Yellow fever epidemic of 1878 in New Orleans. Lecture II. Investigation instituted to determine the relations of the organic and living constituents of the atmosphere to the microscopical and chemical changes of the blood in yellow fever.

              YF
J71y2
NEW ORLEANS MEDICAL AND SURQICAL JOURNAL
YELLOW FEVER EPIDEMIC OF 1878 IN NEW ORLEANS
By
JOSEPH JONES, D.O.
Professor of Chemistry and Clinical Medicine,
Medical Department, Univ. of La.,
Visiting Physician of Charity Hospital, New Orleans
Louisiana State
University
Health Sciences
Center
NEW ORLEANS
MEDICAL fiND Su~G!CJL J~oURt{_AL.
APRIL, 1879.
-
ORIGINAL COMMUNICATIONS.
Yellow Fever Epidemic of 1878 in New Orleans.
By JOSEPH JONES, D. D.,
Profesaor or Cl1emiatry and Clln.loa: MedioiDe, Medioal Department, University of
Lonilnana, ViaitiDg Phy"lolan of Cl1arity Hoepltal, New Orl8AD8.
(Extracts jro11~ Clinical Lecture, Delivered in the .41nphit1teatre of the Oha1·ity
Hospital, January 15th, l$79. &ported for the New Orleans Medical and
Surgical Journal.}
LECTURE II.
INVESTIGATION INSTITUTED TO DETERMINE TBE RELATIONS OF
Tf!E ORGANIC AND LIVING CONSTITUENTS OF THE ATMOS·
PHERE TO THE MICROSCOPICAL AND CIIE!'t1ICAL CHANGES OF
THE BLOOD IN YELLOW FEVER.
GENTLEMEN:
At the close of the pn~cediug lecture I endeavored to give
you a hrief statement ot tue results of the investigation which 1
instituted, upon the air of some of tbe most iufected localities
of New Orleans duriug th~; epidemic yellow fever of 1878; and
we uooire upon the present occasion to present the results of
inve~:~tigations which 1 instituted, to determine if possible the
relations of the organic a.ud living constituents of the atmos­phere
to the microscopical and chemical changes of the blood in
yellow faver. If the sau1t1 wicroscopical organisms, spores or
---,
764 Original Communications. [April
germs in the atmosphere existed also in the blood of those suf.
fering with yellow fe'Ver, it appeared reasonable to regard such
organisms, microzymes, microccoci, spores or germs, as active
agents in the production of the physical and chemical changes
of the blood and of the pathological lesions characteristics of
yellow fever. ln such inquiries we must appeal to facts, and
not to mere hypothesis or idle speculation as to the powers of
the microscope and chemical analysis to elucidate the phe­nomena
of this disease.
Before detailing the actual results of the investigation, let
me ask the question: Has negative testimony any more value
in the discussion of scientific subjects than in courts of justice,
A witness swears that he sn.w the prisoner commit murder; tbt~
witness offers to l)roduce one hundred good witness who will
swear that they did not see him commit murder; but would
such negative testimony justifY the judge in discharging the
prisoner? The value of the testimony of the hundred witnesses,
would depend entirely upon whether they had had the same
opportunity for observation and at the same time, as the first
witness. Although in the testimony to an historical fact, tbt~
fact, from its very nature, bas passed beyond recall, and the
testimony of only those who witnt'ssed the facts can be re­cei>
ed ; in scientific discussions, on the other hand, it is often
possible to again bring the ess{'nt,ial conditions of the facts
under review, and the credibility of the testimony will rest
mainly upon the competence of the witness.
When, therefore, the assertion is made that it is impossiule
to demonstrate the specific poison of yellow fever, either chemi­cally
or microscopically, the student of medicine will estimate
the value of such a proposition by the following conditions:
1st. The credibility of the witnesses making such assertion.
2d. The acquirements of those who assume to be judges of
the limits of chemical and microscopical investigations.
3d. Whether or not the self-appointed judges have themselves
searched by chemical methods and l>y the micr\lscope for the
yellow fever poison.
If the individual or individuals making such assertions are
unknown as chemists and microscopists, auu altogether as
origiual iu vestigators, a.ud if they present 'no facts to show that
•
1879] JoNEs- Yellow Fever Epidemic of 1878. 765
they have made microscopical observations, and chemical ex­periments
and analysis to determine the true nature of the
yellow fever poison, the medical profession is justified in re­jecting
such assertions as baseless ~nd valueless. We wonld
rather set no bounds to the limits of human research, and the
possibilities of human discovery in the future, and endeavor to
emulate at once the perseverance, fortitucie and nobility of the
son of the poor wool-comber of Genoa, who gave to Castile and
Leon a new world.
C.A.SES ILLUSTRATING THE CHARACTER OF THE DISEASE IN THE
HOUSES, IN WHICH THE ORGANIC CONSTITUENTS OF THE AIR
WERE CONDENSED, BY THEIR PaSSAGE THROUGH ICE·COLD
WATER.
1. Group of Oas68 occurring in the lYrick house on 2d floor,
363 MagaziM str66t, within the area of the infected .District,
including the cases on Oonstance and adjacent streets.
This house stands a.t the corner of Thalia and Magazine
street ou what is called the swamp side of the street; it is sub·
stantially built of brick and is detached from surrounding
house~. Both streets are paved.
Oase 30. On the 1st of August, 1878, I was called in consult·
ation to see Miss H., at 363 Magazine street, at about 9 oclock,
P. M. The patieu t had been attacked about the 29th of J nly,
and the consultation was held on the 4th day of the fever.
The patient pr~sented the following symptoms: insensible
comatose; pupils contracted; hot, dry Elkin; temperature of
axilla 106° F.; urinary suppression; slight jaundice. Prog­nosis
u.:favorable. The patient died in about six hours after
the consultation.
