bitten  by  the  same  mosquito, 
thereby  conyeying  the  disease  to  those  who  were  not  im- 
mune. For  reasons  now  well  understood  the  experiments 
made  by  Finlay  to  proye  his  theory  were  uniformly  un- 
successful, but  he  remained  unshaken  in  his  belief  that 
the  particular  house  mosquito  known  to  us  as  the  »S7c- 
(/om//i(i  Cdlopiift}  which  he  obseryed  to  be  inyariably 
present  in  connection  with  yellow  feyer,  was  the  active 
agent  for  its  transmission  and,  unlike  many  pioneers  who 
haye  advocated  a  truth  before  the  world  Avas  ready  to 
reeeiye  it,  he  has  lived  to  see  his  sublime  faith  triumph- 
antly vindicated.  In  one  of  his  able  nuiuographs  Surgeon 
H.  K.  Carter,  of  the  U.  S.  P.  II.  &  :\r.  11.  Service,  aptly 
refers  to  Finlay's  thus  singling  out  the  l^fcgomj/ia  mos- 
quito in  its  causative  relation  to  yellow  fever  as  "a  very 
beautiful  piece  of  inductive  reasoning." 

If  Finlay  could  have  ascertained  what  Carter  later  de- 
termined, viz.:  that  a  definite  ])eri(;d  of  time  must  always 
intervene  between  infecting  and  secondary  cases,  an  ob- 
servation impossible  to  make  in  Havana,  where  the  dis- 
ease was  continuous,  he  would  ])robably  not  have  failed, 
because  he  would  almost  certainly  have  taken  the  hint 
and  have  kept  some  of  his  infected  mosquitoes  over  that 
period. 

It  came  as  a  fitting  sequel  to  Finlay's  long  and  undis- 
couraged  advocacy  of  the  transmission  of  yellow  fever 


'Formerly   called    Culex   fasciata,    and    now   named    Stegomyia 
calopus. 


ETIOLOGY PATTON.  1  1  09 

by  mosquitoes  that  the  immortal  work  of  the  U.  S.  Army 
Commission,  consisting:  of  Drs.  Walter  Reed,  James  Car- 
roll, Aristides  Agramonte  and  Jesse  W,  Lazear,  by  whom 
in  1900  and  1001  the  correctness  of  this  discredited  theory 
was  demonstrated  to  the  world,  was  undertaken  and 
completed  at  Havana,  Finlay's  home  city,  where  for 
twenty  years  he  had  been  resiarded  as  hopelessly  A'ision- 
ary  on  the  subject.  Surely,  the  prophet  shall  not  be  with- 
out honor,  and  it  takes  away  nothin<T  from  the  imperish- 
able fame  of  Walter  Reed  and  his  collaborators,  one  of 
whom,  Lazear,  died  a  martyr  to  the  cause,  while  Carroll 
barely  escaped  the  same  fate,  for  us  to  give  Finlay  due 
credit  for  a])stractly  reasoning-  out  a  great  truth  and  for 
so  steadfastly  upholding  his  belief  despite  of  his  inability 
to  prove  it.  The  substantial  vindication  of  that  truth 
constitutes,  in  the  opinion  of  the  writer,  an  achievement 
outranking  in  value  to  humanity  and  to  science  any 
single  triumph  tlie  world  has  ever  known,  and  has  happily 
settled  forever  the  practical  aspect  of  the  etiology  of  yel- 
low fever. 

Wlien  we  say  that  tlie  practical  aspect  of  this  long 
vexed  question  is  at  last  settled  we  speak  advisc^llv,  since 
the  "germ"  of  the  disease  remains  as  yet  (in  1008)  undis- 
covered and  because,  after  our  many  tribulations,  we  have 
so  much  reason  to  be  content  with  our  present  knowledge 
that  for  practical  purposes  we  can  afford  to  rest  where 
we  now  stand. 

The  Yellow  Fever  Germ. 

Of  course,  there  is  a  special  pathogenic  entity  concerned 
in  the  causation  of  yellow  fever,  since  nothing  can  como 
into  existence  without 'a  definite  cause,  but  it  would  ap- 
pear that  here  we  have  to  do  witli  a  soluble  toxin  that  is 
ultra-microscopic  and  so  intangil)le  as  to  be  susceptible  of 
filtration  through  tlie  very  finest  grained  porcc^lain  with- 
out losing  any  of  its  vindence,  as  shown  by  the  fact  that 
the  serum  of  bb>od  taken  from  a  yelb)w  fever  patient  with- 
in tlie  first  three  days  and  passed  thr(»ugh  a  Chamberland 


]110  AIGUSTIn's    HISTORY    OF    YELLOW    FEVER. 

filter  has  com'municated  the  disease  by  being  injected  sub- 
cutaneously  into  the  system  of  a  non-immune  person. 

So  evanescent  is  this  poison,  that  after  the  third  day  of 
illness  it  seems  to  disa^jpear  from  the  blood  of  the  human 
subject. 

Writers  of  the  present  day  refer  to  the  germ  of  yellow 
fever  as  a  ''parasite,'-  following  the  idea  of  analogy,  much 
as  chemists  have  classified  the  hypothetical  metal  ammo- 
nium. In  a  recent  monograph  on  yellow  fever,  Dr.  Joseph 
Goldberger,-  of  the  U.  S.  P.  H.  &  M.  II.  Service,  writes 
as  follows  on  the  subject: 

''The  Parasite. — While  the  organism  of  yellow  fever 
has  not  yet  been  discovered,  we  are,  nevertheless  in  pos- 
session of  some  facts  which  enable  us  to  form'  some  idea 
of  its  character.  The  disease  has  been  found  to  occur 
only  in  man  and  the  mosquito,  so  that  it  is  inferred  that 
the  parasite  is  one  of  those  that  requires  for  the  complete 
evolution  of  its  life  cycle  a  mammalian  and  an  arthropod 
host.  We  have  familiar  analogies  in  Piroplasma  hige- 
iiiinum  of  Texas  fever  and  the  Plasmodium  of  malaria. 
Because  of  these  analogies  it  is  inferred  that  biologically 
it  may  be  grouped  with  them  as  a  protozoou.  On  the 
basis  of  these  and  other  analogies,  both  Schaudinn  (1901) 
and  Novy  &  Knapp  (1906)  have  suggested  that  it  may 
be  a  ^pirochaeta.  Stimscu's  recent  discovery  of  a  spiro- 
cluT'te-like  organism  in  the  tubules  of  a  yellow  fever  kid- 
ney is  therefore  exceedingly  interesting  and  suggestive." 

It  is  now  historical  how  enthusiastically  the  scientific 
world  welcomed  the  announcement  by  Sanarclli  in  1<S97, 
that  he  had  succeeded  in  isolating  the  long  sought  germ 
of  yellow  fever,  and  how  great  the  corresponding  disayj- 
pointment  was  when  his  famous  Bacillus  Tcfrroidrs  later 
proved  to  be  something  merely  associated  with  the  disease 
without  standing  in  any  causative  relation  to  it.  Since 
that  disappointment  occurred,  certain  other  tentative  an- 


Yellow  Fever.  Etiology,  Symptoms  and  Diagnosis,  by  Joseph 
Goldberger,  July,  1907.  Yellow  Fever  Institute  Bulletin 
No.  16,  Government  Printing  Office,  "Washington. 


ETIOLOGY PATTON.  1111 

nounceinents  of  fluding  the  elusive  "germ"  have  been  made 
only  to  be  discredited,  with  the  result  that  the  medical 
profession,  naturally  disposed  to  be  skeptical,  is  likely 
to  accord  a  very  reluctant  recognition  to  tl^o  veal  parasite, 
should  it  be  found. 

While  admitting  that  science  owes  it  to  itself  to  find 
the  "germ"  of  yellow  fever  if  possible,  it  may  be  said 
that  from  a  purely  practical  standpoint  of<  etiology  it 
makes  comparatively  little  difference  to  the  world  whether 
this  discovery  is  ever  made,  since  the  etiology  of  the  dis- 
ease, so  far  as  the  majority  are  concerned,  seems  to  be 
entirely  comprehended  in  our  knowledge,  severely  tried 
and  found  reliable,  that  yellow  fever,  as  we  know  it,  is 
only  conveyed  to  man  by  the  bite  of  the  female  Stcr/ODiijia 
mosquito  under  certain  narrowly  restricted  conditions  to 
be  presently  named. 

This  is  the  whole  etiology  of  the  disease  in  a  nutshell. 

II. 

Views  Formcrhj  Held. 

In  the  light  of  present  knowledge  it  is  not  without  in- 
terest to  notice  briefly  the  views  relative  to  the  etiology 
of  yellow  fever  formerly  held  b^'  those  in  positions  of 
authority  as  writers  and  health  officials.  Prior  to  the 
introduction  of  the  germ  theory  there  seems  to  have  pre- 
vailed a  general  belief  in  a  sort  of  poisonous  miasm,  either 
diffused  by  the  body  or  breath  of  the  patient,  or  in  some 
other  way  generated  in  connection  with  the  case.  This 
miasm  was  supposed  to  be  highly  iit  feet  ions,  clinging 
tenaciously  to  textile  fabrics  and  even  to  tlie  furniture 
and  Avails  Qf  the  sick-room.  Woolen  articles  were  sup- 
posed to  be  specially  liable  to  attract  and  retain  the  poi- 
son. Everything  thus  presumedly  infected  was  regarded 
as  fomites  capable  of  carrying  the  disease  to  another 
locality  where  conditions  might  be  favorable  for  its  devel- 
opment. 

This  belief  in  the  spread  of  yellow  fever  by  fomites  was 
practically  universal,  inspiring  such  abject  terror  during 


1112  augustin's  history  of  yellow  fever. 

certain  epidemics  that  many  cities  and  towns  quarantined 
"against  the  world/'  preferring-  to  maintain  absolute  non- 
intercourse  and  to  dispense  with  common  necessities  of 
life  rather  than  risk  the  accidental  introduction  of  any- 
thing tainted  with  infection. 

In  striking  contract  with  the  teachings  of  the  genera- 
tion of  medical  authorities  immediately  prior  to  the  reve- 
lation of  the  truth  about  the  causation  of  yellow  fever, 
it  is  to  be  noted  with  all  the  admiration  due  to  a  master 
mind,  that  La  Roche,  whose  classic  work  on  the  subject 
ai^peared  in  the  dark  days  of  1855,  unhesitatingly  ex- 
pressed disbelief  in  the  conveyance  of  yellow  fever  by 
fomites,  devoting  a  large  section  of  one  volume  to  evidence 
and  arguments  against  that  wide-spread  delusion. 

While  there  could  be  no  doubt  about  the  general  infect- 
iousness of  yellow  fever,  many  logical  observers  doubted 
its  being  personally  contagious,  since  so  many  of  those 
in  close  contact  with  cases  as  nurses  and  attendants  es- 
caped, while  hundreds  who  kept  carefully  aloof  were  at- 
tacked. It  seemed  truly  paradoxical  that  the  ''miasm," 
which  must  in  some  way  be  associated  Avith  the  sick, 
should  be  thus  seemingly  inoperative  at  the  bedside,  but 
potent  a  little  distance  away. 

On  this  i^articular  point  another  thinker,  Prof.  Austin 
Flint,  Sr,,  of  New  York,  after  residing  for  a  time  in  New 
Orleans  and  carefully  studying  the  question  with  the  im- 
partiality of  an  outsider,  judicially  summed  up'^  the  evi- 
dence as  being  strongly  opposed  to  the  doctrine  of  per- 
sonal contagion,  declaring  that — "That  great  majority  of 
those  who  have  had  an  extensive  practical  acquaintance 
with  the  disease  believe  it  to  be  non-contagious." 

Relative  to  the  etiology  of  the  fever,  he  makes  this 
guarded  statement — "Of  the  nature  and  source  of  the 
special  cause  of  yellow  fever  we  have  no  positive  knowl- 
edge beyond  the  fact  that  it  originates  without  the  body." 
His  reference  to  the  conveyance  of  the  infection  by  fomites 
is  so  conservative  as  to  suggest  to  one  reading  between 


•Principles  and  Practice  of  Medicine.     Fourth  Edition,  1873. 


EFIOLOGY PATTON,  11  IS 

the  lines  the  idea  that  he  was  not  very  firmly  convinced 
on  this  point,  as  when  he  says,  "may  not  tlie  special  canse 
be  carried  from  one  place  to  others  in  clothing,  merchan- 
dise, etc.,  and  the  disease  in  this  way  be  imported?  Facts 
appear  to  establish  the  affirmative  to  this  question." 

Qnotino-  Dr.  Josiah  Nott,  of  ^Mobile,  Flint  further  states 
that — "Tile  special  cause  is  most  active  near  the  ground; 
persons  on  a  ground  floor  are  more  likely  to  be  attacked 
than  those  in  the  stories  above.  The  cause  is  more  active 
at  night  than  in  the  daytime." 

The  Dr.  Nott  in  (piestion,  a  distinguished  physician  of 
his  day  and  a  thoughtful  observer  of  facts,  after  ingeni- 
ous reasoning  by  (exclusion,  put  himself  on  record  in  1848, 
as  considering  it  "probable  that  yellow  fever  is  caused 
by, an  insect  or  animalcule  bred  on  the  ground,"  even 
naming  the  mosquito  as  a  possible  factor,  though  not 
venturing  any  definite  assertion  on  this  point,  as  did  Fin- 
lay  of  Havana. 

Another  prominent  physician  of  Alal)ania,  Dr.  Jerome 
Cochram.  who  for  years  pri(tr  to  his  fleath,  was  State 
Health  Officer,  commenting  on  the  low  lying  stratum  of 
infection  in  yellow  fever,  is  quoted  as  saying  that  a  wall 
twenty  feet  high  would  check  its  progress.  Rome  ob- 
server with  a  mathematical  turn  of  mind  actually  calcu- 
lated the  rate  at  which  the  fever  appeared  to  spread  from 
a  known  focus  in  a  city  as  being  about  forty  feet  a  day. 

It  was  a  common  observation  that  the  fever  would  hesi- 
tate about  crossing  a  street,  but  readily  traversed  two 
back  yards  to  reach  a  house  in  the  rear. 

The  strange  and  unaccountable  "smouldering"  of  the 
infection  between  the  first  and  second  group  of  ca.«es 
had  been  dulv  noted  from  the  earliest  times,  vrliile  its 
rapid  s])read  in  hot  weathei'  and  magical  snbsidence  after 
the  coming  of  frost  caused  many  to  tliiidv  that  some  mete- 
orological condition  was  concerned  in  its  causation. 

These  and  other  accurate  observation  relative  to  the 
behavior  of  ydlow  fpver  infection,  so  easily  explained  since 
the  habits  of  the  Stegomyia  mosciuito  have  been  carefully 
studied,  shovv-  how  near  to  the  truth  those  good  people 


11 14  augustin's  history  of  yellow  fever. 

blundered  without  guessing  it,  with  the  mosquito  all  the 
while  biting  them  and  singing  in  their  ears. 

AVlien  the  germ  theory  of  the  causation  of  disease  began 
to  gain  ground  an  entirely  new  and  alluring  turn  was 
given  to  speculation  regarding  the  special  cause  of  yellow 
fever.  It  was  at  once  decided  that  there  must  be  a  tangi- 
ble microbe,  very  small  perhaps  and  difficult  to  isolate, 
but  certainly  within  reach  of  the  vaunted  disinfecting 
agents  of  which  such  great  results  were  expected. 

Thus  we  find  Dr.  Saml.  Choppin,  a  high  authority  in 
New  Orleans  and  President  of  the  State  Board  of  Health, 
declaring  in  his  report  for  1878  (page  10)  that  the  mari- 
time quarantine  policy  of  his  Board  was  "based  on  the 
hypothesis  that  the  mat  cries  morhl  of  yellow  fever  con- 
sists of  living  germs,  probably  auimalcular.  The  object 
is  to  attack  tliose  germs,  wherever  existing,  hj  agents  de- 
structive to  I'^w  forms  of  life  without  being  injurious  to 
their  habitat." 

The  germs  were  supposed  to  cling  to  all  sorts  of  fomites 
coming  from  tropical  ports  and  especially  to  proliferate 
in  the  bilge  water  of  wooden  ships,  it  being  held  by  many 
authorities  that  decaying  wood  was  the  most  favorable 
nidus  for  their  growth  and  diffusion,  which  theory  easily 
explained  the  transportation  of  the  disease  by  ships  and 
the  frequency  with  which  laborers  working  in  the  holds 
of  such  ships  at  previously  healtlw  jjorts  were  the  first 
persons  attacked  by  fever. 

It  may  be  mentioned  in  passing  that  the  new  era  of 
maritime  quarantine  practice  so  succc  ssfully  inaugurated 
in  1885  by  the  Louisiana  State  lioard  of  Health  under 
Dr.  Joseph  Holt  comprised  the  forcing  of  sulphur  dioxide 
by  a  powerful  suction  Idower  into  every  portion  of  the 
ship's  hold,  thereby  killing  any  infected  mosquitoes  which 
might  have  been  lurkin<>-  there  Avhen  the  vessel  sailed  from 
a  tropical  port,  while  simiiiar  fumigation  in  detail  was 
performed  by  burning  sulphur  in  every  living  space  of  the 
vessel,  making  a  clean  sweep  of  all  mosciuitoes  on  board. 
Under  the  prevailing  delusion  al)out  "germs"  disinfection 
of  all   fomites  by  steam  heat  was  also  laboriously  per- 


ETIOLOGY l»ATTON.  1115 

formed,  this  xjart  of  the  work  getting  the  principal  credit 
for  the  good  accomplished,  after  which  detention  sufficient 
to  cover  the  estimated  incubation  period  of  the  disease 
was  enforced.  ' 

With  the  further  development  of  the  germ  theory  and 
with  the  trend  of  thought  induced  by  tlie  researches  of 
Koch,  Eberth  and  others,  we  note  a  disposition  to  look 
for  the  germ  of  yellow  fever  as  affecting  specially  the 
alimentary  canal.  Thus,  in  the  section  on  yellow  fev(>r 
in  Looniis  &  Thompson's  American  System  of  Medk-ino, 
published  in  1897,  we  read  the  following  by  no  less  an 
authority  than  Sternberg: 

''Yellow  fever  is  not  a  contagious  disease  in  the  strict 
sense  of  the  word,  i.  e.,  it  is  not  usually  contracted  by 
contact  with  the  sick ;  but,  as  in  cholera  and  typhoid  fever, 
the  infectious  element  multiplies  in  the  body  of  the  sick, 
and  epidemics  usually  extend  from  foci  of  infection  origi- 
nating from  the  introduction  of  cases  of  the  disease  into 
localities  previously  free  from  it.  \ 

Although  not  definitely  demonstrated,  it  seems  ex- 
tremely probable  that  this  occurs  in  the  same  way  as  in 
the  diseases  mentioned,  viz.,  through  the  excreta.  This 
is  indicated  by  the  fact  that  while  contact  with  the  sick 
as  nurse  or  physician  does  not  lead  to  infection,  the  soiled 
clothing  and  bedding  of  yellow  fever  patients  may  induce 
an  attack  in  those  Avho  handle  them,  and  may  originate 
an  epidemic  when  transported  without  having  been  dis- 
infected to  another  locality."     *     *     *     *     * 

"As  heretofore  suggested,  the  yellow  fever  patient,  like 
the  patient  with  cholera  or  typhoid  fever,  ]U'obably  carries 
"germs"  in  his  int(^stines  wliich  are  ca])able  of  abundant 
deveh)pment  outside  the  bodv  wlien  local  conditions  are 
favorable.     *****' 

"In  view  of  the  facts  lieretofore  recorded  and  tlie  con- 
clusions reached  as  the  result  of  experimental  investiga- 
tion, it  is  evident  that  the  dejecta  of  yellow  fever  patients 
should  be  regarded  as  infectious  material  and  should 
never  be  thrown  into  privy  vaults  until  they  have  been 
completely  disinfected." 


1116  augustin's   history   ot   yellow   fever. 

III. 

Ti/rauiii/  of  a  False  Doctrine. 

Whatever  diversity  of  views  existed  as  to  other  points 
in  connection  with  yellow  fever,  physicians  and  laymen 
of  the  South  were  practically  united  in  cherishing'  a 
deepl}'  rooted  belief  in  its  transmission  b}^  fomites.  That 
this  conviction  prevailed  must  appear  not  only  natural, 
but  inevitable,  in  view  of  the  great  mass  of  testimony  in 
support  of  that  belief  which  has  been  handed  down  from 
the  i)ast  by  perfectly  honest  witnesses.  In  fact,  some  of 
the  reported  instances^  of  the  apparent  transmission  of 
yellow  fever  by  fomites  cannot  possibly  be  reconciled  with 
our  present  knowledge,  compelling  the  conclusion  that 
something  is  wanting  in  the  evidence.  It  was  not  strange, 
therefore,  that  medical  men  of  the  South,  and  especially 
those  officially  charged  with  the  responsibility  of  framing 
regulations  for  the  protection  of  the  puldic  health,  were 
somewhat  slow  in  accepting  the  mosquito  doctrine  in  its 
entirety. 

Dr.  Edmund  Souchon,  President  of  the  Louisiana  State 
Board  of  Health,  from  February,  1898,  to  January,  lOOG, 
and  whose  administration  was  thoroughly  progressive,  in 
his  Report  for  1900-01  (pp.  78-9),  correctly  defined  his 
OAvn  position  and  that  of  other  Southern  Health  Officials, 
as  follows: 

"While  admitting  that  the  mosquito  has  been  shown 
to  be  a  potent  factor  in  conveying  the  disease,  we  South- 
ern Health  Officers,  charged  with  the  grave  duty  of  pro- 
tecting our  people  against  this  most  dreaded  of  all  dis- 
eases, are  unwilling  to  accept  the  dictum  of  the  experi- 
menters that  yellow  fever  can  be  conveyed  by  no  other 
auencv. 


*  Those  interested  will  find  a  compilation  of  twenty-seven 
authentically  reported  instances  in  Dr.  Edmond  Souchon's 
paper  on  the  "Treatment  of  Vessels  from  Yellow  Fever 
Ports";  N.  Y.  Medical  Record,  Feb.  8th,  1902.  (Reprinted 
in  the  Biennial  Report  of  the  Louisiana  State  Board  of 
Health  for  1900-01,  pp.  81-102.) 


ETIOLOGY PATTON.  Jll7 

We  are  willing-  to  be  conyinced,  but  are  not  prepared 
to  abandon  established  quarantine  precautions  on  the 
stren<;th  of  such  neji'ative  evidence  as  that  alt'orded  by  the 
reported  experiments  with  fomites." 

Dr.  Souchon,  without  for  a  moment  questioning-  that 
yellow  fever  is  conveyed  by  the  bite  of  a  mosquito,  was 
not  willing-  to  admit  that  fomites  or  other  causes  could 
not  also  transmit  the  disease  until  time  and  further  proofs 
should  demonstrate  this  beyond  all  possibility  of  doubt. 
He  felt  that  until  this  was  done  he  would  not  be  justified 
in  altering  the  quarantine  regulations,  especially  as  the 
people  of  Louisiana,  whose  officer  he  was,  still  believed 
firmly  in  the  conveyance  of  yelloAV  fever  by  fomites. 

In  justice  to  Dr.  Souchon  and  other  leading  sanita- 
rians of  the  South,  it  is  to  be  noted  here  that  they  lost  no 
time  in  profiting  by  the  evidence  in  support  of  the  mos- 
quito doctrine  which  continued  to  accumulate  at  localities 
where  the  occurrence  of  yellow  fever  afforded  opportuni- 
ties to  verify  in  actual  practice  the  conclusions  relative  to 
fonntes  previously  based  only  upon  experiments,  so  that 
long  l)efore  the  outbreak  in  Texas  in  1903  the  useless- 
ness  of  disinfection  in  yellow  fever  for  any  other  object 
than  the  destruction  of  mosquitoes  had  been  officially  rec- 
ognized in  Louisiana  and  to  a  great  extent  in  adjoining 
States. 


