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 they reach the liver and infect hepatocytes (probably indirectly via Kupffer cells), which leads to eosinophilic degradation of these cells and to the release of cytokines. Apoptotic masses known as Councilman bodies appear in the cytoplasm of hepatocytes. Fatality may occur when cytokine storm, shock, and multiple organ failure follow. Yellow fever is most frequently a clinical diagnosis, made from symptoms and where the infected person was before becoming ill. Mild courses of the disease can only be confirmed virologically. Since mild courses of yellow fever can also contribute significantly to regional outbreaks, every suspected case of yellow fever (involving