The disease assumed a new character this year, and was cured by a different force of medicine from that which was employed in some of the years in which it had prevailed in Philadelphia.
I shall briefly describe it in each of the systems, and then take notice of some peculiarities which attended it. Afterwards I shall mention the remedies which were effectual in curing it.
1. The pulse was moderately _tense_ in most cases. It intermitted in one case, and in several others the tension was of a transient nature.
Hæmorrhages occurred in many cases. They were chiefly from the nose, but in some instances they occurred from the stomach, bowels, and hæmorrhoidal vessels.
2. Great flatulency attended in the stomach, but sickness and vomiting were much less frequent than in former years. I saw but one case in which diarrh[oe]a attended this fever.
3. I did not meet with a single instance of a glandular swelling in any part of the body.
4. There was a general disposition to sweat in this fever from its beginning. Two of my patients died, in whom no moisture could be excited on the skin. But I recovered one with a dry skin, by means of a purge, two bleedings, and blisters.
An efflorescence on the skin occurred in several instances. I saw black matter discharged from a blister in one case, and blood in another.
5. The stools were green and black. Bile was generally discharged in puking.
6. The blood exhibited the following appearances: siziness, lotura carnium, sunken crassamentum, red sediment, and what is called dense or unseparated blood. I saw no instance of its being dissolved.
7. The tongue was whitish and dark-coloured. This diseased appearance continued, in some instances, several days after a recovery took place. I saw no smooth, red, nor black tongue, and but one dry and one _natural_ tongue. The latter was followed by death.
I did not see a single case in which the disease came on without an exciting cause; such as light clothing and bed-clothes, sitting at doors after night, a long walk, gunning, and violent and unusual exercises of any kind. It was excited in a number of people by their exertions to extinguish a fire which took place in Water-street, between Market and Chesnut-streets, on the morning of the 25th of August. I saw a fatal instance of it succeed a severe tooth-ach. Whether this pain was the exciting cause, or the first morbid symptom of the fever, I know not; but I was led by it to bleed a young lady twice who complained of that pain, and who had at the same time a tense pulse. Her blood had the usual appearances which occur in the yellow fever.