IV. 

Convi))c'uiff   Ohjrc't    Lr.s-.von.s'   of   1905. 

It  is  safe  to  assert  that  the  experience  gained  during 
the  prevalence  of  yellow  fever  in  Louisiana  and  Missis- 
sippi in  1905  had  the  effect  of  banishing  the  last  lingering 
belief  in  the  conveyance  of  the  disease  by  fomites  so  far 
as  tlie  vast  majority  of  medical  ni/en  in  the  South  were 


1118  auglstin's  history  of  yellow  fever. 

coucerned^^  During-  that  outbreak  no  attention  wliatever 
was  paid  to  tlie  disinfection  of  the  clothing  and  bedding 
of  patients  by  the  State  and  Federal  authorities  who  con- 
ducted the  campaign,  the  first  on  record  in  Avhich  the 
ferer  was  conquered  before  the  coming  of  frost,  all  work 
being  planned  and  carried  out  in  strict  accordance  with 
the  doctrine  of  its  natui'al  transmission  occurring  solely 
by  the  bite  of  the  Stegomjia  mosquito. 

The  magnitude  of  the  demonstration  given  to  the  world 
by  that  campaign  left  no  ground  for  any  objection  that 
might  have  applied  to  experiments  on  a  small  scale  or 
under  artificial  conditions.  After  that  vast  and  costly 
object  lesson  in  our  own  territory,  the  only  "doctors"  left 
unconvinced  were  (and  are)  a  few  old  timers  who  still 
cling  to  the  traditions  of  the  past,  refusing  to  be  per- 
suaded that  an  insect  as  feeble  and  apparently  insigni- 
ficant as  the  mosquito  can  be  the  sole  agent  concerned  in 
conveying  a  disease  so  terrible  as  yellow  fever. 

V. 
Efiological  Role  of  the  Mosquito. 

So  thorough  and  complete  was  the  work  done  by  the 
II.  S.  Army  Commission  in  Havana,  as  set  forth  in  their 
successive  reports,^  that  aside  from  abundant  confirma- 

*  In  New  Orleans  the  g-reat  mass  of  the  laity  became  ready 
converts  to  the  mosquito  doctrine.  This  result  was  accom- 
plished largely  through  good  missionary  work  done  in  the 
city  and  by  public  meetings  and  lectures;  but  the  people 
themselves  entered,  heart  and  soul,  into  the  great  fight  of 
1905,  and  after  witnessing  the  wonderful  success  of  this 
new  method  of  warfare  against  their  ancient  enemy 
needed  no  further  piroof  that  the  doctrine  underlying  that 
method  must  be  correct. 

'  The  Etiology  of  yellow  fever.  A  preliminary  note. — Re3d, 
Carroll,  Agramonte  and  Lazear.  Phil.  Med.  Journal,  Oct. 
27,  1900. 
The  Etiology  of  yellow  fever.  An  additional  note. — Reed, 
Carroll  and  Agramonte.  Jour.  Amer.  Med.  Assn.,  Feb. 
16th,  1901. 

The  Prevention   of  Yellow  Fever. — Reed   and   Carroll.     X.   Y. 

Med.  Record,  Oct.  26th,  1901. 
The   Etiology   of  yellow   fever.     A    supplemental    note. — Reed 

and  Carroll.     American  Medicine   (PMla.),  Fe-b.  22d.  1902. 


ETIOLOGY PATTON.  1119 

lion  hj  other  trustworthy  experimenters  and  the  convinc- 
ing proof  of  the  correctness  of  their  deductions  afforded 
by  the  success  with  which  the  same  liave  been  applied  in 
the  practical  management  of  yellow  fever,  it  may  be  said 
that  nothing  essential  has  been  added  to  our  knowledge 
of  the  mosquito  doctrine  since  it  was  formulated  hj  its 
discoverers.  The  bas^c  jn'inciples  of  that  doctrine  in 
relation  to  the  etiology  of  yellow  fever  (without  direct 
reference  to  quarantine  and  sanitary  work)  may  be  briefly 
stated,  as  follows: 

1.  The  only  natural  agency  by  which  yellow  fever  is 
transmitted  to  human  beings  is  the  bite  of  an  infected 
female  Stegomyia  calopus  mosquito.  (Until  recently 
known  as  Stcgoniijia  fasciafa). 

2.  Therefore,  the  disinfection  of  inanimate  objects,  as 
formerly  practiced  for  protection  against  the  disease,  is 
useless. 

3.  In  order  to  possess  the  power  of  transmitting  the 
disease,  the  mosquito  must,  at  least  twelve  days  previously, 
have  fed  upon  the  blood  of  a  yellow  fever  patient  during 
the  first  three  days  of  that  patient's  illness. 

4.  After  thus  becoming  able  to  transmit  the  disease, 
the  mosquito  retains  (most  probably)  that  power  during 
the  remainder  of  its  life. 

5.  Neither  in  the  mosquito  nor  in  the  human  subject 
does  the  Bacillus  ictcroidcft  or  any  other  parasite  thus  far 
discovered  stand  in  any  etiological  relation  to  the  disease. 

6.  After  being  bitten  by  a  mosquito  capable  of  trans- 
mitting tlie  infection,  a  non-immune  person  will  ordinarily 
develop  yellow  fever  within  five  days,  the  time  of  incuba- 
tion varying  from  two  days  and  one  hour  in  the  shortest 
recorded  period,  to  six  days  and  two  hours  in  the  longest. 

It  is  proper  to  mention  here  that  the  French  C<»mmis- 
sino  consisting  of  ^f.  ;^^archoux,  Salimbeni  and  Siniond, 
by  whom  the  deductions  of  the  U.  S.  Army  Commission 
were  corroborated  in  a  series  of  experiments  undertaken 
to  still  further  study  the  etiological  aspect  of  everything 
connected  with  yellow  fever,  reported  one  instance  in 
which  the  power  of  conveying  infection  appeared  to  have 


1120  augustin's  history  of  yellow  fever. 

been  transmitted  through  the  ova  of  an  infected  female 
insect  to  her  progeny.  Two  of  the  most  expert  and  re- 
liable experimenters  of  the  U.  S.  P.  H.  ^  M.  H.  Service, 
llosenau  and  Goldberger,  entirely  failed  to  find  any  con- 
firmation of  this  hereditary  transmission,  and  in  the  light 
of  much  i)ractical  experience  the  majority  of  American 
authorities  believe  that  it  cannot  take  place. 

The  scope  of  this  article  does  not  warrant  an  exhaustive 
review  of  various  related  matters  of  general  interest,  as 
for  example,  the  habits  and  peculiarities  of  the  ^^tcf/oniijia 
mosquito,  its  distinctive  appearance,  mode  of  attack — the 
female  alone  biting — the  influence  of  temperature  on  its 
•'p<'rnicious  activity,"  its  longevity  after  becoming  infected 
and  ability  to  hibernate  through  a  mild  winter  with  little 
or  no  diminution  of  pathogenic  vigor,  as  must  have  oc- 
curred in  New  Orleans  following  the  little  epidemic  of 
1897,— etc.,  etc. 

However,  two  of  the  special  attributes  of  the  Stegomym 
col o J) lis  are  entitled  to  consideration  here  as  belonging  to 
the  chapter  of  etiology. ,    These  are : 

A.  The  power  which  that  mosquito  alone  appears  to 
possess  of  transmitting  yellow  fever;  and — 

B.  Tlie  interval  of  time,  usually  about  twelve  days 
(belie^<'d  lo  be  influenced  by  temperature)  required  by 
the  femak'  insect  to  develop  that  power  within  her  system 
after  feeding  upon  the  blood  of  a  yellow  fever  i)atient  dur- 
ing the  first  three  days  of  that  patient's  illness.  This  in- 
terval is  the  "Extrinsic  Incubation"  of  Cartt^r,^  who,  in 
1898,  made  a  careful  clinical  study  of  the  subject  and, 
Avithout  detecting  the  agency  of  the  mos()uit(),  correctly 
dctermiiM'd  the  period  of  incubation  outside  the  human 
body  as  being  "usually  in  excess  of  ten  days." 

A. 

The  first  of  the  foregoing  points  may  be  regarded  as 
established  l)eyond  any  reasonable  doubt  l)y  tlie  negative 

'A  Note  on  the  Interval  Between  Infecting  and  Secondary 
Cases  of  Yellow  Fever. — H.  R.  Carter,  M.  D.,  Surg.  U.  S. 
Marine  Hosp.  Service,  New  Orleans  Med.  &  Surg.  Journal, 
May,  1900. 


ETIOLOGY PATTON .  1121 

results  whicli  have  attended  all  experimental  attempts  to 
convey  yellow  fever  through  the  bites  of  other  mosquitoes, 
as  well  as  by  the  fact  that  however  abundant  mosquitoes 
may  be  at  a  locality  in  which  a  case  of  imported  yellow 
fever  develops,  there  is  no  spread  of  the  disease  unless 
the  Stegomi/ia  is  present.  This  explains  why  certain  in- 
terior localities  have  seemed  to  enjoy  immunity,  although 
in  the  "j^ellow  fever  belt."     ' 

As  to  why  this  particular  mosquito  is  the  only  one 
capable  of  transmitting  yellow  fever,  we  are  thus  for  only 
in  a  position  to  conjecture,  but  venturing  a  seemingly 
plausible  supjDosition  covering  the  whole  ground,  we  come 
to  the  second  jDoint : 

B. 

From  analogies  of  susceptibility  and  natural  immunity 
observed  among  animals  we  may  appear  justified  in 
ascribing  to  the  delicate  house-bred  female  Stegomijia 
hatched  from  the  ovum  of  a  mother  fed  on  human  blood, 
an  actual  susceptibility  to  this  human  disease  not  pos- 
sessed by  any  other  mosquito,  but  with  such  natural  power 
of  resistence  as  to  present  an  incubation  period  more 
than  twice  as  long  as  in  the  human  subject,  and  to  remain 
physically  uninjured  by  the  attack. 

flhe  supposition  that  the  mosquito  experiences  some- 
thing corresponding  with  an  attack  of  yellow  fever  in  the 
more  highly  organized  liuman  subject  is  consonant  with 
the  scientific  dogma  that  the  period  of  "extrinsic  incu- 
bation" represents  the  cycle  of  devclo])ment  reciuired  by  a 
hypothetical  parasite  Avithin  the  system  of  the  insect,  in 
accordance  with  analogous  examples  in  nature,  and  helps 
to  account  for  the  profound  impression  evidently  made  on 
that  system.  So  deep  and  lasting  is  tliis  iinj)ressi()n,  like 
that  of  unchecked  syphilis  in  man,  as  to  produce  perm-'- 
nent  change  of  function,  tlie  seci'etion  of  the  salivary 
glands  of  the  infected  mosfiuito  remaining  tainted  for 
life. 


1122  augustin's    history  of  yellow  fever. 

The  period  of  incubation  iii  the  mosquito,  averaging 
about  twelve  days,  added  to  the  three,  four  or  five  days  of 
incubation  required  for  the  development  of  the  disease 
in  the  human  subject,  made  up  the  interval  of  "smould- 
ering" between  the  first  case  (or  group)  and  the  next 
group  of  cases  so  j)uzzling  and  deceptive  in  former  times, 
besides  being  so  disastrous  in  results. 

Surgeon  H.  K.  Carter  of  the  U.  S.  Marine  Hosptal 
Service,  who  is  identified  with  much  of  the  best  yellow 
fever  work  done  in  recent  years,  realizing  the  importance 
of  determining,  if  j^ossible,  the  exact  relationship  of  this 
strange  phenomenon,  took  advantage  of  a  series  of  con- 
secutive cases  at  a  lonely  railroad  telegraph  station  near 
New  Orleans,  in  1897,  to  make  his  first  accurate  observa- 
tions. These  he  was  able  to  verify  the  next  3'ear  under 
singularly  favorable  conditions  at  Orwood  and  Taylor,  in 
north  Mississippi,  where  the  appearance  of  yellow  fever 
among  the  non-immune  population  of  a  sparsely  settled 
district  furnislied  an  opportunity  to  determine  with  ab- 
solute accuracy  the  interval  between  certain  isolated  first 
cases  and  the  resulting  secondary  cases,  the  period  of  in- 
cubation in  the  human  sj'stem  having  already  been  satis- 
factorily ascertained.  In  this  way  he  arrived  at  the  con- 
clusions on  which  he  based  his  first  published  statement 
regarding  tlie  "period  of  extrinsic  incu])ation,"'  the  apt- 
ness of  which  designation  has  been  generally  recognized. 

The  significance  and  scientific  value  of  Dr.  Carter's 
obsevations  were  not  fully  ap])reciated  until  the  F.  S. 
Army  Commission  working  at  Havana  took  up  Finlay's 
uncompleted  studies  relating  to  tlie  mosquito,  after  hav- 
ing determining  that  the  BaclUns  ictcroidcfi  of  Sanarelli 
is  not  an  etiologic  factor  in  yellow  fever.  This  stiiinbliiig 
block  having  been  eliminated,  the  genius  of  the  united 
Commission,  once  started  on  the  true  path,  with  sugges- 
tions drawn  from  the  analogy  of  malarial  transmission 
by  mosquitoes  and  the  aid  supplied  by  Carter's  practical 
studies,  readily  worked  out  the  remaining  elements  of  the 
problem. 


ETIOLOGY PATTON.  112S 

The  Commission  had  no  difflculey  in  securing  human 
subjects  for  experimentation.  At  the  beginning,  a  sub- 
stantial cash  bonus  was  ottered,  but  with  characteristic 
heroism,  American  soldiers  offered  themselves  as  sub- 
jects without  comx^ensation.  There  was  plenty  of  yellow 
I'ever  in  Havana  and  Finlay  aided  in  obtaining  the  prox)er 
mosquitoes  for  the  experiments.  A  sufficient  number  of 
iiisects  were  allowed  to  bite  patients  on  successive  days  to 
enable  the  Commission  to  study  fully  all  questions  of 
time,  with  the  result  that  it  was  found  impossible  for  a 
mosquito  to  become  infected  by  biting  a  patient  after 
about  the  third  day  of  illness,  and  also  imi)ossible  for  a 
mosquito,  even  when  properly  infected  (i.  e.,  by  biting 
during  the  first  three  days  of  the  attack)  to  transmit  the 
disease  to  a  human  subject  earlier  than  about  twelve  or 
fourteen  days  thereafter,  thus  beautifully  demonstrating 
the  rationale  of  Carter's  "extrinsic  incubation,"  of  which 
the  Commission  had  been  duly  mindful.  i 

A  majority  of  the  yellow  fever  cases  experimentally  pro- 
duced, while  relatively  mild,  were  distinctly  typical,  but, 
as  already  mentioned.  Dr.  Lazear  of  the  Commission  died 
of  an  attack  of  the  disease.  Carroll,  who  allowed  himself 
to  be  bitten  by  a  stray  mosquito,  also  had  an  attack  so 
severe  as  to  be  nearly  fatal. 

Among  the  supposedly  non-immune  subjects  experi- 
mented upon  some  did  not  develop  the  disease,  showing 
that  they  enjoyed  a  certain  measure  of  natural  immunity. 

Later,  when  sufficient  proof  of  the  conveyance  of  infec- 
tion by  the  bites  of  mosquitoes  had  accumulated  to  satisfy 
the  most  skeptical,  experiments  on  human  beings  Avere 
discontinued  as  being  attended  with  risk  of  life  even  when 
most  carefully  conducted. 

To  test  the  reputed  conveyance  of  infection  by  fomites, 
a  quantity  of  clothing  and  bedding  dir(M't  from  yellow 
fever  cases  and  variously  soiled  with  black  vomit,  feces, 
etc.,  was  placed  in  boxes  and  stored  in  an  isolated  house 
erected  for  tlie  experiment.  This  house  was  carefully 
screened  toi  exclude  mosquitoes,  and  was  kept  artificially 
heated  to  imitate  natural  conditions.     Seven  non-immune 


1124  ai'gustin's  history  ok  yellow  fener. 

subjects  submitting  to  the  experiment  occupied  a  tent 
near  by  during  tlie  day,  being  carefully  protected  from 
the  bites  of  mosipiitoes.  Ever}-  night  a  squad  would  move 
into  the  screened  house,  where  they  removed  the  funiites 
from  the  boxes,  handling  each  article,  putting  on  the 
soiled  clothing,  sleeping  on  beds  made  up  with  the  "in- 
fected'' sheets  and  blankets,  and  repacking  the  whole  out- 
fit in  the  boxes  the  next  morning.  Although  exposed  in 
this  way  for  three  weeks,  not  one  of  the  seven  subjects 
contracted  the  fever,  but  some  of  them  subsequently  ex- 
perienced experimental  attacks  after  being  bitten  by  in- 
fected mosquitoes  under  the  proper  conditions,  showing 
that  they  were  actually  non-immune. 

The  conclusions  of  the  Commission  were  promptly  put 
to  a  practical  test  by  Major  W.  C.  Gorgas,  Surg.,  U.  S. 
Army  in  charge  of  the  sanitation  of  Havana,  and  with 
such  wonderful  success,  following  absolute  failure  by 
methods  based  on  former  theories,  that  he  succeeded  by 
entirely  eradicating  yellow  fever  from  that  city  Avhere 
the  disease  had  been  perennial  from  time  immemorial, 
thereby  carrying  conviction  to  the  minds  of  admiring 
scientists  all  over  the  world. 

VI. 

TJtc  Bacillii.s  /cfcroidcs. 

Before  dismissing  the  subject  of  experimental  research 
to  discover  the  cause  of  yellow  fever,  it  is  not  inappropri- 
ate to  add  a  final  word  about  the  UaciJlus  ictcroidefi  of 
Sanarelli.  This  parasite,  wliilc  not  tlie  actual  "germ" 
of  the  disease,  is  undenialdy  vci-y  inter(\sting  in  certain 
respects.  It  is  found  in  little  groups  in  the  capillaries 
of  the  liver  and  kidneys  of  y(dlow  fever  subjects,  organs 
strikingly  affected  by  the  disease,  and  its  behavior  in  the 
laboratory,  esix'cially  as  regards  agglutination  tests'^  and 

•Archinard  of  New  Orleans  found  in  1S97  that  among  twenty 
cultures  of  known  parasites  the  only  one  showing  agglu- 
tination with  yellow  fever  blood  was  the  Bacillus 
Icteroides. 


ETIOLOGY PATTON.  1125 

the  causation  in  certain  animals  of  patholoi^ic  conditions 
typical  of  the  disease  in  man,  certainly  justitied  sanguine 
belief  in  its  being  the  long  sought  germ.  Among  ani- 
mals experimented  upon  the  dog  proved  especially  sus- 
ceptible, promptly  developing  characteristic  symptoms  of 
yellow  fever,  viz. :  violent  gastric  disturbance,  intestinal 
hemorrhages,  albuminuria,  suppression  of  urine  and  death 
in  convulsions,  with  post-mortem  findings  of  degenerative 
changes  in  the  liver  and  kidneys  corresponding  with  those 
present  in  human  beings  who  die  of  yellow  fever. 

Sanarelli  reported  five  cases  produced  in  human  sub- 
jects by  inoculation  with  filtered  toxin  from  cultures  of 
the  Bacillus  icteroides,  all  presenting  clinical  pictures  of 
yellow  fever. 

Altogether,  it  seemed  conclusive  that  this  must  he  the 
specific  parasite  of  the  disease,  but  the  impartial  investi- 
gations of  the  U.  S.  Army  Commission  at  Havana,  be- 
sides determining  the  absence  of  the  Bacillus  icteroides  in 
the  blood  of  a  number  of  undoubted  cases  of  yelloAv  fever, 
further  showed  that  blood  serum  from  a  fatal  case,  though 
absolutely  sterile  to  culture  media  favoral)le  to  the  growth 
of  that  parasite,  produced  an  attack  of  yellow  fever  in  a 
non-immune  subject  when  subcutaneously  injected.  A 
similar  sample  of  serum  from  the  case  thus  experimen- 
tally produced  likewise  proved  sterile,  but  also  caused  an 
attack  resembling  yellow  fever  when  injected  into  the  cir- 
culation of  a  non-immune  person. 

From  these  observations,  showing  that  the  Bacillus 
icteroides  is  absent  from  the  blood  of  yellow  fever  lyatients 
at  times  when  the  serum  of  that  blood,  even  after  being 
filtered  through  close  gi*aiiied  porcelain,  is  fully  capable 
of  causing  yellow  fever  if  inlrodiieed  into  tlie  system  of 
non-imimmes,  it  is  self  evident  that  we  must  look  else- 
where for  the  specific  cause  of  the  disease,  howcA-or  in- 
teresting from  a  laboratory  stand])oiiit  that  luiuarkable 
parasite  may  be.  Here,  it  is  evident  that  we  still  have 
something  to  learn. 


11S6  augustin's  history  of  yellow  fever. 

VII. 
Dengue  and  Yellow  Fever. 

In  couclusion,  there  seems  to  be  auotlier  aud  really  ini- 
portant  field  for  study  as  regards  the  frequent  and  hith- 
erto confusing  association  of  yellow  fever  and  dengue. 
Both  diseases  being  transmitted  by  the  bites  of  mosquitoes 
and  often  occurring  simultaneously,  as  it  were,  in  locali- 
ties where  yellow  fever  almost  immediately  afterwards 
becomes  epidemic,  there  would  appear  to  be  some  grounds 
for  suspecting  a  modified  evolution  of  toxin  in  the  system 
of  the  transmitting  mosquito,  either  the  i^icfjomji'm  calo- 
pus  itself  or  of  some  other  memlier  of  the  same  grouj), 
whereby  the  original  poison  thus  modified  instead  of 
causing  undoubt(^d  cases  of  yellow  fever  produces  the  sort 
of  atypical  fever  which  in  the  past  has  proved  so  con- 
fusing and  disastrous. 

It  is,  of  course,  very  easy  to  explain  matters  by  simply 
assuming  that  the  two  diseases  happen  to  lie  present  at 
the  same  time,  but  to  those  who  have  personally  observed 
these  puzzling  twofold  outbreaks  some  other  explanation 
seems  necessary,  and  it  is  not  expecting  too  much  of 
science,  which  has  laid  the  Avorld  under  so  many  obli- 
gations, to  express  the  hope  that  in  the  near  future  the 
solution  of  this  long  standing  problem  will  be  forth- 
coming. 


1127 

THE     SANITARY     PREVENTION     OF     YELLOW 

FEVER. 

By  Quitman  Kohnke,  M.  D., 

Health   Officer  of  the   Citi/  of  Ncio  Orleans,  September 
1898  to  Scptemher  190G. 


The  Yellow  Fever  Mosepiito. 

There  cau  be  no  yellow  fever  as  a  com'miinioal)le  disease 
in  the  absence  of  its  transmitting  agent,  the  Stegonii/ia 
mosquito,  first  classified,  entomologically,  as  culex 
fasciata,  then  as  Stegoiiiijia  fasciata,  and  later  as 
Stef/omyia  ca lopus. 

I'lie  female  only  is  a  blood  feeder  and  disease  conveyer, 
the  male  on  account  of  tlie  peculiar  construction  of  its 
feeding  organ  being  unable  to  pierce  the  skin  to  obtain 
blood. 

The  female  deposits  her  eggs  on  the  surface  of  still 
water,  and  under  favorable  conditions,  the  adult  ins'ccts 
are  develo])ed  therefrom  in  about  one  week. 

The  mosquito  may  be  seen  at  all  hours,  but  is  oftenest 
observed  in  the  morning  and  the  afternoon.  It  selects 
shady  ])laccs  and  avoids  smdight.  It  is  said  to  be  a  day 
feeder  during  the  first  four  days  of  its  existence  after 
which  time  it  feeds  at  any  hour  of  the  day  or  niglit.  It 
may  live  for  several  months,  nu<l  once  infectiMl  with  yel- 
low fever,  remains  infectious  during  tlie  i-est  of  its  life, 
It  is  a  house  mosquito  and  does  not  migrate.  The  possi- 
bilily  of  infectiousness,  transmitted  to  the  off-spring 
through  the  egg,  is  not  yet  established. 


