3d. The persons it attacked, if natives or foreigners? If in habits of temperance, or irregular in their manner of living?

The persons it attacked were all natives of this country, and regular in their habits and manner of living.

4th. The state of the country in which it occurred, the time, the season, if dry or moist, the temperature, &c. ?

The town of Minisinck is bounded on the east by the great drowned lands, and the Wallkill, which circumstance renders the inhabitants liable to intermittent, remittent, and bilious fevers in the fall of the year; but at the time these cases appeared it was remarkably healthy; it being too early in the spring for inflammatory, and too late in the fall for bilious diseases. The spring was moist, and the autumn dry: temperature various.

5. The mode of treatment. Did they bear the lancet well? What were the effects of emetics? Did they throw up much bile? What was the effect of mercury? Did you employ the bark, and what were its general effects?

In some cases blood was taken in the early stage of the disease, but it did not produce that desired good effect which was expected from it: the blood drawn appeared like that of a person in full health, no unusual buffy coat, neither was the crassamentum broken down or destroyed. A cathartic of jalap and calomel was next administered; after the operation of which, I endea. voured to procure a sweat: this was attempted by warm herb teas, with spirits, and the common antimonial mixture; but the time was so short, there was but little oppor

tunity of doing any thing. Emetics were not tried. Much bile was thrown up during the short course of the disease. Mercury was used in the case of Mrs. Eldred with happy effect; but I believe it was not used to the same extent in any other case. Immediately after she was taken, she was bled by Dr. Nathaniel Elmer, her attending physician, who administered a dose of jalap and calomel: I saw her about three hours after she was taken, and advised the use of calomel very freely, which was persisted in, together with wine, for twelve hours. When the petechial spots made their appearance, which were of a bright red colour, the uneasy symptoms began to abate, and in about twenty-four hours she was entirely free from complaint, but remarkably low and exhausted. She was supported by wine and other stimulants, and had a speedy recovery.

6th. What proportion of those attacked died?

By reverting to the second query answered, you will find that six out of seven died.

7th. Did the disease commence with a chill, or shaking? Were they better or worse on alternate days? Were there regular remissions and manifest exacerbations?

The disease uniformly commenced with a chill, and latterly so as to induce violent shaking. There were no remissions or exacerbations.

8th. When it proved fatal, at what period did it take place? Was the skin yellow?

It generally proved fatal in about twenty-four hours, and the skin after death, for some distance around the spots, became dark coloured and livid, though on the other parts of the body it was not changed.

9th. Did patients manifest the same thirst and dryness of tongue as in other fevers?

The tongue and mouth were generally moist and clammy; the patients were so uniformly delirious a few hours after the attack, that we could learn nothing from them but by observation; but they did not appear to drink much when it was offered to them.

10th. Was the stomach affected in the last stages of the disease? Was the usual termination, when fatal, a black vomit resembling coffee grounds, or blood, or mere dirty water?

Although the stomach appeared to be affected through the first stages of the disease, yet it did not increase in the last. Most generally a stupid comatose state appeared a few hours before death; the vomiting ceased, the extremities became cold, and the patient sunk away under a load of disease. In no stage did the matter which they vomited appear like coffee grounds, or blood, or mere dirty water.

111.

OBSERVATIONS on the FEVERS of NORTH-CAROLINA. By Doctor JAMES NORCOM. Communicated to Doctor D. HOSACK.

DEAR SIR,

LEETTER I.

Philadelphia, March 30th, 1810.

Not having received your's of the 23d instant, until the day before yesterday, I had it not in my power to reply sooner. But I hasten now, as far as time and recollection will serve, to answer some of the more important queries which you have proposed to my consideration. To answer all of them correctly or satisfactorily would require more experience, and a greater talent for observation, than I can boast. However, all that I can distinctly remember relative to the object of which you are in pursuit, I will cheerfully communicate; and, as I presume any opinion or speculation of mine will be as useless as it might be visionary or erroneous, shall confine myself to the relation of such facts and circumstances as have fallen under my own immediate observation.

Edenton, the place of my residence, and the principal scene of my practice for ten years past, is a little seaport town in North-Carolina, is situated on the north side of Albemarle Sound, in one of the eastern districts of the state. It is nearly surrounded by a country which is for the most part low and swampy, and in which there is occasionally to be found a great deal of stagnant water,

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rendered offensive by dead vegetable matters that decay and putrefy in them during the heat of summer. Our summers, as regards their temperature, are extremely irregular: sometimes being pleasant throughout, and sometimes marked with intemperate heats and sultry weather. The hot weather generally sets in about the last of May, and ends, sooner or later, in the month of September; though we often have some days in April and October that are exceedingly warm. The mercury, in our hottest months, commonly fluctuates between eighty and ninety degrees of Farenheit's thermometer in the shade, if observed at three o'clock in the afternoon. For a few days together it sometimes rises to ninety-two, three, four, five, and now and then as high as ninetysix or seven. Sometimes, on the other hand, for a day or two it will fall to seventy-two, to sixty-eight, six, four two, and once in a while below sixty. The greatest degree of heat experienced in this part of the state, takes place generally in June about the solstice; but that which is by far the most disagreeable and oppressive, which is most uniform, and continues longest, occurs in August and the first weeks in September. The same variety is observable in our seasons with respect to rain. Sometimes we have the fervours of summer tempered with regular and refreshing showers; sometimes they are characterized by a succession of gusts or tornadoes, with thunder and lightning, and cataracts of rain ; and at other times we have frequent copious distillations every day for weeks together, deluging the country, sweeping away bridges, and drowning our crops in every direction. Then again we have summers extremely dry; insomuch that even the meadows and marshes lose their humidity, vegetation of every kind declines, and the earth presents