Oase 31. MiE~s 0. H. Age ~ years; native of New Orleans,
but had generally passed the warm weather in 'fennessee.
Fair complexion, dark hair, most intelligent countenance, and
bright intellect; nervous temperam..,nt. Mother, native of
Tennessee; fathe1·, native of Louisiana. Miss 0. H. was at­tacked
with violent pain in th"' beau and high fever at 4
o'clock, A. M., Augn!lt 8th. 1 saw this patieut at 7, A. M. Mr.
H. informed me that he bad administerell to his child 3 grain!:\
of calomel, 2 grains of quinine and 3 grains of the bicarbonate
of soda, immediately after the onset of the fever, followed by
a hot mustard foot.l..lath; and in two hours afterwards be ad­ministered
five fluid drachma of castor oil. The castor oil was
rejooted together with undigested and sour portions of the
•
- - - ------ ---.
766 Original OonLmunicatio ns. lAprll
dinner of the preceding day. Mr. H. then gave four tlrachms
of castOl' oi.l which were retained.
7,o'cloc:k, A. M. Pulse 142 per minute, the beats running into
each otlwr and giving a gaseous impulse to the fingers. Tem­peratul't'
of a.xilla.103.:t.O F. When waking from sleep delirious,
but wbt'll fnlly aroused answers coherently, but is vary restless.
Face flushed, conjunctiva of ~yes cong~sted. The s01face of
the ski11 gives a sharp, puogent sensation to the hands. Or·
dered hot foot baths, sedative water to the head, and orange.
leaf te-a :.~sa driuk.
4, o'clol'k, P. M. Pulse 150, temperature of axilla 103.90.
Pati~:~nt very restless, skin hot and tlry and gives a burning
puugeut sensation to the toucu. Tongue very red at tip and
edges aud furred with heav,v white fru· iu centre. Face flushed,
eyes congested and motions of t!Je ualls nervous and restless;
altogethtH' there appears to be great agitation 'of the cerebro­spinal
system. The tem!Jerature both without and within the
bouse is t~levated and most oppl'essive; the thermometer in the
sick rooru is 920 F. In order to promote perspiration and re·
duce the body beat, ordered friction of the surface with fresh
and pure sweet oil.
9l o'clock, P . M. Poise 138, temperature of axilla 101.50.
The patient appears to be moru comfortable and rests more
quietly. The hot foot bath followed by tile frictions of sweet
oil, together with the orauge-leaf tea, llave iuducerl. some per­spiratiou.
Bo,vels have be~:~n moved twice.
12 o'clock, at uight. At t l.ns time tiJe fever increa:secl in in­tensity,
the thermometer iudicating 1030 io the a.xilla, <Mld the
patient became restless aud delirious. Bric.;tions of :sweet oil
aUI.l tlle hot mustard foot batbs apJJeared to produce good re­:
sults aud she became more quiet aud moisture appeared upou
tbe skin. The night was iuteu~:~ely wat·m anti the thermometer
never fell bdow 920 F. Up to the present time tue head bas
beeu kept constantly cool by cloths dipped iu cool water.
August 9th, 9, A. M. Pulse 1J4; teruperatnre of axilla 1030 ;
pulse ra!)id, runniug and gaseous; the heat of the 1.1kin is very
iuteuse and pnrgeut to the toucb.
4 o'clock, P . M. Pulse 118; temperature of axilla 103.90. [u
order to promote diuret>is and diaphoresis, the spirit of nitric
ether (~:~ptritus retheris nitrici), was added to the orange leat
tea.
The frictions of the surface with olive oil as well as the wm·m
foot l>atus appear to have been beneficial. From the onset of
the aLtack, however, there has bet>u a nervous agitation and
restles8ue:ss, often accompanied with uelirium which forebodes
evil and indicates a case of the utmost gravity. The a.pplica­Ltou
of cut cups to the temple <\ud back of the head were aare­fully
cou8idered; but ~ his remeriy was not employed, on tbe
grouud that tl.te patient, eveu iu health, was exceedingly deli­cate
and pale, with but limited amount of red blood.
9 o'clock, P. M. Pnlse 132; temperature of axilla 104.20; ret>·
--- - ----------- ---------------------------....
1879) JONES-YeU<>w FfiV&r Epidemic of 1878. 767
plration 30 per minut"; patient restless and delirious. Incessant
motion of hands aud heacJ. Talks incoherently, but when
aroused will utter one or two coherent sentences. The cold
application to the head, ice water, sedative water and bay
rum, have been wost fi\ithfully continued by her devoted
parents aud uurse, but uo perceptible effects have resulted
therefrom. Uriue liglJt, straw color; perfectly limpid ; with­out
deposits; abundantly, and with only a tra{:e of albumen.
Bowels have moved occasionally. In order to reduce the fre­quency
of tue action of the heart, as well as to calm the ner­vous
excitemeut, the tollowiug was ordered: One drop of the
tincture of aconite root (tioctura aconita radicis, U. S. P.) and
10 grains of the bromide of potasiuw, every 2 to 4 hours, the
effect:;; beiug carefully watched. Thus far, there has been uo
retching or vomiting, aud iu fact the patient has persistently
complained of a feeling of hunger, ao<.l m ord~r to relieve this
millr and lime water were administered in small quantities at
regular intervals, and produced no gastric disturbance.
