Comparative pathology of malarial and yellow fevers.

              [owinnn Stnte Ilniumity - iilc~ica[ a:ltnter
FIRST AID ADVICE.
Rules to Be Observed in Yellow Fever and sug•
gestions as to Treatment of Patient.
Sanitary Treatment of the S ick Room.
1.-Place uoder mosquito bar aud J;eep patient so p1·otected from
mosquitoes during the day aod oight for three full days, so as to prevent
infection of mosquitoe».
2.-Screen openings of the room, doors. windows, transoms, etc.
3.-Fumigate room with su lphu1· to destroy possibly infected mosquitoes
as early as possible after fourth day of fev<>r.
Sanitary Treatment of Neighborhoods to Prevent Spread
of Fever from Cases Introduced.
Destroy the only vehicles of infection-the stegomyia mosquitoes.
Pour into each cistern a cupful or kerosene or insurance oil, and if the
cistern be not screened repeat this every week. Pour oil from several
points so as to spread it.
Pour oil to covet· sudace of every collectioo of water not stocked with
fish or removable by draioage.
After thus cutting off the source of supply, fumigate all rooms to kill
adult mosquitoes.
Sulphur burned in an iron pot is the surest way, and if used in p rope1·
:J_uaotity will not injure fabrics or colors. One pound to au average room
is sufficient if room be closed, and one hour is long enough in ordinary
cases. The fumes of sulphur will not remain loog, a nd household ammonia
sprinkled about the room will hasten their departure. Sulphur candles
for fumigation are sold by druggists.
The fumigation may be done in the morning and the 1·oom will be free of
odor by n ight, and it should be don~ preferably in dry weather. Do not
neglect the downstair;, rooms in two·story houses.
Other methods of fumigation may be adopted, such as burning of py­rethrum
or insect powder, which is not unpleasant, or the ''olatilizing of
liquid chemical preparations, or the spraying of liquids prepared for the
purpose, but sulphur is the most certain in results.
Yellow fever is not a filth disease, and ordinary sanitary cleaulioess
is not effective against it. The removal of filth is commendable at all
times, but for the preventioo of yellow fever is energy misdirected. The
removal of mosquitoes for this purpose is energy scieutifically applied.
Treatment of tbe Patient.
Medical treatment should, whenever possible, be directed by a phy­sician,
but when a physician is not immediately available the following
points in treat111ent should be kept in miod:
To 1·elieve headache and fever cold appli cations to the head may be
employed.
To promote action of skin, cover with blanket and give bot foot bath,
with or without mustard. T o encourage action of kidoeys, g h'e water to
drink at frequent intervals and in small quantities. Use alkalin waters,
vichy, seltzer water, etc. Give watermelon juice. To allay nausea, give
small pieces of ice to dissolve in mouth.
Do not give solid food of any kind during several days, and feed on
milk, principally. An etnpty stomach is better thao a disturbed one, and
food will not nourish unless digested. The patient will not starve.
Keep in bed and do not allow patient to s1t up. The main part of the
treatment of yellow fever is to avoid doiog harm.
Get a doctor as soon as possible, and expectfrom him much advice and
little medicine.
QUITMAN KOHNKE, Health Officer.
·"
.Ab
(omparntlve Pathol
BY J0!-3 M.IJ.
(
Louisiana State Medicat Society.
58818
22
51
tric and intestinal juices and excretions and morbid products;
9th, chemical and microscopical exam.inatwn of tlte various
organs and secretions as the bile 1 lOth, post-mortem observa­tions
of changes of temperature; lith, post-mortem examina­tions,
embracing· accm·ate detaila as to the physical, chemical
and microscopical characters of the solids and fluids ; 12th, pre­vention;
13th, prophylaxis ; 14th, treatment; 15th, relations
of symptoms, pathological chemistry and pl.Jysics, and patho­logical
anatomy, to analogous condition~.; and changes, in related
and diverse diseases.
Even if the investigation~ as to tlte uatm·e, causes and treat­ment
of malarial and yellow fevers, were ~.;o far advanced al) to
admit of the widest and most positive generalizations, time on
the part of the speaker, aud patience on the part of the hearer
would be wanting upon the present occasion; and we shall
content ourselves chiefly with the presentation of such results
of om· investigations as bear upon the following points :
1st. The history of yellow fever, moreespeciaJlyinLouisiana.
2d. Relations of the yellow fever as it prevails in Louisiana
to climate. .
3d. General outline of the symptoms and pathological anat­omy
of yellow fever.
We shall endeavor to illustrate each division of our subject
by comparative observations on malarial fever, and by actual
demonstrations with pathological specimens, microscopical ob­jects,
colored drawings, and tabulated statements. We do not
desire to btu·den this Association with the charge of this mass
of material which •vill find its proper place in the 2d volume of
my Medical and Surgical Memoirs, which will 1·elate chiefly to
the fevers and diseases of our Southern States. In sanitary
science as well as in l)Olitical history we can form a correct
estimate of the fhture, only by a careful study of the experience
of the past; and hence all that relates to the past history of a
terrible scourge which ha-s upon several memorable occasions,
and more especially during the past year carried terror, suffer­ing
and death, far into the interior of the North American Oon­tinent,
should command the attention of the medical profession
as the natural guardia.DS of the public health. The early his­tory
of yellow fever in New Orleans, is of Sf)ecial interest, not
merely to this State and country, but to all other civilized na­tions,
as she is the grand emporium of all the va-st tracts trav­ersed
by the Mississippi, the Missouri, aud their tributary
streams, and enJoys a greater command of intemal navigation
than any other city of either the old or new worlcl. The
Mississippi drains the greater llart of the territory of the
United States lying between thl:l Alleghany and the Rocky
Mountains; its basin more than equal in area to the whole
Continent of Em·ope, exclusi•e of Russsia, Norwa.y and Swe­den,
is greatly diversified in soil, in climate and iu produc­tions,
and opens to commerce more than 20,000 miles of nav.
igable rivers, all tributary to the great Mississippi.
52 .A.bstrMt of Proceedings
No city in the world bat> suffered more obloquy than New
Orleans, in relation to health, and more especiaUy in regard to
its oft' recurring epidemics of yellow fever. It would not be
beyond the boUllds of truth to affirm, that but for this American
scourge, New Orleans, even at this clay, would have exceeded
, every other city of America, as well in the magnitude of its
imports as of its exports. If by the application of all the facts
known to science, the sanitary condition of New Orleans can be
:so far improved as to exclude yellow fever, it is not unreason­able
to believe, when we consider tbe boundless extent and
extraordinary fertility of the basins of the Mississippi and
Mi.:ssouri, that New Orleans is destined to become the great
emporium, not of America only, but of the worlcl. Even at the
present day, she holds commercial relations with almost every
maritime nation and large city of the globe; and as the repre­sentative
and port of this mighty valley, her health and
prosperity is not merely national but cosmopolitan.
Yellow fever in its origin and spread is governed by fixed
laws, which have their origin in the constitution of the physi­cal
universe, and the great question of quarantine must be
discussed and it.s value determined by the adaptation of its
regulations and restrictions to the natural history of the
disease.
MALA.RIA.L FEVER. HISTORY.
It is probable that the various forms of paroxysmal, marsh
(paludal), or miasmatic fever, were coeval in their origin and
prevalence with the oecupation of tropical1 sub-tropical and
temperate regions by the human race. Tne cause of these
fevers appear to have existed from the time of the advent of
the human race on this globe. Accurate descriptions of inter­mittent,
remittent and pernicious malignant fever.!!z. are found
in the earliest medical writers, from the days of l.lippocrates.
And numerous facts recorded in every age, show that countries
are unhealthy in proportion to the quantity of marsh or un­drained
alluvial soil which they contain. It has been observed
for ages that the mortality of countries is st>.riously influenced
by the condition of the soil, the elevation and the temperature.
In former times, l:iefore the introduction of bark and quinine,
the ruortality was in low marshy situations, as high as 1 in 15
of the inhabitants, whH:st in more healthy and elevated coun­tries,
it did not average annually, more than 1 in 40. The
connection of intermittent and remittent fevers with warm
moist climates and marshy, swampy ill drained and badly cul­tivated
countries, is well established by the histories of Rome,
Italy, France, Germany, Holland and England, and of the
United States. The experience of these countries have estab­lished
the great fact1 that drainage and agriculture sensibly
reduce the number of cases of this disease; whilst the neglect
of drainage and agriculture sensibly increases the number and
severity of the cases.
Louisiana State Medical Society. 53
In the Southem States, especially in North Carolina.) South
Carolina and Georgia, the inhabitants suffered severely from
the gravest forms of malarial fever, during the clearing of the
dense virgin forests. With impro-v-ed ch'ainage, and the exten­sion
of agriculture, these forms of malarial fever have to a great
extentdisappea1·ed, autl been replaced by typhoid feYer. During
the recent civil war, 1861, 1865, when immense bodie::; of Con·
federate troops were assembled along the low marshy and
swampy borders of the Southern States, malaria produced
destructive and disa.strous effects, not only destroying many
lives, but aJso permanently impairing the constitutions of
the soldiers. At th<• same time it is well lmown that yellow
fever wa-s absent from the southern armies, limited epidemics
and sporadic cases occurring only a.t Charleston, Wilmington
and Norfolk and New Orleans.
The sudden liberation of the slaves, and the subYersion of
the political and agricultural system of the Soutl.L, at the close
of the war, caused the abandonment of many well cultivated
and thoroughly drained est.'ttes, and to this cause chiefi.y, must
be attributed ·the prevalence since the war of that severe and
fatal form of malarial fever, attended with severe jaundice and
hremonaghes known as hremorraghic and brematuric malarial
fever.
Malarial fever is an endemic of all warm climates. It has
its base within the tropics and extends northwards till it is ar­rested
by decreasing temperature. It is very prevalent in the
West Indies, Ea.st Indies, India, China, and along the southern
coastofNorthAmerica, and within theMississippi Valley, whilst
it is almost unknown in Nova Scotia and in the Ne\v England
States on the Atlantic sea-board. In Europe ague is endemic
on the coa-st of the Gulf of Bothnia, beyond latitude 620 north.
In the interior valley of North America., intermittent fever is
the prevailing malady. From its occurring constantly within
the tropics, but ceasing far south of the Polar circle, it appears
that a high temperature is a condition neeessa.ry to its produc­tion,
but this can only be considered as an exciting cause. It
is found that a summer temperature of 600 is necessary to the
production of the fever, and that it will not prevail as an epi·
demic when the temperatm·e is below 650. It therefore occurs
in winter at places where the season has a mean temperat-... .re
of 60° or upwards, as at Vera Cruz, Tampico, Havana, aml iu
uerta.in winters in New Orleans. But at this latter place, and
generally undel' the 30th pru:allel, where tlle mean winter tem·
peratru·e is un<.ler 500 F., the fever is SUSJ)eucled. At New
Orleans the necessary heat exists for 9 months of the year,
March to November; at St. Lou:is 5 months, May to Septem­ber;
at Montreal 4 and Quebec 3 months. A continuance of
a heat of more than two months, a beat equal to 6oo, is neces­sary
to its development; here it prevails more in October than
April, though their mean temperatures are nearly the same,
and the greatest prevalence of malarial fever iu every latitude
is generally some weeks after hottest months of the year.
Abstract of Proceedings
YELLOW FEVER IDSTORY.
Yellow fever with syphilis have been regarded as strictly
American diseases, the medical history of which do not ante­date
the discoveries of Columbus. With reference to the latter
disease, my explorations of the mounds ancl stone-graves of the
Mississippi Valley have established the important fact that
undoubted marks of syphilis are to be found in the diseased
bones of the aborigines, whose remains antedate the advent of
Europeans on the North American continent.
After a critica,J examination of the works of Herodotus,
Sti·abo, Justlli, Cornelius, Nepos, Euti'opius, Plutarch!. Titus
Linns, Thucidides, Homer, Sallnst, Virgil, Floresl... Vauerius,
Particulus1 Cresar, Horace, Cicero, Xenophou, and Tacitus, we
have failea to recognize the disease now called yellow fever,
in any descriptions of particular plagues or allusions to
any pestilence; a,ud in like manner, whilst in the writings of
the nnddle ages we have descriptions of wide-spread and mortal
plaguesi amongst which may bo recognized the oriental glau­uular
p ague, small-pox, measles, typhus and typhoid fevers,
the sweating sickness1 elephantiasis or leprosy, cholera, dysen­tery,
and cerebro-spmal meningitis; yellow fever finds no
place in these annals of general history, or of medicine, previous
to the discovery o:f America by Columbus.
WAS YELLOW FEVER KNOWN TO THE ABORIGINES OF AMERICA
BEl~ORE ITS DISCOVERY BY COLUMBUS t
As we have failed to fiud any history or record of yellow
fever before the voyage of Christopher Columbus, the ftrst
question of importance which presents itself is, whether yellow
fever bad ever prevaileu among the aboriginal inhabitants of
North aud South .Amelica and the West Indies previous to the
discovery of .Amelica and the explorations of the Spanish
adventtu'e1·s, and the establishment of the Spanish, French,
Portuguese, Dutch and English colonies Y
The West Inilia Islands and certain portions of North and
South AmericaJ... as the Valley of the lVI:ississippi, Mexico, Central
America and .t:'eru appear to ha,~e been, at the time of theh·
discovery by Europeans, peopled with a sufficiently dense popu­lation
for the existence of those conditions upon which the
origin and spread of certain diseases depend. The wholesale
destruction of the native population by 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 whicb 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 rap1d disappearance of the
royal families and priests who were, as in ancient Egypt, the
custodians of the national science and art, have involved in
l55
obscurity many subjects of great and lasting interest to the
medical historian.
The medical historian bas ouJy imperfect and doubtful data
upon which to found any opinion as to the nature of the
epidemic at)d contagious diseases which afflicted the aborigiMR
previous to the discovery of the Western hemisphere.
That the more populous nations of America were not exempt.
from dist>ases of an epidemic and pestilential nature, has been
well established.
ANALOGIES BETWEEN THE MEXICAN PESTILENCE MA.TLAZA­HUATL
AND YELLOW FEVER.
The pestilence called by the Mexicans " Matlazahuatl" deso­lated
tbe cities of the Toltecs in the eleventh century, and
forced them to abandon Mexico, and to continue theii· migra­tions
southward, and to the west and northwest; it invaded the
populous cities of Central America, and a silnilar disease com­mitted
great ravages amongst the Indian tribes which occupied
the country between the mountains and the Atlantic coast ~b
few years before the lauding of the Pilgrim Fathers.
Tlle Matlazahuatl, a disease closely resembling yellow fever,
but which is said to be peculiar to the Indiau race of .America,
has seldom appeared more than once in a century; it raged in
the eleventh century amongst the 'foltecs, it made great ravages
amongst the Mexicans in lii43, 1576, 17:3H, 1737, 1761 and 1763,
and amongst the Indians of the Atlantic coa.st in 1618 and
1619.