1128  acgustin's  history  of  yellow  fever. 

lliboruation  of  the  adult  mosquito  is  supposed  by  some 
authorities  to  occur,  but  has  not  been  actually  observed. 
Hibernation  of  the  egg  and  the  larva  is  also  believed  to 
happen.  My  observations  incline  me  to  the  view  that 
hibernation  is  likeh'  in  the  egg,  jjossibly  occurs  in  the 
larva,  but  does  not  take  place  in  the  pupa  or  adult. 

If  hibernation  of  adults  does  occur  in  Xew  Orleans, 
I  am  of  the  opinion  that  infectiousness  does  not  resist 
the  changes  incident  thereto. 

Eecrudescence  of  yellow  fever  due  to  the  persistence 
of  infectiousness  in  the  mosquito  through  the  period  of 
hibernation  is  held  by  some  observers  to  account  for  the 
reapjiearance  of  the  disease  in  the  summer  following  an 
epidemic  year.  The  recurrence  of  yellow  fever  is  more 
likely  due  to  its  reintroduction  through  imperfectly 
guarded  channels  of  entrance  or,  rarely,  to  the  continu- 
ance of  the  chain  of  cases  through  the  winter  and  their 
increase  in  number  as  the  warm  season  favors  mosquito 
development. 

Much  has  yet  to  be  learned  of  the  habits  and  character 
of  the  S^tcf/OHii/ia  mosquito,  and  the  field  of  observation 
and  research  is  broad  and  comparatively  new  in  this 
direction. 

ATe  are  in  possession,  however,  of  the  essential  facts 
of  its  connection  with  yellow  fever,  and  new  discoveries 
will  be  the  elaboration  of  details,  corroborating  the  main 
truth  and  regulating  its  precise  application  in  sanitary 
practice. 

II. 

Moral  Rc.s])OjisiJ>}lil  1/  for  Epiihiuics. 

Since  the  discovery  of  its  mosquito  transmission,  the 
prevention  of  yellow  fever  is  a  much  simpler  problem 
than  in  the  days  of  our  ignorance  of  the  mode  in  which 
the  disease  invariably  spreads  fi'om  i)erson  to  person. 
While  we  have  not  yet  discovered  the  germ  of  yellow  fever 
or  its  primal  origin,  our   knowledue   of   the  manner   and 


PREVENTION KOHNKE.  1129 

character  of  its  movement  places  a  formidable  weapon  in 
our  hands  against  its  progress,  and  it  may  be  said  in 
reason  and  with  fairness,  that  a  community  sulfering  a 
yellow  fever  epidemic  is  lacking  as  a  whole  in  the  essential 
characteristics  of  intelligent  manhood. 

Yellow  fever  in  the  ignorant  past  was  a  misfortune ; 
in  the  enlightened  present  it  is  a  fault — in  the  moral 
future  it  may  be  a  crime. 

III. 

The  Sauitari/  Creed. 

The  doctrine  of  the  mosquito  conveyance  of  yellow 
fever,  for  the  practical  application  of  preventive  measures 
based  thereon,  may  be  expressed  thus : 

The  immediate  causative  factor,  the  germ  of  t-ie  '.^i^.- 
ease,  is  accessible  to  the  only  natural  vehicle  of  transmis- 
sion, the  mosquito,  during  the  first  three  days  of  the 
fever,  and  the  germ  after  entering  the  mosquito's  stomach 
requires  twelve  days  to  migrate  to  one  of  the  salivary 
glands,  from  which  the  insect,  while  feeding,  may  inject 
it  into  the  blood  stream  of  its  victim,  in  Avhose  system 
the  period  of  incubation  is  usually  from  three  to  five  days, 
rarelj^  six. 

The  human  subject  of  the  disease  may  be  considered 
infectious,  therefore,  to  the  mosquito  during  the  first  three 
days  of  the  fever,  aiid  not  thereafter;  the  mosquito  being 
infectious  after  the  twelfth  day  from  the  date  of  inocula- 
tion, and  not  before.  Its  victim  shows  tlie  first  sym])tom 
of  disease  usuall}-  in  less  than  five  days  after  infection  by 
the  insect. 

The  exceptions  to  this  rule  are  not  sufficient  to  suggest 
its  modification,  but  in  actual  practice  the  patient  is  con- 
sidered possibly  infectious  dnring  four  days,  and  the  mos- 
quito possibly  dangerous  on  the  tenth  day. 

A  case  of  yellow  fever  cannot  occasion  another  case  in 
less  time  than  the  period  of  germ  emigration  in  the  mos- 


1 1  30  augustin's  history  of  yellow  fever. 

quito,  which  is  twelve  days,  added  to  the  period  of  iiicuba- 
tiou  in  the  human  victim,  which  is  seldom  less  than  three ; 
fifteen  days  completing-  the  miDimum  cycle  of  infection. 
We  may  say  approximately  that  explosions  of  infection 
should  be  expected,  and  are  observable  semi-monthly,  and 
the  preventive  effect,  therefore,  of  disinfection  cannot  be 
determined  earlier  than  fifteen  days  thereafter.  We  can 
not  say  how  many  cases  niRj  result  from  one  case  un- 
treated sauitaril}',  but  we  can  say  positively  that  no  case 
will  result  if  there  are  no  mosquitoes  present  of  the  Ste- 
gomy'ia  variet^^  Conversely  we  may  rightly  apprehend  a 
great  infection  in  the  presence  of  great  numbers  of 
mosquitoes. 

Tlie  application  of  the  mosquito  doctrine  to  the  pre- 
vention of  yellow  fever  is  all  that  need  be  done  in  any 
emergency;  but  to  accomplish  this,  is  a  problem  not  to  be 
solved  by  anv  set  formula.  It  is  an  easy  iiiatter  to  set 
down  on  paper  and  in  an  office  a  lot  of  ruks  in  the  abstract 
to  be  carried  out  in  the  field,  but  it  is  a  different  matter 
to  apph'  these  rules  concretely  to  actual  ca!--es  to  obtain 
results. 

Circumstances  and  conditions  met  with  in  actual  prac- 
tice may  radically  change  the  relative  value  of  details,  es- 
teemed of  paramount  importance  theoretically. 

As  a])p]icablo  to  a  locality  or  community,  there  may  be 
considered  three  propositions,  upon  the  first  two  of  which 
is  based  the  third,  which  is  offered  in  the  nature  of  a 
conclusion. 

1.  Quarantine  against  yellow  fever  cannot  be  made 
absolute  in  its  protective  value. 

2.  Early  recogiiih'on  of  the  presence  of  yellow  fever 
infection  is  difficult  always,  and  at  times  impossible. 

3.  Tlie  most  dependable  measure  of  prevention  of  yel- 
low fever  is  destruction  of  the  ^^fr(/o)iii/}<i  mosquitoes  be- 
fore the  i)ossil)ility  of  infection. 

Qiiaranthic. — In  quarantine  against  yelb)w  fc^ver,  two 
essentials  are  to  l)e  considered,  and  uofJiiiif/  rUc.  Deten- 
tion of  persons  ex])osed  to  inf(H-tioii  for  not  less  than  the 
period  of  icubation  of  the  disease,  and  the  prevention  of 
entrance  of  infected  mosquitoes. 


PREVENTION KOHnKI.  11  SI 

The  increasing  facility  of  rapid  travel  makes  quaran- 
tine more  clifficnlt  and  less  reliable.  However,  near  to 
perfection  may  become  onr  maritime  quarantine  system, 
we  shall  always  be  exposed  to  infection  by  rapid  land 
transportation  from  ports  not  themselves  infectible,  or 
which  are  less  careful  for  other  reasons.  Quarantine, 
though  important  and  necessary,  cannot  ever  be  all- 
sufficient. 

Eaylji  Rccof/nition. — Early  recognition  of  yellow  fever 
infection,  so  essential  to  the  prompt  application  of  sani- 
tary remedial  measures,  is  rarely  to  be  expected.  The 
history  in  this  respect  of  1897-8  and  1899,  as  well  as  that 
of  1905,  exemplifies  this,  not  only  in  New  Orleans,  but 
elsewhere,  even  in  Havana,  where  better  preparation  is 
made  and  better  opportunities  offer  for  the  prompt 
discovery  of  early  cases. 

We  should  not  relax  our  constant  watchfulness  during 
the  season  of  danger,  but  we  must  realize  that  knowledge 
of  the  existence  of  first  cases  requires  a  combination  of 
factors  not  always  obtainable  and  not  within  our  practical 
control. 

IV. 
Mortality  Statistics. 

Three  charts  of  mortality  are  shown  for  three  separate 
years,  one  of  which,  1905,  is  a  yellow  fever  year.  All  the 
charts  apply  to  New  Orleans. 

The  causes  of  death  are  those  under  which  yellow  fever 
may  be  concealed,  intentionally  or  not. 

A  careful  analysis  of  these  records  does  not  bear  out 
the  notion,  expressed  by  some,  that  the  presence  of  yellow 
fever  may  be  discovered  early  through  an  inspection  of 
the  mortality  records.  In  1905,  the  presence  of  yellow 
fever  was  suspected  bv  the  report  on  the  afternoon  of 
July  12th,  of  cases  of  illness  for  official  investigation. 
Subsequent  discoverv  Avas  made  of  its  probable  presence 
as  early  as  the  middle  of  'Sli\y.  If  mortality  records  bad 
the  value,  in  this  respect,  that  is  claimed  for  them,  then 
those  for  1905  would  have  furnished  the  warning  of 
danger. 


1132 


AUGUSTIN   S      HISTORY    OF    YELLOW    FEVER. 


No  system  of  investigation  which  will  seem  to  discover 
yellow  fever  in  the  records  of  1905,  prior  to  July  12th, 
will  fail  to  indicate  yellow  fever  also  for  1903  and  1904, 
3'ears  when  yelloAV  fever  was  not  present. 

The  value  of  mortality  charts  may  be  historic  and  cor- 
roborative, but  it  is  certainly  not  prophetic,  in  respect 
to  yellow  fever.  Investigations  of  individual  cases,  whose 
circumstances,  together  Avith  the  given  cause  of  death, 
may  excite  suspicion,  is  more  reliable  than  an  observance 
of  increased  mortality  from  certain  diseases,  and  is  earlier 
available.  But  this  also  is  not  dependable  to  discover 
early  cases,  for  it  was  our  routine  practice  duri^ig  the 
danger  period,  and  was  done  during  the  summer  of  1905, 
as  late  as  the  early  part  of  July,  with  negative  results. 

"  1905. 


January 

February 

March 

Aprrl 

May 

June 

July 

August 

September 

October 

November 

December 

IS04.. 


i.tj        I         ♦J   CO 


Rj  o. 

OH 


Ol.S 

V  o 
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CQ  c^ 


January  

February  .. 

March  

April 

May  

June 

July  

August 

September . 

October 

November 
December  .. 


4 
3 
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4 
6 
.5 
4 
6 
13 
9 
6 
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5 

5 
8 
7 
3 
4 
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II 
14 
19 
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PREVENTION KOHNKE. 


1123 


1903. 


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January  

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August  . . 
September 
October  — . 
November 
December 


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53 
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39 
41 
30 
39 
51 
54 
51 
49 
50 


13 

12 
10 
20 
8-2 
73 
56 
26 
II 
17 
18 
17 


5 
4 

6 
6 

8 
IM 
16 

21 

14 
8 
2 

II 


16 

8 
13 
13 
28 
55 
59 
79 
66 
25 
24 
26 


V. 


Dcstntctioii   of  Htcfjomi/iac. 


Finally,  we  must,  I  think,  conchide  tliat  the  de- 
struction of  the  only  transmitting'  niedinm  is  Tfie 
surest  preventive  of  .yellow  fever.  This  measure 
also  is  subject,  of  course,  to  imperfect  application 
in  practice,  and  incomplete  results.  It  is,  for  this  reason, 
not  sufficient,  alone,  to  i>uarantee  ai»aiiist  infection,  but 
it  offers  the  important  element  of  time  during-  whicli  to 
arran.G,e  for  and  encouraj^e  its  tliorou<ih  a]iplication ;  and 
in  the  event  of  the  failure  of  (luarantine  and  of  the  pr()m])t 
recognition  of  infection,  tlie  spread  of  the  disease  is  modi- 
fied by  even  a  partial  destruction  of  the  conveying  medium, 
and  this  gives  op])ortnnity  for  perfecting  (nganization 
against  tlie  infected  insects. 

The  heal  til  authorities  of  New  Orleans  were  convinced 
of  the  trutli  and  imi)ortance  of  the  mosquito  doctrine  of 
yellow  fever  conveyance,  in  1001,  and  of  the  importance 
of  mosquito  destruction.  Twice  a  law  such  as  is  now 
operative  was  proposed  to  and  rejectiMl,  by  the  city 
council,  and  my  belief  is  now,  as  it  was  then,  that  the  de- 
struction of  ^Sfcf/omj/ia  mosquitoes  prior  to  the  intrctduc- 


1134  AIGUSTIn's    HISTORY     OF     YELLOW    FEVER. 

tion  of  yellow  fever  is  the  oiiiice  of  i^revention  that   is 
better  than  the  pound  of  cure. 

VI. 

Conditions  Ohtaiiiinfj  in  Xcic  Orleans  in   1905. 

The  explosion  of  infection  in  Xew  Orleans  in  1905,  was 
due  to  an  unfortunate  combination  of  unfavorable  con- 
ditions, to  which  was  applied  the  spark  of  introduced  in- 
fection. How  the  fever  entered  the  city  is  not  the  official 
concern  of  the  health  officer,  who  is  siDcciall}'  denied  by 
law  any  function  or  authority  in  maritime  or  inland  quar- 
antine. Wlien  the  fever  got  here,  however,  it  found  ideal 
factors  for  its  development  and  spread.  The  section  of 
the  city  first  infected  is  the  most  densely  populated.  The 
people  are  for  the  most  part  ignorant  of  our  language  and 
illiterate  in  their  own.  Their  habits  are  unsanitary  and 
their  customs  such  as  tend  to  secretiveness  and  improvi- 
dence. They  are  not,  as  a  rule,  vicious,  but  fearful  of 
police  authority,  and  exceedingly  clannish ;  as  is  not  un- 
natural for  foreigners  in  a  strange  country. 

It  is  currently  believed,  and  I  think  correctly  so,  that 
among  them  are  criminals  escaped  or  deported  from  their 
own  country ;  and  that  the  "dago  vote,"  as  it  is  called,  is  a 
political  factor  of  considerable  importance  in  that  section 
of  the  city. 

Medical  attention  in  case  of  illness  is  usually  delayed 
until  the  severity  of  sym]»toius  demands  it,  and  any  but 
severe  ailments  are  likely  to  be  followed  by  recovery  with- 
out medical  interference.  They  are  attended  when  ill, 
mainly  by  physicians  of  their  own  nationality,  not  all  of 
whom  speak  our  language  and  some  of  whom  are  un- 
familiar with  yellow  fever.  They  are  apt  to  resent  the 
reporting  of  any  case  of  communicable  disease  to  the 
authorities,  and  are  likely  to  dismiss  the  attending  physi- 
cian for  this  reason.  Imagine  a  crowded  population  of 
this  kind  whose  water  supply  consists  in  largo  part  of 
turbid  river  water,  kept  for  settling  purposes  in  numerous 


PROTECTION KOHNKK.  1135 

open  barrels,  each  one  an  ideal  breeding  place  for  the 
lStcgo]iii/ico  mosquito. 

For  more  than  four  years  the  health  offlcer,  encouraged 
and  sui)ported  by  the  board  of  health,  had  pointed  out  the 
danger;  had  explained,  urged,  begged  and  prophesied,  but 
other  considerations  were  deemed  of  greater  importance 
than  the  destruction  of  mosquitoes.  In  plain  English, 
the  politicians  thwarted  the  designs  of  the  health  officer 
while  the  general  public  was  indifferent. 

When  the  disaster  came,  however,  the  people  of  New 
Orleans,  awakened  from  a  lethargic  sense  of  security,  rose 
to  the  situation  and  demonstrated  their  willingness  and 
abilit3'  to  tight  the  greatest  battle  that  was  ever  waged 
against  j^ellow  fever;  and  they  conquered.  !  The  united 
forces  of  the  combined  authorities  of  the  City,  State 
and  Nation  and  the  whole  people  of  New  Orleans,  men 
and,  notably-,  Avomen  succeeded  in  turning  a  great  calamity 
into  the  most  glorious  victory  of  modern  times.  For  the 
first  time  in  Ncav  Orleans  an  epidemic  of  yellow  fever  was 
fouglit  with  the  weapons  suggested  by  the  doctrine  of 
mosquito  conveyance  of  the  disease,  and  for  the  first  time 
extensive  yellow  fever  infection  was  controlled  as  early  as 
August. 

The  successful  efforts  of  the  local  authority  were  dis- 
turbed by  internal  bickerings,  jealousies  and  political 
intrigues  which  endangered  the  final  outcome,  and  the 
Federal  government  was  appealed  to  and  invited  to  as- 
sume charge  of  the  situation.  This  was  done  through  tlie 
IMarine  Hospital  Service  by  the  enabling  authority  of  the 
health  officer  and  the  victory  was  continued  to  completion. 

The  first  victory  over  yellow  fever  was  in  FTavana.  the 
greatest  in  New  Orleans. 

The  character  of  the  neighborhood  first  infected,  its 
nearness  to  the  landing  place  of  the  ITavana  steamers,  the 
intimate  connection  of  the  ])eoi)le  witli  llie  Iropical  fruit 
trade,  and  the  facility  witli  which  infection  could  have 
gotten,  and  prob{d)ly  did  get,  to  the  luggers,  the  Innding 
place  for  which  is  in  close  proximity,  these  luggers  being 
connecting  links  with  the  gulf  coast  of  Louisiana,   are 


1136  ai.gistin's  history  of  yellow  fever. 

suggestive;  aud  give  occasion  for  various  speculations, 
Avitli  regard  to  the  mode  of  origin  and  source  of  infection, 
not  likelv  at  this  time  to  reach  the  domain  of  ascertained 
facts. 

Suspicion  was  specially  directed  to  this  neighborhood 
of  tlie  citv  about  the  middle  of  July,  but  subsequent 
knowledge  indicated  the  real  beginning  of  yellow  fever 
infection  to  have  been  probably  six  or  eight  weeks  earlier; 
thus  allowing  infection  to  reach  other  sections  of  the 
State  before  the  suspicion  of  its  presence  was  excited  in 
New  Orleans. 

Never  before  was  an  epidemic  of  yellow  fever  in  New 
Orleans  fought  in  the  same  Avay,  and  the  most  skeptical 
of  reasonable  persons  must  conclude  that  the  control  of 
what  would  have  been  one  of  the  greatest  of  yellow  fever 
epidemics  was  due  solely  to  the  prevention  and  destruction 
of  mosquitoes. 

VII. 

Conclusions. 

Since  the  (^tcf/onn/ia  mosquito  alone  transmits  yellow 
fever,  preventive  measures  need  be  directed  onlv  against 
this  insect,  and  since  the  adult  mosquito  of  this  Aariety 
issues  in  about  one  week  after  the  cixiX  is  dejxssited  upon 
the  surface  of  still  water,  the  following  rule  should  be 
enforced  to  render  a  locality  iiniiiiiiic  to  the  disease. 

Once  a  week  pour  upon  the  the  surface  of  all  still  water, 
not  removable  by  drainage  or  otherwise,  or  stocked  with 
fish,  or  screened  from  mosquitoes,  a  quantity  of  refined 
kerosene  equivalent  to  one  ounce  for  each  ten  square  feet 
of  surface. 

This,  if  begun  before  their  flight,  will  prevent  the  breed- 
ing of  ^tccianijiia  mosquitoes,  and  thereby  remove 
the  possibility  of  spreading  infection  which  they  alone 
can  spread. 

A  locality  so  protected  against  yellow  fever  need  not 
quarantine  against  the  disease,  but  protection  so  obtained 


PREVENTION KOHNKE.  1  1  S7 

can  not  be  more  complete  than  the  work  is  thorough,  and 
the  work  will  not  be  more  thorough  than  the  i)eople  are 
informed. 

If  quarantine  be  advisable,  because  of  infectibility,  this 
measure  of  protection  need  only  include  persons  ex- 
posed to  infection,  (and  these  should  be  detained  only 
during  the  period  of  incubation  of  the  disease)  ;  and  need 
not  include  any  article,  incapable  of  transporting 
mosquitoes.  ; 

An  infectible  locality  is  one  containing  adult  Stegomyia 
mosquitoes,  and,  should  the  disease  be  introduced,  fami- 
gation  to  kill  possibly  infected  mosquitoes  must  be  prac- 
ticed in  infected  domiciles,  and  for  this  the  location  of 
early  cases  is  necessary. 

It  is  my  experience  tliat  early  cases,  not  imported,  are 
not,  recognized  in  time  to  prevent  infection,  and  it  is 
my  belief  that  they  never  will  be.  Diagnosticians  who  can 
at  all  times  differentiate  between  the  very  mild  cases  of 
yellow  fever  and  diseases  resembling  it  exist  mainly  in 
the  imagination  of  the  laity.  , 

Ignorance  and  improvidence  have  permitted  variola  to 
exist  more  than  a  hundred  years  after  the  discovery  of  its 
prevention.  Ignorance,  improvidence  and  commercial 
greed  may  permit  yellow  fever  to  be  occasionally  ei)idemic 
in  our  country  for  an  equal  period. 


(^\■ 


1138  '     ^^  y 

BIBLIOGRAPHY     OF     TRANSMISSION     OF     YELLOW     FEVER     BY 

MOSQUITOES. 

(Compiled  by  George  Augustin.) 

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11 42  augustin's  history  of  yellow  fever. 

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TRANSMISSION    BY    MOSQUITOES BIBLIOGRAPHY.  I  1  4S 

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1144  ALGUSTIN   S    HISTORY    OF    YELLOW    FEVER. 

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1147 

PATHOLOGY  OF  YELLOW  FEVER. 

BY  OLIVER  L.  POTHIER^  M.  D.^ 

Pathologist  to  Charity  Hospital,  New  Orleans. 

Difficulty  of  Pathological  Diagnosis. 

The  pathology  of  yellow  fever,  like  the  clinical  aspect 
of  the  disease,  is  dependent  upon  a  number  of  factors 
which  must  be  taken  collectively,  to  establish  the  lesions 
of  the  infection.  It  could  be  embodied  in  a  very  few 
words  by  describing  it  as  a  general  steatosis.  No  other 
infection  produces  such  intense  and  widespread  fatty 
degeneration  as  3ellow  fever.  The  sudden  and  general 
hemorrhages  appearing  during  its  course  are  due  to  the 
fatty  degeneration  of  the  endothelium.  Yet  there  is  not 
a  single  lesion  of  any  organ  which  can  be  considered 
pathognomomic  of  yellow  fever.  It  is  the  collective 
lesions  and  general  pathological  picture  presented  during 
the  course  of  the  infection  and  at  the  autopsy,  which  char- 
acterizes the  disease. 

We  do  not  find,  as  in  typhoid  fever,  typhus  and  other 
infectious  diseases,  characteristic  lesions  localized  in 
special  organs.  The  lesions  of  yellow  fever  are  dissemi- 
nated throughout  the  body,  and  it  is  the  peculiar  general 
picture  presented  by  the  lesions  of  the  different  organs, 
associated  witli  the  history  of  the  case,  which  makes  up 
the  basis  of  a  pathological  diagnosis.  The  lesions  are 
characteristic  in  that  they  affect  certain  organs,  while 
others  remain  apparently  free.  ' 

Yellow  Color. 