August lOth, 9 o'clock, A. M. Patient very restless anti
delirious. Lips, scarlet; face, flushed; skin feels" burning bot''
to the touch. '.remperature, 103.5°; pulse, 134. The tincture of
aconite and bromide of potassium have been administered at
regular iutervals, but without auy marked effects, either in
re<.luciug the pulse aud temperature, or iu mitigating the ner­vous
agitation antl restlessness. The uriue bas been care­fully
exawineu each day, ou the 8th, 9th aud lOth instants•
antl b.as uuiforwly preseuteu a clear light yellow color, resemb­ling
in all resvects this excretion in heal to. Under the micro­scope
it has contained a few granular casts, wilib. bacteria,
celis of torula and pP-nicillium aud very delkalie thread-like
bodies, Ulost pl'Obably ·a form of bacteria, also ruinute paP'ticles,
vosses~Siug a rutC:ttury or vioratory motion.
4 o'cloc.k., P. b'I. .Utllil'ium contiuues. Pulse 150; temperatu_re
ot axilla 104°. Uriue mo1·e scaut, but stillligl.lt colored. There
is a slight; increase of albUUleu.
9 o'clock, P.M. Pulse so rapid that itcau ~Scarcel;y be counted.
'J:he tem.peraliUre bas iucreaseu, but tlle patient is so restless
that it is diflicu1ti ~o determiue its exact lleigb.t; but it appears
to be auout lOoo 1u the axilla.
Applieu a blister 2 by 4 iuche:>, at the back of the head and
neck, ::overing base of brain aud roeuulla. oblongata. Tlle blis­wr
urew well, an<l there appMn~d to ue ~:>ome relief ut the deli­rium;
iu fact, for a :;lwrt tlWb before death, wh1ch occurred at
8, A. M., ou the moruiug of tile llth of August, the patient
was t;rltil:dy rational.
O<YTI'Ihnentary.-No local cat1se of disease could be discerned
in the bduk dwelling, nor on the pa.ved streets immediately
surrounding. The fiither of Mis.,; C. H., an iutelligenli and ex­verienced
druggist, iufurmeu me that from the first appearanoo
768 OrigtMZ Oomnumicatiom. fApril
of the fever in his neighborhood, about lhe 18th of .July, be
bad a<1ministered quinine as a prophylactic to both of his
daughters, and bad frequently disinfected bis house and prem­ises
with sulphurous acid gas, carbolic acid and per-manga­nate
of potassium. During the period of illness of the pre­ceding
cases, the range of the thermometer was high, as
shown by the records of the Signal tiervice, the place of ob­servation
being several degrees cooler than the bouse of Mr.
H., 363 Magazine street. Tbe maximum temperatures were,
according to tbe record of the Signal Service: July 23d, 920;
24th, 930; 25th, 92°; 26th, 910; 27th, 920; 28th, 910; 29th,
930; 30th, 880; 31st, 90o. August 1st, 980; 2d, 910; 3d, 890;
4th, 830; 5th, 880; 6th, 890; 7th, 910; 8th, 920; 9th, 920;
lOth, 890; 11th, 900. The thermometer io the sick room often
indicated a degree of heat exceeding goo, and never fell below
this point.
In the case ~nder consideration, the bowels were- well opened
in the commeocement of the disease; the treatment pursued
was conservati\'e, anrl the nursing of the most careful and
unexceptionable character. The cerebral symptoms were pro­minent
from the commencement and increased in Reverity to
the moment of death, a.nd appeared to be uninfinenced by treat­ment,
whilst the skin and kidneys responded to treatment.
This child and her sister were noted for their bright intellects,
and it appears that in both cases the force of the disease was
expended chiefly upon the cerebro-spinal system.
Oase 39, 363 Magazine street. J. 0., age 15, native of Indian
Territory; resident of New Orleans 10! years ; clerk in Mr.
H.'s drugstore. Attacked witb. paiu in head and back, fol­lowed
by fever.
August lOth, 6, A. M. Mr. H. administered at ouce 10
grains of calomel aucl 10 grains of the bicarbonate of soda.. I
saw this patieot at 8 o'clock, A. M., few hours after the onset
of the fever. Pulse 134; liE'mperature of axilla. 1040; 12 M.,
Pulse 134; tem [Jerature 104. Onstor oil was ad ministered 3
hours after the calomel a.ocl carbouate of soda, and produced
free purgation. .
August 11th, 9, A.M. Pulse 100; temperature t03.90; 4, P.
M. Pulse 102 ; temperature 102.20.
August 12th, 9, A. M. Pulse 9o ; temperature 101.no ; 12, M.
Pulse 104; temperature 102.20.
August 13th, 10, .A.. M. Pulse 86; temperature 100.40; 7, P.
M. Pulse 84; temperature 100.30.
~-
1879] JoNES-Y~llOlo Fever JJJpidemic of 1878. 769
August 14th, 10, A.. M. Pulse 78; temperature 99.60; 8, P.
M. Pulse 98; temperature 99.6.
August 15th, 8, A.. M. Pulse 86 ; temperature 99.20; 6, P.
M. Pulse 76; tempet•ature 99.50.
August 16th, 9, A.. M. Pulse 72 ; temperature 990; P. M.,
skin cool; patient entirely free from fever.
A.ugast 17, A.M. Pulse 70; temperature 990, This patient
is now 8itting up. Continued liO improve and recovered fully.
This case was treated by free purgation in the beginning, fol·
lowed by 10 grains of the sulpho carbolate of sodium dissolved
in orange leaf tea, every 4 boors. During tbe first four days
of the disease, little or no nourishment was administered. It
will be noted that there was no secondary rise of fever in this
case.
Oase 42. George F., age 30, native of West Virginia; has
been in New Orleans six mouths. Clerk in Mr. H.'s drug store,
363 Magazine street. On the 12th of August, as I passed
through the store to visit his companion, J. 0., suffering with
yellow fever in the second story of the sa.me house, I observed
that the face of Mr. George F. was flushed, aud that his eyes
had a glassy appearance and his countenance a care·worn and
anxious aspect. Upon examination I fonud tllat his skin
was hot aDd dry and his pulse accelerated. I persuaded him to
leave his duties in the drug store aud retire to bed.