According to Alexander Humboldt, the li'Iatlazahuatl,
:Lltlwng·l.l pestilential in its uatw·e, and attended with llremor­l'hag
·e frou1 the nose and stomauh, was distinct from the Vomito
Prieto, anll was peculiar to tl.Je alwrigines of America. The
~pauit;h au thon; call this disea:se a plague. The following pa~­:
sage from Umnboldt's "Politie<tl J~.s:say on New Spain" alJpears
to embo<.l.r all tllat is lrnowu with reference w the nature of the
Matlazalmatl of the Mexicans :
"The i\btlazahuatl, a dh;ease peculiar to the Indian race,
seldoJU appears more than once in a century. lt raged in a
particula1· wanner iu 1545, 1376 and 1i3U. lt is called a plague
uy the ::)paullill authors. As the Jate:st epidemic took place at
a timo wheu medicine wa~ 110t cout~i<lered as a science, eYell ill
the capit<bl, we lJa,ve no exact tlata M to the Matlazahuatl. It
bean; certainly :some analogy to the yellow fever or black voruit­iug
·; btlt it never attacks wllite people, whether Europeans or
ue:s<.amdauts from the uatin~s. 'Che individuals of the race of
<JancasuR flo not appear subject to this mortal typhus, while1 on.
th<:' other hand, the yellow fever or black vomiting very selaom
attacks the Mexican Indians. 'fhe principal site of the Voruito
Prieto is the maritime region, of which the climate is exOO!'JSively
warm 3.lJ.d hUDlid; but the Matla.zahuatl carries terror and de­atructkm
intb· the Vf5rY interior of the country, to the ce'tltrsl
56 Abstract of Proceeding8
table-land, and the coldest and the most arid regions of the
kingdom.
"Father Forribio, a Franciscan, bett.er known by his Mexican
name of Motolina, asserts t;hat the small-pox at its introduc­tion
in 1520, by a uegro slave of Narvaez, carried off half the
inhabitants of Mexico. Toquemada advances the hazardous
opinion that in the two Matlazabuatl 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 witb which we
can at this day estimate in the eastern parts of Europe the
uumber of those who fall victims to the plague, 've shall very
reasonably be inclined to doubt if the Viceroys Mendoza and
Almanza, governors of a recently conquered country, were
able to procure an enumeration of the Indians cut off by the
Matlazahtlatl. I flo not. accuse the two ruoukish historians of
wa.nt of veracity, but there is very little probability that their
calculation is fonnclerl on exact data.
"A very interesting problem remains to be resolved. Was
the pest which is said to have desolated from time to tUne the
Atlantic regions of the Uuited States before the arrival of the
Europeans, and whirh the celebrated Rush and his followers
look upon as the principle of the yellow fever, identical wLh
the Matlaz~thuatl of the Mexican I.ncliaus T We may hope that
this last disease, should it ever reappear in New Spain will be
hereafter carefull;r observed by the physicians."-" Political
Essay on the Kingdom of New Spa.iJ1," vol. i., pp. 117, 118.
"Long before the arrival of Cortez there bas almost periodi­cally
pre>ailed in New Spain an epidemical disease called by
the nati>es Matlazahua.tl, which several autllors have con­founded
with the Vomito or yellow fever. This plague is prob·
ably the same as that which in the eleveuth century forced the
Toltecs to continue their euugrations southwardR. It made
great ravages amongst the MexicanR in 1545, 1576, 1736, 1737,
1761, and 1763; but as we have already observed, it differs
essentially ft·om the Vomito of Vera Cruz. I t attacked few
except the Iudiaus or copper-colored race2 and ra,ged in the in·
terior of the COlUlt.ry on tbe central table-land, at twelve or
tbirten bundrerl toises above the level of the sea. It is true,
no (loubt, that the InclinnR of tbe valley of Mexico who per­ishefl
by t.housaml in 1761 of the 1\btlazaln1at1, vomited blood
a,t tl1e JlORe a,nd mout11; but theRe hrematemeses frequently oc­cru
· under the tropic~, accompanying bilious ataxiea] (ataxi<Jtte&}
fevers; and they were alRo observed in the epidemical disease
which in 1759 prevailed over aU South America, from Potosi
and Oraso to Qnito and Popazau, and which, from the incom­plete
description of Ulloa, was a typhus peculiar to the ele·
vated regions of the Cordilleras. The physicians of the United
St.a,t.es who adopt the opinion that yellow fever originated in
the country itself, think they discover the disease in the pests
which prevaled in 1535 and 1612 among the red men of Oanada
and Nsw Englatud. From the little whi~h we knbw of the
................. ________ _
LouisiAina State Medical Societty. 57
Ma.tluaJmatl of the Mexicans we might be inclined to believe
that in both Americas, from the remotest periods, the copper­colored
race has been subject to a disease which in its compli­cations
resembles in several respects the 'yellow fever of Vera
Cruz and Philadelphia, but which differs essentially from it by
the facility with which it is propagated in a cold zone, where
the thermometer during the day reniains at ten or twelve Oenti­grade
degrees (500 and 530 Fahrenheit)."-" Political Essay on
the Kingdom of New Spain," vol. iv., pp. 135-137.
During the four centuries in which the monarchy of the Toltecs
lasted, they multiplied considerably, eA.-tending their popula­tion
in every direction and founding numerous and large
cities, and building those great pyramids and monuments which
required the united efforts of multitudes for their completion;
hut the calamities which happened to them in the :first year of
the reign of Topillzia.-A. D. 1131-52-gave a fatal shock to
their prosperity and power. For several years their country
was a.fflicted with such a severe drought that their fields failed
to yield them their necessary fruits; the air, infected with
mortal contagion, .tilled their graves with the dead, and the
urinds of the survivors with consternation; a great part of the
oation died by famine and sickness, and the wretched remains
of the nation, in order to save themselves from the common
calamity and from utter destruction, deserted Mexico and
xought relief from their misfortunes in other co1mtries. There
was therefore iu this desolating plague of the Toltecs the usual
association of famine and pestilence i and it is probable, that
as in the history of many other natio11s, the former was the
cause of the latter, anu that the disea.se probably partook of
the nature of the typhus and typhoid fevers of the present day.
Humboldt, however, does not appear to be fully sustained in
resting his opinion as to the ~tbsolute difference between the
Matlazahua.tl of the Mexicans and yellow fever (vomiw prieto ),
upon the fact that the former prevailed at high latitudes and
elevations.
The stereotyped expressions of systematic m·iters a~:~ to the
limitation of yellow fever to certain elevations, must in tbe
light of certain facts be abandoued. It has been supposed
that yellow fever was confined to the SE'tt-shon~, either because
persons who bring that disease disembark there, and goo<lFl
supposed to be impregnated with deleterious miasms are therE'
accumulated, or because on the seaside gaseous emanations of
a peculiar nature ar~ formed. It is certain, however, that
yellow fever has prevailed in the elevated table-land of Oaracas,
3000 feet above the level of the sea, upon more than one occa­sion.
In 1696, a bishop of Venezuela, Diego de Banos, decli­cated
a church to Santa Rosalia of Palermo, for having deliv­ered
the capital from the scourbe of the black vomit (vomito
nigro), which is said to have raged for the space of sixteen
months. A masEI ~elehrA~t.eil I'IVt'l'Y ;vea.r in the Oatheclral, in
8
58 Abstract of Proceedings
the beginning of Septemb~r, perpetuates the remembrance of
this epidemic. The year 1696 was very remarkable for the yel­low
fever which raged with violeuce ·in all the West India
Islands, wl!ere it had begtm to gain an ascendency in 1688.
This disease a1c;o carried off' in Caracas a great number of
European RolclierR iu 1802.
In the remarkable epidemic of yellow fever which prevailed
in Pem ju 18.35 a11Cl 1856, tho ilisease passed even the barrier
of the Ande~;; committing fearful ravages il1 Andine and Trans­aniline
t·egions, at elvatiouR of 14,000 feot. above the level of
the sea. Even the ancieut capital of the Peruv1an emprre,
Cuzco, aa·t the eleva lion of 11,378 feet above the level of the sea,
was not exempt from the ravages of yellow fever. No authentic
records exist1 from which llla.y be ga.thered any fact~; illustrating
the nature ot the pestileuce which, accordiug to the "Gentle­man
of Elvas," de~olat.erl certaiu Indian nations a sh01t time
before the invasion of De Soto i it i.s 8UPJ10sed, however, t.o
bave l1een ~o~imila.r to the Matlaz:H.matl of the Mexicans.•
The terrible pe:stileuce which wasted tlle American Indi;m:-;
in 1618 and 1619, a short time before the Pil~rri.m FatherR landed
in Massacbuset.ts, has been suppol'led by Noah v\'ebsttll' aml
otbers to ua.ve bemt yellow tiwer. Thlti :suppo:sit iou cannot l1e
ma intaiued because, the d.h;ea~;t> prE>Yailecl witlt the greatest
severity <huing tJ1e wiutt-t' aucl itt Pxh·etnt'ly cold weather. \\\•
;ne not just.ifie!l ilt a<loptiu~· tJ:u> c:ondtLo.;ion of Wol>E;ter ~;imply
bcc~ause tlwrl' wa~ <L gt>Jteral yel1owue::;s of the skiu, attt•tHletl
with hremorrhageH from tlte nose.
A hout 1750l a mnliguant, epide111ic tlisease preva.ile<l antollgRI
t.h<'· J n.dia.m; ot tbe Atlantie coa.::;t, but clid 11nt. aftl id the w b ite.o.;,
a11d which, ill like manner, Webster OOJtNi<lerecl a:-; the "intiw·
tiom; yellow teYcr." The patient. were said to have fir~;t cotn­pla.
ined of •~ severe pain in the he:ul a.nd hack, which was fol­lowed
by fover; in three or tour thtys the lik.i.n tnrned yellow
as gold, a Yomiting of black matter took place, aHd generally
a bleecling at the nose and mouth, which continued until the
pati~nt died. These symptoms resemble t.o a certain extent
those of the disease k:nowu to the 1\'lexil:ans as 1\I~ttlazahuatl;
and a1c;o those whic·h characteriZl' the malarial hrematmia,
which, Rinoe the t·eeent war for the establishment of the itltle­])
enclence of tbe Southem State~;, ha.R prevailed to a cou~:~ider·
able exteut, ancl has been attende.l witll a high rate of mot··
tality.
The .AJJLerican l11di<m~:~, in (;OJIIIU01l witll tlte whites, were 1-lUu­ject.
t() the variou.<; iorms of maJarial fever (intermittent, remit­tent,
aud couge~;tive or pernicimu;, ~ml malarial hrematuria),
• !intohilleon'& History of MA<~eaobueottij, vol. 1, pp. ~•. 35
Belknap's Biography, vul. 2, t>· ZO!I.
Gookin's Hletorical Collections ofthelndianeln New England.
Prln06'e Chronological History of New England, p. ~6.
Pnreba.•, vol. 4, 1175.
Winthrop '8 Journal, p. 52.
lllstoryof'Et>iilomio MHI PeatilentiAI Di~~eAt~m~, etc .. by N03h Web<~~r. vot. 1, pp. l'I'J
178.
f
f
f
Louisiana State Medical Society. 59
aud it is well-known that in the fust settlements of both North
and South America, the Spanish, French and English colonists
suffered terribly from these diseases. Many of the most flour­ishing
and populous settlements were in a few yeaa.·s almost
depopulated by these fevers, which committed the g-reatest
ravages in those towns and colonies which were located near
the mouths of large rivers in low marshy regions. Entire
armies were destroyed by these fevers ; and the pioneers who
cleared the forests and drained the low lands, were either sud­denly
cut off by these tt high grades" of bilious fever, which
wel'e often attended with a yellowness of the skin (jaundice),
incessant vomiting of bilious matter, which was sometimes
mixed with blood (black vomit), or were slowly poisoned by the
malaria of the swamps and marshes, and dragged out miser­arable
existences rendered almost,intolerable by enlargements
of the spleen and livert derangements of the blood and nervous
system, neuralgias, ana. dropsies.
Thus it appears from Pu.rcha~:~ that the e:wigrant~:~ to Vir­gtu.
ia in 1619, 1620 1621, aruoUllted to 3570 iu 42 sail of ships.
There were 600 so;;is in that colony before these arrived, making
the whole number 4170. Of these, 349 perished in the Indian
mlUI~:~acre of 16221 which would leave 3821 survivors. But in
L624 no more than 1800 were living. Scant means of sub­sistence
might have contributed to this mortality; but most of
it was in consaquence of fevers, that were probably the effects
of the climate, soil and atmosphere.
Ln that form of paroxysmal malarial fever characterized by
oomplete jaundice, intense vomiting, nausea, and hremorrbage
from the kidneys, which has received different uames at dif­ferent
times and in different countries, and which is no '' new
disease," even in the United States of America, the hremor­rhage
from the kidneys is preceded by capillary congestion of
these organs, and is attended by desquamation of the excretory
cells and tubuli uriniferi.
Malarial hrema.tnria (luem.ogastric m-alarial fever), as a general
rule, occurs only in those who have suffered from repeated
attacks of intermittent fever, or who have been enfeebled by
a protonged attack of remittent fever, or whose constitutions
have been impaired by bad diet, excessive labor1 and :.ti·equent
exposure to cold a.nd wet and the exhalations ot swamps and
marshes. And whilst some of the symptoms-as the nausea)
incessant vomiting (and in extreme cases black vomit), deep
jaundice, and the impeded capillary circulation-resemble those
of yellow feverii yet there are marked differences between this
disease and ye ow fever. The presence of albumen in the urine
of this so-called mala,rial hoomaturia is attended also with th~;
presence of colored blood-corpuscles, excretory cells of the
kidney and of the tubuli uriniferi. The excretory tubes of the
kidney appearing in the urine are often impacted with colored
blood-corpuscles, and deeply stained by the coloring matters of
the blood. As a general rule in yellow fever, the tubuli
60 Abstract of Proceedings
uriniferi are loaded with yellow, granular, albuminoid and
fibroid matter. In some cases immense quantities of green
biliary fluid, or liquid tinged with bile, were vomited, and the
patients died in a state of· collapse, with blue mottled and
purplish extremities, and sunken, pinched features. As a
general rule, suppression of the functions of the kidneys was
a fatal sign, and, as in yellow fever, was sometimes attended
with convulsions, coma and delirium. Careful examination
of the blood revealed a marked decrease in the fibrin and
colored blood·corpnscles; in fact, this change in the blood was
characteristic of all cases of this disease which have come
under my observation. The pathological changes whlch I have
observed after death fi·om malarial h::ematuria are character­istic
of paroxysmal malarial fever, and not of yellow fever­viz.,
enlarged slate-and-bronze-colored liver, loaded with dark
pigment granules, deposited in greatest numbers in the portal
capillary network i gall-bladder distended with truck, ropy
bile, presenting, when seen en masse, a greenish-black color,
and in thin layers a deep yellow. As mnch as 1000 grains of
bile of hlgh specific gravity has been obtained from the gall­bladder,
whilst in yellow fever not more than 120 grains of bile
are, as a general rule contained in the gall-bladder.
As it is well estab~hed that malarial h::ematuria, and the
severe and most fatal forms of malarial fever, prevail only in
certain years, and appear to be dependent to a large extent
upon the degree of heat and moisture, as well as upon the
amount of organic matter in the soil, and as these epidemics
in the tropical and temperate regions of America are often of
the widest extent and severest character, and as the Indians
suffered from these diseases to an almost equal degree with
the whites, and as they were in North America without the
most important remedies-bark and quinine-it is not unrea­sonable
to suppose that at certain seasons large numbers
perished by these diseases. And were it not for the free use
of quinine in the treatment of paroxysmal fevers, many of the
cities of the Southern States, surrounded with swamps and
marshes, would have been depopulated h. and even in the more
elevated regions of the cotmtJ:y, as in t e rich valleys of the
Cumberland and .Allegheny mountains, and along the rivets
flowiug into the Atlantic and Gulf of Mexico, the mortality
from paro~-ysmal mala.rial fever would in certain seasons be
very gTeat but for the free use and powerful antiperiodic vir­tues
of quinine.