To  one  familiar  with  yellow  fever,  the  appearance  of 
the  body  brings  to  his  mind  a  number  of  features,  which, 
though  not  absolutely  characteristic,  present  an  cnscmhlc 
on  which  at  times  a  diagnosis  may  be  based.  The  body 
presents  a.  yellow  color,  not  the  light  or  lemon  color  of 
ordinary  jaundice,  but  a  decided  uniform  deep  orange 
yellow,  which  with  the  peculiar  lividity  generally  exhib- 


1148  AUGUSTIn's   H'.STORY    OF    YELLOW    FEVER. 

ited  by  the  bodies,  gives  them  a  rather  striking  appear- 
ance. On  the  chest,  neck,  genitals,  and,  at  times,  other 
parts  of  the  body,  not  necessarily  the  dependent  parts^ 
are  found  number  of  small  or  large  hemorrhagic  areas, 
which  appear  to  be  cutaneous  and  subcutaneous  hemor- 
rhages. The  dependent  parts  show  as  a  rule  marki^d  post- 
mortem hypostasis.  The  sclera  are  markedly  yellow  and 
frequently  show  hemorrhagic  points;  the  pupils  are 
usually  dilated. 

HcinorrJifn/ic  Hpofs. 

In  a  number  of  places  the  sul»cutaneous  tissue  show 
hemorrhagic  areas,  due  to  overdistention  of  the  capillaries 
of  the  part,  with  rupture  resulting  from  the  fatty  degen- 
eration of  the  endothelium.  In  some  cases  these  hemor- 
rhages are  numerous  and  quite  extensive.  The  skeletal 
muscles  do  not  present  any  marked  changes,  though,  at 
times,  areas  of  fatty  degeneration  are  found.  This,  how- 
ever, is  unusual. 

The  Lungs. 

The  lungs  do  not  present  any  special  lesions.  They 
generally  appear  normal.  The  microscoi)ical  picture  may 
show  slight  engorgement,  but  nothing  else  of  note.  In 
their  report  on  yellow  f(  ver  ^Marchoux  and  Simoud  state 
that  the  oedema  fre([uently  existing  in  autcjiKics  of  yellow 
fever,  is  possibly  due  to  post-moi-tem  changes.  I  must 
say  that  my  experience  with  yellow  fever,  prompts  me  to 
agree  with  their  statements,  and  that  I  have  generally 
observed  that  the  lungs  show  very  few,  if  any,  changes. 

The  Heart. 

The  heart  and  large  vessels  at  its  base  show  frequently 
hemorrhagic  spots  over  their  surfaces.  The  heart  is 
usuall  flabby,  and  of  a  yellowish-red  color.  The  endo- 
cardium frequently  shows  hemorrhagic  spots  also.  The 
organ  may  present  all  of  these  lesions  in  a  marked  degree^ 


PATHOLOGY POTHIER.  1149 

or  one  lesioii  may  be  more  proiiounced,  while  the  others 
do  not  shoAV.  Again  the  organ  may  not  show  any  lesions. 
It  is  rare,  however,  that  one  or  the  other  lesions  are  not 
ajji^arent.  The  microseoi^ical  examination  may  reveal  ab 
times  marked  latty  degeneration,  while  at  others  the 
muscle  is  normal. 

The  Liver. 

The  lesions  of  the  liver  are  more  frequently  met  with 
and  are  more  characteristic,  the  organ  presenting  in  typi- 
cal cases  a  marked  fatty  degeneration.  It  has  a  yellow 
cast,  though  I  cannot  say  that  it  is  always  boxwood  in 
color.  At  times  it  niay  exhibit  that  appearance,  but  in 
the  majority  of  ^Mstances  the  organ  is  simply  yellowish. 
The  microscopical  appearance  in  cases  that  die  early 
show  fatty  degeneration  of  the  middle  part  of  the  lobule, 
'or  in  what  is  kiiown  as  the  hepatic  arteiy  zone.  This 
appearance  does  not  show,  however,  in  cases  that  die  after 
the  fiflth  or  sixth  day  or  tuV'  /Hsease,  is  the  fatty  degenera- 
tion has  involved  all  of  the  loLiile.  In  these  cases 
the  organ  is  transformed  into  a  mass  of  fatty  degenerated 
cells,  little  if  any  of  the  protoplasm  of  the  cells  remaining, 
while  the  blood  capillaries  and  spaces  are  filled  with 
blood. 

The  early  fatty  degeneration  as  described  above,  limited 
to  the  middle  zone  of  the  lobule,  is  considered  by  some 
as  characteristic  of  yellow  fever;  l)ut  it  is  found  in  other 
infectious  diseases,  and  is  rather  a  characteristic  of  the 
fatty  degeneration  of  acute  hepatitis  of  infectious  diseases. 

The  Spleen. 

The  spleen  does  not  show  anything  of  note,  and  is  gen- 
erally normal  in  size.  This  is  a  dirfcrentiiil  ])oiiit  between 
yellow  and  malarial  fevers.  The  spleen  in  the  latter  al- 
ways presentiiig  the  characteristic  ap^iearance  of  malaria. 
The  microscopical  examination  fails  to  show  anything,  but 
at  times  one  may  find  a  laigc  (piantity  of  blood  in  the 
blood  spaces,  with  fatty  degeneration  of  endothelium. 


1150  augustin's  history  of  yellow  fever. 

The  KUlncys. 

The  kidneys  are  usually  of  a  reddish-Yellow  color,  and 
appear  congested.  On  section  the  organ  presents  a 
marked  yellow  color,  mixed  with  red  and  frequently  small 
hemorrhagic  areas  are  disseminated  through  the  sui)stance 
of  the  organ.  In  some  cases,  however,  this  organ  may  not 
show  any  apparert  lesions.  The  microscopical  appearance 
is  generally  that  of  an  acute  parenchymatous  nephritis, 
with  extensive  fatty  degenerations,  the  cells  of  the  tuhules 
appearing  as  granular  masses  lining  the  tubules  and  filled 
with  fat  droplets.  The  cells  or  what  remains  of  them  are 
desquamating  and  in  many  areas  casts  are  found  plugging 
the  lumen  of  the  tubules.  The  capillaries  are  filled 
with  blood  and  in  places  blood  is  found  in  the  connective 
tissue  and  at  times  in  the  tubules.  In  some  cases,  hardly 
any  lesions  can  be  demonstrated,  with  the  exception  of  a 
few  f'attv  cells. 


The  Adrenals.  Tiij/roids  and  Pancreas. 

The  adrenals  thyroids  and  pancreas  all  present  fatty 
degeneration  of  their  respiective  epithelium.  The  degen- 
eration in  the  adrenals  seem  to  be  more  marked  in  the 
zona  fasciculata.  All  of  the  different  organs  i)resent  fatty 
degeneration,  which  seems  to  be  the  main  lesion  of  yellow 
fever. 


The  stomach. 

The  stomach  mucous  membrane  presents  hemorrhagic 
spots,  more  especially  near  tlie  cardiac  extremity.  The 
contents  are  of  a  semi-fluid  or  fluid  dark-grumous  color, 
or  the  viscus  may  be  empty.  The  microscopical  examina- 
tion reveals  a  swollen  mucosa;  the  cells  are  desquamating 
and  fatty,  the  fatty  degeneration  extending  to  the  gland- 
ular cells  even  in  the  fundus  of  the  glands. 


PATHOLOGY POTHIER.  1151 

The  Intestines. 

The  small  and  large  intestines,  if  we  except  the  begin- 
ning- of  the  duodeum,  do  not  present  very  ninch  of  note 
microscopically.  Under  the  micro' cope  we  may  find  in 
the  small  intestines  a  swollen  mucosa.,  the  cells  of  which 
are  desquamating  and,  occasionally,  a  few  fatty  cells;  but 
these  lesions  are  not  constant.  At  the  beginning  of  the 
duodenum,  the  firs^  two  inches  present  very  much  the  same 
lesions  as  those  of  the  stomach. 

The  Blood. 

The  blood  of  yellow  fever  does  not  present  much  of 
note.  The  repeated  examination  of  this  tissue  has  failed 
to  reveal  anything  definite.  Some  cases  present  appar- 
ently an  increase  of  the  platelets,  but  this  is  no\,  a  con- 
stant condition  and  cannot  be  considered  typical  of  the 
disease.  Again  certain  bodies  have  been  reported  as  oc- 
curring in  the  plasma,  but  it  is  very  probal)le  that  tliey  are 
due  to  fragmented  corpuscles  or  some  artefact,  and  are 
not  constant.  The  blood  count  is  practically  normal  and 
there  does  not  seem  to  be  any  constant  variation  in  the 
amount  of  hemoglobin,  thougli  at  times  a  series  of  cases 
may  show  a  slight  diminution.  Taken  as  a  whole  in  a 
large  number  of  <^'ases  the  blood  alteration  are  practically 
nil.  The  leucocytic  count  is  also  normal,  and  there  does 
not  seem  to  be  a  preponderance  of  either  class  of  leuco- 
cytes. In  the  microscopical  examination  of  organs,  one 
is  at  times  struck  with  the  number  of  leucocytes  carrying 
fat  globules,  or  it  may  be  undergoing  fatty  degeneration. 

1  The  Nervous  Sijsteui. 

The  central  nervous  system  sliovvs  lesions  A\lii(h  are 
practically  the  same  as  that  of  the  other  organs.  Fatty 
degeneration,  may  be  present,  though  probably  not  as 
extensive  nor  as  intense.  Tl.e  surface  of  the  organ  is  gen- 
erally congested  and  the  centrum  ovale  shows  a  number  or 
punctiform  red  areas,  showing  dilation  an.l  congestion  of 


1152  augustin's  history  of  yellow  fever. 

the  blood  vessels.  The  surface  and  even  the  white  substance 
of  the  brain  may  show  numeronr,  small  heniorrliajres. 
These  are  the  most  apparent  gross  lesions  of  the  nervous 
system ;  though  at  times  /they  are  not  noticeable.  The 
microscopical  examination  of  the  differt^it  jianglionic 
areas  of  the  organ  shows  fatty  degeneration  of  the  nerve 
cells,  all  of  which  seem  to  be  susceptible  to  the  toxic  in- 
fluence of  the  infection.  The  cells  of  Purkinje,  according 
to  Marchou  and  Simond,  are  less  A'ulnerable. 

The  spinal  cord  present  the  same  general  lesions  found 
in  the  brain. 

Adults  More  (Susceptible. 

We  must  not  forget  that  the  majority  of  fatal  cases 
of  yellow  fever  occurs  in  adults,  and  that  these  may  show 
lesions  of  previous  diseases,  and  these  lesions  must  not 
be  looked  upon  as  forming  part  of  the  pathology  of  yellow 
fever.  Frequently  the  spleen  of  yellow  fever  cases  is 
found  enlarged  and  shows  evidence  of  malarial  infection 
previous  to  the  yellow  fever  which  caused  the  death  of 
the  case.  Cirrhotic  conditions  of  the  liver  are  also  fre- 
quently found,  as  well  as  the  small  granular  kidney  of 
chronic  inteistitial  nephritis. 

In  fact  all  of  the  organs  may  present  lesions  Avhich 
antedated  the  attack  of  yellow  fever.  It  is  a  question 
whether  we  would  have  as  many  deaths  from  yellow  fever, 
if  the  ])atient's  organs  were  healthy  previons  to^  the  occur- 
rence of  yellow  fever.  For  it  is  remarkable  how  rarely 
children  or  young  children  die  of  yellow  fever.  In  fact 
in  them  the  disease  is  so  mild  as  to  pass  unnoticed  by  the 
best  experts  on  yelloAv  fcncM-;  n  fact  noted  by  all  who  have 
seen  yellow  fever  and  who  have  written  on  the  subject. 
It  is  povssible,  however,  that  children  are  less  susceptible 
to  the  poison. 

General  Steatosis  ihr  otHji  i^prcial  Characteristic  Lesion. 

Before  concluding  this  subject  I  wish  again  to  impress 
that  there  is  no  special  characteristic  lesion  of  any  organ 


PATHOLGY POTHIER.  1153 

upon  which  we  can  base  our  diagnosis  at  autopsy.  The 
general  steatosis  of  practically  all  the  organs,  more  or 
less  marked  in  all  of  them,  is  the  only  constant  lesion, 
and  that  it  is  the  general  picture  presented  by  this  char- 
acteristic associated  with  the  clinical  history  of  the  case 
which  enables  us  to  make  a  positive  diagnosis  of  yellow 
fever. 


1154 

diag:\osis  of  yellow  fever. 

By  Hamilton  P.  Jones,  M.  D.,  New  Orleans. 

Resident  Physician  Isolation  Hospital,  Xeic  Orleans,  1897; 
Chief  burgeon  Jones  {Yellow  Fever  Hospital,  Santi- 
ago de  Cuba,  1898,  U.  S.  A.);  Physician-in-Chief 
Emergency  Hospital,  Xew  Orleans,  1905. 

The  diagnosis  of  yellow  fever  is  perhaps  one  of  the  most 
difficult  of  all  to  make  with  certainty  in  the  early  stages 
of  the  disease,  and  there  are  probably  many  light  cases 
of  this  disease  not  recognized  at  all,  and  during  epidemics 
a  great  many  diagnosed  as  such  that  are  not. 

Most  careful  study,  scientific  observation  and  post- 
mortem of  all  of  the  cases  in  the  Isolation  Hospital  (New 
Orleans,  1897),  in  the  Jones  Yellow  Fever  Hospital  (San- 
tiago de  Cuba,  1898),  and  the  Emergency  Hospital  (New 
Orleans,  1905),  all  of  which  I  had  charge,  and  in  which 
over  a  total  of  a  thousand  cases  were  treated,  convinced 
me  that  not  less  than  ten  per  cent,  of  the  cases  sent  into 
these  yellow  fever  hospitals  did  not  have  the  disease. 
These  institutions  were  all  established  with  the  primary 
end  in  view  of  protecting  the  communities  from  the  in- 
fection, and  for  the  treatment  of  yellow  fever  only,  and  in 
man}'  instances  police  power  had  to  be  exercised  to  force 
indigent  or  unruly  patients  into  them.  It  is  natural  to 
suppose  that  no  such  extreme  steps  would  be  taken  until 
the  physicians  had  convinced  themselves  of  tlie  truth  of 
their  diagnosis.  If  ten  per  cent,  are  sent  into  hospitals 
wrongly  diagnosed,  it  is  reasonable  to  suppose  that  at 
least  ten  per  cent,  escape  diagnosis  at  all.  This,  it  will  be 
seen,  still  leaves  the  number  of  reported  cases  in  any  given 
outbreak  approximately  the  correct  number. 

It,  therefore,  l)ecomes  imperative  that  tlie  physician 
take  every  precaution  for  the  community,  by  not  being  too 
sure  of  himself,  but  very  sure  of  his  screens  for  the  first 
four  days  of  any  fever  that  might  be  confounded  with  this 
disease.  While  there  is  no  doubt  in  my  mind  that  the 
mosquito  is  the  medium  of  conveyance  of  yellow  fever 


DIAGNOSIS JONES .  1155 

from  man  to  man,  and  that  the  infected  mosquito  may  pos- 
sibly be  carried  greater  or  less  distances  to  accomijlish 
this,  3'et  the  history  of  all  outbreaks  are  traced  to  the  im- 
portation of  some  human  being  sick  of  the  disease,  upon 
whom  the  local  mosquitoes  feed  and  become  infected. 

With  this  important  fact  in  mind,  it,  therefore,  becomes 
imperative  to  get  an  absolutely  correct  history  of  the 
patient's  movements  for  at  least  ten  days  prior  to  being 
stricken  down,  and  equally  important  to  determine  his 
haunts,  the  localities  whence  his  associates  have  come, 
and  whether  or  not  there  has  been  sickness  among  them. 
Equal  in  importance  with  the  above  as  an  aid  to  diagnosis, 
is  a  careful  medical  history  of  not  only  the  present  attack 
but  the  medical  history  of  his  whole  life,  personal  habits 
and  environment,  all  of  which  if  known  might  help  to 
clear  up  an  awkward  situation;  for  instance,  history  of 
gaH  stones,  cirrhosis  of  the  liver,  with  repeated  attacks 
of  albuminuria  and  jaundice,  etc. 

Unfortunately  there  is  no  cardinal  symptom  of  yellow 
fever,  nor  any  two  or  three  symptoms  that  may  be  taken 
as  f)athognomic  at  any  one  stage  of  the  disease.  The  pic- 
ture is  a  complex  one,  gradually  unfolding  itself.  In  mild 
cases  all  symptoms  may  be  so  light  as  to  escape  all  but  the 
most  careful  scrutiny,  while  in  severe  cases  so  pro- 
nounced as  to  almost  stamp  the  diagnosis  on  the  body  and 
face  of  your  patient.  Persons  ill  with  yellow  fever  always 
say  that  they  are  very  sick  and  always,  no  matter  liow 
light  the  case  may  be,  give  the  attending  i^hysician  that 
impression. 

Yellow  fever,  in  common  with  such  contagious  diseases 
as  smallpox,  measles  and  scarlet  fever,  occurs  as  a  gen- 
eral rule,  but  once  during  life,  differing  from  them,  how- 
ever, in  that  it  has  never  been  known  to  propagate  beyond 
48°  north  and  ?>S°  south  latitude,  nor  lieloAV  a  temperature 
of  65°  farenheit,  corresponding  to  the  possible  geographi- 
cal distribution  of  the  stcf/omi/ia  calopii.^  and  its  temera- 
ture  of  activity;  the  disease  sparing  neither  age  nor  sex,. 
only  those  ])eing  exempt  from  its  influence  who  have  at 
some  former  time  had  it.  Its  attacks  are  confined  neither 
to  the  night  nor  day,  nor  to  any  state  of  the  system, 


1156  augustin's  history  of  yellow  fevkr. 

whether  of  fasting  or  feasting,  of  plethora  or  anaemia,  of 
robust  health  or  chronic  disease. 


First  Stage. 


Yellow  fever  presents  two  well  defined  stages: 
First  stage. — This  is  characterized  by  severe  pains  in 
the  head,  confined  chiefl^^  to  the  eyes  and  forehead,  back, 
lower  extremities  and  epigastric  region,  with  increase  of 
pain  and  tenderness  over  the  liver  on  pressure,  a  peculiar 
siilning  or  drunken  appearance  in  the  eyes,  rapid  circula- 
tion, and  marked  peripheral  venous  stasis  and  elevated: 
temperature.  It  more  often  attacks  those  who  are  appar- 
ently in  perfect  health ;  they  are  seized  with  intense^lreu'd- 
aehe,  chill,  shivering  pain  in  the  limbs  and  back,  followed 
by  rapid  elevation  of  temperature,  increased  action  of  the 
heart,  animated  congested  countenance,  red.  glistening, 
suffused  eyes,  congestion  of  gums,  as  a  rule,  but  not 
always;  intense  thirst,  anorexia,  uneasiness  of  the  epigas- 
trium, nausea  and  vomiting.  This  stage  may  extend  from 
36  to  ISOJiours  without  any  distinct  remissions,  according 
to  the  severity  of  the  disease. 


Second  Stage. 

Second  stage. — This  is  characterized  by  dei^ression  of 
the  nervous  and  muscular  systems,  and  of  the  general  and 
capillary  circulation;  capillary  congestion  more  marked; 
slow  and  intermittent  pulse;  jaundice,  albuminous  urine 
loaded  with  granular  casts  and  debris — always^  bile — 
stained.  In  more  marked  cases  some,  or  all  of  these  addi- 
tional symptoms  may  appear:  A  purplish  and  yellowish 
mottled  appearance  of  the  surface,  urinary  suppression, 
passive  hemorrhages  from  the  ears,  stomach  and  l)0wels, 
gums,  nose,  tongiie,  uterus,  vagina,  gall  bladder  and  anus ; 
black  vomit,  interstitial  hemorrhages,  delirium,  convul- 
sions and  coma. 


DIAGNOSIS — JONES.  1157 

The  Blood. 

The  blood  in  yellow  fever  has  not  shown  any  charac- 
teristic of  the  disease,  except  that  it  seems  to  be  more 
concentrated  than  normal,  all  the  various  cells  beinji; 
found,  in  uncomplicated  cases,  in  otherwise  healthy  in- 
dividuals, in  slightly  greater  numbers  than  in  health,  but 
in  proper  ratio  with  probably  more  platelets  than  normal. 
Hemoglobin  percentage  is  always  high  in  simple  uncom- 
plicated cases  of  yellow  fever,  100  per  cent,  and  over. 

Urine. 

Albumin  is  an  invariable  constituent  of  the  urine  at  one 
time  or  another  during  the  course  of  yellow  fever,  ranging 
from  a  trace  to  80  per  cent,  moist.  Casts,  renal  epithelium, 
and  debris,  always  bile-stained,  and  other  evidences  of  an 
acute  inflamation  of  the  kidneys  present  in  a  great 
majority  of  all  cases.  In  several  instances  the  finding  of 
casts  and  debris  not  bile-stained  led  me  to  suspect  that 
the  patient  was  not  sutfering  from  yellow  fever,  but  fron\ 
some  other  disease  associated  with  kidney  troubles,  and 
subsequent  developments  confirmed  the  suspicion.  One 
would  naturally  expect  in  the  early  stages  of  yellow  fever, 
in  a  person  already  suffering  from  a  cast  producing  dis- 
ease of  the  kidneys,  to  find  casts  not  bile-stained,  but  they 
would  as  the  disease  progressed  become  so  stained.  In 
any  other  condition  of  the  system  associated  with  casts 
and  bile  pigments  in  the  urine,  we  would  expect  to,  and 
have  found,  the  casts  and  debris  bile-stained. 

I  consider  this  observation  of  the  greatest  importance 
in  the  differential  diagnosis  of  yellow  fever. 

Facial  Expression. 

There  is  a  peculiar  facial  expression  in  yellow  fever, 
brought  about  by  the  combination  of  the  flushed  and  con- 
gested face  and  eyes  and  the  underlying  tinge  of  yellow 
that  is  quite  characteristic  of  the  disease. 


1158  augustin's  history  of  yellow  fever. 

Jaundice. 

Early  in  the  onset,  while  congestion  is  still  active, 
blanching  the  lips  or  skin  will  reveal  jaundice  of  the  skin 
and  mucous  membranes.  Jaundice  usually  develops  rap- 
idly and  is  well  marked  by  the  time  the  congestive  stage 
has  subsided. 

Circulation. 

The  venous  statis  is  an  important  sign,  and  while  not 
peculiar  to  this  disease,  is  more  or  less  well  marked  in  all 
cases,  the  mark  left  by  pressing  with  the  finger  on  the 
cheek  taking  an  appreciable  time  to  return  to  the  color 
of  the  surrounding  tissues,  from  a  few  seconds  to  a  minute 
or  more,  depending  on  the  stage  of  the  case  and  its 
severity. 

Temperature. 

The  temperature  in  yellow  fever  is  continuous,  lasting 
from  24  to  150  hours.  There  may  be  a  period  of  calm 
lasting  a  few  hours,  followed  by  a  secondary  rise ;  this  is 
a  septic  fever,  of  colon  bacillus  origin.  Tellow  fever  it- 
self is  a  fever  of  one  paroxysm  only,  but  opens  the  way 
for  many  secondary  infections,  evidenced  by  furunculosis, 
parotiditis,  carbuucles,  etc.  Cases  having  a  temperature 
above  102>2  degrees  farenheit,  are  severe,  and  on  the  ap- 
proach of  death  the  temperature  may  go  to  10()  or  107,  con- 
tinuing to  rise  after  death  for  hours,  sometimes  reaching 
the  extraordinary  height  of  112  or  114,  a  condition  not 
often  noted  in  other  diseases,  except  sometimes  in  sun- 
stroke and  injuries  or  diseases,  affecting  seriously  the 
central  nervous  system,  as  abscess  of  the  brain,  apoplexy, 
etc. 