5 o'clock, P. M. Pulse 124; temperature of axilla 103.50. I
bad ordered in the root·ning lO grains of calomel and 10 grains
of quinine, to be administered at once and to be followed by a
fluid ounce of castor oil in three hours. These purgatives have
caused a. free motion of the bowels.
August 13th. The patient has passed a restle~s uight. 9,
A.. M., face greatly congested; conjunctiva of eyes red;; tongue
furred in centre, very red at edges aud tip. Patient anxious
and very rest-less. Pulse 92, temperature of axilla 101.50. We
observe a decided fall both iu the pulse aud in the temperature,
which is entirely at variance with the Llleory tha~ iu tile early
stages of yellow fever the pulse descends while the temperature
rises.
7 o'clock, P. M., pulse 88, temperature 102.80.
August 14th, 10 o'clock, A.. M., pulse 88, temperature 103.90 ;
9, A. .. M., pulse 92, temperature 104.60, Tlris secondary rise of
temperature forebodes no good, and must be caused by sec­ondary
lesions, or rather by the aggravation of the primary
lesions of the heart, stomach, liver aud kidneys.
August 15th, 10, A. M., pulse 88, temperature of axilla
103.30, From the 13th iust. up to the present time, the patient
has been taking 10 grains of the sulpl.!o-carbolate of sodium
every 4 hours.
6 o'clock, P. M., pulse 92, temperature 103.50.
A ngnet 16th, 9, A.. M., pulse 90, temperature 102.20. 5, P.M.,
pulse 9o, teillpetature 103,40.
770 Original Oo11mvunicati<Jns. lApril
August 17th, 10, A. M., pulse 90, temperature 103.80; 5
o'clock, P. M., pulse 88, temperature 101.so.
During this day I suffered with fever and severe pain in the
head and back, and in the eveuing was compelled by the severity
of the fever (temperature of axilla 104.50, pulse 120) w surrender
temporarily the care of my sick. On tha13th, however, fonrdays
before my attack of fever, I barl pas:-ed, with the assistance of
Mr. H. the air of the various rooms of his house (363 Magazine
street), through crushed ice aud ice-cold water, and examined
the product tho~ obtained both microscopically and chemi­caUy,
and iujected the water into living animals.
I was informed by Mr. H. that this patient sank into a state
of utwr dejection, followed by delirium, in which condition he
died August 21st.
In this case the bowels were freely aud fqlly evacuated during
the first six hours, and the patient was faithfully and efficiently
cared for by Mr. H., his employer, and by the professional nurse.
Oase 43. Miss E. R., 363 Magazint~ street ; fifth case in the
bouse of Mr. H., druggist L age 20, native of PaRcagoula, Miss.
Attacked August 12th, 7, 1:'. M., with p~in in back of head and
extremities and loius, Md chill, followed by high fever.
Tfln gra.ius of calomel aud ten grains of quinine were ad min­istered
and followecl by castor oil in three hours.
9 o'clock, P.M., pulse 130, wmperature of axilla 104.30.
August 13th, 10, A. M. Pulse 104, temperature 104P. Inces­sant
nausea. Did uot retain the oil. Delirium. Appears to­be
unconscious of her situation; passe~:~ urine and excrements
in bed. Ordered tbe following: B... Quiuire sulph. grains xxx-tinct.
opii m. xv, acidi acetici m. \'i1 aqure uestillatre q viij. l
Mix: one-third by enema every 3 hours. Hot mustard foot
bath. Oold aft'usious to head and body.
7 o'clock, P.M. Pulse 130, temperatuL"e of a,xiiJa 1050. Or­dered
repetition of quinine enema, as betore, until 40 grains
are administered.
August 14th, 10, A. M. Pulse 102, temperature of axilla
105.50. Eighty grains of thl:l sulphate of quinia have been ad·
ministered by enema and have been retained, without any
percevtible eftect; it1 fact the temperature, so far from l>t~ing
reduced, bas risen from 1040 F. to 105.50.
9 o'clock, P. M. Pulse 96, temperature 1050,
August 15th, 10, A. M. Pulse 84, temperature 10305. Uri·
nary suppression. Have been able to obtain uo urine for
analysis. Black vomit. Patient has thrown up black vomit.
Skin presents a jaundiced hue. Groat congestion of capil­laries.
Eyes red and congested. 1.'ongue red at tip and edges,
1879] JoNEs-Yellow Fever Epidemic of 1878. 771
heavily coated with fur in centre. I expressed the belief that
this case would certainly terminate fatally.
6 o'clock, P. M. Continues to throw up black vomit. Uri­na.
r.v suppression also continues. Surface of a golden yellow
color. Can retain nothing npon sJOmach. Case hopeless.
Pulse 90, temperature 103:8o.
16th, 10 A.. M. Patient wholly unconscious. Uraemic
convulsions occut· at short intervals. Throws up black vomit,
and also passes dark, foul, altered blood by the bowels. Sur­face
of a (leep golden color. Extremities and dependent por­tions
of the body mottled from ca.pillary congestion. Features
present a swollen and stolid appearance. A disgusting and
foul odor surrounds the unfot·tunate patient. Died at 4 o'clock,
P. M. After death the body presented a deep golden color,
the dependent portions being purplish and mottled.
Oommentar-y.-This case rushed forward to its conclusion
apparently uninfluenced by treatment. Quinine by the rectum
and also by the surface in the form of liniment, as well as the
sulpho carbolate of sodium and cold affusions, did not abate
the severity of the symptoms or the height of the fever.