[t is evident, therefore, that the origin of the American
plague m: typhus (vomito p1·ieto, jiev1'e jawne, yellow fever) is
involved ill doubt, on account of the prevalence in the tropical
and sub-tropical. regious and temperate zones, both amongst
the natives and foreigner·s, of some forms of malarial fever,
often attended with jatmdice, passi>e h::emorrhages, and black
vomit. If it could be determined at what time thls terrible
disease was clearly recognized by the medical profession and
Louisiana State Medical Society. 61
historical writers as distinct from paroxysmal malarial fever,
and a,s dependent upon a specific cause or upon a combination
of causes peculiar to itself, a firm ground for the discns::;ion
of its origin and of its relations to the native population, as
well as to the foreign elements, would be E'Stablishecl. But it
is well known that many of the descriptions giYen by various
authors will apply as well to the severe form~,; of parol:yt~J.U<tl
malarial fever as to yellow fever, and alF;O tbat the distinction
of the one from the other has been the result of comparatively
recent labors, and even a,t tbe present t.ime there are not a
few physiciaus who bold to the identity of both diseases in
their origin aud essential nature.
THE IMPOSSIBILITY OF DETERMINING WITR A.VCURACY 'rEiE
DATE AND MODE OF ORIGIN OF YELLOW FEVER, U.LUS·
TRA.TED BY AN EXAMINATION 01!' THE THEORIES WRICR
11AVE BEEN ADVANCED AT D!Fl''ERENT TIMES BY VARIOUS
WRITERS AS TO ITS NATURE AND CAUSES.
The opinions in regard to the causes or yellow fever havP.
been arranged by systematic writers m•der three heads-
1. That it is a disease induced solely and est~eutially by cou­tagion.
2. That it is essentially of endemic origin. 3. 1'hat,
being of endemic origin, it afterwards becomes contagions. The
doctriue that not only intermittent rell.littent, and congestive
or pernicious paroxysmal malarial fever, but also yellow fever,
assume more or less, according to circumstances, the type of
one another, has been extensively entertained by the mecl:icaJ
profession. Believing them to arise from essentially the same
causes, variously modified, which a.ssail the system thl'ough
tbe same avenues, these fevers are regarded by this class of
reasoners as essentially the same, modified by the intensity of
the cause and by the prevailing constitution. And it has
t~trangely been sought to maintaiu this position by the fact
that the natives of southern cities, in 'vhich yellow fever is
of such frequent occurrence a.s to be pronom1ced endemic~J,
possess in a great measure au exemption from this malady,
and suffer only from the mild intermittent and remittent
whilst those lately arrived from northeru latitudes so often fail
victims to yellow fever that it has in some cities received the
name of strangers' fever.
To sustain the opinion that yellow fever aritles from mias­matic
effiuvia, the following facts haYe been frequently cit.ed :
1. Yellow fever always appears simultaneously with lJilions
1·emittent. 2. A h:igll range of atmospheric temperatm'e is
essential to the generation of its cause. :3. Its first appearance
is almost always in the lowest and most filthy parts of towns,
and in localities favorable to the production of miasmata.
4. The supervention of storms, heavy rains, or cold weather
puts an immediate check to its progress.
It has been asserted that whilst at New Orleans, Charleston,
62 Abstract of Proceedings
Savannah and Gibraltar the same individual is seldom twice
attacked by yellow fever, in the West Indies and on the coast
of Africa it is said to secure no subsequent immunity. Witb
some writers it is still even a disputed question whether certaiu
fevers which have, or are supposed to have, their source in
veg-eta.ble miasms or in effluvia ft·om marshes, or .from infusoria
or fungi developed aud propagated under certain combinations
of heat, moistun~, and putre(ying- vegetable :tllcl ani mal Ulatterti,
are subset]uently spread by contagion; whilst some writers con­tend
that within the tropics yellow fe,er may at any time, under
certain conditions of moistute and tem]>erature, arise de novo iu
the impure atmosphere of the cro"wded and filthy ship or city.
Others, again, as strem10usly uphold the doctrine that it is a
specifLC contagions l)estilential dh;ease, which, like swall-pox
or measles, may be transported and communicated from one
.ship or city to others, thus following- the great avenues of
oommerce. Whilst a tbiru class adopt and advocate a doctrine
whicb embraces the main features of both lJropo~:>itiom;. Some
who 1Jold that yellow fever may be engendered (W novo in the
ltolu or atmosphere of ships navigating in the warm, moist
tropical regions, .have coupled with this view the doctrine that
if this poisoned atmosphere be allowed to escape at the wharves
of cities situated beyonu the yellow fever zone, those only who
come witlti:n the sphere of its in:fiuence will be affected; and its
::~ubsequeut spread will uepend upon conditions of filth and
crowding of such localities, the disease neve1' spreading endemi­cally,
and falling harmless among the inhabitants of a Halubri­cms
locality.
According· to t'his view, the development of this malignant
fever requires the conjoint operation of both local and general
causes, constituting an endemico-epidemic, wWch is uusu~­ceptible
of propagation by specific contagion; and in the sum­mer
atmosphere of a city lying beyond the yellow fever zone
there must exist some peculiar combination of ciecumstances,
or some peculiar agency favorable to its development. In these
cases it is affirmed that there is g·enera.lly found an infected
district, which slowly and reg-ularly e>rtends its boundaries,
rendering all wbo come within its limits subject to this form of
fever. It bas been said that the experience of several centmies
teaches us that the cause of this feve1· iR pro·enni~y present w
the tropical and sub-tropical cities of America; that it is indis­solubly
connected with climate; that it maintain::~ the same
relation towards the human system as the other malarious
emanations of swamps and lowlands; and that it is liable to
be developed at any time in different degrees of intensity by
the combined operation of heat and other agents. •
Among-st the most striking circumstances iu the etiology of
yellow fever are the marked geograpllical boundaries within
which it is confined and the circttmscribed location in which it
prevails, t1Je disease being rarely met with south of the 35th or
north of the 40th degree of latitude, and even between these
I
I
Louisianw State Medical Society. 63
limits being more fi'equent in the Western t.hau in the Eastern
Hemisphere; its almost unive.rsallimHntion t.o commercia.} sea ..
ports elevated but a few feet above the level of the sea, althongb
it occasionally spreads to t.owns a.nd citie::~ in the neighborhood
of the latter, situated in the interior country or on the bank~ of
navigable rivers j and the fact that it is very frequently cir­cumscribed
within certain limited aud well-defined portious of
the locality or city in which it prevails. The shorcH of the
Western A.rchipelago1 aud of the Gulf of Mexico and the
Oaribbeau Sea, const1tnte the prolific hot-bed iu which ha."
been generated.a.!'l>nd pl'opagated tue mysterions poison of this
disease, which uas desolated cities1 armies, and tleets, and
1Lestroyed the successive swarms ot adventurers and invaclerR
from Europe and the colonies of North America.
GENERAL OUTLINE OF THE HISTORY OF YELLOW FEVER,
ILLUSTRATING THE DIFFERENT VIEWS WHICH HAVE BEEN
HELD AT DIFFERENT TIMES AS TO THE PLACE AND MODE
OF ITS ORIGIN.
[f it were possible t.o determine with accuracy the ua.tme of
the severe and fatal forms of fever wlrich afflicted the fin•t ex­plorers
and colouists of the tropical and sub-tropical regious of
America, and eYen the very companions of Columbus, Lhe queH­tion
of the origiu of yellow fever would be relieved of urucll
lutCeltainty and doubt. If we are to credit the aooowll,s of
some aut.hors, the :first trace of yellow fever was ol>serve(l at.
lhe eud of the fifteenth and beginning of the sixteenth c~nttu·y
at l:iau Domingo all(l Porto Rico, in the Continent of ~uuth
8..merica, and in the Gulf of Darien, at which latter place it i~;
sa..iU. to have prevented the Spaniards fi·om settliug. In No,•em­b~:
u·, 14!.!3, Columbus lauded at San Domingo with 1500 :::3pa.u­iat'lls,
iu order t.o fouml the city of lsabella.. A severe a.nd
fatal fever carried otr tbe greater part of them within a yea.r
afWl' their at-rivaJ, a nti the disea.se js described as being "yel­low
as t:~a.ffi·on or goltl." From 1544 to l 368 there is no recoru
of the disease haYing prevailed as au epidemic until l 636, when
. it appeared iu Guadalonpe, and tl.Jeuceforward it occw·red at
regular iuterYaL-,. lu tl.Je seYentce11th century it spread along
the Contiuent of l:)onth America to latitude 8° south, and iu
~orth A.w&·lca to latitude -:12°, but ouly on the eastern coa.st of
both. The first <~ppea.ra.nce of the clh;ease in the United
State!:\ was at .Bo:sto11 iu Hi!.lJ, and iu Charle:ston and
l'biladelpl.Ua iu 1o~HI. Lt is said tin;t to have appeat'ed
iu the Hulf of .Mexico at Biloxi Bay iu 1702 and Mobile
ill 1705; but Huruholdt held that it bad prevailed fi·om the
v&-y loundation of V &-a Crii.z, and was indigenous to this
city. It prevailed at Pensacola and Mobile in 1765.
In the eighteenth century it appeared on the west coast of
~ont.b America in latitude 20 south. On the North American
64 Abstract of Proceedings
continent it spread to latitude 420 north; it extended even to
Europe, and reached the Pacific and Madagascar. At the
beginning of the nineteentll c<'utu.ry it penetrated deeper into
thf' North .American eontineut than formerly, reaching as high
as latitude 470 nortb, and in Europe it ex.'teuded to latitude 4So,
and prevailed in the Canary Islands and Leghorn.
Ever since yellow fever attracted attention it was recognized
as a tUstinct disease from the remittent autnmnal fevers of t.he
temperate zone. It bas preyailed as an endemic in Havana,
raging epiclemically frow April w December, and occurring
sporadically dmi11g the rest of the year. From time immem·
orial it has been endemic at Vera Ornz, in the Gulf of Mexico,
where its chief victims are strangers who come ft·om cold re­gions
during the hot season, as well as Europeans and those
natives wbo exchange the more elevated and cool regions of
Mexico for the coast.
At the time when Spain possessed by far the best and
largest portion of the American continent, extending from the
north of OaJiforn:ia to the Straits of Magellan-a space of
between 6000 and 7000 miles-a system of commerce wM estah­li:-~
hed which appeared to be elUinently favorable to the origin
and spread of yellow fever. The Spanish galleons were in
fa.ct, very large men-of-war, built iu such a manner as to afford
ample room for the st.owage of merchandise, with which they
were commonly RO eacumberecl as to be remlered incapable of
defence. The fleet of gaHeoua consh;te<l of eight such men-of·
wa,r, aml genemU,y convoyed frou tweh'e to sixteen merchant­men.
Dm·iug times of pt"ace the galleons sailed once a year
regularly, thoug·h at no ~:~et time, lmt according to the plea~ure
of the King of Spain aucl the com•enienee of the merchants.
They sailerl from Ufl.di.z to the Ol'M taries, thence for the AD·
t.illes, and after reaching thi~ lougitu<le they bore away for
Oarthagm1a. .As soon as they came iu sight before the mouth
of Rio de la Racha, after having doubled Cape do la Vela,
advice of their ani>al was selJt to all pru:ts, that everything
might be prepared for thl!ir rt><:eptiou. 'l'hey remained a month
in the J1arbor of Oartbegena., and landt>d there whatever was
de!:ligued fo1· terra jirmo. They tlle11 sailed to Puerto Velo,
where having ~t.ctye<l fluriug the fair, which lasted five or six
weeks, tbey lauded the mercuandiAe intended for Peru, and
received the trelU;lli'e!:l and commotlities ~:~ent from thence. The
galleon10 then sailed b!Wk w Carthag·eua, aud remaiuetl there till
their retnru to Spain, whic·h wmaJJy happened within the space
of Lwo years. When orders fOt' retmuiug home arrived, they
sailed first to the Ha,·aua, and having joined the flota, and
what other ships were bound to Emope, they steered north­ward
as far as Caroliua, and then, takiug the westerly winds,
they shaped their course to the Azores, wheu, having watered
and victnalecl a.fresh at Terceira, t.hey thence coutinued their
voyagp to Cadiz.
Louisiana State MedioalSocie~. 65
The Spanish ftota. consisted, like the galleons, of a certain
number of men-of-war and merchant ships; there were seldom
more than three of the former and sixt<len of the latter in t.bis
fleet. They sailed from the coast of Spain some time in the
month of August in order to obtain the winds that blow in
November for the more easy pursuing their voyage to Vera
Cruz. They called at Puert,o Rico on their way to refresh,
passed in sight of Hispaniola, .Jamaica and Cuba, and, accord­ing
to tho winds and season, sailed either to the coast of Yu­catan,
or higher through the Gulf to Vera Cruz. Tbe Spanish
liotilla being intended to fm·nish uot only l\1exico, but the
Plillippine Islands also, with the goods of Europe, wal'l obliged
to remain in Vera Cruz for a considerable time1 . aml sometiu1es
fountl it necessary to winter in that port. This fteet usually
sailed from Vera Cruz in the month of 1\fa.y, but was sometimes
detained as late as August; it tbeu made for Havana, and
retmned to Spain iu company with the galleons.
The Spanish towns were generally built in low, nnhealthy
localities, surrounded by marshes and swamps, with narrow
streets and high walls and fortifications, which not only com­pressed
the towus within certain limits, and induced crowding
and favoured the accumulation of .filth, but also prevented to
a eertain extent the free circulation of air.
If the history of yellow fever in the Western Hemisphere be
criticaJJy examined, it will be fouud that the accounts and
dates of its origin varied with the extent and character of the
information of the writers in eac)l city, locality, or island; and
each one in turn was tempted to assign to the disease a.
foreign origin. No city or place has been found to claim the
honour of the origin and continuous propagation of yellow
fever. Thus, the French writers, calle<l this disease mal de
Sia11~, and held the tradition that the disease had been imported
in the ship Or~ftanne, which sailed with French colonists from
Siam in the latter part of the year 16!)0. Monsieur Ponpee
Desportes, who practised at St. Dominique from 1732 until
1748, says that this fever was so called frolll its first being
taken notice of in the islancl of Martinique at a time when
some vessels were there from Siam.-(" Hist. des 1\Ialad. de St.
Dominique," vol. i, pp. 191, 192). But it is w~ll kno>vn that
the Orijlame touched at Brazil where yellow fever had been
prevailing for several years, and Father Laba,t, who arrived
at Ma.rtiuico on January 29, 1694, tells us that the passengers
of this ship caught the disease in Brazil.
Equally incorrect was the account given by Dr. Warren of
its introduction into Barbadoes between the years 1732 and
1738. Dr. Warren concluded that the yellow fever which he
saw at Barbadoes in 1732 and tho following years was a con­tinuation
of the plague which in 1720 and 1721 had been
brought from Palestine to Marseilles, ancl which be imagined
had been brought from the latter place to Martinico, aud
thence to Barbadoes in 1721 by the liynn ship of war.
9
66 Abstract of Pt·oceedings
Dr. Towne, who lived and practised as a physician at Bar­badoes
at the time of the alleged introduction of the plague
fl'Ow Marseilles (1721), and who wrote in 1724 (before the
arrival of Dr. Warren) on yellow fever under the denom.inar
tion of febris wrdens biliosa, made no allusion to any such
importation, but considered it as an endemic disease in the
West Indies to which Europeans were subject upon their first
arrival.