Pulse. 

The  pulse  during  the  onset  of  the  attack  is  rapid  as  a 
rule  and  fairly  full  and  strong,  the  rapidity,  however, 
rarely  corresponding  to  that  found  in  other  diseases  with 


DIAGNOSIS JONES.  1159 

an  equal  temperature.  It  frequently  liapi^ens,  however, 
that  the  i^ulse  may  never  go  above  100,  no  matter  how 
high  the  temperature  goes.  Cases  vary  in  this  resj)ect 
very  much.  As  a  general  rule  there  is  lack  of  correlation 
between  the  pulse  and  temperature,  frequently  the  pulse 
becoming  slower  while  the  temperature  continues  to  rise. 
Even  where  there  is  correlation  between  pulse  and  temper- 
ature in  3'ellow  fever,  the  pulse  and  temperature  going  up 
and  down  together,  the  pulse  is  usually  from  fifteen  to 
thirty  beats  per  minute  less  than  would  be  found  in  other 
diseases. 

As  the  pulse  in  j-ellow  fever  falls,  it  becomes  weaker, 
softer  and  more  or  less  irregular  as  to  time  and  strength 
of  beat,  and  often  intermittent.  In  fact  so  true  is  this 
that  the  attention  of  the  attending  physician  may  be 
drawn  to  the  possibility  of  the  presence  of  yellow  ijever 
by  the  character  of  the  pulse  of  other  members  of  the 
household  who  give  a  recent  history  of  some  undetermined 
sickness.  This  is  particularly  valuable  in  the  lighter  cases 
of  children.  This  slowness  and  irregularity  of  the  pulse 
may  last  from  a  day  or  two  to  several  weeks. 

Respiration. 

Respiration  in  yellow  fever  is  rarely  affected  unless 
there  is  some  intercurrent  disturbing  factor. 

Blood  Pressure.        ^ 

Blood  pressure  is  almost  uniformly  low  in  yellow  fever. 
At  the  onset  of  the  disease  it  may  be  higher  than  normal, 
but  as  the  disease  progresses,  usually  by  the  end  of  the 
second  day  it  has  fallen  below  120  m.m.  of  mercury,  with 
a  Riva  Rochi  Sphygmanometor  10  cm.  bag,  and  may  go 
below  70  m.m'.  This  low  blood  pressure  is  a  valuable 
sign  of  this  disease  and  seems  almost  to  be  a  conservative 
protective  step  taken  on  the  part  of  nature,  and  the  blood 
pressure  observations  made  at  the  Emero-ency  Hospital, 
New  Orleans,  100.5,  threw  important  and  interestinu;  light 
on  certain  phases  of  the  disease  not  before  understood. 


1160  augustin's  history  or  yellow  fevir. 

In  order  to  briug  my  ideas  out  more  clearly  ou  this 
phase  of  the  disease,  it  will  become  necessary  for  me  to 
digress  from  the  diagnosis  for  a  moment. 

One  of  the  most  pronounced  effects  of  the  yellow  fever 
toxin  is  the  profound  fatty  degeneration  of  every  organ 
and  structure  of  the  body  i)roduced.  Even  the  epithelial 
cells  and  muscles  of  the  deep  urethra  are  affected.  The 
effect  of  this  fatty  degeneration  on  the  heart  muscle  is 
to  weaken  its  action.  The  elfect  ol^  this  fatty  degenera- 
tion on  the  blood  vessels  and  capillaries  is  to  impair  their 
strength,  and  render  stasis  and  hemorrhages,  particularly 
capillary,  more  easy  to  i^roduce.  When  a  patient  becomes 
frightened,  delirious,  unruly  or  through  ignorance  gets  up 
and  exerts  himself,  the  disastrous  and  oftimes  fatal  con- 
sequences are  brought  about  by  the  increased  heart  action, 
and  consequent  increased  blood  j^ressure,  causing  rupture 
of  the  weakened  and  degenerated  smaller  blood  vessels, 
producing  hemorrhages  into  the  meninges  and  gastro  in- 
testinal mucous  membrane,  causing  delirium,  convulsions, 
black  vomit,  hemorrhages  from  the  bowels,  uremia  and 
frequently  death.  The  fatal  effects  of  over-eating  are  due 
to  the  increased  blood  pressure,  produced  by  the  meal.  A 
rapid  pulse  and  high  blood  pressure,  either  singly  or  to- 
gether, are  of  the  gravest  import  in  yellow  fever.  From 
my  observations  it  would  appear  that  the  crossing  of  blood 
pressure  and  pulse  lines  does  not  have  the  same  sinister 
significance  that  the  crossing  of  the  temperature  and  pulse 
lines  has  in  the  chart;  howcA'er,  it  is  not  altogether  fav- 
orable for  it  to  do  so. 

In  reference  to  the  degeneration  of  the  blood  vessels,  I 
have  noted  that  yellow  fever  patients  are  more  easily 
bruised,  and  that  hypodermics  are  more  liable  to  produce 
sul)cutaneous  abscesses  and  sloughs  than  in  most  other 
diseases. 

Differ civtial  Diagnosis. 

The  following  diseases  may  cause  difficulty  in  making  a 
differential  diagnosis: 

Malaria.  Yellow  fever  may  be  mistaken  for  certain 
unusual  forms  of  malarial  fever.  Microscopical  examina- 
tion of  the  blood,  and  the  use  of  quinine  will  usually  clear 


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DIAGNOSIS JONES.  1161 

up  this  diagnosis,  however,  it  is  perfectly  i)ossible  to  have 
yellow  fever  and  malarial  fever  also.  Jii  this  case  the 
greatest  care  will  be  necessary,  and  difticulty  will  be  ex- 
perienced in  making  the  differentiation. 

Hemoglohinuric  Fever.  This  gravest  form  of  malaria 
resembles  yellow  fever  somewhat  in  its  onset  and  symp- 
toms— jaundice  and  albuminuria — but  is  characteristi- 
cally different  in  that  you  have  evidence  of  the  destruc- 
tive intluences  in  the  reduced  number  of  red  blood  cor- 
puscles and  low  hemoglobin  precentage  in  malaria  and 
abscence  of  hemoglobin  in  the  urine,  of  uncomplicated 
yellow  fever. 

Dengue.  It  is  not  difficult  to  differentiate  be- 
tween marked  types  of  yellow  fever  and  dengue 
after  the  first  two  or  three  days.  The  principal 
points  of  difference  are  the  almost  universal  pres- 
ence of  an  eruption  in  dengue  and  the  absence 
of  an  eruption  in  yellow  fever;  the  presence  of  jaun- 
dice in  yellow  and  the  almost  universal  absence  of  jaun- 
dice in  dengue.  Albuminuria  is  almost  universally  absent 
in  dengue.  It  is  possible  for  dengue  and  yellow  fever  to 
exist  by  side,  but  in  that  event  it  would  be  necessary  to 
carefully  and  closely  observe  a  good  number  of  cases  be- 
fore a  positive  differentiation  could  be  made.  It  is  not 
probable  that  a  large  number  of  cases  of  dengue  and  mild 
yellow  fever  could  be  observed  Avithout  some  of  tliese  cases 
showing  the  characteristic  lesions  of  the  particular  dis- 
ease more  pronouncedly  than  the  other,  thereby  relieving 
the  doubt. 

La  Giippe  and  acute  lobar-pneumonia,  particularly  of 
apex,  may  possibly  be  counfounded  with  yellow  fever,  but 
a  careful  study  of  the  case  will  reveal  catarrhal  symptoms, 
and  the  absence  of  bile-stained  casts  and  debris  in  the 
urine,  and  ought  not  to  be  confounded  with  yellow  fever. 
In  3^ellow  fever,  the  lungs  are  normal. 

Typhoid  Fever  in  the  early  stages  may  possibly  be  taken 
fotr  yellow  fever,  but  the  history  of  the  case  and  the  finding 


1162  AUGUSTIn's  HISTORY    OF    YELLOW    (EVER. 

of  the  Ebertli  bacillus,  the  Widal  reaction,  and  the  co- 
relation  of  pulse  to  temperature  will  help  to  clear  up  the 
diagnosis.  Yellow  fever  may  engraft  itself  upon  au}-  dis- 
ease, and  I  have  held  post-mortems  in  Cuba,  showing  the 
characteristic  lesions  of  yellow  fever  and  of  typhoid  fever, 
in  cases  in  which  malarial  plasmodia  were  found  in  the 
blood  during  life. 

Acute  Yellow  Atrophy  of  the  Liver  is  a  very  rare  dis- 
ease, accompanied  with  a  rapid  reduction  of  the  size  of 
the  liver,  whereas  in  yellow  l^ever  the  size  of  the  liver  is 
normal  or  is  slightly  enlarged. 

WciVs  Disease  simulates  yellow  fever  closely,  the  symp- 
toms being  fever,  jaundice,  diarrhea  and  nephritis.     The. 
marked  enlargement  of  the  spleen  and  diarrhea  will  tend 
to  differentiate  this  disease.     The  spleen  in  yellow  fever  is 
not  enlarged  or  tender. 

Catarrhal  Jaundice.  In  this  disease  we  have  little  or 
no  fever  and  none  of  the  evidences  of  pain  and  violent 
acute  toxemia  found  in  yellow  fever. 

It  may  at  times  become  exceedingly  difficult  to  differen- 
tiate between  a  case  of  gastroduodinitis  in  a  chronic  alco- 
holic suffering  from  exacerbation  of  his  chronic  nephritis. 
Careful  investigation  of  the  history  of  a  case  of  this  sort 
and  examination  of  the  stools  will  throw  light  on  the 
case.  ; 

Acute  Peritonitis  associated  with  black  vomit,  may  be 
mistaken  for  yellow  fever,  but  here  again  the  absence  of 
bile-staining  of  the  urinary  debris  will  eliminate  yellow 
fever.* 

General  Suinniarij.         i 

No  reasonable  person  will,  of  course,  discredit  the  value 
of  clinical  experience  as  an  aid  in  diagnosis,  and  when 
the  clinically  experienced  practitioner  avails  himself  of 
the  clinical  laboratory  aids,  there  is  small  likelihood  of 
error. 

*  Goldberger,  Bulletin  No.  16,  U.  S.  P.  H.  &  M.  H.  Service. 


DIAGNOSIS JONES .  1163 

For  the  purpose  of  aiding  those  who  may  never  have 
seen  a  case  of  yellow  fever  before,  the  following  symptoms 
in  the  light  of  our  present  knowledge  justify  a  diagnosis 
of  yellow  fever,  after  all  other  diseases  have  ibeeji.  consid-^ 
ered  and  excluded,  where  possible,  bearing  in  mind,  how- 
ever, that  in  a  small  percentage  of  cases,  yellow  fever  may 
be  associated  with  any  chronic  disease,  and  some  of  the 
acute,  as  malaria  and  typhoid : 

1.  A  continuous  fever  of  one  paroxysm  lasting  more 
than  twenty-four  hours,  with  sudden  onset,  assoeiated 
with  violent  pain  in  head,  back  or  epigastrium,  or  any  one 
of  these  localities — anorexia,  nausea  and  vomiting. 

2.  Pulse  rapid  at  onset,  but  steadily  becoming  slower 
in  many  instances,  while  the  temperature,  continues  to 
rise;  even,  if  rising  and  falling  with  temperature  syn- 
chronously, being  from  15  to  30  beats  less  than  the  usual 
ratio  between  pulse  and  temperature  found  to  exist  in 
most  other  diseases,  often  becoming  very  slow,  GO  or  be- 
low, soft  and  at  times  intermittent,  and  very  irregular, 

3.  Low  blood  pressure,  10  to  Go  m.m.  of  mercury  below 
normal. 

4.  High  blood  count  4,000,000  and  over,  with  other  ele- 
ments in  proportion,  sliowing  a  concentrated  blood. 

5.  High  percentage  of  homoglobin  in  the  blood,  often 
100  per  cent,  and  over. 

G.  Venous  congestion,  followed  by  stasis  and  jaundice 
in  from  one  to  several  days,  tending  to  l)ruise  easily,  and 
to  hemorrhages  of  gums,  bowels,  etc.,  but  never  of  kid- 
neys or  bladder,  sometimes,  of  urethra. 

7.  Albuminous  urine,  containing  bile-stained  casts  and 
debris  from  the  urinary  tract;  and  often  bile,  and  bile 
pigments. 


1164 

PEOGKOSIS  OF  YELLOW  FEVER. 

BY  CHARLES  CHASSAIGXAC,   M.   D. 

Dcau    Xcw    Orleans    FohjcJinic;    Editor    Xciu    Orleans 
^'Medical  and  Surgical  Journal,"  etc. 

Tlie  prognosis  of  yellow  fever  may  be  studied  both 
from  the  general  standiDoint  and  that  of  the  individual 
patient. 

To-day  tlie  relative  virulence  of  an  outbreak  or  epidemic 
can  be  estimated  fairly  well  in  advance.  Such  estimate 
should  be  based  on  three  factors  especially:  1°  The  data 
of  the  inception  or  the  introduction  of  the  disease  in  a 
given  locality;  2°  the  interval  elapsing  before  the  exist- 
ence of  3'ellow  fever  is  discovered  or  acknowledged;  3" 
the  degree  of  ability  or  desire  on  the  part  of  the  com- 
munity in  which  the  disease  prevails  to  carrj-  out  the 
proper  sanitary  measures. 

1°  The  earlier  in  the  season  the  first  case  occurs  the 
more,  everything  else  equal,  is  there  likelihood  of  an  epi- 
demic and  of  the  prevalence  of  a  severe  type  of  the  dis- 
ease. Statistics  show  that  in  the  past  all  the  bad  epidemics 
occurring  in  the  City  of  New  Orleans  began  early,  notably 
that  of  1853,  the  worst  in  its  history;  that  year  the  first 
case  was  reported  as  early  as  ]\Iay.  All  the  other  great 
epidemics  started  in  either  ]May,  June  or  July.  On  the 
other  hand,  outbreaks  beginning  as  late  as  August  or 
September  have  invariably  been  of  a  comparatively  mild 
type. 

2°  The  longer  the  period  between  the  outset  of  the 
disease  in  a  given  place  and  the  discovery  of  its  exist- 
ence, the  greater  the  severity  both  as  to  the  extent  of  its 
prevalence  and  its  virulence. 

3°  When  the  authorities  of  an  infected  locality  recog- 
nize the  importance  of  intelligent  sanitary  work,  where 
tlie  inhabitants  co-operate  earnestly  with  them,  and  if 
sufticient  means  are  available  to  institute  promptly  all 
measures  necessary  for  the  protection  of  the  sick  against 
the  bites  of  stegomyia  mosquitoes,  the  destruction  of  in- 


PROGNOSIS CHASSAIGNAC.  1165 

fected  mosquitoes,  and  finally  the  annihilation  of  all 
mosquitoes  of  the  dangerous  kind,  either  there  is  little 
danger  of  an  epidemic  if  the  early  eases  have  neither  been 
overlooked  nor  concealed,  or  at  the  worst  the  epidemic 
will  be  of  a  comparatively  mild  type  and  of  short 
duration. 

It  is  unnecessary  to  go  into  details  concerning  the  points 
outlined  above  in  reference  to  prognosis  in  general,  as 
they  are  readily  supplied  and  explained  by  the  mosquito 
doctrine  of  yellow  fever  which  is  adequately  treated  in 
other  sections  of  this  work. 

The  prognosis  in  individual  cases  is  not  so  easily  made 
because  numerous  conditions  and  circumstances  must  be 
taken  into  account  and  carefully  Aveighed  before  anything 
like  a  safe  estimate  can  be  made  of  the  patient's  chances 
of  recovery. 

There  is  no  doubt  that  the  average  case  of  yellow  fever 
in  an  individual  blessed  with  healthy  organs  is  far  from 
being  the  terrible  thing  that  it  is  usually  pictured.  That 
it  is  a  disease,  nevertheless,  which  at  times  puts  the  in- 
effaceable stamp  of  death  on  its  victims  at  the  outset  can 
not  be  denied.  At  the  present  time,  the  knoAvledge  we 
possess  concerning  the  propagation  of  yellow  fever  and 
its  practical  application  to  a  modification  of  the  type  of 
the  disease,  justifies  the  prediction  that  the  latter  Avill 
become  less  and  less  to  be  feared. 

Apart  from  the  general  tendency  of  yellow  fever  in  any 
given  outbreak,  as  already  considered,  the  points  chiefly 
to  be  taken  into  account  in  Aveighing  the  chances  of  any 
particular  patient  are  as  follows:  1°  age;  2°  condition 
of  the  vital  organs;  3°  habits;  4°  probable  relative 
amount  of  poison  introduced  into  the  system;  5°  sur- 
roundings of  ])atient;  G°  race;  7°  treatment. 

We  shall  review  these  points  scfidiiiii,  leaving  for  sub- 
sequent consideration  the  diagnostic  significance  of  some 
of  the  important  symptoms  of  the  disease. 

Age.  The  younger  the  ])atient,  tlie  Ix'lter  his  chance 
of  recovery.  In  infants  and  small  children  the  disease  i» 
so  mild  as  to  have  led  to  the  belief  that  natives  of  New 
Orleans  and  other  points  formerly  subject  to  frequent 


1166  augustin's  history  of  yellow  fever. 

outbreaks  of  yellow  fever  were  immune  to  the  disease. 
Natives  usually  had  durino-  childhood  an  attack  so  mild 
as  to  be  unrecognized  yet  sufficient  to  produce  immunity. 
The  risk  increases  as  the  age  advances,  except  in  females 
at  about  the  age  of  puberty,  in  whom  the  mortality  ap- 
pears to  be  higher  than  in  those  a  little  older. 

Condition  of  the  Vital  Organs.  When  the  organs  are 
sound  the  patient,  of  course,  has  a  better  chance;  especi- 
ally is  this  true  as  far  as  the  kidneys,  the  liver  and  the 
heart  are  concerned,  in  the  order  named.  The  nearer 
normal  is  the  individual,  the  less  likelihood  is  there  that 
some  important  organ  will  succumb  either  from  toxemia 
or  secondary  septicemia,  for  the  better  can  elimination 
IDrogress  and  the  more  pronounced  the  resistance  of  the 
organism  as  a  whole. 

Habits.  The  patient's  former  ha])its  should  be  taken 
into  account  in  attempting  to  prognosticate  the  outcome 
of  an  attack  of  yellow  fever.  The  alcoholic,  those  guilty 
of  other  excesses,  the  overworked — all  make  poor  subjects 
and  are  apt  to  offer  less  resistance  to  the  inroads  of  the 
disease,  one  of  the  organs  bearing  the  brunt  of  the  attack 
is  much  more  apt  to  be  weakened  already.  Temperate, 
steady,  sanely  and  not  too  strenuously  occupied  individ- 
uals stand  the  disease  better  and,  other  things  reasonably 
favorable,  are  very  likely  to  recover. 

Amount  of  Poison.  There  is  no  doubt  in  the  writer's 
mind  that  the  comparative  amount  of  poison  injected  into 
the  system  of  the  victim  hy  infected  mosquitoes,  plays 
an  important  part  in  determining  the  virulency  of  a 
given  attack,  as  well  as  does  the  rapidity  with  which  that 
poison  is  introduced.  If  and  when  that  degree  of  infec- 
tion may  be  ascertained  a  prognostic  element  of  value 
will  have  been  secured.  An  individual  who,  through 
ignorance  of  danger  or  through  apathy,  recklessness,  or 
the  necessity  of  circumstances,  receives  numerous  bites 
within  a  short  period  stands  a  good  chance  of  having  a 
dangerous  attack  and  perhaps  succumbing  if  some  other 
unfavorable  feature  is  present  in  his  case.  On  the  other 
hand,  one  who.  despite  his  understanding  of  the  conse- 
quences and  all  care  possible,  still  gets  a  bite  or  two 


PROGNOSIS CHASSAIGNAC.  1167 

will  probably  have  only  a  mild  attack.  The  French  ob- 
servers iu  Brazil  have  stated  as  one  of  the  conclusions  of 
their  experiments  that  a  single  bite  from  an  infected  mos- 
quito never  proved  fatal. 

Surroundmgs.  It  stands  to  reason  that  well  nourished 
people  in  comfortable  and  sanitary  habitations,  invalided 
in  cheerful  and  well  ventilated  apartments  do  better  than 
those  who  live  in  dark,  dingy,  close  and  unsanitary  tene- 
ments. The  mortality  is  always  higher  among  the  alien 
IDOor  who  live  more  or  less  crowded  together  in  unsan- 
itary tenements. 

Bace.  The  prognosis  is  better  by  far  among  the  blacks 
and  colored  than  among  the  whites,  even  when  the  former 
are  otherwise  in  less  favorable  condition  or  surroundings. 
Whether  this  is  because  the  darkies  merely  possess  a 
higher  degree  of  resistance  to  this  particular  poison,  or 
because  their  skin  being  tougher  and  their  odor  more 
repellent  to  the  mosquito,  they  are  less  frequently  bitten, 
we  are  not  i^repared  to  say.  The  fact  remains  that  the 
majority  have  the  disease  in  a  mild  form  and  that  the 
mortality  among  them  is  almost  nil,  so  much  so  that  they, 
like  white  children,  had  been  supposed  to  be  immune  until 
comparatively  recently. 

Treatment.  The  medical  treatment  and  the  nursing 
the  patient  receives  figure  largely  in  the  result  and  a 
knowledge  of  what  it  is  to  be  in  any  given  case  may  be 
of  material  assistance  in  our  prognostications.  The  suf- 
ferer who  is  fortunate  enough  to  have  an  intelligent  and 
experienced  medical  attendant  of  the  ^'let  Avell  enough 
alone"  type,  and  to  be  nursed  by  a  quiet,  careful  nurse 
of  judgment  stands  the  best  chance  of  getting  well.  The 
one  who  is  treated  by  an  inexperienced  physician  who  is 
guided  by  the  advice  set  down  in  Uw  book  of  some  noted 
therapeutic  authority  who  has  never  seen  a  case  of  yellow 
fever  is  very  apt  to  die. 

By  weighing  the  elements  tending  for  or  against  the 
patient  according  to  the  points  considered  under  the 
seven  heads  above,  one  possessed  of  a  fair  amount  of  judg- 
ment can  make  a  pretty  fair  prediction  as  to  the  outcome 


1168  augustin's  history  of   yellow  fever. 

of  any  particular  case,  if  at  the  same  time,  proper  con- 
sideration is  given  to  tlie  prevalent  type  of  the  disease. 

In  addition  to  what  has  jnst  been  said,  it  is  proper  to 
call  attention  to  the  relative  prognostic  value  of  some  of 
the  symptoms  of  the  disease.  These  are  mainly :  the  tem- 
perature, icterus,  the  urine,  aud  hemorrhage,  including 
black  vomit. 

Temperature.  If  at  the  outset  the  temperature  is  only 
of  moderate  inteusity,  ranging  not  above  103  1/2°  to 
101°  in  adults,  and  especially  if  defervescence  is  prompt 
and  rapid,  the  prognosis  is  good  as  far  as  this  point  alone 
can  be  a  guide.  With  the  same  degree  of  elevation  in  the 
beginning,  if  tlie  temperature  remains  stationary  or,  par- 
ticularly, if  it  rises  at  all  the  next  day,  the  prognosis  is 
gi'ave.  Should  the  fever  reach  or  surpass  the  105  degree 
point  during  the  first  twenty-four  hours  the  prognosis  is 
l>ad;  the  patient  has  a  very  slim  chance  of  recovery  and 
that  onh'  if  all  other  indications  are  favorable. 

Icterus.  The  more  intense  the  icterus  and  the  earlier 
it  shows  itself  the  graver  the  prognosis.  When  there  is 
a  very  marked  jaundice  by  the  third  day  or  earlier,  it  is 
an  evidence  of  jDrofound  toxemia  and  there  is  good  ground 
for  serious  anxiety  as  to  the  outcome  of  the  case. 