EXPERIMENTS UPON THE AIR OF THE SICK ROOMS IN THE HOUSE
NO. 363 MAGAZINE STREET.
As we have just shown by the records of the cases treated,
of five cases fonr oorminated fatally. During the entire period
of the continuance of these cases, the temperature, both within
and witont the house, was high. Thus, continuing the record
from the date of the death of Miss C. H., we have the follow­ing
figures as representing the temperature as rendered by the
Signal Service at the Customhouse: August 11th, goo F.; 12th,
890; 13th, 900; 14th, 890; 15th, 9LO; 16th, 840; 17th, 880;
18th, 90; 19th, 91 o; 20th, 920; 21st, 930; 22d, 94,0 ; 23d, 91 o;
24th, 910.
The average maximum temperature for July was 900 F.;
the average minimum temperature 77.50; the average daily
range 12.4o; mean height of the barometer 29.958; the mean
relative humidity 83.8 ·
The total rain fall 5-66 inches. For the month of August,
the mean maximum temperature was 89.14; the mean minimum
76.80; the mean daily range 130; mean height of barometer
29,954 inches; relative humidity 72.3; totally rain fall 4·77.
2
772 Origina£ Oomrwunications. (April
The mortality during this period in the entire city was also
heavy, being as follows: For tht> week ending August 4th.
Deaths from yellow fever 49, total dea.ths from all causes 176.
Week ending August 11th. Yellow fever 74, all causes 206.
Week ending August 18th. Yellow fever 185, all causes 315.
Week ending AuguRt 25th. Yellow fever 308, all causes 493.
Total for the period stated: Yellow fever 616, all causes 1190.
Impartial judges will admit that this was a suitable location,
in the heart of the infected district, and a suitable season, to
condense and eumine microscopically and chemically the yel­low
fever atmosphere. The air of the rooms occupied respec­tively
by Mr. H. as a sleeping apartmeut, and in which no ca.se
of fever or other illueRs b.at.l occurred, and by Miss R., Mr. D.
and Mr. 0., was passed through ice and ice cold water on the
13th, 14tb. and 15th of August. A.bout 600,000 cubic centi­metres
were passed through the ice a.ud ice cold water in each
room. It is worthy of note that two deaths had occurred in the
room occu!)ied by Miss R. Tlle air was subjected to tb.is treat­ment
both at night and during the day.
A marked difference was observed between the water of the
melted ice from the large front room of Mr. H.'s house and
the three small side roomtt of the wing of the brick
house facing Thalia street. . The water from the front
room was perfectly transparent, whilst that from the yellow
fever rooms presented a turbid, milky appearance, and let fall
a considerable deposit.
When the water from the yellow fever rooms was ~:~ubjected
to microscopical examination, the follow:iug ~xtraneous mat­ters
were observed :
1st. Numerous minute particles, many of which had a vibra­tory
motiou. Under a magnifying power of 420 diameters,
with Beck's best 1-5th of an inch (a superior glass of excellent
uefi.uiug vower) these appeared as minute oval specks. Under
!-18th of au inch (1050 diameters) these particles were resolved
iuto distinct oval cells witll a central nucleus, resembling in all
respects the spores of delicate fungi.
2d. Bacteria and delicate tllread-like filaments, similar to
those observeu in the urine and in the blood of yellow fever.
1879] JONEs-Yellow Ftroer JlJpidemic of 1878. 773
3d. Revolving minute animalculm and spores, with active
rotatory movements.
4. Minute particles which could not be resolved into distinct
structures by the highest powers. When magnified 1050 diam­eters,
these resembled mere specks of matter, many of which
have an active vibratory motion.
5th. Epithelial cells.
6th. Particle!:~ of dust evidently inorganic in their nature.
7th. Oil globules. As the patients were well rubbed with
olive oil the oil globules may have in part beeu derived
from this source; but as oil increases in the blood and in cer­tain
organs, as the liver, heart and kidneys, during the progress
of yellow fever, I was disposed to refer a portion of the oil
globules to the diseased bodies. It is possible that oil might
be exhaled from the pulmonary surface in small quantities
during the progress of the disease.
8th. Hairs and particles of cotton and sheep wool from the
clothing and bedding of the patients with numerous adherent
spores.
When the liquid from the yellow fever rooms was evapo­ratheu,
a distinct deposit was left in the watch glasses and
upon glass slides, which, in addition to tl:e various organic
substances Apecified, contained numerous l!tellate and accic­ular
a.nd prysmatic crystals and granular particles. The crystals
appear to be those of the chloride and carbonate of ammonia.
Reaction of water slightly alkaline.
The presence of vrganic matter was still farther shown by
the usual chemical tests, as charring by heat, blackauing IJy
sulphuric acid, and decoloration of the solution of the per-man­ganate
of potassa.
When glass slides were moistened with ice cold water and
held so aa to receive the breath of yellow fever patients in
respiration, the microscopicai examination yielded results sim­ilar
to those recorded above.
After the most minute examination of the individual speci­mens
from the different rooms in Mr. Harrison's bouse, not
only immediately after the experiments, but also during various
periods, embracing nearly six months, I discovered uo forms
which could be referred to such microscopical plan:ts as
774 I April
the Oblorocoooum vulgare, Protococcus viridis, Palmella cru­enta,
Coccochloris brebinonii, antl other confervoidem, or unicel­lular
algm capable of producing clllorophyl. Certain granular
cells observed iu malarial fever (iu the blood), resemble most
nearly the restiug spore of Bnlbochmte intermedia, and the
granular cellt.1 of PalmeUa cruenta; but no such cells were ob­served
in the yellow fever atmosphere in the brick house 363
Magazine street. In fact it would be difficult to conceive how
the algm of any description couJc.l thrive and multip!y in this
well paved anc.1 dry situation. The forms were referable to those
most nearly connected witll putrefaction aud fermentation, as
the Bacteria and Torulm, Penicillins and Micrococci a.ud Oryvto­coccem.