Mr. Hughes says, in his "N aturaJ. History of Barba{ioes," that
Dr. Gamble remembers that it was very fatal in 1691, and that
it wa.s theu ca,Ued the '' new distemper," and afterwards, "Ken·
dal's fever," also the "pestilential fever," and "billions fever."
This statement is also confirmed by Captain Thoma-s Phillips,
\vho was at Barbadoes wi'th a large ship in 1694, and says, in
the account of his voyage to Africa and Barbadoes, that it
was the fate of that 1slaud to be then " violently infected with
the plague."-(Churchill's Collect., vol. i., p. 253.)
It appears, however, from the st.atement of Mr. Richard
Vines, a planter and practitioner of physic in Barbadoes, that
yellow fever prevailed with destructive effect a.s "an absolute
plague" as early as 1647; and Dr. Edward Nathaniel Bancroft,
in his essay on yellow fever, suggests that it was called "a
new distemper" in 1691-94, because all who had had any accu­rate
knowledge of it in 1647 were probably dead or removed.
Mr. Richard Ligon in his history of Barbadoes, published iu
1657, says that when he arrived there in 1647, in the early part
of September, the inhabitants of the island and shipping too
were so seriously visited by the plague (or as deadly a disease)
that "before a month was expired after our aa·l'ival the living
were hardly able t~ bury the dead." In considering the causes
of this disease-whether it was brought thither in shipping or
was occa.sioned by the irregularities, debaucheries, and ill diet
of the peoplel and the unhealthy, low, marshy situation, subject
to overflow-he inclined to the latter.
A similar fever, anu probably from the same causes, prevailed
at the same time at St CbJ:istopher, Guadaloupe, and other
islauds, and there ilied at St. Kitts and Barbadoes each five or
six thousand inhabitant-s.
P. D11 Tertre aJ~o mentions this disease, and calls it the plague.
He says that it began at St. Christopher, and in eighteen
months carried oft' one-third of the inhabitants, and that it was
accompanied with violent pain in the head, great debility of
the limbs, auu a constant vomiting; and that in three days it
sent the patient to the g-rave.
Dr. Hillary, who enJoyed a high reputation as a successful
practitioner and learned physician in Barbadoes, affirms that
the disease was indige11ous and endemic to the West India
Islands.
'J'he testimony of Alexander Humboldt is similar to that of
Dr. Hillaa·y, and is worthy of the most careful consideration in
the light in which it presents the history of yellow fever. :r.
Louisiana State Medica,l Socie~. 67
his " Political Essay on the Kingdom of New Spain," this dis­tinguished
traveler, naturalist, and philosopher says:-
" The typhus, which the SpauiarclR designate by the name of
'black vomiting' ( vontito p1·ieto ), has long prevailed between
the mouth of the Rio Antigua and the present port of Vera
Cruz. The Abbe Clavigero(a) and Rome other 'niters affirm
that this dlsease appeared for the first time in 1725. We know
not on what this assertion, which is so contra,ry to the tradi­tions
preserved among the inhabitants of Vera Cruz, is
founded. No ancient document informs ns of the first appear­ance
of this scourge; for throughout all the warmer parts of
equinoctial America, where the termites and other destructive
insects abound, it is infinitely rare to find papers which go fifty
or sixty years back. It is believed, however, at Mexico, as
well as at Vera Cruz, that the old town, now merely a village,
known by the name of La Antigua, was abandoned towards
the end of the sixteenth centu.ry(b) on account of the disease
which then carried off the Europeans.
"Long before the arrival of Cortez there bas almost periodi­cally
prevailed in New Spain an epidemical disease called by
the natives' Matlazahuatl,' which several authors (c) have eon­founded
with the vomito or yellow fever. • • •
"It is certain that the ?IO?Jtito, which is eudemical at Vera
Cruz, Carthagena, and Havana, is the same disease with the
yellow fever, which, 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, (d) is generally 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, aud by those who
have carefully studied the excellent nosological descriptions of
of MM. Makittrick, Rush, Valentin, and Luzuriaga. We shall
not decide whether the yellow fever is perceptible in the CCIIU8'US
of Hippocrates, which is followed, like several remittent bilious
fevers, by a vomiting of black matter i. but we think that the
yellow fever has been sporadical in tue two 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 appearances.
"It is not to be wondered at that at a period when the coru­munica.
tions between the Old and New Continents were far
from numerous, and when the number of Europeans who au­nua.
lly frequented the West India. Islands were still small, a
disease which only attacks the individuals who are uot Nea-
(a) •· Storl.a eli .Voasloo," t. i, p. 1 n.
(b) " New Spain," -roL ii., p. ~-
(o) Letter of Ahate in the "Voyage de Chappe."
(dl •• A~nta de la ll'i~bre Amarilla de Cadb," t.l .. p. I .:I.
'
68 .A..bsflract of Proceedings
soned to the climate, should have very little engaged the at­tention
of tbe physicians of Europe.
"In the sixteenth and seventeenth century the mortality
must not bave been so great..-1st. Because, at tbat period the
equinoctial 1·egions of America were only visited by Spaniards
and Portuguese-two nations of the south of ]huope less ex­posed,
from their constitution, to feel the fata.l effects of an ex­cessively
bot climate than the English, Danes, and other in­habitant-
s of tbe uorth of Europe who now frequent the West
India Islands. 2dly. Because, in the islands of Cuba, Jam­aica,
and Hayti, the first colonists were not assembled together
in such populous cities as were afterwards built. 3rdly. Be­cause,
on the ruscovery of continental America, the Span­iards
were less attracted by commerce towards the shore, which
is generally warm a.ncl hn.mid, and prefen-ed a residence in tbe
interior of the coUlltry, on elevated table·lands, where they
found a temperature analogous to that of their native couutry.
In fact, at the commencement of tJ.Je conquest the ports of
Panama and NombredeDios(e)were the oulyoneswheretbere
wa..s a great concourse of strangers; but from 1535 the resi­dence
at Pauama,(f) wa.s as mucll clreadetl by the Enropea11S
as in our times a re::;iclence at Vera. Ornz, Oma,, or Porto Cabello.
It cannot be denied from the f3c~ relat-ed by Sydenham and
other excellCllt observers that, tutdet· certain circmnstaitCl'S,
germs of ne1v diseases may l>~ den .. loped ; (g) but there is no­thing
to prove that the yel1ow fever h~ls not existed fo1· seveml
centuries ju the eqniuoctial regionl-3. \\' e must llOt confound
tbe period at which a disease has be.eu fin;t described, on ac­count
of its ba.vi.Jtg committed clrea<lful ra,-ages in a short sp1we
of time, with the period of its fu·st ap}1ea.rance.
" The oldest description of the yellow fever is that of tbe
Portuguese physician Joam Ferreym DaRosa, (b) who ob­served
the epidemic which prevailed at Olinda, iu Brazil,
bet,veeu 1687 a.nd 1694, shortly after a. Portug·uese army had
matle the conquest of Pernambuco. V\-e kuow in the same
manner witu certainty tbat in 1691 the yellow fever mauife.'ltc(l
itself at the island of Barbadoes, wlteJ.·e it we11t by the name of
' Kendal' fever, without tbe smallest proof apvearing that it
was brought there by vessels from Pernambuco. ffiloa (i)
speaking of the clutpeW'Iuulas, or fevers to which Europeans are e:<..'})osed on their arrival in the West Inclies, relates that accord- mg to the opinion of the people of the country, the vomiro prieto was unlo10wu at Santa Martha aurl Carthagena befol'e 1729 and 1730, and at Carthagena previous to 1740: The first
(ol Nombro do Dlos, eitnatod to ihe ea.st of Po1·to &11<>. Willi abandoned in 1~ .
(f) Pedro do Clcca, c. ii., p . 5.
(g) Su "Beepecting t.u A.ft'ect1on of tho Larynx "bich prenUe opldolllicaUy at Ota­herto
elnoe the arrival of a Spa.nleb vessel V'atiC<)uutr," t-1 .• p. \75.
(b)·· Trattado dA Constltuicam PestUencial de Pernambooo, .. par ,Joam 'Fotreyra. da. IWo!a, ew Lillboa. 169-4. (I) .. Voyage;• t. 1., pp. 11 aod 14V.
Louisiana, State Medical Society. 69
epidemic at Santa Martha was described by J nan Josef de
Gastalbrude, (k) a Spanish physician. Since that period the
yellow fever has several times raged out of the West; India.
Islands and Spanish America, on the Senegal, in the United
St.ates, (l) at Malaga, Cadiz, (m} L<'ghorn, and according to the
excellent work of Cleghorn, eveu i11 the isla11d of Miuorca (n).
We have t.bought it propm· to l'elau,o tl.tese facts (many of w b1ch
are not genera.lly known) because they tJuow some light on tbf'
nature and cause of this cruel di~;ease. The opinion that the
epidemics which since 1793 have nearly e\"'ery year afflicted
North An1erica differ essentially fi·om those wbich for ceuturie."
)lave preva.iled at Vera Cn1z, aml that the yellow fever was
imported from the coast of .Africa into Grena(la., aud frolll
t.hence into PhHadelpbia, is equally destitute of foundation
with tbe hypothesis formerly very generally believe<l-tbat a
s(]uadron fi·om Siam introduced the 1•omito into America (o).
"In aJl climates men appear to :find some eonsolatiou in the
idea that a disease considered pe::;tilential is of toreig11 origin .
.As malignant fevers eMily originate in a nwnerous crew coopeu
U}> in dirty ves8e1s, t i.Je beginning of an epidemic ruay be fre­quently
traced to the period of the arrival of a squadron ; and
tbeu, instead of attributing the disea.se to the vitiated ail· cou­taiued
in vessels deprived of ventilation, or to the eftect::; of an
ardeut aud uuhealty climate on ~;aiJors uewly landed, tbuy atli.rm
Lbat it was imported from a neighboring port, where a 8quafl­ron
or convoy touched at during its navigation from Em·ope to
America.. '£hns we frequently hear in Mexico that the :sbip-of­wa.
r which brought snch-or-sucb ~L viceroy to Vera <Jrnz ba.::;
int.roduced the yellow 1eve1· wlucb tor sevexnl years bad not
prevaileu there; and in this manucr during Lbe season of great­e::;
t heat the Havana, Vera Cruz, and ti.Je jJOrts of the Ouited
States, mutually accuse one anotJJer of couununicatiug tbe
germ of the co11tagiou. It is witJ1 the yellow fcnrer as witJt tlte
mortal typlJUs !mown by the name of 'Oriental pe~;t,' wbicL the
inhabitants of Egypt attrilmte to tbe alTival of Greek ves~el~;,
while in Hreece anu Uonstantiuople the same }Jest is cou~;idered
a~ coming from l{osctta or Alexaudria.'' (J>.)-'' .Political Ess:-~.y
ou the Kingdom of New ::ipai.u," vol. iv., l'l>· 135-143).
Tile precelling facts :shu"· tlte fallacy of atteu1pting to decide
the date of the origin or yellow teYer from the statements of
the writens of a.uy one locality; and they also show the im­propriety
of con.fow1diug the period at which a di:>ea.se bas been
fu·Rt de~Scribed, ou a.cconnt of jts ha,ving COlHlru.tted ravages at
(kl •· Luzuriag><ll.e Ia ()aJenLu• t\ Rtlios .. ;· t. 1., p. 7.
(II Io 1741, 1747, 17GJ.
(m) .H.()adiz iu l't.IJ, 1733, 1734, ~774, 1746, and 1764. and at \lalaga in 1741.
(o) 111114-4, 1740 ( · Tommasinl :Fobbre de Lt<'oruo dellS04," p. 65.)
(OJ t.obat'• "Voynge a.ur lsi~&, t. I., p. 73. .RMpeccing tho pla.gus of Bou.lllam in
Africa.. oee Cbisbo[m "Oo PeetUentlal Fever,' ' f· 61: Miller, •· Hlotolre de LA Flilvre de
New York." p. 61; and Volney, "1'abloau de So de A:mer,que, t. il., p. 3:14.
IPI Pugne~, Sur l~~& .F'i~vea dn Le..-ant et dee A.nl.lllee,' pp. 97 and 331
70 Ab8tract of Proceeding~;
!lOme particular 1ocality or time, with the period of its first
appearance.
From the preceding facts we conclude:
lst. .d..~ destructit•e ancl e.r:tensit•e ]Jestilenc:es, ?'eRetnbling yellou•
je1•er, hame. de.vtroyed the aboriginal inhabitants, in former time.,,
ICihen they .formed, a ntunerou.~ and compamti NJly dense pozmlation,
we ewe j~t.9tified in lwlcling that tlte American Continent has been
in past age.~ s-ttl?jected to wide sprectd terrestial, oele.stia.l and clint·
ut-io conditions which were hostile t<J lnmum life.
2d. Tlte experience c?f the past lectds to the belief that .snch
destnu;ti~>e oombinatiou.y 01· c;onditiou.~ nwy oc·cur in tltefuture and
cau8e wide S]Jreacl destruction twcontrollalile liy kumurn means.
3t.l. Yellow j~ver has, since tlte talvent of Etu·oJJeans in th~
Antilles, and in North ancl Soutll America, jJI'evailed at 1•ariow1
Jleriml.y1 M;para.tecl by no 1mij'onu intervals, 1oitll great 1•iolence and
during such period.s its area ha .. s been wir1el.y e:r:tenr1er7, as im 1878.
4th. How011C?· perfect the .~an itary armngements and complete
the quaJ-antine ?'egttlations of cities sitnated within certain Jlarallels
of latitude, it is p!'Obable that in .~cason.~ of great epidemic in­jlneuce,
human agency ma,tJ fail in the circttiWIJeut.ion m· nrrest of
the AmeriC"an ]Jl<t{JIIe. .
.ltb. In insul<u', tropical a.nrl sttbtropiual Am,erica, ()ne of the
most e.~.~ential conditions for tlte i1wJ·ea.~e of yellow fever, is the
accession mul crow,ling of nnacolimaterJ. persons, natives of the
oolder ~·egions of America cuul Europe, i1~ cities or on shi]J·board.
Armies anr~ navies are the great .fields of its ravages.
YELLOW l•'EV8R COEVAL WlTH 1'HE F!RHT SETTLEMENT OF THE
GULF t.:OA!=iT OF LOUISIANA BY TBE FRENCH. HISTORY
DURLNG FRENuH DOMINATION 1684-1763.
Father Cluistian Le Clerq in his "aooownt of La J:ialle's at­telnpt
to reaclt the 1JJis.sissiJJpi by sea, and of the establishment of
a F1·ench colony in St. Louis Blty," states that in September, 1684,
La Salle suffered with a dangerous malady in the Island of St.
Domingo, wl1icb brought him to t.lle verge of t.he grave, and
tbe soldiers and most of the crew, bavine- plunged into every
kind of debauchery ancl intemperance, so (.)()mmou ill these
parts, were so ruined, and contracted such dangerous disorders
that some died on tbe Island and others never recovel'ed. The
clisea.se appea,rs to have been of an infectious and contagious
cha,raoter, for Father Christian Le Clel'q states farther, that
after the con~tructiou of the torts in St. Louis Bay, on the
coast of the present State of Texa!'l, " the maladies which the
soldiers had contracted were visibly carrying them off, and a
hundred died in a few days, notwitllstauding all the relief
afforded by broths, preserves and wiue, which \vere given them."