Urine.  The  condition  of  the  urine  furnishes  valuable 
indications  as  to  the  prospect  of  recovery.  Its  quantity 
is  of  greater  comparative  significance  even  than  its  con- 
dition. As  long  as  the  patient  can  urinate  abundantly 
the  prospects  are  good,  even  if  the  percentage  of  albuuien 
is  fairly  large.  In  fact,  I  have  seen  patients  recover  whose 
urine  was  highly  albuminous  and  loaded  with  casts  but 
continued  co])ious;  the  laboratory  prognosis  differed  from 
the  clinical  and  the  clinical  proved  correct. 

Whenever  the  urinary  secretion  becomes  scanty,  dan- 
ger must  be  apprehended  and  suppression  of  urine  moans 
death,  the  exception  being  that  Avliich  proves  the  rule. 
The  patient  is  overwhelmed  by  toxemia,  uremia  and  some- 
tiijies  septicemia  combined,  coma  or  convulsions  super- 
vene and  the  patient's  sufferings  are  ended. 

Even  retention  of  urine  is  a  bad  omen  as  it  is  frequently 
a  forerunner  of  anuria.       This  is  probably  because  the 


PROGNCSIS CHASSAIGNAC.  1169 

impairment  of  fuuctiou  leads  to  a  very  slow  and  gradual 
filling-  of  the  bladder,  the  call  for  urination  being  slight 
in  consequence  and  not  becoming  insistent  before  the 
secretion  ceases ;  when  the  catheter  is  introduced  the  first 
time  a  fair  amount  of  urine  may  be  withdrawn  while 
at  its  second  introduction,  several  hours  subsequentl}', 
scarcely  any  maj-  be  found — there  is  no  longer  retention 
but  suppression. 

Kothwithstanding  what  has  just  been  written  about  the 
greater  importance  of  the  abundance  of  urine,  it  must  not 
be  concluded  that  the  urinary  findings  are  of  no  prognostic 
value.  A  very  large  proportion  of  albumin  is  of  serious 
imi)ort,  more  so  if  jjresent  early  and  especially  as  earl^'  as 
the  second  day  of  the  disease.  The  more  casts  are  found, 
the  more  danger  of  serious  damage  to  the  kidneys.  When 
the  urine  is  highly  albuminous,  loaded  with  casts,  and  at 
the  same  time  scantj^,  the  prognosis  is  most  gloomy. 

Hcmorrhaf/c.  From  the  injection  of  the  conjunctiva, 
the  flushing  of  the  face,  epistaxis  and,  later,  other  hemor- 
rhages, there  is  evidence  througliout  of  the  decided  effect 
of  the  disease  on  the  circulation.  The  degree  of  this 
effect  and  the  time  at  which  its  phenomena  appear  are  of 
prognostic  import. 

Epistaxis  and  moderate  menorrhagia  or  metrorrhagia, 
at  the  outset,  produce  relief  often  and  are  not  a  bad  sign, 
except  during  pregnancy.  It  must  be  remembered,  how- 
ever, that  the  bleeding  at  the  nose  may  give  rise  to  un- 
necessary alarm  when  the  blood  is  swallowed  and  then  is 
vomited  after  being  in  tlie  stomach  f(.r  a  while.  This  is 
taken  by  the  inexi)erienced  for  black  vomit,  but  may  be 
differentiated  chiefly  by  the  fact  that  it  can  be  ascertained 
there  has  been  nose  bleeding  and  that  this  occurrence 
comes  early,  generally  some  tinu'  on  the  second  day,  a 
period  too  early  for  the  true  and  much  dreaded  black 
vomit.  ! 

Bleeding  from  the  gums  is  a  grave  sympto/m  and  the 
earlier  it  appears  the  more  significance  must  be  attached 
to  it.  Coming  as  early  as  the  third  or  fourth  day,  it  in- 
dicates   a    very     serious     condition.      Danger     need     be 


1170  augustin's  history  of  yellow  fever. 

apprehended  less  if  the  si^onginess  and  bleeding  of  the 
gums  is  ])resent  only  after  the  fourth  day. 

Hemorrhage  from  the  intestines  is  always  a  dangerous 
indieation  and  death  is  ver^-  apt  to  follow  when  there 
occur  bloody  stools  of  a  gangrenous  odor. 

Like  other  hemorrhagic  symptoms,  bleeding  from  the 
stomach,  which  produces  what  is  usually  termed  black 
vomit,  is  of  the  grayest  import  when  it  occurs  as  early 
as  the  third  day;  on  the  fourth  day  it  is  still  a  very  bad 
sign  and  means  almost  sure  death  if  the  gums  also  are 
bleeding;  if  only  on  the  fifth  or  sixth  day  and,  particularly 
if  at  that  time  the  gums  are  still  firm  and  do  not  bleed, 
the  prognosis  is  not  so  gloomy.  The  quantity  of  vomit 
also  counts,  the  more  of  it  and  the  more  often  it  happens, 
the  worse  the  indication. 

It  has  been  outlined,   then,   that  by  the  aid  of  some 
definite  propositions  it  is  possible  to  prophesy  about  the 
type  or  degree  of  virulence  of  the  disease  which  is  to  be 
characteristic  of  a  given  outbreak.     It  has  been  shown 
next  that  the  past  historj^  and  the  actual  condition  of 
the  patient  can  furnish  valuable  prognostic  data.  Finally, 
we  have  determined  that  a  proper  stud}'  of  some  of  the 
important  symptoms  will  yield  important  information  as 
to  the  outcome  of  an  attack  of  yellow  fever.     It  must 
be  added  that,  after  all  is  said,  tlie  experience  and  judg- 
ment of  the  observer  must  remain  important  factors  m 
determining  the  accuracy  of  his  prognosis.     Xeitlier  must 
it  be  forgotten  tliat  ''yellow  fever  is  a  dij-ease  of  sui  iirises." 
Some  patients  have  died  whose  recovery  had  been  con- 
fidently expected,  wliile  wo  have  known  others  who  re- 
covered after  their  death  certificates  had  actually  been 
written  out. 

As  Touatre  has  said,  ''a  patient  must  never  be  given 
up  !■' 


1171 
THE  TEEATME:NT  of  YELLOAY  FEVEli. 
By  Lucien  F.  Salomon,  M.  D. 
Secretary  Louisiana  State  Board  of  Health,  1886-1893. 

In  i)reparing  this  article  ui)oii  the  treatment  of  3'ellow 
fever,  it  has  been  my  effort  to  avoid  technical  terms  and 
phrases,  and  so  ex^n'ess  myself  as  to  make  the  subject 
plain  to  the  lay  mind  so  that  in  the  event  of  a  physician 
not  being  obtainable  any  person  of  intelligence  will  be 
able  to  manage  a  case,  until  the  patient  can  be  seen  by 
one.  On  the  other  hand,  the  treatment  here  given  is 
recommended  to  practitioners  of  medicine  as  the  result  of 
a  very  large  and  successful  experience  in  yellow  lever. 

Many  j^ears  ago,  in  the  early  days  of  my  practice,  I 
found  that  potassium  nitrate  was  almost  as  efficient,  if 
not  as  sure  an  antidote  to  the  malarial  poison,  as  quinine; 
and  long  before  the  microbiological  investigations  which 
have  since  been  made,  deuilonstrated  that  Yellow  Fever 
was  not  caused  by  a  microbe,  the  peculiar  hemorrhagic 
tendency  of  the  disease,  resembling  so  closely  the  hemor- 
rhagic form  of  malarial  fever,  led  me  to  use  potassium 
nitrate  in  the  treatment  of  Yellow  Fever.  As  a  result,  I 
am  i:)repared  to  state,  and  also  confidently^  assert,  that  in 
a  majority  of  instances,  a  case,  if  seen  within  the  first 
twenty-four  hours  and  treated  according  to  the  method 
which  I  shall  give,  is  converted  into  a  simple  pyrexia, 
with  rapidly  declining  temperature,  terminating  at  the 
end  of  tlie  third  day,  and  not  followed  by  the  secondary 
rise  so  often  seen. 

Of  course,  the  mere  administration  of  drugs  does  not 
constitute  the  entire  treatment  of  any  disease,  but,  having 
in  the  first  instance  administered  what  I  cousider  an 
antidote  to  the  poison,  tlien  it  becomes  our  duty  to  so 
manage  the  case  as  to  conduct  our  patient  to  the  safe 
liarl)or  of  recovery. 

Witli  these  preliminary  remarks,  I  shall  now  proceed 
to  describe  how  to  treat  Yellow   Fever.     The  first  step 


1172  AUGUSTIN    S     HISTORY     OK    YELLOW     FEVER. 

necessary  is  the  admiuistration  of  a  large  saline  purga- 
tive, preferably  sodium  sulphate.  This  will  thoroughly 
cleanse  tlie  entire  intestinal  tract.  It  is  not  necessary 
to  give  calomel  or  any  other  purgative,  because  the  sodium 
sulphate,  in  addition  to  its  flushing  power,  also  acts  as 
a  cholagogue.  It  will  often  be  found  that  when  the 
patient  is  seized  with  the  attack  there  is  undigested  food 
in  the  stomach.  If  such  should  occur  within  a  short  time 
after  eating,  he  will  vomit  and  empty  the  stomach  of  the 
food.  If  the  seizure  should  come  on  three  or  four  hours 
after  a  meal,  and  there  is  still  some  undigested  food  in 
the  stomacli,  there  will  be  nausea.  In  sucli  cases  it  is 
well  to  give  minute  doses  of  calomel,  for  the  purposes  of 
quieting  the  stomach,  so  that  the  sodium  suli)hate  will 
not  be  rejected.  For  this  purpose,  the  following  combi- 
nation is  best  adapted  to  the  i)urpose:  A  powder  con- 
sisting of  one-quarter  grain  of  calomel  Avith  one  grain  of 
ingiuvin.  This  to  be  repeated  every  twenty  minutes  until 
four  are  taken,  and  then  folloAved,  in  one-half  an  hour, 
with  one-half  or  one  ounce  of  sodium  sul])hate  dissolved 
in  a  glassful  of  water.  It  will  be  found  very  frecpiently 
that  the  intense  headache  accompanying  the  onset  of  the 
attack  will  be  relieved  after  the  administration  of  the 
saline.  If  not,  relief  can  be  obtained  by  the  old-time  hot 
foot-bath,  which,  by  the  way,  I  never  use  except  for  the 
relief  of  said  condition.  One  hour  after  the  administra- 
tion of  the  purgative,  and  without  necessarilv  waiting  for 
its  action,  begin  the  administration  of  the  following 
prescription : 

Potassi  nitratis 1        dram 

Liq.  ammonije  acetatis 3K'   ounces 

Syr.  aurant  flor Yi  ounce 

The  adult  dosc^  of  Ihis  mixtnri^  is  one-lialf  <»nnce,  re- 
peated i'\(n-y  two  hours  during  the  continuance  of  the 
fever.  The  liquor  ammonijpe  acetatis  is  administered  in 
conjunction  with  the  potasium  salt  for  its  action  on  the 
skin,  as  it  causes  frcM'  dia])lioresis,  thus  favoring  elimina- 
tion.    The  potassium  nitrate,  in  addition  to  what  I  con- 


TREATMENT SALOMON.  1173 

sider  its  specitic  effect  as  an  anti-toxin,  also  plays  a  very 
important  part  by  actini>-  as  a  prophylactic  diurectic. 

It  will  be  fonnd,  as  a  rule,  within  a  few  hours  after 
beginning  the  administration  of  the  above  mixture,  that 
the  temperature,  no  matter  how  high  at  the  onset,  will 
begin  to  decline,  and  will  decline  progressively  until  the 
end  of  the  third  day,  when  convalescence  will  begin. 

In  addition  to  the  remedies  above  mentioned,  there  are 
several  cardinal  points  in  the  management  of  a  case  of 
Yellow  Fever  which  should  be  borne  in  mind.  The  first 
is  absolute  rest  in  the  recumbent  posture,  not  allowing 
the  patient  even  to  raise  his  head  for  any  purpose  what- 
ever. Second — Absolute  abstinence  from  food  of  any 
description,  liquid  or  otherwise,  until  the  complete  subsi- 
dence of  the  fever.  Third — Careful  attention  to  the 
thorough  enipt3ing  and  cleansing  of  the  lower  bowel  by 
large  enemata  administered  at  least  once  daily,  using  for 
this  purpose  at  least  two  quarts  of  normal  salt  solution. 
Water  and  ice  should  be  allowed  ad  Vihiinm,  prefeial»ly 
carbonated  water,  such  as  Apollinaris,  carbonated  lithia 
water  or  seltzer  water.  If  the  patient  is  averse  to  the 
carbonated  water,  plain  vichy  may  be  given. 

After  the  fever  has  subsided,  the  temperature  often 
becomes  sub-normal.  The  patient  is  now  in  what  is  called 
the  algid  stage.  Very  often,  the  extremeties  will  be  cold; 
sometimes  the  entire  body  is  cold  and  clammy  to  the 
touch.  For  this  condition  there  is  nothing  better  to  re- 
store the  patient  to  a  normal  condition  than  a  small  glass 
of  ale  administered  every  two  hours,  in  conjunction  with 
mix  vomica  and  caffeine.  I  usually  administer  one-eighth 
of  a  grain  of  extract  of  nux  vomica  with  one  or  two  grains 
of  caffeine  citrate  every  two  or  three  h(5urs,  as  the  case 
may  require. 

In  beginning  to  feed  the  patient,  which  may  be  done  on 
the  fourth  or  fifth  day  of  the  disease,  great  care  is  neces- 
s<ary.  For  the  first  day,  give  two  ounces  of  weak  chicken 
broth,  to  be  repeated  at  intervals,  and  nothing  (^Ise.  The 
next  best  step  in  the  feeding  of  the  patient  is  the  aduiiiiis- 
tration  of  butter  milk.     Butter  milk   is  easily  retained 


1174  augustin's   history  of  yellow  fever. 

and  digested,  besides  being  grateful  to  the  jjatient.  From 
this,  go  to  sweet  milk,  beef  or  chicken  soup  thickened  with 
rice  or  barlej',  and  after  a  few  days,  gradually  to  the  nor- 
mal diet. 

I  have  outlined  above  the  treatment  of  a  simple,  un- 
complicated case  of  Yellow  Fever,  but  one  will  often  be 
confronted  with  cases  that  will  tax  one's  ability  and  in- 
genuity to  the  utmost. 

^VG  will  begin  Avith  the  most  ordinary  complication,  the 
one  most  often  met  with^that  is  nausea.  This  can  gen- 
erally be  relieved  with  milk  of  magnesia.  This  failing, 
there  may  be  added  to  it  one  or  Iavo  minims  of  creosote. 

You  Avill  occasionally  find  that,  in  spite  of  aboA'e  treat- 
ment, the  temperature  continues  high.  In  efforts  to  re- 
duce high  temperature  beware  of  the  use  of  so-called  anti- 
pyretics; such  drugs  as  phenacetiji  and  its  congeners  are 
positively  A'icious  in  their  effects.  The  disease  itself  is 
sufficiently  depressing  without  adding  to  the  depression. 
I  believe  firmly  that  many  a  life  has  l)een  lost  in  Yellow 
Fever  by  the  administration  of  tliese  preparations.  Water 
externally,  either  by  sponging  or  the  application  of  the 
wet  towel,  Avill  almost  invariably  reduce  the  temperature. 
Never  use  ice  Avater.  ^fy  method  is  to  use  tepid  Avater 
always.  Frequent  sponging  will  generally  reduce  the 
temperature.  If  not,  the  ai)plication  of  the  wet  toAvel  Avill 
accomplisli  the  desired  result,  particularly  if  it  is  carried 
out  the  folloAving  plan  Avhich  I  have  often  adopted  :  The 
patient  is  coA^ered  from  chin  to  feet  Avitli  a  large  batli 
towel  saturated  Avith  tepid  Avater,  and  then  the  nurse  or 
attendant  is  made  to  fan  the  ])atient,  thus  creating  a 
current  of  air  and  causing  rapid  evaporation,  and  equallv 
rapid  reduction  of  temperature,  I  liaA'e  many  times  in 
this  manner  brought  a  temperature  of  lOlK'  or  105  beloAV 
103  in  half  an  hour. 

The  next  step  to  be  considered  is  black  vomit.  I  pause 
liere  to  state  that  in  1878,  at  the  outbreak  of  Yellow  Fever 
in  New  Orleans,  I  gaA'e  the  result  of  my  experience  (in  a 
discussion  before  the  New  Orleans  ^Medical  and  Surgical 
Association)  Avith  ergot  in  controlling  black  vomit.     The 


TPJEATMENT SALOMON.  1175 

suggestions  then  thrown  out  based  upon  past  experience, 
were  adopted  by  a  number  of  pli^-sieians  during  that  epi- 
demic, and  Dr.  S.  S.  Herrick  published  the  result  of  his 
experience  in  the  use  of  ergot  in  Yellow  Fever.  I  have 
frequently,  and  almost  invariably,  controlled  black  vomit 
W'ith  hypodermics  of  ergot,  administration  by  the  stomach 
of  creosote,  either  with  chalk  mixture  or  milk  of  mag- 
nesia, and  the  application  of  the  ice  bag  to  the  epigastrium. 

Now  we  come  to  the  most  dangerous  condition  that  may 
arise  in  Yellow  Fever,  and  one  of  the  most  diflflcult  to 
overcome — that  is  the  sup])ression  of  urine.  As  a  rule, 
under  the  treatment  above  suggested,  tliis  condition  is  very 
rare,  owing,  as  stated  in  the  beginning,  to  the  prophy- 
lactic diuretic  effect  of  the  potassium  nitrate.  Should, 
however,  the  urine  become  scanty,  or  altogether  cease,  tlie 
remedy  is  ergot.  Ergot  administered  hypodermatically 
will  almost  always  relieve  this  condition,  especially  if 
combined  with  the  administration  of  caffeine. 

Of  course,  the  above  briefly  outlined  treatment  of  Yellow 
Fever,  it  is  not  claimed  will  cure  all  cases.  That  is  some- 
thing beyond  hunmn  altility,  but  from  an  experience  of 
over  two  hundred  and  thirty  cases  without  a  death,  I  am 
led  to  believe  that  by  the  method  given  and  tlie  proper 
care  of  each  individual  case  the  mortality  Avill  be  exceed- 
ingly small,  and  I  put  it  forth  in  the  sincere  hope  that  it 
will  be  to  some  extent  helpful  in  saving  human  life. 


1176 

THE    LOUISIANA    SYSTEM    OF    HYGIENIC 
EDUCATION. 

By  Fked  J.  Mayer,  M.  D. 

Secretary  Louisiana  State  Sanitary  Association. 

"Every  mind  was  made  for  growth,  for  knowledge,  and  in  its 
nature  is  sinned  against,  when  it  is  doomed  to  ignorance." — Channing. 

"A  knowledge  of  the  laws  of  life  is  more  important  than  any  other 
knowledge  whatever.  *  *  *  a  knowledge  which  subserves  direct 
selfpreservation,  by  preventing  loss  of  health,  is  of  primary  im- 
portance."— Spencer. 

At  the  beginning  of  the  great  Tello^Y  fever  epidemic  of 
1878,  a  medical  student,  from  one  of  the  interior  towns  of 
Louisiana,  who  had  been  studying  the  svmptomology  of 
the  disease  in  New  Orleans,  fell  sick,  and  profoundly  im- 
pressed with  the  non-contagiousness  of  the  disease,  re- 
turned to  his  home  and  Avas  received  at  point  of  pike  and 
gun,  and  for  a  period  of  nearly  forty  days  subjected  to  a 
brutal  and  inhuman  quarantine.  After  recovery  from 
the  attack,  sui)posed  to  be  yellow  fever,  for  wliich  the 
quarantine  was  imposed,  and  from  the  first  wild  outlnirst 
of  passion  against  those  in  authority  responsible  for  the 
inhuman  restrictions,  leveled  against  the  victim,  his 
motlier  an  immune  who  nursed  him  and  his  l)rotlier  who 
met  him  on  his  arrival,  his  tlioughts  naturally  reverted 
to  the  cause  of  the  wild,  panicky  and  insensate  fears  that 
would  drive  a  community  to  treat  the  victims  of  a  con- 
tagious or  infectious  disease  as  tliough  they  were  crim- 
inals, nay  worse,  for  even  with  barbaric  tribes  the  con- 
demned criminal  is  afforded  food  and  shelter  until  such 
time  when  he  must  pay  the  penalty  for  his  iufraction  of 
the  tribal  law,  while  in  civilized  communities  the  poor  un- 
fortunate victim  of  a  disease,  for  which  he  is  in  no  wise 
responsible,  is  not  only  frequently  denied  these,  but  at 
the  point  of  a  shot  gun  is  prohibited  from  securing  the 
necessities  of  life,  wliich  he  may  have  the  ability  and 
desire  to  pay  for. 


LOUISIANA    SYSTEM    OF    HYGIENIC    EDUCATION MAYER.  1177 

This  train  of  tliouglit  could  lead  to  but  one  conclusion : 
That  ignorance  of  the  cause  of  the  disease,  its  manner 
oS  propagation  and  its  prevention,  was  at  the  botTom  of 
the  trouble;  another  thought  occurred:  that  this  niagni- 
ticent  State,  with  its  wonderful  resources  of  field,  farm 
and  mine,  reticulated  with  4000  miles  of  navigable  water- 
ways, with  a  balmy  climate  and  a  soil  rioting  in  ])rofusion 
of  raw  materials  and  fuel  to  convert  them  into  tliose  pro- 
ducts upon  which  empires  are  built,  with  a  hospitable 
people  in  whom  the  American  instinct  of  fair  play  was 
strong,  whose  qualities  of  physical  courage  had  been  tested 
in  the  crucible  of  Civil  War  and  Reconstruction,  should 
be  absolutely  inhibited  in  its  growth  and  evolutionary 
development  by  the  fear  of  an  ultra-microscopic  germ, 
periodically  sown  by  the  bronzed  harvester  of  Death. 

The  strange  immunity  of  those  communities  in  the  in- 
fected areas,  off  the  lines  of  travel,  or  which  had  insti- 
tuted rigid  quarantine,  plainly  poiuted  to  some  vehicle 
of  transmission  of  the  yellow  fever  germ  at  that  time 
supposed  to  be  fomites,  and  suggested  that  the  only  sen- 
sible Avay  to  deal  with  the  problem  was  to  institute  a 
sane  and  scientific  quarantine,  with  tlie  minimum  of  hard- 
ship inflicted  on  the  commercial  interests,  and  that  until 
the  masses  of  the  people  were  sufficiently  instructed  to 
apply  the  fundamental  principles  of  hygiene  to  the  sup- 
pression of  disease,  this  panicky  feeling  woubl  continue 
and  periodical  exhibitions  of  shot  gun  quarantine  bar- 
barities would  recur— tlie  remedy  was  a])parent :  Educate 
the  masses — not  only  the  children  in  tlie  scliools,  but  tlie 
grown  folks — many  of  whom  had  successfully  crossed  the 
pons  asinorum',  and  could  most  learnedly  discourse  with 
the  muses,  but  who  were  profoundW  ignorant  of  the  rudi- 
mentary rules  of  lii^e.  ' 

Of  a  verity  the  paraphrased  caustic  lines  from  Iludibras 
fitly  apply: 

"Full  many  a  j-oiith  returns  from  school 
A  Latin,  Greek  and  Hebrew  Fool. 
Full  many  a  man  returns  from  college 
With  a  head  choke  full  of  useless  knowledge 
In  sanitary  science  still  a  block 
Tho'  deeply  skilled  in  hie  haec  hoc." 


11 78  augustin's  history  of  yellow  fever. 