Kutziug includes his geuera Cryptococcus, Ulvina and
Spbmrotilus, amongst the families of algm, but they apvear to
be the conidia (reproduction cells, stylospore~ and spermatia) of
the myceli<~ of"mildew tungi. The a.bst~uce of auy ut' the kuown
forms of the algm in the air of yellow fe~er collected m this
locality, which is as tree from any source of swamp malaria as
the best drained and pavel.i portious of the city of New Orleans,
is important in that this class of plants is thus excluded from
the consideration of the questions rt:llatiug to tile origin anu
causation of yellow fever.
EXPERIMENTS UPON LIVING ANIMALS WITH THE WATER,
THROUGH WHICH lHE YELLOW FEVER Al'MOSPHERB HAD
BEEN PASSED, IN THE BRWK RESIDENCE, 36a MAGAZINE
STREET.
The liquid obtained by passing the air ot' the rooms in wbtcll
the yellow fever patit~uts lc.~oy tllrougb ice a.ud ice-cold \Vater,
was conveyed immeiliatt:lly ro wy la.uoratory, auu iujecteu sub·
cutaneously iuto eleven rabbits anu into two ptgeous. ln
several of the raul>its the water was iuj~cted directly iuoo 'he
blood, through the large vessels ot" tile ears. lu tlle pigeous,
the liquiu was injected into the pectoral muscle. No rabblt
was destroyed by these procedlll'es, although abscesses formec.l
iu several places in uifterent auimals, iu the neigbuurhood of
the points of injection, aud in such instauoes the animal!! mani­fested
febrile phenomena. A pregua.ntfemalerabbitgave birth
to folll' living rabbits several days a.foor the experiment.
,.
1879] JONES-Yellow F~er Epidemic of 1878. 775
The mother appeared to have no milk, and although we
attempted to rear the young ones by artificial means, they per­ished;
the mother, however, survived and is l!tillliving and bas
since given birth to thirteen ra.bits, seven at one time and six
at another.
One of the pigeons was killed by a cock in my yard, about
ten days after the injection of the "yellow j~er water" into the
left pectoral muscle. Upon dissection, I found the pectoral
muscles on the left side to be atroJJbied and iu a state of acute
fatty degenerativn. 'Upon microscopal examination I found
that some of the fibres of the blanket covering the yellow fever
patient bad been injected along with the water into the pectoral
muscle.
Two views may be taken as to the effects produced upon this
bird.
1st. The fibres of the blanket acted as a local irritant, and
induced degeneration and atrophy of the muscula1· tissue.
2d. 'l'he granular matter aud spores of the yellow fever
atmosphere induced chemical changes in the muscular struc­tures,
which were converted into oil.
The latter supposition is at lea:$t worthy of consideration, as
the yellow fever poison iuuuces rapid fatty degeneration of the
heart, liver and kidneys. It ill also worthy of note, in this con­nection,
that the grauular matter possessiug active motion, as
well as the sporules, of the yellow fever atmosphere, are found
in greatest a.bundauce adhering to the fibres ot cotton and wool
condensed in the water.
The other pigeon was killed at tl.le end of two weeks, and
found to be healtiJy.
n. SECOND GROUP Ol!, CAI:l~S, 46 SOU'l'H VILLERE STREET, 44
SOUTH VILLERE STREET AN.D 47 ROBINSON STREET.
Oase 27. Thomal! S., native of New OrlN~us, age 20. Was
attacked July 31st, in tile u.oruiog, with pa.io in tbe head aud
back, followed by fever. 1 Sll.W tiJis pa.tieu t; at 4 o'clock, P. M.;
pulse 104, temperature of axilla 1020 ; ordered oue fluid ounce
of castor oil, hot musta.rtl foot ba.tll, aud orange leaf tea.
August 1st, 4 o'clock, P. M. 1.'tJmperature ·lf axilla. 990,
pulse 74; tongue red at tip aud edges, coa~<l in centre, skin
oatlled with perspiration, gums red a.ud spongy, continued
orange leaf tea with barley water for nourishment, olive oil
frictions.
•
•
776 Original Oommunications. [April
August 2d, 10 o'clock, A. M. Temperature 990, pulse 64;
great muscular and nervous prostration. August 3d, 10 o'clock,
A. M., temperature 990, pulse 72. August 4th, temperature
990, pulse 70. Improving, orrlered chicken tea. Capillary
congestion of face and conjunctiva of eyes well marked.
August 5th, pulse 6(). Augusli 6th, pulse 58, slow and regular,
great prostration. August 7th, 10 o'clock, A. M., pulse 50.
August 8th, pulse 56, patient setting up. Recovered.
The preceding case is a type of the cases as they frequently
occurred in adult natives of New Orleans, iu whom the fever was
attended without any secondary lesions, or elevations of tem­perature.
In many of these cases a purgative in the first stage,
together with orange leaf tea, olive oil frictions and warm foot
baths, absolute rest in the recumbent position and absolute
diet, were the only remedies employed.
Oase 22. S. J.P., No. 44 South Villere street. Age 36, na­tive
of Mississippi, resident of New Orleansll years. Attacked
with pain iu head and back and chill, followf'd by fever.
