1793 Philadelphia yellow fever epidemic while rejecting his etiology of the disease. Others deprecated his therapies, such as Dr. Deveze, but agreed that the fever had local origins. Deveze had arrived on the refugee ship from Saint-Domingue which many accused of having carried the disease, but he thought it healthy. The doctors did not understand the origin or transmittal of the disease. Historians believe it was brought by refugees from Saint-Domingue, where it was endemic, and transmitted by mosquitoes between the infected and healthy persons. Dr. Kuhn advised drinking wine, "at first weaker wines, such as claret and Rhenish; if these cannot be had, Lisbon
Yellow fever titer (compared to an earlier sample) can confirm yellow fever. Together with clinical symptoms, the detection of IgM or a four-fold increase in IgG titer is considered sufficient indication for yellow fever. Since these tests can cross-react with other flaviviruses, such as dengue virus, these indirect methods cannot conclusively prove yellow fever infection. Liver biopsy can verify inflammation and necrosis of hepatocytes and detect viral antigens. Because of the bleeding tendency of yellow fever patients, a biopsy is only advisable "post mortem" to confirm the cause of death. In a differential diagnosis, infections with yellow fever must be distinguished from