Foundations of Early Bacteriology


especially those from impoverished Ireland, were crowded into the
squalid slums of our larger cities. Many persons were without jobs,
with little food, and used water from surface wells subject to contami-
nation from a few overused privies. Given the specific microorgan-
isms, these were ideal conditions for the spread of infectious disease.
And some of the new arrivals brought such organisms with them.
  All epidemic diseases were at that time classified under the general
head of zymotic or fermentation diseases, and all fevers were thought
to have a common cause, namely the miasmas emanating from putre-
fying organic matter. Benjamin Rush stated, "there is only one fever
and only one cause, stimulus."

Yellow Fever
             MATHEW CAREY, GEORGE M. STERNBERG,
             CARLOS J. FINLAY, HENRY R. CARTER,
             WALTER REED, JAMES CARROLL,
             JESSE W. LAZEAR, AND ARISTIDES AGRAMONTE
   Most terrifying have been the devastations of yellow fever in its
 erratic wanderings up and down our coast from 1647 until the early
 part of the present century. Although the disease apparently had its
 origin in Central Africa,4 yet it has for centuries been endemic both
 there, in the northern half of South America, and in a number of the
 islands of the West Indies. An occasional severe epidemic has occurred
 in Europe, for example in Spain in i 8oo with 6o,ooo fatalities, yet yel-
 low fever has spread in more numerous epidemics over the western
 hemisphere, with estimated deaths in the United States alone of
 500,000 from 1793 to i9oo. Because of controversies, but more espe-
 cially because of the brilliant contributions to knowledge of this disease
 made in this hemisphere, a history of early microbiology in this country
 must present the chronicle in considerable detail. It is our best story.
 Yellow jack, the black vomit, malignant yellow fever, the bilious
 remitting-fever, the Barbadoes distemper; by any name it smells to
 heaven, and each epidemic has given us terror and tragedy. For example,
 the Philadelphia outbreak of 1793 et seq. supplied the ocasion for strik-
 ing contemporary accounts; among them were those by Benajmin
 Rush, Mathew Carey, and William Currie.5 Selected passages will
 paint the picture of fear and death for us of more comfortable later
 generations. Carey's account (1794), dedicated to the American Philo-


46