August 3d, !878, 1 o'clock, P. M. Saw the patient first August
4th, 1 o'clock, P. M.; had taken three doses of castor oil, pulse
rapid, skin hot and dry, higb fever. Angu~:~t 5th, patient rest­less,
anxious and prostrated, tongue red at tip and edges, and
heavily coated in the centre; pulse 68, temperature of axilla
1010. August 6th, pulse 80, skin hot aou moist. August 7th,
11 o'clock, A, M., pulse 76, skiu warm and moist, fever. August
8th, 11 o'clock, A M., pulse 74, temperature 100°. August
9th, pulse 80, temverature of axilla 102°. August lOth, pulse
72, temperatme 103.!&0. August 11th, pulse 58, temperature
10o.so. August 12th, pulse 60, temperat.ure 100.50. August
13th, pulse 50, temperature 99.5°. August 14th, pulse 70,
patient convalescent and ~:~etting up. Recovered.
During his illuess there was great muscular and nervous
prostration, and at time$ the pulse was intermittent. This
patient was treated by quiuiue injections per rectum (teu
grains every 4 hours, on the 7th and 8th insts.), bot mustard
foot baths, orange leaf tea, light diet (barley water and chick­en
and beef tea), absolute rest in bed, sweet oil frictions.
Bowels were kept opeu by enema. Iu this case, as in many
others, there was a greali accumulation of gas in the intestines
wbich often embarrassed t·espiration, aud produced great op­pression
and ncce::>sita.ted the use of stimulating enema., in
which tincture of assatoo~ida. and oil of turpentine were
employed.
Case 19. G. F., male, 47 Robertson street, directly in the
rear of 46 Villere street. This house adjoined the one iu which
the first cases upon the street died, to which we have alluded
in the first 1ectQre on yellow fever (January 8tb, 1879). At-
1879] JoNEs-Yelloto Fevqr Epidemic of l87g. 777
tacked with yellow fever August 1st, 9, o'clock, A. M. ; 102-,
o'clock, A. M., pul~e 146, temperature of axilla 1010. The
bowels were freely moved by calomel and castor oil. August
2d. Pulse 120, temperature of axilla. 1000. Great capillary
eongestiou. Conjunctiva congested. Tongue red at tip a.nd
edges and coated iu the cen t.re. Gums red. August 3d.
Pulse 120. tempera.ture of axilla. 1010. Have ordered 3 grains
of sulphate of quiuia. to be repeated 3 times this day, and also
upon the succeeding day. August 4th. .Pulse 116, tempera­ture
1000. Has some appetite <tud asks for sometbiug to eat.
August 5th. Pulse 108, temperature 1000. August 7th. Pulse
94. August Stb. Pulse 108 io sitting posture. Oouvalesceut.
Recovered.
Oase 20. J. J. T., wale, age 4 years, 47 Robertson st.rE>et,
outive of New Orleaus. Attacked with fever August lltb, 2
o'clock, P. M. At this time rapid pulse with considerable
febrile heat. A.d1ninistered two grains ea.ch of calomel nud qui­nine,
to be followed with castor oil in 4 b 1urs. The fever rose
rapidly and the child appeared to be threatenerl with convnl­sions.
The father applied to the resident surgeon of the Char­ity
Hospital at 8 o'clock the next moruiag, August J2tb. Dr.
Pratt states that at this time thP temperature of the cbild was
104.50. He applied the ice bath to tile surface. The body
was rubbed with ice and ice was tll)l)lied to the bead. These
measures reduced the temperatnt·e, ao<l at 1.0.30 o'clock, A. M ..
two hours after tile application of the ice b:-~.tb, [ found the
little patient with a pulse of 160, tem1>erature of ftxi lla 101.50,
comatose, congestion of capillaries of extremities, which felt
cold to the touch. Urinary suppression. August 13th. Un­conscious;
moves the head from side to side. Has passed no
urine; bladder empty. Pulse 1381 temperature of axilla 102.5o.
Blister to base of cranium a.ud over regiou of medull~t. oblon­gata.
Mustard to extr~mities. Died <Lt 6 o'clock, P. M.
Oase 21. M. F., female, 47 Robertson street, age 2 years.
August lltb, 2 o'clock, P. M. Fever, ordered castor oil as a
purgative. The fever rose rapidly at about 5 o'clock, P. M.
At 8 o'clock, P . .M., the little patient was seized with convul­sions.
The nearest pby~icia.u. the resident surgeon at the
Charity Hospiool, was tmmmoaed. He fouod the temperature
of the child to bt~l07.5o, and placed the child io a bath of ice
cold water aud kept tile little patient there\ aoout one hour, and
at the end of this time the thermometer nuder the tonglle iucli­cated
only 980 F. Consciousness appeared to be temporarily
restored by the ice bath, but the child died at 2 o'clock, A.
M., about 5 hours after the application of the ice cold water.
The next morning I found the corpse of a. yellow color, with
deep purplish congestion of the capillaries of the dependent
portions of the body.
778 Original 001wmunications. fApril
Tile two preceding cases clearly illustrate the fact. that the
febrile hea.t is not the disease in yelloto fever, and that its reduc­tion
even to the standard of health, does IMt neoe.~sari/y .9eoure a, fa­vorable
result.
Oase 26. J. N., male, 46 South Villere street. Age 6, native
of New Orleans. Attacked August 4th, 10 o'clock, P. M., with
chill, pa.io in he;\d, Oj\,Ck and extremities au cl fever. Adminjq.
teretl 5 graius of calomel and 5 gL'.,ius of sulphate of quinia,
followed by castor oil.
August 5tlt, 10 o'clock, A. M., pulse 120. August 6th, 11
o'clock, A. M., pulse 112. Aug.1st 7th, 11 o'clock, A. M.,
pulse 110. August 8th, 11 o'clock, A. M., pulse 108. August
9th, 11 o'clock, A. M., pulse 108. August lOth, pulse 92.