In  1S82,  Koch  having-  pointed  out :  "'tlie  constant  pres- 
ence in  tubercnlons  tissue  or  matter  of  a  well  defined 
micro-organism,  capable  of  reproducing  tuberculosis  when 
isolated  and  injected  into  healthy  animals/'  it  was  evi- 
dent: that  tlie  theory  of  heredity  was  no  longer  tenable, 
and  that  this  dreadful  disease,  which  since  the  dawn  of 
history,  "arose  and  o'ershadowed  the  earth  with  its  name," 
could  only  be  stayed  in  its  triumphant  march  l)y  a  study 
of  its  cause,  nature  and  prevention ;  and  that  this  knowl- 
edge should  not  be  confined  to  the  family  physician,  but 
should  be  made  common  property,  so  that  the  simplest 
mind  could  realize  the  dangers  of  tuberculous  sputum, 
of  meat  and  milk  from  dairy  herds  that  had  not  been 
subjected  to  the  tuberculin  test,  and  the  role  that  the 
common  house  fly  and  bed  bug  plays  in  the  transmission 
of  the  bacillus  tuberculosis. 

The  extreme  conservatism  of  the  medical  profession, 
which  seemed  to  regard  as  unethical  any  discussion  of 
medical  subjects  with  the  laity,  stood  as  a  bar  to  any 
acquiesence  in  or  ready  acceptance  of  the  principle  oi! 
public  instruction  in  the  cause,  nature  and  prevention  of 
com mui cable  diseases,  the  writer,  while  never  accepting 
the  correctness  of  this  ultra-conservatism,  holding  it  a 
colossal  mistake  to  permit  lay  wi'itcrs  to  trench  upon 
ground,  Avliich  should  have  been  traversed  by  medical  men 
alone,  yet  not  wishing  to  appear  unethical,  pushed  the 
plea  for  public  instrrictiou  before  the  old  Attaka])as  ^Fedi- 
cal  Society,  before  the  Orleaiis  Parish  ^Medical  aiid  Surgi- 
cal Society,  and  before  the  T.fuiisiana  Slate  Medical  Socie- 
ty, until  it  Avon  their  apprOA^al  as  evidenced  by  the  fcn'uial 
resolutions  ado])ted.  Thv  State  Auricultural  Association 
endorsed  this  plan  of  hygienic  education,  twice  by  formal 
resolution:  the  State  Pharmaceutical  and  Dental  Associa- 
tions and  the  ^fobile  Quarantine  Convention  endorsed  the 
principle  unanimously. 

Armed  with  this  medical  endorsement,  the  fight  for  the 
principle  was  carried  before  the  American  Public  Health 
Association  at  the  ^Fexico  meeting  in  1803.  Later,  at  the 
annual  convention  of  the  same  body  in  New  Orleans,  and 
at  the  100(1   meeting  in   tlu^  City  of  :\l('xico;  under  the 


LOUISIANA    SYSTEM    OF    HYGIENIC    EDUCATION MAYER.  1179 

rules  of  this  Association,  all  resolutions  are  referred  to 
tlie  executive  committee  which  failed  to  report  back  the 
resolutions,  there  is  no  question  that  in  an  open  field,  on 
the  floor  of  the  House,  it  would  have  won  recofiiiition, 
since  the  principle  underlies  tlie  objects  and  purposes  of 
the  organization,  as  set  forth  in  Article  2  of  the  Consti- 
tution, viz. :  "the  advancement  of  sanitary  science  and  the 
pr(>motion  of  organizations,  and  the  measures  for  the  prac- 
tical application  of  public  hygiene,"  the  Louisiana  "system 
simply  goes  a  step  further  in  carrying  hygienic  instruc- 
tion to  the  masses  of  the  people  in  the  homes  and  by  their 
firesides,  by  Chatauquan  methods. 

At  the  New  Orleans  meeting  of  the  American  Medical 
Association,  a  resolution  offered  by  Dr.  Sanders,  State 
Health  Officer  of  Alabama,  endorsing  the  principle  of  this 
system  was  unanimously  adopted  by  the  section  on 
hygiene,  referred  under  the  rules  to  the  general  Committee 
en  Resolutions  and  never  reported  back,  so  evidently  the 
medical  mind  is  not  yet  fully  converted  to  the  idea  that 
the  highest  duty  of  the  physician  is  prevention  and  not 
cure.* 

*Since  this  was  written,  the  American  Medical  Association  has 
had  Dr.  McCormaclc  visiting  the  entire  country,  advocating 
Public  Education  in  Hygiene,  and  at  the  Chicago  Meeting 
of  the  Association,  June  2-5,  1908,  Dr.  Burrell  of  Boston,  its 
President,  devoted  his  Presidential  address  to  the  "New 
Duty  of  the  Medical  Profession,  the  Education  of  the 
Public  in  Scientific  Medicine.  Vide  Journal  A.  M.  A.,  Vol. 
No.  23,  p.  1873.  At  the  same  meeting  Dr.  Harrington,  of 
Boston,  in  his  address  on  "States  Rights  and  the  National 
Health,"  among  other  things  said: 

"In  arousing  the  public  to  a  proper  appreciation  of  the 
importance  of  public  hygiene,  we  have  far  more  to  fear  from 
professional  than  from  lay  ignorance."     *     *     * 

The  creation  of  educated  public  interest  in  the  National 
health  is  a  duty  which  happily  does  not  belong  to  any  one 
class  or  calling,  each  in  his  way  can  do  his  part  by  precept 
and  example,  of  great  value  as  shown  in  the  agitation  for 
the  law  relative  to  foods,  and  here,  there  and  everywhere 
for  the  establishment  of  Sanatoria,  for  ordinances  against 
the  spitting  habit,  are  popular  lectures,  magazine  articles, 
and  the  sympathy  of  the  press. 


1180  augustin's  history  of  yellow  fever. 

In  tbe  winter  of  1882,  with  the  memory  of  the  yellow 
fever  epidemic  of  1878-1879,  still  fresh,  and  the  mortuary 
statistics  of  tuberculosis  bristlinji,-  with  its  annual  holo- 
caust, a  scheme  of  Public  Instruction  in  Hygiene  was 
evolved,  which  should  start  in  at  the  Kindergarten,  con- 
tinue through  the  primary  and  academic  grades,  to  the 
college  and  university,  and  university  extension  Hvith 
s«me  great  Central  Institute  of  Hygiene  as  a  focal  point 
from  whose  portals  could  be  issued  a  journal,  bulletins 
and  leaflets  in  all  the  tongues  spoken  in  the  State,  and 
a  corps  of  trained  Lecturers  organized  for  the  instruction 
of  the  masses. 

The  scheme  was  considered  a  Utopian  dream  by  most 
medical  men,  who  hebl  tliat  the  ^Medical  Colleges  nad 
Chairs  of  Hygiene,  and  that  the  rudiments  of  that  science 
could  be  taught  in  the  pul)lic  school,  unmindful  of  the  fact 
that  even  in  ^Medical  Colleges  Hygiene  was  usually  an  un- 
im])ortant  adjunct  to  the  Chair  of  Materia-^NIedica,  and 
that  the  teachers  in  the  public  schools  themselves  needed 
instruction,  and  so  the  plan  for  want  of  means  to  carry  it 
into  execution  failed  to  materialize. 


"Two  years  ago  there  was  inaugurated  at  the  Harvard 
Medical  School  a  series  of  free  public  lectures,  given  on 
Saturday  evenings  and  Sunday  afternoons  for  four  months, 
mainly  on  Preventive  Medicine.  The  first  series  was  a  most 
giatifying  success;  the  second  so  largely  attended  that  at 
times  more  people  were  turned  away  than  succeeded  in 
securing  places.  The  chief  result  is  a  widespread  interest 
in  public  hygiene,  and  marked  strengthening  of  the  cordial 
relations  which  ought  to  exist  everywhere  between  the  pro- 
fession and  public."     (Journal  A.M.  A.,  Vol.  No.  24,  p.  1959.) 

On  July  18,  1908,  the  editor  of  the  Journal  A.  M.  A.,  in  an 
article  entitled  "Relation  of  Education  to  Preventive 
Medicine,"  in  commenting  on  Dr.  Ditman's  monograph  on 
"Education  and  its  Economic  Value  in  the  Field  of  Preven- 
tive Medicine,"  says:  "Eff active  measures  for  removing  the 
causes  of  disease  can  be  carried  out  only  with  the  support 
of  an  enlightened  public  opinion,  and  this  must  be  formed 
by  education."     (Vide  Journal  A.  M.  A.,  Vol.  2,  No.  3,  p.  227). 

In  volume  51,  No.  4,  p.  323,  in  commenting  on  "The  Louisi- 
ana  Sy.stem  of  Hygienic  Education,"  the  editor  says:     "On 


LOUISIANA    SYSTEM    OF    HYGIENIC    EDUCATION MAYER.  1181 

One  of  the  distinctive  features  of  tlie  system,  and  tlie 
one  from  which  it  was  expected  to  i-et  the  best  results, 
was  a  series  of  popular  lectures  illustrated  with  lantern 
slides,  breaking  the  continuity  ofi'  the  strain  on  the  lay 
mind  by  appropriate  musical  and  recitative  numbers,  be- 
tween each  lecture  and  discussion.  In  1885,  as  an  exper- 
iment to  test  the  correctness  of  the  theory,  this  idea  was 
carried  into  execution  and  the  most  gruesome  subject 
purposeh'  selected  for  a  popular  lecture,  viz. :  ''The  Sani- 
tary disposition  of  the  dead.'-  The  kindly  manner  in 
which  this  dismal  topic  was  received,  confirmed  the  cor- 
rectness of  the  theory;  the  only  thing  that  remained  to  be 
proven,  was:  whether  public  interest  could  be  kei)t  up  for 
any  length  of  time,  and  the  opportunity  for  proving  this 
did  not  present  itself  until  1897,  when  the  first  popular 
Institute  of  Hygiene  ever  held  was  convened  in  the  town 
of  Opelousas,  in  this  State.  The  session  opened  in  the 
morning,  lasted  all  day  and  all  night.  At  mid-night  an 
adjournment  was  taken  to  enable  the  ladies  to  retire,  and 

the  intelligent  co-cperation  of  the  public  the  ultimate  suc- 
cess of  Sanitary  legislation  must  largely  depend.  A  useful 
auxiliary  in  this  direction  already  exists  in  what  has  been 
called  'The  Louisiana  System  of  Hygienic  Education,'  the 
essential  feature  of  this  movement,  according  to  Dr.  F.  J. 
Mayer  (Rept.  of  Spec.  Med.  Insp.  La.  State  Board  of  Health, 
1908),  consits  in  the  holding  of  Institutes  of  Hygiene  before 
Colleges,  High  Schoo'.s  and  Special  Institutes.  By  this 
means  not  only  is  a  considerable  portion  of  the  populace 
instructed  in  the  nature  and  prophylaxis  of  transmissible 
diseases,  but  the  movement  is  farther  extended  by  the  'per- 
fect correlation  of  the  clergy  of  all  denominations,  educa- 
tors, scientists  and  the  press  with  the  health  service  of  the 
State  in  its  educational  efforts.'    *     *     * 

"The  further  extension  of  this  movement  is  much  to  be 
desired.  It  seems  desirable,  however,  as  Dr.  Mayer  suggests, 
that  the  educators  should  be  independent  officials,  not 
engaged  also  in  field  work;  not  only  because  there  is  work 
enough  of  that  kind  alone  to  engage  their  attention,  but 
also  because  their  teaching  is  apt  to  be  looked  on  with 
suspicion  by  the  ignorant  if  it  emanates  from  one  charged 
with  executing  the  ordinances  of  the  Board."  (V.  J.  A.  M. 
A.,  Vol.  2,  No.  4,  page  323). 


1182  augu&tin's  history  of  yellow  fever. 

the  lustitnte  reassembled  at  12:30  P.  M.,  when  a  lecture 
was  delivered  for  men  only;  it  was  2  o'clock  A.  M.  hefoi'e 
the  successful  experiment  adjourned  sine  die.  Many  of 
the  leadini;-  Sanitarians  of  the  State  participated ;  includ- 
ing Drs.  Dalrvmple,  Metz,  Dver,  Chassaignac,  Formento, 
E.  D.  Martin  and  others.  Those  who  have  had  experi- 
ence with  agricultural  and  pedagogical  institute  work  will 
recognize  the  success  of  holding  the  wrapt  attention  of  an 
audience  ilor  such  a  len^lliv  period.  Water,  Hygiene  of 
the  skin,  Sexual  Hygiene,  Cremation,  Antlirax  (Charbon), 
Variola  and  Vaccination,  Yellow  Fever,  Typhoid  and  Con- 
sumption were  lectured  on  and  discussed  before  a  packed 
house. 

The  practical  benefits  of  this  institute  were  felt  the  next 
day  in  an  overhauling  and  cleaning  of  cisterns,  the  chief 
source  of  drinking  water  in  the  town.  Some  of  these 
tanks  had  not  been  cleaned  since  the  war,  and  contained 
two  feet  of  black  pultaceous  mud  reeking  with  organic 
filth.  Attention  was  directed  to  the  dangers  of  polluted 
milk  supply,  and  peo])le  boiled  milk  who  formerly  had  con- 
sumed it  raw,  although  the  cows  sup^tlying  it  drank  from 
the  town  creeks  polluted  with  sewage.** 

The  next  year  another  institute  was  held  in  Baton 
Rouge,  through  the  exertious  of  Dr.  Dalrymple,  Professor 
of  Comparative  Anatomy  in  the  L.  S.  U.  &  A.  ]\r.  College, 
and  recently  elected  President  of  the  American  Veterinary 
^ledical  xVssociation. 

These  two  institutes,  whih^  demonstrating  the  feasibilty 
of  the  plan,  nmde  maniftvst  the  fact,  that  the  expense  was 

**The  unbroken  continuity  of  interest  manifested  at  this  Institute 
was  due  to  the  fact:  that  under  the  guidance  of  an  eminent 
musician  the  physiological  effect  of  music  on  the  nervous 
system  wa3  taken  full  advantage  of  in  lessening  the  strain 
on  the  lay  mind,  which  otherwise  would  have  been  unbear- 
able in  a  mixed  audience.  The  use  of  music  is  an  impor- 
tant adjunct  of  the  Louisiana  System  of  Hygienic  Education, 
and  applies  with  equal  force  to  all  institute  work;  like  all 
nerve  stimuli,  it  must  be  used  with  discriminatory  judgment, 
hence  the  very  best  musicians  should  be  consulted  in  ar- 
ranging the  musical  part  of  the  program;  it  would  never  do 
to  follow  a  discourse  on  death  in  its  protean  forms,  with  an 
aria,  one  might  say  mal-aria,  the  lugubrious  strains  of  which 


LOUISIANA    SYSVEM    Off"    HYGIENIC    EDUCATION MAYKR.  118S 

too  heavy  for  the  individual,  and  that  it  was  the  duty  of 
the  State  to  furuish  tliis  instruction.  These  institutes 
were  held  under  the  auspices  of  the  ''Louisiana  State  Sani- 
tary Association."  The  purposes  and  objects  of  this  cor- 
poration as  set  forth  in  Article  II  of  its  constitution 
adopted  November  22nd,  1897,  are  declared  to  be: 

''The  advancement  of  sanitary  science, 

"First.  By  the  organization  of  a  central  body  with 
auxilarj'  circles  in  every  parish  in  the  State  and  its  ex- 
tension, until  it  embraces  all  the  Southern,  and  particu- 
larly the  Gulf  and  the  South  Atlantic  States. 

Second.  The  founding  of  a  school  of  Hygiene  and  Quar- 
antine on  the  Chatau(pian  plan  of  correspondence.  Lec- 
tures and  Summer  Institutes. 

Third.  The  publication  of  a  monthly  Journal  devoted 
to  the  objects  of  the  Associations. 

Fourth.  To  secure  through  an  educated  public  opinion 
the  enactment  of  adequate  health  laws ;  laws  on  vital  stat- 
istics on  food  adulteration  and  water  pollution,  on  meat, 
and  dairy  inspection,  on  vaccination  and  their  enforce- 
ment; and  the  founding  of  hospitals  for  contagious 
diseases. 

Fifth.  To  systematically  educate  the  people  of  the 
State  to  the  necessity  of  substituting  rational,  scientific, 
uniform,  maritime  and  inland  quarantines  during  periods 
of  epidemic  danger  or  invasion  for  the  barluirous  shot- 
gun quarantines,  whicli  while  crippling  commerce,  afford 
at  best  a  doubtful  and  insecure  ])rotection. 

Sixth.  The  restriction  and  prevention  of  tul»erculosis 
and  the  founding  of  sanitaria  for  its  Hygienic-Dietetic 
treatment." 


following  closely  after  the  dreary  dissertation  might  pile 
Pelion  on  Ossa;  nor  would  it  serve  the  purpose  to  follow 
the  discourse  with  some  excruciating  rag-time  that  would 
rudely  check  the  rising  tide  of  sympathy  and  deflect  its 
current  into  a  channel  of  levitj%  the  sympathetic  interest 
and  attention  of  the  audience  would  be  balked.  Rostand 
elaborated  the  idea  in  "Cyrano  de  Bergerac,"  when  the 
thoughts  of  the  starving  Cadets  of  Gascony  were  turned 
and  raised  to  higher  levels  by  music  that  appealed  to  loftier 
instincts. 


1184  augustin's   history  of  yellow  fever. 

The  charter  provides  for  representation  of  all  interests 
coneerned  particularly  to  that  mighty  a}j;ent  of  reform, 
the  Press  and  declares :  "That  its  Advisory  Council  shall 
consist  of  dele<»ates  from  each  Sanitary  Circle  in  the 
State,  from  each  Town  Council  and  Police  Jury  of  the 
State,  from  tlie  Ccimnun'cial  Exchanges  and  Boards  of 
Trade,  from  the  Boards  of  Health,  from  the  Medical, 
Pharmaceutical  and  Dental  Societies,  from  the  Colleges, 
from  the  Louisiana  Chatauqua  and  other  educational  and 
scientific  hodies,  from  the  Press  Association  of  the  State, 
and  the  Press  Club  of  New  Orleans,  and  the  Commercial 
Travelers'  Association ;  the  basis  of  representation  from 
each  to  be  fixed  by  the  Executive  Committee.'' 

These  two  committees  shall,  in  joint  session,  "Serve  as 
a  nominating  committee  of  officers  and  committeemen,  for 
the  ensuing  year  and  nmke  such  recommendations  to  the 
Association  as  shall  best  secure  the  (tbjects  of  its 
creation." 

The  membership  is  composed  of  active,  associate,  hon- 
orary- and  non-resident  corresponding  members,  the  Exec- 
utive Committee  determining  for  which  class  a  proposed 
member  shall  belong;  there  is  no  initiation  fee  and  the 
annual  dues  are  fixed  at  |1.00,  and  the  liabilities  of  mem- 
bers limited  to  the  amount  of  their  annual  diu'S,  and  "this 
society  may  incorporate  with  similar  or  other  sanitary 
associations  in  the  other  Southern  States  in  such  manner 
as  its  Executive  Committee  may  detei-miue."' 

The  Secretary  is  ex-officio  State  organizer. 

Copies  of  this  Charter  were  sent  to  the  Exchanges  and 
Transportation  Companies,  but  failed  to  attract  atten- 
tion, although  as  per  reference  to  Section  5,  of  the  Char- 
ter, it  will  be  seen  they  would  have  been  the  chief  benefici- 
aries. The  business  mind  had  no  patience  with  any 
system  that  required  time  for  a  proper  evolutionary  devel- 
opment; what  it  desired  was  a  speedy  estoppel  to  shot 
gun  embargoes  on  commerce,  and  vainly  inuigined,  as 
manj'  of  them  still  do,  that  all  that  was  necessary  was 
the  exhibition  of  physical  force  on  the  part  of  the  State 
or  National  government. 


Louisiana  system  of  hygienic  education — maver.        1185 

Here  it  is  where  a  great  divergence  of  opinion  exists, 
tliose  who  have  more  closely  studied  the  (question,  recog- 
nize that  the  average  American  is  imbued  with  the  old 
Anglo-Saxon  idea,  that  every  man's  house  is  his  castle, 
and  that  he  has  an  inherent  and  inalienable  right  to  de- 
fend it  from  invasion,  whether  the  invader  comes  in  the 
form  of  a  burglar  or  a  foreign  disease  germ,  and  that, 
whether  he  has  a  legal  right  or  not,  he  is  going  to  take 
it;  now  when  whole  communities  become  obsessed  with 
this  view,  and,  in  the  furtherance  of  their  belief  in  the 
right  of  self-ijreservation,  commit  excesses  not  warranted 
by  science,  it  is  apparent  that  the  only  permanent  relief 
to  be  obtained  is  from  a  better  enlightened  public  opinion. 
In  the  reign  of  Elizabeth,  a  gibbet  Avas  set  up  at  every 
mile  post,  from  Lands  End  to  New  Castle,  in  the  hope  of 
stopping  smuggling,  and  failed,  and  our  own  well  ap- 
pointed revenue  service  cannot  wholly  prevent  infraction 
of  the  law;  the  whole  army  of  the  United  States  if  im- 
pressed into  service  as  a  quarantine  guard  might  for  a 
time  enforce  the  passage  of  trains  through  territory  quar- 
antineed  against  infected  areas,  but  it  could  not  prevent 
the  torch  from  being  applied  to  a  railroad  bridge,  nor  the 
raising  of  a  rail  by  the  inid-night  prowler,  and  this  would 
for  a  time  put  a  stop  to  commerce.  Nor  could  all  the 
powers  of  the  United  States  force  a  commuity  to  carry 
on  business  relations  with  centers  of  inf/ection  if  they 
felt  indisposed  so  to  do ;  so  in  the  last  analysis  any  sys- 
tem of  inter  or  intra-State  (|uarantine,  whether  under  the 
control  of  the  Federal  or  State  authorities,  to  be  effective 
must  have  an  enlightened  public  o])inion  back  of  it  so 
that  its  provisions  may  be  enforced.  For  as  Lincoln  said : 
''With  public  sentiment  nothing  can  fail,  witliout  public 
sentiment  nothing  can  succeed,  consequently  he  who 
moulds  public  sentiment  goes  deeper  than  he  who  enacts 
statutes,  or  pronounces  decisions,  lie  makes  statutes  and 
decisions  possible  to  be  executed.'' 

In  1898,  and  for  four  years  thereafter,  through  the 
courtesy  of  the  State  Department  of  Agriculture,  it  was 
made  possible  to  carry  on  a  series  of  Lectures  on  Hygiene 
of  the  Home  and  Farm,  including  Lectures  on  Consump- 


1186  augustin's  history  of  yellow  fever. 

tion,  Small-pox,  Typhoid  Fever,  Anthrax,  Water  and  In- 
sects in  their  relation  to  public  health,  drainage,  etc. 
At  these  lectures  it  was  noticeable  that  the  farmers  took 
as  much  interest  in  Hygiene  as  thev  did  in  the  agricul- 
tural discussions,  their  questions  showing  that  they  real- 
ized that  ill-health  in  man  and  beast  was  the  most  serious 
economic  leak  on  the  farm. 

In  1900,  a  bill  was  drafted  and  presented  to  the  Gen- 
eral Assembly  by  the  late  Ex-Speaker  Henry,  of  Cameron, 
to  create  a  Commissioner  of  Hygiene  whose  function 
would  have  been  purely  educational  and  whose  principal 
duty  would  have  been  to  lecture  before  the  Agricultural 
and  Pedagogical  Institutes,  the  Colleges  and  High 
Schools,  and  before  Special  Institutes  of  Hygiene  at  the 
Cotmty  Seat  of  every  Parish. 