It is evident therefore, that the soldiers, sailors and colonists of
tile fleet of the celebrated and unfortunate La Salle, which
sa.i led from Rochelle, France, on the 15th of August7 1684,
Roffered E.~everely from an infectiouR fever, a.fter reaching the
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Louisiana Stat~ Medical So£Mty. 71
isla.nd of St. Domingo on the 14th of September, and tbi~:~
fever, which came nea.r destroying the commander, was trans­ferred
to the shores of Louisiana, and continued its ravages
t\.fter the foundation of the Fort of St. Louis.
It is probable, tllerefore, that yellow feverl. was coeval with
tht} settlement of tho French on the coast of Louisiana.
According to M. Benard de La Harpe, M. d'Iberville, built
the fort at Biloxi in the month of April 1699, "ith four bastions,
which he mounted with 12 cannon, and gave the colDllland of
it to his b1·others Sanville auc.l Bienville, and ~:~et sail tor Fxauce,
t>U the 4th of May, 16!J~. Ou the ~~cl of Augnst, 1701, M. de
Sanville J.ied of a fever, supposed to have been yello'v fever;
and by the same ilisease, the garrison lost upwards of sixty
men, leaving only one huu<lretl and ftfty persons iu the colony.
This circlllllstanc~ a,'S well a~:~ the poverty of the ~>mrounding
t~oil at Biloxi led J:Sieuville to commence on the 16th of January,
1702, a settlement on the Mobile river. about eighty leagues
from the sea.
According to La. Harpe, on the 24tll of April, 1704, M. Dn
Condray Guimont, arrived at Dauphine Island witl.t the Pelican,
of fifty guns, from France, bearing provisions aud other articles
for the colony. lie also brought sixty-five soldiers, four
priests, two grey uuns1 twenty-three poor girls, and four fam­ilies
of artisans. In tile month of December a great deal of
gickness prevailed in the colony. 1\f. Du Condray Guimont,
Lost the half of his crew and was obliged to take twenty meu
from the garrison to sail the vessel l>ack to Fl·ance. MM. de
Tonti, et le Vassem·, Father Donge, a Jesuit, and thirty t~ol­diers
of the new troops, who had just arrived at the fort, died
during the month.
On the 19th of October, 1706, M. de Obateaugue arrived
at Mobile from Havana, and reported that M. de lberville llatl
fitted up a fleet to t~eize upon Jamaica, and had taken on board
at Martinique about 2000 buccaneers, but, hearing that the
English had been informed of his intentions1 he sailed for
1Iavana, and took on board oue thousand Sparuards to iuvade
Carolina. The fever or pest (yellow fever) which prevailed at
that time, broke out among his troops, of which Iberville died
and 800 men.
• In the spring of 1718, Bienville selected a site for a town on
the banks of the Mississippi, and placed fifty men to clear off
the grounds, as the location of the future capital of the pro­vince.
The ground selected was that which is 110\V covered by
the lower portion, or French part, of the present city of New
Orleans. Next spring the river overflowed itt> !>auks, the new
settlement was completely inundated, and tlle site seemed to
present an uncertain location for a. city, which remained for
several years little more thau a military post remote n·om the
settlements. For three years Bienville's headquarters remained
at Mobile.
The historian, M. Le Page Du Pra.llZ, who came over with a.
72 Abstract of Proceedings
colony of eight hmulreu men in 1718, under the auspices of the
West Inuia Company, states that !:>ix weeks before the arrival
:tt Cape Fr(m9oi~l S_t. Domiugo, fifteen hunth·etl persons dietl of
an epidemi~; ca.uecl the Siam J)j!)temper. Du Pratz gives,
however, no facts to show tbat a.uy of the body of emigrants
some of whom settleu at New Orleans, and ot-hers at Natclte~,
::;uffered with yellow fever, for be states that after a passag·e of
three months, inchlttillg- the six weeks spent at Cape Fran~tois,
they an-ived at the L~land of Jlfas~aere, since called Isle of
DattjJlt iue, on August 25th, aftcw a pro::;perom; voyag~ uo one
having clit>.d, or having bc•en evcm dangerously ill. uu Praiz
describe.-; lihe location of the futlll'e ca piLal of Louisiana. i.u 1718,
a.-; hciug lllarked otlt l>y a hut covered with palutetto lPave~-S.
As early as tlte yea.r 1718, in wllic:l.l New Orleaus was fbundecl,
a company ship ha<l sailed from France with troops and one
hundred convicts, destined for Louisiana, but haclne,·er been
heMcl oi. 'fowa.rd the close of 1821, there arrivetl in Louisiana,
a French officer who gave ~:;omc accoLmt of this ill-fatecl Yessel.
U wa." . ' no'v tliscoYere1l that like the tleet of La Salle, she had
mi~secl the Missis:siplli, nncl ha<l been d.riven to the west. Htlr
commander hacl rnistl~keu the ishm<l of Uuba. for that of St.
Domingo, aUtl ll<l<l been compelled to Jla.':;::; through t11e old
chaun<'l to get into the Gulf. He ma<le a, large bay, i.u the 29th
cleg:ree of latitude, and discovered that he ·had lost his way.
His misfortune was increa.-sed by a contagions disease breaking
OHt <Unong the convicts. Five of the officers thought it less
dangerous to laud, with provisions for eight days, and thei.r
arms, thau .to continue on board. The first importation of
African slaves numbering 300, wa.'S made in 1719, a large por­tion
of which. was sent to New Or1eans, and trausferrecl to the
west bank of the river to a plantatiou owned by a company.
'rbe remainder were solcl chiefly to the agricultural settlements
of the lower Mississippi. We have no acco1mts of any importa­tion
of yellow fe,·er by these or subsequent cargoes of :slaves
under the French reign.
Beuar·d de la Harpe states that on tl1e 1st of July, 1720, the
Iring's ships, Le Comte de Toulouse, sixty-four gnus, com­manded
by M. <le Vatel, after the death of l\f. de Oafaro, on the
t7th of .June, aud the Saint Henri, seventy guns, commanded
by l\f. Douce, arrived iu Loui-;iana. They brought with them ~
from the island of St. Domingo, a cont;-tgious fever, or malady,
which carried off a g.reat number of persons every day. After
openiug several bodies, it was discovered that the tlisease came
from a corruption which eugendered a quantity of worlHs in the
~tomacl1.
Fraugois Xavier Martin gives a wholly different account of
the origin and nature of this malady, and classes it with the
Oriental Plague. He says: "Two line-of-battle shlps came iu
the latter part of J1me, 1720, from 'foulon. They were i.u great
distress ; Oaffaro, the commodore, and most of their crews hacJ
fallen victims to the plague, which some sailors in these ships
.£owi8iCIIna State Medical Eociety. 73
who had come from Marseilles, had communicated to the
others; that city being ravaged by pestilencet. brought there
by a ship from Lyde, in the Levant. Father Laval, a Jesuit,
royal professor of hydrography in the college of Toulon, had by
the king's order, taken past;age on boaxcl tbis fieetJ with direc­tions
to make astronomical observations in Lomsiana. The
chaplains of the ship having died, the father, considering
science an oQject of minor consideration to a minister of the
altar, thought it his duty to bestow all his time in administer­i.
ug spiritual relief to the sick, who for a long time were very
numerous, and he sailed back \vith the t;hips.
Experiment having shown that Europeans could not stand
the labors of the field, but sickened and died nnder the burning
suns of Louisiana, and the chilling dews and fogs of night; the
Western Company was therefore compelled to introduce African
negroes to cultivate the plantationt; scattererl on the bayous a.nu
rivers of the clelta of the Mi.":!sissippi <llid for several yeru:s it fnr­nished
tbe agricultural inte1·el:lts of the colony with seventl hun­<
lred annually, which was tbe origin of Airicall slavery iu Louisi­ana.
.Iu 1824, M. de Bienville c.b:ew up a code, containing all the
legislati'On applicable to slaves in Louisiana, whieh remained in
foxce urltil1803. It appears that during the year 1781, Louisi­ana
received no less than 1367 uegroes from tbe coast of Africa.
We have failed to discover in the writings of La Haxpe, Du
Pratz, Ohadevois, Marttn, Gayarre and others, any facts suR­taining
the view advanced by some, that yellow fever was
first imported into Louisiana. by the slave ship:).
Du Pratz, who visited New Orleans and Biloxi iu 1722,
st,a.tes that at the latter place more than five hundred persons
died of famine. He states that " the great plenty of oysters
found upon the coast saved the lives of some of them, althoug-h
obliged to wade up to their thig-hs for them a guushot :from the
shore. If this food nourished several of them, it threw num­bers
into sickness, which wa.s still more heightened by the long­time
they were obliged to be in the water."
In the beginning of August, 1723, Bienville remoYed his
headquarters to New Oderu:J.S. A most destructive hw·ricane
desolated the province on the 11th of SepteLUber, 1723. The
ehureh, hospital and thirty bonse.s were levelled to the gTonuJ
in New Orleans i three ,-essels thatla.3· before it were dri,·en on
shore. The crops abo...-e and below were totally destroyed, and
many houses of the planters blown uo\VD. Famine threatened
the colonists with its horrors, but they were in some degree
relieved by the appearance of an unexpected crop of rice. Dis­ease
adc1eil in the fall, 'its ltorrot·s to tltose of impending cleath.
In 172-1, the white population of Louisiana, says La llarpe,
amounted to about 1700 souls, and the black population to
3300. If La Harpe's statement be true, it shows an astonish­ing
dimi,nution of the white population, which in 1"721, was
computed at 5400.
10
74 Abstract of Proceedings
During the fall of 1726, Perrier, a lieutenant of the King's
ships, having been appointed commandant general of Louis­iana,
shortly after, Bienville sailed for France : one of the
articles of instruction to Govf:'rnor Perrier ran thus : " Whereas
it -is maintained thett the diseases which prevail in New Orlean.s
dtwing the 8U?n?ner proceed jro1n the wwnt of ai1· and front tl!e city
being smothered, by tlle neighboring woods, tohicl~ 1n·ess so close
wrottn(l it, it shall be tlle care of M. Pen·ier t.o have tliCJn cut d.own,
as far as La.ke Pontcha1·train." TheRe instructions sbow: Tha.t
at that r('mote time, tbe HtUllmer was ilie Rickly season at New
Orleans, as it has continued ev<.'r since up t.o the present day;
aml t.hat. to make the city more JJealtJJy, the govemmcut as far
back a::; 17~G, was struck with the ueces~:;ity of a.n improvement
which wa-s only linally executed to fn.J:fill tbe neces~Sities of the
Federal troops dmiug tlJeir hostile occupation in 1863, 1864 aurl.
1865.
In the year 1727, the land on whicL the city of New Orleans
now stands, not being protected by an adequate levee, was
subject to :'lnunaJ inundations, a.nd was a pel'fect quagmire,
presenting 110 better aspect than that of a >ast sink or sewer.
The waters of the l\Iississil)Pi :'lll(l tho::;e of Lake Pontchar­train,
met at a ridge of high land wbich by their common
deposits they hatl formed between Bayou St. John and New
Orleans, called the hig'l:tland of the lepers. To drain the city,
a wide ditch was dug on Bourbon street, t:Ue third from aHd
parallel to the ri n•r; each lot was ~nrrounded by a small ditclJ,
which in the cmtrHe of time tilleclup, e..~ct.!pt the part fronting
tbe street, so that every square im:~tead of every lot was
ditched iu. The waole city was sm-ro1mded by a laxge ditch,
an(l fence<:l in 'vitb sharp stakes wedged close together. In
this way a. convenient space was drained. In the language of
Gn.yane, "mosquitoes buzzed, and enormous frogs croaked in­ce::;
santly in concert with otl1er ilJcloscribable !SOlUldS; tall re~ds
aud grasse!S of every variety grew in the ~:;treets, antl in the
yards, so as to inter·cept all commuuication, and oife1·ed a safe
retreat and places of concealment to venomous 1·eptile..c::, wild
beast.-. arHl malefactors, who, protected by these impenetrable
jnHglc:-;, comurittecl with imptmity: all sorts of e:nl deeds." ls
it a,uy matter of smprise, therefore, that the bot months of
snmmer and antumn were even at tbi~ ea.rly da.y, dreaded for
tltoir clestructiYe, pestilential fevers.
01)\'cruor Pcrriel' sig11alized the hegiiruing of his administra­tion,
by the completion on the 15th of No,ember, 1727, in
ti·out of New Orleans, a le,·ee of eighteen hundred yards in
leugth, amlHO uroad that its snmmit nW<ti'JtU'ed eighteen feet
in width. 'fLi~ same leYee, althoug·h cowsiclcrably reduceu in
its proportion, he caw,;ed to be contiuued eighteen Ulil&; on
both sicle~S of the city above a.n<1 below. He announced to the
company that he woulu soo11 1.10dertake to cut a canal from
New Ol'leans to Bayou St. John, in order to open a .communi­cation
with the sea., tL.rongh the lakes, a.nd he ntentions the
Louisiana State Medica~ SociefiiJ. 75
arrangements which lle bad made with tbe inhabitants in rela­tion
to the negroes they were to furuish for the execution of
this work, which was actually begnn, but to which subsequent
events put a stop. Thus it is seen that the plan of the canal
which now bears the na,me of Carondelet, did not originate
with the Spanish go~ernor.
From a dispatch of Diron d' AI·tagnette, dated April23, 1733,
we learn that the small-pox was tbeu raging in Louisiana, and
that from this cause and famine, the result of the destruction
of the crops by a ht!.U'ricane, the colony was on the eve of beiltg
depopulated.
Bienville and Salmon, in a joint dispatch of the 31st of
August, 1735, say : "The mortality of ca,ttle is frightful, tlte
drought is excessive and the heat is suffocating. Such hot
weather has never been known siJ1ce the foundation of the col­ony,
and it has now lasted four months without any cbauge."
WbiJe the plantei'S were suffering ii·om drought, after ba\ri.ng
suffered from inundations, the illhabitauts of New Orleans
were laboring under a ::~trauge kind of iufectjou. They coulu
hardly venture out of their houses without being bit by mad
dogs. These animals had increased to such an extent, that
they had become a.u intolerable uuisance, and to remedy the
evil, the royal commissary, Salmon, ordereu them to be
hw1ted down, on certain daysJ from five o'clock to six o'clock in
tile morning. He also prohioited negroes and Indians from
having dogs; under the penalty for the oi:l:'ender of being sen­tenced
to wear an iron collar.
In 17341 Bieuvill~ was re-appointed Governor of Louisiana.
The force which l:Sienville assembled in 1739, for the subjec­tion
of the Chickasaw Indians, consisted of upwards of 1200
white, and double that number of Indian and black troops.
This comparatjvely laa:ge army, unaccountably spent six mouths
in making preparatjons for its march. In the meanwl1ile, the
troops lately arrived from France became w1ltea.lthy, and many
died, and the clim<'lite had au almost equally deleteri6u~:> influ­ence
on those from Canada. Early the uext fall, the regulars
and militia of Canada aJ.ld Louisiana, who had escaped the
antumnal disease, were prostrated by fatjgue, aud Bienville
was compelled to confute hi::; call for service, t<> his red antl
black men. They were his only effective force. In tlle Chicka­sa,
w war peace was purchased at the price of many valuable
lives-estimated at 600, out of 1200 white troops, not slain in
battle, but destroyed by tlle fevers of the dimate.
On the third of November, 1763, a secret treaty was signed
at Paris, between the French and Spanish Kings, by wltich the
former ceded to the latter, the part of the province of Louisi­ana
which lies on the western side of the Mississippi, with
the city of New Orleans, ant! the island on which it stands.
