There are great differences of opinion as to the proper treatment of this disease. Dr. Blair, one of the highest anthorities on yellow fever, holds that the disease may be cut short or aborted by prescribing " 20 grains of calomel added to 24 graMs of quinine, afterward followed by two drams of carbonate of magnesia, and two ounces of sulphate of magnesia in eight ounces of peppermint water." These aborting doses were repeated at intervals of four or six hours, one dose being generally efficient, but four have been given before the quinine induced its special symptoms of cin chonism. Many physicians who have had much experience of this disease, have no belief in the abortive treatment; and some treat their cases with antiphlogistin or lowering remedies, and others with stimulants. It is probable that there is no one mode of treatment suitable for all cases, and that each should be treated according to its special symptoms. The extreme heat of the surface (a temperature of 107° has been observed in the arm-pit) may be relieved by the frequent application of the sheet; cupping or leeches often relieve the head-symptoms; and a blister to the• gastric region may relieve the irritation of the stomach. If there is no suppression of urine, and if that fluid is free from albumen, morphia is of great service, but it must be given with great caution. The food should be of the mildest form, such as chicken-tea,. arrowroot, sago,' and barley-water, and these should be taken frequently in very small doses, in consequence of the state of the stomach. Similarly, with regard to all drinks, which are most likely to be retained if sucked through a tube or given by tetisp6On fuls. Tea usually disagrees, but cold infusion of oatmeal, and very dilute brandy and are usually relished. Our highest authority on tropical diseases, sir J. Ranald Martin, states that, whenever the disease breaks out, " the most speedy means of preven tion [of its spreading] in respect to towns and garrisons, will always be found in the removal of both the sick and the healthy to a locality where the temperature is suffi ciently low, such as a neighboring range, or dry ventilated ground." In all ships on service on the w. coast of Africa and other stations, the following. rules (which we borrow from Dr. Aitken's Handbook of the Sctence and Practice of Medicine) should be strictly attended to. A prophylactic dose of quinine (five grains) should be administered to the men daily (a precaution that should be taken in all malarious regions, independently of yellow fever). Whenever the fever appears on board, the ship sjiould at once put out to sea, and should proceed to the coolest atmosphere within reach. The most inunediate measures of prevention should be, to obviate direct solar exposure, to prevent fatigue, and to check any excesses in the use of spirits. Seamen should be kept as remote from unhealthy coasts as is consistent with duty, anchoring every evening a few miles from the shore if possible. Duties in boats should as much as pos sible be conducted during, the mornings and evenings, the noon-day heats and the deadly nocturnal emanations being to be equally avoided. When men are leaded, they should be encamped on high and dry ground. Meals should be regularly sefved and carefully cooked, and coffee should be given early in the morning, and after unusual fatigue or exposure, and no work should be commenced till the coffee has been taken. Holds of ships should not be cleansed on the spots where the fever has originated, or during its prevalence, but the process should be deferred till the vessel is in a colder latitude. Lastly, green wood should not be placed on board ship in hot climates, but the wood should be barked and partly charred.
Dr. Craigie, in his learned Practice of Physic, gives the following ,extensive lilt of synonyms of yellow fever: " Febris llama, Typhus ecterodes, Sauvages and La M'aladie de Barn, La R&M Matelotte, Vomito Prieto, Chapetonada, Fiebre panorunt et new distemper of 1691 ;.Kendal's fever, pestilential fever, bilious fever of Gamble; endemial causus or burning fever of Moseley; malignant pestileutial fever of Chisholm; remittent and bilious remittent of Hunter; concentrated endemic fever of Jackson; tropical continued fever of Lempriere." We shall conclude with a short notice of the history of this disorder. Long before the arrival of Cortez in Mexico, an extremely fatal epidemic disease used to prevail among the native Mexi cans. Epidemics of special severity occurred in 1545, 1576, 1736-37, and 1761-69.
Although Humboldt thinks that the elevation of the table-land of Mexico (7,200 to 7,800 ft. above the level of the sea) is sufficient to exclude any idea of the identity of this disease, known as hiallazahuall, with yellow fever, there can be little doubt, from the similarity of the symptoms, that the two diseases are really the same. The Europeans visiting the shores of America soon became painfully familiar with the disease; and it is almost certain that "the plague" which so often destroyed the English and Spanish troops at the end of the 15th and the beginning of the 16th centuries was in reality yellow fever. A disease bearing the character of yellow fever appeared in 1618 among the Indians in certain parts of Massachusetts, and prevailed with much severity till 1622, and it committed great havoc among the emigrants to Virginia. When the expedition against Hispaniola in 1655, under Venables, returned to Jamaica, they met there "an enemy (the plague) more severe than the Spaniards, which in a little time reduced the army, originally 7,000, to fewer than 2,000 men." There can be little doubt that this plague was yellow fever. In 1691 it was very fatal in Barbadoes, where it was known as the new distemper. From about this date yellow fever has been endemic in the West Indies. It was unknown at Carthagena and along the coast till 1729, when it committed dreadful havoc; the Spanish galleons never remaining any time without interring one half or at least one-third of their men. In 1740 it first appeared at Guayaquil, since which timy it has often occurred; and in all the towns on the coast of the American continent and islands between 45° n. let. and 10' s. let. it appeared in proportion as Europeans began to visit them. "In this manner," says Dr. Craigie, "Vera Cruz, Cumana, Havana, Acapulco, and La Guayra have successively become its endemial abodes; and its appearance in these towns is as uniform and certain as the arrival of the sun at the tropic of Cancer. Of these places Vera Cruz and Havana may be regarded as the nursery of yellow fever; and from the month of March to that of September or October the disease rages like a pestilence among the recently arrived Europeans, and those natives who descend from the elevated table-lands of the interior." Until the year 1793 the disease was regarded as having a spontaneous origin, and being due to tropical peculiarities operating on European and unseasoned constitutions; but that year the doctrine of infection suddenly started. In that year the disease appeared with great virulence in the island of Grenada, and rapidly spread over the Antilles to Philadelphia and many parts of the state of Pennsylvania. to Massachusetts, Nev York, Caroline co., Md., Alexandria in Va., several counties in North Carolina, and Caraceas in Venezuela. This outbreak was preceded by a few days by the arrival of a vessel from Bulam, on the w. African coast, at a harbor in St. Grenada, in which vessel, when stationed off Bulam, fever had prevailed about five months before to a great and fatal extent. This disease was at the time termed the Bulam fever, but soon turned out to be ordinary yellow fever. Since 1763 yellow fever has very often appeared as an epidemic in the West India islands and various parts of the American states, and has even been endemic in various parts of the s. of Europe, especially Gibraltar and Malaga. From the testimony of many medical writers it is certain that a disease essentially identical with yellow fever prevails endemically along the w. coast of Africa, at Senegal, Sierra Leone, Cape Coast Castle, and the island of Fernando Po. Fortunately for this country, this fell disease, which has repeatedly been brought to our shores (Swansea, Southampton, etc.), is at once nipped out by our climatic conditions. When, in 1866, it was imported into Swansea, Dr. Buchanan, who was at once sent down by the government to watch the disease, and take the necessary measures to prevent it from spreading, recorded 12 instances in which, with filth, bad ventilation, and every other condition favoring the levet it failed in every case to spread beyond the original victim. Altogether there were 20 cases, of which 15 were fatal.
The most terrible recent visitation of yellow fever scourged portions of the lower Mississippi valley in the autumn of 1878. In New Orleans and Memphis alone the deaths exceeded 5,000.