Under  the  political  conditions  existing  at  that  time, 
it  was  considered  a  hopeless  task  to  attempt  to  pass  any 
measure  opposed  by  the  Chief  Executive,  for  the  appoint- 
ive power  i^laced  in  the  Governor's  hand,  a  sword  with 
which  he  could  slash  right  and  left  and  Avhip  recalcitrants 
into  line  with  the  flat  side.  Nevertheless,  before  this  able 
body,  with  the  Governor  violently  opposed  to  its  passage, 
tlie  Hygiene  Bill  won  recognition  b^'  a  vote  of  63 
to  27  in  the  Lower  House,  and  26  to  6  in  the  Senate, 
solely  on  the  strength  of  its  merit.  The  Governor 
vetoed  the  measure  on  the  ground  that  the  State  was 
not  able  to  stand  the  expense  of  |4000  per  annum 
asked  for.  Two  years  later  the  Bill  was  reintroduced 
by  Hon.  W.  W.  ^'entress,  a  distinguished  Sugar  Planter 
of  Iberville,  passed  the  Lower  House  by  63  to  IT, 
with  18  of  its  avowed  protagonists  unavoidably  ab- 
sent, passed  the  Senate  unanimously  in  desi)ite  of  the 
unprecedented  and  unseenly  opposition  of  the  Governor, 
and  was  again  vetoed  by  him  on  the  grounds  set  forth  in 
his  original  veto  message,  that  it  was  "a  meritorious 
measure  regretfully  refused"  for  want  of  funds,  and  this 
in  the  face  of  his  own  message  setting  h:)vt\\  the  fine 
financial  condition  of  the  State,  and  so  for  a  season,  a 
plan  of  public  instruction  in  hygiene,  upon  which  the  leg- 


LOUISIANA    SVSTKM    OF    HVGIEMC    EDUCATION MAYER.  1187 

islative  will  had  been  twice  affirmatively  expressed,  fell, 
through  the  petty  oppositiou  o.f  a  politician — 

"  Drest  in  a  little  brief  authority 
Most  ignorant  of  what  he's  most  assured, 
His  glassy  essence  like  an  angry  ape, 
Plays  such  fantastic  tricks  before  high  heaven 
As  make  the  Angels  weep." 

The  passage  of  this  Bill,  and  the  efficient  execution  of 
its  provisions,  would  have  saved  the  State  the  epidemic 
of  1905,  and  the  incidental  loss  of  two  hundred  millions  of 
dollars  to  her  comm,erce;  this  bold  assertion  is  based  on 
the  fact,  that  after  the  epidemic  had  started  and  was 
under  full  headway,  a  campaign  of  Sanitary  Educatioin 
along  the  lines  i)roposed  by  the  vetoed  measure,  succeeded 
in  the  brief  period  of  sixty  days  in  converting  the  people 
to  the  mosquito  doctrine  who  for  over  a  hundred  years 
had  been  wedded  to  the  fomites  theory ;  even  the  ignorant 
colored  population  being  converted  and  co-operating  with 
the  magniticent  work  of  the  medicos  and  sanitarians  of 
New  Orleans;  and  for  the  first  time  in  sanitary  history  an 
epidemic  of  yellow  fever  was  practically  stamped  out  of  a 
great  center  of  population  before  the  advent  of  frost ;  and 
the  commercial  conscience  awakened  to  a  realization  that 
"Honesty  is  the  best  policy,"  and  that  the  frank  admission 
of  the  existence  of  a  contagious  or  infectious  disease,  to- 
gether with  tangible  evidence  that  prom])t  and  scientific 
methods  for  its  extinguishment  are  being  pursued,  is  bet- 
ter than  a  policy  of  conc(>alment,  which  always  leaves  in 
the  public  mind  a  belief  that  the  evils  hidden  are 
infinitely  worse  than  they  really  are;  it  is  the  myste- 
rious and  uidcnown  that  has  always  cai-ricd  tei'ror  to  the 
human  heart,  full  many  a  warrior  wlio  has  hacked  and 
hewn  his  way  through  aisles  of  bristling  steel  to  fame, 
who  on  a  hundred  battl(»  fields  has  ytroudlv  carried  his  es- 
cutcheon untarnished  by  a  stain,  h;is  forgoUcn  the  obli- 
gations of  Christian  chivalry  and  sullied  his  knighthood 
with  a  craven  and  dastardly  fear  in  the  ])resence  of  un- 
known danger,  or  supernatural  terrors,  especially  when 
clothed  in  the  garb  of  pestilential  disease. 


1188  augustin's  history  of  yellow  fever. 

In  1000,  when  Dr.  C  H.  Irion  became  president  of  the 
Louisiana  State  Board  of  Health,  one  of  Ids  first  acts  was 
to  carry  into  execntion  some  of  the  measures  of  this 
scheme  of  public  education,  and  over  one  hundred  insti- 
tutes of  hvgiene  were  held  throuii,hout  the  Infected  area 
of  tlie  year  before ;  where  the  mos(|uito  doctrine  was  ex- 
pounded in  a  series  of  illustrated  lectures  in  English, 
French,  German  and  Italian.  At  these  institutes  the  co- 
operation of  the  priestliood  and  cleriiY  was  earnestly 
sought  and  secured,  and  by  their  influence  aided  materi- 
ally in  securing  attentive  audiences.  The  good  results 
were  soon  apparent  in  the  passage  of  screening  ordinances 
in  most  of  the  towns  of  the  State,  by  post-c^pidemic  fumi- 
gation, and  other  sanitary  steps,  Avith  the  result  that  there 
was  no  recrudescence  of  yellow  fever  for  the  first  time  in 
sanitary  history,  in  a  year  following  an  epidemic  year, 
the  single  exception  occurring  in  a  town  that  had  persis- 
tently neglected  screening  and  other  sanitary  precautions, 
and  made  no  effort  to  secure  the  educational  advantages 
of  an  institute. 

This  correlated  educational  sanitary  work  was  followed 
by  a  remarkable  exemption  later  from  the  incursions  of 
mosquitoes,  and  better  health  conditions  generally  than 
had  ever  been  observed  before,  during  the  summer  and 
autumn  following  prevailed  indeed,  the  iiii]»roved  condi- 
tions incident  to  the  sanitary  precautions  taken  in  lOOfi, 
bore  fruit  as  well  in  1907,  after  they  had  ceased  opera- 
tions, and  this  improvement  continued  until  the  people 
had  lapsed  back  into  the  usual  callous  indifference  that 
re(piires  rude  awakening  by  ei)i(lemic  danger  and  constant 
preaching  on  sanitation. 

This  institute  work  was  supplemented  by  an  annual 
Conference  of  the  Sanitary  Officers  of  the  State,  Parishes 
and  ]\runicipalities  wherein  representation  was  accorded 
to  all  educational,  medical,  sanitary,  commercial  and 
transportation  bodies,  and  sanitary  measures  were  ex- 
hanstively  discussed.  At  the  last  rouference  held  in 
Opelousas,  the  State  Press  Association,  sitting  in  annual 
Convention  in  Lafayette,  realizing  the  educational  advan- 
tage adjourned  as  a  body  and  joined  the  Sanitary  Confer- 


LOUISIANA    SVSTEM    OF    HYGIENIC    EniXATION MAYER.  1189 

once  on  invitation  of  President  Irion.  Tlie  lit.  Rev.  James 
Blenk,  Arelibisliop  of  tlie  Diocese  of  New  Orleans-,  sent 
his  personal  representative  to  this  Conference,  the  Rev. 
Father  Kavanangh,  Catholic  Sni)erinten(lent  of  Educa- 
tion; the  minutes  of  every  meeting  Avere  published  by  the 
daily  press,  so  the  educational  propaganda  was  carried  to 
the  farthest  limits  of  the  State.*** 

During  the  early  months  of  the  year  an  Anti-Tubercu- 
losis league  was  organized,  whieli  has  already  succeeded 
in  establishing  a  consumptive  sanitarium  in  the  ozone  belt 
of  the  State,  besides  carrying  on  its  educational  work  by 
the  Louisiana  method.  The  earnest  and  noble  women 
who  took  the  initiative  in  this  matter  are  very  much  hand, 
icapped  by  want  of  means. 

Among  the  unique  results  of  this  hygienic  educational 
work  was  an  institute,  held  l»y  an  attache  of  the  Roard  of 
Health,  for  the -exclusive  benefit  of  the  nuns,  nearly  four 
huudreel  in  number,  under  the  auspices  of  the  Superin- 
tendent of  Catholic  Educatiou.  The  good  results  of 
which  cannot  be  doubted,  when  it  is  rememl)ered  that 
most  of  these  noble  women  are  teachers,  Avith  a  Avide  circle 
of  influence  outside  the  school  room,  anel  that  sixty  per 
cent,  of  their  number  throughoiU  the  Avcrld  die  of  tubercu- 
losis, most  frequently  contracted  in  the  rounds  of  their 
diiily  charity  labors. 

The  State  Board  of  Health  has  endeavored  to  give  an 
institute  AvhereA'er  one  Avas  desired,  and  is  now  i)lanniug 
an  extensive  programme  commencing  A\ith  a  scorce  of 
county  fairs  to  bo  held  throughout  the  State.  The  prin- 
ciple  of   this   system   has   received    recognition    in   other 

***Since  this  article  was  written,  another  sanitary  convention 
under  the  auspices  of  the  Louisiana  State  Board  of  Health 
was  held  in  the  spring  of  1908,  at  Alexandria,  which 
traversed  the  field  of  preventive  medicine  and  was  attended 
by  Dr.  McCormack,  Secretary  Kentucky  Board  of  Health; 
Dr.  Brumby,  Chief  Executive  of  the  Health  Department  of 
Texas;  Prof.  Aswell,  State  Superintendent  of  Public  Educa- 
tion; Dr.  Caldwell,  of  the  State  Normal;  Bishop  Vander  Ven, 
of  the  Catholic  Diocese  of  Natchitoches;  Dr.  Kramer,  Grand 
Master  of  the  Masonic  Order  in  Louisiana,  who  all  delivered 
addresses. 


1190  augustin's  history  of  yellow  fever. 

states,  notably  in  Indiai^a,  where  under  the  able  adminis- 
tration of  Dr.  Hurty,  the  politicians  have  been  whipped 
into  line  by  the  farmers  who  recognized  the  value  of 
hj'gienic  lectures  at  their  Agricultural  Institutes.  In 
New  York  last  year  a  start  was  made,  indeed  the  Health 
Commissioner  in  his  report  claims  the  honor  of!  priority 
of  a  plan  tentively  tested  in  this  State  in  1885,  where  it 
passed  the  experimental  stage  in  1897,  and  received  a  mag- 
nificent accentuation  by  the  Legislative  Assembly  of  1900 
and  1902,  and  by  the  Anti-mosquito  Campaign  of  1905 
and  1906,  and  is  now  the  fixed  policy  of  the  State  Board 
of  Health,  being  the  first  practical  answer  to  Bowditches 
plea  in  187G,  before  the  National  Medical  Congress  in 
Philadelphia,  when  he  said :  ^'Our  j^resent  duty  is  prgau- 
izatiou,  National,  State,  Municipal  and  Village,  from  the 
highest  place  in  the  National  Council  down  to  the  smallest 
village  Board  of  Health,  we  need  organization,  jcith  these 
organizations  we  can  study  and  often  prevent  disease." 

The  principle  underlying  the  Louisiana  system :  Edu- 
cation, hand  in  hand  with  prevention,  has  reached  France, 
and  is  protagouized  by  no  lesser  personage  than  ex-Pres- 
ident Loubet  in  his  "PuerK'ulture," — Child  Cultivation, 
who  has  brought  together  the  National  Union  of  Presi- 
dents of  Mutual  Benefit  Societies  and  the  ^Medical  and 
Pharmaceutical  Union  in  an  educational  camitnign  on  the 
plan  of  the  Mutualists  Anti-Tuberculosis  Dispensary  of 
the  13th  Ward  of  Paris,  and  a  camjiaign  has  been  started 
against  food  adulteration,  foul  air,  dirt,  polluted  milk, 
want  and  sanitary  ignorance. 

The  results  obtained  by  the  Schneiders  at  Cruzot,  whose 
sanitary  surveillance  ofl  the  milk  supply  has  reduced  the 
infant  m^ortality  during  the  first  year  of  life  (the  most 
dangerous  period)  from  eighteen  per  cent,  the  average  for 
all  France,  to  nine  per  cent,  for  the  past  year,  proves  that 
no  greater  philanthropy  or  more  patriotic  duty  confronts 
the  people  of  our  sister  republic,  than  that  now  engaging 
the  thouglitlis  of  ex-President  Loubet.**** 

****The  establishment~of  Infant^Milir^Dep^ots.^Iilk  Dispensaries, 
or  "Goutte  de  Haut,"  in  different  parts  of  the  world,  have 
invariably  lessened  infant  mortality.  The  first  institution 
of  the  kind  was  established  in  Stamberg  in  1889,  followed 


LOUISIANA    SYSTEM    OF    HYGIENIC    EDUCATION MAYER.  1191 

The  purve3'or  of  depraved  milk,  the  ''great  liquid  food" 
iipou  which  so  many  iuiiocents  depend  for  sustenance  and 
life,  is  the  most  contemptible  and  sordid  criminal  that 
lives  ''unwhipped  of  justice,"  beside  whom  the  sneak  thief, 
the  burglar  and  the  murderer  stand  in  relative  respect- 
ability, for  he  steals  without  the  excuse  of;  hunger  or 
other  pressing  want,  and  murders  helpless  innocents  by 
inanition  and  deadly  disease  germs,  one  of  which  alone: 
Tuberculosis,  (frequently  transmitted  by  milk)  carries  oft" 
fifty  per  cent,  of  the  children  of  Christendom, 

Under  these  institutes,  it  was  intended  that  lectures 
would  be  delivered  on  Hygiene,  Quarantine,  ^larltiine  and 
Inland,  Miasmatic  and  Acute  Contagious  Diseases,  Path- 
ology of  Miasmatic,  Contagious  and  ^lalarial  Diseases, 
Bacteriology,  Serum-Therapy,  Physiology,  Malarial  Dis- 
eases, Contagious  and  Infectious  Diseases  of  Children, 
Hygiene  of  Surgery,  of  the  Eye,  Ear,  Nose  and  Throat, 
of  the  Skin,  of  the  Mouth,  Sexual  Hygiene,  Leprosy,  Diet- 
etics, Influence  of  Alcohol  and  Narcotics  in  their  relation 
to  Public  Health,  Toxicology,  School  Hygiene,  Agricult- 
ure and  Manufactories  in  thcr  relation  to  Hygiene,  Con- 
tagious and  Infectious  Diseases  ofl  Animals,  Sanitary 
Engineering,  Sanitary  Transportation  and  Disposition  of 
the  dead.  Insane  Asylums,  Metereolooy  and  Climatology, 
IMunicipal  Sanitation,  Pailroad  Car  Sanitation,  Construc- 
tion and  Management  of  Detention  and  Observation 
Camps  during  Epidemics.  Insects  in  their  relation  to 
public  health.  Tuberculosis  restriction  and  ])ievention, 
Tuberculosis  Hygienic,  Dietetic  treatment.  The  Louis- 
iana system  has  always  emphasized  the  necessity  of  co- 
operation on  the  part  of  school  aiithoT-ities  and  teachers 
with  the  healtli  authorities  in  securing  better  school 
hygiene,  recognizing  that  "as  the  twig  is  bent,  the  tree's 
inclined."  and  that  among  the  children  attending  public 


by  one  at  the  Belleville  Dispensary,  Paris,  in  1892;  the  first 
in  this  country  was  founded  in  New  York  City,  by  the 
philanthropist,  Nathan  Straus,  who  is  indefatisable  in  his 
exertions  to  improve  the  milk  supply  furnished  infants; 
.aside  from  the  immediate  good  results  that  found  their  es- 
tablishment, they  are  valuable  object  lessons  in  pointing 
out  the  evils  of  impure  milk  and  educating  the  masses  to 
the  danger. 


119i 

scliools  there  were  thousands  who  were  siifferiug  from 
l)reyeiitable  diseases,  the  direct  result  of  ignorance  both 
on  the  part  of  parents  and  of  the  children  themselves; 
that  the  pieaching  they  most  needed  was  the  gospel  of 
soap,  and  that  a  vast  stride  in  the  right  direction  would 
be  made,  if  all  the  children  attending  the  i)ublic  schools 
were  examined  by  physicians,  free  of  cost,  with  special 
reference  to  vaccination,  tuberculosis,  trachoma,  decayed 
teeth,  i)ersonal  hygiene  and  malnutrition.  The  institute 
conductor  of  the  Louisiana  Board  of  Health  addressed 
thousands  of  children  in  their  sehools  during  the  educa- 
tional campaign  of  1 !)()(),  on  personal  and  school  hygiene, 
and  on  the  subject  of  mos<|uitoes  and  flies  as  transmitters 
of  disease. 

It  is  pleasing  to  note  that  New  York  is  also  taking  up 
the  question  of  more  hygiene  and  less  phj-sical  culture  in 
the  schools,  a  committee  headed  hj  an  ex-Superin- 
tendent (tf  Education,  Mr.  IJurliugham,  recently  discov- 
ered an  appalling  condition  of  affairs,  reporting  that  out 
of  (;00,()OI)  schoorchildren,  4(1,500  are  physically'defective; 
that  among  the  cases  of  malnutritiou,  the  greatest  num- 
ber were  foun<l  in  families  having  an  income  of  over 
f 20.00  a  week;  that  72.4  per  cent,  had  defective  teeth,  and 
that  soap  was  an  unknown  ({uantity  to  thousands. 

The  Louisiana  system  recognizes  that  sporadic  efforts 
at  teaching  hygiene  will  not  alone  suffice,  that  the  work 
must  be  kept  u])  day  by  day,  year  in  and  year  out,  with  the 
same  ardor  that  fills  the  teachers  of  religion;  if  the  latter 
were  to  stop  preaching  for  only  one  year  and  the  churches 
remained  closed,  how  many  lapses  from  grace  would  fol- 
low? The  moi'e  tiue  is  this  of  the  tenets  of  a  doctrine, 
the  truth  of  which  is  only  beginning  to  break  upon  the 
world,*  and  of  a  svstem  which  seeks  to  correlate  all  the 


*  At  the  recent  Anti-Tuberculosis  Congress  held  in  Washington, 
D.  C,  universal  opinion  favored  public  education  in  the 
cause  and  prevention  of  the  disease  as  the  keynote  of  the 
fisht  against  its  ravages  and  there  is  no  doubt  that  had 
the  Committee  on  Resolutions  submitted  to  the  Congress 
a  resolution,  sent  up  by  Section  VII,  declaring  it  to  be 
the  duty  of  the  State  to  furnish  this  instruction,  it  would 
have  been  unanimously  adopted. 


LOUISIANA    SYSTEM    OF    HYGIENIC    EDLCATION MAYER.  1193 

educational  factors  of  the  State  in  a  coniprelien^-ive  effort 
to  remove  tliose  ills  which  are  the  direct  result  of  ''igno- 
rance deep  seated,  far  reachinji,  profound  and  appallinji;; 
an  ignorance  not  confined  to  the  lower  strata  of  society, 
but  permeating  all  classes;  an  ignorance  which  in  its 
blind  but  gigantic  strength  is  bracing  its  mighty  shoulders 
against  the  pillars  of  the  temple  of  Hygiea,  and  threaten- 
ing to  engulf  us  in  ruins  darker  than  a  buried  Babylon." 

THE  ENORMOUS  ECONOMIC  LOSS  INCIDENT  TO 

EPIDEMICS. 

If  one-half  of  the  monc}^  most  properly  spent  for  the 
suppression  of  disease  in.  hogs  and  potatoes  l>y  a  ])aternal 
g(xvernuieiit,  was  only  devoted  to  educating  the  rising 
generation  in  the  value  of  ])revention  of  disease,  the  go(ul 
results  folhtwing  would  show  the  wisdom  of  the  ex- 
penditure. 

^Millions  are  spent  for  the  encouragement  of  nnassimil- 
abl(^  immigrants,  ignorant  in  many  instances  of  our  cus- 
toms, lial)its,  speech,  institutions  and  rcligi(in,  but  noi  one 
cent  for  the  conservation  of  the  lives  of  our  ])eo])le,  200,000 
of  whom  annually  go  down  to  a  consumptive  grave,  the 
majority  at  the  age  of  greatest  productivity.  Tlie  econo- 
mic loss  has  been  conservatively  set  at  three  hnndicd  mil- 
lions annually,  aside  from  the  humarJtarian  aspect,  }Uid 
taking  a  cold  blooded,  business  view,  it  would  pay  to  edu- 
cntr  the  i^asses  to  n  i)i<  per  appreciation  of  the  dangers 
+iiat  hourly  confront  them. 

The  American  Public  Health  Association  and  the  Sani- 
tary Institute  of  Great  Britain  for  over  a  (piaiter  of  a 
century  have  carried  on  their  educational  work  among 
sanitarians;  the  Louisiana  system  goes  a  step  farlher  and 
carries  this  instruction  to  the  masses  of  the  people,  teach- 
ing themi  not  alone  the  aphorism  of  the  Lai  in  poet 
Martial:  "Life  is  not  mere  living  but  the  enjoyment  of 
health,"  and  tlie  maxim  ((f  the  Koman  law  giver:  "The 
sanitary  safety  of  the  Bepublic  is  the  supreme  law,"  b"t 
that  the  economic  loss  in  the  nntimelv  removal  of  millions 
of  human  l^:ot  t(nt  ,  at  th.'  ]»eriod  of  Iheir  greatest  prodnc- 


1194  augustin's  history  of  bellow   kkver. 

tivity,  from  (•oimniiiiicablc,  prcvciitabJe  diseases  is  due  to 
ignorance,  which  it  is  the  highest  duty  of  tlie  State  to 
enlighten.  Tlie  system  appeals  not  alone  to  the  humanity 
hut  to  tli(^  common  sense  of  the  American  people,  pcnnts 
out  that  the  victim  of  a  contagious  or  infectious  disease 
is  not  a  criminal  to  be  hounded  to  earth,  but  the  victim 
of  the  sanitary  laches  of  a  community,  it  reiterates  the 
averment  of  Dr.  Benj.  Rush  :  "City  authorities  were  justly 
chargeable  with  the  lives  of  all  who  die  of  preventable 
diseases  within  their  jurisdiction,  and  that  they  should  be 
made  responsible  bef(U'e  the  Courts  of  Justice."  It  ful- 
fills a  high  civic  duty  in  correlating  all  educational  fac- 
tors in  the  State,  and  focusing  them  on  the  all  important 
moral,  economic  and  political  necessity  of  preserving  the 
public  health  by  reaching  the  masses  and  teaching  the 
individual  the  value  of  a  sound  mind  in  a  sound  body, 
that  to  attain  this  it  will  not  do  to  violate  the  sanitary 
law,  and  in  our  daily  lives  act — 

"  As  if  this  flesh  which  walls  about  our  life 
Were  brass  impregnable." 

The  annual  address  before  the  Orleans  Parisli  .Medical 
Society  in  January,  1898,  was  devoted  to  this  topic,  and 
an  elaborate  plan  for  a  State  Institute  of  Hygiene  jU'o- 
])<;sed  which  has  never  been  carried  iuto  coni])l(»te  (execu- 
tion for  want  of  uieans,  the  ec(tnomic  value  of  such  a 
system  is  beginning  to  be  appreciated,  and  the  day 
is  not  far  distant  when  every  civilized  State  will 
liave  an  Institute  of  Hygiene  on  the  Louisiana  ])lan, 
with  a  National  Institute  to  su])i)lement  the  w(n-k  of  the 
States,  and  an  International  Institute  to  focus  a  woi-ld 
wide  movement  in  i^ublic  instruction  in  hygieue,  when 
the  world  will  awaken  to  a  realizing  sens-e  that  an  epi- 
(h'mic  is  the  remorse  of  a  guilty  community,  guilty  of  sani- 
tary laches,  guilty  of  pollutions  and  desecrations  of  the 
Sacred  Altar  of  Hygiea,  in  the  words  of  Aristotle: 
"Of  all  these  things  the  judge  -"s  time." 


J 


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