I have drawn the following conclusions, from data which I
have collected from every available sotuce, and purchased and
preserved in my library, relating chiefly to the Medical History
76 ilbst?·act of P1·oceedings
of Lonisiana, as viewed in connection with its commercial and
agricultural development, during the French rul~2 extending
fl-om the settlement in Matagorda Bay, by La Saue in J684 to
the treaty of Paris in 1763, wl1eu Frauce ceded to Spain and
Jjjnglaud her possessions in Not'th America.
lst. Uuder the French goverumeut, the growth of the popu­nlation
of Louisiaua, was very slow. According to a census
of the inhabitallts of Lhe province, three years after
the treaty of Paris, it had 1893 men fit l;o carry arms,
J O..U marriageable women, 1:375 boys, 1244 girls, in all
;)5.)() white individuals. The blacks were nearly as numer­ous.
The entire population at the end of near 80
yeaa:~:~, did Hot cxceell 12,000. The growth of tbe cap·
itol, New Orleans, hacl been very slow, and in 51 years after its
i(nmdation, the population amotmted to only 3190 persons of
all colors, sexe~:~ a]l(l ages.
2cl. Tbe commerce of New Orleaus, and of the province geu­t>
rally, was exceedingly limited during the French domiuation.
:.3d. It is probable iliat LaSalle and hls men suffel'ed wit11
yellow fe,•er, itt the West Intlieil a.s early a.s 1684, and they
appou.r to ltav·e hronght tlle ten'r with them to the shores of
the Gnlf of :Mexico. 'l'he. next visitn,tions of yellow feYer were
at Biloxi. inl701 u.ulll704. Ibro:ville and 800 of hiR men died
of yellow fever in the \Ve."!t Indies in 170G. The historian M.
JJePage Du Pratz states t1w.t six weeks before his arrival at
(;a.pe Fr;mr,;ois, St. Domi.ugo, in 17 J 8, fifteen 1much·ed persons
died of au epidemic ~listempt·r, called the Siam distemper,
wuich wa,-; one of the French names for y(•Uow fever. It is
pl'obablt> that ~"eilow fever caused tlte great mortality amongst
tl•e trOo}Js and couvicts in 17J 8, ou boa.rd the French ship,
whicll hall lost its reckoning, and missed its destiuatiou, aml
passed to the west of the mouths of the Mississippi.
-UJJ. 'l'he mL\igation of tl1e 1\lissi!.lsippi, from the Gulf to New
New Orleaus, wa::s very tedious llefore tbe introduction of steam,
and ol'teu occupied one month. The commerce of the city was
very limited dming- the French domination.
5th. Tbe record of the diseases of New Orleans during the
first half centmy Mter iw founclation, a.re very imperfect, and
we are not ju ·tiiied in affirming that during this period yel­hnl'
fever was Ltnknowu. We Jla,ve seen that as early as 1726,
eig·ht years after its foundation, the severefevm·s of the summer
~Mtd autumn tLttracted the ~ttteution of the government.
6th. There nre uo facts to sbow that during this period, yel­low
fever was inti ortnced by the slave ships. The mortality on
theso shi]JS 1'::t :-> oltit'D fl'ightful, aud was chie:fiy occasioned by
bad diet, ere .vdiug·, foul air, scmvy, diarrhrea and dysentery.
7th. The record· of the casuaJ.tie anu disea~es and surgery
of the vaJ'ions armies employed by tlle French at different
timeR against the Indians, English and Spaniaa:ds, are either
entirely wanting·, or wholly inaccessible to the .American stu-
Louisiam.a State Medical Society. 77
dent; bnt we have recorded the destruction of tlle men of the
31l'illY of Bienville, by fever, during the summer and autumn
of 1739.
IDSTORY OF YELLOW FEVER IN NEW ORLEANS, LOUISIAN!.,
DURING THE SPANISH RULE, 1763-180~.
Iu the archives of tile Department of Marine iu France, is to
be found a memorial, written on the luth of August, 1763, 011
tbe situation of Loull!iu,na, by oue Redou de Rassa~, who seerus
to have occupied an official position in the colony. Among the
causes which he give!:! as having operated as obstades to the
prosperity of Louisiana, are the following:
"1st. Under M. De Vandreuil, half of the married men sent
to Lonisiana bad 110 clrildren, and were betwe<'U forty and sixty.
":.ld. A good many families are located below tbe Engli!:lh
Turn, in marshy aucl unwholesome ground requiring incessant
labor to make and keep Llp embaukmeu~. To this mu.st be
added Lbe deleterious inftuence of poverty, a,nd evru:y variety
of misery, the a~iect,ioll of the men and the prostitution of the
WOUlCll.
"3cl. Tile officer!:!, addicted to trading, and converting tlleir
soldiers into slaves; a shameful system of plunder authoriZed
by the governors, provided they bad their sllare in it; the dis·
solute morals of the military, drunkeuness, ln:awls and duels,
by which half of the population was destroyed."
.1!"raucis Xavier Martin !:!tates that tlle fall ofl765 wa~:~ extremely
sickly; D. Abadie tlierl, and tile supreme command ot' tl~e pro­vince
devolved on Aub1·y, the senior military officer.
We have 110 record of tlte diseases of New Orleans during
the year 17G5, but yellow fever prevailed iu other portions of
the province.
Yellow fever prevailed at Mobile in 1765. The most autllen­tic
and detailed account of the epidemic was given by Captain
Bernard Romans, in his concise Natru·al IIistory of Ea~:>t and
West Florida, and is as follows: "This fatal disease has been
followed by the entire ruin of Mobile, and had nearly 'spoiled
the reput.'l.tiou of Pensacola. • • • Iu the year 1765, ar­rived
a regiment (I think the twenty-first) from Jamaica; with
them they brought a contagious distemper. contracted either in
the island or on their passage; these men~ like most sol(liers, lived
a life of intemperance, and besides ctrauk the water out of
stagnant pools; this aud other inconveniences of a soldier's life
joiued to tlteir arriving jn a ba<l season, swept tilem off so as
scarce to leave a living one to bury the dead." When describ·
ing the diseases of Florida, Bernard Romans remarks, " I am
persuaded that wherever the yellow fever has made its appear­ance
in the Floridas, it was imported from Jamaica or Havana, as
was the case in 1765, which (by the way) was almost univer­sally
an unhealthy era, as well in Europe as elsewhere." Con­cise
Nat·nral Histot·y of East and West Florida, p.12-13, p. 232.
78 Abstra<Jt of Proceedings
Dr. James Lind, in his Essay on Diseases Incidental to Eu~·o­peans
in Hot Olinwtes, bas recorded the prevalence of yellow
fever in 17651 at Pensacola. He says: "At Pensa~ola, where
the soil is sandy, and quite banen, tho English have suffered
much from sickness. Some for want of vegetables, died of
the scurvy; but a, far greater part of fevers. The excessive
heat of the weather, has sometimes produced in this place a
mortal siulmess, similar to that which i.u the West Indies, goes
nuder the name of tl1e yellow fever; this il1 the year 1765,
provetl very fatal to a regiment of soldiers seut fi.·om England,
uuseasoued to l:!uch clitu<1"Ws, ii.·om tile uufortnnate circwnstance
of their being landed there in the height of the sickly season;
it raged chietly in the fort, where tlle air iu the soldier's bar­racks
being sheltered from the sea breeze, by the walls of the
fort, was extremely sultry a.ud unhealthy.
It. is worthy of remark, t uat during the fatal rage of this
fever a.t Peusacoht, such as lived on boat·tl the slrips in tbe
ba,r·bor escaped it.
Pcns<teola, hOWl'Ver, is of late esteemed more healthy than
Mobile, where intermitting fevers prENail in the months of
July, August and September." "Lately, when a mortal sick­ness,
in the year 1765, prevailed at Pensacola by which a
regiment newly anived there lost 120 men, and eieven out of
twel\e of the officers' ladies, who were landed with them, were
said to have died; the companies of the meu-of-war, lying· at a
mile's distance from the shore, enjoyed tile most perfect health.
These sltip:s were the Tartar and Prince Edw~w:d, of whose
men, three ouJy, who bad beeu on shore, were seized v.1th this
malignant fever, and all of them recovered when they g·ot ou
board. It was likewise remarkable that :such gentlemen as
were seized with this fever at Pensacola, aml carried on board
shi})S, quickly recovered; or at least, by tllis change of air, tlle
fever, being divested of most of its mortal symptoms, soon
assumetl the form of an intermittent."
Dr. James Lind also records the fact, that 1' in the year 1766,
sixteen French Protesta-nt families, consisti.11g of sixty })ersons,
were sent at the e.A.-peuse of the English government to West
Florida. The ground allotted for their residen.ce was on the
side of a bill, SlU'l'OUllded with mat·shes, at the mouth of the
ri\er Scambia. These new planters arrived in winter, and
continued perfectly healthy uutil tl1e sickly months, which in
that country are those of J nly aud August. About this time,
eigb t gentlemen (from one of whom 1 received this account),
went to this new settlement to solicit votes for the election of
a representative to the General Assembly of that province;
where, by remaining but one night, every one of them wa8
seized with a violent intermitting fever, of which the candi­date,
for being the representative, and another of their number
ilied. The next day seven gentlemen came upon the same bu­siness1
to this unhealthy spot of grouud; but by Jea\'iug it be­fore
mght, they had the good fortuue to esc~1>pe this sickness,
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Louisiana State Medical Sooief:rJ. 79
and all continued in perfect health. Dtuing the same mouths,
the annual fever of that climate proved so fatal to these
French settlers on that unwholesome spot, that of sixty per-
1 sons, fourteen only stuvived it; and even tllo,e who remained
f alive, in the September and October follo,ving, were all in a
very ill state of health, bnt one of them llaviug escaped the
attack of the fever, autl 1nost of them. clyiJ1g wjthin a few
months afterwards, from llie injury it bad clone their consti­tutions."
Some writers have fixed U})On 1766, as tlle first visitation of
yellow fever in New Orleans.
Ma1·tin says: "This year, the province was visited by a ells­ease,
not clissitnilar to tba,t known as yellow fever. It was
severely felt in \Vest Florida, wllere a number of emigrauts
bad lately arrived. Sixteen families of French Protestants,
transported at the expense of the British government on llie
. river Escambia, consisting of sixty-fotu persong, were almost
eutixely swept away by the deleterious sickness." History of
Lotlisiana, vol. 1, p. 354.
The learned and accomplished historian, Charles Gayarre,
says that in 1766, Ulloa, "ordered a censu1-1 to bt> made of the
white population of Louisiana and the resnlt was fonucl to be
1893 men able to CaJ."l'Y aJ.'ms, 1044 woruen, maJ.·ried or ttnmar­ried,
1375 male children, and 1240 of the other sex. Total
6562. The blacks were about a.os numerous. But the popula­tion
was somewllat reduced by an epidemic which prevailed in
that year (17Gfi), and which, it is said, clo::;ely resembled the
disease now so well known here under the name of yellow
fever." Hist. of Louisiana under French Domination, 'ol. ii, .
pp. 133, 134.
The 17th and 18th of January, 17681 were the two coldest
days that had ever been lmo·wn in Lomsiana. AU the orange
trees perished a second time tllroughout the colony as in 1748.
In front of N e~ Orleans, the river was frozen on both sides to
thil:ty or forty feet from its bauks.
Norman, in ltis "New Orleans and its Environs, 1845," says
that "The first visitation of yellow fever was in 1769. Since
that time it llas continued to be almost au allnual scourge. It
was iu.trocluced into this coutiueut, in tllo above named yeru:·,
by ct British ·ves.sel, from the coast of Africa, with a cat·go of
81£wes.''
'vV e have ~:~een that no allu~:~ion to the introduction of yellow
fever or any infe<.;tions disease by tlle slave ships is found in the
prececliug colonial records. Norman does not cite authority for
lti1:1 ~<;tatement, which wonld place the fu·st epidemic of ye1low
fever in the year 176H. On tl.le other haud, Dr. Thomas fixes
the first inva~:~iou of the fever iu New Orlean~;, in 1796, or about
twenty-seven years later. Essai sur la Fin'l'e Jaune d'Amer­ique,
p . 70.
Dr. Daniel Drake, says, "This however is a mistake as we
!:>hall presently see. Throuf.hout the whole period, the com-
~0 Abstract of P1·oceedings
merce of the city was exceedingly limited and up to the year
1788, seventy-eight years after the first settlement, the popula­tion
amounted to only 5338, including negroes. On the whole
we may conclude that throughout the period meJJtioued, the
town suftered but little or at all from that malady. Since the
year 1700, it has become gradually more frequent and formida­ble;
but throughout tlle fu·st twenty-seven years the accounts
of its invasion are meagre and unsatisfactory." Principal Dis­seases
of the Valley of North America, 1854, pp. 201, 202.
Louisiana altbough ceded to Spain in 1763, was not tmder
tlle entire control of tllat power before the 18th of August,
1769, when O'Heilly took formal po~s&;sion of tbe country.
One of tlJe fu·st acttS of O'Reilly, was au order for a cell8us
of the inbabitants of New Orleans. It was executed with great
accuracy. It a1)pearccl that the aggregate population amotmted
to 3190 persons, of every age, :'lex and eolor. The number of
J'ree persons were 1902 ; 3J of whom \vere black, aud 68 of
mixe(l blood. There were 1225 slaves, tmd 60 domesticated
IudiH.ns. Tile n tuuber of houses were 46tl; the greater pari of
them were iu the thircl ann fourth st.rects from the riYet•, n.nu
vrincipall.r in the latter.
Iu J 778, oue of the most !leriou~> <~t11ict i oul'l of the province iu
this year, as :iu the preceding one, was tile small-pox, which
provt>d very fatal in New Orleaus, a.ud on the plantations aoove
and below. It appears to have been, for many years in Louisi­ana,
th0 disease most prevalent and most feared. Hunicanes
seem also to have been one of its chief scourges.
The army of 1400 men. assembled by Galvez for an expedi­tion
against the Euglish, suffered considerable Joss, towards
tile end of the sttmmer of 1779, from the diseases incident to
the climate; and when the Spaniards came in sig-ht of Fo1t
Manchac, sitJiated at a distance of about one huuclred and
tifteen miles from New Orleans, disease a.ncl the fatig·ues of the
journey bad caused a diminution of more than one-third of
their number.
The winter of 1784, was of extraordinary severity. On the
13th of February, the whole bed of the river, in front of New
Orleans, was filled up with fragmeuts of ice, the size of most of
whlcl1 was from t.welve to thirty feet, with a thickness of two
or three feet.
Oue of the :first measures of Mil·o's adm:inistration, which
sncceeded that of Galvez, in 1785, was of a most remarkable
character, autl charitable iu its pnrpos;e, namely, the follnda­tion
of a Hospital for Lepers. Tllere being a number of person:-.
in the Province of Louisiana, alflicted with lep,·osy, the Uabiluo
erected au hospitaJ for tbeir reception; in the rear of the city,
ou a ridge of hlgh laud, between it and Bayou St. John. ·
There are uo facts to show the precise nature of t be lep­rosy
of Louisiana, of those clays, but it may with reason be
supposed, that several affections were confounded with the true
leprosy of the ancient Egyptians, Hebrews and Greeks, as
81
constitutional syphilis, elephantiasis and the yaws of the
.African ra.ce. I have upon a former occasion, pre&ented to
the New Orleans Medical and Surgical Association, the results
of my investigations into the History of Leprosy in the South-
ern States, and the paper has been published in the New Or­leans
MEDICAL AND SURGIO.AL JOURNAL.
