Volume 1

Yellow fever : considered in its historical, pathological, etiological, and therapeutical relations. Including a sketch of the disease as it has occurred in Philadelphia from 1699 to 1854, with an examination of the connections between it and the fevers known under the same name in other parts of temperate, as well as in tropical, regions / By R. La Roche.

René La Roche

Date:: 1855

Credit: Yellow fever : considered in its historical, pathological, etiological, and therapeutical relations. Including a sketch of the disease as it has occurred in Philadelphia from 1699 to 1854, with an examination of the connections between it and the fevers known under the same name in other parts of temperate, as well as in tropical, regions / By R. La Roche. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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$of urine, tlie locality where it broke out, the luaiiuer in which it s])read, the rapidity with which some of the cases ended fatally; all these circumstances— ► as well as the fact that while it raged here a disease of kindred nature pre- ; vailed, not only in the West Indies but on this very continent, and at no great \ distance from this city (in New Yoi’k^and Virginia^) which so little resem- [ bled the ordinary fever of the season as to take the physicians by sur- i prise—lead to the conclusion that the disease was, notwithstanding the name i of “palatine” given to it by some, analogous to that which had prevailed in \ 1699, and, like it, was entitled to the name of yellow fever. But we possess stronger proof to that effect; for, in the memorandum already mentioned, Dr. Kearsley has left us a sufficiently copious account of the symptoms of the disease to enable us to form an idea of the class to which it belongs. The jiaucity of materials we possess on the subject must be my apology for insert- ing this memorandum, notwithstanding the rather antiquated pathological views it exhibits. Comparing the disease with that described by Dr. Mitchell, of Virginia, Dr. Kearsley says :— “1. Wandering pains, like those attending a rheumatic fever, but much more severe, were generally much complained of from the first by those who had the disease in Pennsylvania. They are not mentioned by Dr. M. “ 2. A very great anxiety, with sickness and pain in the stomach, attended with an excessive convulsive vomiting, which no medicine would scarce re- lieve. This appeared on the first and second day, but more commonly on the third, when it was generally fatal, by bringing on hiccough, inflammation of the stomach and viscera, with a large discharge, by vomit, of a black, atra- bilious matter, like coffee-grounds, mixed with bloody lymph or coagulated blood; which frequently put a period to the patient’s life, though some re- covered under this symptom by an early discharge of the black matter by stool. “ 3. The atra-bilious humour, as Dr. Mitchell calls it, was highly acrid, yet not so viscid as that in Virginia, which gave it a more easy passage through the biliary ducts; and, being thereby more easily pumped up by the convul- sive retchings of the stomach, hence, by its greater acrimony, it rendered this symptom more violent and fatal than it seems to have been in Virginia.”^ No one at the time seemed, as it would appear, inclined to look for the cause of the epidemic in the local sources of infection existing^ in the city. It was found more natural to attribute its development to importation from abroad. But, as generally happens in such cases, those who, not being able to discover in and about the city circumstances calculated to produce the fever, referred it to a foreign origin, differed as to the place whence it was to be I traced, and the mode of its introduction. Mr. Pemberton, recalling the fact i of a military expedition which proved unsuccessful, “being promoted a short \ time before by Great Britain against some of the West India possessions, [ particularly Carthagena,” adds that “troops were raised in Pennsylvania, and ’ Golden, New York Med. Repos., xiv. pp. 1, 156. ^ Mitchell, Med. Mus., i. p. 1. ® Loc. cit., pp. 20, 21.$

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