August 11th, pulse 90. AugulSt 12th, pulse 84. August 13th,
pulse 90. August 14th, pulse 82. August 15th, 82. Recov­ered.
Oase 28. 0. S., female, 46 South Villere street. Age 8, na­tive
of New Orleans. Attacked with chill, pain in bead and
back and extremitie::~, followed by m<\rked febrile heat, August
5th, 2 o'clock, P. M. August 6th, 11 o'clock, A. M., pulse 164,
temperature of axilla 1020. Administered 5 grains of calomel
and 5 grains of sulphate of quinia, :\Ud followed with castor
oil in three hours. Threw up the powder, but retained tl.te cas­tor
oil.
August 7th, A. M., pulsA 148, temperature 1000. August
8th, pulse 112, temperature 1010. august 9th, A. M., pulse
120, tempemtut'e 1030, August lOth, 1 o'clock, P. M., pulse
1114, temperature 103.20. August 11th, t>ulse 102, temperature
102.50. During the past three dR.ys (commencing Aug. 8th),
have administered 2 grains of quiuia every 3 hours, until 6
grains were taken each da.y. This treatment was repeated
on the 9th and lOth of August, and on the lOth, administered
oue-half drop of the tint:ture of acouite root and 5 grains of
the bromide of potassium every 4 hours. Frictions of olive
oil have been useu up to the present time, also sweet spirits of
nitre and ora.uge leaf tea b ~ve been administered at regular
intervals. The quioia has had no effect upou the temperature.
August llltb, pulse 104. temperature 103.20. August 11th,
pulse 102, temperature 102.50. August 12th, pulse 100, tem­perature
101.80. Angut>t 13th, pulse 102, temperature 102.20.
August 14tb, pulse 102, temperature 1020. August 15th, pulse
92, temperature 1010. After the latter date, the improvement
wati marked and progressive, and the patient recovered en­tirely.
This was an obstinate case, the fever continuing eleven
days without intermission.
Oase 29. J. S., m<~le, age 16, 46 South Villere street. At­tacked
August lOth, 6 o'clock:, A. M., pulse 140, temperature
of axilla 103.50, Administered 10 graius of calomel and 10
l87!J) JONES-Yellow F(fl)er Epidtmtic of 1878. 779
grains of quima, and followed with castor oil iu 4 hours. The
fever continued nt> to tlle close of the 11th. August; 12th;
pulse 74, temperature 99.50. August 13th, pulse 70, tempera­ture
99.5°. ·August 14th, pulse 54, temperature 9!).50. August
15th, puis~ 52, temperature 98.20. From the date of the last
obsen' ation, the patient continued to improvE~. Recovered.
Oase 30. M.A. S., female, age 11 years, 46 Sooth Villere
street, nati,·e of Ne'v Orleans. Attacked witll fever, August
12th, P. 1\f. Twelve grains of calomel and 12 grains of the
carbonate of soda Wt!re administered, which produced but
slight etJects upon the bowels.
August 13tl1, 12 o'clock, M., pulse 156, tewpera.ture 1030,
skin uot aut! dry, t.ongue very red at tip aod edges, bot heavily
coated with for in the centre. August 14th, P. M., pulse
108, temperature 101.20. August 15th, P. 1\I., pulse 102, tem·
perature 1010. Quinia, 2 grains every 2 hours until 8 grains
were takeu during the day. Recovered.
EXPERTh1ENTS UPON TErn AIR 01!' THE SICK ROOMS AND IN TilE
YARD OF 46 SOUTH VILLERE STREET.
'l'ba air of the rooms in which the patients sui:lAred witll
yellow fever, also tllat obtn,iued from the ueighborbood of a.
foul stinking gutter in the yard of 46 S. Villere street, wllich
also acterl as a surface tlraiu to the surrounding houses, was
subjected to the same treatment, as in the residence 363 Mag­azine
street, 400,000 cubic centimetres of ait·, iu each of these
sick rooms, containing fou1· cases, were passed through crushed
ice nod ice cold water, uuriug tile <lay, and a! so at midnight;
600,000 cubic centimetres of ai1· were at midnight treated in
tile same manner, tbe bellows baing Lleld over th11 foul drain
iu tile yard. Total amount of air tuns examined at the locality
1,800,000 cubic ct>ntimetres.
The air from the sick rooms presented the same elements as
were observed iu the precetling experiments on Magazine street,
with the addition of several colored cells which evidently
belonged to the pla.uts, resembling the chlorococcum vulgare,
protococcus viridis and palmella. crueuta. The true characters
of these elements were fully shown by examinations of the
water, at ~arious points cxteudiug over five months, during
which time the cells increased considerably in size. The most
numerous elements were as in tile case of the water obtained
(
780 Original Oammwnicatwna. (April
from the siolt rooms at 363 Magazine street, minute spores,
minute threadlike bodies, bacteria, and miunte granules which
could not be resolved by the highest powers into auy tlistinct
animal or vegetQble structure, epithelial cells, oil globules,
several parasites from the skiu, aud fibres of wool and cottou,
and particles uf dust were also observed under the microscope.
The crystalline bodies also appeare1l \Vhen the liquid was slowly
coagulated.
The water through which the air over the foul gutter was
passeu contained chiefly cells of the plants resembling the
algae, as the testing spores of Bulbochrete iuterwedia cbloro·
coccum vulgare protoccus 'dridiR and palmella cruenta. Bac-
. teria. and minute spores a.url minute particles were also
abundant.
When the Wcl.ters obtaiucu iu the wannot· stateu from this
locality were injected subcutaneously into living a.uima.ls, the
results were similar to those previously detailed.