According to the census taken by order of Galvez, New Or­leans
contained in 1785, 4980 inhabitants.
Much light would be thrown upon the history of yellow
tever and other disea-ses, in New Orleans, were it possible to
recover tbe records of the l~oyal Hospital of New Orleans, for
which there was extlEmded in 178.1, the fo1lo11riug sum~; : a
com:vtroller $GOO; commissary $300 ; steward $-!80; physician
$600; chaplain $480; first ~:~urgeou $600; a.~siRtaut stU·geon
$360; mate $192; two ruin or ~:~urgeons $360; apothecary $480;
apothecaries' attendants and cook $964; :vrovisious and JUedi­ciues
$18,000. The total expeuses of the government of Louis­iana,
were $449,389. Whilst the expenses of North Carolina,,
with a population of 377,721, was only $561930, or iifteeu cents
par bead; those of Louisiana, with her 27,.184 inhabitants
(14,217 whites, 1203 free colored and 16,594 slaves), were six­teen
clollru:s and :fifty-five cents.
The summer of 1787 was marked by fevers which frequeutly
and easily assumed a malignant type. There was also an epi­demic
catarrh, from which few were exempt, and by which
many were seriously incommoded. The small-l>Ox infested the
whole province, and those whom fear }Jrevented from
being inoculated, beeruue the vieti.ms of then: prejudiCe&. All
those who were attacked oy the contagion, either d.ied, or were
dangerously sick. The inoculation was fatal only to ve1'Y few,
but this was enough to confirm in their systematic opposition
those who declaimed again~;t this wise and humane practice.
After the massacre by the negroes, on the night of the 23d
of August, 1791, of the French of the Island of Hispaniola, a
portion of the white inhabitants fied to Louisiana.
Dr. Daniel Drake, who ,,.,isited New Orleans ancl instituted
personal inquiries, states, that the first invasion of yellow
fever in New Orleans, of which he h.ad an autbeutic account, was
iu the year 1791. Dr. Drake's informant, Richaad Relf, Esq.,
one of the most venerable citizens of New Orleans, soo1 t after
his arrival experienced an attack, and three of his fellow
lodgers, full victims to the fever. After his recovery l1e :;;a.w
many ca.ses, and in subsequent years became xo fa.wiliar "rith
it that he could not be mistaken aR to the character of the cli:s­ease.
1'he Principal Diseases of the Valley of North America,
2<l series, 1854., p. 201.
On the 9th of Ma,y, 1794, Don Francisco Louis Hector Barou
de Carondelet, gave uotice of his inteution to dig a canai, wl.Lich
carrying off the water of the city and its environ into oue of
the, branches of the Bayou St. John, woulc.l rid New Orleans of
11
82 .Absm·aut o) Proceedings
the stagnating ponds which rendered it sickly, and the multi­tude
of musquitoes, which hru:rassed the inhabitants.
Baron Caa:ondelet designed the canal to run from the ditches,
that ran along the ramparts, with which the town was encircled,
to Bayou E:>t. John, and tb·us t<> w·ain the putrid waters, stag­.
natiug aroLmd the city, and producing those epidemics which
were so fatal to its prosperity.
In the month of October, 1795, Baron Carondelet by a publi·
cation in Le .Jlonitew· de la Louisiane (the only periodical paper
published in tbe province during it.s suQjection to Spain)
brought to view tile future gra.udem of New Orleans, and
aonoUllced that in five days more the Oul on.ial Government
· would complete the cana1; and in another publication on the
23d of November, draws attention of the inhabitants to the
commercial facilities afforded by the canal, and to the marked
diminution of Jllortal·itlj rlt~ring the preceding three mo'nths.
The gre<'l.t sanitary problem or New Orleans, drainage, en·
ga.ged the attention of its governors, for si'<ty-four years, before
the vr-actical and valuable experiuteut of Baron Carondelet.
Iu 1796, the canal behlud the city was completed, and a unm­ber
of vessels went through it to a basin, wbich harl been dug
near the ramparts.
'J'.LU: ~PiDBMIC YELLOW FEVER OF 1?96, NOT THE .l!'lRST VISlTA·
TION OF THIS DlSEASE IN NEW ORLEANS.
A.ccordiu~ to Charles Gayane, ·'New Orleans wa-s visited1 it is said fol' tbe fust time, with the yellow fever in tbe fall ot
tbe year 1796. That autumn proved besides very sickly in every
other wa.y. The Intendant Ventlll'a Morales, in a despatch of
the 31st of October, speaks of it i.u the following terms: Au
epidemic which broke out in the latter part of .August and
whicb is prevalent to thi.>S day, has terrified and still keeps in a
state of consternation the whole population of this town. Some
of the medical faculty call it a maJignaut fever , some say that
it is the ilisease so well known in America under the name of
Black Vomit, a.ud finally others affirm that it is the yellow
f(nrer, which proved so t~ttal i.Jt Philadelphia i.u the autumn of
179-!. Although the umnber of deaths ba:s not been excessive,
cou:sidering that ae<:ordiug t<> the parish registry, it has not yet
reached two lm.ndred among the wbi~ since the breaking· out
of the epi1lemic, and considering tht\t mauy died from other
<lh;eases, still it must be admitted, tl1at tbe loss of"lives is very
gTeat, becau~:~e although those who clietl out of the precincts of
tl1e town, aud tbc protestants ·who lleri ·llecl (aml they were
••mut>rons), have not been registered, nevertheless the uuwber
of dc}ttbs exceeds by two-thirds those wbicb occurrecl iu the
same lap:se of time in ordinary years. A peculiarity to be
remnrkecl iu this clisea:se is that it attacks foreiguen; in prefer­ence
to the natives, and what is singular, it seems to select the
Flemisb, the English, and the Americans, who rarely recover,
1
J
Looi.siana State MedU:al Society. 83
and wbo generally die the second or third day after the ilt va.­sion
of the uisease. Such is not tiJe ca.c;e with the Spaniru:ds
and the colored people, with whom the recipe of Dr. Mns<levall
bas produced marvellous effects." HiHtory of 1Jouisia.ua, Span­ish
Domination, p. 375.
A small pamphlet of 48 pages was published in New Orleans,
in 1796, with the following title: " Medic<tmen.s et preces r7c la
Metlwile de y,._ j]fa.sdeva.ll, Doctem· Metlecin ilm Roi cl' E.~pagne,
Charles IV, pou1· guein routes les J[aladies Epidcntiques, JHtbiiles
et 11falignes, jievrcs rle d~tferentY genres, &c., et powr en presen,er
divises en pa1·agra]JM~1 et en nume1·os con·e.ypmu)ens u lhtsage (]es
jarnilles clt 1>otwvue8 r1e Mrdecins. Prix 4 escalin8 brooM. Chez
Lo1'is Dtwlot. Imprimeu1· a ut N'lle Orleans, 1796, ane(; permis-sion
dtt Gmtvernment." .
This work is dedicated to Francis Louis Hector, Baron de
Carondelet, who was at that time the Governor of Louisiana.
In the preface allusions are made to the effort-s of Bu.ron
Carondelet in improving the health and extending the com­merce
of the city, in causing tl1e construction of a canal. In the
first paragTaph it is stated that Doctor .Joseph Masrlevall, bad in
the year 1783, observed tbe epidemics of putrid aud malignn,ut
fevers, wlllch had desolated Oatalogne, by direction of Charles
Ill. This account was published in l\1a.d.ricl in 178G. This p<tm­phlet,
published in New Orleans in l7!>G, and which has been
regarded as one of tl1e earliest, if not the ea1·Uest mellical work
issued in Louisiaua, appears tv consist cltieUy of extract.'3 fioom
the work of Dr. ~lasde,~au, published ten years before il1
Madrid. After ca.refltl examination of this small me,lie:al tract,
I have discovered no facts relating to the orig-iJJ, nature and
spread of the yellow fever of 1796 iu New Orleans. Tartar
emetic entered hwgely into the composition of the various
febrifuge reruedies recommended by Dr. Masd~vall.
Martin makes uo allusion to the prevalence of yellow feve1·
in the ~:>ommer and Jail of 1796, but say~:~ : " tl1e :tall of (1797)
this year was very sickly in New Orleans, and tbe city wa.s vil:l­ited
by the yellow fever." Hi~:>tory of Louisiana, vol. ii., p. 147.
Of the origin of the epidemic of 1796, D1·. Thoma.-,; (E:s~ai ~nr
la Fievre Jaune, p. 70}, gives the following a<JCOunt:
" It is said that vellow fever had neve!' been ohsorveu in
New Orlea.ns, before 1796. CJp to that time the city wal-l of no
great extent, and was surronucled by trees, which, by their
shade, preveutetl the pntretactiou of tbe \Vater CO\'ering the
ground at their root.'3, and which absorbeu to a great degree
(a quality which they are known to possess), tue cleleterious
miasm. The Spanish Baron Carondelet., theu g-ovemor of
Louisiana, caused a number of works to be executed ab(lut this
timet of which tbe priucipal were, 1st, tbe coustrnctiou of a
canal two miles long, which still bears his name, and termin­ates
in New Orlea.us in a basiu (larp;e euough to contain a great
number of small vessels from 25 to lOU t.ons burcleu, dng ex­actly
in the vlace where the olu cemeteri~s were situated), and
84 Aln;tnwt uf .Pruc~ii~!J:S
at the other euu in a small river emptjing into Lake Pontcllar­tmiu
; 2d, fortilicat10ns sunouuded by ditches; 3d, a clearing
away for a cousiuerable distance of tile trees which surround
the city. Thls laid b<tl'e a com;idcrable extent of marshy la~1d,
which dangerously in.fiuenced by the solar heat, soon clisen·
gaged effiuvia iu abundance.
rrhese works, and particulaJ:ly the cana.l, were finished in
179G, al:l is shown l>y the records of the city, from which I have
obtained these lletails; and it is exactly, at the time, that the
fhst epidemic of yellow fever occurred, which carried off at its
inception, all tbe laborers eugaged on tbe works, as eye-wit­uesscs
testisy. Tbe tlisastrou::; r~:~sults of disturbing the soil,
have been demonstrated auew-, in the epidemic of Natchez,
1819. Dr. Prouens, a wcll·t>.ducated physician, who practices
mediciue, tbeu wrote ou this subJect to the Medical Society of
New Orleans (of which he is a cone::;pondent), that the obviow;
cause of this epidemic wa.s not au im}JOrtation of it by the
river, as the coutagiouists contend; for the mortality began to
show itself in a place quite remote from the pott, ~~nd in tbe
ilulllediate viciuity of some very considerable excavations,
wbicb had been made a. short time before for the pmpose of
levelfu1g the stteets. The old inl.Jauitants of St. Domingo have
asstned me that lUany ~•ua.logons examples were known to have
occtu·red on that island, from the same cause. It will be seen,
in reailing the description of the epiuemic of 1822, that excava­tion
of the earth way be cousider·ed as one of the causes which
fixed its limits." The preceding opiniou advanced by Thomas,
tlhat tile yellow fever of 1796, was of local origiu, appears at
that time to llave been contested, for the late Professor Car­penter
(Sketches from tlle History of Yellow Fever, p. 13),
copyi.o.g fi·oru the .£mtisiana Oou?·ier for November, 1820, says
"it wa-s tl.-aeed to a. vessel which had brought it."
The view held hy Thomas, that the (so-calle<l) ji1·st epiden-no
of yellow fe,er in Ne"" Orleans, was 1·eferable in its origin and
causation to local causes, a.ud especially to au e>..'tensive clis­tUl'bance
of the :soil, found au ardent and able ad vocate in the
late Dr. Edward R. Barton, wlwse views were fully unfolded
in the Report of the Sanitary Oo1mni:s:sion of New Orleans, in the
JJJpidmwio Ye17ow Fever of 18fi3. Dr. Barton says, " I wish to
be tmde1·stood distiuctly as stating that since 1796-7, to the
p1·esent time, tltere ha.li been ItO gre<tt epidemic yellow jwe1· vn this
city, without an extensive breakiug up1 di$turbance and e.x:postwe of
the Ol'i!J inal .yoil of the cowntry ; antl that tlte extent and mctlignanoy
of tlte disea~c lta8 been p1·ett:y ?Jmch in propm·tion to the e;ctent of
these e.xpo:sure:s."
Iu connection with the preceding speculations, it is worthy
of note, that the canal Oa.ron.delet was commenced in the
mouth of J uue, 179-1; that in the autumn of 1795 there was a
navigable canal remote from the city by way of the lakes to
the sea, aud tllat the ca.ual autl. basin were in successful opera­tion
in 1796.
Dr. Bennet Dowler, who appears to have endorsed to a cer­tain
extent the opinion~; of Thomas and Barton as to the local
origin of the epidemic of 1796, is manifestly iu error when he
states that "the health oj' New Orleans anterior· to the 01ppea.1·­ance
of yellow fever (in 1796), ·was uns1trpasse<l by any city in
A1nerica i'' for 'vithout recapitulating the facts which we have
recoi•clecl to show that pestilential fevers had affiictccl the city
at various times, as well as small-pox aucl leprosy, the incor­rectness
of hi~; statemeut is showu by t!Je following facts:
lu1787, the popnlation of New Orleans was 5284, with a.
total mortality of 338; one death in 15.04 inhabitants, and a
ratio per thousand of population (MillesinluJ mortality) of
63.9~.
In 1796, the population of ~ew Orl~aus was 8756, with a
total mortality of 638; one deatll iu 13.57 of iuhabitauts, ~~ud a.
ratio per 1000 of population (1\lillcsimal mortality) of 72.86.
It will be· seen from the preceding statistics, that in 1787,
wheu we bad no record of au epidemic in New Orlean~;, the
mortality reached the fearful proportion of oue in fifteen of the
iullabitauts, and iu 1796, this heavy mortality was still farther
increased by the yellow fever to one death in 13.1J7 inhabitant.\!.
The mortality of both these ytJars 1787 aud 1796, was in
relation to the actual population, far heavier than that of the
past year 1878, which will be me1uorable for its epidemic of
yeJlow fever, which stands as tbil'd in the list of great epidemics
in New Orleans from its foundation in 1718 to 1879.
'l'hus the totJ mortality for tbe year 1878, was 10,::H81 of
which 80u2 were whites, and 225G colored, making of ail colors
one death m about 20 iuhabitauts; or 50.17 per 1000 of popu­lation;
or 55.32 per 1000 of white populatiou, and 3!l.13 per
1000 of colored population.
The number that died of yellow fe;er, was 4:04G, of wbich
3863 were whites, aud 183 were colored; 4050 deducted from
10 318 would give for all other diseases G27!t; making of all
colors a ratio of mortality 30.0~ per 1000 of population, or 28.81
per 1000 of white population, and 35.95 per 1000 of colored
population. The ratio' of mortality pei· 1000 from yellow fever
was 19.30 per 1000 population; and from malarial fevers 3.77
per 1000 of entire population.
In the light of such facts it is but just to hold the view that
New Orleans has beeu su~ject to pestilential fever;:; at variou~;
ti.ules from its foundatwn, and that the opinions as to it.\! won­derful
healthfuluess from its :first foundation in 1718 to 1796,
the date of the so-oalled Pit·st! Epidemic of yellow fever, are
mere opinions without foundation iu fact. And we atta-ch little
or no weight to the ass&·tiou of Beuuet Dowlex· and many
ot.her ~vt·iters of les;s note, that whilst New Orleans from its
foundation had been clo ·ely connected by geographical position,
commercial intercourse, language and goverruneuts, witll both
insular and continental America, where yellow fever had pre­vailed
for ceutaries, unde1· Spanish, French aud English ~ule,
86 . Abstract of Procedlings
it had yet always remained exempt from yellow fever up to the
year 1796.
