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1896. Sept. 24 Hovebarius.

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Papers on the Summer Epidemic or Yellow Fever, in several

Ports of North America, and the West India Islands.

Statement of the Yellow Feder, as it occurred in Newo-Orleans,

1819. By J. Baxter, M.D., &c. honorary Member of the Philadelphia Medical Society.

I WILL premise with an account of the state of the weather,according to my own observations noted at the time.

June.-The latter part of this month (on the 24th of which I arrived at the city) was attended with severe squalls, much thunder and lightning, rain, high winds, and cloudy, cool weather, especially at night.

July-was mostly cloudy, with frequent showers, there being nineteen days on which rain fell; and the last four days it fell constantly, attended with high winds, blowing to a violent gale, which did considerable damage, more especially at Mobile, and Bay of St. Louis.

The highest degree of heat I observed this month, was on the 15th, at 2 o'clock, when the thermometer stood at 940 Fahr. and the lowest at the same time of day, and in the same place, viz. in the shade, and in a passage, was 76°, on the 30th and 31st of the month; on the morning of the 29th it stood at 73° ; its usual range was from 82° to 88°.

August-was cloudy and rainy, there not being one entire
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clear day; the sky was constantly more or less covered with clouds, and rain fell every day, with the exception of six. The range of the thermometer was from 76° to 86°; in no instance did I observe it to rise higher. The sickness and mortality increased very much during this month.

September. The first few days partook of the character of the last month,-the weather afterward becoming dry, cool, and clear. The thermometer rose as high as 90 degrees on the 11th, but from 79° to 83° was the usual range ;-on the evening of 30th, it fell to 72° :—the mortality was at its maximum this month. There had been several cases of fever previous to my arrival, and one very early in the spring. Mr. Sweetser, of Boston, died in March, after a few days illness, attended with black vomit.

The first case that occurred to me, was on the 29th of June, some of the particulars of which I referred to in a letter to my friend, Dr. J. G. Coffin, of Boston, republished by you, in your Number for January last,--and the next was on the 30th of the same month, after which, cases continued to occur frequently, until towards the latter part of July; the symptoms had, however, gradually become more malignant, and deaths in proportion :-at the end of the month the disease seemed to be suspended ; it was at this time the gale occurred, when the thermometer within an hour, fell from 92° to 85°

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and af. terward to 76°, where it remained for three days. Of those already sick,none died, as was observed to be the case in a like pause in Philadelphia, in 1793;-—this was but deceitful; and the disease renewed its progress soon after the beginning of August, with increased vigour, and with the most malignant symptoms.

At the beginning of the season it took on the intermittent form, but at the latter part, especially after the above pause, it became remittent, and continued. The 3d, 5th, and 7th days were the most critical; those who reached the 7th day generally recovered: one of my patients lingered to the 29th day, and then died :-relapses usually proved fatal.

The disease attacked with the watery, fiery, rolling eye, incessant vomiting, pain in the head, back, and extremities, and at the epigastrium, with soreness on pressure ; pulse sometimes low, and fluttering, at others full, frequent, and hard,-skin at first hot, afterward cold to the touch, with a sensation of great internal heat to the patient, which was a very fatal symptom, as were also a clean tongue, and partial perspiration, involuntary passing of urine, and fæces, and delirium; but the most fatal symptoms, were a total suppression of urine and hiccough; these went off in one of my patients before death, and I had but one recovery with the last-mentioned symptom. The suppression did not seem to arise from retention, as far as I could judge, or learn, but rather from a want of the secretion, and that not from an engorgement. Dr. Randolph informed me, he had once seen pus in the kidneys.

The black vomit was not so general as is usual; I saw but one case of it; the suppression of urine seemed to have superseded it,--this was also remarked to me by several medical gentlemen of the place. Towards the last of the season, nausea and vomiting were not so common as at first. A physician informed me, that he had seen several patients who called on him with the black vomit. I was also informed of a lady who walked about till within a few hours of her death; the most prominent, and almost the only symptom of her disease, was suppression of urine. I had one patient with scalding of urine, and two with swelled testicle; the tongue was generally white, or red, but usual. Jy black in fatal cases,-yellowness of the eyes and skin came on about the 3d or 5th day; this was by no means a universal symptom: in one case it went off before death. In one of my patients, there was a great soreness of the joints, cramp in the gastrocnemii muscles, and total incapacity to

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