Yellow fever (French: fièvre jaune) is a viral haemorrhagic disease that initially causes a high fever and, in most cases, dissipates after five days. However, in 15% of cases, the illness rages back with a greater virulence, causing the patient to have a jaundiced appearance, with vomiting, leading to organ failure and death. Yellow fever had its origins in Africa and was initially transported to the New World aboard slave ships. It soon became a leading cause of death in the tropical and semi-tropical Americas, especially in in the West Indies, killing many thousands of people annually.
For decades, doctors and scientists struggled to understand the origin of the yellow fever, how it spread and how it could be mitigated, or cured. While some of their remedies may have marginally helped an infected patient to fight off death, comprehending of the scourge, let alone the discovery of a cure, was long in the future.
A breakthrough of sorts occurred in 1822, when after conducting exhaustive scientific experiments, Dr. Pierre Lafort, the chief crown physician of Martinique, proved that yellow fever was not contagious, human-to-human.
However, it would not be until 1881 that a Cuban doctor, Carlos Juan Finlay, correctly proposed that the vector of yellow fever was the Aedes aegypti mosquito. While this was not proven for some years, Findlay’s assertion was critical in setting researchers upon the right course. It also caused public health officials in places such as Havana and the Panama Canal Zone to conduct anti-mosquito campaigns, which surely reduced the spread of the disease.
In 1927, yellow fever was the first human virus to be isolated, and in 1937 in the South African-American physician Max Theiler discovered an effective vaccine that largely eradicated yellow fever in most of the world.
Enter Antoine Poissonnier-Desperrières: Combatting the Scourge of Saint-Domingue
The French colony of Saint-Domingue (Haiti), which comprised the western third of the island of Hispaniola, was the Caribbean’s leading sugar-slave economy. By the 1780s, Saint-Domingue would produce 40% of the sugar and 60% of the coffee consumed in Europe. However, the colony, and especially its Europeans population, were severely affected by bouts of yellow fever, that killed hundreds, or oven thousands of people, in matter of weeks. By the mid 18th century, combatting the diseases become the colony’s number one public health priority.
Antoine Poissonnier-Desperrières (1722/3 – 1793) was one of the leading French public health professionals of the 18th century, whose focus was tropical and naval medicine. He had practiced as a physician for some years in Saint-Domingue during the late 1740s amd ’50s, and subsequently held various senior medial roles, including as a King’s Physician, Deputy Inspector-General of Naval Hospitals, and Royal Censor, while being a Member of the Royal Society of Medicine and of the Academy of Dijon.
In addition to the present work, which was his first major publication, Poissonnier-Desperrières was the author of several important tomes focusing on the health and diet of sailors, including Traité des maladies des gens de mer (1767); Mémoire sur les avantages qu’il y auroit à changer absolument la nourriture des gens de mer (1771); Réponse d’un chirurgien au second mémoire qui concerne le régime végétal, proposé pour les gens de mer (1776) and Observations sur le discours de M. Pringle, qui termine la relation des voyages de M. Cook, lues à la Société royale de médecine (1779). Notably, his Mémoire of 1771 bought him to have an acrimonious and very public debate with his prominent colleague Dr. Étienne Chardon de Courcelles regarding the diet of French sailors.
Following years of firsthand experience treating patients with yellow fever in Saint-Domingue, Poissonnier-Desperrières turned his attention towards describing and analysing the illness, for the benefit of the French state and mankind in general.
The Present Work in Focus
The Traité des fièvres de l’isle de S. Domingue, present here in the extremely rare first edition of 1763, is the most important work on yellow fever in Saint-Domingue, and one of the most influential French tropical medicine books of the late Enlightenment. It was submitted to the French War & Navy Secretary, the Duke of Choiseul, the dedicatee of the book. Here Poissonnier-Desperrières shows his magisterial command of international literature on the subject, and his dedication to firsthand observation and experimentation in forming hypotheses on yellow fever and other ailments with afflicted Saint-Domingue. While he was far from understanding the cause of yellow fever’s spread and his prescribed remedies were well short of cures, his description of yellow fever’s symptoms are perhaps the most detailed and accurate of the era.
Poissonnier-Desperrières never used the term ‘fièvre jaune’, instead calling the fever a Causos (an archaic term from Hippocrates), or the “Ardent fever” (see p. 10). He correctly asserts that the disease can only manifest itself in tropical or semitropical conditions, and while he states that “man is a flexible animal, who can adapt himself to all climates” (p. xvi), he observes that Europeans in Saint-Domingue have not have enough time adjust to yellow fever, unlike those whose forbears hailed from torrid zones. He goes on to describe yellow fever and its symptoms in great detail, while discussing the treatments that he administered to patients, which included a disciplined regimen of anticeptics like vinegar, lemonade and Epsom salts, while ensuring constant hydration. Of course, as we know today, such methods were far from being a cure for yellow fever, but it is possible that Poissonnier-Desperrières’s remedies may have helped to give a slight advantage to a patient who was otherwise strongly fighting the disease.
Poissonnier-Desperrières’s work also covers other maladies that affected Saint-Domingue, including what he called the “fiévre ardente bâtarde” (p. 104), which while its initial symptoms could mimic those of yellow fever, was only a common form of remittent fever that had a far lower mortality rate.
Importantly, the work concludes with twelve diverse firsthand case studies (pp. 152-80) of patients afflicted with fevers, and mostly yellow fever, noting the treatments that Poissonnier-Desperrières administered and the outcomes.
The present work proved extremely influential and was republished in 1766 and 1780 (the latter was combined with the reprinting of Poissonnier-Desperrières’s Mémoire sur les avantages qu’il y auroit à changer absolument la nourriture des gens de mer). It was heavily cited in several seminal works on yellow fever written in various countries for many years, a notable example being Colin Chisholm’s An Essay on the Malignant Pestilential Fever Introduced Into the Westindia Islands 1793 – 1796 (1801).
While Poissonnier-Desperrières’s work helped the spread awareness of the dangers and nature of yellow fever, it did not prevent the greatest ever ‘epidemic’ of the disease to occur on Saint-Domingue. During the latter part of the Haitian Revolution (1791-1804), whereby the colony’s slaves and free coloured people rebelled against French rule, Napoleon Bonaparte sent a massive army across the Atlantic to retake Saint-Domingue. During the campaign, an estimated 35,000 to 45,000 French troops died from yellow fever. This was all in a lost cause, as the revolutionaries were victorious, creating the Republic of Haiti, the first black-governed nation in the Americas.
A Note on Rarity
The present first edition of Poissonnier-Desperrières’s Traité des fièvres de l’isle de S. Domingue is very rare. We can trace around half a dozen institutional examples, while we cannot trace any sales records for another example since one sold at a Paris auction in 2013.
References: Bibliothèque nationale de France: 8-TD59-83; British Library: General Reference Collection T.458.(2.); National Library of Medicine (Bethesda, Md.): 18th c. P771.; Sabin, no. 63713: Katherine ARNER, ‘The Malady of Revolutions: Yellow Fever in the Atlantic World, 1793-1828’, Ph.D. Dissertation, Johns Hopkins University (June 2014), pp. 50-1. Cf. (background on Poissonnier-Despèrrieres:) J.E. McClellan, Colonialism & Science: St. Domingue and the Old Regime (Chicago: Univesity of Chicago Press, 2010), p. 140: Michael Osborne, The Emergence of Tropical Medicine in France (Chicago: University of Chicago Press, 2014), 29-32.