We have seen that l\'fartin states that yellow fever prevailed
ill 1797. M. Victor Debouchel, in his history of Louisiana,
puhUshed in J ~:1:1, says tb<tt the yellow fever desolated New Or­leans
in the following years, namely: 1767, 1797, 1802, 1810,
1814, 1818, 1822, 1824, 1827' 1831, 1835, 1837.
Dr. Oarpeute1· states that in 179U, " there wa.s what was
considered as proof of it..s importation." Sketches from the
History of Yellow Fever, p. 14. Dr. Carpenter refers to the Lou­isiana
Oomier of November 20th, 1820, as the source of this
su1'ruise. Dr. Dow, of New Orleans, in his visit to Philadelpl\ia
iu 1800, informed Dr. Benjamin Rush, that the natives and old
citizens of New Orleans, who retired into the country tlming
the prevalence of yellow fever iu that city the year before 1799,
were often a.1fected by it, whilst all such persons who did not
cllange their residences escaped it (Rusll Inquiry, 10, 126).
lu a dispatch of the 25th of July, 1799, Morales informed
his government of tlle cleatb of Gayoso, iu the fo1Jowing terms:
"On tll~:~ 18th inst., it pleased God to put au end to the life and
govermneut of Brigadier-Oeneral Don Manuel Gayoso de
Lemes. .He clied of a maligna11t fever, of the nature of. those
which prevail iu this cow1try during the summer, aud the dan­gerous
characte1· of which was known only a few bom·s before
it terminated fatally. He had uo time to lose iu fulfilling the
last duties of the Uhristiau anti. in making ills testamentary
dispositions."
In a remarkable memoir submitted on the 15th of September,
1800, to the First Consul of the French Republic, by M. Ponta­bla,
he says that, " Louisiana cannot dispense with the slave
tl·ade. The excessive heat prevailing duriug t.he five months in
which the hanlest works are to be executed, ou the plantations,
does not allow of the use of free and white labor, and renders
the blacks indispensable."
In Ma.rch, 1801, Baron ue CS!·ondelet, in an official document,
set forth the importance ofimproving the topography of the city,
so as to draill off in CanaJ Carondelet, the stagnant waters
whlch abounded "uear the city," and which he regarded as
"the cause of m1teh mo'rtality," a mea8ln·e which 11e says would
put an end to pestilential fev(m (Martin, voL ii, pp. 176, 177),
in which category be doubtless included yellow fever, which
a few months later occurred as an epidemic.
Dr. Snead, of New Orleans, detailed the mode of treatment
and critised it as inefficient.
In 1802, the government of the United States applied to the
Spanish government for permission to establish a ~farine Hos­pital
at New Orleans, for American seamen, mauy having died
there in a destitute comlition.
Dr. Rush represents 1803, as a year exempt from epidemic yellow fever in the United States, Charleston excepted, it pre- vailed however in New Orlea.ns.
Lou~iana Stalf; .Mediw.l liuci~:ty. 8'i
One of the first acts of the colonial prefect, Laussat, who
arrived at New Orleans ou tlte ~6th of March, 1803, wa~ to ex­amine
the fortificatiotts, which eleveu yea1·s before, had been
erected by the Baron lie Carondelet, and in his report to .Miuis­ter
Decres, he says : " It has lately been proposed to tLe King
of Spain to razee or at lea-:st greati~· to reduce these works, as
being useless or even mischievous, because the feve1:s which
every year, carrying oft' the most. valuable portion of the popula­tion
of this city, date from the time when there were dug rouud
it those ditches which are always full of stagnating water."
Iu a work entitled " Vue ue la Oolouie Espagnole du Missis·
sippi ou des .Provinces U.e Lonh;iane ~:~t Floriua Occichmtal cu
Il Anne, 1802. Par un ObservateUl' ~siclont sru· L~ Lieux. H.
Duvallou, Editeur, Paris, 18031 au accm·ate description of yel­low
fever is gi·ven, and the statemt>ut is made that it had pre­va.
ilcd uuring the swumer and autnnm iu New Orleans, duruur
the preceding six or seven years, pp. 84-HH. According to tllit~
writer yellow fever preva.iled iH 17!J4, l'iU3, 1796, 17!J7, 17Vo,
17VU, 1801. The writer of this work, wbilst d:iJ:ectiug attentiou
to tlte pectiliar topography of lower Louisiana, with i~ tlcLL
depressetl surface, auu cltaugeable cluuatc, states that the
country was compa1·atively healthy for botlt whited autl blacks,
whilst on the other hand, New Orleans, was, dtu·iug the months
of July, August, September and October, ra,·aged by the yellow
fever. He says: "The city of New Orleans has for se.,·eral
years during the mouths of July, August, September anu part
of October, been atl:lictetl with a species of maligna.ut fever of
the gravest torru. Tb.e symptoms and accideuts of this disease,
va..l'icd to ~:~uch an extent, that the physicians of the city, cou­si::;
ting of eight or ten smgeons, with a few exceptions without
letteni, were entirely ignol'ant of the methods of cure in thi~:~
d~tructi ,.e plague." 'fhis mala-dy ha , druing tlle past six or
seven years, made ravages almost eYery sui.Ul.Uer upon N e"
Orleans; but has uot atl"ected the couu.try to any exteut, where
it is knowu only by or tlrrough commuuicatious from oue point
to mlOther; aud as the cou~:~equent of such communications."
After gbing a.u accru·ate desuription or tue tlisease, the author
thus discusses it:s orig·in: "But why sbonld thls diseaSe be eu­U.
ewic i 11 tlle city and noll in the smrotmtling conutry ~ The c.'l.nses
which deady corrupt tbc ai1· breathed in New Orleans, aud dur­ing
tLe lleat of sUllllUer, reudtr it su~:~ceptible of being impreg­nated
from impure anu fatal wiusms, •u·e LLe exces~Sive amount of
filth tlistril>uteu in the towu, along the lovee, in tbe stl:eets, iu the
vacaut lotS, aud eYeu iu tile com·t yaru:s or litany hou:ses, wltore
eviueutly the slop~S arc t.hrowu, antl frow wlumce they are uot
takeJJ <LW<LY, except partially, aml at loug ir1tervals; the accu­mulation
of pools of ~;t.'l.gututt water mixed with ordure (excre­ments,
l>oth u:uiwaJ and btlman), within the confines of the
city: the accumulation of large heap of pntre(yllig infections
matters in the middle of the unpaved streets, and in .mauy
other placM.
-----------------------
Abstract of Proceeding.<~
The high brick houses that have been erected dm:ing several
years past, preserve and communicate more dampness, in a
locality that is always damp, and a.lso stop aud prevent the
fJ:ee circulation of the a.ir. The air is tlms Tendered stagnant,
aud tile poiRoo is thus aceunJUlatetl in the lower atmosphere.
'fbe ditches snnonnding the fortificatiom; erected ~:;everal years
ago, are filled with stagnant water, which, during the heated
tenn, exhale fretid vapors, which were unknown before the dig­gillg
of these trenches or canals arotmd the town.
1'o thexe causes of il1salubrity, from which all persons suffer,
anil the exist~.>w:e of w:Uiclt no one upon examination will deny,
another may be added, to which the oldest people of the city,
attribute great iulinence, a11d eYen tlte OI'igiu of the diseast-.
As in a matter so important. to tbe preservation of humanity,
nothing should be neglecterl, we 'vill therefore cite this ca.use,
or explanation, without adopting or r~jectiug it, tmtil expe­rien<;
e :ntd observation shall bave clissii)ated all nncertaiuty.
It. is heltl hy so111e, tl1at ti.Jis disea ·e llas ouly been known in
Nt'W Orleans, dnring the pa~t six or seven years, or the period
at "·l1icll dntct\ the great extension of Ame1·ican conun~rce to
~ew Orleans, an(l it i~S inferred tl1at as tbis disease '~as already
spread in the ~orth of America, befor(' this period, as is
lmown from tbe raYag-es wl1ic1J it ma<le in Philadelphia and
other place~ in 1793, tllat it ]Hl.S been brought llere- by the
.Americans, who are in fad its pl'incipaJ victims. Witbont
fleci1ling- this question I 'vill say, that it is uotorions aud
au estallti~be(l fact that this fe,·er has S})read duriug· the
past 0011 yean> iu the tlitfereut cities of North A:mer­icn,
a11d especially in Philadelphia aud New York, where
1t appem.·s to l1a.n~ originated, and f>ven where it received the
uame which it bea,rs, and tllat ~ince its first appearance it makes
mmual ra>ages during· .Tuly, Ang·ust, Se.pterober and part of
October, so as to render tht•se cities a.lmost desolated, and iso­lated
during t11e violence of the malady. In these towns the
disease exert.'\ its chief violence upon Americans, rather tbau
stranger~>~, who are found there in large numbers. I believe
tllat the rellow fe•er is endemic in the United States, and I tlo
not bold that it is only twelve or fifteen years since the disease
was lmowu."
The same writer states, t:Uat the ~ick in the country, were
most ge.neraUy brought into New Orleans for treatment, aU<l
t:bis custom couYertecl the city into a vast hospital, and tended
to introduce the germs of disease.
lt appears tha.t at this time, the vractice of IJledicine in New
Orleru1~, was Yery lucrative.
C. C. Robin, in bis valuable work,• records the observ;l-
• Vorages d•DA 1'\nterieur do Ia Loulsiane, de la.Florlde Oecidentale et dans lea tales de
Ia Martinique e~ lie Saint Domlnjtuo. pendant lea auuoell 1802, lt'03, 1804, IQO$ et 1806.
Coutena.n~ ~e Nonvelles Ob~ervatloue sur l'Hiatoi re NaLnrelle Ia Geograpbie, lea Moonre,
l'A!!1ionltnre, le Commerce, I'Iudustrieetleelilalades de oes Con tree&, pulieullemeot stu
Ia Fievre Jaune. et lee Moyeos do Joe prevenir, etc. Par C. C., Robin, autrb de plnaloura
ouVTages eur Ia Literature et l~a Science's. 3 vola. A Pari&, 1801, vol. t, pp. H5, 1!00.
Louisiana Btate Me<J,ical Somet;y. 89
tion, that the pulse gives no index of the severity of the attack
of yellow fever. He describes accurately the symptoms of the
disease, aud states, " There is generally repeated vomiting of
black blood. Very often again, as is said by Father Labat, the
people who suffer but little from pain in the head expire sud­denly.
In New Orlea.us dming the summer of 1805, several
English and .Anglo-Americans bave died in this sudden man­ner.
One among them, attacked by this malady, expired at
once on the levee, holding in his hand a piece of melon which
he was eating. His skin was congested, and his count~nance
anima.ted. A physician who was asked by a citizen to pass by
his house, and visit his wife. who was dangerously ill, said to
this party, after looking at him, 1 And you, sir, how do you
feel 'I' ' Very well!' 'Very well!' replied the physician~
' let me feel your pulse. You are also sick, and very danger­ously
so; go without loss of time to bed ; I will follow yon ! '
.A. tew days after, this man died."
Robin states that the yellow fever prevailed with destrncti ve
effects in New Orleans in 1805. He also records the fact that
at this early date calomel in large doses was employed in the
treatment of this disease.
Whilst alluding to the fact that-yellow fever had prevailed
during several years preceding his visit to New Orleans, and
reaffirming the observation that strangers, and especially the
Americans, from their habits oflife, and use of strong drinks,
were more s11bject to the disease than the Spaniards and the
natives (Creoles), French and negroes; on the other hand he
does not give any specific date as to the :first appearance of this
disease in New Orleans. Robin affhms that yellow fever was
un.lmown in the early history of New Orleans, when only a few
small cottages neatly white-wash~d, occupied the commodious
squ&·es and whilst the risin o- town was surrounded by forest
trees. He refers the origiu of the disease to several causes, as
the clearing of the surrounding forests, the exposure of the
marshy soil, the accumulation of filth in the city, and the
building of lofty houses, which obstructed the circulation of
the air, and at the same time increased the heat by reflection
of the rays and absorption. Robin quotes Father Labat to
pro\7e that yellow fever had been long knowu in the West India
Islands.
M. Perrin Du Lac, in his " Voyage clwns les Deux LouisU~nes,
et chez les Nations Satwages du Missou1·i par les Etats U111is,
l!Olvio, et les P1·ovinces qwi le bo1·dent, en 1801, 1802, et 1803: .A..
Lyon, An. x:iii, 1805 ;"allude~ to the prevalence of yellow fever
in the American cities as early as 17 -!5, aud to it<> nwage~ ill Phil­adelphia
and New York in 1794. With reference to the que.s­tion
of contagion aud importation, M. Perrin Du Lac appears
to iucline to the opinion that the disease ol'ig;ua.ted in those
citi~~.J chiefi.}' in and about the filthy wharves and iu low ill­ventilated
tenement houses.
12
90 Abstract of Proceedings
He states that for several years preceding his visit to New
Orleaus, yellow fever had prevailed, and he attributes its ori­gin
to the filthy condition of the streets and honses, and the
putrefying ultb and garbage about the markets. He directs
attention, also to the fact tbat the negroes in New York and
Philadelpllia were comparatively exempt from the ravages of
the disease, and also that the Creoles, French and Spaniards
were but infrequently attacked by tbe disease in New Orleans,
wl1ich proved so fatal to Europeans and Americans (pp. 11- 19,
392-396).
'l'he following conclnsions may be drawn from the preceding
outline of the HistoiJ· of Yellow Fever iu Louisiana, dming the
Spanish rule, 1764-1803 :
1st. Whilst New Orleans snfferecl annually with malignant
malarial fe,ers, similru· in all respects to those known at the
present time as intermittent, remittent, congesti-ve, pernicious,
pat·oxysmal, paludal, marsh, swamp and malarial fevers, yellow
fever tloes not appear to have attracted much attention in this
city before the year 1796, aud consequently we find but few
allusions to its existence ill the works of the earliest travelers
through Louisiana.
2d. During the Spanish t'tlle, ~ also during the p1·eceding
French dominiou, New Orleaus and the entire region named
Louisiana, was without medical journals, and produced no
native rueclical works. Wilen neither medical writers nor books
existed, it would be absul'd to affil'ln that the mere absence of
records, demonstta.tefl the absence of any Rpeciuc disease as
yellow fe-ver.
3d. The fall of 1765, was very sickly in New Orleans, as well
as that nf 1766, wllen tile popuhLtion of the city was reduced,
by a11 epi<lewic, whicl1 is said to have closely r«.>sembled the
disease.
!tb. A careful consideration of all the testimony presented
i11 the preceding historical sketch, will show that yellow fever
dicl uot appear for the fust time in Ne'v Orleans in 1796. It
was cert.awly pl'esent in 1791, 1794 and 1705.
.)tb. Tluougl.tout all her past h111tory, up to the present
moment, the grand sanitary problems, of New Orleans, were
<>ffective drrumtge, efficient police of private premises and pub­lic
thoroughfares, the daily and rapid removal of all offaJ
and excrementitious matter, the proper elevation of and con­
»trtlction of houses, free ventilation; abundant water supply;
I lw proper distribntion of the population, so as to aYoid o-ver-
<·rowtliug. ·
Gth. Many writers, attributed the origin of yellow fever, to
the stagnant and foul fermenting putrid waters of the ditch,
caHal or bayou A surrounding the wall of tbe city, and referred its
first advent to tlJe exten